Proteus

Rev Rhum Ed Fr, 1993 May, 60(5 Pt 2), 30S - 35S
{Infectious origin of rheumatoid arthritis}; Youinou P et al.; Three preliminary concepts are developed: antigen presentation, "peptidic self" and superantigen . Several infectious contenders for rheumatoid arthritis (RA) are then reviewed: Epstein-Barr virus, mycobacteria, parvovirus, proteus and streptococcus . Finally, the most important hypotheses are discussed: microbe present and still accessible, microbe present but hidden, microbe absent but perpetuated by the immune system . In the latest case, molecular mimicry could possibly be the mechanism operating in RA.

J Clin Microbiol, 1993 May, 31(5), 1055 - 9
Arbitrarily primed polymerase chain reaction provides rapid differentiation of Proteus mirabilis isolates from a pediatric hospital; Bingen E et al.; During a systematic survey, maternal carriage of Proteus mirabilis was found over a 25-day period in 18 pregnant women admitted to the delivery ward of our hospital maternity . Five neonates born to these mothers were found to be colonized with P . mirabilis . We report here on the use of DNA fingerprinting by the arbitrarily primed polymerase chain reaction technique (AP-PCR) for the epidemiological investigation of this sudden outbreak . This approach was compared with the analysis of restriction fragment length polymorphisms of ribosomal DNA regions (ribotyping) . Results of the AP-PCR and of ribotyping were in complete agreement in showing the genetic unrelatedness of the isolates obtained from each mother . Moreover, the results showed mother-to-infant vertical transmission of P . mirabilis in the neonates . AP-PCR is a rapid and discriminative method which seems particularly well suited to the epidemiological study of P . mirabilis.

Am J Med Genet, 1993 Apr 15, 46(2), 145 - 8
Proteus syndrome with cardiomyopathy and a myocardial mass; Shaw C et al.; Proteus syndrome is an overgrowth syndrome principally affecting cutaneous and skeletal tissues, accompanied by subcutaneous hamartomas . We report on a patient with predominantly skeletal and visceral involvement, including a cardiac mass and thickening of the myocardial septum affecting cardiac conduction and contraction.

J Antimicrob Chemother, 1993 Apr, 31(4), 489 - 96
P-nitrophenylglycerol in susceptibility testing media alters the MICs of antimicrobials for Pseudomonas aeruginosa; Ward PB et al.; Diagnostic microbiology laboratories in Australia and the UK commonly incorporate p-nitrophenylglycerol (PNPG) into solid susceptibility testing media in order to prevent the swarming of Proteus spp . We have investigated the effects of PNPG and adjusting the cation concentrations of the media to physiological levels on the MICs of aminoglycosides and other antibiotics for 128 strains of Pseudomonas aeruginosa isolated from the sputa of children with cystic fibrosis . The addition of PNPG to the media led to higher MICs of gentamicin and tobramycin for up to 23% of the isolates . Depending on the base medium, supplementation with the cations, calcium and magnesium, also increased the MICs of these aminoglycosides for 12-27% of the strains tested . Both incorporation of PNPG and cation adjustment led to higher MICs for 25-53% of isolates, again depending on the base medium . The MICs of ticarcillin, ciprofloxacin and colistin (on Iso-Sensitest agar) for significant numbers of strains were lower in the presence of PNPG, while those of ceftazidime varied from higher to lower, according to the concentration of the drug and the base medium . In many instances these changes would have altered the way in which the susceptibilities of the organisms would have been reported . PNPG clearly exerts an important effect when the in-vitro activities of various antibiotics against P . aeruginosa are determined by the agar dilution method . Recommendations for the inclusion of PNPG in susceptibility testing media should therefore be reviewed.

