Proteus

Can J Microbiol, 2000 Oct, 46(10), 961 - 6
The binding of Proteus mirabilis nonagglutinating fimbriae to ganglio-series asialoglycolipids and lactosyl ceramide; Lee KK et al.; Proteus mirabilis is a common opportunistic Gram-negative uropathogen that infects the upper urinary tract . We have examined the role of the nonagglutinating fimbriae (NAF) of P . mirabilis in mediating bacterial adhesion to cell surface receptors . Purified NAF of P . mirabilis were demonstrated to bind to a number of glycolipids, including asialo-GM1, asialo-GM2, and lactosyl ceramide (LacCer) in solid-phase binding assays and in thin layer chromatography (TLC) overlay assays . Furthermore, preincubation of the biotinylated NAF (Bt-NAF) with anti-NAF monoclonal antibodies resulted in inhibition of NAF binding to immobilized asialo-GM1, asialo-GM2, and LacCer . In adherence assays, P . mirabilis binding to Madin-Darby canine kidney (MDCK) cells was inhibited by murine anti-asialo-GM1 monoclonal antibodies H2G10 to about 50% of the binding level in the absence of the antibody, specific for the terminal beta-galactopyranosyl residue of asialo-GM1 (Harrison et al . 1998) . The results of this study suggest that NAF of P . mirabilis recognize a GalNAc beta 1-4Gal moiety present in the ganglio-series of asialoglycolipids, and that the terminal beta-galactopyranosyl-containing glycoconjugates play a role in NAF-mediated adherence of P . mirabilis to MDCK cells . Similarly to other bacteria, P . mirabilis NAF was also shown to express the LacCer specificity.

Eur J Dermatol, 2000 Oct-Nov, 10(7), 551 - 4
Cerebriform plantar hyperplasia: ultrastructural study of two cases; Winik BC et al.; In the present work we report the histopathological features of the cerebriform plantar hyperplasia observed in two patients with a mild form of the Proteus syndrome . Light microscopy revealed increased fibro-adipose tissue and adnexal structures in the dermis . Ultrastructurally, densely packed collagen fibrils variable in diameter and configuration, described as composite fibrils and unraveled fibrils, as well as a few fragmented elastic fibrils presenting an altered ratio between the elastin and the microfibrillar components were the major features observed . We consider that these histopathological findings will contribute to further delineate cerebriform plantar hyperplasia and also to establish clues for the early diagnosis of the Proteus syndrome.

J Endotoxin Res, 2000, 6(3), 223 - 34
Complement activation by Proteus mirabilis negatively charged lipopolysaccharides; Kaca W et al.; Proteus mirabilis strains are human pathogens responsible for urinary tract infections and bacteremias and may be involved in rheumatoid arthritis . Lipopolysaccharide (LPS, bacterial endotoxin), the major component of the cell wall, is one of the virulence factors of Proteus . In the presented studies, we have investigated complement activation by LPSs isolated from P . mirabilis O10, O23, O30, and O43 strains, which differ in the number of negative COO- groups on their polysaccharide components . Four P . mirabilis strains studied were sensitive to complement-mediated killing, despite complement binding by their LPSs . The optimal complement binding by LPSs was detected in serum with functional assays for both the classical and alternative pathways . Complement activation in 80% serum by the smooth, uronic acid, and hexosamine containing P . mirabilis LPSs was not critically determined by the structure of their O-chain polysaccharides . One of four LPSs used as a model, P . mirabilis O10 LPS, fragmented C3 in an LPS dose- and time-dependent manner . It was detected by crossed-immunoelectrophoresis and capture ELISA with anti-C3c antibodies . The lower complement activation by 023 LPS correlates with its reduced C3 fragmentation, compared with three other Proteus LPSs studied . Rabbit anti-O antibodies enhanced the complement binding and factor C3 fragmentation by O10, O23, O30, and O43 P . mirabilis LPSs.

Eur J Anaesthesiol, 2000 Oct, 17(10), 645 - 7
Anaesthesia for Proteus syndrome; Ceyhan A et al.; A 4-month-old boy with Proteus syndrome underwent a successful operation for a left abdominal mass due to hydroureter and hydronephrosis with left ureterovesical stenosis . The operation lasted 4.5 h under general anaesthesia; there were no anaesthetic complications . There is only one previous report on anaesthesia in a patient with Proteus syndrome.

Biochemistry (Mosc), 2000 Sep, 65(9), 1055 - 9
Structure of the O-specific polysaccharide of the bacterium Proteus vulgaris O23; Perepelov AV et al.; An acidic O-specific polysaccharide was obtained by mild acid degradation of the lipopolysaccharide of the bacterium Proteus vulgaris O23 (strain PrK 44/57) and found to contain 2-acetamido-2-deoxy-D-galactose, 2-acetamido-2-deoxy-D-glucose, and D-galacturonic acid . Based on 1H- and 13C-NMR spectroscopic studies, including two-dimensional correlation spectroscopy (COSY), total correlation spectroscopy (TOCSY), nuclear Overhauser effect spectroscopy (NOESY), and 1H,13C heteronuclear multiple-quantum coherence (HMQC) experiments, the following structure of the branched tetrasaccharide repeating unit of the polysaccharide was established: {figure}, where the degree of O-acetylation of the terminal GalA residue at position 4 is about 80% . A structural similarity of the O-specific polysaccharides of P . vulgaris O23 and P . mirabilis O23 is discussed.

Epidemiol Mikrobiol Imunol, 1999 Feb, 48(1), 21 - 7
{Transfer of resistance to 3rd generation cephalosporins and aztreonam in strains of Klebsiella pneumoniae producing extended spectrum beta-lactamases}; Babalova M et al.; The authors demonstrated the transferability of antibiotic resistance genes in nosocomial strains of Klebsiella pneumoniae, isolated from newborn children at the Paediatric University Hospital in Bratislava . Strains were resistant to cefotaxime, ceftazidime and aztreonam . The determinants of resistance (carbenicillin, cephaloridine, cefotaxime, ceftazidime and aztreonam) were transferred to recipient strains of Escherichia coli K-12 and Proteus mirabilis P-38 . The transfer of resistance determinant from donor strains was demonstrated by the analysis of the resistance spectrum in transconjugant clones of recipient strains by the method of indirect selection . The ability of production of extended spectrum beta-lactamases (ESBL) was demonstrated by the double disc diffusion test . Synergy between clavulanate and cefotaxime, clavulanate and ceftazidime and/or clavulanate and aztreonam indicated production of ESBL by these strains.

Microbios, 2000, 103(404), 17 - 25
Endotoxins stimulate generation of superoxide radicals and lipid peroxidation in blood platelets; Saluk-Juszczak J et al.; Lipopolysaccharide (LPS, endotoxin) is an important structural constituent of the membrane of gram-negative bacteria with a wide range of biological effects . It can activate blood platelets . The purpose of present study was to determine the direct effect of endotoxins from Proteus mirabilis, differing significantly in their composition, on the generation of superoxide radicals and thiobarbituric acid reactive substances (TBARS) in blood platelets . Superoxide radicals were measured by means of superoxide dismutase-inhibitable reduction of cytochrome C . The TBARS determination (malonyldialdehyde) was used as a marker of endogenous arachidonate metabolism and thromboxane A2 synthesis . Results demonstrate that three endotoxins (LPS S1959, LPS R110, LPS R45) after 2 min of action, even at the lowest concentration (0.03 microg/10(8) platelets) stimulated the generation of TBARS and release of superoxide radicals . All LPS contain lipid A as a component but differ in their chemical composition in the polysaccharide part . It is suggested that the observed effects of LPS on blood platelets are attributable to their lipid A portion.

Carbohydr Res, 2000 Sep 8, 328(2), 229 - 34
Structure of an O-acetylated acidic O-specific polysaccharide of Proteus vulgaris O46; Perepelov AV et al.; An acidic O-specific polysaccharide was obtained by mild acid degradation of the lipopolysaccharide of Proteus vulgaris O46 and studied by chemical methods (O-deacetylation, sugar and methylation analyses, partial solvolysis) and 1H and 13C NMR spectroscopy . Solvolysis of the O-deacetylated polysaccharide with trifluoromethanesulfonic acid resulted in a alpha-D-GlcpNAc-(1 --> 3)-D-GlcA disaccharide that demonstrated the usefulness of this reagent for selective cleavage of heteropolysaccharides . The following structure for the polysaccharide was established: --> 4)-alpha-D-Glcp6Ac(1 --> 3)-beta-D-GlcpA4Ac-(1 --> 3)-alpha-D-GlcpNAc-(1 --> 3)-beta-D-GlcpA4Ac-(1 --> where the degree of O-acetylation is approximately 65% at position 6 of Glc and 80-95% at position 4 of GlcA residues.

FEMS Immunol Med Microbiol, 2000 Oct, 29(2), 137 - 43
Virulence of a Proteus mirabilis ATF isogenic mutant is not impaired in a mouse model of ascending urinary tract infection; Zunino P et al.; Proteus mirabilis, a common cause of urinary tract infection, produces a number of different fimbriae, including ambient temperature fimbriae (ATF) . These fimbriae are optimally expressed at 23 degrees C and their contribution to urinary tract infection has so far remained unknown . In the present study, a clinical isolate of P . mirabilis and an isogenic allelic replacement mutant unable to express ATF were tested for their ability to cause infection in the ascending urinary tract infection model in mice . The atf mutant colonised the urinary tract as well as the wild-type strain and was also able to outcompete the wild-type strain in a co-challenge experiment . Different non-clinical P . mirabilis isolates showed a reactive AtfA band after Western blot analysis using a polyclonal rabbit AtfA antiserum . These data together suggest that ATF does not play a role in P . mirabilis urinary tract infection.

Biochem J, 2000 Oct 15, 351 Pt 2, 341 - 6
Evaluation of the role of two conserved active-site residues in beta class glutathione S-transferases; Allocati N et al.; Glutathione S-transferases (GSTs) normally use hydroxy-group-containing residues in the N-terminal domain of the enzyme for stabilizing the activated form of the co-substrate, glutathione . However, previous mutagenesis studies have shown that this is not true for Beta class GSTs and thus the origin of the stabilization remains a mystery . The recently determined crystal structure of Proteus mirabilis GST B1-1 (PmGST B1-1) suggested that the stabilizing role might be fulfilled in Beta class GSTs by one or more residues in the C-terminal domain of the enzyme . To test this hypothesis we mutated His(106) and Lys(107) of PmGST B1-1 to investigate their possible role in the enzyme's catalytic activity . His(106) was mutated to Ala, Asn and Phe, and Lys(107) to Ala and Arg . The effects of the replacement on the activity, thermal stability and antibiotic-binding capacity of the enzyme were examined . The results are consistent with the involvement of His(106) and Lys(107) in interacting with glutathione at the active site but these residues do not contribute significantly to catalysis, folding or antibiotic binding.

Biochem Cell Biol, 2000, 78(4), 487 - 94
Reversible changes in size of cell nuclei isolated from Amoeba proteus: role of the cytoskeleton; Pomorski P et al.; Micrurgically isolated interphasal nuclei of Amoeba proteus, which preserve F-actin cytoskeletal shells on their surface, shrink after perfusion with imidazole buffer without ATP, and expand to about 200% of their cross-sectional area upon addition of pyrophosphate . These changes in size may be reproduced several times with the same nucleus . The shrunken nuclei are insensitive to the osmotic effects of sugars and distilled water, whereas the expanded ones react only to the distilled water, showing further swelling . The shrinking-expansion cycles are partially inhibited by cytochalasins . They are attributed to the state of actomyosin complex in the perinuclear cytoskeleton, which is supposed to be in the rigor state in the imidazole buffer without ATP, and to dissociate in the presence of pyrophosphate . Inflow of external medium to the nuclei during dissociation of the myosin from the perinuclear F-actin may be due to colloidal osmosis depending on other macromolecular components of the karyoplasm.

Electrophoresis, 2000 Aug, 21(14), 3020 - 7
Capillary electrophoretic analysis of wild type and mutant Proteus penneri outer membrane proteins; Kustos I et al.; In this study the virulence factors, outer membrane proteins (OMP), lipopolysaccharides (LPS), hemolysin, and the in vivo and in vitro virulence of wild-type Proteus penneri 357 and its two isogenic mutant variants--a transposon and a spontaneous mutant--were examined . The OMPs of these variants were analyzed by a new and fast technique, "dynamic sieving" capillary electrophoresis (CE) . The OMP profiles were dominated by two peaks (39 and 43 kDa) . In the P . penneri clone examined, both the transposon and the spontaneous mutations induced significant changes in the OMP patterns (in the relative percentage of the dominant proteins) . CE was suitable for the comparative analysis of bacterial protein patterns in the genetic variants of this strain, and provided valuable results in connection with the bacteriological virulence . The LPS composition of the genetic variants also showed alterations . The wild type of P . penneri 357 showed a typical ladder pattern, an "S" form, and the mutants possessed "R" LPS patterns (only few bands) in the gels . In the bacteriological virulence tests the wild type of P . penneri 357 was virulent in the in vivo, and toxic in the in vitro assays, while both mutants showed neither toxicity nor pathogenicity.

Infect Immun, 2000 Oct, 68(10), 5742 - 8
Genetic characterization of DNA region containing the trh and ure genes of Vibrio parahaemolyticus; Park KS et al.; We have demonstrated that possession of the gene for thermostable direct hemolysin-related hemolysin (trh) coincides with the presence of the urease gene among clinical Vibrio parahaemolyticus strains and that the location of the two genes are in close proximity on the chromosome . Here, we cloned and sequenced the 15,754-bp DNA region containing the trh gene and the gene cluster for urease production from the chromosome of clinical V . parahaemolyticus (TH3996) . We found 16 open reading frames (ORFs) and a lower G+C content (41%) compared with the total genome of this bacterium (46 to 47%) . The ure cluster consisted of eight genes, namely, ureDABCEFG and ureR . ureR was located 5.2 kb upstream of the other seven genes in the opposite direction . The genetic organization and sequences of the ure genes resembled those found in Proteus mirabilis . Between ureR and the other ure genes, there were five ORFs, which are homologous with the nickel transport operon (nik) of Escherichia coli . We disrupted each of the ureR, ureC, and nikD genes in TH3996 by homologous recombination and analyzed the phenotype of the mutants . In the presence of urea these mutant strains had dramatically less urease activity than the strain they were derived from . Disruption of ureR, nikD, or ureC, however, had no effect on TRH production . The DNA region containing the trh, nik, and ure genes was found in only trh-positive strains and not in Kanagawa phenomenon-positive and environmental V . parahaemolyticus strains . At the end of the region, an insertion sequence-like element existed . These results suggest that the DNA region was introduced into V . parahaemolyticus in the past through a mechanism mediated by insertion sequences . This is the first reported case that the genes for an ATP-binding cassette-type nickel transport system, which may play a role in nickel transport through bacterial cytoplasmic membrane, are located adjacent to the ure cluster on the genome of an organism.

Antimicrob Agents Chemother, 2000 Oct, 44(10), 2869 - 72
Effect of subinhibitory concentrations of macrolides on expression of flagellin in Pseudomonas aeruginosa and Proteus mirabilis; Kawamura-Sato K et al.; In the present study we showed by molecular analysis that the inhibition of motility by macrolides in Proteus mirabilis and Pseudomonas aeruginosa was well correlated with the loss of the expression of flagellin . Erythromycin, clarithromycin, and azithromycin at subinhibitory concentrations (sub-MICs) suppressed the expression of flagellin dose dependently . Azithromycin had the strongest inhibitory effect on the expression of P . aeruginosa flagellin, whereas 16-membered rokitamycin had only a weak inhibitory effect . These results indicate the potential effectiveness of sub-MICs of erythromycin, clarithromycin, and azithromycin for the treatment of patients with P . mirabilis and P . aeruginosa infections.

Pediatr Dermatol, 2000 Jul-Aug, 17(4), 270 - 6
Macrodactyly: report of eight cases and review of the literature; Krengel S et al.; Congenital enlargement of one or several digits of the hands or feet (macrodactyly) is a rare disorder . A considerable proportion of the patients with this condition are referred to dermatology departments . The majority of the cases reported in the literature represent hamartomas with combined hypertrophy of several, predominantly lipomatous, soft tissue components and overgrowth of bone . The differential diagnosis includes Klippel-Trenaunay-Weber syndrome, neurofibromatosis, Milroy disease, and Proteus syndrome . We describe eight cases of congenital macrodactyly, discuss the findings, and propose a simple clinicopathologic terminology.

J Food Prot, 2000 Sep, 63(9), 1231 - 9
Reduction of endogenous bacteria associated with catfish fillets using the Grovac process; Ramos M et al.; Fresh catfish (Ictalurus punctatus) fillets are known to be contaminated with a large number of spoilage and pathogenic bacteria . The Grovac method, a new patented (U.S . 5,543,163) process, was evaluated for its efficacy in reducing the number of pathogens and spoilage microorganisms associated with food . This process involves using a processing solution containing ascorbic acid (AA) and sodium chloride (NaCl), vacuum, and tumbling . A total of 51 bacterial isolates were isolated and identified from whole catfish and catfish fillets using both selective and nonselective media, phenotypic tests, and the Vitek identification system . Psychrotrophic foodborne pathogens included: Aeromonas hydrophila, Escherichia coli, Listeria sp., Plesiomonas shigelloides, Proteus sp., Staphylococcus aureus, and Vibrio parahaemolyticus . High aerobic plate counts (2.6 x 10(7) CFU/g) for catfish fillets indicated that fillets were heavily contaminated during processing of catfish . The Grovac process showed that various treatment combinations of AA and NaCl resulted in a 1.2 to 2.3 CFU/g log reduction of microbial counts associated with catfish fillets . The effectiveness of the process may be related to the synergistic effect of tumbling, AA, NaCl, and vacuum . These results suggested that the Grovac process could be used as an alternative processing procedure to reduce microbial populations associated with catfish fillets and may be useful to improve the shelf-life and food safety of the product . Microbiological data from this study will be used for the development of a hazard analysis for the implementation of the hazard analysis critical control point program for processed catfish fillets.

J Mol Biol, 2000 Aug 18, 301(3), 585 - 95
Extreme functional sensitivity to conservative amino acid changes on enzyme exteriors; Axe DD; Mutagenesis studies and alignments of homologous sequences have demonstrated that protein function typically is compatible with a variety of amino-acid residues at most exterior non-active-site positions . These observations have led to the current view that functional constraints on sequence are minimal at these positions . Here, it is shown that this inference assumes that the set of acceptable residues at each position is independent of the overall sequence context . Two approaches are used to test this assumption . First, highly conservative replacements of exterior residues, none of which would cause significant functional disruption alone, are combined until roughly one in five have been changed . This is found to cause complete loss of function in vivo for two unrelated monomeric enzymes: barnase (a bacterial RNase) and TEM-1 beta-lactamase . Second, a set of hybrid sequences is constructed from the 50 %-identical TEM-1 and Proteus mirabilis beta-lactamases . These hybrids match the TEM-1 sequence except for a region at the C-terminal end, where they are random composites of the two parents . All of these hybrids are biologically inactive . In both experiments, complete loss of activity demonstrates the importance of sequence context in determining whether substitutions are functionally acceptable . Contrary to the prevalent view, then, enzyme function places severe constraints on residue identities at positions showing evolutionary variability, and at exterior non-active-site positions, in particular . Homologues sharing less than about two-thirds sequence identity should probably be viewed as distinct designs with their own sets of optimising features .

Rev Med Chil, 2000 Apr, 128(4), 379 - 86
{Immunosenescence: delayed cutaneous hypersensitivity tests in independently-living Chilean elderly individuals}; Blackburn E et al.; BACKGROUND: Delayed cutaneous hypersensitivity tests are a globally accepted test to assess cellular immunity in vivo . The quality and quantity of the response to these type of tests, varies in different populations . AIM: To study delayed cutaneous hypersensitivity in a group of healthy Chilean elders . MATERIAL AND METHODS: Forty two elders (32 male), aged 60 to 76 years old were studied . Multitest-CMI was applied in the left forearm . This test allows the subcutaneous administration of seven antigens and a glycerin control . Results were compared with those of a group of young adults studied by the authors . RESULTS: Among males there was a mean of 2.7 +/- 1.4 positive responses compared with women, that had 1.7 +/- 1 positive responses (p = 0.016) . The sum of response diameters was 4.2 +/- 1.5 and 3.6 +/- 1.9 mm in men and women respectively (p = NS) . Compared to young adults, elderly women had a lower response to tetanus and diphtheria toxoids and men had a lower response to diphtheria and Proteus mirabilis . CONCLUSIONS: Elderly people have a less intense response to delayed cutaneous hypersensitivity tests than young adults . This response must be assessed in each population to account for regional variability.

Prev Vet Med, 2000 Sep 1, 46(4), 267 - 78
Antimicrobial-resistance trends in bacterial isolates from companion-animal community practice in the UK; Normand EH et al.; We conducted a longitudinal, retrospective investigation of antimicrobial resistance in bacterial isolates obtained from canine and feline clinical cases in veterinary community practice in UK (1989-1997) . Individual-drug resistance was examined using isolates of Escherichia coli and Staphylococcus spp . as Gram-negative and Gram-positive indicator organisms, respectively . The annual prevalence of resistance was calculated for each organism to each of nine (for E . coli) and 11 (for Staphylococcus spp.) selected antimicrobials . The annual prevalence of multiple-drug resistance (MDR) was calculated for E . coli, Proteus spp., Pseudomonas spp., staphylococci and streptococci.Using a chi-square test for trend, significant rising trends were identified in individual resistance of E . coli to clavulanate-amoxycillin and streptomycin, and in MDR of E . coli, Proteus spp . and Pseudomonas spp . Declining trends were identified in individual resistance of Staphylococcus spp . to ampicillin and penicillin . Comparison with previously reported results from a contemporaneous investigation of companion-animal hospital patients indicated that selection pressures acting on the two populations overlapped but were not identical.

Tsitologiia, 2000, 42(6), 602 - 12
{Tartrate-sensitive and tartrate-resistant acid phosphatases in Amoeba proteus}; Sopina VA et al.; In free-living Amoeba proteus (strain B), acid phosphatase (AcP) was examined by disc-electrophoresis in polyacrylamide gel . The tartrate-sensitive amebian AcP was greatly inhibited by dithiothreitol and Cu2+, and only partly inhibited by sodium orthovanadate, ammonium molybdate, EDTA, disodium salt and Mg2+, Ca2+, Zn2+ and Mn2+ . On the contrary, it appeared to be resistant to sulfhydryl reagents--4(hydroxymercury) benzoic acid, sodium salt and N-ethylmaleimide . Unlike the tartrate-sensitive enzyme, the tartrate-resistant AcP was greatly inhibited by EDTA and partly inhibited by dithiothreitol, Mg2+ and Cu2+ (Mn2+ > Cu2+), being activated by orthovanadate, molybdate, sulfhydryl reagents, Mg2+, Ca2+ and Zn2+ . Both tartrate-sensitive and tartrate-resistant AcPs lack apparently free SH-groups necessary for their catalytic activities . Using 2-naphthyl phosphate as a substrate at pH 4.5, six AcP electromorphs were revealed in cytosol and sediment, four of these being most frequently localized in the former, and two in the latter . Two other AcP electromorphs were confined to the sediment only . Depending on the quantity of sedimented amoebae making a homogenate (0.5 or 2.0 cm3), that was added to Percoll solution, the lysosomal AcP fraction in polyacrylamide gel was represented by one or two tartrate-sensitive electromorphs . Therefore, tartrate-resistant AcP in A . proteus may be a lysosomal enzyme, while tartrate-resistant AcP may correspond to serine/threonine protein phosphatase.

Ann Urol (Paris), 2000 Jun, 34(3), 161 - 4
{Pyonephrosis: diagnosis and treatment: report of 14 cases}; Rabii R et al.; Prior to the introduction of antibiotics, the treatment of pyelonephrosis frequently consisted of nephrectomy to remove the non-functional kidney, which was a potentially dangerous source of systemic infection . This approach was later modified as a result of the advances made in antibiotic therapy, and included vigorous antibiotic treatment and prompt drainage of the kidney . At present, percutaneous nephrostomy provides a means of draining off the pus and determining a possible residual renal function . In this study, 14 cases of pyonephrosis were observed over a 7-month period . Lumbar pain was noted in 70% of cases, painful lumbar contact in 5 cases and fever, shivering and pyuria in all cases . Cytobacteriological urine analysis showed the presence of Escherichia coli in 7 patients, Proteus in 4 patients, and in 3 cases abacterial leucocyturia; in 2 patients with only one functional kidney, renal insufficiency was observed . In all cases, the diagnosis was confirmed by ultrasonography . The main etiological factors were urinary lithiasis in 10 patients (71%), followed by uropathy of the pyeloureteral junction in 4 patients (29%) . Treatment consisted of primary nephrectomy in 10 cases; in 3 cases, primary nephrostomy was performed with a positive outcome and recovery of renal function in 2 subjects; in one case of renal failure treated by nephrostomy followed by conservative surgery, the patient did not survive . In conclusion, nephrectomy is advocated as the treatment of choice in the case of a damaged kidney and a normal contralateral kidney . Conservative treatment should be envisaged particularly in the case of a single kidney, or if the patient's state of health is poor . The best treatment consists of the detection and cure of the lithiasis which is the main etiological factor in this pathology.

Clin Ther, 2000 Jul, 22(7), 818 - 25
Cefdinir versus cefaclor in the treatment of uncomplicated urinary tract infection; Leigh AP et al.; OBJECTIVE: This multicenter, double-blind, randomized, parallel-group study was conducted in Europe, South Africa, and Australia to compare the clinical and microbiologic efficacy and the tolerability of a cephalosporin antibiotic, cefdinir, with those of cefaclor in the treatment of uncomplicated urinary tract infection . METHODS: Patients were randomized in a 1:1 ratio to 5 days of treatment with either cefdinir 100 mg BID or cefaclor 250 mg TID . RESULTS: A total of 661 patients were randomized to treatment . They were 90% female, with a median age of 44 years . There were no clinically important differences between groups in terms of demographic characteristics or symptoms on admission . The most frequently isolated pathogens in admission urine cultures were Escherichia coli (383 patients), Proteus mirabilis (20 patients), Staphylococcus saprophyticus (14 patients), and Klebsiella pneumoniae (9 patients) . Of the admission pathogens with documented susceptibility results, significantly more were resistant to cefaclor (6.7%) than to cefdinir (3.7%; P < 0.003) . Significantly more admission isolates of E . coli were resistant to cefaclor (5.1%) than to cefdinir (2.0%; P < 0.007) . A total of 383 patients were assessable for efficacy, 196 in the cefdinir group and 187 in the cefaclor group . Clinical cure rates and microbiologic response rates for cefdinir and cefaclor were statistically equivalent at 5 to 9 days posttherapy (test-of-cure visit), using a 95% CI approach . The rate of treatment-related adverse events was higher in cefdinir-treated patients (20.2%) than in cefaclor-treated patients (13.0%; P = 0.025), mainly due to the greater frequency of diarrhea in the former group . However, only 4 patients (1.2%) discontinued cefdinir treatment due to diarrhea . CONCLUSION: Empiric therapy with cefdinir appears to be a reasonable choice for patients with uncomplicated urinary tract infection in whom cephalosporin treatment is indicated.

East Afr Med J, 2000 Jan, 77(1), 20 - 2
Bacteriology of chronic otitis media in Dar es Salaam, Tanzania; Moshi NH et al.; OBJECTIVES: To determine the aetiology of chronic otitis media (COM) in Dar es Salaam and to find out the shelf life of boric acid in spirit ear drops (BAISED) . DESIGN: Cross-sectional study . SETTING: Muhimbili Medical Centre and selected primary schools within Dar es Salaam . MAIN OUTCOME MEASURES: Bacterial isolates and their sensitivity patterns and shelf life of BAISED . SUBJECTS AND METHODS: One hundred and seventy six pus swab specimens obtained from 150 patients with COM for more than three months were submitted for culture and antimicrobial sensitivity testing in 1997 . RESULTS: The isolates included Pseudomonas aeruginosa (51.7%), Staphylococcus aureus (17.2%), Proteus mirabilis (13.2%), Klebsiella spp . (8.0%), Escherichia coli (5.8%) and unidentified coliforms in 4.0% . All isolates were sensitive to gentamicin . Sensitivity of Pseudomonas aeruginosa and Proteus mirabilis to kanamycin was 98.5% and 100%, respectively . P . aeruginosa was sensitive to chloramphenicol, ampicillin and tetracycline by 58.1%, 10.1% and 8.3%, respectively . Three per cent BAISED inhibited the growth of all Pseudomonas aeruginosa even after it has been stored at room temperature for six weeks . CONCLUSION: Based on these results, the drug of choice for management of COM in Dar es Salaam is gentamicin . However, given its ototoxicity effects and the fact that BAISED is effective and affordable, the later should be the treatment of choice.

Biotechnol Bioeng, 2000 Oct 5, 70(1), 109 - 14
Effect of initial carbon sources on the performance of microbial fuel cells containing Proteus vulgaris; Kim N et al.; Mediator-coupled microbial fuel cells containing Proteus vulgaris were constructed and the cell performance was tested . Fuel cell efficiency depended on the carbon source in the initial medium of the microorganism . Maltose and trehalose were not utilized substantially by P . vulgaris; however, their presence in the initial medium resulted in enhanced cell performance . In particular, galactose showed 63% coulombic efficiency in a biofuel cell after P . vulgaris was cultured in a trehalose-containing medium . This work demonstrates that optimum utilization of carbon sources by microorganisms, which leads to the maximization of fuel cell performance, is possible simply by adjusting initial carbon sources .

Indian J Med Res, 2000 Apr, 111, 118 - 20
Prevalence of multidrug resistant organisms in an intensive care burn unit; Ram S et al.; During January to December, 1998, analysis of an outbreak of infections in the burn intensive care unit (BICU) of the hospital attached to the Dayanand Medical College, Ludhiana was carried out . A total of 868 clinical samples from 290 patients with more than 40 per cent thermal injury were investigated . These samples included 322 wound swabs, 325 blood and 221 urine samples . Bacterial pathogens were isolated from 80, 62 and 48 per cent samples of pus, blood and urine respectively . Among the nine different pathogens isolated, the more common were Pseudomona aeruginosa from pus, Staphylococcus aureus from blood and Escherichia coli from urine samples . Multidrug resistance was observed among these predominant pathogens . Identical drug susceptibility pattern was depicted by large number of isolates of Ps . aeruginosa, Staph . aureus, Esch . coli and Proteus mirabilis . Similar pathogens with identical drug sensitivity pattern were isolated from environmental samples of the BICU . The ongoing outbreak of hospital acquired infection (HAI) was significantly reduced after strictly adhering to the guidelines for control of HAI.

J Med Microbiol, 2000 Aug, 49(8), 725 - 31
Inhibition of virulence factor expression and swarming differentiation in Proteus mirabilis by p-nitrophenylglycerol; Liaw SJ et al.; Proteus mirabilis is a common cause of upper urinary tract infections that can involve invasion of host urothelial cells . The ability to invade urothelial cells is coupled closely to swarming, a form of multicellular behaviour in which vegetative bacteria differentiate into hyperflagellate, filamentous swarming cells capable of co-ordinated and rapid population migration . Co-ordinate expression of virulence factors including urease, protease, haemolysin and flagellin during swarm-cell differentiation in P . mirabilis has been reported . To investigate the effects of p-nitrophenylglycerol (PNPG), a potent anti-swarming agent, on the various swarming-associated traits of P . mirabilis and to elucidate the relationships among them, P . mirabilis growth rate, swarming/swimming activity, cell invasion ability and the ability to express various virulence factors were monitored in the presence or absence of PNPG . It was found that PNPG could inhibit the growth rate, swarming differentiation and swarming/swimming activities of P . mirabilis . The expression of virulence factors such as protease, urease, haemolysin and flagellin in P . mirabilis was also inhibited by PNPG . The ability of P . mirabilis to invade human urothelial cells was reduced dramatically in the presence of PNPG . These results suggest that PNPG has the potential to be developed as an agent active against the effects of P . mirabilis infection.

Acta Crystallogr D Biol Crystallogr, 2000 Jul, 56 ( Pt 7), 904 - 6
Crystallization and preliminary X-ray analysis of chondroitin sulfate ABC lyases I and II from Proteus vulgaris; Huang W et al.; Chondroitin sulfate ABC lyases (E.C . 4.2.2.4) are broad-specificity glycosaminoglycan-degrading enzymes . Their preferred substrates are chondroitin sulfate and dermatan sulfate, which are broken down to short oligosaccharides . Proteus vulgaris produces two such lyases, ABC lyase I and II, with molecular weights of 112-113 kDa . Diffraction-quality crystals of both enzymes have been obtained by the hanging-drop vapour-diffusion method . ABC lyase I crystallizes in space group P2(1)2(1)2(1), with unit-cell parameters a = 49.3, b = 95.1, c = 230.0 A, Z = 4, and diffracts to 1.9 A resolution . Crystals of ABC lyase II belong to space group P1, with unit-cell parameters a = 64.2, b = 64.3, c = 142.1 A, alpha = 95.7, beta = 98 . 1, gamma = 95.5 degrees, Z = 2; diffraction extends to at least 2.1 A.

Am J Med Genet, 2000 Jul 31, 93(3), 234 - 40
Multiple meningiomas, craniofacial hyperostosis and retinal abnormalities in Proteus syndrome; Gilbert-Barness E et al.; Because clinical evidence suggests that Proteus syndrome may be caused by a somatic mutation during early development, resulting in mosaicism, the possible types of abnormalities and their clinical distributions are highly variable . Here, we report on an unusual patient with Proteus syndrome . Manifestations included multiple meningiomas, polymicrogyria, and periventricular heterotopias . Both eyes had epibulbar cystic lesions . The retina showed diffuse disorganization with nodular gliosis, retinal pigmentary abnormalities, chronic papilledema, and optic atrophy . Other abnormalities included progressive cranial, mandibular, maxillary, and auditory canal hyperostoses, epidermal nevi, and mental deficiency . The limbs were proportionate, and the hands and feet were normal.

Med Microbiol Immunol (Berl), 2000 Jun, 188(4), 169 - 75
Culture independent and rapid identification of bacterial pathogens in necrotising fasciitis and streptococcal toxic shock syndrome by fluorescence in situ hybridisation; Trebesius K et al.; Fluorescence in situ hybridisation (FISH) targeted to ribosomal RNA is well established for studies in environmental microbiology . Initial applications of this technique in the field of medical microbiology showed that FISH is also a suitable means for the rapid, reliable and cultivation-independent identification of bacterial pathogens . In particular, for infectious diseases that follow a fulminant live-threatening course, such as sepsis or necrotising fasciitis (NF), a fast and reliable detection technique is of great importance . This study describes the development of an rRNA-targeted oligonucleotide set covering more than 95% of the pathogens associated with NF . These probes were tested with a broad collection of target and non-target organisms and found to be highly specific . Subsequently, the FISH approach was applied for the direct detection of bacterial pathogens in clinical samples . Two cases of NF and one case of streptococcal toxic shock syndrome (STSS) were analysed . FISH correctly identified almost all pathogens present in the samples examined within 2-3 h . However, Proteus mirabilis, which was identified in one sample by conventional methods was detected as a rod-shaped bacteria but could not be identified by FISH, since no specific probe was available for this particular organism . In contrast, identification of pathogens in these samples by conventional laboratory methods took 48-72 h . Furthermore, in one patient with pre-sampling antimicrobial therapy bacteria could not be grown from any of the samples . FISH unequivocally revealed the presence of Streptococcus pyogenes in affected tissue samples from this patient . In an experimental setting we demonstrated that FISH readily identifies S . pyogenes cells rendered non-cultivable by antibiotic treatment.

Curr Microbiol, 2000 Sep, 41(3), 151 - 6
Waste water bacterial isolates resistant to heavy metals and antibiotics; Filali BK et al.; Sewage water of Casablanca, an industrial city in Morocco, was studied for microorganisms resistant to heavy metals . Isolates were purified and collected on agar slants to be screened for resistance to heavy metals, including mercury in vitro . The strains that showed high resistance to heavy metals were also studied for their resistance to antibiotics and aromatic hydrocarbons . Results indicated that the strains most resistant to all tested products belonged to Ps . fluorescens, Ps . aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus sp . These strains exhibit high minimal inhibitory concentrations for heavy metals such as cadmium (2 mm) or mercury (1.2 mm) . Growth of Ps . fluorescens and Klebsiella pneumoniae in the presence of heavy metals was also determined, and the growth curves indicated that mercury, copper, and zinc present a slight inhibitory action, while cadmium and silver could have a potent inhibitory action on growth compared with the controls . These studies also investigated growth in media containing aromatic compounds as the sole source of carbon . The results demonstrate that these strains could be good candidates for remediation of some heavy metals and aromatic compounds in heavily polluted sites.

Can J Microbiol, 1999 Oct, 45(10), 849 - 55
Specific mucosal immunity in the pathophysiology of bacterial prostatitis in a rat model; Ceri H et al.; Mucosal immunity was established in the rat prostate by stimulating the common mucosal system through serosal exposure of formalin-killed Escherichia coli . Immunized but not sham-immunized rats developed bacterial specific IgG and IgA in prostatic fluid, and IgA in urine . Immunized (n = 21) and sham-immunized control rats (n = 30) were challenged by transurethral injection of E . coli into the prostate ducts . Mortality, gross and microscopic pathology, tissue bacterial counts, bacterial associated immunoglobulins, and antibody titers in serum and urine were assessed at 7 days following the challenge . Increased E . coli specific immunoglobulin titers were seen in immunized rats, and E . coli, but not Proteus, found in the prostates of immunized animals were coated with IgG and IgA . Immunization protected against toxaemia and septicemia, seen as a rare complication of acute prostatitis, but did not protect against acute prostatitis, nor alter the degree of tissue damage seen in the rat model.

Curr Genet, 2000 Jun, 37(6), 349 - 55
Characterization of trans-splicing in Euglenoids; Frantz C et al.; We have looked for trans-splicing of nuclear mRNAs in several Euglenoid species . In Cyclidiopsis acus, Phacus curvicauda, Rhabdomonas costata and Menoidium pellucidum we showed that several premRNAs chosen at random are matured by a transsplicing process: we identified SL-RNA genes whose 5' ends (SLs for spliced leader-sequences) were transferred to the 5' extremities of mRNAs . The SL-RNA genes are located on repeated DNA fragments which also encode 5S rRNA in P . curvicauda and C . acus . The potential secondary structures of SL-RNAs are compared to those previously characterized in two other Euglenoids: Euglena gracilis and Entosiphon sulcatum . In another Euglenoid species, Distigma proteus, since none of the mRNAs examined were trans-spliced, it is possible that trans-splicing does not occur . Phylogeny based on 5S rRNA sequences suggests that the species which have, or have had, chloroplasts (E . gracilis, P . curvicauda, C . acus) diverged early from the others.

Biochem J, 2000 Aug 1, 349 Pt 3, 805 - 12
Fusion of the tissue factor extracellular domain to a tumour stroma specific single-chain fragment variable antibody results in an antigen-specific coagulation-promoting molecule; Rippmann JF et al.; Solid tumours growing beyond a size of 1-2 mm in diameter induce supporting connective tissue structures, the tumour stroma, comprising activated fibroblasts and newly formed blood vessels, embedded in an extracellular matrix . The selective destruction of this tissue or the inhibition of its function (e.g . tumour neoangiogenesis) may result in the destruction of tumour nodules, thus providing novel opportunities for tumour therapy . Our approach aims at an antibody-mediated induction of coagulation in tumour nodules to cut off their blood supply . As a target structure the fibroblast activation protein (FAP) is used, which is specifically and abundantly expressed on the activated fibroblasts of the tumour stroma . We constructed a fusion protein comprising a single-chain module of a FAP-specific humanized antibody {single-chain fragment variable (scFv) OS4} and the extracellular domain of human tissue factor . The fusion protein, designated TFOS4, was produced in the Proteus mirabilis protoplast expression system with a yield of 15 microg/ml . Biochemical characterization of TFOS4 revealed high-affinity binding to cellular FAP . Further, TFOS4 bound to factor VIIa and also exerted allosteric activation of factor VIIa . A complex of TFOS4 and factor VIIa bound to FAP-expressing cells efficiently generated activated factor X . Finally, cell-bound TFOS4 selectively induced plasma coagulation, implying its activity under physiological conditions, notably with relevant concentrations of coagulation factors and their natural inhibitors . These findings suggest that TFOS4 has the potential to increase the procoagulant state in a cell-type-specific fashion . No systemic coagulation or side effects were observed when TFOS4 was injected intravenously into normal mice, indicating the biosafety and specificity of the recombinant protein.

Carbohydr Res, 2000 Jun 16, 326(3), 185 - 93
The structure of the core part of Proteus penneri strain 16 lipopolysaccharide; Vinogradov E et al.; The structure of the carbohydrate backbone of the lipid A-core region of the lipopolysaccharide (LPS) from Proteus penneri strain 16 was determined using NMR and chemical analysis of the core oligosaccharide, obtained by mild acid hydrolysis of the LPS, and of the products of alkaline deacylation of the LPS: formula {see text} . Incomplete substitution is indicated by bold italics . All sugars are in the pyranose form, alpha-Hep is the residue of L-glycero-alpha-D-manno-Hep, alpha-DD-Hep is the residue of D-glycero-alpha-D-manno-Hep, Bu is the (R)-3-hydroxybutyryl residue.

Braz J Med Biol Res, 2000 Jul, 33(7), 765 - 70
Development of an operational substrate for ZapA, a metalloprotease secreted by the bacterium Proteus mirabilis; Fernandes BL et al.; The protease ZapA, secreted by Proteus mirabilis, has been considered to be a virulence factor of this opportunistic bacterium . The control of its expression requires the use of an appropriate methodology, which until now has not been developed . The present study focused on the replacement of azocasein with fluorogenic substrates, and on the definition of enzyme specificity . Eight fluorogenic substrates were tested, and the peptide Abz-Ala-Phe-Arg-Ser-Ala-Ala-Gln-EDDnp was found to be the most convenient for use as an operational substrate for ZapA . A single peptide bond (Arg-Ser) was cleaved with a Km of 4.6 microM, a k cat of 1.73 s-1, and a catalytic efficiency of 376 (mM s)-1 . Another good substrate for ZapA was peptide 6 (Abz-Arg-Pro-Pro-Gly-Phe-Ser-Pro-Phe-Arg-Gln-EDDnp) which was cleaved at a single bond (Phe-Ser) with a Km of 13.6 microM, a k cat of 3.96 s-1 and a catalytic efficiency of 291 (mM s)-1 . The properties of the amino acids flanking the scissile bonds were also evaluated, and no clear requirement for the amino acid residue at P1 was found, although the enzyme seems to have a preference for a hydrophobic residue at P2.

Respir Med, 2000 May, 94(5), 436 - 40
Influence of clinical history on airways bacterial colonization in subjects with chronic tracheostomy; Lusuardi M et al.; Patients with chronic tracheostomy are subject to significant bacterial colonization of the airways, a risk factor for respiratory infections . The aim of our study was to verify whether bacterial colonization and humoral immune response in the airways can be influenced by the disease which led to chronic respiratory failure and tracheostomy . Thirty-nine clinically stable outpatients with chronic tracheostomy were considered: 24 were affected by chronic obstructive pulmonary disease (COPD) (mean age 66 years, range 54-78, M/F 19/3; months since tracheostomy 23, range 3-62), 15 by restrictive lung disease (RLD) (12 thoracic wall deformities, three neuromuscular disease; age 57 years, range 41-72; M/F 3/12, months since tracheostomy 22, range 2-68) . Recent antibiotic or corticosteroid treatments (< 1 month) were among exclusion criteria . Bacterial counts were assessed in tracheobronchial secretions with the method of serial dilutions . Identification of bacterial strains was performed by routine methods . Albumin, IgG, A, and M were measured in airways secretions with an immunoturbidimetric method . No significant differences were found between the two groups as regards either the quantitative bacterial cultures (RLD 81.4, 2.6-4200 x 10(4); COPD 75.9, 1.0-1530 x 10(4) colony forming units (cfu)/ml, geometric mean, range) or the prevalence of the main bacterial strains, (Pseudomonas species: 38 and 37%, Serratia marcescens: 31 and 23%, Staphylococcus aureus: 14 and 6%, Proteus species: 3 and 8%, for RLD and COPD respectively) as a percentage of total strains isolated (RLD = 26, COPD = 48) . Immunoglobulin levels did not show significant differences, apart from being higher in underweight subjects . We conclude that in our series of stable outpatients with chronic tracheostomy, bacteria-host interaction in the airways was not influenced by the clinical history.

Am J Med Genet, 2000 Jun 19, 92(5), 350 - 2
Ocular manifestations in Proteus syndrome; De Becker I et al.; We report on the ocular manifestations of a Proteus syndrome patient . Several of the manifestations are due to severe maldevelopment and malfunction of the neuroretina including strabismus, nystagmus, high myopia, and retinal pigmentary abnormalities . In reviewing the literature, strabismus and epibulbar tumors were recorded most commonly . Some articles about presumed Proteus syndrome are spurious; these have not been included here . Also, because of anecdotal and nonsystematic study of the eye and because of the ascertainment bias inherent in literature reports, numbers of cases of each ocular manifestation have not been tabulated .

Antimicrob Agents Chemother, 2000 Jul, 44(7), 1930 - 5
Prevalence of beta-lactamases among 1,072 clinical strains of Proteus mirabilis: a 2-year survey in a French hospital; Chanal C et al.; beta-Lactam resistance was studied in 1,072 consecutive P . mirabilis clinical strains isolated at the Clermont-Ferrand teaching hospital between April 1996 and March 1998 . The frequency of amoxicillin resistance was 48.5% . Among the 520 amoxicillin-resistant isolates, three resistance phenotypes were detected: penicillinase (407 strains {78.3%}), extended-spectrum beta-lactamase (74 strains {14 . 2%}), and inhibitor resistance (39 strains {7.5%}) . The penicillinase phenotype isolates were divided into three groups according to the level of resistance to beta-lactams, which was shown to be related to the strength of the promoter . The characterization of the different beta-lactamases showed that amoxicillin resistance in P . mirabilis was almost always (97%) associated with TEM or TEM-derived beta-lactamases, most of which evolved via TEM-2.

J Vet Diagn Invest, 2000 May, 12(3), 218 - 23
In vitro activity of difloxacin against canine bacterial isolates; van den Hoven R et al.; The in vitro activity of difloxacin against canine bacterial isolates from clinical cases was studied in the United States and The Netherlands . Minimal inhibitory concentrations (MIC), the postantibiotic effect, the effect of pH on antimicrobial activity, and the bacterial killing rate tests were determined according to standard techniques . The MICs of American and Dutch isolates agreed in general . The MICs of the American gram-negative isolates ranged from 0.06 to 2.0 microg/ml, and the MICs of the Dutch gram-negative isolates ranged from 0.016 to 8.0 microg/ml . A few European strains of Proteus mirabilis and Klebsiella pneumoniae had relatively high MICs . Bordetella bronchiseptica also was less susceptible to difloxacin . The MICs of the American gram-positive cocci ranged from 0.125 to 4.0 microg/ml, and the MICs of Dutch isolates ranged from 0.125 to 2.0 microg/ ml . Difloxacin induced a concentration-dependent postantibiotic effect that lasted 0.2-3 hours in cultures with Escherichia coli, Staphylococcus intermedius, Streptococcus canis, Proteus spp., and Klebsiella pneumoniae . There was no postantibiotic effect observed against canine Pseudomonas aeruginosa . Decreasing the pH of the medium increased the MIC of Proteus mirabilis for difloxacin . The MICs of Escherichia coli and Klebsiella pneumoniae were lowest at neutral pH and were slightly increased in acid or alkaline media . At a neutral pH, most tested bacterial species were killed at a difloxacin concentration of 4 times the MIC . Similar results were obtained when these same bacteria were tested against enrofloxacin . A Klebsiella pneumoniae strain in an acidic environment was readily killed at difloxacin or enrofloxacin MIC, but at neutral pH the drug concentration had to be raised to 4 times the MIC for a bactericidal effect . After 24 hours of incubation at pH 7.1, difloxacin and enrofloxacin had similar bactericidal activity for all bacteria tested except Staphylococcus intermedius . Against S . intermedius, difloxacin was more bactericidal than enrofloxacin.

J Antimicrob Chemother, 2000 Apr, 45 Suppl 1, 87 - 93
Comparative efficacy of gemifloxacin in experimental models of pyelonephritis and wound infection; Berry V et al.; Gemifloxacin (SB-265805) is a potent, novel fluoroquinolone with broad-spectrum antimicrobial activity . In this study, the efficacy of gemifloxacin was studied in experimental models of Gram-negative pyelonephritis (caused by Escherichia coli or Proteus mirabilis) and Gram-positive wound infection resulting from Streptococcus pyogenes, Staphylococcus epidermidis or Staphylococcus aureus . Gemifloxacin activity against these pathogens was compared with those of amoxycillin-clavulanate, ciprofloxacin, cefuroxime, azithromycin, trovafloxacin, grepafloxacin, levofloxacin and tosufloxacin . Oral treatment was initiated 1 h after infection and continued once or twice daily for 3 days . Around 17 h after the end of treatment, animals were killed and the infected kidneys or the skin around the wound site were excised for the enumeration of viable bacteria . In the pyelonephritis model (either microorganism), gemifloxacin reduced bacterial numbers significantly (P < 0.01) compared with no treatment . No comparator agent had a greater effect than gemifloxacin . Notably, grepafloxacin and azithromycin were significantly less effective (P < 0.01) than gemifloxacin against E . coli pyelonephritis, and amoxycillin-clavulanate, azithromycin and trovafloxacin were inferior (P < 0.01) against P . mirabilis infection . In the S . pyogenes wound infection model, gemifloxacin, amoxycillin-clavulanate, cefuroxime and azithromycin reduced bacterial numbers significantly compared with controls (P < 0.01) . Results for the comparator quinolones were not significantly different from untreated controls (P > 0.05) . Gemifloxacin was also effective against staphylococcal infection, as were grepafloxacin and levofloxacin, while ciprofloxacin, trovafloxacin and tosufloxacin were significantly less effective against these pathogens than gemifloxacin (P < 0.01) . No comparator agent had greater activity than gemifloxacin against S . pyogenes or S . aureus infections . These data demonstrate the potential benefit of gemifloxacin in the treatment of Gram-negative urinary tract infection and Gram-positive skin and soft tissue infection.

Amino Acids, 2000, 18(2), 177 - 91
Synthesis and antibacterial activity of some new non-proteinogenic amino acids containing thiazole residues; Stanchev M et al.; Some new thioamides and thiazoles have been synthesized using canavanine, S-cysteine, homo-S-cysteinesulfonamides and their N-omega aminoethylated derivatives as adducts in order to investigate the structure-antimicrobial activity relationships . The compounds showed substantial antibacterial activity in vitro against various gram-positive (Staphylococcus aureus, Bacillus cereus etc.) and gram-negative (Escherichia coli, Proteus vulgaris etc.) bacteria . These findings indicate that the presence of the thiazole residue is an essential factor for the antibacterial effect.

Clin Nephrol, 2000 Apr, 53(4), 283 - 7
alpha1-microglobulin as a marker of proximal tubular damage in urinary tract infection in children; Mantur M et al.; The urinary alpha1-microglobulin (alpha1-M) as a marker of proximal tubular damage was measured in 86 children, aged 3/12 to 12 years, with a diagnosis of urinary tract infection (UTI) and fever . All patients had normal glomerular filtration rates (GFR) . They were divided into 2 groups: A: with UTI and etiological factor E . coli, B: with UTI and etiological factor Proteus sp . Similar measurements of alpha1-M were obtained for a control group of healthy children . An increased mean level serum alpha1-M was observed in patients with UTI and fever compared to control group (p < 0.001) . Urinary alpha1-M as the alpha1-microglobulin/creatinine ratio was higher in both tested group of patients with UTI and fever . Those found in group A1 and B1 before treatment were the highest and statistically significantly elevated after treatment (group A2 and B2: p < 0.001) . Our results indicate the usefulness of the urinary alpha-microglobulin/creatinine ratio as a marker of proximal kidney tubule damage in children with E . coli and Proteus sp . infections . Additionally, it seems to be associated with the humoral and cellular immune response.

J Tissue Viability, 1999 Oct, 9(4), 127 - 32
The anti-microbial activity of maggot secretions: results of a preliminary study; Thomas S et al.; The ability of larval secretions to kill or prevent the growth of a range of potentially pathogenic bacteria was investigated in a preliminary laboratory study . Marked anti-microbial activity was detected against Streptococcus A and B and Staphylococcus aureus . Some activity was also detected against Pseudomonas sp . and a clinical isolate of a resistant strain of S . aureus (MRSA) . No evidence of inhibition was recorded against Enterococcus or the Gram-negative bacteria Escherichia coli and Proteus . These findings are consistent with clinical observations made by us and others that larvae of the common greenbottle are able to combat clinical infections in a variety of wound types including those caused by antibiotic-resistant strains of bacteria.

Med Dosw Mikrobiol, 1999, 51(3-4), 323 - 30
{Drug resistance and proticinogenic types of Proteus mirabilis isolated from urinary tract infections}; Szymaniak L et al.; Proteus mirabilis strains (88 isolates) from hospitalised patients with urinary tract infection were tested for antibiotic susceptibility, ESBL production and their ability to produce proticin or on their susceptibility to proticin . Antibiotic susceptibility test was performed by standard disc diffusion method according to NCCLS . Proticin typing was made by the standard strain set from the B . W . Senior collection . Most (59%) strains belonged to ESBL producers and were more resistant to antibiotics than ESBL-negative strains . Predominant proticin patterns among the ESBL (+) strains were: P1,2(6)/SO (23%), P1,2/SO (13.5%) . Among the ESBL-negative strains more frequent were P6/SO (16.6%), P1,2/SO (13.8%) and P3,6/SO (13.8%) proticin types.

Ann Allergy Asthma Immunol, 2000 Apr, 84(4), 445 - 50
Gender differences in response to the multitest CMI skin test in the general population; Vine MF et al.; BACKGROUND: Previous studies of gender differences in response to the Multitest CMI skin test have produced conflicting results . OBJECTIVE: To determine whether gender is associated with response to the Multitest CMI skin test . METHODS: Two-hundred ninety-seven adults, aged 18 to 64 years, recruited originally for a study of the immune effects associated with living near a hazardous waste site containing primarily organochlorine pesticides, underwent a skin test using the Multitest CMI skin test . Six of seven antigens were tested: tetanus toxoid, diphtheria toxoid, Candida, Tricophyton, Streptococcus, and Proteus . The tuberculin antigen was excluded . Lymphocyte function was also evaluated in vitro using standardized methods of mitogen stimulation with phytohemaglutinin (PHA), concanavalin A (CON-A), and pokeweed mitogen . RESULTS: The frequency of positive responses to the skin tests was significantly (P < .001) higher among males (80.4%) than among females (55.7%) . Males were more likely than females to respond to all six antigens tested (P < .05) . The mean diameter of positive skin test measurements for males statistically significantly (P < .05) exceeded female responses for tetanus and diphtheria . Although not statistically significant, male response size exceeded that of females for all other antigens except Trycophyton . Controlling for age, race, smoking, income, and plasma DDE levels did not change these results . Skin test positivity was not associated with mitogen stimulation assay results overall or within gender groups . CONCLUSION: Significant gender differences in response to the Multitest CMI skin test could limit its use as a marker of anergy in general population studies.

BJU Int, 2000 May, 85(7), 874 - 8
Paediatric anatrophic nephrolithotomy; stone clearance - at what price?
Gough DC, Baillie CT.
OBJECTIVE: To evaluate the functional outcome of anatrophic nephrolithotomy in children . PATIENTS AND METHODS: All children undergoing anatrophic nephrolithotomy for complex branching and multiple renal calculi over an 11-year period were studied prospectively . Demographic data, treatment details and outcome, as assessed by X-ray, ultrasonography and isotope studies, were recorded . Anatrophic nephrolithotomy was carried out with surface cooling of the kidney followed by nephrostomy drainage for 5-7 days . RESULTS: Nine children (median age 4 years, range 7 months to 9 years) underwent anatrophic nephrolithotomy . Predisposing factors included urinary tract infection (by Proteus mirabilis) in all and hyper-calciuria in two children . The median (range) total ischaemic time at operation was 25 (15-40) min and the operative duration 150 (120-200) min . Three children required a blood transfusion . Stone clearance was incomplete in one child . There was no recurrent stone formation after a long-term follow-up (median 32 months, range 14-107) in the other patients . Isotope studies showed impaired split renal function (<40%) in six children before surgery; there was a significant decline (>5%) in divided function in five children (range 6-16%) after surgery . CONCLUSION: Anatrophic nephrolithotomy is an effective means of rendering children with branching calculi stone-free, but this study suggests that it leads to some further parenchymal damage.

J Clin Microbiol, 2000 May, 38(5), 1791 - 6
Occurrence and detection of AmpC beta-lactamases among Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis isolates at a veterans medical center; Coudron PE et al.; AmpC beta-lactamases are cephalosporinases that confer resistance to a wide variety of beta-lactam drugs and that may thereby create serious therapeutic problems . Although reported with increasing frequency, the true rate of occurrence of AmpC beta-lactamases in Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis remains unknown . We tested a total of 1,286 consecutive, nonrepeat isolates of these three species and found that, overall, 45 (3.5%) yielded a cefoxitin zone diameter less than 18 mm (screen positive) and that 16 (1.2%) demonstrated AmpC bands by isoelectric focusing . Based on the species, of 683 E . coli, 371 K . pneumoniae, and 232 P . mirabilis isolates tested, 13 (1.9%), 28 (7.6%), and 4 (1.7%), respectively, demonstrated decreased zone diameters and 11 (1.6%), 4 (1.1%), and 1 (0.4%), respectively, demonstrated AmpC bands . Cefoxitin resistance was transferred for all but 8 (E . coli) of the 16 AmpC producers . We also describe a three-dimensional extract test, which was used to detect phenotypically isolates that harbor AmpC beta-lactamase . Of the 45 cefoxitin-resistant isolates, the three-dimensional extract test accurately identified all 16 AmpC producers and 28 of 29 (97%) isolates as non-AmpC producers . Interestingly, most (86%) isolates in the latter group were K . pneumoniae isolates . These data confirm that, at our institution, E . coli, K . pneumoniae, and P . mirabilis harbor plasmid-mediated AmpC enzymes.

Med Clin (Barc), 2000 Mar 25, 114(11), 407 - 10
{Laboratory diagnosis and serologic course in patients with tularemia}; Duenas AI et al.; BACKGROUND: Tularemia was practically unknown in Spain until the end of 1997, when an epidemic outbreak was declared . This paper presents the data on microbiological diagnosis of 55 patients who suffered from tularemia . PATIENTS AND METHODS: Thirty-two samples from 19 patients and 151 serum samples from 55 patients were obtained for culture . Serologic diagnosis was performed by tube sero-agglutination and microagglutination . Three types of tests were performed on all sera: Wright sero-agglutination (WSA), Coombs test against Brucella spp . and sero-agglutination against Yersinia enterocolitica O:3, Yersinia enterocolitica O:3, and Proteus OX 19 . RESULTS: F . tularensis was found in two samples (6.25%) of the 32 received . Titers > or = 1/160 were obtained in 78.2% and 74.5% of the initial sera by tube sero-agglutination and microagglutination, respectively . Correlation between the two tests was 0.80 (p < 0.001) . Prozone phenomenon was observed in 59.9% of the sera, while crossed reactivity to Brucella spp . and Proteus spp . was found in 9.3% and 22.8%, respectively . No crossed reactivity was observed with Yersinia spp . CONCLUSIONS: Culture of F . tularensis has low sensitivity . The correlation obtained between tube sero-agglutination and microagglutination is good . Both techniques are useful in routine diagnosis of tularemia, although microagglutination has some advantages over tube agglutination.

Folia Med (Plovdiv), 1999, 41(4), 59 - 61
Frequency and clinical characteristics of mycoplasma urinary tract infections in the early post-transplantation period in renal allograft patients; Dimitrakov D et al.; Using a highly sensitive and specific polymerase chain reaction (PCR) protocol, we studied 36 renal allograft recipients and 30 healthy controls . Midstream urine samples were analyzed using routine microbiological methods and the Mycoplasma IST (BioMerieux, France) . Mycoplasma infections of the upper urinary tract were found in 9 patients . In three of them E.coli and Proteus were also present . We discuss the clinical characteristics of mycoplasma infections in the early post-transplantation period and its possible implications for graft rejection.

Carbohydr Res, 2000 Jan 12, 323(1-4), 81 - 6
Structure of the O-specific polysaccharide of Proteus mirabilis O11, another Proteus O-antigen containing an amide of D-galacturonic acid with L-threonine; Arbatsky NP et al.; The O-specific polysaccharide of Proteus mirabilis O11 was studied by sugar analysis, Smith degradation, 1H and 13C NMR spectroscopy, including two-dimensional COSY, TOCSY, NOESY, and 1H-detected 1H, 13C HMQC experiments . The following structure of a pentasaccharide repeating unit of the polysaccharide was established: {formual: see text} where D-GalA6LThr is N-(D-galacturonoyl)-L-threonine . ELISA with anti-P . mirabilis O11 serum showed that D-GalA6LThr is of minor importance for manifesting the O11 immunospecificity.

Wound Repair Regen, 1999 Jul-Aug, 7(4), 238 - 43
Assessment of the potential for microbial resistance to topical use of multiple antimicrobial agents; Holder IA et al.; The goal of this study was to reduce the likelihood of the generation and/or persistence of bacterial resistance to some antimicrobial components contained in a topical antimicrobial mixture (neomycin, polymyxin B, mupirocin and ciprofloxacin) for use with cultured skin grafts, by substitution of alternative antimicrobials, specifically fusidic acid for mupirocin and ofloxacin for ciprofloxacin . The alternative agents failed to serve that purpose . However, with the exception of specific genera of bacteria, Proteus sp . and Providencia stuartii, 90% or more of all other bacteria tested were susceptible to the action of one or more of the individual antimicrobial agents contained in the original mixture . This was true when bacteria were highly susceptible to the antimicrobials, generally, or when bacteria resistant to specific antimicrobials such as penicillin-class antibiotics and ciprofloxacin, were tested . These results suggest that the redundancy of antimicrobials contained in this mixture reduces the chance that resistant bacteria generated by the use of this mixture or already present on wounds would persist when the mixture is used clinically.

Surgery, 2000 Apr, 127(4), 427 - 32
Frequency and time course of pancreatic and extrapancreatic bacterial infection in experimental acute pancreatitis in rats; Schwarz M et al.; BACKGROUND: Infectious complications in severe pancreatitis are the main factors determining clinical course and outcome . The taurocholate model for acute necrotizing pancreatitis was evaluated for frequency and time course of pancreatic and extrapancreatic bacterial infection . METHODS: Sixty-five male Wistar rats were divided into 5 groups of 13 animals each . Specimens for bacteriologic examination were taken, and pancreatitis was induced by intraductal infusion of 3% taurocholate under sterile conditions . Animals were killed 8, 16, 24, or 32 hours thereafter, and bacteriologic examination was performed . A control group of animals with intraductal infusion of 0.9% saline solution were killed after 32 hours . RESULTS: There was no significant pancreatic infection in the control group and in the 8-hour group (1 of 13 rats) . Sixteen and 24 hours after induction of pancreatitis, infection and inflammation of the pancreas were found in 77% (10 of 13 rats), and after 32 hours pancreatic infection occurred in 69% (9 of 13 rats) . Extrapancreatic bacterial infection after 16 hours occurred in the liver (62%), spleen (62%), and mesenteric lymph nodes (46%) . Bacteria infecting the pancreas reflected the bacterial spectrum of the large bowel and terminal ileum before induction of pancreatitis (Escherichia coli {77%}, Proteus {43%}, Enterococcus {37%}, and Staphylococcus {23%}) . CONCLUSIONS: Pancreatic infection is an early and frequent finding in the taurocholate model of acute necrotizing pancreatitis . Infection occurs between 8 and 16 hours after induction of pancreatitis . The source of infecting bacteria seems to be the large bowel or the terminal ileum . We present a useful model of severe pancreatitis in which to study bacterial translocation, the further route of spread, and therapeutic approaches.

Int J Pediatr Otorhinolaryngol, 2000 Apr 15, 52(2), 143 - 8
Intracranial complications of acute mastoiditis; Go C et al.; OBJECTIVE: Oral antibiotic use may have changed the incidence and microbiology of otitic intracranial complications . We reviewed cases of acute mastoiditis to document: (1) incidence of intracranial complications; (2) risk factors; and (3) identify pathologic organisms . METHODS: A retrospective study of children at a tertiary care children's hospital with acute mastoiditis from July, 1986 through June, 1998 . RESULTS: 118 children with acute mastoiditis were identified . Eight patients (6.8%), ages 20 months to 14 years, had intracranial complications related to acute mastoiditis . Three children had a sigmoid sinus thrombosis, two children had an epidural abscess, and two children had both complications of sigmoid sinus thrombosis and epidural abscess, and a sigmoid sinus thrombosis and meningitis was present in one child . Pre-admission oral antibiotics were administered for an average of 10 days in seven of the eight patients . Persistent otorrhea and/or otalgia were present in all patients . Intraoperative cultures were negative in four cases (50%) . Organisms isolated included: Streptococcus pneumoniae (2); Proteus mirabilis (1); Pseudomonas aeruginosa (1); and coagulase negative Staphylococcus (1) . Multi-drug resistant organisms were documented in only one case . All patients underwent a contrast enhanced CT of the temporal bones and brain . Surgical management included complete mastoidectomy in all patients and a pressure equalization tube in seven of the eight cases . CONCLUSIONS: Our review did not document an increase in the incidence of otitic intracranial complications . Persistent otalgia or otorrhea while on oral antibiotics with associated neurologic symptoms are ominous signs suggestive of a complication . Multi-drug resistant organisms are uncommon whereas negative intraoperative cultures are common.

Pediatr Neurosurg, 2000 Jan, 32(1), 20 - 3
Aerobic and anaerobic microbiology of wound infection following spinal fusion in children; Brook I et al.; OBJECTIVE: To study the aerobic and anaerobic microbiology of wound infections following spinal fusion in children . METHODS: Retrospective review of clinical and microbiological records . RESULTS: Aspirates of pus from 18 infection sites showed bacterial growth . Anaerobic bacteria only were recovered in 3 (17%) specimens, aerobic bacteria only in 3 (17%) and mixed aerobic and anaerobic bacteria in 12 (67%) . Forty-two isolates were recovered: 18 anaerobes (1.0 isolates per specimen) and 24 aerobes (1.3 per specimen) . The predominant anaerobes were Bacteroides sp . (9 isolates, including 8 Bacteroides fragilis group) and 5 Peptostreptococcus sp . The predominant aerobes were Escherichia coli (6) and Proteus sp . (5) . An increase in recovery of E . coli and B . fragilis was noted in children with bowel or bladder incontinence . CONCLUSIONS: This study highlights the polymicrobial nature and predominance of anaerobic bacteria in wound infections following spinal fusion in children .

J Bacteriol, 2000 May, 182(9), 2649 - 53
H-NS is a repressor of the Proteus mirabilis urease transcriptional activator gene ureR; Coker C et al.; Expression of Proteus mirabilis urease is governed by UreR, an AraC-like positive transcriptional activator . A poly(A) tract nucleotide sequence, consisting of A(6)TA(2)CA(2)TGGTA(5)GA(6)TGA(5), is located 16 bp upstream of the sigma(70)-like ureR promoter P2 . Since poly(A) tracts of DNA serve as binding sites for the gene repressor histone-like nucleoid structuring protein (H-NS), we measured beta-galactosidase activity of wild-type Escherichia coli MC4100 (H-NS(+)) and its isogenic derivative ATM121 (hns::Tn10) (H-NS(-)) harboring a ureR-lacZ operon fusion plasmid (pLC9801) . beta-Galactosidase activity in the H-NS(-) host strain was constitutive and sevenfold greater (P < 0.0001) than that in the H-NS(+) host . A recombinant plasmid containing cloned P . mirabilis hns was able to complement and restore repression of the ureR promoter in the H-NS(-) host when provided in trans . Deletion of the poly(A) tract nucleotide sequence from pLC9801 resulted in an increase in beta-galactosidase activity in the H-NS(+) host to nearly the same levels as that observed for wild-type pLC9801 harbored by the H-NS(-) host . Urease activity in strains harboring the recombinant plasmid pMID1010 (encoding the entire urease gene cluster of P . mirabilis) was equivalent in both the H-NS(-) background and the H-NS(+) background in the presence of urea but was eightfold greater (P = 0.0001) in the H-NS(-) background in the absence of urea . We conclude that H-NS represses ureR expression in the absence of urea induction.

Eur J Biochem, 2000 Apr, 267(8), 2439 - 46
Structural analysis of the core region of lipopolysaccharides from Proteus mirabilis serotypes O6, O48 and O57; Vinogradov E et al.; The structure of lipid A core region of the lipopolysaccharides (LPS) from Proteus mirabilis serotypes O6, O57 and O48 was determined using NMR, MS and chemical analysis of the oligosaccharides, obtained by mild acid hydrolysis, alkaline deacylation, and deamination of LPS: {see text for structure} . Incomplete substitutions are indicated by bold italic type . All sugars are present in pyranose form, alpha-Hep is the residue of L-glycero-alpha-D-manno-Hep, alpha-DD-Hep is the residue of D-glycero-alpha-D-manno-Hep, L-Ara4N is 4-amino-4-deoxy-L-arabinose, Qui4NAlaAla is the residue of 4-N-(L-alanyl-L-alanyl)-4-amino-4,6-dideoxyglucose . All sugars except L-Ara4N have D-configuration . beta-GalA* is partially present in the form of amide with 1,4-diaminobutane (putrescine)-HN(CH2)4NH2 or spermidine-HN(CH2)3NH(CH2)4NH2.

Hum Mol Genet, 2000 Mar 22, 9(5), 765 - 8
Germline and germline mosaic PTEN mutations associated with a Proteus-like syndrome of hemihypertrophy, lower limb asymmetry, arteriovenous malformations and lipomatosis; Zhou XP et al.; Germline PTEN mutations cause Cowden syndrome (CS) and Bannayan-Riley-Ruvalcaba syndrome (BRR), two hamartoma-tumour syndromes, and somatic PTEN alterations have been shown to participate, to a greater or lesser extent, in a wide variety of sporadic neoplasia . PTEN is a tumour suppressor and dual-specificity phosphatase which affects apoptosis via its lipid phosphatase activity in the phosphoinositol-3-kinase and AKT pathway as well as inhibiting cell spreading via the focal adhesion kinase pathway . CS and BRR share some features, such as hamartomas and lipomatosis . To determine whether other syndromes characterized by overgrowth and lipomas are part of the PTEN syndrome spectrum, we ascertained six individuals with overgrowth and lipomas but who did not meet the diagnostic criteria for CS or BRR . Five had Proteus syndrome and one, a Proteus-like syndrome . When germline DNA and DNA from at least one involved tissue per case were examined for PTEN mutations, only the Proteus-like patient was found to harbour a germline R335X mutation . Interestingly, a lipomatous mass, an epidermoid naevus and arteriovenous malformation tissue, all of which were sampled from physically distinct sites, were all found to carry a second hit R130X mutation on the allele opposite the germline R335X . Both mutations have been described in CS and BRR . We postulate that the second hit, R130X, occurred early in embryonic development and may even represent germline mosaicism . Thus, PTEN may be involved in Proteus-like syndrome with its implications for cancer development in the future.

Urol Int, 1999, 63(4), 215 - 9
Urinary tract infection in diabetic patients; Bonadio M et al.; AIM: The aim of the study was to compare the epidemiological, microbiological and clinical features of diabetic patients with urinary tract infection (UTI) to those of nondiabetic ones . METHODS: A prospective study was performed on 490 consecutive patients with proven UTI . The patients were studied on the basis of a specific questionnaire and hospital records . RESULTS: Of 490 enrolled patients, 89 (18.1%) had diabetes mellitus . The mean age of diabetics and nondiabetics was respectively 64.9 +/- 13.2 (SD) and 54.4 +/- 23.3 years . Most diabetics had asymptomatic bacteriuria and had undergone bladder catheterization more frequently than the nondiabetics . The most frequent causative agents of UTI in diabetics and nondiabetics were: E . coli (respectively, 56.1 vs . 56.8%), Proteus sp . (7.9% vs . 7.2%), Pseudomonas sp . (6.7 vs . 8.2%), Enterococcus sp . (6.7 vs . 7.2%) . More than 50% of the isolated Pseudomonas sp . strains in both groups were resistant to gentamicin, piperacillin and norfloxacin . Both diabetics (52.8%) and nondiabetics (42.2%) had recurrent UTI during the follow-up period; the difference in the incidences did not reach statistical significance . CONCLUSION: No significant differences in epidemiological, clinical and microbiological evaluated features of diabetics and nondiabetics were pointed out, except for the higher frequency of bladder catheterization of diabetics than nondiabetics . However, the eradication of UTI seemed to be more difficult in diabetics than in nondiabetics.

Skeletal Radiol, 2000 Feb, 29(2), 101 - 3
Proteus syndrome: MRI characteristics of plantar cerebriform hyperplasia; Vanhoenacker FM et al.; Proteus syndrome is a rare congenital hamartomatous syndrome with a variety of abnormalities . It shares many features with other congenital hamartomatous disorders, but cerebriform hyperplasia of the soles and the palms is known as a quite distinctive characteristic in the dermatologic literature . The purpose of this case report is to demonstrate the MRI features of plantar cerebriform hyperplasia in a 9-year-old boy with known Proteus syndrome.

Biol Neonate, 2000 Mar, 77(3), 139 - 46
Treatment of gram-negative bacterial meningitis in term neonates with third generation cephalosporins plus amikacin; Dellagrammaticas HD et al.; The aim of this retrospective study was to evaluate the clinical efficacy in terms of mortality and long-term morbidity of third generation cephalosporins and amikacin in combination for the treatment of gram-negative bacterial meningitis in a homogeneous group of neonates . A 15-year experience (1983-1997) with 72 term neonates without central nervous system anomalies and with gram-negative organisms grown in their cerebrospinal fluid treated with the above combination of antibiotics is presented . All isolated organisms were sensitive to cefotaxime or ceftazidime and to amikacin but 80% were resistant to ampicillin . The predominant infecting organism was Escherichia coli (68.0%) which was sensitive to both cefotaxime and amikacin in all cases but resistant to ampicillin in 48% of cases . Survival at discharge was 97.2% but ultimate survival was reduced to 94.4%, as 2 patients died a few months following discharge of conditions unrelated to meningitis . Ventriculitis was diagnosed in 10 neonates (13.8%) . Among survivors, 1 neonate (1.3%) developed hydrocephalus needing shunting and 1 neonate (1.3%) with Proteus mirabilis developed a brain abscess with relapse of meningitis which was successfully treated with a 6-week course of chloramphenicol . At follow-up at an age greater than 6 months, 91.1% of the surviving infants were normal, while 92.3% of survivors at an age greater than 6 years were normal and attended normal school . These results, despite any reservations due to the nature of the study (retrospective, uncontrolled study), strongly support the use of third generation cephalosporins and amikacin in combination for the treatment of neonatal gram-negative bacterial meningitis .