Mol Microbiol, 1993 Apr, 8(1), 53 - 60
Cell differentiation of Proteus mirabilis is initiated by glutamine, a specific chemoattractant for swarming cells; Allison C et al.; Swarming by Proteus mirabilis involves differentiation of typical short vegetative rods into filamentous hyperflagellated swarm cells which undergo cycles of rapid and co-ordinated population migration across surfaces and exhibit high levels of virulence gene expression . By supplementing a minimal growth medium (MGM) unable to support swarming migration we identified a single amino acid, glutamine, as sufficient to signal initiation of cell differentiation and migration . Bacteria isolated from the migrating edge of colonies grown for 8 h with glutamine as the only amino acid were filamentous and synthesized the characteristic high levels of flagellin and haemolysin . In contrast, addition of the other 19 common amino acids (excluding glutamine) individually or in combination did not initiate differentiation even after 24 h, cells remaining typical vegetative rods with basal levels of haemolysin and flagellin . The glutamine analogue gamma-glutamyl hydroxamate (GH) inhibited swarming but not growth of P . mirabilis on glutamine MGM and transposon mutants defective in glutamine uptake retained their response to glutamine signalling and its inhibition by GH, suggesting that differentiation signalling by glutamine may be transduced independently of the cellular glutamine transport system . Levels of mRNA transcribed from the haemolysin (hpmA) and flagellin (fliC) genes were low in vegetative cells grown on MGM without glutamine or with glutamine and GH, but were specifically increased c . 40-fold during glutamine-dependent differentiation . In liquid glutamine-MGM cultures, differentiation to filamentous hyper-flagellated hyper-haemolytic swarm cells occurred early in the exponential phase of growth, and increased concomitantly with the concentration of glutamine from a 0.1 mM threshold up to 10 mM.(ABSTRACT TRUNCATED AT 250 WORDS)

Antimicrob Agents Chemother, 1993 Apr, 37(4), 769 - 74
Potent inhibitory action of the gastric proton pump inhibitor lansoprazole against urease activity of Helicobacter pylori: unique action selective for H . pylori cells; Nagata K et al.; The gastric proton pump inhibitor lansoprazole, its active analog AG-2000, and omeprazole dose dependently inhibited urease activity extracted with distilled water from Helicobacter pylori cells; the 50% inhibitory concentrations were between 3.6 and 9.5 microM, which were more potent than those of urease inhibitors, such as acetohydroxamic acid, hydroxyurea, and thiourea . These compounds also inhibited urease activity in intact cells of H . pylori and Helicobacter mustelae but did not inhibit ureases from other bacteria, such as Proteus vulgaris, Proteus mirabilis, and Providencia rettgeri . The mechanism of urease inhibition was considered to be blockage of the SH groups of H . pylori urease, since SH residues in the enzyme decreased after preincubation with lansoprazole and glutathione or dithiothreitol completely abolished the inhibitory action . The SH-blocking reagents N-ethylmaleimide and idoacetamide were also examined for their inhibition of the urease activity; their 50% inhibitory concentrations were 100- to 1,000-fold higher than those of lansoprazole . These results suggest that lansoprazole and omeprazole can potently and selectively inhibit H . pylori urease and that inhibition may be related to earlier findings indicating that these compounds have selective activity against HP growth.

Zhonghua Yi Xue Za Zhi (Taipei), 1993 Apr, 51(4), 271 - 5
Bacteriology of necrotizing fasciitis: a review of 58 cases; Ou LF et al.; Necrotizing fasciitis is a relatively rare soft tissue infection that is characterized by rapidly widespread necrosis of the fascia and subcutaneous tissue . Fifty-eight cases were reviewed over a 5.5-year period . The majority of wound cultures were polymicrobial and single culture rate was 18.6% . The facultative organisms were most frequently recovered . The most frequently discovered bacteria were E . coli, Proteus mirabilis, Klebsiella pneumoniae, Staphylococcus aureus and group D enterococcus . The overall mortality rate was 48.3% . Early recognition, serial radical surgical debridement and strong and appropriate antibiotics were essential for survival.

Can J Surg, 1993 Apr, 36(2), 170 - 2
Foot infections in diabetics: the antibiotic choice; Asfar SK et al.; The authors studied 59 diabetics with foot infections to determine the organisms responsible and the sensitivity to antibiotics . All infections were polymicrobial (aerobic and anaerobic) . On average 3.2 isolates per culture were obtained from the depth of the infection . The commonest organisms in order of frequency were: Staphylococcus aureus, beta-hemolytic streptococci, Proteus sp., Bacteroides sp., enterococci, Klebsiella sp . and Pseudomonas aeruginosa . A combination of piperacillin and cloxacillin is recommended as initial therapy for foot infections in diabetic patients because it was found to be effective for 73% of the causative microorganisms.