Biochemistry (Mosc), 2000 Feb, 65(2), 176 - 9
Structure of the O-specific polysaccharide of the bacterium Proteus mirabilis O29; Perepelov AV et al.; An O-specific polysaccharide was obtained by mild acid degradation of P . mirabilis O29 lipopolysaccharide (LPS) and found to contain 2-acetamido-2-deoxy-D-galactose and D-glucuronic acid (D-GlcA) in the ratio 3:1 . Studies of the polysaccharide by 1H- and 13C-NMR spectroscopy including two-dimensional correlation spectroscopy (COSY), total correlation spectroscopy (TOCSY), nuclear Overhauser effect spectroscopy (NOESY), and H-detected 1H,13C-heteronuclear multiple-quantum coherence (HMQC) experiments demonstrated the following structure of the branched tetrasaccharide repeating unit:

Vet Rec, 2000 Feb 5, 146(6), 151 - 5
Trends of antimicrobial resistance in bacterial isolates from a small animal referral hospital; Normand EH et al.; A longitudinal, retrospective investigation was made of antimicrobial resistance in bacterial isolates obtained from clinical cases in a small animal hospital between 1989 and 1997 . Isolates of Escherichia coli and Staphylococcus species were used as Gram-negative and Gram-positive indicator organisms, respectively, and the annual prevalence of antimicrobial resistance was calculated for each organism to each of nine (for E coli) and 11 (for Staphylococcus species) appropriate antimicrobials, including enrofloxacin . Using a chi-square test for trend, statistically significant, rising trends were identified in the resistance of E coli to amoxycillin (P=0.04), clavulanate-amoxycillin (P<0.01) and streptomycin (P<0.01), and in the resistance of Staphylococcus species to erythromycin (P<0.01) . There was an equivocal, rising trend for the resistance of Staphylococcus species to cephalexin . No significant trends were apparent for any of the other 15 organism/drug interactions . The annual prevalence of multiple drug resistance was calculated for E coli, Proteus species, Pseudomonas species, staphylococci and streptococci, but no statistically significant trends were identified.

J Clin Microbiol, 2000 Mar, 38(3), 1077 - 80
Evaluation of the discriminatory powers of the Dienes test and ribotyping as typing methods for Proteus mirabilis; Pfaller MA et al.; A total of 63 clinical isolates of Proteus mirabilis collected over a 19-month period were typed by the Dienes test and ribotyping . Ribotyping was performed using the fully automated RiboPrinter Microbial Characterization System (Qualicon, Wilmington, Del.) . Isolates that were indistinguishable by the Dienes test and/or ribotyping were characterized further by pulsed-field gel electrophoresis (PFGE) . Most of the isolates represented unique strains as judged by the Dienes test and ribotyping . Forty isolates represented 40 different ribotypes and Dienes types . The remaining 23 isolates were grouped into 13 Dienes types, 12 ribotypes, and 14 PFGE types . The index of discrimination was 0.980 for the Dienes test, 0.979 for ribotyping, and 0.992 for PFGE . Both the Dienes test and ribotyping are useful methods for identifying individual strains of P . mirabilis . The Dienes test is simple, inexpensive, and easy to perform . It can be performed in virtually any laboratory and should be used in the initial epidemiologic characterization of P . mirabilis isolates.

J Pharm Pharmacol, 1999 Dec, 51(12), 1455 - 60
Investigation of plants used in Jamaican folk medicine for anti-bacterial activity; Facey PC et al.; We have started a systematic scientific study of folklore medicinal plants currently used as alternative medicine in Jamaican society . In this initial study, extracts of plants widely used by the islanders are studied for antibacterial activity against five common pathogens; Streptococcus group A, Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa and Escherichia coli . These studies revealed that 25% (approx.) of the plant extracts had antimicrobial activity against at least one of the microbes used . Subsequent to these observations, extracts from Mikania micrantha were examined in detail . This led to the isolation of two sesquiterpenoids, mikanolide and dihydromikanolide, with activity against S . aureus and C . albicans . The results suggest that traditional folk medicine could be used as a guide in our continuing search for new natural products with potential medicinal properties.

Indian J Med Sci, 1999 May, 53(5), 216 - 9
Bacteriological analysis of burn sepsis; Nagoba BS et al.; A total of 114 opportunistic bacteria were isolated from 65 swabs from burn sepsis . P . aeruginosa (53.8%) was the most common agent followed by S . aureus (38.4%), Klebsiella Spp . (27.6%), Proteus (18.4%), E . coil (10.7%) and others . The infection was monobacterial in 25 cases (38.4%) and polybacterial in 49 cases (61.5%) . P . aeruginosa was predominated in both monobacterial and polybacterial infections . Ciprofloxacin (42.9%) was found to be the most effective antibacterial agent . Results indicate that resistance in burn isolates is higher and increasing day by day.

J Hazard Mater, 2000 Jan 7, 71(1-3), 439 - 48
PROTEUS, a technical and management model for aquatic risk assessment of industrial spills; Stam GJ et al.; The assessment of risks to the aquatic environment related to industrial installations is a priority in environmental pollution control in the Netherlands . Major accidents to the surface water such as the Sandoz incident, but also the high number of smaller accidents that occur every year has invoked the need for an effective method to assess these risks . Two different models have been used in this field in the Netherlands over several years . These two software applications, VERIS and RISAM were developed from two different perspectives: VERIS from the perspective of supplying major accidents related information in the safety report, RISAM form the perspective of controlling risks for both smaller and larger facilities that may pollute surface waters through accidents . Both systems comprised particular strong points: VERIS considers safety management aspects in the assessment, RISAM considers differences in surface water vulnerability and involves quantitative probabilities in the assessment . It was decided to integrate both methods and maintain these strong points in the resulting method . This paper describes the new integrated risk assessment method that now has been developed in a concerted effort between the Ministry of Transport, Public Works and Water Management, the Ministry of Housing, Spatial Planning and Environment, and the National Institute for Public Health and Environment . It also describes the essential elements of the computer program PROTEUS that is based on the new method and that makes the assessment of aquatic risks for industrial activities an easy task, partly due to the automatic generation of the assessment report.

Am J Infect Control, 2000 Feb, 28(1), 8 - 13
Microbiologic survey of long-term care facilities; Smith PW et al.; BACKGROUND: We undertook a microbiologic survey of long-term care facilities to categorize bacteria found in cultures of residents . Culture and sensitivity data were collected on 566 samples from indwelling bladder catheters, percutaneous gastrostomy tubes, nares, stool, wounds, pressure ulcers, and tracheostomies in 25 Nebraska and Iowa facilities . Information was also collected on resident factors (eg, presence of indwelling urinary catheter, prior antibiotic administration) and institutional variables (eg, number of beds, nosocomial infection rates) . RESULTS: There were 478 gram-negative isolates, the leading organisms being Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, and Klebsiella pneumoniae . There were 221 gram-positive isolates, the most frequently seen of which were enterococci and Staphylococcus aureus . Of the 442 residents sampled in the study, 168 (38%) were taking, or had within the previous month been taking, a systemic antibiotic . Quinolones were the most frequently prescribed antibiotic class . The institutional prevalence of urinary catheterization averaged 6.7% . CONCLUSIONS: Significant antibiotic pressure exists in long-term care facilities, a fact that is reflected in antibiotic resistance patterns . A variety of gram-positive and gram-negative bacteria were found in nursing home culture specimens.

J Endod, 1999 Sep, 25(9), 589 - 92
Evaluation of pigmented intraorifice barriers in endodontically treated teeth; Wolcott JF et al.; The purpose of this study was to evaluate the effectiveness of three pigmented glass ionomer cements used as intraorifice barriers to prevent coronal microleakage . One hundred ten extracted mandibular human premolars were divided into four experimental groups of 25 teeth each and two control groups of 5 teeth each . The experimental teeth were instrumented and obturated using thermoplasticized gutta-percha and AH26 sealer . Group 1 teeth received no further treatment . Teeth in groups 2 through 4 had 1 of 3 pigmented glass ionomers (Vitrebond, GC America, and Ketac-Bond) placed as an intraorifice barrier . Positive control teeth were instrumented but not obturated . The negative control teeth were instrumented, obturated, and externally sealed with epoxy resin . The coronal 3 mm of each root was sealed into the lumen of an 18-mm segment of latex surgical tubing . After the apparatus was sterilized, 2.0 ml of a 24 h growth of Proteus vulgaris in trypticase soy broth (TSB) was placed in the coronal reservoir of the tooth . The inoculated apparatus was placed into a presterilized test tube containing 1.5 ml of TSB and incubated for 90 days at 37 degrees C . The TSB in the lower reservoir was observed daily for turbidity, which would indicate leakage along the full length of the obturated root canal . To determine if differences in microbial leakage occurred among the four experimental groups, Pearson's chi 2 and Fisher's exact tests were performed . The confidence level was set at 95% . The positive and negative controls validated the microbial testing method . The teeth without an intraorifice barrier leaked significantly more than teeth with Vitrebond intraorifice barriers (p < 0.05) . The difference in leakage among the experimental glass ionomer barriers was not significant (p > 0.05).

Indian J Exp Biol, 1999 Sep, 37(9), 919 - 24
Plant beneficial effect of two strains of Proteus vulgaris isolated from tea plantations; Barthakur M et al.; Two strains of Proteus isolated from tea plantation soil were tested for their ability to colonise the roots of gram (Cicer arietinum), bean (Phaseolus radiatus) and mung (Phaseolus mungo) using a gnotobiotic system . Seeds bacterized with the two strains grew faster and showed significant increase in root and shoot enlargement of the plants tested . The bioactive fractions obtained from the culture filtrates and separated through HPLC showed that the plant growth promoting fractions were not always fungicidal and that the insecticidal fraction which was found only in RRLJ 16 was not plant growth promoting . These results suggest that the plant growth promotion effect of the plant beneficial bacteria may not always be due to disease suppression.

Fiziol Zh, 1999, 45(6), 37 - 9
{The protective activity of anti-Proteus blood preparations}; Nazarchuk LV et al.; Human blood anti-Proteus preparation activity has been studied on the model of Proteus etiology sepsis in white not pedigree mice . It has been found out that anti-Proteus plasma and anti-Proteus immunoglobulin with antibody titre 1:80 possess marked therapeutic properties . The obtained results of the experimental studies are the grounds for clinical studies carrying out with the use of blood anti-Proteus preparations in combined therapy of the patients with diseases of Proteus etiology.

Antimicrob Agents Chemother, 2000 Mar, 44(3), 622 - 32
Biochemical sequence analyses of GES-1, a novel class A extended-spectrum beta-lactamase, and the class 1 integron In52 from Klebsiella pneumoniae; Poirel L et al.; Klebsiella pneumoniae ORI-1 was isolated in 1998 in France from a rectal swab of a 1-month-old girl who was previously hospitalized in Cayenne Hospital, Cayenne, French Guiana . This strain harbored a ca . 140-kb nontransferable plasmid, pTK1, that conferred an extended-spectrum cephalosporin resistance profile antagonized by the addition of clavulanic acid, tazobactam, or imipenem . The gene for GES-1 (Guiana extended-spectrum beta-lactamase) was cloned, and its protein was expressed in Escherichia coli DH10B, where this pI-5 . 8 beta-lactamase of a ca . 31-kDa molecular mass conferred resistance to oxyimino cephalosporins (mostly to ceftazidime) . GES-1 is weakly related to the other plasmid-located Ambler class A extended-spectrum beta-lactamases (ESBLs) . The highest percentage of amino acid identity was obtained with the carbenicillinase GN79 from Proteus mirabilis; with YENT, a chromosome-borne penicillinase from Yersinia enterocolitica; and with L-2, a chromosome-borne class A cephalosporinase from Stenotrophomonas maltophilia (36% amino acid identity each) . However, a dendrogram analysis showed that GES-1 clustered within a class A ESBL subgroup together with ESBLs VEB-1 and PER-1 . Sequencing of a 7,098-bp DNA fragment from plasmid pTK1 revealed that the GES-1 gene was located on a novel class 1 integron named In52 that was characterized by (i) a 5' conserved segment containing an intI1 gene possessing two putative promoters, P(1) and P(2), for coordinated expression of the downstream antibiotic resistance genes and an attI1 recombination site; (ii) five antibiotic gene cassettes, bla(GES-1), aac(6')Ib' (gentamicin resistance and amikacin susceptibility), dfrXVb (trimethoprim resistance), a novel chloramphenicol resistance gene (cmlA4), and aadA2 (streptomycin-spectinomycin resistance); and (iii) a 3' conserved segment consisting of qacEDelta1 and sulI . The bla(GES-1) and aadA2 gene cassettes were peculiar, since they lacked a typical 59-base element . This work identified the second class A ESBL gene of a non-TEM, non-SHV series which was located in the plasmid and integron, thus providing it additional means for its spread and its expression.

J Med Microbiol, 2000 Feb, 49(2), 127 - 38
Biological activities of lipopolysaccharides of Proteus spp . and their interactions with polymyxin B and an 18-kDa cationic antimicrobial protein (CAP18)-derived peptide; St Swierzko A et al.; The saccharide constituents of lipopolysaccharides (LPS) of Proteus spp . vary with the strain and contain unique components about which little is known . The biological activities of LPS and lipid A from S- and R-forms of 10 Proteus strains were examined . LPS from all S-form Proteus strains was lethal to D-(+)-galactosamine (GalN)-loaded, LPS-responsive, C3H/HeN mice, but not to LPS-hypo-responsive C3H/HeJ mice . P . vulgaris 025 LPS evoked strong anaphylactoid reactions in N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP)-primed C3H/HeJ mice . LPS from S- and R-form Proteus strains induced production of nitric oxide (NO) and tumour necrosis factor (TNF) by macrophages isolated from C3H/HeN but not C3H/HeJ mice . Lipid A from Proteus strains also induced NO and TNF production, although lipid A was less potent than LPS . The effects of LPS were mainly dependent on CD14; LPS-induced NO and TNF production in CD14+ J774.1 cells was significantly greater than in CD14-J7.DEF.3 cells . All LPS from Proteus strains, and especially from P . vulgaris 025, exhibited higher anti-complementary activity than LPS from Escherichia coli or Pseudomonas aeruginosa . Polymyxin B inactivated proteus LPS in a dose-dependent manner, but these LPS preparations were more resistant to polymyxin B than E . coli LPS . CAP18(109-135), a granulocyte-derived peptide, inhibited proteus LPS endotoxicity only when the LPS:CAP18(109-135) ratio was appropriate, which suggests that CAP18(109-135) acts through a different mechanism than polymyxin B . The results indicate that LPS from Proteus spp . are potently endotoxic, but that the toxicity is different from that of LPS from E . coli or Salmonella spp . and even varies among different Proteus strains . The variation in biological activities among proteus LPS may be due to unique components within the respective LPS.

Biosci Biotechnol Biochem, 1999 Dec, 63(12), 2244 - 7
Cloning of L-amino acid deaminase gene from Proteus vulgaris; Takahashi E et al.; The L-amino acid degrading enzyme gene from Proteus vulgaris was cloned and the nucleotide sequence of the enzyme gene was clarified . An open reading frame of 1,413 bp starting at an ATG methionine codon was found, which encodes a protein of 471 amino acid residues, the calculated molecular weight of which is 51,518 . The amino acid sequence of P . vulgaris was 58.6% identical with the L-amino acid deaminase of P . mirabilis . A significantly conserved sequence was found around the FAD-binding sequence of flavo-proteins . The partially purified wild and recombinant enzymes had the same substrate specificity for L-amino acids to form the respective keto-acids, however not for D-amino acids.

J Ethnopharmacol, 2000 Jan, 69(1), 63 - 71
Antibacterial activity of some folklore medicinal plants used by tribals in Western Ghats of India; Samy RP et al.; A series of 30 Indian folklore medicinal plants used by tribal healers to treat infections, were screened for antibacterial properties at 10 mg/ml concentration by using disc diffusion method against Bacillus subtilis, Escherichia coli, Klebsiella aerogenes, Proteus vulgaris, Pseudomonas aerogenes and Staphylococcus aureus . Twenty plant species showed activity against one or more species of bacteria used in this assay; among them the leaf extracts of Cassia occidentalis and Cassia auriculata exhibited significant broad spectrum activity against B . subtilis and S . aureus . Ten plant species were not found active against all tested bacteria . These results were compared with results obtained using standard antibiotics, chloramphenicol (30 microg/disc) and streptomycin (30 microg/disc) which served as a reference for inhibition zone diameter.

J Dermatol, 1999 Dec, 26(12), 808 - 12
Encephalocraniocutaneous lipomatosis: a new case report and review of the literature; Romiti R et al.; Encephalocraniocutaneous lipomatosis is a rare neurocutaneous syndrome characterized by lipomatous hamartomas ranging in size from a few millimeters to several centimeters and affecting the head . Ocular anomalies and a variable degree of mental retardation with or without convulsions are usually observed . This disorder should be distinguished from other mosaic neurocutaneous phenotypes such as Proteus syndrome, oculocerebrocutaneous syndrome, and nevus sebaceous syndrome . We report the clinicopathologic findings of a 4-year-old Brazilian girl affected by this syndrome and review the literature . To our best knowledge, this is the first documented case of encephalocraniocutaneous lipomatosis occurring sporadically in South America.

Folia Med (Plovdiv), 1998, 40(3), 24 - 8
PCR studies on the presence of Chlamydia trachomatis in the upper urinary tract of patients with obstructive pyelonephritis; Dimitrakov J et al.; Chlamydia trachomatis infections are among the most common sexually transmitted diseases in the world and it is only logical to hypothesize that it alone or in association with mycoplasmas can participate in the initiation and persistence of upper urinary tract infections . Having in mind the inconclusive evidence regarding the role of C . trachomatis in upper urinary tract infections we decided to study the presence of C . trachomatis in the upper urinary tract of patients with obstructive pyelonephritis using the polymerase chain reaction . We studied 20 patients (12 female and 8 male, aged 20-60 years) with symptoms and signs of acute pyelonephritis in accordance with Kunin's criteria (1997) . Samples were taken during surgery of the upper urinary tract by aspirating urine from the renal pelvis or the ureter above the level of the obstruction and analyzed for the presence of bacterial pathogens using routine microbiological techniques and employing the "AMPLICOR CT/NG" test (Roche Diagnostic Systems, Branchburg, NJ, USA) for the presence of C . trachomatis . Chlamydia trachomatis was found in the aspirated urine of 5 patients (25%) . In 3 of the patients the microbiological tests of the aspirated urine did not establish any other microbial agent . In the other two Escherichia coli and Proteus mirabilis were cultured . The analysis of the clinical and laboratory findings in the patients with Chlamydia trachomatis infection alone and those with an associated bacterial pathogen failed to reach statistical significance . Following the operation all of the patients received treatment with Ofloxacin 200 mg bid for 7 days with a favorable clinical and laboratory outcome . In our opinion, the AMPLICOR CT/NG test is a sensitive and specific method for diagnosing low-number Chlamydia trachomatis infections of the upper urinary tract in patients with obstructive pyelonephritis . Chlamydia trachomatis should be considered as a possible etiologic agent in acute pyelonephritis and the therapeutic regimen in such patients should be targeted at its possible underlying presence.

Nippon Ronen Igakkai Zasshi, 1999 Nov, 36(11), 826 - 9
{Five cases of purple urine bag syndrome in a geriatric ward}; Ishida T et al.; We report five cases of purple urine bag syndrome (PUBS) . All the patients were women and they had been bed-ridden for a long period due to cerebrovascular diseases . They tended to be constipated as a result of habitual use of laxatives . Indicanuria was proven in the all urinary samples from the patients . The four assessable urinary cultures showed Proteus mirabilis contamination . Total days without evacuation per month in patients with PUBS and control subjects (5 catheterized subjects without PUBS) were 16.5 +/- 3.7 and 6.8 +/- 4.8, respectively (mean +/- SD), showing a significant difference (p < 0.05) . In each case, this syndrome was not considered to have affected their clinical course . We concluded that it is unnecessary to treat patients with PUBS aggressively . Control of evacuation and urological sanitation are important in these patients.

J Clin Microbiol, 2000 Feb, 38(2), 677 - 81
Problems related to determination of MICs of oximino-type expanded-spectrum cephems for Proteus vulgaris; Ohno A et al.; During in vitro susceptibility testing of clinical isolates of Proteus vulgaris, we noted that the MICs of several expanded-spectrum cephems were much higher in the broth microdilution method than in the agar dilution method (termed the MIC gap phenomenon) . Here we investigated the mechanism of the MIC gap phenomenon . Cephems with the MIC gap phenomenon were of the oximino type, such as cefotaxime, cefteram, and cefpodoxime, which serve as good substrates for inducible class A beta-lactamase (CumA) enzymes produced by P . vulgaris; this finding suggests a relationship between the MIC gap phenomenon and CumA . Since peptidoglycan recycling shares a system common to that inducing CumA, we analyzed the mechanism of the MIC gap phenomenon using P . vulgaris B317 and isogenic mutants with mutations in the peptidoglycan recycling and beta-lactamase induction systems . The MIC gap phenomenon was observed in the parent strain B317 but not in B317G (cumG-defective mutant; defective peptidoglycan recycling) and B317R (cumR-defective mutant; defective CumA transcriptional regulator) . No beta-lactamase activity was detected in B317G and B317R . beta-Lactamase activity and the MIC gap phenomenon were restored in B317G/pMD301 (strain transcomplemented by a cloned cumG gene) and B317R/pMD501 (strain transcomplemented by a cloned cumR gene) . MICs determined by the agar dilution method increased when lower agar concentrations were used . Our results indicated that the mechanism of the MIC gap phenomenon is related to peptidoglycan recycling and CumA induction systems . However, it remains unclear how beta-lactamase induction of P . vulgaris is suppressed on agar plates.

Pflugers Arch, 2000, 439(3 Suppl), R175 - 7
The ultrastructure of photoreceptor cells in the pineal organ of the blind cave salamander, Proteus anguinus (Amphibia, Urodela); Kos M et al.; We studied ultrastructure of the photoreceptor cells in the pineal organ of blind, depigmented, neotenic cave salamander, Proteus anguinus . Unlike in epigean vertebrates the outer segments of most photoreceptor cells consists of concentrically arranged lamellae, however; in few cells, the outer segments contain 7-9 plasma membrane disks . In both types of photoreceptor cells the outer segments enclose lumps of vesicles of different sizes . The photoreceptor cells of Proteus anguinus are similar to those in other cavernicolous fish species.

Pflugers Arch, 2000, 439(3 Suppl), R165 - 7
Functional morphology of the inner ear and underwater audiograms of Proteus anguinus (Amphibia, Urodela); Bulog B et al.; Octavolateral sensory organs (auditory and lateral line organs) of cave salamander Proteus anguinus are highly differentiated . In the saccular macula of the inner ear the complex pattern of hair cell orientation and the large otoconial mass enable particle displacement direction detection . Additionally, the same organ, through air cavities within the body, enables detection of underwater sound pressure changes thus acting as a hearing organ . The cavities in the lungs and mouth of Proteus are a resonators that transmit underwater sound pressure to the inner ear . Behaviourally determined audiograms indicate hearing sensitivity of 60 dB (rel . 1 microPa) at frequencies between 1 and 10 kHz . The hearing frequency range was between 10 Hz and 10 kHz . The hearing sensitivities of depigmented Proteus and black Proteus were compared . The highest sensitivities of the depigmented animals (N=4) were at frequencies 1.3-1.7 kHz and it was 2 kHz in black animals (N=1) . Excellent underwater hearing abilities of Proteus are sensory adaptations to cave habitat.

Eur J Biochem, 2000 Feb, 267(3), 815 - 20
Structure of a 2-aminoethyl phosphate-containing O-specific polysaccharide of Proteus penneri 8 from a new serogroup O67; Knirel YA et al.; An acidic O-specific polysaccharide was obtained by mild acid degradation of the Proteus penneri 8 lipopolysaccharide and found to contain D-glucose, D-galacturonic acid, 2-acetamido-2-deoxy-D-glucose, 2-acetamido-2-deoxy-D-galactose, 2-acetamido-2,6-dideoxy-L-galactose (L-FucNAc) and 2-aminoethyl phosphate (PEtn) in the ratios 2 : 1 : 1 : 1 : 1 : 1 . 1H and 13C NMR spectroscopy was applied to the intact and dephosphorylated polysaccharides, and the following structure of the hexasaccharide repeating unit was established: The O-specific polysaccharide has a unique structure, and, accordingly, we propose for P . penneri 8 a new Proteus O67 serogroup, in which this strain is at present the single representative . The nature of epitopes on LPS of P . penneri 34, P . mirabilis O16, P . mirabilis O23 and P . vulgaris O22, which cross-react with O-antiserum against P . penneri 8, is discussed.

Eur J Biochem, 2000 Feb, 267(3), 808 - 14
Structure of the O-specific polysaccharide of Proteus penneri 71 and classification of cross-reactive P . penneri strains to a new proposed serogroup O64; Zych K et al.; A neutral O-specific polysaccharide (O-antigen) was isolated from the lipopolysaccharide (LPS) of the bacterium Proteus penneri 71 . On the basis of sugar analysis and 1H- and 13C-NMR spectroscopic studies, including two-dimensional COSY, 13C,1H heteronuclear COSY and ROESY, the following structure of the trisaccharide repeating unit of the polysaccharide was established: -->3)-beta-D-GlcpNAc-(1-->4)-beta-D-GlcpNAc-(1-->3)-alpha-D-Galp-(1-- > The polysaccharide has the same carbohydrate backbone as the O-specific polysaccharide of P . penneri 19 and both are similar to that of P . penneri 62 studied by us previously . A cross-reactivity of anti-P . penneri 71, 19 and 62 O-antisera with 11 P . penneri strains was revealed and substantiated at the level of the O-antigen structures . These strains could be divided into three subgroups within a new proposed Proteus O64 serogroup containing P . penneri strains only.

Eur J Biochem, 2000 Feb, 267(3), 788 - 93
Structure of a glycerol teichoic acid-like O-specific polysaccharide of Proteus vulgaris O12; Perepelov AV et al.; A phosphorylated O-specific polysaccharide (O-antigen) was obtained by mild acid degradation of Proteus vulgaris O12 lipopolysaccharide and studied by sugar and methylation analyses, 1H-, 13C- and 31P-NMR spectroscopy, including two-dimensional COSY, TOCSY, NOESY, H-detected 1H, 13C and 1H, 31P heteronuclear multiple-quantum coherence experiments . It was found that the polysaccharide consists of pentasaccharide repeating units connected via a glycerol phosphate group, and has the following structure: where FucNAc is 2-acetamido-2,6-dideoxygalactose and the degree of O-acetylation at position 4 of GalNAc is approximately 25% . Immunochemical studies with P . vulgaris O12 O-antiserum suggested that the lipopolysaccharide studied shares common epitopes with the lipopolysaccharide core of P . vulgaris O8 and with the O-antigens of P . penneri strains 8 and 63.

J Nat Prod, 2000 Jan, 63(1), 41 - 3
Biosynthetically diverse compounds from a saltwater culture of sponge-derived Aspergillus niger; Varoglu M et al.; The new compound, asperic acid (1), and the known compounds hexylitaconic acid (2), malformin C (3), pyrophen (4), and asperazine (5) were isolated from the saltwater culture of Aspergillus niger derived from a Caribbean sponge, Hyrtios proteus . The structure elucidation of asperic acid is presented.

Nat Biotechnol, 2000 Jan, 18(1), 97 - 100
Insertional transposon mutagenesis by electroporation of released Tn5 transposition complexes; Goryshin IY et al.; DNA transposition is an important biological phenomenon that mediates genome rearrangements, inheritance of antibiotic resistance determinants, and integration of retroviral DNA . Transposition has also become a powerful tool in genetic analysis, with applications in creating insertional knockout mutations, generating gene-operon fusions to reporter functions, providing physical or genetic landmarks for the cloning of adjacent DNAs, and locating primer binding sites for DNA sequence analysis . DNA transposition studies to date usually have involved strictly in vivo approaches, in which the transposon of choice and the gene encoding the transposase responsible for catalyzing the transposition have to be introduced into the cell to be studied (microbial systems and applications are reviewed in ref . 1) . However, all in vivo systems have a number of technical limitations . For instance, the transposase must be expressed in the target host, the transposon must be introduced into the host on a suicide vector, and the transposase usually is expressed in subsequent generations, resulting in potential genetic instability . A number of in vitro transposition systems (for Tn5, Tn7, Mu, Himar1, and Ty1) have been described, which bypass many limitations of in vivo systems . For this purpose, we have developed a technique for transposition that involves the formation in vitro of released Tn5 transposition complexes (TransposomesTM) followed by introduction of the complexes into the target cell of choice by electroporation . In this report, we show that this simple, robust technology can generate high-efficiency transposition in all tested bacterial species (Escherichia coli, Salmonella typhimurium, and Proteus vulgaris) We also isolated transposition events in the yeast Saccharomyces cerevisiae.

J Formos Med Assoc, 1999 Dec, 98(12), 844 - 50
Use of polymerase chain reaction to detect Proteus mirabilis and Ureaplasma urealyticum in urinary calculi; Huang HS et al.; In this study, we evaluated the efficacy of the polymerase chain reaction (PCR) in detecting urea-splitting microorganisms in desiccated urinary tract infection stones . Seventy-eight urinary tract stones were tested for the presence of Proteus mirabilis and Ureaplasma urealyticum by means of PCR with species-specific primers . Twenty-seven stone samples were composed of struvite and/or carbonate apatite (infection stone); 40 were calcium oxalate and/or calcium phosphate; seven were mixed, with struvite/carbonate apatite and calcium oxalate; and four were uric acid stones . PCR was performed with DNA extracted from pulverized stone pieces . Initial assays using the pulverized stone specimens spiked with microorganisms showed that PCR could not detect U . urealyticum at densities below 10(3) color changing units (CCU), or P . mirabilis at densities below 10(4) colony-forming units (CFU) . PCR was negative for U . urealyticum and P . mirabilis in all metabolic stones from patients . P . mirabilis was detected by PCR in 10 of 34 patients with infection stones . Preoperative urine cultures grew P . mirabilis in three of these 10 patients, and were negative for P . mirabilis in the other seven . U . urealyticum was detected by PCR in stone samples from four patients, two of which were also PCR-positive for P . mirabilis . All four of these patients had infection stones: two had residual stones, and the other two had recurrence of urinary stones after their operations . These results demonstrate that microorganisms in urinary stones can be detected by PCR even when the voided urine culture is negative . Investigations into the role of bacterial infection in stone formation will require further improvements in the sensitivity of PCR assays for pathogen detection.

Eur J Biochem, 2000 Jan, 267(2), 601 - 5
Structure of a 2-aminoethyl phosphate-containing O-specific polysaccharide of Proteus penneri 63 from a new serogroup O68; Shashkov AS et al.; Lipopolysaccharide of Proteus penneri strain 63 was degraded by mild acid to give a high molecular mass O-specific polysaccharide that was isolated by gel-permeation chromatography . Sugar and methylation analyses and NMR spectroscopic studies, including two-dimensional 1H, 1H COSY, TOCSY rotating-frame NOE spectroscopy, H-detected 1H,13C and 1H,31P heteronuclear multiple-quantum coherence (HMQC), and 1H, 13C HMQC-TOCSY experiments, demonstrated the following structure of the polysaccharide: where FucNAc is 2-acetamido-2,6-dideoxygalactose and PEtn is 2-aminoethyl phosphate . The polysaccharide studied shares some structural features, such as the presence of D-GlcNAc6PEtn and an alpha-L-FucNAc-(1-->3)-D-GlcNAc disaccharide, with other Proteus O-specific polysaccharides . A marked cross-reactivity of P . penneri 63 O-antiserum with P . vulgaris O12 was observed and substantiated by a structural similarity of the O-specific polysaccharides of the two strains . In spite of this, the polysaccharide of P . penneri 63 has the unique structure among Proteus O-antigens, and therefore a new, separate serogroup, O68, is proposed for this strain.

J Bacteriol, 2000 Jan, 182(2), 385 - 93
Dynamic aspects of the structured cell population in a swarming colony of Proteus mirabilis; Matsuyama T et al.; Proteus mirabilis forms a concentric-ring colony by undergoing periodic swarming . A colony in the process of such synchronized expansion was examined for its internal population structure . In alternating phases, i.e., swarming (active migration) and consolidation (growth without colony perimeter expansion), phase-specific distribution of cells differing in length, in situ mobility, and migration ability on an agar medium were recognized . In the consolidation phase, the distribution of mobile cells was restricted to the inner part of a new ring and a previous terrace . Cells composing the outer part of the ring were immobile in spite of their ordinary swimming ability in a viscous solution . A sectorial cell population having such an internal structure was replica printed on fresh agar medium . After printing, a transplant which was in the swarming phase continued its ongoing swarming while a transplanted consolidation front continued its scheduled consolidation . This shows that cessation of migration during the consolidation phase was not due to substances present in the underlying agar medium . The ongoing swarming schedule was modifiable by separative cutting of the swarming front or disruption of the ring pattern by random mixing of the pattern-forming cell population . The structured cell population seemed to play a role in characteristic colony growth . However, separation of a narrow consolidation front from a backward area did not induce disturbance in the ongoing swarming schedule . Thus, cells at the frontal part of consolidation area were independent of the internal cell population and destined to exert consolidation and swarming with the ongoing ordinary schedule.

Khirurgiia (Mosk), 1999, (12), 10 - 2
{Surgical policy in false aneurysm of proximal anastomosis secondary to reconstruction of aortofemoral segment}; Butylkin AA et al.; The results of surgical treatment of 10 patients with a false aneurysm of the proximal anastomosis are analyzed . An average time for development of a false aneurysm made up 57.2 months . Fluorlon-lavsan vascular woven prosthesis of Russian produce was used in primary reconstruction . Bacteriological examination of operation material was carried out in 9 patients . 8 cases revealed the growth: of Staph . aureus (4) epidermal staphylococcus flora (3) and Proteus vulg . (1) . The authors suggest that surgical treatment of patients with false aneurysms of the proximal anastomosis should consist in resection of the aneurysms and revascularization of the extremities from the proximal segment of the aorta with partial or total removal of the old vascular prosthesis . The application of this method in 7 patients allowed to avoid the repeated development of false aneurysms during a mean follow up period of 4.1 years.

Microbios, 1999, 99(392), 45 - 53
Stimulatory effects of endotoxin on the platelet secretory process; Saluk-Juszczak J et al.; The effects of the lipopolysaccharides (LPS) of Proteus mirabilis (smooth and rough types), differing significantly in their composition on the release of compounds stored in specific platelet granules, were studied . There are two main types of secretory granules in blood platelets . Dense granules contain adenine nucleotides, and in alpha-granules different proteins are stored . The LPS were found to cause a dose-dependent release of proteins and adenine nucleotides . In the extracellular medium LDH activity was not present . The results presented in this study indicate that LPS from P . mirabilis act directly on blood platelets and induce the platelet secretory process . In comparison with thrombin, a strong platelet agonist, the action of the endotoxins tested was weak.

Tokai J Exp Clin Med, 1998 Dec, 23(6), 273 - 8
Interactions of "Limax amoebae" and gram-negative bacteria: experimental studies and review of current problems; Walochnik J et al.; Free-living amoebae can harbour bacteria inside their cysts giving them a microhabitat and protecting them from disinfectants . The aim of this study was to evaluate the potential importance of "Limax amoebae" as vectors for environmental and nosocomial bacteria in a hospital . It was shown that free-living amoebae are ubiquitous in the investigated hospital, occur syntopically with facultative human pathogens (Comamonas acidovorans and Pseudomonas aeruginosa) and may serve as hosts not only for these but also for bacteria isolated from clinical specimens (Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa); temperature is apparently of crucial importance for the interactions between these microorganisms . Recent studies have shown that "Limax amoebae" apart from acting as protective hosts, may also play a role for the thermotolerance, invasiveness and antibiotic-resistance of bacteria . Considering also the reduced immune-status of many patients, this "symbiosis" of free-living amoebae and bacteria might still be of underestimated hospital-hygienic importance.

FEMS Microbiol Lett, 2000 Jan 15, 182(2), 313 - 7
Synthesis of cefminox by cell-free extracts of Streptomyces clavuligerus; Kim JK et al.; In vitro synthesis of cefminox by cell-free extracts of Streptomyces clavuligerus was investigated using alpha-ketoglutarate, L-ascorbic acid, FeSO(4), S-adenosyl-L-methionine, and 7alpha-demethoxycefminox as the substrates . The formation of cefminox was detected both by a biological assay with Proteus vulgaris GN 76/C-1 and by high performance liquid chromatography . Although the conversion rate of 7alpha-demethoxycefminox to cefminox was observed to be quite low, it still demonstrated the potential for an enzymatic process to replace the chemical steps which are currently in use for the production of cefminox.

FEMS Microbiol Lett, 2000 Jan 15, 182(2), 213 - 8
Introduction of a mini-gene encoding a five-amino acid peptide confers erythromycin resistance on Bacillus subtilis and provides temporary erythromycin protection in Proteus mirabilis; Novikova SI et al.; A 15-bp mini-gene was introduced into Bacillus subtilis and into stable protoplast-like L-forms of Proteus mirabilis . This mini-gene encoded the peptide MVLFV and modeled a fragment of Escherichia coli 23S rRNA responsible for E . coli erythromycin (Ery) resistance . Expression of the introduced mini-gene conferred permanent Ery resistance on B . subtilis . In L-forms of P . mirabilis, the Ery-protective effect was maintained in the course of several generations . Herewith, the mechanism of Ery resistance mediated by expression of specific short peptides was shown to exist in evolutionary distant bacteria . Three new plasmids were constructed containing the gene under study transcriptionally fused with the genes encoding glutamylendopeptidase of Bacillus licheniformis or delta-endotoxin of Bacillus thuringiensis . The Ery resistance pentapeptide (E-peptide) mini-gene served as an efficient direct transcriptional reporter and allowed to select bacillar glutamylendopeptidase with improved productivity . The mini-genes encoding E-peptides may be applied as selective markers to transform both Gram-positive and Gram-negative bacteria . The small size of the E-peptide mini-genes makes them attractive selective markers for vector construction.

J Ethnopharmacol, 1999 Nov 1, 67(2), 197 - 202
Isolation and antibacterial activity of phenylpropanoid derivatives from Ballota nigra; Didry N et al.; In addition to the previously isolated phenylpropanoid glycosides verbascoside 1, forsythoside B 2, arenarioside 3 and ballotetroside 4, another four compounds were isolated from generative aerial parts of Ballota nigra: three phenylpropanoid glycosides, alyssonoside 5, lavandulifolioside 6 and angoroside A 7 and a non-glycosidic derivative (+)-(E)-caffeoyl-L-malic acid 8 . The antibacterial activity of the five major compounds (1-4 and 8) was tested against gram-positive and gram-negative bacteria . Three of them (1-3) exhibited a moderate antimicrobial activity against Proteus mirabilis and Staphylococcus aureus including one methicillin-resistant strain.

Cell Motil Cytoskeleton, 2000 Jan, 45(1), 10 - 26
Immediate and long-term galvanotactic responses of Amoeba proteus to dc electric fields; Korohoda W et al.; The long-term and immediate galvanotactic responses of Amoeba proteus to the direct current electric fields (dcEFs) were studied with the methods of computer-aided image analysis . It was found that in contrast to earlier reports, amoebae continued locomotion towards cathode (the negative pole) for hours and the increase in the field strength in the range 300-600 mV/mm caused the straightening of cell trajectories accompanied by the decreased frequency of the lateral pseudopods formation and lesser change in the speed of cell movement . In the cell regions pointing to the anode, the formation of new pseudopodia was prevented and the higher cEFs strength the more extended were the regions in which formation of new pseudopods was inhibited . Replacement of calcium with magnesium in the extracellular medium reduced the galvanotactic cell responses . Research on the localisation and kinetics of the primary cell responses to the dcEF or to change in its direction revealed that the primary cell responses occurred at the anode oriented cell regions . The cell response to the field reversal appeared to be localised and to take place in less than 1 sec . First the retraction and withdrawal of the anode-directed pseudopodium was observed whereas the uroid (cell tail) moved for 10-40 sec in the original direction before it begun to react to the field reversal . The exposure of amoebae to the dcEFs sensitised them to the reversion in the field direction and induced an acceleration of cell responses . The results presented are difficult to reconcile with the attempt to explain the cell galvanotaxis as a consequence of the membrane protein lateral electrophoresis or electroosmosis . It is suggested that the lateral electrophoresis of ions and the modification of ionic conditions at the vicinity of ion channels may be involved in the induction of fast responses of cells to external dcEFs .

Eur J Biochem, 2000 Jan, 267(1), 262 - 9
The structure of the carbohydrate backbone of core-lipid A region ofthe lipopolysaccharides from Proteus mirabilis wild-type strain S1959 (serotype O3) and its Ra mutant R110/1959; Vinogradov E et al.; The following structure of core-lipid A region of the lipopolysaccharide (LPS) from Proteus mirabilis strain 1959 (serotype O3) and its rough mutant R110/1959 (Proteus type II core) was determined using NMR and chemical analysis of the core oligosaccharide, obtained by mild acid hydrolysis of LPS, and of the products of alkaline deacylation of the LPS: Incomplete substitutions are indicated by italics . All sugars are in pyranose form, alpha-Hep is the residue Lglycero-alpha-Dmanno-Hep, alpha-DD-Hep is the residue Dglycero-alpha-Dmanno-Hep . The differences with the previously reported structures are discussed.

Neuroradiology, 1999 Nov, 41(11), 840 - 3
Proteus syndrome: craniofacial and cerebral MRI; DeLone DR et al.; The Proteus syndrome is a rare hamartoneoplastic syndrome that may affect the brain, skull, and extracranial head and neck . We present a case with severe, characteristic findings . Brain abnormalities are not common in Proteus syndrome; when present, hemimegalencephaly and migrational disorders are typically seen, commonly with an associated seizure disorder . Maxillary and mandibular dysmorphism may occur, including unilateral condylar hyperplasia . Subcutaneous fatty, fibrous, lymphangiomatous masses commonly seen in this syndrome may involve the neck and face, leading to disfigurement and potential airway compromise.

J Microsc, 1999 Oct, 196 ( Pt 1), 74 - 8
An exploration of the accuracy of an invasive method for measuring the volume of specimens of Amoeba proteus; Whalen TA et al.; A method is described for measuring the volume of individual specimens of Amoeba proteus which utilizes an easily constructed compressor to flatten the specimen to a known thickness . The microscopic image of the flattened specimen is captured on tape, digitized and analysed with the NIH Image software . The results from one specimen are given to illustrate the sources and magnitude of errors affecting these volume measurements.

Radiats Biol Radioecol, 1999 Sep-Oct, 39(5), 563 - 7
{Advances and prospects of a combined therapy of acute radiation injury in experiments}; Chertkov KS et al.; We present the results of a long-standing experimental development of ways and means for acute radiation sickness treatment that have been authorized for application in medicine and are mostly aimed at large-scale accidental injuries . The paper describes means for early treatment (prodigiosan, desoxynate, typhoid vaccine, proteus vaccine), a myeolopoiesis stimulant (estradiol dipropionate), a detoxication procedure (hemosorption), substitution therapy with bone marrow cells and peripheral blood mononuclears, anti-infectious schemes comprising antibiotics and polyvitamins.

Carbohydr Res, 1999 Aug 15, 320(3-4), 239 - 43
The structure of the core part of Proteus vulgaris OX2 lipopolysaccharide; Vinogradov E et al.; The identity of a novel structural component, an open-chain acetalic linkage, in the core part of the lipopolysaccharide (LPS) from Proteus vulgaris serotype OX2 has been determined by extensive NMR spectroscopic analysis of fragments isolated after mild acid hydrolysis of the intact LPS . The open-chain N-acetylgalactosamine fragment is substituted in the 4-position by non-stoichiometric amounts of a beta-galactopyranose residue and the overall structure of the core is as follows: {formula: see text} All sugars except the N-acetylgalactosamine are in the pyranose form, alpha-Hep refers to L-glycero-alpha-D-manno-heptopyranose and alpha-DDHep to D-glycero-alpha-D-manno-heptopyranose . Bold italics indicate non-stoichiometric substituents.

Infect Immun, 1999 Dec, 67(12), 6683 - 7
Serum immunoglobulin response and protection from homologous challenge by Proteus mirabilis in a mouse model of ascending urinary tract infection; Johnson DE et al.; We tested the hypothesis that experimental Proteus mirabilis urinary tract infection in mice would protect against homologous bladder rechallenge . Despite production of serum immunoglobulin G (IgG) and IgM (median titers of 1:320 and 1:80, respectively), vaccinated (infected and antibiotic-cured) mice did not show a decrease in mortality upon rechallenge; the survivors experienced only modest protection from infection (mean log(10) number of CFU of P . mirabilis Nal(r) HI4320 per milliliter or gram in vaccinated mice versus sham-vaccinated mice: urine, 100-fold less {3.5 versus 5.5; P = 0.13}; bladder, 100-fold less {3.1 versus 5.1; P = 0.066}; kidneys, 40-fold less {2.7 versus 4.3; P = 0.016}) . Western blots using protein from the wild-type strain and isogenic mutants demonstrated antibody responses to MR/P and PMF fimbriae and flagella . There was no correlation between serum IgG or IgM levels and protection from mortality or infection . There was a trend toward elevated serum IgA titers and protection from subsequent challenge (P >/= 0.09), although only a few mice developed significant serum IgA levels . We conclude that prior infection with P . mirabilis does not protect significantly against homologous challenge.

J Trauma, 1999 Nov, 47(5), 912 - 7
Effect of thermal injury with Pseudomonas aeruginosa infection on pulmonary and systemic bacterial clearance; Wilkinson RA et al.; BACKGROUND: Despite improvements in burn wound care, infections, particularly pneumonia, remain a major hurdle to recovery from thermal injury . After burns, a variety of systemic immune and inflammatory changes contribute to the risk of infection . Clinically, infection coupled with burn injury seems to adversely affect susceptibility to subsequent infection . METHODS: Using a mouse model of 10% total body surface area, full-thickness, third-degree burns with quantitative bacterial cultures of multiple tissues, the effect of graded intratracheal and intraperitoneal infections with Pseudomonas aeruginosa on the development of infection was assessed . RESULTS: P . aeruginosa infection of blood and lung were demonstrated in burned mice 4 hours after they received 1 to 7.2x10(5) P . aeruginosa intratracheally but not in unburned control mice . Disseminated infection from endogenous bacterial species (Proteus, Enterococcus, Streptococcus) involving the lungs, liver, blood, and subeschar space was observed in mice that received both burns and infection with P . aeruginosa (intraperitoneally and intratracheally) but not with infection or burn alone (p<0.01) . After burns, pulmonary bacterial clearance was delayed in association with both pulmonary infection (7.2x10(5) P . aeruginosa intratracheally) and intraperitoneal infection (10(7) P . aeruginosa intraperitoneally) . Histologically, diffuse pneumonitis was observed in mice that received burns and infection but not in mice with either infection or burns alone . CONCLUSION: Small thermal injuries coupled with transient infection of the lungs or peritoneum delay the clearance of bacteria from the lungs and contribute to infection of the lungs, liver, burn site, and blood by endogenous organisms . These studies support the synergy of relatively small thermal injuries with infectious exposures in the pathogenesis of pneumonia and systemic infections after burns.

J Am Optom Assoc, 1999 Oct, 70(10), 661 - 5
Preseptal cellulitis secondary to Proteus species: a case report and review; Sears JM et al.; BACKGROUND: Preseptal cellulitis is a serious ocular condition that--if left untreated--has the potential to cross the septal barrier, spread to the posterior orbit, and may result in fatal complications . Because it is difficult to determine the pathogen responsible for any cellulitis without aspirating a culture sample, treatment is usually instituted by an assumption of the most common causative organisms, Staphylococcus or Streptococcus . CASE REPORT: A 42-year-old black woman manifested signs and symptoms consistent with right preseptal cellulitis . Throughout treatment, visual acuity remained 20/20 for both eyes, extraocular muscles were unrestricted without pain, and anterior globe structures were clear . The patient was started on a regimen of 250-mg oral dicloxacillin four times a day . When no response was seen at 36 hours, the patient was changed to 500-mg oral ciprofloxacin every 12 hours . She responded to the 500-mg ciprofloxacin and recovered with no sequelae . An abscess, which had formed during the cellulitis, self expressed and this material was cultured . The cultures identified the responsible organism as Proteus species, an unexpected pathogen in a well-groomed patient . CONCLUSION: This case demonstrates the need to consider alternate pathogens when treating preseptal cellulitis, change medications accordingly, and consider alternate treatments as needed.

Antimicrob Agents Chemother, 1999 Nov, 43(11), 2671 - 7
Diversity of TEM mutants in Proteus mirabilis; Bonnet R et al.; In a survey of resistance to amoxicillin among clinical isolates of Proteus mirabilis, 10 TEM-type beta-lactamases were characterized: (i) the well-known penicillinases TEM-1 and TEM-2, the extended-spectrum beta-lactamases (ESBLs) TEM-3 and TEM-24, and the inhibitor-resistant TEM (IRT) TEM-44 and (ii) five novel enzymes, a penicillinase TEM-57 similar to TEM-1, an ESBL TEM-66 similar to TEM-3, and three IRTs, TEM-65, TEM-73, and TEM-74 . The penicillinase TEM-57 and the ESBL TEM-66 differed from TEM-1 and TEM-3, respectively, by the amino acid substitution Gly-92-->Asp (nucleotide mutation G-477-->A) . This substitution could have accounted for the decrease in pIs (5.2 for TEM-57 and 6.0 for TEM-66) but did not necessarily affect the intrinsic activities of these enzymes . The IRT TEM-65 was an IRT-1-like IRT (Cys-244) related to TEM-2 (Lys-39) . The two other IRTs, TEM-73 and TEM-74, were related to IRT-1 (Cys-244) and IRT-2 (Ser-244), respectively, and harbored the amino acid substitutions Leu-21-->Phe and Thr-265-->Met . In this study, the ESBLs TEM-66, TEM-24, and TEM-3 were encoded by large (170- to 180-kb) conjugative plasmids that exhibited similar patterns after digestion and hybridization with the TEM and AAC(6')I probes . The three IRTs TEM-65, TEM-73, and TEM-74 were encoded by plasmids that ranged in size from 42 to 70 kb but for which no transfer was obtained . The characterization of five new plasmid-mediated TEM-type beta-lactamases and the first report of TEM-24 in P . mirabilis are evidence of the wide diversity of beta-lactamases produced in this species and of its possible role as a beta-lactamase-encoding plasmid reservoir.

Clin Dysmorphol, 1999 Oct, 8(4), 283 - 6
A child with hemimegalencephaly, hemihypertrophy, macrocephaly, cutaneous vascular malformation, psychomotor retardation and intestinal lymphangiectasia--a diagnostic dilemma; Thong MK et al.; Although the clinical delineation of the majority of overgrowth syndromes is straightforward, we believe there is a subset of patients with overlapping features from a number of overgrowth syndromes . We report a patient with hemimegalencephaly, hemihypertrophy, macrocephaly, vascular lesions, psychomotor retardation and intestinal lymphangiectasia . The clinical history and findings posed a diagnostic dilemma as the features overlapped between several conditions, namely macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC), Klippel-Trenaunay-Weber syndrome (KTWS), Proteus syndrome and a provisional unique syndrome described by Reardon et al . (1996, Am J Med Genet 66:144-149) . We anticipate that only when the molecular basis is delineated will it become clear whether these disorders are separate entities or merely differing ends of the same spectrum.

Infect Immun, 1999 Nov, 67(11), 6104 - 8
Identification and molecular analysis of the gene encoding Rickettsia typhi hemolysin; Radulovic S et al.; Rickettsia typhi, the causative agent of murine typhus, grows directly within the host cell cytoplasm, accumulating a large number of progeny, and eventually lyses the cells . Typhus group rickettsiae (R . typhi and R . prowazekii) adhere to and lyse human and sheep erythrocytes . However, the molecular mechanism underlying erythrocyte lysis by R . typhi has not been defined . Here we describe the cloning and nucleotide sequence analysis of the gene (tlyC) encoding a hemolysin from R . typhi . DNA sequence analysis of R . typhi tlyC revealed an open reading frame of 912 bp, which encodes a protein of 304 amino acids with a predicted molecular mass of 38 kDa . To associate the R . typhi tlyC gene product with hemolytic activity, we performed complementation studies with hemolysin-negative Proteus mirabilis WPM111 (a HpmA(-) mutant of BA6163) transformed with R . typhi tlyC or R . typhi GFPuv-tlyC constructs . We demonstrated that the cloned tlyC gene conferred a hemolytic phenotype on an otherwise nonhemolytic mutant of P . mirabilis . The availability of the cloned R . typhi tlyC will permit further characterization and definition of its role in rickettsial virulence.

J Urol, 1999 Nov, 162(5), 1666 - 9
Proteus mirabilis viability after lithotripsy of struvite calculi; Prabakharan S et al.; PURPOSE: We tested the hypotheses that Proteus mirabilis viability of struvite calculi differs after exposure to different lithotripsy modalities and that the photothermal mechanism of holmium:YAG lithotripsy is antibacterial . MATERIALS AND METHODS: Human calculi of known struvite composition (greater than 90% magnesium ammonium phosphate hexohydrate) were incubated with P . mirabilis . Calculi were randomly distributed and fragmented with no lithotripsy (controls), or shock wave, intracorporeal ultrasonic, electrohydraulic, pneumatic, holmium:YAG or pulsed dye laser lithotripsy . After lithotripsy fragments were sonicated and specimens were serially plated for 48 hours at 38C . Bacterial counts and the rate of bacterial sterilization were compared . RESULTS: Median bacterial counts (colony-forming units per ml.) were 8 x 10(6) in controls and 3 x 10(6) in shock wave, 3 x 10(7) in ultrasonic, 4 x 10(5) in electrohydraulic, 8 x 10(6) in pneumatic, 5 x 10(4) in holmium:YAG and 1 x 10(6) in pulsed dye laser lithotripsy cases (p <0.001) . The rate of bacterial sterilization was 50% for holmium:YAG lithotripsy treated stones versus 0% for each of the other cohorts (p <0.01) . CONCLUSIONS: P . mirabilis viability varies among lithotrites . The photothermal mechanism of holmium:YAG lithotripsy is antibacterial.

Amino Acids, 1999, 17(2), 207 - 26
Evolutionary changes reflected by the cellular amino acid composition; Sorimachi K; Comparison of the amino acid composition of cell-proteins using 17 amino acids has been used to investigate the biological evolution of organisms such as bacteria, blue-green alga, green alga, fungi, slime mold, protozoa and vertebrates . The degree of difference in the amino acid ratios between any two groups reflects the degree of divergency in biological evolution . The amino acid composition of the Gram-negative bacteria (Escherichia coli, Klebsiella, Proteus, and Vibrio alginolyticus) was identical . However, the amino acid composition of Staphylococcus aureus and Bacillus subtilis, which are Gram-positive bacteria, differed from each other and from the Gram-negative bacteria . The amino acid composition of the blue-green alga (Cyanobacterium, Chroococidiopsis) was quite similar to that of E . coli . A marked difference in the amino acid composition was observed between E . coli and green alga (Chlorella), and significant differences were observed between E . coli and other organisms, such as fungi, protozoa (Tetrahymena), slime mold (Dictyostelium discoideum) and vertebrates . In conclusion, the change in cellular amino acid composition reflects the divergence which has occurred during biological evolution, whereas a basic pattern of amino acid composition is maintained in spite of a long period of evolutional divergence among the various organisms . Thus, it is proposed that the primitive life forms established at the end of prebiotic evolution had a similar amino acid composition.

Biochemistry, 1999 Oct 12, 38(41), 13643 - 53
Molecular mechanisms of interaction of rabbit CAP18 with outer membranes of gram-negative bacteria; Gutsmann T et al.; The mechanism of interaction of the cationic antimicrobial protein (18 kDa), CAP18, with the outer membrane of Gram-negative bacteria was investigated applying transmission electron microscopy and voltage-clamp techniques on artificial planar bilayer membranes . Electron micrographs of bacterial cells exposed to CAP18 showed damage to the outer membrane of the sensitive Escherichia coli strains F515 and ATCC 11775, whereas the membrane of the resistant Proteus mirabilis strain R45 remained intact . Electrical measurements on various planar asymmetric bilayer membranes, one side consisting of a phospholipid mixture and the other of different phospholipids or of lipopolysaccharide (reconstitution model of the outer membrane), yielded information about the influence of CAP18 on membrane integrity . Addition of CAP18 to the side with the varying lipid composition led to lipid-specific adsorption of CAP18 and subsequent induction of current fluctuations due to the formation of transient membrane lesions at a lipid-specific clamp voltage . We propose that the applied clamp voltage leads to reorientation of CAP18 molecules adsorbed to the bilayer into an active transmembrane configuration, allowing the formation of lesions by multimeric clustering.

Carbohydr Res, 1999 Jun 30, 319(1-4), 199 - 203
Structure of an acidic O-specific polysaccharide of Proteus mirabilis O5; Shashkov AS et al.; The following structure of the O-specific polysaccharide of Proteus mirabilis O5 was established by 1H and 13C NMR spectroscopy at 500 MHz, including two-dimensional COSY, TOCSY, NOESY, and H-detected 1H, 13C heteronuclear multiple-quantum coherence (HMQC) experiments: {formula: see text} where O-acetylation of alpha-D-GlcNAc at both positions is nonstoichiometric.

Carbohydr Res, 1999 Jun 30, 319(1-4), 92 - 101
The structure of the core part of Proteus mirabilis O27 lipopolysaccharide with a new type of glycosidic linkage; Vinogradov E et al.; The structural assignment of the intact lipopolysaccharide core from Proteus mirabilis O27 has been completed based on a combination of chemical degradation studies, NMR spectroscopy and ES-MS spectroscopy . The overall core structure is as follows: {formula: see text} where all sugars are in the pyranose form except the N-acetylglycosamine residue, Hep refers to L-glycero-alpha-D-manno-heptopyranose and alpha-DDHep to D-glycero-alpha-D-manno-heptopyranose . Bold italics indicate non-stoichiometric substituents . A new type of glycosidic linkage has been discovered wherein a GalNAc residue is linked as an open form acetal to the 4- and 6-positions of a 2-amino-2-deoxygalactopyranose residue . This structural element is abbreviated GaloNAc-4,6-, where the 'o' indicates the open form of the sugar residue.

Carbohydr Res, 1999 May 31, 318(1-4), 186 - 92
Structure and cross-reactivity of the O-antigen of Proteus vulgaris O8; Perepelov AV et al.; A high-molecular-mass O-specific polysaccharide was obtained by mild acid degradation of Proteus vulgaris O8 lipopolysaccharide followed by gel permeation chromatography . Studies of the polysaccharide by sugar and methylation analyses and 1H and 13C NMR spectroscopy, including 2D COSY, TOCSY, NOESY, and H-detected 1H, 13C heteronuclear multiple-quantum coherence (HMQC) experiments, demonstrated the presence of a tetrasaccharide repeating unit having the following structure: {sequence: see text} The role of an epitope associated with the alpha-L-FucpNAc-(1-->3)-D-GlcpNAc disaccharide in serological cross-reactivity of P . vulgaris O8 is discussed.

Carbohydr Res, 1999 May 31, 318(1-4), 146 - 53
Structure of a new acidic O-antigen of Proteus vulgaris O22 containing O-acetylated 3-acetamido-3,6-dideoxy-D-glucose; Toukach FV et al.; The acidic O-specific polysaccharide of Proteus vulgaris O22 was studied using 1H and 13C NMR spectroscopy, including 2D COSY, TOCSY, NOESY, and H-detected 1H, 13C heteronuclear multiple-quantum coherence (HMQC) experiments, and the following structure for the branched pentasaccharide repeating unit was established: {sequence: see text} where Qui3NAc is 3-acetamido-3,6-dideoxyglucose, O-acetylation of QuiNAc at position 4 is stoichiometric and at position 2 nonstoichiometric . Serological relationships of P . vulgaris O22 with some other Proteus strains were substantiated on the level of the O-antigen structures.

Lancet, 1999 Oct 2, 354(9185), 1169 - 73
Association of Rickettsia helvetica with chronic perimyocarditis in sudden cardiac death; Nilsson K et al.; BACKGROUND: Rickettsia helvetica is the only non-imported rickettsia found in Scandinavia . It was first detected in Ixodes ricinus ticks, but has never been linked to human disease . We studied two young Swedish men who died of sudden cardiac failure during exercise, and who showed signs of perimyocarditis similar to those described in rickettsial disease . METHODS: Samples from the heart and other organs were analysed by PCR and DNA sequencing . May-Grunwald-Giemsa, Grocott, and acridine-orange stains were used for histopathological examinations . Staining of R . helvetica grown on shell-vials in vero cells, and the early descriptions of R . rickettsii by H T Ricketts and S B Wohlbach served as controls . Immunohistochemistry was done with Proteus OX-19 rabbit antisera as the primary antibody . The structure of rickettsia-like organisms was investigated by transmission electron microscopy . Serological analyses were carried out by indirect immunofluorescence with R . helvetica as the antigen . FINDINGS: By use of a semi-nested PCR, with primers specific for the 16S rRNA and 17-kDa outer-membrane-protein genes, and sequence analysis of the amplified products, genetic material from R . helvetica was detected in the pericardium and in a lymph node from the pulmonary hilum in case 1, and in a coronary artery and the heart muscle in case 2 . A serological response in case 1 revealed an endpoint titre for R . helvetica of 1/320 (1/256 with R . rickettsii as the antigen) . Examination of PCR-positive tissue showed chronic interstitial inflammation and the presence of rickettsia-like organisms predominantly located in the endothelium . These organisms reacted with Proteus OX-19 antisera, and their size and form were consistent with rickettsia . Electron microscopy confirmed that the appearance of the organisms was similar to that described for spotted-fever rickettsia . INTERPRETATION: R . helvetica, transmitted by I . ricinus ticks, may be an important pathogen in the aetiology of perimyocarditis, which can result in sudden unexpected cardiac death in young people.

Infect Immun, 1999 Oct, 67(10), 5106 - 16
Genomic subtractive hybridization and selective capture of transcribed sequences identify a novel Salmonella typhimurium fimbrial operon and putative transcriptional regulator that are absent from the Salmonella typhi genome; Morrow BJ et al.; Salmonella typhi, the etiologic agent of typhoid fever, is adapted to the human host and unable to infect nonprimate species . The genetic basis for host specificity in S . typhi is unknown . The avirulence of S . typhi in animal hosts may result from a lack of genes present in the broad-host-range pathogen Salmonella typhimurium . Genomic subtractive hybridization was successfully employed to isolate S . typhimurium genomic sequences which are absent from the S . typhi genome . These genomic subtracted sequences mapped to 17 regions distributed throughout the S . typhimurium chromosome . A positive cDNA selection method was then used to identify subtracted sequences which were transcribed by S . typhimurium following macrophage phagocytosis . A novel putative transcriptional regulator of the LysR family was identified as transcribed by intramacrophage S . typhimurium . This putative transcriptional regulator was absent from the genomes of the human-adapted serovars S . typhi and Salmonella paratyphi A . Mutations within this gene did not alter the level of S . typhimurium survival within macrophages or virulence within mice . A subtracted genomic fragment derived from the ferrichrome operon also hybridized to the intramacrophage cDNA . Nucleotide sequence analysis of S . typhimurium and S . typhi chromosomal sequences flanking the ferrichrome operon identified a novel S . typhimurium fimbrial operon with a high level of similarity to sequences encoding Proteus mirabilis mannose-resistant fimbriae . The novel fimbrial operon was absent from the S . typhi genome . The absence of specific genes may have allowed S . typhi to evolve as a highly invasive, systemic human pathogen.

Lijec Vjesn, 1999 Jun, 121(6), 185 - 7
{Clinical success of treatment of chronic otitis media using topical and peroral administration of ofloxacin}; Kovacic M et al.; The paper presents results of the treatment of 32 patients (35 ears) with chronic otitis media and long lasting purulent otorrhea with local and oral ofloxacin . The patients were divided in two groups . Group A included 17 patients (49%), with previous middle ear surgery . Group B comprised 15 patients (18 ears, 51%) treated with local and systemic antimicrobial drugs . Ofloxacin was administered after taking the swab sample, and the duration of treatment was the same in all patients . The most frequently isolated microorganisms were P . aeruginosa (50%), S . aureus (17.7%) and Proteus sp . (14.7%) . Upon the completion of treatment which lasted two weeks, 76% of patients in group A had no otorrhea, and in group B 95% of patients were free of otorrhea . At follow-up three months after the treatment, the success rate of ofloxacin therapy remained the same in group A . In group B in four cases there was recurrence of otorrhea, so the success rate in this group decreased to 72% . Ofloxacin treatment gave good result in reduction of otorrhea, regardless of the earlier treatment of chronic otitis media.

J Comp Pathol, 1999 Oct, 121(3), 295 - 9
Canine distemper virus infection in binturongs (Arctictis binturong); Hur K et al.; Two binturongs (Arctictis binturong) kept in outdoor exhibits at Everland Zoological Gardens in Korea died within 10 days of the onset of clinical signs that included depression, dyspnoea, diarrhoea and convulsions . On necropsy, the significant gross findings were limited to the lungs and the gastrointestinal tract . Proteus vulgaris was isolated from the lung of one animal . Histopathologically, diffuse severe bronchointerstitial pneumonia with secondary bacterial infection was noted in the lungs . Intracytoplasmic eosinophilic inclusion bodies were seen in the lining epithelium of the bronchi, bronchioles, small and large intestines, renal pelvis and urinary bladder . Canine distemper virus (CDV)-specific antigens were demonstrated in frozen sections of the lungs by the direct immunofluorescence technique . This is believed to be the first confirmed report of CDV infection in binturongs .

Int Urol Nephrol, 1999, 31(2), 173 - 9
Paediatric nosocomial urinary tract infection at a regional hospital; Orrett FA et al.; From a total of 26,603 admissions to the paediatric wards, 1360 paediatric nosocomial urinary tract infections (PNUTI) were identified during a 5-year retrospective chart review at the SFGH . The ages ranged from 3 days to 13 years, with 46% boys and 54% girls . The highest rates of PNUTI per service per 100 admissions were seen in the nursery (11.28) followed by paediatric surgery (2.89) and paediatric medicine (2.86) . Although the greatest number of PNUTI occurred in the nursery, comparison between the years was not statistically significant . About 90% (1218 of 1360) of PNUTI occurred in catheterized patients . No documentation was found specifying the type of catheterization (intermittent or continuous) . About 90% (1210 of 1360) of isolates were single organisms with Escherichia coli, Proteus mirabilis, Klebsiella spp . and Group B streptococci accounting for a total of approximately 70% of all pathogens . However, the composition of the most common isolate in each service differed . The most common isolate in the nursery was E . coli, in the paediatric medical and surgical services the most common isolates were Klebsiella spp . and Proteus mirabilis, respectively . Proteus mirabilis was isolated predominantly from boys with structural abnormality of the urethral tract . No PNUTIs were complicated by bacteraemia . The antibiotics with least effectiveness (in increasing order) for UTIs were cephalexin, ampicillin, trimethoprim, co-trimoxazole and tetracycline . The most effective antibiotics were nalidixic acid, gentamicin and amoxicillin-clavulanic acid.

Arch Immunol Ther Exp (Warsz), 1999, 47(3), 195 - 201
Investigation of influence of Proteus mirabilis LPS polysaccharide part on the murine immune cells activation; Klink M et al.; The biological activities were investigated of Proteus mirabilis lipopolysaccharides (LPSs) and their fragments, namely, the induction of nitric oxide (NO) and interleukin 1 (IL-1) synthesis by murine macrophages and the proliferation of murine spleen cells . The O-specific polysaccharide (F1), core oligosaccharide (F2) and lipid A were as effective as intact LPS in stimulating murine macrophages to produce NO . IL-1 synthesis was also induced by all studied types of endotoxins (S, Ra, Re) and partial structures, however F1, F2 and lipid A fractions required the presence of serum . In contrast to LPS, the O-specific polysaccharide, core oligosaccharide and lipid A were not able to induce the blast response of murine non-adherent splenocytes.

Med Hypotheses, 1999 Apr, 52(4), 293 - 6
Microbes and sequestered substances as mechanisms for disease: Bartonella and L-forms as common global etiological agents; Sood FH et al.; The pathogenicity of microbes may be determined by substances sequestered from blood and bound to their constituent lipid . The brain may not perceive substances sequestered by microbes, to interfere with control to maintain normal levels . Pathological conditions can be induced as organisms exposed to antimicrobial substances/conditions and/or deprived of nutrients essential to cell wall synthesis, disintegrate to free lipid-bound compounds and produce L-forms that can deplete nutrients as they revert to bacteria . Microbes may act as active carriers for the continuing interaction of sequestered substances . Changes in the molecular structure of substances effected during sequesteration could cause them to be seen as substances 'synthesized' by an organism . In media that contain substances to inhibit 'contaminants', L-forms can be seen as mycoplasma . Elementary bodies of L-forms with a specific substance or tissue affinity may be seen as 'receptors' . Bartonella are global agents for disease--pleomorphic organisms (description suits Proteus)--and they can be seen as 'contaminants'.

J Food Prot, 1997 Jan, 60(1), 6 - 9
Comparison of the beta-glucuronidase assay and the conventional method for identification of Escherichia coli on eosin-methylene blue agar; Huang SW et al.; The purpose of this study was to compare the IMViC (indole, methyl red, Voges-Proskauer and citrate utilization) tests with the beta-glucuronidase (GUD) assay for the identification of suspect Escherichia coli on Levine's eosin-methylene blue (EMB) agar . After testing 258 suspect E . coli colonies from raw meat and meat products, 163 and 44 were found to be E . coli and non-E . coli, respectively, by both methods . Nine isolates were IMViC positive (i.e., + + - - or - + - -) but GUD negative; among these isolates, six were confirmed to be E . coli by API 20E (bioMerieux, Marcy-I'Etoile, France) with the remaining three being non-E . coli . There were 42 isolates that were IMViC negative but GUD positive; among these isolates, seven were pure E . coli cultures, 33 were mixed cultures containing E . coli, and the remaining two were Proteus spp . The sensitivities for the identification of E . coli on EMB were 80.9% (169/209) and 97.1% (203/209), respectively, by the IMViC tests and GUD assay; whereas the specificities were 93.9% (46/49) and 95.9% (47/49), respectively, by the IMViC tests and GUD assay . It is proposed that the GUD assay can be an effective alternative to the conventional IMViC tests for the identification of suspect E . coli on EMB.

Mem Inst Oswaldo Cruz, 1999 Sep-Oct, 94(5), 675 - 8
Antibacterial activity of Ocimum gratissimum L . essential oil; Nakamura CV et al.; The essential oil (EO) of Ocimum gratissimum inhibited Staphylococcus aureus at a concentration of 0.75 mg/ml . The minimal inhibitory concentrations (MICs) for Shigella flexineri, Salmonella enteritidis, Escherichia coli, Klebsiella sp., and Proteus mirabilis were at concentrations ranging from 3 to 12 microg/ml . The endpoint was not reached for Pseudomonas aeruginosa (>=24 mg/ml) . The MICs of the reference drugs used in this study were similar to those presented in other reports . The minimum bactericidal concentration of EO was within a twofold dilution of the MIC for this organism . The compound that showed antibacterial activity in the EO of O . gratissimum was identified as eugenol and structural findings were further supported by gas chromatography/mass spectra retention time data . The structure was supported by spectroscopic methods.

Clin Dysmorphol, 1999 Jul, 8(3), 229 - 31
Proteus syndrome: a possible case associated to precocious puberty; Oliveira Mda C et al.; We report a boy with possible Proteus syndrome and precocious puberty . This appears to be the first report of this association.

FEBS Lett, 1999 Aug 6, 456(2), 227 - 31
Structures of the O-specific polysaccharides and a serological cross-reactivity of the lipopolysaccharides of Proteus mirabilis O24 and O29; Literacka E et al.; Strains of Proteus mirabilis belonging to serogroups O24 and O29 are frequent in clinical specimens . Anti-P . mirabilis O24 serum cross-reacted with the lipopolysaccharide (LPS) of P . mirabilis O29 and vice versa . The structures of the O-specific polysaccharides (OPSs, O-antigens) of both LPSs were established using sugar analysis and one- and two-dimensional 1H- and 13C-NMR spectroscopy and found to be different . SDS-PAGE and Western immunoblotting suggested that the serological cross-reactivity of the LPSs is due to a common epitope(s) on the core-lipid A moiety, rather than on the OPS . Therefore, the epitope specificity and the structures of the O-antigens studied are unique among Proteus serogroups.

J Ind Microbiol Biotechnol, 1999 Jul, 23(1), 686 - 90
Microbial decolorization of azo dyes by Proteus mirabilis; Chen KC et al.; A bacterium identified as Proteus mirabilis was isolated from acclimated sludge from a dyeing wastewater treatment plant . This strain rapidly decolorized a deep red azo dye solution (RED RBN) . Features of the decolorizing process related to biodegradation and biosorption were also studied . Although P . mirabilis displayed good growth in shake culture, color removal was best in anoxic static cultures . For color removal, the optimal pH and temperature were 6.5-7.5 and 30-35 degrees C, respectively . The organism exhibited a remarkable color removal capability, even at a high concentration of azo dye . More than 95% of azo dye was reduced within 20 h at a dye concentration of 1.0 g L-1 . Decolorization appears to proceed primarily by enzymatic reduction associated with a minor portion, 13-17%, of biosorption to inactivated microbial cells.

Scand J Infect Dis, 1999, 31(2), 179 - 84
Antibacterial effects of lactoferricin B; Vorland LH et al.; The antimicrobial peptide, lactoferricin, can be generated upon gastric pepsin cleavage of lactoferrin . We have examined the inhibitory efficacy of lactoferricin of bovine origin (Lf-cin B) on Escherichia coli, Proteus mirabilis and Staphylococcus aureus with or without a cell wall . We found that spheroplasts and protoplasts had a lower MIC than their counterparts with a cell wall . We also compared the efficacies of Lf-cin B (17-31) made of all L-amino acids and all D-amino acids . The peptide made of all D-amino acids was more active than the corresponding L-enantiomer . Furthermore, we examined the influence of Lf-cin B on the motility of E . coli and the influence of temperature on the susceptibility of bacteria exposed to Lf-cin B . Bacteria exposed to sub-MIC of Lf-cin B lost their motility . Bacteria exposed to Lf-cin B at 20 degrees C were more sensitive to Lf-cin B than when exposed at 37 degrees C . These findings indicate that the cell envelope is a limiting step for Lf-cin B to exert its antibiotic effect . We cannot rule out a receptor-mediated first step for Lf-cin B (17-31).

J Biol Chem, 1999 Aug 13, 274(33), 22993 - 8
The structure of the colony migration factor from pathogenic Proteus mirabilis . A capsular polysaccharide that facilitates swarming; Rahman MM et al.; Swarming by Proteus mirabilis is characterized by cycles of rapid and coordinated population migration across surfaces following differentiation of vegetative cells into elongated hyperflagellated swarm cells . It has been shown that surface colony expansion by the swarm cell population is facilitated by a colony migration factor (Cmf), a capsular polysaccharide (CPS) that also contributes to the uropathogenicity of P . mirabilis (Gygi, D., Rahman, M . M., Lai, H.-C., Carlson, R., Guard-Petter, J., and Hughes, C . (1995) Mol . Microbiol . 17, 1167-1175) . In this report, the Cmf-CPS was extracted with hot water, precipitated with ethanol, and further purified by gel permeation chromatography . Its structure was established by glycosyl composition and linkage analyses, and by one- and two-dimensional NMR spectroscopy . The Cmf-CPS is composed of the following tetrasaccharide repeating unit . {see text}

FEMS Microbiol Lett, 1999 Aug 1, 177(1), 57 - 62
An EPR investigation of surfactant action on bacterial membranes; Glover RE et al.; The effects of the surfactants, alcohol ethoxylate, amine ethoxylate, amine oxide and SDS on cell membranes were investigated using the lipid soluble spin label 5-doxyl stearic acid (5-DS) . Electron paramagnetic resonance (EPR) spectroscopy revealed that the action of the surfactants was to significantly increase membrane fluidity of Proteus mirabilis, Staphylococcus aureus and Saccharomyces cerevisiae . The action of these surfactants as biocides was investigated and found to be dependent on the type of organism tested . There was, however, no direct correlation between enhanced membrane fluidity observed due to the action of the surfactants and biocidal activity . Data presented suggest that perturbing the fluidity of the cytoplasmic membrane is not immediately responsible for cell death.