Clin Exp Immunol, 1993 Apr, 92(1), 1 - 6
Rheumatoid arthritis: how well do the theories fit the evidence?
McCulloch J, Lydyard PM, Rook GA.
In this brief review, inspired partly by a symposium at the autumn meeting of the British Society for Immunology, 1992, varying hypotheses concerning the etiopathogenesis of rheumatoid arthritis (RA) are explored and tested against current evidence . Immunogenetic considerations, whilst of interest, have not aided our understanding of the development of this disease . The association with restricted HLA-DR beta chain hypervariable sequences does not hold true with all cases of RA (but may be related to disease severity) and studies of T cell receptor (TCR) beta chain usage fail to show consistent oligoclonality of infiltrating T cells in the synovial compartment . Etiologies based on triggering by bacteria are also considered: homologies between the 'shared epitope' sequences of HLA-DR1 and DR4 beta chains, Escherichia coli dnaJ and Proteus haemolysin do not indicate any feasible mechanisms for the development of RA, and cannot explain the many cases in which such DR sequences do not occur, though new data from man and animals enhance interest in the role of bowel flora . Finally, the striking parallels between slow bacterial infections and RA, in terms of immunogenetics, pathology, IgG glycosylation abnormalities and autoimmune manifestations, are put forward as circumstantial evidence that such bacterial infections may underly, or trigger, this serious disease.

J Parasitol, 1993 Apr, 79(2), 280 - 3
Effects of Schistosoma mansoni infection on phagocytosis and killing of Proteus vulgaris in Biomphalaria glabrata hemocytes; Douglas JS et al.; With the use of a fluorescence microassay, in vitro phagocytosis and killing of Proteus vulgaris were measured in hemocytes of NIH albino Biomphalaria glabrata infected with Schistosoma mansoni for 1, 2, 3, or 4 wk . Although hemocytes of infected snails displayed decreased phagocytosis, relative to hemocytes of uninfected snails, at 4 wk postinfection (PI), they exhibited enhanced microbicidal activity at 3 wk PI . No microbicidal activity was detected in the plasma of either infected or uninfected snails.

Zentralbl Bakteriol, 1993 Apr, 278(2-3), 306 - 15
Activation and secretion of Serratia hemolysin; Braun V et al.; The hemolysin of Serratia marcescens (ShlA) is secreted into the culture medium and forms small pores of a defined size in erythrocytes and in black lipid membranes . The protein is synthesized as an inactive precursor of 1608 residues which is translocated across the cytoplasmic membrane by the Sec-export system . In the absence of the outer membrane protein ShlB, the ShlA protein (designated ShlA*) stays in the periplasm and displays about 0.1% of the activity of the secreted form . Secretion of ShlA with the help of ShlB is accompanied by its conversion to the hemolytic form . A ShlA derivative consisting of the N-terminal 238 residues of ShlA is secreted by ShlB, showing that the secretion signal resides in the amino terminal part of ShlA . ShlA* can be activated in vitro by a cell lysate containing ShlB, the activated ShlA remains hemolytic upon removal of ShlB . The assumed covalent modification of ShlA* by ShlB occurs in the N-terminus of ShlA since an amino terminal fragment (M(r) 28,000) secreted by ShlB, and a trypsin fragment of ShlA (M(r) 15,000) are both able to convert ShlA* to a hemolytic protein . In contrast to the permanent modification of ShlA* by ShlB, ShlA activity achieved by complementation with the ShlA fragments is abolished upon removal of the fragments . Apparently, the N-terminal portion of ShlA contains the information for secretion through the outer membrane and for insertion into the erythrocyte membrane . This information is lacking in ShlA* formed in the absence of ShlB but contained in the ShlA fragments formed in the presence of ShlB . The latter bind to ShlA* and direct ShlA* into the erythrocyte membrane . The fragments themselves are too short to build pores . The HpmA hemolysin of Proteus mirabilis shows extensive homology to ShlA . In vitro activation of HpmA* by ShlB and complementation by the 28 kDa ShlA fragment indicates a common activation mechanism.

Lab Anim Sci, 1993 Apr, 43(2), 127 - 32
Spontaneous and experimental infections in scid and scid/beige mice; Percy DH et al.; Severe combined immunodeficient (scid) mice are valuable animals to study a variety of physiologic and disease processes . Their capacity to support multiple tissue xenografts permits these mice to be used as intermediate models for host-specific, fastidious organisms for which a small animal model has not been available previously . However, because they are unable to mount a normal immune response, they are very susceptible to a variety of primary and opportunistic microbial pathogens . Fatal, naturally occurring infections with bacteria such as Proteus mirabilis, Streptococcus viridans, and Escherichia coli have been observed . In addition, based on observations after experimental or naturally occurring viral infections, scid and scid/beige mice have been shown to be very susceptible to infections with viruses such as mouse hepatitis virus, Sendai virus, and murine respiratory virus, with resulting mortality . Of the parasitic infections, Pneumocystis carinii is a relatively common contaminant of the respiratory tracts of scid mice and may complicate research projects, particularly experimental respiratory tract infections . In view of the enhanced susceptibility of these mice to infections of this type, it is essential that they be housed under optimal conditions, which include implementing stringent management practices and a functional barrier system.

Am J Med, 1993 Mar 22, 94(3A), 155S - 158S
Open trial of oral fleroxacin versus amoxicillin/clavulanate in the treatment of infections of skin and soft tissue; Powers RD; In a multicenter, prospective, randomized trial, fleroxacin was compared with amoxicillin/clavulanate potassium (AMX/CP) for the treatment of infections of skin and soft tissue . Fleroxacin was given at a dosage of 400 mg once daily, and AMX/CP was given at a dosage of 500 mg/125 mg three times a day . Each was administered for 4-21 days . Adult patients with the clinical diagnosis of skin or soft tissue infections were eligible for enrollment . Patients were randomized in a 2:1 ratio . A total of 191 patients were enrolled; 126 took fleroxacin, and 65 took AMX/CP . Of these patients, 42 in the fleroxacin group and 26 in the AMX/CP group were evaluable for both clinical and bacteriologic efficacies . Patients with abscesses comprised the largest single category in each group . Principle reasons for exclusion included: patients lost to follow-up (17 {13%} fleroxacin, 12 {18%} AMX/CP); failure to isolate a causative pathogen (19 {15%} fleroxacin, 9 {14%} AMX/CP); and resistance to study drug (11 {9%} fleroxacin, 2 {3%} AMX/CP) . Staphylococcus aureus was the most commonly isolated pathogen . Streptococcus group A, Staphylococcus coagulase-negative, Escherichia coli, and Proteus species, in decreasing order, were the next most common pathogens . Clinical and bacteriologic efficacy was excellent in both groups, with a cure rate of > or = 90% . There were two bacteriologic failures in each group . Patients taking fleroxacin complained of slightly more adverse events, which involved primarily the digestive and central nervous systems . The rate of withdrawal from the study because of adverse events was 4% in both groups . Fleroxacin, 400 mg given once daily, is safe and as effective as AMX/CP in the treatment of skin and soft tissue infections in adults.

Am J Med, 1993 Mar 22, 94(3A), 126S - 130S
A sequential study of intravenous and oral fleroxacin in the treatment of complicated urinary tract infection; Gelfand MS et al.; This study enrolled patients with complicated urinary tract infections (UTIs) in a trial to determine the efficacy and safety of sequential therapy with intravenous fleroxacin (first 3 days) followed by oral fleroxacin, for a total course of 7-14 days, both administered at a dosage of 400 mg once a day . We enrolled 68 patients with complicated UTIs or acute pyelonephritis, 32 of whom were evaluable for bacteriologic and clinical efficacy . The pathogens isolated included Escherichia coli, 15; enterococci, 9; miscellaneous, 15 . Intravenous fleroxacin was given for a mean of 3.2 days, followed by oral fleroxacin for a mean of 5.3 days . A total of 27 patients were clinically cured (84%), two improved, and three failed . A total of 26 patients were bacteriologically cured (81%), and six failed (19%) . The bacteria that were not eradicated included enterococci, 4; Staphylococcus epidermidis, 1; and Pseudomonas species, 1 . One enterococcal isolate became resistant to fleroxacin . Four patients were bacteremic (E . coli, 3; Proteus mirabilis, 1); the pathogen was eradicated in all cases . Two patients developed urinary enterococcal superinfections . A total of 12 patients experienced 16 adverse reactions remotely, possibly, or probably related to fleroxacin (insomnia, 3; dizziness, 2; miscellaneous, 11) . One patient had a grand mal seizure after aspirating gastric contents; the seizure was thought to be only remotely related to the study drug . Fleroxacin was discontinued in two patients because of adverse effects (phlebitis at intravenous access site, 1; anxiety and insomnia, 1) . Only minor and asymptomatic laboratory abnormalities were observed . All clinical and laboratory abnormalities resolved with discontinuation of the study drug . Fleroxacin is a safe and effective antibiotic for sequential intravenous and oral treatment of acute pyelonephritis and complicated UTIs . Enterococci may be problematic pathogens, as reported with other fluoroquinolones.