Clin Infect Dis, 1999 Jul, 29(1), 113 - 9
Demographic, clinical, and treatment parameters influencing the outcome of acute cystitis; Echols RM et al.; A meta-analysis of six double-blinded clinical trials was undertaken to identify risk factors associated with bacteriologic outcome in 3,108 women with acute cystitis . Eleven antibiotic regimens were used, including ciprofloxacin, ofloxacin, norfloxacin, trimethoprim-sulfamethoxazole, and nitrofurantoin . Entry criteria for all studies were identical . Among 2,409 patients who were defined to be valid for efficacy analysis, pathogens included Escherichia coli (78.6%), Staphylococcus saprophyticus (4.4%), Klebsiella pneumoniae (4.3%), Proteus mirabilis (3.7%), and "other" (9%) . Causative bacteria were eradicated at the end of treatment in 93% of patients . The following parameters were associated with successful bacteriologic outcome: not using a diaphragm (P = .0041), treatment for > or = 3 days (P = .0043), pathogen not "other" (P = .0043), symptom duration of < 2 days (P = .0096), and African American race (P = .0147) . K . pneumoniae (P = .0496) and "other" pathogens (P = .0018) were associated with increased probability of bacteriologic treatment failure . The presence of pyuria (> or = 10 WBCs per high-power field) did not correlate with outcome and was inversely correlated with the finding of > or = 10(5) bacterial colony-forming units per mL of urine (P < .001) . This large database identifies new parameters associated with treatment outcomes of acute cystitis and calls into question current clinical trial guidelines.

Int J Food Microbiol, 1999 May 1, 48(2), 125 - 30
Antimicrobial activity of tea as affected by the degree of fermentation and manufacturing season; Chou CC et al.; Bacillus subtilis, Escherichia coli, Proteus vulgaris, Pseudomonas fluorescens, Salmonella sp . and Staphylococcus aureus were used to test the antimicrobial activity of tea flush extract and extracts of various tea products . Among the six test organisms, P . fluorescens was the most sensitive to the extracts, while B . subtilis was the least sensitive . In general, antimicrobial activity decreased when the extents of tea fermentation increased . The antimicrobial activities of tea flush extract and extracts of tea products with different extents of fermentation varied with test organisms . Tea flush and Green tea, the unfermented tea, exerted the strongest antimicrobial activity followed by the partially fermented tea products such as Longjing, Tieh-Kuan-Ying, Paochung, and Oolong teas . On the other hand, Black tea, the completely fermented tea, showed the least antimicrobial activity . It was also noted that extracts of Oolong tea prepared in summer exhibited the strongest antimicrobial activity, followed by those prepared in spring, winter and fall.

Gastrointest Endosc, 1999 Aug, 50(2), 209 - 13
Does bile of patients with acute gallstone pancreatitis cause pancreatic inflammatory lesions? A study of the pancreatic toxicity of choledochal secretions collected at ERCP; Arendt T et al.; BACKGROUND: Bile flow into the pancreatic duct has been proposed as the cause of acute biliary pancreatitis . However, the pancreatic toxicity of choledochal bile from patients with acute gallstone pancreatitis has not been studied . METHODS: Bile was collected endoscopically from the common bile ducts of 21 patients with acute gallstone pancreatitis within 72 hours after the onset of disease . The bile samples were instilled into the pancreatic duct of rabbits, and light microscopic examination of the pancreas morphology was performed to assess the toxicity of human bile . Microbiologic quantitative analysis of the aerobic and anaerobic bacterial bile flora was performed . RESULTS: Bile of six patients with acute gallstone pancreatitis (29%) induced interstitial inflammation in the rabbit pancreas . Choledochal bile of these patients harbored more than 10(4) CFU/mL bacteria (Proteus vulgaris, n = 1; Klebsiella pneumoniae, n = 1; Escherichia coli, n = 2; enterococci, n = 2) . After sterilization, the bile samples did not induce acute pancreatitis . In 15 patients (71%), bile did not cause acute pancreatitis in the rabbit pancreas . These choledochal secretions were sterile or contained less than 10(4) CFU/mL . CONCLUSIONS: Reflux of infected bile may be a potential cause of acute pancreatitis in the minority of patients with bacterobilia . In most patients with gallstone pancreatitis, bile is neither infected nor harmful to the pancreas, and its flow into the gland is unlikely to be the cause of inflammation.

Ophthalmologica, 1999, 213(4), 265 - 8
In vitro viability of external eye microbial flora in hydroxy-propyl-methylcellulose; Mastropasqua L et al.; The aim of this study was to verify the in vitro influence of various dilutions of a viscoelastic substance containing 2% hydroxy-propyl-methylcellulose (HPMC) on the viability of some microbial strains representative of the normal flora of the external eye . Pure reference strain cultures of Candida albicans, Pseudomonas aeruginosa, Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis and a fresh clinical isolate of Proteus mirabilis were selected for this study . Serial twofold dilutions of 2% HPMC, prepared so as to obtain a final concentration ranging from 50 to 0.78% of the product in sterile saline solution (0.85% NaCl), were taken out with a pipette that delivered 1.0 ml per tube . One hundred microliters of the abovementioned microbial inocula, used for the evaluation of the positive control of the test organism, were dispensed into each tube . After 24 h of incubation, 100 microl of samples were taken from each tube and plated into the specific medium for the growth of the test organism . After 24-48 h of incubation, these agar plates were examined and the colony-forming-unit count of each test organism was compared to the corresponding total colony count, acting as a positive control, in order to determine the quantitative variation of the test organism grown in the presence of the viscoelastic compounds . C . albicans and P . aeruginosa showed a statistically significant increase in growth with HPMC dilutions varying from 1:2 to 1:16 . P . acnes and P . mirabilis growth was significantly reduced by all dilutions except for the 1:128 one . S . epidermidis growth was also significantly reduced in the presence of HPMC dilutions varying from 1:2 to 1:64 . S . aureus growth was not significantly influenced . The viability of P . aeruginosa in HPMC dilutions needs to be carefully considered because of the ability of this organism to induce endophthalmitis, and the possibility that during cataract surgery, a small amount of HPMC may be left in the eye, trapped behind the intraocular lens optic.

J Biotechnol, 1999 Apr 30, 70(1-3), 61 - 3
Cyanobacteria--a potential source of new biologically active substances; Kreitlow S et al.; Hydrophilic and lipophilic extracts of twelve cyanobacterial strains, isolated from fresh and brackish water, and two waterblooms, collected during the summer from the Baltic Sea, were investigated for their antibiotic activities against seven microorganisms . No inhibitory effects were found against the three Gram-negative bacteria Escherichia coli, Proteus mirabilis and Serratia marcescens and the yeast Candida maltosa . Of all cyanobacterial samples, extracts from seven species inhibited the growth of at least one of the Gram-positive bacteria Micrococcus flavus, Staphylococcus aureus and Bacillus subtilis . M . flavus proved to be the most sensitive bacterium in the agar diffusion test system . In particular, the hexane and dichlormethane extracts showed antimicrobial effects . But only one water extract, prepared from material of a natural waterbloom, was found to be active.

J Forensic Sci, 1999 May, 44(3), 592 - 6
PCR-based identification of postmortem microbial contaminants--a preliminary study; Kupfer DM et al.; Investigation of postmortem blood can reveal the presence of significant ethanol levels . However, in some instances it cannot easily be determined if the source of ethanol is from ingestion or from postmortem endogenous fermentation by contaminating microbes . Described here is a robust polymerase chain reaction (PCR)-based method for detecting the presence of common ethanol producing microbial contaminants in human blood . A set of DNA primers were designed for use in PCR to amplify and detect the genomic DNA from humans and three test microorganisms Escherichia coli, Proteus vulgaris, and Candida albicans . A rapid and reproducible protocol was developed for isolating genomic DNA from mixed human blood-microorganism samples that yields a suitable template for PCR . The organism-specific primer pairs can detect the presence of the target microorganisms in human blood at concentrations as low as 10 colony forming units/mL . The PCR products readily can be detected after agarose gel electrophoresis . This method provides an additional means of rapidly identifying microbial contaminants in postmortem blood samples.

J Med Microbiol, 1999 Jul, 48(7), 623 - 8
Investigation of the types and characteristics of the proteolytic enzymes formed by diverse strains of Proteus species; Senior BW; Many diverse clinical isolates of Proteus mirabilis (48 strains), P . penneri (25), P . vulgaris biogroup 2 (48) and P . vulgaris biogroup 3 (21) from man were examined for their ability to produce proteolytic enzymes and the nature and characteristics of the proteases were studied . All the P . penneri isolates, most (94-90%) of the P . mirabilis and P . vulgaris biogroup 2 isolates, but only 71% of the P . vulgaris biogroup 3 isolates, secreted proteolytic enzymes . These were detected most readily at pH 8 with gelatin as substrate . A strong correlation was found between the ability of a strain to form swarming growth and its ability to secrete proteases . Non-swarming isolates invariably appeared to be non-proteolytic . However, some isolates, particularly of P . vulgaris biogroup 3, were non-proteolytic even when they formed swarming growth . Analysis of the secreted enzymes of the different Proteus spp . on polyacrylamide-gelatin gels under various constraints of pH and other factors showed that they were all EDTA-sensitive metalloproteinases . Analysis of the kinetics of production of the proteases revealed the formation of an additional protease of undefined type and function that was cell-associated and formed before the others were secreted . The secreted protease was subsequently modified to two isoforms whose mass (53-46 kDa) varied with the Proteus spp . and the strain . There was no evidence that the secreted proteases of strains of Proteus spp . were of types other than metalloproteinases.

Indian J Med Res, 1999 Apr, 109, 152 - 6
Detection of glutamate dehydrogenase enzyme activity in Plasmodium falciparum infection; Rodriguez-Acosta A et al.; We describe the separation of an active glutamate dehydrogenase {GDH (NADP+)} enzyme from the plasma of patients with P . falciparum infection using columns of sepharose anti-GDH (NADP+) of Proteus spp . The activity of this enzyme was also detected in P . falciparum culture supernatant . The parasitic origin of this enzyme was suggested by western blot analysis using anti-P . falciparum culture supernatant and anti-whole parasite antibodies . The differential inhibition of the P . falciparum GDH (NADP+) indicates that some epitopes recognised by the antibodies in both preparations may be different . The determination of P . falciparum GDH (NADP+) activity could be developed into a specific technique for the diagnosis of falciparum malaria.

Pharmazie, 1999 Jun, 54(6), 452 - 6
Aspects of the antimicrobial efficacy of grapefruit seed extract and its relation to preservative substances contained; von Woedtke T et al.; The antimicrobial efficacy as well as the content of preservative agents of six commercially available grapefruit seed extracts were examined . Five of the six extracts showed a high growth inhibiting activity against the test germs Bacillus subtilis SBUG 14, Micrococcus flavus SBUG 16, Staphylococcus aureus SBUG 11, Serratia marcescens SBUG 9, Escherichia coli SBUG 17, Proteus mirabilis SBUG 47, and Candida maltosa SBUG 700 . In all of the antimicrobial active grapefruit seed extracts, the preservative benzethonium chloride was detected by thin layer chromatography . Additionally, three extracts contained the preserving substances triclosan and methyl parabene . In only one of the grapefruit seed extracts tested no preservative agent was found . However, with this extract as well as with several self-made extracts from seed and juiceless pulp of grapefruits (Citrus paradisi) no antimicrobial activity could be detected (standard serial broth dilution assay, agar diffusion test) . Thus, it is concluded that the potent as well as nearly universal antimicrobial activity being attributed to grapefruit seed extract is merely due to the synthetic preservative agents contained within . Natural products with antimicrobial activity do not appear to be present.

Am J Med Genet, 1999 Aug 6, 85(4), 355 - 8
Concept of twin spotting; Koopman RJ; This article describes the formation of apparent twin spots presumed to be caused by a specific form of somatic recombination . Twin spots consist of two genetically different clones of neighboring cells in a background of normal cells . The phenomenon is well known in plants and animals and is used as a marker to evaluate the recombinogenic activity of chemicals . The equivalent of the twin spot phenomenon in humans has only been described recently . We now give a review on a number of paired skin disorders possibly caused by the mechanism of twin spotting . They include vascular twin nevi, phacomatosis pigmentovascularis, phacomatosis pigmentokeratotica, Proteus syndrome, and cutis tricolor . Clinicians will probably spot other nevoid skin lesions occurring in close proximity to each other, which might be explained by the twin spot phenomenon .

Am J Med Genet, 1999 Aug 6, 85(4), 342 - 5
Cutaneous mosaicism of lethal mutations; Hamm H; The concept of autosomal lethal genes surviving only in a mosaic state was proposed by Happle to explain the genetic basis of several syndromes characterized by (almost always) sporadic occurrence, distribution of lesions in a scattered or asymmetrical pattern, variable extent of involvement, lack of diffuse involvement of entire organs, and equal sex ratio . The mosaic may either arise from a gametic half-chromatid mutation or from an early postzygotic mutation . The purpose of this article is to review current knowledge of the genetics and cutaneous manifestations of some of the birth defects to which the lethal gene concept is thought to apply: the Schimmelpenning (Feuerstein-Mims) syndrome, Proteus syndrome, encephalocraniocutaneous lipomatosis, Sturge-Weber and Klippel-Trenaunay syndrome, cutis marmorata teleangiectatica congenita (van Lohuizen syndrome), and neurocutaneous melanosis .

Ann Rheum Dis, 1999 Jul, 58(7), 435 - 40
Ankylosing spondylitis in monozygotic twins: studies on immunological parameters; Hohler T et al.; OBJECTIVE: To examine immunological parameters that might explain disease discordance in monozygotic twin pairs with ankylosing spondylitis (AS) . METHODS: 11 monozygotic twin pairs (nine with AS, two with undifferentiated spondyloarthropathy) were investigated . The peripheral T cell receptor Vbeta repertoire was investigated using FACS analysis and 14 different Vbeta antibodies . In addition serum samples were tested for antibodies to Klebsiella pneumoniae, Streptococcus pyogenes, Candida albicans, Proteus mirabilis, and Escherichia coli . Peripheral blood lymphocyte reactivity against a number of bacteria was investigated by interferon gamma ELISPOT assays . RESULTS: Twins suffering from AS showed cellular hyporeactivity against K pneumoniae, S pyogenes, C albicans in the ELISPOT assays compared with healthy twins . In contrast with the antibody data, where no significant differences were observed between the two groups, AS concordant twins showed the most pronounced differences in their Vbeta repertoire on CD4+ and CD8+ lymphocytes . CONCLUSIONS: Cellular hyporeactivity of peripheral blood cells to bacterial antigens might reflect defective T cell responses allowing bacterial antigens to persist in diseased patients . There are probably other environmental factors that influence disease concordance.

Mol Microbiol, 1999 May, 32(4), 825 - 36
ZapA, the IgA-degrading metalloprotease of Proteus mirabilis, is a virulence factor expressed specifically in swarmer cells; Walker KE et al.; The IgA-degrading metalloprotease, ZapA, of the urinary tract pathogen Proteus mirabilis is co-ordinately expressed along with other proteins and virulence factors during swarmer cell differentiation . In this communication, we have used zapA to monitor IgA protease expression during the differentiation of vegetative swimmer cells to fully differentiated swarmer cells . Northern blot analysis of wild-type cells and beta-galactosidase measurements using a zapA:lacZ fusion strain indicate that zapA is fully expressed only in differentiated swarmer cells . Moreover, the expression of zapA on nutrient agar medium is co-ordinately regulated in concert with the cycles of cellular differentiation, swarm migration and consolidation that produce the bull's-eye colonies typically associated with P . mirabilis . ZapA activity is not required for swarmer cell differentiation or swarming behaviour, as ZapA- strains produce wild-type colony patterns . ZapA- strains fail to degrade IgA and show decreased survival compared with the wild-type cells during infection in a mouse model of ascending urinary tract infection (UTI) . These data underscore the importance of the P . mirabilis IgA-degrading metalloprotease in UTI . Analysis of the nucleotide sequences adjacent to zapA reveals four additional genes, zapE, zapB, zapC and zapD, which appear to possess functions required for ZapA activity and IgA proteolysis . Based on homology to other known proteins, these genes encode a second metalloprotease, ZapE, as well as a ZapA-specific ABC transporter system (ZapB, ZapC and ZapD) . A model describing the function and interaction of each of these five proteins in the degradation of host IgA during UTI is presented.

Am J Med Genet, 1999 Jun 11, 84(5), 389 - 95
Proteus syndrome: diagnostic criteria, differential diagnosis, and patient evaluation; Biesecker LG et al.; Proteus syndrome is a complex disorder comprising malformations and overgrowth of multiple tissues . The disorder is highly variable and appears to affect patients in a mosaic manner . This intrinsic variability has led to diagnostic confusion associated with a dearth of longitudinal data on the natural history of Proteus syndrome . To clarify some of these issues, a workshop on Proteus syndrome was held in March 1998 at the National Institutes of Health, and participants developed recommendations for diagnostic criteria, differential diagnosis, and guidelines for the evaluation of patients . This is a review of those recommendations.

J Med Microbiol, 1999 Jun, 48(6), 527 - 34
Growth, cellular differentiation and virulence factor expression by Proteus mirabilis in vitro and in vivo; Zunino P et al.; A uropathogenic strain of Proteus mirabilis was grown in vitro in human and mouse urine and brain-heart infusion broth (BHIB) and in vivo in subcutaneous open chambers (SOC) in mice, intraperitoneal diffusion chambers (IPC) in rats and by ascending urinary tract infection in mice in order to compare growth pattern, cellular differentiation and expression of virulence factors . Although the growth rate was slower in vivo than in vitro, the extent of growth was similar after 24 h . PR mirabilis differentiated into filamentous swarmer cells in all in-vitro culture conditions, but no filamentous cells were observed in either of the in-vivo chamber models . Transurethrally infected mice showed a rapid release or loss of filamentous cells and these could not be seen in kidney or bladder homogenates 7 days after infection . Bacteria showed increasing haemagglutination titres for fresh and tanned red blood cells after subculturing in BHIB, but bacteria grown in vivo did not show haemagglutination . An increasing resistance to normal serum was found when bacteria were grown in vivo . Significant haemolytic activity was detected with bacteria grown in BHIB and IPC, but almost no activity was found when bacteria had grown in urine . These findings improve the understanding of the role of P . mirabilis uropathogenic virulence factors in vivo.

Eur J Clin Microbiol Infect Dis, 1999 Mar, 18(3), 206 - 8
Ability of Proteus mirabilis to swarm over urethral catheters; Stickler D et al.; The aim of this study was to investigate the ability of Proteus mirabilis to swarm over various types of urinary catheters . The test strain was found to swarm over catheters for distances of up to 10 cm within 24 h . Migration was significantly more rapid over hydrogel-coated latex catheters than over all-silicone or silicone-coated latex catheters . Scanning electron micrographs revealed discrete rafts of typically elongated swarmer cells on catheter surfaces . Migration of swarmers along catheters into the bladder could thus initiate Proteus mirabilis catheter-associated infections.

Biochem Cell Biol, 1998, 76(5), 787 - 90
A Zn(II)-translocating P-type ATPase from Proteus mirabilis; Rensing C et al.; A mutant of Proteus mirabilis had been previously isolated as defective in swarming . The mutation had been found to be in a gene related to the Escherichia coli zntA gene, which encodes the ZntA Zn(II)-translocating P-type ATPase . In this study the P . mirabilis gene was expressed in an E . coli strain in which the zntA gene had been disrupted . The P . mirabilis gene complemented the sensitivity to salts of zinc and cadmium . Everted membrane vesicles from the zntA-disrupted strain lost ATP-driven 65Zn(II) uptake . Membranes from the complemented strain had restored 65Zn(II) transport . These results demonstrate that the P . mirabilis homologue of ZntA is a Zn(II)-translocating P-type ATPase.

J Infect, 1999 Mar, 38(2), 99 - 106
Evidence that patients with rheumatoid arthritis have asymptomatic 'non-significant' Proteus mirabilis bacteriuria more frequently than healthy controls; Senior BW et al.; OBJECTIVES: patients with rheumatoid arthritis (RA) are reported to have in their sera raised levels of antibody specific to Proteus mirabilis . The aim of the study was to verify this and to determine an explanation for it by investigating the frequency of P . mirabilis urinary tract infection in RA patients and matched controls . METHODS: freshly voided urine was examined for the presence, number and identity of infecting bacteria . The levels of antibody in blood and in urine of the IgM, IgA and IgG classes to the common O serotypes of P . mirabilis and the antigens to which they reacted were determined by enzyme-linked immunosorbent assay (ELISA) and immunoblotting . RESULTS: analysis of urine from 76 patients with RA and 48 age- and gender-matched healthy controls showed that only two (4%) of the control urines but 25 (33%) of those from the RA patients were infected . The commonest infecting organism in the RA patients' urine was Proteus mirabilis which occurred twice as frequently as Escherichia coli . Proteus mirabilis was found in 52% of the infected urines of the RA patients and was always detected as a pure growth and usually in insignificant (< 10(4)/ml) numbers . It is highly improbable that this finding was the outcome of differences in age, physical ability or medication between the RA and control patient groups . Comparison of antibody levels to P . mirabilis by ELISA showed RA patients had raised (P < 0.0001, P = 0.001, P = 0.0063) levels of IgA, IgG and IgM respectively in their sera and raised (P < 0.0001, P < 0.0001, P = 0.0001) levels of IgG, IgM and IgA respectively in their urine compared with the control group . It was not possible to detect an antibody reacting to a P . mirabilis antigen that was specific to the RA patients . CONCLUSION: the results confirm that RA patients have raised levels of antibody to P . mirabilis not only in blood but also in urine and suggest that this arises because RA patients have an asymptomatic, non-significant P . mirabilis bacteriuria more frequently or more prolonged than control patients . This may be the trigger for their RA condition.

J Cell Sci, 1999 Jun, 112 ( Pt 12), 2043 - 8
Signal-mediated nuclear transport in the amoeba; Feldherr CM et al.; The evolutionary changes that occur in signal-mediated nuclear transport would be expected to reflect an increasing need to regulate nucleocytoplasmic exchanges as the complexity of organisms increases . This could involve changes in both the composition and structure of the pore complex, as well as the cytosolic factors that mediate transport . In this regard, we investigated the transport process in amoebae (Amoeba proteus and Chaos carolinensis), primitive cells that would be expected to have less stringent regulatory requirements than more complex organisms . Colloidal gold particles, coated with bovine serum albumin (BSA) conjugated with simple (large T) nuclear localization signals (NLSs), bipartite (nucleoplasmin) NLSs or mutant NLSs, were used to assay nuclear import . It was found that in amoebae (1) the diameter of the particles that are able to enter the nucleoplasm is significantly less than in vertebrate cells, (2) the simple NLS is more effective in mediating nuclear import than the bipartite NLS, and (3) the nucleoporins do not appear to be glycosylated . Evidence was also obtained suggesting that, in amoebae, the simple NLS can mediate nuclear export.

Infect Immun, 1999 Jun, 67(6), 2822 - 33
Requirement of MrpH for mannose-resistant Proteus-like fimbria-mediated hemagglutination by Proteus mirabilis; Li X et al.; Two new genes, mrpH and mrpJ, were identified downstream of mrpG in the mrp gene cluster encoding mannose-resistant Proteus-like (MR/P) fimbriae of uropathogenic Proteus mirabilis . Since the predicted MrpH has 30% amino acid sequence identity to PapG, the Galalpha(1-4)Gal-binding adhesin of Escherichia coli P fimbriae, we hypothesized that mrpH encodes the functional MR/P hemagglutinin . MR/P fimbriae, expressed in E . coli DH5alpha, conferred on bacteria both the ability to cause mannose-resistant hemagglutination and the ability to aggregate to form pellicles on the broth surface . Both a DeltamrpH mutant expressed in E . coli DH5alpha and an isogenic mrpH::aphA mutant of P . mirabilis were unable to produce normal MR/P fimbriae efficiently, suggesting that MrpH was involved in fimbrial assembly . Amino acid residue substitution of the N-terminal cysteine residues (C66S and C128S) of MrpH abolished the receptor-binding activity (hemagglutinating ability) of MrpH but allowed normal fimbrial assembly, supporting the notion that MrpH was the functional MR/P hemagglutinin . Immunogold electron microscopy of P . mirabilis HI4320 revealed that MrpH was located at the tip of MR/P fimbriae, also consistent with its role in receptor binding . The isogenic mrpH::aphA mutant of HI4320 was less able to colonize the urine, bladder, and kidneys in a mouse model of ascending urinary tract infection (P < 0.01), and therefore MR/P fimbriae contribute significantly to bacterial colonization in mice . While there are similarities between P . mirabilis MR/P and E . coli P fimbriae, there are more notable differences: (i) synthesis of the MrpH adhesin is required to initiate fimbrial assembly, (ii) MR/P fimbriae confer an aggregation phenotype, (iii) site-directed mutation of specific residues can abolish receptor binding but allows fimbrial assembly, and (iv) mutation of the adhesin gene abolishes virulence in a mouse model of ascending urinary tract infection.

Infect Immun, 1999 Jun, 67(6), 2769 - 75
Cross-reactivity between the rheumatoid arthritis-associated motif EQKRAA and structurally related sequences found in Proteus mirabilis; Tiwana H et al.; Cross-reactivity or molecular mimicry may be one of the underlying mechanisms involved in the etiopathogenesis of rheumatoid arthritis (RA) . Antiserum against the RA susceptibility sequence EQKRAA was shown to bind to a similar peptide ESRRAL present in the hemolysin of the gram-negative bacterium Proteus mirabilis, and an anti-ESRRAL serum reacted with EQKRAA . There was no reactivity with either anti-EQKRAA or anti-ESRRAL to a peptide containing the EDERAA sequence which is present in HLA-DRB1*0402, an allele not associated with RA . Furthermore, the EQKRAA and ESRRAL antisera bound to a mouse fibroblast transfectant cell line (Dap.3) expressing HLA-DRB1*0401 but not to DRB1*0402 . However, peptide sequences structurally related to the RA susceptibility motif LEIEKDFTTYGEE (P . mirabilis urease), VEIRAEGNRFTY (collagen type II) and DELSPETSPYVKE (collagen type XI) did not bind significantly to cell lines expressing HLA-DRB1*0401 or HLA-DRB1*0402 compared to the control peptide YASGASGASGAS . It is suggested here that molecular mimicry between HLA alleles associated with RA and P . mirabilis may be relevant in the etiopathogenesis of the disease.

J Bacteriol, 1999 May, 181(10), 3220 - 5
Differential expression of nonagglutinating fimbriae and MR/P pili in swarming colonies of Proteus mirabilis; Latta RK et al.; The expression of nonagglutinating fimbriae (NAF) and mannose-resistant/Proteus-like (MR/P) pili in swarming colonies of Proteus mirabilis was investigated . Elongated swarmer cells do not express pili, and the relative number of bacteria expressing NAF during swarming and early consolidation phases was very low (<5%) . Relative expression of NAF in a terrace increased to approximately 30% at 48 h . We also determined the expression of NAF and MR/P pili in two phenotypically distinguishable regions of each terrace . The expression of both NAF and MR/P pili was always higher in the region closer (proximal) to the middle of the colony than in the distal region of the terrace . The relative numbers of bacteria expressing NAF or MR/P pili in the proximal region were between 39.1 and 63% and between 5.9 and 7.7%, respectively . In the distal region, expression levels were between 20.8 and 27.3% and between 3.7 and 5 . 6%, respectively . A time course experiment testing NAF expression in both the proximal and distal regions of a terrace indicated that NAF expression in the proximal regions was always higher than in the distal regions and increased to a plateau 40 to 50 h after the start of the swarming phase for any given terrace . These results indicate that expression of NAF or MR/P pili in swarming colonies of P . mirabilis is highly organized, spatially and temporally . The significance of this controlled differentiation remains to be uncovered.

Clin Dysmorphol, 1999 Apr, 8(2), 111 - 5
Arteriovenous and lymphatic malformations, linear verrucous epidermal nevus and mild overgrowth: another hamartoneoplastic syndrome?
Hennekam RC, Kwa VI, van Amerongen A.
We report a 22 year old female presenting with slowly progressive paraparesis, who appeared to have many (mainly subcutaneous) hamartomas . The neurological symptoms were caused by intraspinal masses and arteriovenous malformations . In addition, she had mild overgrowth of one leg and lymph vessel malformations . This combination of symptoms resembles Proteus syndrome, but is different in symptomatology and progression and may be yet another hamartoneoplastic syndrome.

Eur J Biochem, 1999 Apr, 261(2), 392 - 7
Structure of the O-specific polysaccharide of a serologically separate strain Proteus penneri 2 from a new proposed serogroup O66; Arbatsky NP et al.; O-specific polysaccharide chain of Proteus penneri strain 2 lipopolysaccharide was studied by full and partial acid hydrolysis, Smith degradation, methylation analysis, and NMR spectroscopy, including two-dimensional rotating-frame NOE spectroscopy (ROESY) and 1H,13C heteronuclear multiple-quantum coherence (HMQC) experiments . Together with D-glucose and 2-acetamido-2-deoxy-D-glucose, the polysaccharide was found to contain two rarely occurring sugars, 6-deoxy-L-talose (L-6dTal) and 2,3-diacetamido-2,3,6-trideoxy-L-mannose (L-RhaNAc3NAc), and the following structure of a non-stoichiometrically O-acetylated tetrasaccharide repeating unit was established: {equation: see text} The O-specific polysaccharide studied has a unique composition and structure and, accordingly, P . penneri 2 is serologically separate among Proteus strains . Therefore, we propose for P . penneri 2 a new Proteus O-serogroup O66 where this strain is at present the single representative.

Eur J Biochem, 1999 Apr, 261(2), 347 - 53
Structural and serological studies on the O-antigen of Proteus mirabilis O14, a new polysaccharide containing 2-{(R)-1-carboxyethylamino}ethyl phosphate; Perepelov AV et al.; An O-specific polysaccharide was obtained by mild acid degradation of Proteus mirabilis O14 lipopolysaccharide (LPS) and found to contain D-galactose, 2-acetamido-2-deoxy-D-glalactose, phosphate, N-(2-hydroxyethyl)-D-alanine (D-AlaEtn), and O-acetyl groups . Studies of the initial and O-deacetylated polysaccharides using one- and two-dimensional 1H- and 13C-NMR spectroscopy, including COSY, TOCSY, NOESY, H-detected 1H,13C heteronuclear multiple-quantum coherence, and heteronuclear multiple-bond correlation experiments, demonstrated the following structure of the repeating unit: {equation: see text} This is the second bacterial polysaccharide reported to contain alpha-D-Galp6PAlaEtn, whereas the first one was the O-antigen of P . mirabilis EU313 taken erroneously as strain PrK 6/57 from the O3 serogroup {Vinogradov, E . V., Kaca, W., Shashkov, A.S., Krajewska-Pietrasik, D., Rozalski, A., Knirel, Y.A . & Kochetkov, N.K . (1990) Eur . J . Biochem., 188, 645-651} . Anti-(P . mirabilis O14) serum cross-reacted with LPS of P . mirabilis EU313 and vice versa in passive hemolysis and ELISA . Absorption of both O-antisera with the heterologous LPS decreased markedly but did not abolish the reaction with the homologous LPS . These and chemical data indicated that both strains have similar but not identical O-antigens . Therefore, we propose that P . mirabilis EU313 should belong to a new subgroup of the O14 serogroup.

Am J Med Genet, 1999 May 7, 84(1), 25 - 8
Elattoproteus syndrome: delineation of an inverse form of Proteus syndrome; Happle R; A 7-year-old boy had partial lipohypoplasia and patchy dermal hypoplasia involving large areas of his body . These areas of deficient growth were similar to those described in many cases of Proteus syndrome . Paradoxically, however, he had only few and rather mild lesions of disproportionate overgrowth . This unusual case is taken as a clue to postulate the Elattoproteus syndrome, an inverse form of Proteus syndrome . The paradoxical coexistence of hyperplastic and hypoplastic lesions may reflect a twin spot phenomenon . The patient would carry at the Proteus locus one allele giving rise to overgrowth of tissues (Pleioproteus allele--from Greek pleion, meaning plus), whereas the other allele would cause deficient growth of tissues (Elattoproteus allele--from Greek elatton, meaning minus) . At an early stage of embryogenesis, somatic recombination would give rise to two different populations of cells homozygous for either allele . From a heuristic point of view, one may postulate the existence of the Elattoproteus syndrome, a purely inverse form of Proteus syndrome that would develop in the absence of the Pleioproteus allele.

J Laryngol Otol, 1998 Oct, 112(10), 925 - 8
The antibacterial activity of acetic acid and Burow's solution as topical otological preparations; Thorp MA et al.; At present there are no topical otological preparations on the World Health Organisation's essential drug list, largely due to the ototoxic potential of preparations containing aminoglycoside antibiotics . Acetic acid and Burow's solution have long been used in the treatment of the discharging ear . The aim of this study was to ascertain the antibacterial activity of these two preparations against the most commonly occurring bacteria isolated from discharging ears in our department . Twenty fresh isolates of each of the following organisms--Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis and Streptococcus pyogenes--were plated onto blood agar and tested against one per cent, two per cent and three per cent acetic acid and Burow's solution (13 per cent aluminium acetate) . The activity of each agent was ascertained by the size of the zone of inhibition of bacterial growth . Burow's solution showed significantly larger average zones of inhibition than acetic acid (p < 0.001) . The two per cent and three per cent acetic acid as well as the Burow's solution were active against all the organisms tested.

Mol Cell Probes, 1999 Apr, 13(2), 133 - 40
Amplification of Proteus mirabilis chromosomal DNA using the polymerase chain reaction; Mansy MS et al.; A Proteus mirabilis-specific polymerase chain reaction (PCR) was developed and standardized . The origin of the primers was a recombinant clone that contained P . mirabilis-specific Hind III fragment DNA of 3.5-kilobase pairs . Based on the sequence data of P . mirabilis recombinant clone, two primers designated MMKAP 1 and MMKAP 2 were synthesized for use in the PCR . A P . mirabilis-specific 3.5-kb pair DNA product was amplified by the primers from 18 strains of P . mirabilis, but not from other Protease species and bacteria . The minimum amount of target DNA detected by P . mirabilis PCR was 10 fg using ethidium bromide/ultraviolet exposure of gels or Southern blot hybridization with a P . mirabilis recombinant DNA probe .

Pharmacol Res, 1999 Apr, 39(4), 321 - 3
Antibacterial activity of gentamicin and ciprofloxacin against Gram-negative bacteria: interactions with pig and calf sera; Miglioli PA et al.; The antibacterial activity of pig and calf serum and its ability to interact with gentamicin and ciprofloxacin were studied in vitro using Escherichia coli K-12, Proteus rettgeri (Sanelli) and Klebsiella pneumoniae ATCC 10031 . The antimicrobial activity of the above drugs, alone or in combination with serum, was investigated by the checkerboard method and expressed as the minimal inhibitory concentration (microg ml-1) . Pig serum (25%) with gentamicin had a synergistic antibacterial effect against Escherichia coli K-12 and pig serum (25%) with ciprofloxacin against Proteus rettgeri (Sanelli) and Klebsiella pneumoniae ATCC 10031 . Calf serum (25%) had a synergistic effect with gentamicin against Proteus rettgeri (Sanelli) and calf serum (25%) plus ciprofloxacin against Klebsiella pneumoniae ATCC 10031 . The effects of these drugs may be enhanced by pig and calf sera .

Microbiology, 1999 Jan, 145 ( Pt 1), 185 - 95
Identification of protease and rpoN-associated genes of uropathogenic Proteus mirabilis by negative selection in a mouse model of ascending urinary tract infection; Zhao H et al.; Proteus mirabilis, a motile gram-negative bacterium, is a principal cause of urinary tract infections in patients with functional or anatomical abnormalities of the urinary tract or those with urinary catheters in place . Thus far, virulence factors including urease, flagella, haemolysin, various fimbriae, IgA protease and a deaminase have been characterized based on the phenotypic traits conferred by these proteins . In this study, an attempt was made to identify new virulence genes of P . mirabilis that may not have identifiable phenotypes using the recently described technique of signature-tagged mutagenesis . A pool of chromosomal transposon mutants was made through conjugation and kanamycin/tetracycline selection; random insertion was confirmed by Southern blotting of chromosomal DNA isolated from 16 mutants using the aphA gene as a probe . From the total pool, 2.3% (9/397) auxotrophic mutants and 3.5% (14/397) swarming mutants were identified by screening on minimal salts agar and Luria agar plates, respectively . Thirty per cent of the mutants, found to have either no tag or an unamplifiable tag, were removed from the input pool . Then 10(7) c.f.u . from a 96-mutant pool (approximately 10(5) c.f.u . of each mutant) were used as an input pool to transurethrally inoculate seven CBA mice . After 2 d infection, bacteria were recovered from the bladders and kidneys and yielded about 10(5) c.f.u . as an output pool . Dot blot analysis showed that two of the 96 mutants, designated B2 and B5, could not be hybridized by signature tags amplified from the bladder output pool . Interrupted genes from these two mutants were cloned and sequenced . The interrupted gene in B2 predicts a polypeptide of 37.3 kDa that shares amino acid similarity with a putative protease or collagenase precursor . The gene in B5 predicts a polypeptide of 32.6 kDa that is very similar to that encoded by ORF284 of the rpoN operon controlling expression of nitrogen-regulated genes from several bacterial species . The virulence of the two mutants was tested further by co-challenging CBA mice with each mutant and the parental strain . After 1 week of infection, the B2 and B5 mutants were recovered in numbers 100-fold and 1000-fold less than the parental strain, respectively . Using an in vitro assay, it was shown that the B2 mutant had significantly less (P = 0.0001) extracellular protease activity than the wild-type strain . These findings demonstrate that signature-tagged mutagenesis is a viable approach to identify bacterial genes associated with the ability to infect the urinary tract.

J Hosp Infect, 1999 Mar, 41(3), 233 - 43
A comparison of teicoplanin versus cephradine plus metronidazole in the prophylaxis of post-operative infection in vascular surgery; Kester RC et al.; A total of 272 patients were enrolled into this prospective, unblinded, randomized comparison of single-dose teicoplanin vs three doses of cephradine plus metronidazole as prophylaxis for vascular surgery at St James's and Seacroft Hospitals, Leeds, UK . In all, 71.3% of patients (194/272) were enrolled at St James's University Hospital . Patients received either a single dose of teicoplanin, 6 mg/kg i.v., or cephradine, 1 g i.v . with metronidazole, 1 g rectally, at induction of anaesthesia followed by two further 1 g doses of cephradine and metronidazole 8 and 16 hours later . There were 136 patients in each treatment group . The most common operations were femoropopliteal grafts (96) and aortic aneurysm repairs (47) . In the 'intention-to-treat' analysis, primary wound infections were seen in 4.4% of patients (6/136) receiving teicoplanin and 5.9% of patients (8/136) receiving cephradine plus metronidazole (95% CI -6.7%, +3.8%) . Other disturbances to wound healing occurred in 23 patients (11 in the teicoplanin and 12 in the cephradine plus metronidazole group) . Secondary respiratory tract infections occurred in 17 patients (8 receiving teicoplanin and 9 receiving cephradine plus metronidazole) . In the evaluable patients analysis, primary wound infections occurred in 3.5% of patients (4/114) receiving teicoplanin and 5.1% of patients (6/117) receiving cephradine plus metronidazole . Staphylococcus aureus and Proteus sp . were the most common pathogens in primary wound infections . Despite the absence of Gram-negative cover in the teicoplanin group, Gram-negative infections occurred more often in the cephradine plus metronidazole group . Surgery of the lower extremities carried the highest risk of post-operative infection . Rates of infection were significantly higher at Seacroft Hospital (P = 0.001), and significantly higher for cephradine plus metronidazole between the two hospitals (P = 0.0008) . Adverse events occurred in 40 patients receiving teicoplanin (29.4%) and 39 patients receiving cephradine plus metronidazole (28.7%) . In 19 patients receiving teicoplanin (14%) and 15 receiving cephradine plus metronidazole (11%) these events were considered to be related to the study drugs . The most often reported events were infections, cardiac events and vascular phenomena (haematoma or emboli) . Marked changes in haematological parameters and liver function tests were noted seven days after operation in patients in each treatment group, but these resolved quickly as the effects of the operation subsided . ESR remained elevated in both groups at the six-month follow-up assessment . It is concluded from this two-centre study that a single dose of teicoplanin shows similar efficacy to a three-dose regimen of cephradine plus metronidazole as prophylaxis for wound infection in vascular surgery . Both regimens were well tolerated, and there was an equal incidence of adverse events in the two regimens, which reflected the poor general health status of this elderly study population.

Arch Neurol, 1999 Mar, 56(3), 364 - 5
Neurofibromatosis type 1; Morse RP; Neurofibromatosis (NF) has perhaps been the most notorious of the neurocutaneous disorders . Both Quasimoto of Victor Hugo's The Hunchback of Notre Dame and John Merrick, known as the Elephant Man (who subsequently has been more properly classified as having Proteus syndrome, a quite different disorder), are 2 infamous examples that have shaped many popular misconceptions about this disease . Neurofibromatosis is now understood as a hamartomatous disorder on the basis of molecular genetic studies . Studies on NF have been pivotal to understanding the functions of oncogenes in tumorigenesis.

Folia Microbiol (Praha), 1998, 43(6), 679 - 82
Antibacterial effect of some 2,6-disubstituted 4-anilinoquinazolines; Gottasova R et al.; Two synthetic 2,6-disubstituted 4-anilinoquinazolines exerted a significant effect on the G+ bacteria Bacillus subtilis and staphylococcus aureus . None of 12 tested derivatives influenced Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa . Derivatives having the aromatic ring non-substituted or substituted by bromine, the pyrimidine ring by phenyl, morpholine or piperidine and the aniline skeleton non-substituted or substituted by methyl or amino group exerted a considerable antibacterial activity.

J Bacteriol, 1999 Apr, 181(7), 2008 - 16
A novel membrane protein influencing cell shape and multicellular swarming of Proteus mirabilis; Hay NA et al.; Swarming in Proteus mirabilis is characterized by the coordinated surface migration of multicellular rafts of highly elongated, hyperflagellated swarm cells . We describe a transposon mutant, MNS185, that was unable to swarm even though vegetative cells retained normal motility and the ability to differentiate into swarm cells . However, these elongated cells were irregularly curved and had variable diameters, suggesting that the migration defect results from the inability of these deformed swarm cells to align into multicellular rafts . The transposon was inserted at codon 196 of a 228-codon gene that lacks recognizable homologs . Multiple copies of the wild-type gene, called ccmA, for curved cell morphology, restored swarming to the mutant . The 25-kDa CcmA protein is predicted to span the inner membrane twice, with its C-terminal major domain being present in the cytoplasm . Membrane localization was confirmed both by immunoblotting and by electron microscopy of immunogold-labelled sections . Two forms of CcmA were identified for wild-type P . mirabilis; they were full-length integral membrane CcmA1 and N-terminally truncated peripheral membrane CcmA2, both present at approximately 20-fold higher concentrations in swarm cells . Differentiated MNS185 mutant cells contained wild-type levels of the C-terminally truncated versions of both proteins . Elongated cells of a ccmA null mutant were less misshapen than those of MNS185 and were able to swarm, albeit more slowly than wild-type cells . The truncated CcmA proteins may therefore interfere with normal morphogenesis, while the wild-type proteins, which are not essential for swarming, may enhance migration by maintaining the linearity of highly elongated cells . Consistent with this view, overexpression of the ccmA gene caused cells of both Escherichia coli and P . mirabilis to become enlarged and ellipsoidal.

FEBS Lett, 1999 Feb 26, 445(2-3), 347 - 50
Functional analysis of the evolutionarily conserved proline 53 residue in Proteus mirabilis glutathione transferase B1-1; Allocati N et al.; The role of the evolutionarily conserved residue Pro-53 in Proteus mirabilis glutathione transferase B1-1 has been examined by replacing it with a serine residue using site-directed mutagenesis . The effect of the replacement on the activity, thermal stability and antibiotic binding capacity of the enzyme was examined . The results presented support the view that Pro-53 participates in the maintenance of the proper conformation of the enzyme fold rather than playing a direct role in the catalytic reaction . Furthermore, this residue appears to be an important determinant of the antibiotic binding to the enzyme . Experiments with wild type and mutated enzymes provide evidence that glutathione transferases may play an important role in antibiotic resistance exhibited by bacteria.

J Nutr, 1999 Mar, 129(3), 634 - 40
The isoflavone genistein inhibits internalization of enteric bacteria by cultured Caco-2 and HT-29 enterocytes; Wells CL et al.; The dietary isoflavone genistein is the focus of much research involving its role as a potential therapeutic agent in a variety of diseases, including cancer and heart disease . However, there is recent evidence that dietary genistein may also have an inhibitory effect on extraintestinal invasion of enteric bacteria . To study the effects of genistein on bacterial adherence and internalization by confluent enterocytes, Caco-2 and HT-29 enterocytes (cultivated for 15-18 d and 21-24 d, respectively) were pretreated for 1 h with 0, 30, 100, or 300 micromol/L genistein, followed by 1-h incubation with pure cultures of Listeria monocytogenes, Salmonella typhimurium, Proteus mirabilis, or Escherichia coli . Pretreatment of Caco-2 and HT-29 enterocytes with genistein inhibited bacterial internalization in a dose-dependent manner (r = 0.60-0.79) . Compared to untreated enterocytes, 1-h pretreatment with 300 micromol/L genistein was generally associated with decreased bacterial internalization (P < 0 . 05) without a corresponding decrease in bacterial adherence . Using Caco-2 cell cultures, decreased bacterial internalization was associated with increased integrity of enterocyte tight junctions {measured by increased transepithelial electrical resistance (TEER)}, with alterations in the distribution of enterocyte perijunctional actin filaments (visualized by fluorescein-labeled phalloidin), and with abrogation of the decreased TEER associated with S . typhimurium and E . coli incubation with the enterocytes (P < 0.01) . Thus, genistein was associated with inhibition of enterocyte internalization of enteric bacteria by a mechanism that might be related to the integrity of the enterocyte tight junctions, suggesting that genistein might function as a barrier-sustaining agent, inhibiting extraintestinal invasion of enteric bacteria.

Klin Khir, 1998, (12), 23 - 7
{Use of a composite organic biosilicone sorption preparation imosdinit in the treatment of anaerobic infections in surgery}; Bieliaieva OO et al.; New application sorbent on the base of hydrogel and xerogel of methylsilicone acid with immobilized nitazole in connection with dimexide- imosdynit was investigated in experiment . High efficacy of imosdynit in the treatment of clostridial and non-clostridial anaerobic infection, caused by Klebsiella, was established . Proteus and blue pus bacillus are nonsensitive to imosdynit . Preparation was applied in 56 patients with purulent peritonitis . The frequency of wounds suppuration reduced by 2.4 times.

Forensic Sci Int, 1999 Jan 4, 99(1), 53 - 9
Bacteria in lung tissue from an autopsy population of alcoholics; Thomsen JL et al.; The retrieval of bacteria from the lungs postmortem was examined in a population of alcoholics who had a medico-legal autopsy performed . The results were compared with non-alcoholic controls . Pneumococci were found more frequently in alcoholics, but in general there were no major differences . Proteus mirabilis was detected in three out of five alcoholics with unascertainable cause of death . It is speculated whether this species may cause septicaemia in some alcoholics due to abnormal splanchnicus circulation.

Korean J Intern Med, 1999 Jan, 14(1), 73 - 6
Pylephlebitis associated with appendicitis; Lim HE et al.; Pylephlebitis usually occurs secondary to infection in the region drained by the portal venous system . A most common antesecent focus of infection is diverticulitis and the most common blood isolate is E . coli (54%), followed by Proteus mirabilis (23%) . Overall mortality is 32% and most of the patients who had died had severe sepsis prior to the initiation of antibiotic therapy . We describe a case of pylephlebitis which had appendicitis and consequent septic thrombosis of the portal vein and its branches, with dissemination of infection to the liver . The patient had recovered due to timely antibiotic treatment alone and resulted in complete resolution . Early diagnosis and treatment are basic to a favorable clinical course.

Proc Natl Acad Sci U S A, 1999 Mar 2, 96(5), 1971 - 6
An Escherichia coli strain with all chromosomal rRNA operons inactivated: complete exchange of rRNA genes between bacteria; Asai T et al.; Current global phylogenies are built predominantly on rRNA sequences . However, an experimental system for studying the evolution of rRNA is not readily available, mainly because the rRNA genes are highly repeated in most experimental organisms . We have constructed an Escherichia coli strain in which all seven chromosomal rRNA operons are inactivated by deletions spanning the 16S and 23S coding regions . A single E . coli rRNA operon carried by a multicopy plasmid supplies 16S and 23S rRNA to the cell . By using this strain we have succeeded in creating microorganisms that contain only a foreign rRNA operon derived from either Salmonella typhimurium or Proteus vulgaris, microorganisms that have diverged from E . coli about 120-350 million years ago . We also were able to replace the E . coli rRNA operon with an E . coli/yeast hybrid one in which the GTPase center of E . coli 23S rRNA had been substituted by the corresponding domain from Saccharomyces cerevisiae . These results suggest that, contrary to common belief, coevolution of rRNA with many other components in the translational machinery may not completely preclude the horizontal transfer of rRNA genes.

J Bacteriol, 1999 Mar, 181(5), 1530 - 6
Role of ribosome release in regulation of tna operon expression in Escherichia coli; Konan KV et al.; Expression of the degradative tryptophanase (tna) operon of Escherichia coli is regulated by catabolite repression and tryptophan-induced transcription antitermination . In cultures growing in the absence of added tryptophan, transcription of the structural genes of the tna operon is limited by Rho-dependent transcription termination in the leader region of the operon . Tryptophan induction prevents this Rho-dependent termination, and requires in-frame translation of a 24-residue leader peptide coding region, tnaC, that contains a single, crucial, Trp codon . Studies with a lacZ reporter construct lacking the spacer region between tnaC and the first major structural gene, tnaA, suggested that tryptophan induction might involve cis action by the TnaC leader peptide on the ribosome translating the tnaC coding region . The leader peptide was hypothesized to inhibit ribosome release at the tnaC stop codon, thereby blocking Rho's access to the transcript . Regulatory studies with deletion constructs of the tna operon of Proteus vulgaris supported this interpretation . In the present study the putative role of the tnaC stop codon in tna operon regulation in E . coli was examined further by replacing the natural tnaC stop codon, UGA, with UAG or UAA in a tnaC-stop codon-tnaA'-'lacZ reporter construct . Basal level expression was reduced to 20 and 50% when the UGA stop codon was replaced by UAG or UAA, respectively, consistent with the finding that in E . coli translation terminates more efficiently at UAG and UAA than at UGA . Tryptophan induction was observed in strains with any of the stop codons . However, when UAG or UAA replaced UGA, the induced level of expression was also reduced to 15 and 50% of that obtained with UGA as the tnaC stop codon, respectively . Introduction of a mutant allele encoding a temperature-sensitive release factor 1, prfA1, increased basal level expression 60-fold when the tnaC stop codon was UAG and 3-fold when this stop codon was UAA; basal level expression was reduced by 50% in the construct with the natural stop codon, UGA . In strains with any of the three stop codons and the prfA1 mutation, the induced levels of tna operon expression were virtually identical . The effects of tnaC stop codon identity on expression were also examined in the absence of Rho action, using tnaC-stop codon-'lacZ constructs that lack the tnaC-tnaA spacer region . Expression was low in the absence of tnaC stop codon suppression . In most cases, tryptophan addition resulted in about 50% inhibition of expression when UGA was replaced by UAG or UAA and the appropriate suppressor was present . Introduction of the prfA1 mutant allele increased expression of the suppressed construct with the UAG stop codon; tryptophan addition also resulted in ca . 50% inhibition . These findings provide additional evidence implicating the behavior of the ribosome translating tnaC in the regulation of tna operon expression.

Mol Microbiol, 1999 Jan, 31(2), 679 - 90
Genomic rearrangements in the flagellin genes of Proteus mirabilis; Murphy CA et al.; Molecular analyses have revealed that Proteus mirabilis possesses two genes, flaA and flaB, that are homologous to each other and to flagellin genes of many other species . Both swimmer and swarmer cells transcribe flaA, but not flaB . FlaA- mutants are non-motile and do not differentiate showing the essential role of flaA in swarmer cell differentiation and behaviour . At a low frequency, motile, differentiation-proficient revertants have been found in FlaA-populations . These revertants produce an antigenically and biochemically distinct flagellin protein . The revertant flagellin is the result of a genetic fusion between highly homologous regions of flaA and flaB that places the active flaA promoter and the 5' coding region of flaA adjacent to previously silent regions of flaB generating a hybrid flagellin protein . Analysis of the flaA-flaB region of two such revertants reveals that a portion of this locus has undergone a rearrangement and deletion event that is unique to each revertant . Using a polymerase chain reaction (PCR) to amplify the falA-flaB locus from wild-type swimmer cells, swarmer cells and cells obtained after urinary tract infection, we uncover at least six general classes of rearrangements between flaA and flaB . Each class of rearrangement occurs within one of nine domains of homology between flaA and flaB . Rearrangement of flaA and flaB results in a hybrid flagellin protein of nearly identical size and biochemical properties, suggesting a concerted mechanism may be involved in this process . The data also reveal that the frequency and distribution of flaAB rearrangements is predicted on environmental conditions . Thus, rearrangement between flaA and flaB may be a significant virulence component of P . mirabilis in urinary tract infections.

Acta Microbiol Pol, 1998, 47(3), 313 - 9
Genomic fingerprinting of Proteus species using repetitive sequence based PCR (rep-PCR); Serwecinska L et al.; Three Proteus species P . vulgaris, P . mirabilis and P . penneri have been characterized by repetitive sequence-based PCR . Four families of repetitive sequence based primers REP, ERIC, BOXA1R and BOXA2R, give specific patterns for each Proteus species . Species differentiation was best afforded using BOXA2R for detection of P . mirabilis, either REP-Dt or BOXA1R primers for detection of P . penneri and ERIC primer pair for P . vulgaris.

Br J Dermatol, 1998 Dec, 139(6), 1060 - 3
Proteus syndrome with widespread portwine stain naevus; Plotz SG et al.; Proteus syndrome is a rare condition comprising asymmetrical overgrowth of different parts of the body in association with various cutaneous abnormalities . We describe a 3-year-old boy with Proteus syndrome, who presented with hemihypertrophy of the right leg, asymmetric macrodactyly, subcutaneous masses and a widespread portwine stain interspersed with angiokeratomas on the right leg, scrotum and on the middle and left side of the back . Doppler ultrasound of the right leg did not show hypercirculation, but did reveal the absence of the right superficial femoral vein.

Graefes Arch Clin Exp Ophthalmol, 1999 Feb, 237(2), 89 - 92
Penetration of ciprofloxacin, norfloxacin and ofloxacin into the aqueous humor using different topical application modes; Beck R et al.; BACKGROUND: A prospective study was undertaken to determine the transcorneal penetration of three topically applied fluoroquinolones into aqueous humor . METHODS: Cataract patients (n = 224) preoperatively received topically applied gyrase inhibitors (0.3% ciprofloxacin, 0.3% norfloxacin, 0.3% ofloxacin) in two different application modes . In application mode I, patients received on the day before operation 3 x 1 eye drop at 2-h intervals, and on the day of operation 3 drops at 1-h intervals . In application mode II, patients received 9 drops at 15-min intervals on the day of operation only . Just before cataract surgery 50-100 ml aqueous humor was aspirated and stored at -80 degrees C . The HPLC method was used for measuring the concentration . RESULTS: The highest concentrations of all tested antibiotics were measured after the mode of application in which one drop was given every 15 min between 06:00 and 08:00 hours before operation . In this mode, ciprofloxacin achieved a mean aqueous level of 379.8 +/- 327.8 mg/l (range 33-1388 mg/l), norfloxacin 182.1 +/- 118.1 mg/l (range 38-480 mg/l) and ofloxacin 563.9 +/- 372.1 mg/l (range 64-1455 mg/l) . These mean concentration are all above the MIC90 of gram-negative bacteria like Proteus mirabilis and Escherichia coli . In some cases the concentrations of ciprofloxacin and ofloxacin, but never norfloxacin, reached therapeutic values above the MIC90 of Staphylococcus aureus and Staphylococcus epidermidis . CONCLUSIONS: The mean concentration value of 0.3% ciprofloxacin and of 0.3% ofloxacin in the aqueous humor reached the MIC90 values of the frequently occurring gram-positive and gram-negative bacteria . Of the currently available topical fluoroquinolones, ofloxacin achieved the highest aqueous humor concentration . Considering the higher antimicrobial activity of ciprofloxacin, both ciprofloxacin and ofloxacin may be useful ophthalmic agents in antibacterial management, but they are not efficient against Streptococcus pneumoniae and Pseudomonas aeruginosa.

J Clin Microbiol, 1999 Mar, 37(3), 841 - 3
Aerobic and anaerobic microbiology of surgical-site infection following spinal fusion; Brook I et al.; The aerobic and anaerobic microbiology of surgical-site infections (SSI) following spinal fusion was retrospectively studied . This was done by reviewing the clinical and microbiological records at the Naval Hospital in Bethesda, Md., from 1980 to 1992 . Aspirates of pus from 25 infection sites showed bacterial growth . Aerobic bacteria only were recovered from 9 (36%) specimens, anaerobic bacteria only were recovered from 4 (16%), and mixed aerobic and anaerobic bacteria were recovered from 12 (48%) . Sixty isolates were recovered: 38 aerobes (1.5 isolates per specimen) and 22 anaerobes (0.9 isolate per specimen) . The predominant aerobes were Escherichia coli (n = 8) and Proteus sp . (n = 7) . The predominant anaerobes were Bacteroides fragilis group (n = 9) and Peptostreptococcus sp . (n = 6) isolates . An increase in recovery of E . coli and B . fragilis was noted in patients with bowel or bladder incontinence . This study highlights the polymicrobial nature of SSI and the importance of anaerobic bacteria in SSI following spinal fusion.

Plast Reconstr Surg, 1999 Feb, 103(2), 666 - 70
The antibacterial effects of tumescent liposuction fluid; Craig SB et al.; Tumescent liposuction is currently one of the most commonly performed aesthetic procedures . Despite the variable use of preoperative antibiotics, infection is uncommon . Prior works suggest that the low incidence of infection may be due to lidocaine's antibacterial properties . However, these properties have only been demonstrated using concentrations of lidocaine above 0.8%, significantly higher than those used in tumescent liposuction . The purpose of this study was to determine if the commonly used tumescent fluid containing 0.1% lidocaine, 1:1000,000 epinephrine, and 0.012 mEq sodium bicarbonate possesses antibacterial activity . Using the broth microdilution method, the minimum inhibitory concentrations of Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureus, and Group A beta-hemolytic Streptococcus were determined after exposure to either lidocaine, epinephrine, bicarbonate, or the combination of all three agents . To determine if there were significant growth differences not detectable by the broth microdilution method, bacterial concentrations were obtained through the use of a spectrophotometer, and significant differences from the controls were calculated by one-way analysis of variance . To determine if prolonged exposure to the tumescent mix would alter bacterial growth, a Killing Time study was also undertaken . The results indicated that the minimum inhibitory concentration of lidocaine was not less than 0.5% for any of the bacteria, whereas the lowest minimum inhibitory concentration of the combined solution was 0.25% . The lowest inhibitory concentration as determined by spectrophotometric analysis for the combined solution was 0.13% (p < 0.01) . Analysis of the Killing Time data revealed no inhibition of bacterial growth over time . In conclusion, lidocaine, epinephrine, and bicarbonate do exhibit antibacterial properties at high concentrations . However, the commonly used tumescent mixture containing dilute concentrations of these agents does not significantly inhibit the growth of commonly encountered bacteria.

J Clin Pathol, 1998 Sep, 51(9), 657 - 61
Absence of Escherichia coli, Listeria monocytogenes, and Klebsiella pneumoniae antigens within inflammatory bowel disease tissues; Walmsley RS et al.; BACKGROUND: Escherichia coli, listeria, and streptococcal antigens have been found in Crohn's disease tissues . Antibodies to Klebsiella pneumoniae have been found in patients with inflammatory bowel disease and ankylosing spondylitis . The presence of these bacterial antigens in Crohn's granulomas would be of aetiological interest, while their presence in ulcers alone would be more likely to indicate secondary infection . AIM: To investigate inflammatory bowel disease tissues for the presence of these bacteria . METHODS: Formalin fixed, paraffin processed sections from 53 patients (19 ulcerative colitis, 23 Crohn's disease; 11 normal tissues from cancer resections) were studied by immunohistochemistry . Control tissue consisted of normal human small bowel injected submucosally with either E coli, Listeria monocytogenes, Proteus mirabilis, or Klebsiella pneumoniae serotypes K2, 3, 17, 21, 26, 36, and 50, and colonic biopsies from a child with E coli 0114 infection . Tissues were stained by Gram-Twort, and with specific antibodies for E coli (Dako B357), L monocytogenes (Difco 2302-50), and K pneumoniae (Biogenesis 5580-5208) using an immunoperoxidase technique . RESULTS: Positive staining for E coli was observed on the luminal surface epithelium and in ulcers in 35% of Crohn's disease patients, 26% of ulcerative colitis patients, and no normal controls . Superficial staining for L monocytogenes was observed in one case of ulcerative colitis only . Staining for K pneumoniae was observed in one case of ulcerative colitis and one of Crohn's disease . No granulomas, giant cells, or germinal centres stained positively for any of the three bacterial antigens . CONCLUSIONS: These data do not support a primary role for E coli, L monocytogenes, and K pneumoniae in inflammatory bowel disease . The presence of E coli antigens in ulcers suggests secondary infection in these lesions.

Acta Vet Scand, 1998, 39(4), 423 - 32
Bacteriological and histological investigation of the postpartum bovine uterus in two Estonian dairy herds; Kask K et al.; Postpartum uterine infections, endometrial histology and resumption of ovarian activity in cows were studied in 2 Estonian dairy herds with different herd sizes, milk yields and management systems . Ten cows at Farm A and 5 cows at Farm B were studied in the experiment . All cows in the study had normal calving performance . Endometrial biopsies for bacteriological and histological examinations were collected once a week starting on the second week postpartum and continuing for 7 weeks postpartum . Milk progesterone samples were collected twice a week during the whole study period . In both herds, the uterine flora contained mainly facultative anaerobic bacteria (Streptococcus spp., E . coli, Staphylococcus spp., Proteus vulgaris) . Among obligate anaerobic bacteria only Bacteroides spp . were found . After 7 weeks of collection at farm A, a bacterial uterine flora still persisted in 2 of the cows . At farm B, on the other hand, bacterial elimination was complete after 6 weeks . Presence of inflammatory cells in uterine histology specimens remained higher at the end of collection and resumption of ovarian activity was delayed at farm A . After 7 weeks postpartum, only 6 of the 10 cows at farm A had resumed ovarian cyclicity, while at farm B the first oestrous cycle had occurred in all cows . The study showed that differences regarding uterine infections and their clearance occurred between farms and, despite these differences, cows with normal calving performance will effectively recover without any treatment.

Antimicrob Agents Chemother, 1999 Feb, 43(2), 297 - 301
Characterization and nucleotide sequence of CARB-6, a new carbenicillin-hydrolyzing beta-lactamase from Vibrio cholerae; Choury D et al.; A clinical strain of Vibrio cholerae non-O1 non-O139 isolated in France produced a new beta-lactamase with a pI of 5.35 . The purified enzyme, with a molecular mass of 33,000 Da, was characterized . Its kinetic constants show it to be a carbenicillin-hydrolyzing enzyme comparable to the five previously reported CARB beta-lactamases and to SAR-1, another carbenicillin-hydrolyzing beta-lactamase that has a pI of 4.9 and that is produced by a V . cholerae strain from Tanzania . This beta-lactamase is designated CARB-6, and the gene for CARB-6 could not be transferred to Escherichia coli K-12 by conjugation . The nucleotide sequence of the structural gene was determined by direct sequencing of PCR-generated fragments from plasmid DNA with four pairs of primers covering the whole sequence of the reference CARB-3 gene . The gene encodes a 288-amino-acid protein that shares 94% homology with the CARB-1, CARB-2, and CARB-3 enzymes, 93% homology with the Proteus mirabilis N29 enzyme, and 86.5% homology with the CARB-4 enzyme . The sequence of CARB-6 differs from those of CARB-3, CARB-2, CARB-1, N29, and CARB-4 at 15, 16, 17, 19, and 37 amino acid positions, respectively . All these mutations are located in the C-terminal region of the sequence and at the surface of the molecule, according to the crystal structure of the Staphylococcus aureus PC-1 beta-lactamase.

West Afr J Med, 1998 Oct-Dec, 17(4), 239 - 42
Effect of sun-drying and chemical disinfection on contaminated cleaning cloth; Ofielu LO; In domestic environment, cross-contamination by contaminated cleaning cloth represents an infection hazard . Could disinfectant use, detergent wash and rinse, and proper sun-drying be a panacea for cross-contamination? This is the fact-finding goal of this work . A sterilized towel (66.5 cm) was used to mop the eating tables of Nnamdi Azikiwe University cafeteria for 3 days, then aseptically collected and cut into six equal size, each for: estimation of total bacterial count; determination of the effects of detergent, sun-drying strength Ringer's solution was used as neutralizing medium . Seven organisms, Escherichia Coli, Staphylococcus aureus, Proteus . Bacillus, Klebsiella, and pseudomonas species were isolated from the mop . The total bacterial count was 2.9 x 10(12) cfu/cm2 . However, detergent washing cum sun-drying proved effective in reducing, to acceptable standards, the bacterial numbers and types . Disinfectant use gave a second best result . The present hygienic practices in student's cafeteria and other similar places in Nigeria and elsewhere (where mop is not properly washed and sufficiently sun-dried before re-use) may not be quite healthy after all.

Int J Antimicrob Agents, 1998 Nov, 10(4), 317 - 9
Antibacterial activity of human pleural fluid: alone and in combination with antibiotics; Miglioli PA et al.; This study investigated the antibacterial activity of human pleural fluid (HPF) and its interaction with gentamicin (GM), meropenem (MRPM), ciprofloxacin (CPFX) and clarithromycin (CLTM) against Escherichia coli K-12, Proteus rettgeri (Sanelli) and Staphylococcus aureus . Minimal inhibitory concentrations or volumes, expressed as MIC or volume percentage (MIV, V/V%), were measured using a micro-dilution technique in microtiter plates . The antimicrobial activity of HPF combinations with antimicrobial drugs was evaluated by the chequerboard method calculating the fractional inhibitory concentration index (FIC) values . HPF MIVs (%) were: 37.54; 19.85; 1.74 for E . coli, P . rettgeri and S . aureus, respectively . FIC values indicated a synergistic effect with GM, MRPM and CPFX against E . coli and P . rettgeri and an additive effect for the combination HPF plus CLTM or indifference with HPF plus GM and CPFX against S . aureus . The presence of antibodies, complement factors, lysozyme, alpha-defensins and enzymes could explain the antimicrobial activity of HPF and its synergistic effect with certain antibiotics.

Eur J Biochem, 1999 Jan, 259(1-2), 212 - 7
Structure and serological specificity of a new acidic O-specific polysaccharide of Proteus vulgaris O45; Bartodziejska B et al.; The following structure of the O-specific polysaccharide (OPS) of Proteus vulgaris O45 lipopolysaccharide (LPS) was established using 1H- and 13C-NMR spectroscopy, including two-dimensional NOESY and H-detected 1H, 13C heteronuclear multiple-quantum coherence ( HMQC) experiments: {structure: see text text} Immunochemical studies, using rabbit polyclonal anti-P . vulgaris O45 serum and LPS, OPS and Smith-degraded OPS of P . vulgaris O45, showed the importance of beta-D-GlcA in manifesting the serological specificity of the O-antigen studied.

Annu Rev Microbiol, 1998, 52, 81 - 104
Thinking about bacterial populations as multicellular organisms; Shapiro JA; It has been a decade since multicellularity was proposed as a general bacterial trait . Intercellular communication and multicellular coordination are now known to be widespread among prokaryotes and to affect multiple phenotypes . Many different classes of signaling molecules have been identified in both Gram-positive and Gram-negative species . Bacteria have sophisticated signal transduction networks for integrating intercellular signals with other information to make decisions about gene expression and cellular differentiation . Coordinated multicellular behavior can be observed in a variety of situations, including development of E . coli and B . subtilis colonies, swarming by Proteus and Serratia, and spatially organized interspecific metabolic cooperation in anaerobic bioreactor granules . Bacteria benefit from multicellular cooperation by using cellular division of labor, accessing resources that cannot effectively be utilized by single cells, collectively defending against antagonists, and optimizing population survival by differentiating into distinct cell types.

Braz J Med Biol Res, 1998 Sep, 31(9), 1149 - 55
Characterization of Plasmodium falciparum glutamate dehydrogenase-soluble antigen; Rodriguez-Acosta A et al.; The major aim of this study was to characterize a soluble Plasmodium falciparum antigen from the plasma of malaria-infected humans and Plasmodium falciparum culture supernatants, using immunoabsorbent techniques and Western blotting . An Mr 60-kDa protein was isolated from the plasma of patients with Plasmodium falciparum malaria by affinity chromatography using rabbit anti-Proteus spp GDH(NADP+) serum as ligand . This protein, present in plasma of patients with acute Plasmodium falciparum infection, in Plasmodium falciparum culture supernatants, and in immune complexes, was tested with Plasmodium falciparum malaria hyperimmune serum from patients living in hyperendemic areas and rabbit anti-Proteus spp GDH(NADP+) serum prepared in the laboratory . In this report, we describe the results of a study showing that parasite GDH(NADP+) can be used to detect the presence of Plasmodium falciparum . It appears that this technique permits the chromatographic detection of a Plasmodium falciparum excretion antigen that may be used in the production of monoclonal antibodies to improve immunodiagnostic assays for the detection of antigenemia, and opens the possibility of its use as a non-microscopic screening method.

Nephron, 1999, 81 Suppl 1, 50 - 9
Struvite stones; Rodman JS; Struvite stones constitute only about 2-3% of the stones reaching the laboratory for analysis, but the clinical problems they create including sepsis and even renal demise are greater than with any other stone type . This article reviews the evidence that bacterial urease, usually from a Proteus species, is responsible for the chemical changes in urine which result in struvite formation . Available urease inhibitors and other forms of medical management of patients with these stones are discussed . A patient with struvite stones should be assumed to have a progressive disease which cannot be ignored . Even after seemingly successful elimination of stones with lithotripsy and/or percutaneous nephrolithotomy, careful medical follow-up is critical . The medical profession is probably underutilizing postprocedure hemiacidrin irrigation because of shortsighted financial considerations . Primary-care physicians need to be educated in the importance of aggressive management of Proteus and other urea-splitting infections.

Zhonghua Yi Xue Za Zhi (Taipei), 1998 Nov, 61(11), 651 - 6
Complicated urinary tract infection: analysis of 179 patients; Chen SS et al.; BACKGROUND: The aim of our study was to investigate the incidence, bacteriology, management and outcome of complicated urinary tract infections (UTIs) at the Veterans General Hospital-Taipei . METHODS: Between June, 1993, and July, 1994, medical records of 2,566 patients admitted to the Division of Urology, Veterans General Hospital-Taipei, were retrospectively reviewed . Of these patient, 1,322 had a diagnosis of benign prostatic hyperplasia (BPH), 607 were admitted for renal stones, 496 for ureteral stones, 75 for transitional cell carcinoma (TCC) of the urinary bladder, 47 for renal tumors and 19 for TCC of the ureter . Among all patients studied, 179 (6.98%) acquired a complicated UTI . Of these, 81 were admitted for BPH, 46 for renal stones, 42 for ureteral stones, five for TCC of the urinary bladder, three for renal tumors and two for TCC of the ureter . RESULTS: Of the 179 patients with complicated UTIs, 155 were men and 24 were women . The urine culture positive rate was 76.0% (136/179) and the most common bacteria were Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa . The principle mode of treatment included parenteral antibiotics and urinary diversion (percutaneous nephrostomy and Foley catheterization), when necessary . The infection control rate for these complicated UTIs was 96.3% for BPH, 95.5% for renal stone, 97.6% for ureteral stone, 80% for TCC of the urinary bladder, 100% for renal tumor and 100% for TCC of the ureter . Mortality due to complicated UTI was 3.9% (7/179) . CONCLUSIONS: We concluded that the prognosis of complicated UTI is good if diagnosis and appropriate treatment are given promptly . Early drainage to relieve obstruction and intravenous antibiotics are initially necessary . Surgical intervention is required to resolve functional or structural abnormalities after the UTI has been controlled.

J Eukaryot Microbiol, 1998 Nov-Dec, 45(6), 600 - 5
Characterization of myosin heavy chain and its gene in Amoeba proteus; Oh SW et al.; Monoclonal antibodies against the myosin heavy chain of Amoeba proteus were obtained and used to localize myosin inside amoebae and to clone cDNAs encoding myosin . Myosin was found throughout the amoeba cytoplasm but was more concentrated in the ectoplasmic regions as determined by indirect immunofluorescence microscopy . In symbiont-bearing xD amoebae, myosin was also found on the symbiosome membranes, as checked by indirect immunofluorescence microscopy and by immunoelectron microscopy . The open reading frame of a cloned myosin cDNA contained 6,414 nucleotides, coding for a polypeptide of 2,138 amino acids . While the amino-acid sequence of the globular head region of amoeba's myosin had a high degree of similarity with that of myosins from various organisms, the tail region building a coiled-coil structure did not show a significant sequence similarity . There appeared to be at least three different isoforms of myosins in amoebae, with closely related amino acids in the globular head region.

Ned Tijdschr Geneeskd, 1998 Oct 31, 142(44), 2414 - 5
{Hyperammonemia in hydronephrosis}; van Daele PL et al.; A man aged 81 with bilateral hydronephrosis presented with lethargy deepening into coma caused by hyperammonaemia . The hyperammonaemia was most likely caused by excessive absorption of ammonia produced by Proteus mirabilis in the obstructed and dilated urinary tract . The patient died within a few hours.

Zentralbl Bakteriol, 1998 Nov, 288(3), 351 - 60
Diversity among clinical isolates of Proteus penneri detected by random amplified polymorphic DNA analysis; Hoffmann G et al.; DNA of thirteen haemolytic Proteus penneri strains of clinical origin, all producing calcium dependent haemolysin and having been derived from four European countries was examined for plasmid profile, and outer membrane protein profile, by random amplified polymorphic DNA-PCR (RAPD-PCR) method, and digestions with restriction endonucleases were performed . All strains contained two large plasmids of approximately 60 and 70 kilobase pairs (kb) . In addition, four strains contained a small plasmid of about 6 kb . These four strains produced cell-bound haemolysin only . Outer membrane protein analysis revealed subtle differences between strains . RAPD-PCR with primer I (CCGCAGCCAA) revealed 13 types, whereas primer II (AACGCGCAAC) yielded only two main types of different patterns . Results with primer I suggests a DNA sequence diversity within this species . The RAPD-PCR method provides a fast, economical and reproducible means for the typing of P . penneri . Digestion with restriction endonucleases indicated a high level of DNA methylation in this species.