J Laryngol Otol, 1993 Mar, 107(3), 222 - 7
Radiotherapeutic effect on oropharyngeal flora in patients with head and neck cancer; Abu Shara KA et al.; The affect of radiotherapy on oropharyngeal bacterial flora was studied in the hope that this might help in controlling post-operative infections in previously irradiated patients . Eighty patients were included from whom swabs were taken before and at the end of irradiation, Swabs were also taken two weeks after treatment in the last 40 patients . Thirty healty controls were included . It was found that coagulase positive Staphylococcus aureus, beta-haemolytic streptococci, Candida albicans, B . proteus, and Pseudomonas aeruginosa, were significantly increased at the end of irradiation, while Klebsiella was increased significantly in the period after irradiation . Culture and sensitivity was performed for the organisms isolated in the last 40 patients . From this study it is evident that irradiation has a significant effect on oropharyngeal flora.

APMIS, 1993 Mar, 101(3), 229 - 34
Effect of a human IgG preparation rich in antibodies to a wide range of lipopolysaccharides on gram-negative bacterial sepsis in burned mice; Fomsgaard A et al.; A human intravenous IgG preparation (Anti-LPS IgG) rich in antibodies to different lipopolysaccharides (LPS) and a normal human intravenous IgG (NIgG) were investigated for their ability to confer passive immunity . Both preparations were given at the time of infection (prophylaxis) or during sepsis (therapy) to burned mice with lethal infection induced by various clinically relevant gram-negative bacteria . When given at the time of infection both IgG preparations (5 mg/mouse) inhibited lethality induced by some bacteria (Pseudomonas aeruginosa serogroup G and B), but not others (Serratia marcescens, Klebsiella pneumonia, Proteus mirabilis), indicating a protection by by strain-specific antibodies . However, no significant protection was seen when mice were treated during sepsis . The range of specific antibody titers to the whole live bacteria and heat-killed (LPS-preserved) bacteria in the NIgG paralleled that of Anti-LPS IgG; however, the magnitude of the antibody titers did not accurately reflect the protective capacity in vivo . Thus, the exact specificity of the protective antibodies is still unknown . The protective effect of both IgG preparations was dose-dependent; at low IgG doses (0.5 mg/mouse) better protection was obtained with Anti-LPS IgG, whilst at higher doses (> or = 1 mg/mouse) both preparations exhibited identical effects . Low doses of either IgG preparation in combination with subtherapeutic doses of piperacillin significantly enhanced early survival (day 2 for NIgG and day 2 + 3 for Anti-LPS IgG) against P . aeruginosa, but the protective effect waned thereafter . We conclude that a strain-specific antibacterial effect in a compromised mouse infection model can be obtained by early passive immunization with human IgG from large plasma pools . It is suggested that Anti-LPS IgG or NIgG may be of benefit in some cases of gram-negative sepsis when administered as prophylaxis together with proper antibiotic treatment.

Indian J Med Res, 1993 Mar, 97, 85 - 6
Antibacterial activity of the bryozoan Electra bellula (Hincks); Nair PS; The antibacterial activity of the extracts of bryozoan E . bellula (Hincks) was tested against ten bacterial strains by antibiotic disc diffusion method . The maximum activity was observed against Proteus vulgaris, while Klebsiella pneumoniae and Shigella flexneri were insensitive to the bryozoan.

Arch Ital Urol Nefrol Androl, 1993 Mar, 65(1), 31 - 3
{Ureteritis}; Giambroni L et al.; We relate our experience about ureteritis, especially non specific ureteritis . The traumatic, radiation ureteritis will be discussed in others chapters . Most cases of ureteritis are infective, and may be due to any of the organism normally found in urinary tract infections, particularly Escherichia Coli, staphylococci, streptococci, enterococci, proteus and pyocyaneus . It is really primary, but it usually ascending from an associated cystitis, descending from pyelonephritis, or due to direct spread from and adjacent inflammatory lesion such as appendicitis or salpingitis . The infection may also reach the ureter by lymphatic spread, particularly from the prostate and seminal vesicles . Any associated abnormalities of the ureter, such as stricture, megaloureter, ureterocele, and so on, will naturally predispose to infective ureteritis . As ureteritis is rarely primary, the first step in treatment must be toward the elucidation and cure of any underlying lesion . Thus calculi, cystitis, pyelitis, and so on, will need appropriate therapy, and this in itself will considerably improve or cure the ureteritis, and specially in the more acute cases . In the chronic cases with stricture formation, dilation or even excision of the stenosed portion may be required . For the treatment of the strictures we want emphasize the role of the ureteral stenting thinking its use is necessary to preserve the renal function.

Ophthalmology, 1993 Mar, 100(3), 334 - 8
Ophthalmologic examination in the diagnosis of Proteus syndrome; Bouzas EA et al.; PURPOSE: To describe the clinical features of Proteus syndrome, a rare recently recognized hamartoneoplastic malformation, with emphasis on the ocular findings . METHODS: Complete physical and ocular examination of two new patients with Proteus syndrome . RESULTS: The two reported cases illustrate the wide clinical polymorphism of Proteus syndrome and the overlap of its clinical manifestations with those of other overgrowth syndromes . Both patients had periorbital exostoses and epibulbar tumors . The ocular findings are compared with those in the literature . CONCLUSION: Considering the paucity of information in the ophthalmic literature, this article explores the role of the ophthalmologist in diagnosing this rare entity.

J Pediatr Orthop, 1993 Mar-Apr, 13(2), 225 - 7
Osteomyelitis in sickle cell disease; Piehl FC et al.; Records of the Sickle Cell Clinics of the South Carolina Children's Rehabilitative Services from 1977 to 1990 were analyzed for cases of osteomyelitis . Cases included in the study demonstrated either positive bone cultures or blood cultures with correlating radiographs . Seven hundred seventeen charts were reviewed, and 16 cases of osteomyelitis were identified in 15 patients . Thirteen cases were due to Salmonella sp., one was due to Proteus mirabilis, one to Escherichia coli, and one to Staphylococcus aureus . The annual incidence of osteomyelitis in our series was 0.36%.

Aust N Z J Surg, 1993 Mar, 63(3), 203 - 4
Microwave sterilization of polyethylene catheters for intermittent self-catheterization; Griffith D et al.; A standard household 650 W microwave oven was used to sterilize polyethylene catheters of the type used for intermittent self-catheterization . The catheters were infected with Proteus sp . bacteria and microwaved at 650 W for periods of 2, 4, 6 and 8 minutes . The effect of microwaving was assessed by determining the resultant colony counts following catheter culture . It was determined that 6 minutes of microwaving were required to achieve sterility . It is suggested that use of a microwave oven is a reliable and cost-effective method of sterilizing polyethylene catheters for intermittent self-catheterization.

Pol Tyg Lek, 1993 Mar 1-8, 48(9-10), 229 - 32
{Phage and serological types of bacteria infecting patients in anesthesiology and intensive therapy (1988-1990)}; Ziolkowski G et al.; 1736 of biological materials, being taken from 264 patients, were investigated since 1988 to 1990 . 1410 kinds of microorganisms were cultured from 999 biological materials, in which the growth of bacterial flora was noticed . Following species were isolated most frequently: Pseudomonas aeruginosa 15.39%, Proteus mirabilis 12.91%, Klebsiella pneumoniae 10.43% and Staphylococcus aureus 10.43% . The most frequent serological type according to Fisher's scheme was Pseudomonas aeruginosa--immunotype T 3.7 and according to Habs scheme--immunotype P 16 . Strains of Staphylococcus aureus were most frequently sensitive to phages the group II . In case of Klebsiella sp . bacilli, the most predominant strains were not typed either by basic or extended phage sets.

EMBO J, 1993 Mar, 12(3), 889 - 96
A novel multicopy suppressor of a groEL mutation includes two nested open reading frames transcribed from different promoters; Greener T et al.; When present on a multicopy plasmid, a newly discovered gene (sugE) mapping to 94 min on the Escherichia coli chromosome, suppresses a groEL mutation and mimics the effects of groE overexpression . A groEL mutant of E.coli, transformed with the Klebsiella pneumoniae nif gene cluster, failed to accumulate nitrogenase components {Govezensky et al . (1991) J . Bacteriol., 173, 6339-6346} . Transformation with sugE reversed the mutant phenotype . In wild type K.pneumoniae, transformation with sugE accelerated the rate of nitrogenase biogenesis after nif derepression . In E.coli, transformation with sugE enabled bacteriophage T4 growth in a groEL mutant . A continuous 178 codon open reading frame (ORF) in sugE encloses another, in-frame, 105 codon ORF similar to a predicted ORF in Proteus vulgaris . In vivo products of both sugE ORFs were observed in transformants expressing the gene from a T7 promoter . In non-transformed cells, a typical sigma 70-dependent promoter found upstream of the larger ORF directs sugE transcription during growth at 30 degrees C . At elevated temperatures or in stationary phase cells, another promoter, found within the coding sequence upstream of the smaller ORF, is activated independently of sigma 32 . The results suggest that sugE encodes a chaperonin-related system whose composition might vary with temperature and growth phase.