Aviakosm Ekolog Med, 1998, 32(4), 21 - 5
{Carbohydrate adaptive substance for prophylaxis of immune disorders and correction of dysbacterioses}; Vikha GV et al.; Effects of a new preparation, adaptokhit, on the intestinal microbiocenosis and some parameters of immune resistance were studied in Macaque rhesus during 13-day hypokinesia . Experimental animals were given adaptokhit as an alimentary supplement preventing dysbiotic consequences of the microecologic unbalance due to motor restraint . Results of the investigation showed certain distinctions in the intestinal microflora in the experimental and control animals as early as on day three of the experiment . Intestinal microflora of the experimental primates who daily consumed adaptokhit at 50 mg/kg of the body remained stable throughout the period of observation . In contrast, in their controls lactoflora was found to decrease in parallel to the growth of opportunistically pathogenic endobacteria including representatives of Proteus and Clostridia sp., and development of dysbacteriosis of categories II and III . Besides, in the experimental animals adaptokhit prevented decline in the proliferative activity of lymphocytes further into adaptation . Also, at the final stage of observation following canceling the preparation there were signs of normalization of the allergologic status of primates in the experimental group . Therefore, adaptokhit can be used as an alimentary supplement to strengthen the colony resistance of animals in extreme conditions.

Microbiol Immunol, 1998, 42(10), 669 - 75
Serological studies of an acid-labile O-polysaccharide of Proteus vulgaris OX19 lipopolysaccharide using human and rabbit antibodies; Kaca W et al.; In a Weil-Felix test, sera from patients infected with Rickettsia sp . agglutinate Proteus OX types of bacteria and Proteus lipopolysaccharide (LPS) are responsible for the cross-reaction . Data on the character of LPS of one of the OX group strains, Proteus vulgaris OX19, are contradictory, and it remained unclear whether it has an O-polysaccharide (OPS) and is thus LPS of the smooth type (S) or not (rough-type LPS) . Our studies showed that P . vulgaris OX19 (strain PZH-24) produces a smooth-type LPS that contains a long-chain OPS, but it undergoes depolymerization during mild acid hydrolysis conventionally used for LPS delipidation and loses the serological activity . An elucidation of the complete structure of OPS demonstrated the presence of a glycosyl phosphate linkage responsible for the acid-lability of the polysaccharide chain . In ELISA, both IgM type antibodies in a Weil-Felix test with human anti-Rickettsia typhi sera and rabbit anti-P . vulgaris OX19 antibodies reacted with OPS . Rabbit antibodies did not inhibit the cross-reaction with human antibodies and thus bind to different epitopes.

Med Dosw Mikrobiol, 1998, 50(1-2), 21 - 9
{Examination of selected biological properties for swarm cells in Proteus mirabilis}; Krajewska-Pietrasik D et al.; Certain biological properties, which generally are thought to play a role in the bacterial pathogenicity, were compared in short rods, swarm cells and penicillin-induced filaments of Proteus mirabilis S1959 . Swarm cells of P . mirabilis S1959 weakly adhere to human uroepithelial cells and also do not penetrate L929 line of mouse fibroblasts . They do not show any cytotoxic activity, are poorly phagocytized by macrophages and granulocytes and start to divide by the end of the phagocytosis process . Their well-marked cell-bound haemolytic activity is correlated with fast division to the short rods . In in vivo experiments we have demonstrated the presence of long filamentous multinucleate nonseptate cells in the bladder and in the kidneys of infected animals . However there was no correlation between the number of swarm cells seen under microscopic examination and the intensity of infection.

Khirurgiia (Sofiia), 1998, 51(1), 41 - 6
{Infections in urology departments}; Ribarova N et al.; The wide-spreading of intrahospital infections in urological departments on a nationwide scale are analyzed over the period 1982 through 1996 . Their epidemiological, etiological and nosological characterization is also defined . In this country over 6 per cent of all hospital infections occur in urological departments . Annually, in Bulgaria 5/100 discharged urological patients develop infection in hospital conditions . Both gram-negative and gram-positive microorganisms are the etiological causing factors identified, with E . coli and Proteus mirabilis being predominant . Among the patients in urological departments urinary tract infections are the leading infectious pathology so far documented -80.85% + 0.61 . The low efficacy of the prophylactic and antiepidemiological measures undertaken correlate with the low rate of diagnosing such infections, and with the insufficient theoretical and methodological training of the medical personnel along these lines.

Ann Med Interne (Paris), 1998 Oct, 149(6), 326 - 30
{Emphysematous pyelonephritis}; Hansmann Y et al.; Pyelonephritis is a frequent infection of variable severity . Mortality is low since the era of antibiotics . Emphysematous pyelonephritis is however a rare but life threatening form of kidney infection, which affect more frequently diabetic subjects, characterized by gas producing bacteria . These gaseous lesions can be localized in the renal parenchyma or in the perirenal or retroperitoneal space . Diagnosis became easier with the advent of CT scan . Treatment usually requires surgery and antibiotics . We report a case of emphysematous pyelonephritis in a diabetic patient . The CT scan strongly suggested the diagnosis which was confirmed per-operatively . Proteus mirabilis is exceptionally described in emphysematous pyelonephritis.

Can J Microbiol, 1998 Sep, 44(9), 896 - 904
The effect of growth conditions on in vitro adherence, invasion, and NAF expression by Proteus mirabilis 7570; Latta RK et al.; Proteus mirabilis is a common cause of upper urinary tract infections . Fimbriae-mediated adherence of this organism to urinary tract epithelium and invasion of host cells are factors thought to be important in its pathogenesis . We have assessed the effect of growth in serum, blood, and urine on the ability of P . mirabilis 7570 to adhere to and invade in vitro the cell line EJ/28, derived from a human urinary tract tumour, and to express nonagglutinating fimbriae (NAF) . Proteus mirabilis was capable of adhering to EJ/28 cells to varying degrees depending upon the growth conditions used . It was invasive under all conditions, except when grown in urine, and was found to be particularly so when serum or blood was present in the media . Expression of NAF occurred under all growth conditions examined and was limited only by a decrease in temperature.

Acta Biol Hung, 1997, 48(4), 395 - 8
Genetic diversity in Proteus penneri; Hoffmann G et al.; DNA of thirteen Proteus penneri strains derived from four European countries (nine strains from Germany, two strains from United Kingdom, one strain from Turkey, one strain from Hungary) was examined by random amplified polymorphic DNA-PCR (RAPD-PCR) method . RAPD with primer AACGCGCAAC gave different patterns, which suggests a DNA sequence microdiversity within this species . The method provides a fast, economical and reproducible means for typing P . penneri.

Pediatr Dev Pathol, 1998 Sep-Oct, 1(5), 443 - 8
Pathology of lipomatous lesions in Proteus syndrome; Tihan T et al.; Proteus syndrome is an extremely rare, complex hamartomatous disorder with markedly variable clinical expression . We present a case of Proteus syndrome with multiple disfiguring soft tissue masses that were present since early childhood . The lesions involved predominantly the right side of the body and included scoliosis, macrodactyly, and limited hyperostosis in the right foot . There was no evidence of cranial or skin lesions . The patient underwent multiple resections of soft tissue masses, including an amputation of the right foot because of severe gait disturbance . All specimens exhibited lipomatous lesions that were probably hamartomatous rather than neoplastic . She carried a diagnosis of neurofibromatosis for more than a decade, but a re-evaluation of clinical features and pathological findings prompted the diagnosis of Proteus syndrome . We believe that a more informed evaluation of the pathology material may help to identify this rare entity.

Acta Microbiol Pol, 1998, 47(2), 141 - 51
The comparison of some biological activities of lipopolysaccharides obtained from smooth and rough Proteus mirabilis strains; Klink M et al.; The biological activity of lipopolysaccharide (LPS) obtained from Proteus mirabilis smooth and rough strains was investigated . The tested endotoxins (differing in polysaccharide chain lenght) were isolated from wild S1959 strain as well as from its rough mutants Ra and Re . Induction of tumor necrosis factor-alpha (TNF-alpha), and nitric oxide production as well as activation of complement system by lipopolysaccharide are the pathophysiological reaction in a host response to gram-negative bacteria . In this study, it was found that S (S1959), Ra (R110) and Re (R45) chemotypes of LPS similarly induced the human neutrophils to release TNF-alpha . In contrast none of the LPS stimulated the neutrophils to synthesis of nitric oxide regardless of doses used and culture time . Te Re form of LPS showed the strongest anticomplementary activity.

Carbohydr Res, 1998 Nov, 312(1-2), 97 - 101
Structure of a new neutral O-specific polysaccharide of Proteus penneri 34; Toukach FV et al.; The O-specific polysaccharide of Proteus penneri strain 34 was studied using 1H and 13C NMR spectroscopy, including 2D COSY, TOCSY, NOESY, and H-detected 1H, 13C HMQC experiments . The following structure was established, which is unique among the known structures of Proteus O-antigens:-->4)-beta-D-Glcp-(1-->3)-beta-D-GalpNAc-(1-->4)-beta- D-GalpNAc-(1-->4)-beta-D-Galp-(1--> . Accordingly, no cross-reaction was observed between P . penneri 34 O-antiserum and O-antigens of other Proteus strains . Therefore, the strain studied should belong to a new Proteus serogroup O65.

Appl Environ Microbiol, 1998 Dec, 64(12), 4862 - 9
Procaryotic expression of single-chain variable-fragment (scFv) antibodies: secretion in L-form cells of Proteus mirabilis leads to active product and overcomes the limitations of periplasmic expression in Escherichia coli; Rippmann JF et al.; Recently it has been demonstrated that L-form cells of Proteus mirabilis (L VI), which lack a periplasmic compartment, can be efficiently used in the production and secretion of heterologous proteins . In search of novel expression systems for recombinant antibodies, we compared levels of single-chain variable-fragment (scFv) production in Escherichia coli JM109 and P . mirabilis L VI, which express four distinct scFvs of potential clinical interest that show differences in levels of expression and in their tendencies to form aggregates upon periplasmic expression . Production of all analyzed scFvs in E . coli was limited by the severe toxic effect of the heterologous product as indicated by inhibition of culture growth and the formation of insoluble aggregates in the periplasmic space, limiting the yield of active product . In contrast, the L-form cells exhibited nearly unlimited growth under the tested production conditions for all scFvs examined . Moreover, expression experiments with P . mirabilis L VI led to scFv concentrations in the range of 40 to 200 mg per liter of culture medium (corresponding to volume yields 33- to 160-fold higher than those with E . coli JM109), depending on the expressed antibody . In a translocation inhibition experiment the secretion of the scFv constructs was shown to be an active transport coupled to the signal cleavage . We suppose that this direct release of the newly synthesized product into a large volume of the growth medium favors folding into the native active structure . The limited aggregation of scFv observed in the P . mirabilis L VI supernatant (occurring in a first-order-kinetics manner) was found to be due to intrinsic features of the scFv and not related to the expression process of the host cells . The P . mirabilis L VI supernatant was found to be advantageous for scFv purification . A two-step chromatography procedure led to homogeneous scFv with high antigen binding activity as revealed from binding experiments with eukaryotic cells.

J Bacteriol, 1998 Dec, 180(23), 6126 - 39
Characterization of Proteus mirabilis precocious swarming mutants: identification of rsbA, encoding a regulator of swarming behavior; Belas R et al.; Proteus mirabilis swarming behavior is characterized by the development of concentric rings of growth that are formed as cyclic events of swarmer cell differentiation, swarming migration, and cellular differentiation are repeated during colony translocation across a surface . This cycle produces the bull's-eye colony often associated with cultures of P . mirabilis . How the cells communicate with one another to coordinate these perfectly synchronized rings is presently unknown . We report here the identification of a genetic locus that, when mutated, results in a precocious swarming phenotype . These mutants are defective in the temporal control of swarming migration and start swarming ca . 60 min sooner than wild-type cells . Unlike the wild type, precocious swarming mutants are also constitutive swarmer cells and swarm on minimal agar medium . The defects were found to be localized to a 5.4-kb locus on the P . mirabilis genome encoding RsbA (regulator of swarming behavior) and the P . mirabilis homologs to RcsB and RcsC . RsbA is homologous to membrane sensor histidine kinases of the two-component family of regulatory proteins, suggesting that RsbA may function as a sensor of environmental conditions required to initiate swarming migration . Introduction of a rsbA mutation back into the wild type via allelic-exchange mutagenesis reconstructed the precocious swarming phenotype, which could be complemented in trans by a plasmid-borne copy of rsbA . Overexpression of RsbA in wild-type cells resulted in precocious swarming, suggesting that RsbA may have both positive and negative functions in regulating swarming migration . A possible model to describe the role of RsbA in swarming migration is discussed.

Prenat Diagn, 1998 Oct, 18(10), 1091 - 4
Prenatal ultrasonographic findings in Proteus syndrome; Sigaudy S et al.; Proteus syndrome, a disorder which consists of skeletal, hamartomatous and other mesodermal malformations proves to be tremendously variable . Although most of the patients show deformities at birth, the diagnosis is usually made later in life as the phenotype develops over time . We report on the case of a fetus presenting in utero, with a cystic abdominal mass and malposition of the fingers, which was found to have additional features of Proteus syndrome after termination of pregnancy . This case demonstrates that severe cases of Proteus syndrome can be detected prenatally.

Zh Mikrobiol Epidemiol Immunobiol, 1998 Sep-Oct, (5), 13 - 7
{Electron microscopic study of pathogenic bacteria on environmental objects}; Pavlova IB et al.; The morphological picture of different bacteria (Salmonella typhimurium, Proteus vulgaris, Klebsiella pneumoniae, Pseudomonas aeruginosa, Yersinia enterocolitica O3, Y.pseudotuberculosis 1, Y.frederiksenii, Y.intermedia, Y.kristensenii) on environmental objects was studied with the use of scanning electron microscopy (SEM) . Bacteria adhered to the surface of pieces of fodder, egg shell, cabbage leaves and form microcolonies, whose morphology was similar to colonies, grown on nutrient media . The cells produced extracellular substances, seen in SEM as integuments . These integuments were gourd to protect the population from the action of unfavorable factors.

Wiad Lek, 1998, 51 Suppl 3, 98 - 101
{Staghorn calculi of the kidney and ureter as a urologic complication ina child with cerebral palsy}; Kroll P et al.; We present a child with cerebral palsy, treated for renal and ureteral staghorn calculi . Calculosis was associated with neurogenic voiding dysfunction . CASE REPORT: A 10 year boy was admitted to Pediatric Surgery Clinic in Poznan because of urolithiasis . In neurologic examination four-extremities spastic paresis and convergent strabismus was found . Intellectual contact with this child was very poor . Constant urine leakage from urethra was observed . In urine analysis pH < 7, leucocytes and erythrocytes, in urine culture Proteus vulgaris > 10(5) . Ultrasonography revealed three staghorn calculi in right kidney . On the plain x-ray film three calculi in right kidney and two staghorn calculi in right ureter . In urodynamic evaluation in cystometry: low bladder compliance, no detrusor overactivity, no bladder sensation, "leak point" pressure 25-27 cm H2O . In profilometry incompetent urethral closure mechanism . All stones were evacuated during one operation . Postoperative course was uneventful . Risk factors in the treatment of patients with cerebral palsy are stressed . CONCLUSIONS: 1 . Dysfunction of lower urinary tract is an important clinical problem in children with cerebral palsy . 2 . Voiding dysfunction could be a risk factor in the development of urinary stones . 3 . In the treatment of children with cerebral palsy multispecialistic team is needed.

Pediatr Nephrol, 1998 Oct, 12(8), 658 - 9
Hyperammonaemia due to Klebsiella infection in a neuropathic bladder; Cheang HK et al.; A boy with a neuropathic bladder and a single hydronephrotic kidney developed hyperammonaemic encephalopathy during a urinary tract infection with Klebsiella oxytoca . Although particularly associated with Proteus infections and prune belly syndrome, hyperammonaemia can complicate infection with any urease-producing bacteria if there is urinary stasis.

Carbohydr Res, 1998 Aug, 310(1-2), 85 - 90
Structure of the O-specific polysaccharide of a serologically separate Proteus penneri strain 22; Arbatsky NP et al.; The O-specific polysaccharide chain (O-antigen) of Proteus penneri strain 22 lipopolysaccharide was studied using chemical methods, including partial acid hydrolysis and Smith degradation, as well as one- and two-dimensional 1H and 13C NMR spectroscopy . The following structure of the pentasaccharide repeating unit was established: {sequence: see text} The O-specific polysaccharide contains a GalNAc residue in the furanose form which has not been hitherto found in bacterial polysaccharides . The O-antigen studied is serologically and structurally unique among Proteus strains and, therefore, a new Proteus serogroup O63 is proposed for P . penneri strain 22.

Cell Motil Cytoskeleton, 1998, 41(2), 181 - 93
Protrusive activity, cytoplasmic compartmentalization, and restriction rings in locomoting blebbing Walker carcinosarcoma cells are related to detachment of cortical actin from the plasma membrane; Keller H et al.; The dynamic events at the front of locomoting blebbing Walker carcinosarcoma cells {Keller and Bebie, Cell Motil . Cytoskeleton 33:241-251, 1996} are interpreted on the basis of an analysis of the actin cytoskeleton and its relationship to the plasma membrane in fixed cells using a novel double-staining procedure . The data show that blebs are formed where cortical actin is locally depolymerized and/or by detachment of the plasma membrane from more or less intact cortical actin layers . Dissociation between the cortical actin layer and the plasma membrane, which is stimulated by microtubule disassembly, is achieved by forward movement of the plasma membrane, rather than by retraction of the actin layer . Therefore, the detached actin layers form a boundary between the newly forming protrusions and the rest of the cell . They can be associated with "constriction rings," which we have termed "restriction rings." Detached actin layers can impede entry of organelles and the nucleus into the protrusions and thereby compartmentalize the cytoplasm . Later, detached cortical actin layers depolymerize, allowing for relaxation of the restriction rings and for forward movement of cytoplasmic organelles and the nucleus . Actin may repolymerize along the detached plasma membrane allowing for a new cycle to occur . Estimates indicate that the actin polymerization/depolymerization cycles may be largely confined to the front of blebbing cells . The findings suggest that the dynamic events at the front of blebbing metazoan cells are similar to those previously found in Amoeba proteus {Grebecki, Protoplasma, 154:98-111, 1990} but different from those found in lamellipodia.

Am J Med Genet, 1998 Oct 2, 79(4), 311 - 8
Clinical differentiation between Proteus syndrome and hemihyperplasia: description of a distinct form of hemihyperplasia; Biesecker LG et al.; Proteus syndrome is a rare and highly variable hamartomatous syndrome that can affect multiple organ systems . It is characterized by hyperplastic lesions of connective tissue, vascular malformations, linear verrucous epidermal nevi, and hyperostoses . The cause of the disorder is unknown, but the current working hypothesis is that it is caused by a mosaic alteration that leads to a highly variable phenotype, equal sex ratio, sporadic occurrence, and discordant monozygotic twins . Herein we describe our experience with 18 patients with a referring diagnosis of Proteus syndrome . It was found that imaging studies are very useful for the characterization of the syndrome . One finding was that splenic hyperplasia can be a manifestation of Proteus syndrome . Analysis of the clinical data shows that Proteus syndrome is frequently confused with "hemihyperplasia." A distinct subtype of hemihyperplasia is defined that includes static or mildly progressive hemihyperplasia and multiple lipomata.

Spinal Cord, 1998 Sep, 36(9), 617 - 20
A quantitative study of genital skin flora and urinary colonization in spinal cord injured patients; Hamamci N et al.; This study was performed to define the relation between colonization of genital skin flora and bacteriuria in spinal cord injured patients with neurogenic bladder dysfunction . Twenty-seven female and 23 male spinal cord injured patients were included in the study . Patients were evaluated regarding their type of bladder management, educational status, level and degree of the spinal cord lesion . Quantitative cultures were obtained from the perineum labium/dorsum of penis, external meatus of urethra, and urine . We investigated whether the organisms isolated from urine were also present in one or more skin sites in every patient . In total 54 identical bacterial isolates were observed both from urine and one or more skin sites in 43 of the patients . Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, and Proteus stuartii were the most common bacterial isolates . The distribution of identical colonization of genital skin flora with urine were as follows: 30 in urethra, one in perineum, four in urethra and perineum, nine in urethra and labium/dorsum of penis, and 10 in both three skin sites . Identical colonization of both perineum and labium/dorsum of penis with urine were significantly higher in female patients than those of males (P = 0.037, P = 0.003, respectively) . No significant difference was found in the presence/distribution of colonization with respect to type of bladder management, educational status, and neurologic status . These results demonstrate the importance of the urethra, perineum, and labium/dorsum of penis as a source of bacteria causing urinary infection in spinal cord injured patients.

Ter Arkh, 1998, 70(8), 56 - 8
{Hospital infectious endocarditis and endocarditis in drug addicts}; Butkevich OM et al.; AIM: To specify etiology and clinical course of nosocomial infectious endocarditis (IE) and IE of drug addicts (AIE) . MATERIALS AND METHODS: 8 cases of AIE and 27 IE cases after various invasive interventions (nosocomial endocarditis) . RESULTS: Among causing agents of IE and AIE were Staphylococcus aureus, Proteus, Escherichia coli, Pseudomonas aeruginosa, anaerobic microflora, pathogenic fungi . AIE is characterized by affection of the tricuspid valve, pulmonary artery thromboembolism . Among nosocomial endocarditides are frequent IE of the replaced valve, caused by infection of venous catheters, dental manipulations, chronic hemodialysis . IE and AIE are most frequently treated with the following antibiotics: ampicilin, gentamycin, augmentin, unasin, cephalosporins, rifadin, ciprofloxin, tienam . CONCLUSION: Nosocomial IE and AIE have drawn much attention in the last decade because of development of new complex invasive treatments and expansion of narcomania.

FEMS Microbiol Lett, 1998 Sep 15, 166(2), 243 - 8
Identification of iron-regulated outer membrane proteins in uropathogenic Proteus mirabilis and its relationship with heme uptake; Piccini CD et al.; The effect of iron deprivation on the expression of outer membrane proteins and the ability to use heme as an iron source by uropathogenic Proteus mirabilis, Pr 6515, was studied . Examination of iron-restricted bacteria showed three outer membrane proteins ranging from 66 to 75 kDa to be affected by iron restriction, as well as a newly expressed 64-kDa protein . These proteins were induced within 15 minutes of iron-deprivation . The strain grew in the presence of ferric citrate, hemin and hemoglobin as iron sources, but could not use transferrin, lactoferrin or siderophores from exogenous sources . The 64- and 66-kDa proteins showed hemin-binding activity by affinity chromatography, and both reacted in Western blots with sera from mice transurethrally infected with the same strain . We suggest that P . mirabilis expresses iron-regulated outer membrane proteins that could be involved in heme uptake and may have a role in pathogenesis.

Br J Dermatol, 1998 Jul, 139(1), 132 - 6
Proteus syndrome: diagnosis in adulthood; Child FJ et al.; We describe a 24-year-old woman with many of the classical features of the Proteus syndrome . In childhood she had undergone bilateral forefoot amputations because of massive bilateral cerebriform hypertrophy of the feet . Other features include abnormally large fingers on one hand, a lymphangioma circumscriptum, an epidermal naevus, prominent venous varicosities and scattered lipomas . The disorder occurs sporadically and is thought to be secondary to a postzygotic mutation that survives by mosaicism.

Eur J Biochem, 1998 Sep 1, 256(2), 488 - 93
Structural and serological studies on a new acidic O-specific polysaccharide of Proteus vulgaris O32; Bartodziejska B et al.; The following structure of the O-specific polysaccharide chain (O-antigen) of the Proteus vulgaris 032 lipopolysaccharide (LPS) was established by 1H-NMR and 13C-NMR spectroscopy, including two-dimensional NOESY and H-detected 1H,13C heteronuclear multiple-quantum coherence (HMQC) experiments: -->2)-alpha-L-RhapI-(1-->2)-alpha-L-RhapII-(1-->4)-beta-D-++ +GalpA(I)-(1-->3)-beta-D-GlcpNAc-(1-->4)-alpha-D-GalpA(II)-(1-- > . In addition, an O-acetyl group was detected, which, most probably, is located at position 3 of a part of RhapI residues . Serological studies, using rabbit polyclonal anti-(P . vulgaris 032) serum, homologous and heterologous Proteus O-antigens and related artificial antigens, revealed the importance of an a-D-GalA-associated epitope in manifesting the immunospecificity of P . vulgaris 032 and substantiated serological relationships between the O-antigen studied and those of some other Proteus strains.

Otolaryngol Pol, 1997, 51 Suppl 25, 207 - 12
{The evaluation of cellular immunity in patients with allergy to pollen}; Jurkiewicz D; The study comprised 180 patients with pollinosis, 30 patients with vasomotor rhinitis and 30 healthy male adults . The skin reactions of cellular immunity were determined by Multitest CMI . The numbers of lymphocytes T and numbers of CD4 and CD8 lymphocytes were determined under influence of histamine or clemastinum and histamine or cimetidine and histamine . There were statistically significant decrease of percentage of CD8 lymphocytes in patients with pollinosis after addition of histamine . Statistically significant increase of percentage of CD8 lymphocytes after the addition of H2 receptor blocker indicated that blocking of this receptor neutralized the effect of histamine on the CD8 lymphocytes . Author observed increase of Multitest CMI skin reactions (particularly for antigens: Streptococcus and Proteus mirabilis).

FEMS Immunol Med Microbiol, 1998 Aug, 21(4), 297 - 302
Carbapenem-induced endotoxin release in gram-negative bacterial sepsis rat models; Horii T et al.; The carbapenem-induced endotoxin release was evaluated using experimental models of gram-negative bacterial sepsis in Wistar rats . Infections with Escherichia coli, Serratia marcescens, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus vulgaris and Proteus mirabilis resulted in an increase of the plasma endotoxin concentration after treatment with ceftazidime and carbapenems including imipenem, panipenem, meropenem and biapenem . Except for P . aeruginosa, the plasma endotoxin concentrations after carbapenem treatment were significantly lower than those after ceftazidime treatment . It is noteworthy that treatment of P . aeruginosa sepsis with meropenem or biapenem induced significantly more endotoxin release than other carbapenems and the endotoxin concentrations induced by these carbapenems reached those of ceftazidime treatment . The plasma endotoxin concentrations appeared to correlate with the reduction of platelet counts and the elevation of both glutamic oxaloacetic transaminase and glutamic pyruvic transaminase values.

Lett Appl Microbiol, 1998 Sep, 27(3), 135 - 41
Comparative antibacterial effects of novel Pelargonium essential oils and solvent extracts; Lis-Balchin M et al.; The scented leaves of a number of Pelargonium (Geraniaceae) species and cultivars were extracted using steam distillation, petroleum spirit and methanol . The extracts were assessed for their antibacterial activity in vitro against Staphylococcus aureus, Proteus vulgaris, Bacillus cereus and Staph . epidermidis . The results indicated substantial antibacterial activity and suggested that Pelargonium essential oils could be used as novel antibacterial agents . The methanolic and petroleum spirit extracts were more potent antibacterial agents than the steam-distilled volatile samples . The results suggest that Pelargonium essential oils and solvent extracts could be used as novel food or cosmetic antimicrobial agents.

Exp Brain Res, 1998 Aug, 121(3), 300 - 10
Acute and long-lasting changes in extracellular-matrix chondroitin-sulphate proteoglycans induced by injection of chondroitinase ABC in the adult rat brain; Bruckner G et al.; Lattice-like perineuronal accumulations of extracellular-matrix proteoglycans have been shown to develop during postnatal maturation and to persist throughout life as perineuronal nets (PNs) in many brain regions . However, the dynamics of their reorganization in adults are as yet unknown . The aim of the present study was to examine the capability of PNs for reconstitution after experimental destruction and to search for possible consequences of extracellular-matrix degradation for neurons and glial cells . The changes were induced by single intracortical injections of Proteus vulgaris chondroitinase ABC and studied after postinjection periods of 1 day to 5 months . The N-acetylgalactosamine-binding Wisteria floribunda agglutinin (WFA), an antibody against chondroitin-sulphate proteoglycans, three antibodies recognizing initial chondroitin or chondroitin-sulphate moieties ('stubs') of proteoglycan core proteins, an antibody against the hyaluronan-binding protein component of versican, and biotinylated hyaluronectin, which binds to hyaluronan, were used as cytochemical markers . One day postinjection, the WFA-binding sites and hyaluronan were shown to be almost completely removed within a circumscribed digestion zone . The staining of different core-protein components revealed only fragments of PNs . These changes were found to be partly compensated 4 weeks after injection of chondroitinase ABC . After 8 and 12 weeks postinjection, the cytochemical and structural characteristics as well as the area-specific distribution patterns of PNs were progressively reconstituted . At 5 months postinjection, they could not be distinguished from those in untreated tissue . In contrast to such transient changes, a diffuse chondroitin-sulphate proteoglycan immunoreactivity persisted in the neuropil . Loss of neurons or alterations of their structure as well as reactions of glial cells were not observed . We conclude from this study that PNs, enzymatically destroyed in the adult rat brain, can be completely reconstituted, but the restoration of their extracellular-matrix components needs several months.

J Ethnopharmacol, 1998 Sep, 62(2), 173 - 82
Screening of 34 Indian medicinal plants for antibacterial properties; Perumal Samy R et al.; A total of 34 plant species belonging to 18 different families, selected on the basis of folklore medicinal reports practised by the tribal people of Western Ghats, India, were assayed for antibacterial activity against Escherichia coli, Klebsiella aerogenes, Proteus vulgaris, and Pseudomonas aerogenes (gram-negative bacteria) at 1000-5000 ppm using the disc diffusion method . Of these 16 plants showed activity; among them Cassia fistula, Terminalia arjuna and Vitex negundo showed significant antibacterial activity against the tested bacteria . Our findings confirm the traditional therapeutic claims for these herbs.

Ann Dermatol Venereol, 1997, 124(8), 549 - 51
{Encephalocraniocutaneous lipomatosis}; Louvet S et al.; BACKGROUND: Encephalocraniocutaneous lipomatosis (ECL) involving the scalp and cerebellum was observed without asymptomatic expression . CASE REPORT: A seven-month-old infant presented with two soft subcutaneous hairless tumors of the scalp without any associated clinical anomaly . Neuroradiology explorations (radiography, CT-scan and MRI) showed a lipoma in the cerebellum linked with a occipital cutaneous lipoma through a bone defect . At the age of 3 years, the child remains healthy . DISCUSSION: ECL is a rare neurocutaneous disorder that consists of skin lipomas associated with various cerebral anomalies . ECL may occur as a circumscribed form of the Proteus syndrome, since a few ECL patients have associated manifestations of proteus syndrome as well as localized hypertrophy . However, minor forms of ECL are possible and may be compatible with normal life.

Clin Ther, 1998 Jul-Aug, 20(4), 744 - 59
Clinical trial of ototopical ofloxacin for treatment of chronic suppurative otitis media; Agro AS et al.; A multicenter, open-label prospective trial was performed to determine the clinical and microbiologic efficacy of ofloxacin (OFLX) otic solution in the treatment of subjects > or =12 years with chronic suppurative otitis media (CSOM) and a chronically perforated tympanic membrane in the infected ear(s) . A total of 207 patients at 27 centers in the United States and Central America received OFLX 0.5 mL instilled ototopically twice daily for 14 consecutive days . The primary clinical end point was cure (dry ear) or failure (not dry ear) . The primary microbiologic end point was eradication of baseline pathogens . Because there was no comparator and there were few data in the literature regarding clinical efficacy in patients treated with other regimens, the efficacy of OFLX was compared with data recorded in the clinical records of historical-practice control (HPC) or current-practice control (CPC) subjects . The incidence of clinical cure in clinically evaluable OFLX-treated patients (91%; 148 of 162 subjects) was significantly higher than in HPC subjects (67%; 124 of 185 subjects) or CPC subjects (70%; 38 of 54 subjects) . OFLX eradicated all baseline pathogens isolated in microbiologically evaluable subjects . These pathogens were predominantly Staphylococcus aureus, Pseudomonas aeruginosa, and Proteus mirabilis . The most common treatment-related adverse event, bitter taste, occurred in 17% (35 of 207) of OFLX-treated subjects . Thus OFLX 0.5 mL administered twice daily for 14 days was effective in resolving the signs and symptoms of CSOM in subjects > or =12 years, was significantly more effective than therapies used to treat HPC or CPC subjects, and was well tolerated.

Arch Microbiol, 1998 Oct, 170(4), 236 - 42
The Serratia marcescens hemolysin is secreted but not activated by stable protoplast-type L-forms of Proteus mirabilis; Sieben S et al.; The outer-membrane protein ShlB of Serratia marcescens activates and secretes hemolytic ShlA into the culture medium . Without ShlB, inactive ShlA (termed ShlA*) remains in the periplasm . Since Proteus mirabilis L-form cells lack an outer membrane and a periplasm, it was of interest to determine in which compartment recombinant ShlA* and ShlB are localized and whether ShlB activates ShlA* . The cloned shlB and shlA genes were transcribed in P . mirabilis stable L-form cells by the temperature-inducible phage T7 RNA polymerase . Radiolabeling, Western blotting, and complementation with C-terminally truncated ShlA (ShlA255) identified inactive ShlA* in the culture supernatant . ShlB remained cell-bound and did not activate ShlA without integration in an outer membrane . Although hemolytic ShlA added to L-form cells had access to the cytoplasmic membrane, it did not affect L-form cells . Synthesis of the large ShlA protein (165 kDa) in P . mirabilis L-form cells under phage T7 promoter control demonstrates that L-form cells are suitable for the synthesis and secretion of large recombinant proteins . This property and the easy isolation of released proteins make L-form cells suitable for the biotechnological production of proteins.

J Vet Pharmacol Ther, 1998 Aug, 21(4), 288 - 97
Pharmacokinetics of enrofloxacin after intravenous, intramuscular and oral administration in houbara bustard (Chlamydotis undulata macqueenii); Bailey TA et al.; The in-vitro activity of enrofloxacin against 117 strains of bacteria isolated from bustards was determined . Minimum inhibitory concentrations for 72% of the Proteus spp., E . coli, Salmonella spp . and Klebsiella spp . (n = 61) and for 48% of the Streptococci spp . and Staphylococci spp . (n = 31) were < or = 0.5 microg/mL . The minimum inhibitory concentration (MIC) of 76% of Pseudomonas spp . (n = 25) was < or = 2 microg/mL . Fourteen strains were resistant to concentrations > or = 128 microg/mL . The elimination half-lives (t1/2 elim beta) (mean +/- SEM) of 10 mg/kg enrofloxacin in eight houbara bustards (Chlamydotis undulata) were 6.80 +/- 0.79, 6.39 +/- 1.49 and 5.63 +/- 0.54 h after oral (p.o.), intramuscular (i.m.) and intravenous (i.v.) administration, respectively . Enrofloxacin was rapidly absorbed from the bustard gastro-intestinal tract and maximum plasma concentrations of 1.84 +/- 0.16 microg/mL were achieved after 0.66 +/- 0.05 h . Maximum plasma concentration after i.m . administration of 10 mg/kg was 2.75 +/- 0.11 microg/mL at 1.72 +/- 0.19 h . Maximum plasma concentration after i.m . administration of 15 mg/kg in two birds was 4.86 microg/mL . Bioavailability was 97.3 +/- 13.7% and 62.7 +/- 11.1% after i.m . and oral administration, respectively . Plasma concentrations of enrofloxacin > or = 0.5 microg/mL were maintained for at least 12 h for all routes at 10 mg/kg and for 24 h after i.m . administration at 15 mg/kg . Plasma enrofloxacin concentrations were monitored during the first 3 days of treatment in five houbara bustards and kori bustards (Ardeotis kori) with bacterial infections receiving a single daily i.m . injection of 10 mg/kg for 3 days . The mean plasma enrofloxacin concentrations in the clinical cases at 27 and 51 h (3.69 and 3.86 microg/mL) and at 48 h (0.70 microg/mL) were significantly higher compared with the 3 h and 24 h time intervals from clinically normal birds . The maximum plasma concentration (Cmax)/MIC ratio was ranked i.v . (10/mg/kg) > i.m . (15 mg/kg) > i.m . (10 mg/kg) > oral (10 mg/kg), but it was only higher than 8:1 for i.v . and i.m . administrations of enrofloxacin at 10 mg/kg and 15 mg/kg, respectively, against a low MIC (0.5 microg/mL) . A dosage regimen of 10 mg/kg repeated every 12 h, or 15 mg/kg repeated every 24 h, would be expected to give blood concentrations above 0 . 5 microg/mL and hence provide therapeutic response in the bustard against a wide range of bacterial infections.

Zentralbl Bakteriol, 1998 Jul, 288(1), 75 - 86
Transfer of resistance to oxy-imino-cephalosporins and of extended-spectrum beta-lactamase productions in Klebsiella pneumoniae strains from infected neonates; Blahova J et al.; In this communication, we describe the occurrence of strains of Klebsiella pneumoniae resistant to cephalosporins of all generations and to aztreonam due to their production of Extended Spectrum beta-Lactamases (ESBLs), in two hospitals in Slovakia . They were found to transfer the genetic determinants of resistance of cefotaxime, ceftazidime and aztreonam and of ESBL production to suitable recipient strains of Escherichia coli K-12 No . 3110 and Proteus mirabilis P-38 . Six donor K . pneumoniae strains were collected from six prematurely born babies gradually infected with strains of K . pneumoniae resistant to cefotaxime, ceftazidime and aztreonam . All six strains of K . pneumoniae gave an identical pattern in ESBL testing (double-disk diffusion test) . The second cycle of transfers to nalidixin-resistant E . coli K-12 No . 185 nal+ also confirmed that all transconjugants were resistant to all beta-lactams tested . We conclude that a single gene was transferred from donor strains which confers 'en bloc' the resistance to the beta-lactams tested . Four strains of K . pneumoniae produced a uniform type of ESBI . Although with different quantitative expression . All transconjugants tested produced identical types of ESBL as did the donor strains of K . pneumoniae . This transfer of an identical pattern of ESBL production was confirmed also in the second cycle of transfers . Cefotaxime, ceftazidime and aztreonam were actively hydrolysed (as shown by the relative rate of hydrolysis {Vmax}) by strains of K . pneumoniae as well as by transconjugant colonies and clavulanate inhibited the hydrolysis of these beta-lactam antibiotics.

Mol Microbiol, 1998 Aug, 29(3), 741 - 51
Novel genes that upregulate the Proteus mirabilis flhDC master operon controlling flagellar biogenesis and swarming; Dufour A et al.; By screening for restoration of multicellular migration in a non-swarming but motile Proteus mirabilis mutant lacking the FIgN facilitator of flagella assembly, we identified four distinct genes that, in trans and multicopy, increased flagella production and cell length . Each of the genes upregulated expression of the flhDC master operon that controls flagellar biogenesis, cell division and swarming, not only in the mutant but also in the wild type . The genes were named umoA, umoB, umoC and umoD . Disruption of each of the wild-type chromosomal umo genes caused corresponding reductions in swarming and cell elongation, which correlated with decreased expression of the flhDC operon . The umoA, umoB, umoC and umoD genes are not closely linked, and only umoB is part of an operon . The sequences of the calculated gene products, UmoA (20.6 kDa), UmoB (78.0 kDa), UmoC (15.2 kDa) and UmoD (19.2 kDa), contain putative N-terminal secretion signals and predict a location in the cell membranes or periplasm . UmoB and UmoD have sequence similarity to the Escherichia coli uncharacterized open reading frames YrfF and YcfJ respectively; UmoA and UmoC have no known homologues . The umoB and umoC gene transcripts were present at very low levels, but umoA and umoD expression was similar to that of flhDC and increased in parallel with flhDC expression during differentiation into elongated hyperflagellated swarm cells . Like flhDC, umoA and umoD expression was subject to negative feedback in aflagellar assembly mutant lacking the FlhA inner membrane component of the export machinery . Assays of umo gene expression and cross-complementation indicated that the umo genes do not act in sequence within a pathway to upregulate flhDC, but revealed that umoA and umoD are reciprocally upregulated by FlhDC . Our findings strengthen the picture of the flhDC master operon as a major assimilatory checkpoint in Proteus mirabilis and other Gram-negative bacteria and expand the view of a complex regulatory network coupled to flagellar biogenesis.

Lett Appl Microbiol, 1998 Jul, 27(1), 57 - 61
A rapid method for determination of in vitro susceptibility to antibiotics with a bulk acoustic wave bacterial growth biosensor; Tan H et al.; A novel bulk acoustic wave (BAW) bacterial growth biosensor was developed to study in vitro susceptibility by continuous monitoring of disturbances of bacterial growth at low antibiotic concentrations, followed by the accurate and rapid estimation of growth kinetic parameters and minimum inhibitory concentrations (MICs) . The susceptibilities of bacteria, e.g . Escherichia coli, Staphylococcus aureus, Proteus vulgaris, Pr . morganii and Pr . mirabilis, to various antibiotics, e.g . penicillin, streptomycin, gentamicin and cefotaxime, were investigated, respectively, and the MICs were rapidly determined with a higher reproducibility than the conventional broth micro-dilution technique (BMDT) . The effects of cell constant of conductivity electrode, pH and temperature on bacterial growth and biosensor signals were discussed in detail . The proposed method offers an effective alternative to the conventional methods.

Folia Microbiol (Praha), 1998, 43(2), 136 - 40
A new bacteriophage typing scheme for Proteus mirabilis and Proteus vulgaris strains . 3 . Analysis of lytic properties; Sekaninova G et al.; The lytic properties of 21 bacteriophages constituting a new typing set for Proteus were examined in 507 Proteus mirabilis and 29 P . vulgaris strains isolated from patients and healthy subjects . Comparison of their morphological, serological, genetic and lytic properties showed that, in the Myoviridae and Podoviridae families, some phages were so closely related that the presence of all of them in the set was redundant . Analysis of the lytic properties revealed that some of the bacteriophages were not active enough to facilitate the differentiation of Proteus strains . The size of the final typing set was reduced from 21 to 12 phages but it was suggested that, in order to improve the differentiation capacity of the set, new phages should be included.

Microbiology, 1998 Aug, 144 ( Pt 8), 2247 - 53
Asymmetric reduction of racemic sulfoxides by dimethyl sulfoxide reductases from Rhodobacter capsulatus, Escherichia coli and Proteus species; Hanlon SP et al.; The enantioselective reduction of racemic sulfoxides by dimethyl sulfoxide reductases from Rhodobacter capsulatus, Escherichia coli, Proteus mirabilis and Proteus vulgaris was investigated . Purified dimethyl sulfoxide reductase from Rhodobacter capsulatus catalysed the selective removal of (S)-methyl p-tolyl sulfoxide from a racemic mixture of methyl p-tolyl sulfoxide and resulted in an 88% recovery of enantiomerically pure (R)-methyl p-tolyl sulfoxide . Rhodobacter capsulatus was shown to be able to grow photoheterotrophically in the presence of certain chiral sulfoxides under conditions where a sulfoxide is needed as an electron sink . Whole cells of Rhodobacter capsulatus were shown to catalyse the enantioselective reduction of methyl p-tolyl sulfoxide, ethyl 2-pyridyl sulfoxide, methylthiomethyl methyl sulfoxide and methoxymethyl phenyl sulfoxide . Similarly, whole cells of Escherichia coli, Proteus mirabilis and Proteus vulgaris reduced these sulfoxides but with opposite enantioselectivity.

Lancet, 1998 Aug 15, 352(9127), 557 - 65
Lyme borreliosis; Nadelman RB et al.; Lyme borreliosis (Lyme disease) is often said to be associated with "protean" manifestations, a reference to the ancient god Proteus, who could assume many forms and thus elude his pursuers . This legendary quality has clouded our understanding of Lyme borreliosis by giving Borrelia burgdorferi infection a mythical aura of its own . This review shows that this illness, while incompletely understood, is far more palpable than Proteus and is (in most cases) much more readily subdued . The clinical presentations of Lyme borreliosis do differ in North America and Eurasia, possibly due to the differing pathogenicity of distinct genospecies of Borrelia burgdorferi . The most common manifestation, however, in both continents is erythema migrans . Diagnosis should rest on a careful history and objective clinical findings, supported by appropriately chosen laboratory tests . Reports of coinfection with other tick-borne diseases should prompt a fresh look at Lyme borreliosis . Assertions about "protean manifestations" of B burgdorferi infection should be reappraised . Advances in laboratory techniques are welcome but culture remains the gold standard for the diagnosis--and no laboratory test result should substitute for careful clinical observation and critical analysis.

J Eukaryot Microbiol, 1998 Jul-Aug, 45(4), 431 - 8
Characterization of a monoclonal antibody and a cDNA for polyubiquitin of Amoeba proteus; Lee SY et al.; A monoclonal antibody was obtained that reacts with many different proteins (14-200 kDa) of Amoeba proteus . By indirect immunofluorescence microscopy we found the antigens to be dispersed throughout the cytoplasm but were more concentrated in the nucleus . The antibody cross-reacted with proteins of Tetrahymena, Xenopus embryo, and mouse macrophages . Using the antibody as a probe we cloned a cDNA of 1.2 kb coding for ubiquitin in five repeats . Amino acid sequences of ameba's polyubiquitin showed the most variations among the nineteen polyubiquitins of other organisms compared . The well-conserved 20Ser and 55Thr residues were replaced with Gly and Ser, respectively . The 28Ala residue found in most organisms was replaced with Gln or Glu in the amoeba . Amoebae contained two ubiquitin-mRNAs that could be detected by Northern blot analysis using the cDNA as a probe . In an analysis for specificity, the antibody reacted with polyubiquitin and ubiquitin-fusion proteins larger than 14 kDa but not with monomeric ubiquitin . The antibody is a useful probe in the detection and characterization of proteins ubiquitinated in response to cellular stresses.

Acta Clin Belg, 1998 Jun, 53(3), 184 - 8
Which bacteria are found in Belgian women with uncomplicated urinary tract infections in primary health care, and what is their susceptibility pattern anno 95-96?
Christiaens TH, Heytens S, Verschraegen G, De Meyere M, De Maeseneer J.
Dysuria is a frequent reason for encounter in general practice and also gynaecologists and urologists will be frequently confronted with it . In female patients 1/2 to 2/3 of dysuric episodes are due to urinary tract infections . In nearly all cases therapy is started before the results of a culture is available . Therefore it is very important to know which bacteria are most prevalent in the treated population, and what their susceptibility pattern is . Because most available information is based on retrospective data issued from very mixed populations, we performed a prospective study including the most frequently involved population: symptomatic adult women without any symptom of complicated UTI . Among 279 urine specimens collected in general practices, 164 were positive (59%) . The most frequent micro-organism found was E . coli (78%), followed by S . saprophyticus (9%) and Proteus spp . (4%) . In the 15 remaining specimens, 8 different bacterial species were found . Overall resistance to ampicillin was 30%, to cotrimoxazole 14%, to nitrofurantoin 7%, to fluoroquinolones 1% . The E.coli resistance to ampicillin was 27%, to co-trimoxazole 17%, to nitrofurantoin 1% and to fluoroquinolones 1% . In this population the same bacteria, in the same proportion, are found as in earlier studies in other countries . The susceptibility pattern confirms a substantial resistance level to ampicillin and co-trimoxazole . On the contrary, resistance to nitrofurantoin and fluoroquinolones is negligible . Resistance data from Belgian regional laboratories in their outpatient population were significantly different from ours.

Obstet Gynecol, 1998 Aug, 92(2), 262 - 8
Effects of prophylactic antibiotics on endometrial flora in women with postcesarean endometritis; Newton ER et al.; OBJECTIVE: To determine the effect of prophylactic antibiotics on endometrial and endocervical microflora upon diagnosis of postcesarean endometritis . METHODS: The medical records of patients enrolled in open-label comparative trials of therapeutic antibiotics for postpartum endometritis between 1989 and 1994 were reviewed (n = 682) . Endometritis was diagnosed by a standard definition that included fever and localizing signs . Endometrial cultures were obtained by a sheathed injection/aspiration technique . Aerobes and anaerobes were isolated by standard microbiologic techniques . The primary outcome, endometrial and endocervical microflora, was compared in women who received intravenous ampicillin (2 g every 6 hours for 1-3 doses), cephalosporin (2 g every 6 hours for 1-3 doses), or no prophylaxis . Secondary outcomes included the cure of endometritis and the prevalence of wound infection in the three groups . RESULTS: Four hundred sixty-five of 682 patients (67%) had a cesarean delivery . One hundred fifty-one patients received ampicillin prophylaxis, 100 patients received cefazolin prophylaxis, 18 patients received extended-spectrum antibiotics, and 196 patients received no prophylaxis . Patients who received cefazolin prophylaxis had a significant increase in enterococcus (P < .05) and a significant decrease in Proteus species (P < .05) from endometrial samples . Patients who received ampicillin prophylaxis had a significant increase of Mycoplasma species (P < .05), Klebsiella pneumoniae (P < .0001), Escherichia coli (P = .04), and any aerobic gram-negative rod (P = .003) from endometrial samples . Ampicillin prophylaxis was associated with a decrease in Prevotella bivia (P < .05) and any anaerobe (P < .01) . Endometritis cure rates were similar between prophylaxis groups and between prophylaxis and treatment groups . However, the cefazolin prophylaxis followed by cephalosporin treatment was associated with more wound infections (19%) than other prophylaxis and treatment groups, (6%, P < .01) . CONCLUSION: Ampicillin and cefazolin prophylaxis alters endometrial and endocervical microflora of women who develop endometritis . Whereas these changes had no effect on endometritis cure rate (power > 80%), the association between cefazolin prophylaxis followed by an extended-spectrum cephalosporin and wound infection may warrant caution against the use of the combination.

Microbiology, 1998 Jul, 144 ( Pt 7), 1957 - 61
A swarming-defective mutant of Proteus mirabilis lacking a putative cation-transporting membrane P-type ATPase; Lai HC et al.; The motile TnphoA mutant IC24 of Proteus mirabilis U6450 generates an aberrant swarming colony, and was shown to be impaired in swarm cell differentiation, i.e . cell elongation and hyperflagellation, causing delayed and slower population migration across a solid growth medium . Levels of transcript from the flagellin filament gene fliC, the flagellar master operon flhDC, and the leucine-responsive regulatory protein gene lrp, a regulator of swarming differentiation, were reduced in IC24 mutant swarm cells . The transposon had inserted into a gene encoding a putative P-type ATPase closely related to those transporting cations across bacterial membranes . This ppa gene (Proteus P-type ATPase) was maximally expressed in differentiated swarm cells . The data suggest an effect of ion homeostasis on swarm cell differentiation, possibly mediated via the lrp-flhDC pathway.

J Biol Chem, 1998 Aug 14, 273(33), 21393 - 401
Identification of a novel transcription regulator from Proteus mirabilis, PMTR, revealed a possible role of YJAI protein in balancing zinc in Escherichia coli; Noll M et al.; Zinc is an essential trace element required for structural integrity and functional activity of numerous proteins, yet mechanisms by which cells regulate zinc concentration are poorly understood . Here, we identified a gene from Proteus mirabilis that encodes a 135-amino acid residue protein, PMTR (P . mirabilis transcription regulator), a new member of the MerR family of transcription activators . Transformation of Escherichia coli with PMTR-carrying vectors specifically increases cell tolerance to zinc, suggesting the role of PMTR in zinc homeostasis . In response to zinc, PMTR-containing cells robustly accumulate a 12-kDa protein, the amount of which correlates with the cells' ability to grow at high zinc concentrations . The 12-kDa protein is not induced in the presence of Ni2+, Co2+, Cd2+, Mn2+, or Fe2+, indicating that the PMTR-dependent expression of the 12-kDa protein is specifically regulated by zinc . The 12-kDa protein was identified as the C-terminal fragment of E . coli protein YJAI, and was shown to contain two zinc-binding motifs . Metal-affinity chromatography and 65Zn blotting assay confirmed the ability of the 12-kDa protein to bind zinc specifically (zinc > cobalt >> cadmium) . We propose that YJAI is an important component of the zinc-balancing mechanism in E . coli, the up-regulation of which with PMTR results in an increased tolerance to zinc.

Biotechnol Prog, 1998 Jul-Aug, 14(4), 639 - 44
Bulk acoustic wave bacterial growth sensor applied to analysis of antimicrobial properties of tea; Yao S et al.; A bulk acoustic wave (BAW) bacterial growth sensor has been proposed for study of inhibitory effects of tea by continuous monitoring of disturbances in Proteus growth in the aqueous extracts of various teas, e.g . green tea, Fuzhuan brick tea, Oolong tea, Kudin tea, and black tea . The kinetic parameters, e.g . asymptote (A), maximum specific growth rate (microm), lag time (lambda), and generation time (g), accurately estimated by using the growth response model, have been first used to characterize antimicrobial properties of tea . All of the parameters were changed via the inhibitory effects by tea . Green tea gives the weakest inhibitory action while others show stronger inhibitory actions . These inhibitory effects have also been examined by using the pour plate count technique . Both of the results show that, in addition to the antimicrobial properties of tea polyphenols and catechins, etc., the inhibitory effects may be attributed to the metabolites produced during the fermentation processing of these teas except green tea . The conventional disk diffusion test has been used to determine the minimum inhibitory concentration (MIC) against P . rettgeri . The MICs of green tea, Fuzhuan brick tea, Oolong tea, and black tea were found to be 1113, 818.0, 681.2, and 510.4 microg/mL, respectively . The BAW bacterial growth sensor has shown to have advantages over other techniques, including the disk diffusion test, photometry, and the impedance method.

Planta Med, 1998 Jun, 64(5), 473 - 5
Terpenoid composition of the wound-induced bark exudate of Commiphora tenuis from Ethiopia; Asres K et al.; The bark of Commiphora tenuis Vollensen exudes a translucent, free-flowing odoriferous liquid upon wounding which was analysed by capillary GLC and GLC-MS . 42 mono- and sesquiterpenes were detected and 37 identified . The main components of the monoterpenoid fraction were alpha-pinene (60.8%), beta-pinene (8.8%), sabinene (6.3%), alpha-thujene (8.9%), limonene (5.5%), 3-carene (3.7%), beta-myrcene (1.8%), and beta-elemene (1.1%) constituting 97% of the oil . Identified sesquiterpenoid components constituted approximately 1.6% of the oil . Oleanolic acid acetate was isolated and identified as the main triterpene from the resin by 1H- and 13C-NMR . Three other triterpenes of the olean-12-ene group were also detected using GC-MS . The essential oil exhibited antibacterial activities against Staphylococcus aureus . Proteus mirabilis and E . coli with MIC between 0.5 and 1%.

Pediatr Infect Dis J, 1998 Jul, 17(7), 639 - 44
Cefepine vs . ceftazidime treatment of pyelonephritis: a European, randomized, controlled study of 300 pediatric cases . European Society for Paediatric Infectious Diseases (ESPID) Pyelonephritis Study Group; Schaad UB et al.; BACKGROUND: Cefepime has been used in clinical therapeutic trials for meningitis, serious infection and febrile neutropenia, comprising more than 800 pediatric patients . This agent has also been used in patients 12 years of age and older with uncomplicated and complicated urinary tract infections including pyelonephritis, but not in younger patients . In this study the safety and efficacy of cefepime were compared with those of ceftazidime for treatment of pyelonephritis in pediatric patients younger than 12 years of age . METHODS: Two hundred ninety-nine pediatric patients (ages 1 month to 12 years) with pyelonephritis (300 episodes) were enrolled in a randomized, open label, multicenter trial . Individual results were evaluated by a blinded committee of experts . Cefepime was compared with ceftazidime, both administered parenterally at 50 mg/kg every 8 h . Patients were to receive the assigned study drug until at least 48 h after becoming afebrile . The i.v . treatment was then to be continued or replaced by oral trimethoprimsulfamethoxazole for a maximum of 12 to 14 days . RESULTS: The predominant causative pathogens were Escherichia coli, 88%; Proteus spp., 6%; Pseudomonas aeruginosa, 2%; and Klebsiella spp., 2% . Bacteriologic eradication was achieved in 96 and 94% of cefepime and ceftazidime patients, respectively, at the end of i.v . study drug treatment and was maintained in 94 and 91%, respectively, at the end of total study therapy . After study therapy bacteriologic eradication was maintained after 4 to 6 weeks in 86% of cefepime cases and in 83% of ceftazidime cases . A satisfactory clinical response occurred in 98 and 96% of cefepime and ceftazidime patients, respectively, at the end of i.v . treatment and in 93% at the end of total study therapy in both treatment arms . Drug-related clinical adverse events occurred in 14 cefepime patients (91%) and in 10 ceftazidime patients (7%) . CONCLUSIONS: Cefepime and ceftazidime are equally safe and efficacious treatment for pyelonephritis in pediatric patients.

J Med Genet, 1998 Jul, 35(7), 600 - 3
Mosaicism for a tandem duplication dup(1)(q12q22) in an 18 year old female; de Silva D et al.; The clinical features and cytogenetic results of an 18 year old mentally handicapped female found to be a mosaic for a tandem duplication of chromosome 1 (46,XX,dup(1)(q12q22)/46,XX) are reported . The case is compared with the three previously described cases and possible mechanisms for the origin of the duplication are discussed . This patient was not found to have features of Proteus syndrome which was previously reported in a subject mosaic for a tandem duplication involving chromosome (1)(q11q25).

Spinal Cord, 1998 Jul, 36(7), 454 - 62
Recurrent bilateral renal calculi in a tetraplegic patient; Vaidyanathan S et al.; An 18-year-old male developed C-5 complete tetraplegia following a motor-cycle accident in May 1975 . The neuropathic bladder was managed by an indwelling urethral catheter . He developed recurrent episodes of urinary infection with Proteus species . In September 1975, an X-ray of the abdomen revealed small calculi in both the kidneys . In July 1976, he underwent transurethral resection of the bladder neck and division of the external urethral sphincter; subsequently, he was put on a penile sheath drainage . He continued to suffer from repeated episodes of urinary tract infection with Proteus, Providencia, and Pseudomonas species, and he was treated with antibiotics . In 1980, intravenous urography (IVU) showed two large stones in the left kidney with marked caliectasis . The IVU performed in 1984 showed an increase in the size of the calculi in the left kidney which was grossly hydronephrotic . There were clusters of small calculi in the right kidney . The left renal calculi were treated by percutaneous lithotripsy in two sessions . In 1988, an X-ray of the abdomen revealed staghorn calculus in the right kidney and recurrence of stones in the left kidney . The staghorn calculus in the right kidney was treated by percutaneous nephrostolithotomy in two sessions . In 1991, he was admitted with acute urinary infection . IVU showed a stone in the pelviureteric junction with no excretion of contrast in the left kidney . Percutaneous nephrostomy drainage was established followed by left percutaneous nephrostolithotomy . In 1992, he was found to retain large amount of urine in the bladder; subsequently, his mother was taught to perform regular intermittent catheterisations . In 1995, he was admitted with acute urine infection . Abdominal X-ray revealed recurrence of large stones in both kidneys . With multiple sessions of Extracorporeal Shockwave Lithotripsy (ESWL), about 80% clearance was achieved on the left side . Right staghorn renal stone awaits treatment . This case shows that recurrent urinary infection in spinal cord injury patients is a predisposing factor for renal lithiasis . These patients require annual urological evaluation . Urinary tract calculi, if detected, should be dealt with promptly to prevent renal damage due to urinary obstruction and urosepsis . Renal calculi can be treated effectively and safely by ESWL in spinal cord injury patients, thus avoiding the need for an invasive procedure . It is essential to achieve low-pressure, adequate emptying of the urinary bladder in patients with spinal cord injury in order to prevent recurrent urinary infection and its sequelae . Social issues involved in the care of a tetraplegic patient play a vital role in the implementation of ideal medical treatment and need to be addressed promptly to avoid any compromise in the quality of medical care.

J Oral Maxillofac Surg, 1998 Jul, 56(7), 838 - 43; discussion 843-4
Management of animal bite injuries of the face: experience with 94 patients; Wolff KD; PURPOSE: Because of the large number of bacteria in the oral cavity, animal bite wounds are generally contaminated, and their treatment is difficult because of the risk of infection, especially in extensive injuries . This report describes the management of a large series of patients and recommends treatment guidelines on the basis of the results . PATIENTS AND METHODS: Ninety-four animal bite wounds on the face and head were analyzed according to the type of animal, location and extent of the soft tissue wound, duration and type of surgical treatment, occurrence of infections and their pathogen spectrum, as well as the choice of antibiotic therapy . RESULTS: Dogs caused 91% of the bite wounds . Infections developed in 4 of 53 patients who underwent primary wound closure with minor edge excision and prophylactic administration of oral penicillin . Without antibiotic administration, 2 of 15 patients had infections, which were treated on an outpatient basis . Of 26 patients with initially delayed treatment, 18 showed clinical inflammatory symptoms with a wide spectrum of pathogens (Escherichia coli, Streptococcus, Enterococcus, Staphylococcus epidermidis, and Proteus) on presentation . CONCLUSION: Extensive animal bite wounds on the face, even with soft tissue defects, should be treated according to the criteria of a esthetic reconstructive facial surgery . In view of the low infection rate, routine antibiotic prophylaxis is not justified.

FEMS Immunol Med Microbiol, 1998 May, 21(1), 1 - 9
Structure of the O-specific polysaccharide of Proteus penneri strain 41 from a new proposed serogroup O62; Zych K et al.; O-specific polysaccharide of Proteus penneri strain 41 was studied using 1H- and 13C-NMR spectroscopy, including two-dimensional COSY, heteronuclear 13C,1H-correlation (HETCOR) and one-dimensional NOE spectroscopy, and the following structure of a non-stoichiometrically O-acetylated hexasaccharide repeating unit was established:{structure: see text} where RGlcNAc is 2-acetamido-4-O-{(S)-1-carboxyethyl}-2-deoxyglucose . Cross-reactivity of anti-P . penneri 41 O-serum with other P . penneri strains is discussed, and a new, separate O62 serogroup is proposed which is the next Proteus O-serogroup containing P . penneri strains only.

Structure, 1998 Jun 15, 6(6), 721 - 34
A mixed disulfide bond in bacterial glutathione transferase: functional and evolutionary implications; Rossjohn J et al.; BACKGROUND: Glutathione S-transferases (GSTs) are a multifunctional group of enzymes, widely distributed in aerobic organisms, that have a critical role in the cellular detoxification process . Unlike their mammalian counterparts, bacterial GSTs often catalyze quite specific reactions, suggesting that their roles in bacteria might be different . The GST from Proteus mirabilis (PmGST B1-1) is known to bind certain antibiotics tightly and reduce the antimicrobial activity of beta-lactam drugs . Hence, bacterial GSTs may play a part in bacterial resistance towards antibiotics and are the subject of intense interest . RESULTS: Here we present the structure of a bacterial GST, PmGST B1-1, which has been determined from two different crystal forms . The enzyme adopts the canonical GST fold although it shares less than 20% sequence identity with GSTs from higher organisms . The most surprising aspect of the structure is the observation that the substrate, glutathione, is covalently bound to Cys 10 of the enzyme . In addition, the highly structurally conserved N-terminal domain is found to have an additional beta strand . CONCLUSIONS: The crystal structure of PmGST B1-1 has highlighted the importance of a cysteine residue in the catalytic cycle . Sequence analyses suggest that a number of other GSTs share this property, leading us to propose a new class of GSTs - the beta class . The data suggest that the in vivo role of the beta class GSTs could be as metabolic or redox enzymes rather than conjugating enzymes . Compelling evidence is presented that the theta class of GSTs evolved from an ancestral member of the thioredoxin superfamily.

Eur J Biochem, 1998 May 1, 253(3), 730 - 3
Structure and cross-reactivity of the O-specific polysaccharide of Proteus penneri strain 26, another neutral Proteus O-antigen containing 2-acetamido-2,6-dideoxy-L-glucose (N-acetyl-L-quinovosamine); Shashkov AS et al.; A neutral O-specific polysaccharide obtained from the lipopolysaccharide of Proteus penneri strain 26 was studied using sugar analysis and 1H and 13C NMR spectroscopy, including two-dimensional NMR techniques . The following structure of the trisaccharide repeating unit was established: -->6)-alpha-D-GlcpNAc-(1-->3)-alpha-L-QuipNAc-(1-->3)-alpha-D-Glcp NAc-(1--> where L-QuiNAc is 2-acetamido-2,6-dideoxy-L-glucose (N-acetyl-L-quinovosamine) . Cross-reactivity of the Proteus penneri 26 anti-O serum with other strains of P . penneri isolated in Poland and USA and one strain of P . vulgaris is discussed.

Scand J Gastroenterol, 1998 May, 33(5), 529 - 34
Escherichia coli and Proteus mirabilis inhibit the perinuclear but not the circulating antineutrophil cytoplasmic antibody reaction; Yang P et al.; BACKGROUND: Perinuclear antineutrophil cytoplasmic antibodies (P-ANCA) are found in 48%-83% of serum samples from patients with ulcerative colitis (UC) . Their pathogenic role and initiating stimuli are unknown . In contrast to patients with vasculitides and ANCA reactivities, the antibodies in UC patients do not react with myeloperoxidase (MPO) or proteinase 3 (PR3) . The aim of the present study was to investigate whether bacterial species of the intestinal tract and other sources could interfere with P-ANCA in sera from patients with UC . METHODS: Seventeen P-ANCA-positive and anti-MPO-negative serum samples from patients with UC were tested with Escherichia coli 014 and Staphylococcus aureus Wood 46 . Six of these serum samples with different P-ANCA titres were selected to test further the influence of 15 different gram-negative or gram-positive bacterial strains . Six anti-MPO positive P-ANCA, 5 anti-PR3 positive C-ANCA, and 10 antinuclear antibody (ANA)-positive serum samples were used as controls . The antineutrophil cytoplasmic antibodies (ANCAs) were analysed by an indirect immunofluorescence method (IIF) on ethanol-fixed neutrophils, and the ANAs were tested by IIF on HEp-2 cells or rat liver tissues . The bacteria used in the experiments were either live or killed by formalin or glutaraldehyde fixation or heated at 80 degrees C for 30 min . The test was first performed as a bacterial absorption test with sedimented organisms and then at various temperatures with the supernatant from suspension of live bacteria . RESULTS: Both MPO-positive and MPO-negative P-ANCA reactivity was abolished by absorption of patient sera with live E . coli and Proteus mirabilis but not with bacteria representing members of 10 other species, suggesting that antibody reactivity was absorbed away . However, continued experiments indicated that the inhibition of P-ANCA was not due to classic antigen-antibody interactions but rather to decomposition of the antigenic substrate of the neutrophils by factors present in the supernatants of live E . coli and P . mirabilis . The activity of the supernatant was temperature-dependent, with strong activity at room temperature and 37 degrees C, no activity at 0 degrees C, and abolished by mild heat treatment (56 degrees or 60 degrees C) . No activity was shown in the supernatants from bacteria treated with formaldehyde or glutaraldehyde . CONCLUSIONS: Soluble material from live E . coli and P . mirabilis has the capacity to decompose the antigenic substrate of neutrophils responsible for both MPO-positive and MPO-negative P-ANCA, most probably brought about through enzymatic activity . Anti PR3-positive C-ANCA were not affected, which suggests substrate specificity of the proposed enzymatic activity.

Pediatr Surg Int, 1998 Jul, 13(5-6), 449 - 50
Median nerve compression in Proteus syndrome; McCullagh M et al.; Proteus syndrome is a multi-organ disorder, a prime feature of which is localized gigantism, usually clinically obvious . Symptoms secondary to hypertrophy of nerves has not been previously recognized as a part of the syndrome.

Ostomy Wound Manage, 1998 Mar, 44(3), 40 - 2, 44, 46
Microbiologic evaluation of cutaneous wounds in hospitalized dermatology patients; Colsky AS et al.; The purpose of this study is to identify predictability of wound flora which may be helpful in the selection of empiric antibiotic therapy of wound infections while awaiting the results of bacterial cultures . Toward this end, results of an ongoing microbiologic surveillance of skin wound flora in hospitalized dermatology patients are presented . Bacterial isolates cultured from patients with skin wounds admitted to a tertiary care dermatology inpatient unit were evaluated and comparison was made to a previous survey of the same inpatient service done in 1992 . Microbiologic evaluation of superficial skin wounds, leg ulcers, and pressure ulcers showed that Staphylococcus aureus was the principal isolate in superficial wounds (77%) compared to the equal prevalence of S . aureus (43%) and Pseudomonas aeruginosa (42%) cultured from leg ulcers . Cultures from pressure ulcers grew Proteus mirabilis as the dominant isolate . These data agree with previous surveillance data from the same inpatient base performed in 1992 and support the relatively predictable wound flora cultured from skin wounds in our hospital inpatient unit over the 4 years surveillance period . This predictability can enhance empiric antibiotic selection for wound infections while awaiting the results of bacterial culture, and supports the value of local microbiologic surveillance programs in the management of wound infections.

J Med Assoc Thai, 1998 Apr, 81(4), 301 - 4
In vitro activity and clinical evaluation of cefixime in urinary tract infection; Asvanich K et al.; Thirty-five women with uncomplicated acute lower urinary tract infections proven by significant pre-treatment bacteriuria (> or = 10(5)CFU/ml) were treated with an oral dose of 100 mg cefixime twice a day for seven days . Thirty five patients included in this study were checked for response to treatment on the last day of therapy, 7-14 days and 4 weeks post therapy . The clinical response and bacterial eradication rate for cefixime were 91.4 per cent (32/35) . The infecting organisms, E . coli and Proteus mirabilis, were inhibited at MIC90 = 0.5 and < or = 0.03 microgram/ml, and MBC = 1 and 0.06 microgram/ml respectively . No adverse events were found in this study.

Mikrobiol Z, 1998 Jan-Feb, 60(1), 83 - 91
{Nitazole--an antimicrobial substance}; Kalinichenko NF; The antibacterial activity of protistocide drug nitazole has been revealed for the first time in the 80's at the Laboratory of Clinical Microbiology of the Mechnikov Research Institute of Microbiology and Immunology . Unlike other imidazoles, such as metronidazole and tinidazole, nitazole acts as the inhibitor of growth of gram-positive facultative and obligate anaerobic microorganisms as well as gram-negatives except for Pseudomonas aeruginosa and Proteus . Nitazole, as a main antimicrobial agent of many multicomponent drugs which are created on the hydrophilic basis (matrices), is particularly useful for topical treatment of wounds and burns in the first and second phases of these processes . Drugs which include nitazole possess not only antibacterial and protistocide activity but also act as anti-inflammatory, wound-healing ones and have osmotic property . These drugs are approved by the Ukrainian Ministry of Public Health for wide use in surgical, gynecological, proctological and dermatological clinics as well as in combustology.

Eye, 1998, 12 ( Pt 1), 139 - 40
Post-keratoplasty endophthalmitis caused by Proteus mirabilis; Lam DS et al.; A diabetic patient who underwent a triple procedure (penetrating keratoplasty, cataract extraction and posterior chamber intraocular lens implantation), developed endophthalmitis caused by Proteus mirabilis . The source of infection was the infected donor cornea, which was imported from Sri Lanka . The organism was resistant to gentamicin, which was the only antibiotic present in the storage medium . On top of an aggressive antibiotic treatment regime (topical, systemic and intravitreal), exchange of the infected with a fresh corneal graft and pars plana vitrectomy were performed . The patient had a speedy recovery and the visual outcome was 20/40 two and a half years after the incident . To our knowledge, post-keratoplasty endophthalmitis caused by P . mirabilis has never been reported in the literature . We report herein such a case with good visual outcome . Newer storage medium, such as Optisol GS, might have a role in preventing keratoplasty-related infection.

Chemotherapy, 1998 May-Jun, 44(3), 149 - 52
Antibacterial activity of peritoneal exudate in patients treated with 2 g cefotiam for surgical anti-microbial prophylaxis; Miglioli PA et al.; The objective of this study was to investigate the presence of antibacterial activity in peritoneal exudate (PE) of patients treated with cefotiam (CFT) . CFT (2 g) was administered as a 'single-shot' antimicrobial prophylaxis to 6 patients at the beginning of colorectal resection . Samples of PE were collected from each patient on days 1, 2 and 3 after surgery . CFT was detectable in the samples of day 1 for 5 of the 6 patients . The influence of PE on antibacterial activity of the antimicrobial drug was evaluated carrying out the MICs of CFT against Escherichia coli K-12, E . coli (ATCC 10798), Klebsiella pneumoniae (ATCC 1003), Proteus rettgeri (Sanelli) and Staphylococcus aureus (ATCC 29213) with and without the addition of PE . The presence of PE enhanced the antimicrobial activity of CFT against gram-negative strains, but not against S . aureus (ATCC 29213) . These results suggest the presence of substances in PE that possess endogenous antibacterial activity . Thus, antimicrobial activity in PE cannot be predicted by evaluating pathogen sensitivity in vitro only.

J Ethnopharmacol, 1998 Apr, 60(3), 265 - 71
Antimicrobial activity of 20 plants used in folkloric medicine in the Palestinian area; Ali-Shtayeh MS et al.; Ethanolic and aqueous extracts of 20 Palestinian plant species used in folk medicine were investigated for their antimicrobial activities against five bacterial species (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Proteus vulgaris, Pseudomonas aeruginosa) and one yeast (Candida albicans) . The plants showed 90% of antimicrobial activity, with significant difference in activity between the different plants . The most antimicrobially active plants were Phagnalon rupestre and Micromeria nervosa, whereas, the least active plant was Ziziphus spina-christi . Only ten of the tested plant extracts were active against C . albicans, with the most active from M . nervosa and Inula viscosa and the least active from Ruscus aculeatus . Of all extracts the ethanolic extract of M . nervosa was the most active, whereas, the aqueous extract of Phagnalon rupestre was the most active of all aqueous extracts tested . The ethanolic extracts (70%) showed activity against both Gram positive and negative bacteria and 40% of these extracts showed anticandidal activity, whereas, 50% of the aqueous extracts showed antibacterial activity and 20% of these extracts showed anticandidal activity.

AJNR Am J Neuroradiol, 1998 May, 19(5), 987 - 90
The Proteus syndrome: CNS manifestations; Dietrich RB et al.; Proteus syndrome is a complex hamartomatous disorder characterized by multiple, diverse, somatic manifestations . We present a case in which severe, evolving CNS abnormalities were also exhibited . Imaging findings at presentation included hemimegalencephaly, subependymal calcified nodules, and periventricular cysts . Subsequently, dural sinus thrombosis developed . Eight previously reported patients may also have had hemimegalencephaly . When neuroimaging studies show hemimegalencephaly in a child with pigmented skin lesions, Proteus syndrome should be considered in the differential diagnosis.

Antibiot Khimioter, 1998, 43(3), 19 - 21
{Improvement of effectiveness of antibiotic therapy by pyrimidine derivatives in reparative regeneration of skin in rats}; Ismagilova AF et al.; It was shown on noninbred albino rats with various affections of the skin that pyrimidine derivatives stimulated the skin reparative regeneration and increased the efficacy of antibiotic therapy of Staphylococcus and Proteus infected wounds . The therapeutic effect of 2-methyl-4-amino-6-oxypyrimidine was much higher than that of oxymethyluracil or methyluracil . The pyrimidine derivatives proved to be universal accelerators for reparative regeneration, were compatible with antibiotics and increased their efficacy.

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