Infect Immun, 1993 Mar, 61(3), 884 - 91
Proteus mirabilis fimbriae: N-terminal amino acid sequence of a major fimbrial subunit and nucleotide sequences of the genes from two strains; Bahrani FK et al.; Proteus mirabilis, a common cause of urinary tract infection in hospitalized and catheterized patients, produces mannose-resistant/klebsiella-like (MR/K) and mannose-resistant/proteus-like (MR/P) hemagglutinins . The gene encoding the major structural subunit of a fimbria, possibly MR/K, was identified in two strains . A degenerate oligonucleotide probe based on the N terminus of the Proteus uroepithelial cell adhesin and antiserum raised against the denatured polypeptide were used to screen a cosmid gene bank of strain HU1069 . A cosmid clone that reacted with the probe and antiserum was identified, and a fimbria-like open reading frame was determined by nucleotide sequencing . The predicted N-terminal amino acid sequence of the processed polypeptide, ENETPAPKVSSTKGEIQLKG (residues 23 to 42), did not match the uroepithelial cell adhesin N terminus but, rather, matched exactly the N-terminal amino acid sequence of a polypeptide with an apparent molecular size of 19.5 kDa isolated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of a fimbrial preparation from strain HI4320 expressing MR/K hemagglutinin . By using an oligonucleotide from the HU1069 open reading frame, the fimbrial gene was isolated and sequenced from a cosmid gene bank clone of strain HI4320 . A 552-bp open reading frame predicts a 184-amino-acid polypeptide including a 22-amino-acid hydrophobic leader sequence . The unprocessed polypeptide is predicted to be 18,921 Da; the processed polypeptide is predicted to be 16,749 Da . The predicted amino acid sequence of the polypeptide encoded by the gene, designated pmfA, displayed 36% exact matches with the mannose-resistant fimbrial subunit encoded by smfA of Serratia marcescens but only 15% exact matches with the predicted sequence encoded by mrkA of Klebsiella pneumoniae.

Zh Mikrobiol Epidemiol Immunobiol, 1993 Mar-Apr, (2), 41 - 7
{The secreted proteolytic enzymes of Proteus mirabilis}; Bondarenko VM et al.; Experiments on white mice, made with the use of genetically linked pair of P . mirabilis differing in the presence of protease activity, have demonstrated the role of this activity in the aggravation of the infectious process, observed only in cases of the parenteral introduction of microorganisms . The damaging action of proteases manifests by decreased antiprotease capacity of the blood and the dissemination of bacteria into organs and tissues with the predominant colonization of the urinary tract . The damage of the epithelial barrier of the gastrointestinal mucosa after the intragastric administration of bacteria can be observed after preliminary destruction of the protective layer consisting of mucin and containing sIgA.

Mol Immunol, 1993 Mar, 30(4), 395 - 402
Junctional diversification in the generation of the precursor of a discrete immune response; George J et al.; Phosphocholine (PC)-specific antibodies that arise in the mouse in response to Proteus morganii (PM) and use V1-DFL16.1-JH1 are characterized by a number of recurring mutations . Most striking is an invariant A for G substitution in codon 95 of VH which results in an asparagine instead of aspartate at that position . Because of the apparent importance of this substitution in an anti-PC(PM) response, we wanted to determine the molecular basis for this base change . A cDNA library derived from pre-immune splenic B cells was examined for the frequency of VDJ containing the A substitution at 95 and the presence of additional point mutations in these sequences . Six different cDNA were isolated which contained an A substitution at the VD junction (frequency 0.00009); a seventh positive cDNA could not be examined . The V segments of four of these cDNA matched known germline genes and were, therefore, unmutated . Two others closely matched V in families whose members have not all been characterized, hence, it is not known whether the mutations observed are somatic or germline in origin . Sequences of 35 cDNA clones, containing the same V segment but differing in D, J and junctional nucleotides, revealed no mutations . These results indicate that the A substitution generated at codon 95 is most likely a product of V-DJ joining.

J Med Microbiol, 1993 Mar, 38(3), 187 - 90
Bacteriology of brain abscess--observations on 50 cases; Lakshmi V et al.; The bacteriology of brain abscess is complex--both aerobic and anaerobic organisms are involved, and their incidence varies from centre to centre . In this study of 50 consecutive cases of brain abscess, the value of both modern imaging techniques and the time-honoured Gram's stain was demonstrated . The Gram's stain showed organisms in 41 cases (82%) and culture was positive in 44 cases (88%) . Thirty cultures yielded pure aerobic growth: Staphylococcus aureus, beta-haemolytic streptococci and Proteus spp . were predominant . Five cases gave mixed aerobic cultures, and in seven cases anaerobes were isolated . Of these, three showed a mixed aerobic and anaerobic flora . Mycobacterium tuberculosis was cultured from one of the samples, which had shown acid-fast bacilli on direct smear . M . fortuitum was cultured from one sample, although no organisms were seen in the gram-stained preparation.

Ophthalmologe, 1993 Feb, 90(1), 17 - 20
{Recurrent canaliculitis and dacryocystitis as a sequela of persistent infection with Chlamydia trachomatis}; Janssen K et al.; We report on 4 patients aged 39-62 years with follicular conjunctivitis, canaliculitis, canalicular obstruction, dacryocystitis and nasolacrimal duct obstruction caused by chronic oculogenital infection with Chlamydia trachomatis . Microbiological diagnosis was accomplished by means of the McCoy cell culture technique as a highly specific tool for detection of the chlamydial infection . In addition, serological tests (IgA-IPA and IgG-IPA techniques) were performed . Bacteriological examination of conjunctival smears showed coinfection in 3 patients (Proteus mirabilis in 1, Staphylococcus aureus coagulase-positive in 3) . Despite successful operation techniques, the obstructive inflammation caused by oculogenital chlamydial infection could only be cured by systemic treatment with specific antibiotics, such as doxycycline or erythromycin . All cases of chronic follicular conjunctivitis with lacrimal inflammation that are resistant to topical antibiotics should suggest the possibility of infection with Chlamydia trachomatis.

J Gen Intern Med, 1993 Feb, 8(2), 89 - 92
Bacteremia in the elderly; Richardson JP; Bacteremia has a high mortality rate in all elderly populations, but especially nursing home residents and the hospitalized elderly . Elderly patients with bacteremia may present in a nonspecific fashion with incontinence, with falls, or afebrile . Mortality is greater in patients whose bacteremia originates outside the genitourinary tract or who are bacteremic with gram-positive organisms . Early appropriate treatment has been found to reduce mortality in some studies, especially in patients over 85 years old or with gram-positive bacteremias . Gram-negative bacteremias are more common than those caused by gram-positive organisms in most studies . E . coli is the most common gram-negative isolate, followed in most studies by either Proteus or Klebsiella . Staphylococcus aureus is the most common gram-positive isolate; enterococcus and pneumococcus are also frequently isolated . Bacteremia in the elderly may present in a subtle fashion . Appropriate antibiotic therapy may reduce mortality and should include antibiotic coverage for S . aureus and gram-negative bacilli, as well as for anaerobes if pressure ulcers are suspected as the source . Clinicians who care for the elderly should be aware of the possible presentations of bacteremia and the appropriate treatment in all clinical settings.

Eur J Biochem, 1993 Feb 1, 211(3), 421 - 5
The amino acid sequence of glutathione transferase from Proteus mirabilis, a prototype of a new class of enzymes; Mignogna G et al.; The complete amino acid sequence of glutathione transferase from Proteus mirabilis was determined . The sequence was reconstructed by analysis of peptides obtained after cleavage by trypsin, Glu-C and Asp-N endoproteinases . The enzyme subunit is composed of 203 amino acid residues corresponding to a molecular mass of 22856 Da . Comparison of this sequence with other known primary structures of the corresponding enzyme from different sources shows a low level of identity (17-26%) with only seven conserved residues in all the sequences considered . This novel glutathione transferase could represent the prototype of a new class, possibly including other bacterial enzymes.

Antimicrob Agents Chemother, 1993 Feb, 37(2), 354 - 6
Outer membrane permeability barrier to azithromycin, clarithromycin, and roxithromycin in gram-negative enteric bacteria; Vaara M; Mutations which severely affect the function of the outer membrane of Escherichia coli and Salmonella typhimurium (lpxA and firA mutations of lipid A synthesis and rfaE mutation of the lipopolysaccharide inner-core synthesis) were found to decrease the MICs of erythromycin, roxithromycin, clarithromycin, and azithromycin by factors of 32 to 512, 32 to 1,024, 64 to 512, and 16 to 64, respectively . The sensitization factors for three other hydrophobic antibiotics (rifampin, fusidic acid, and mupirocin) ranged from 16 to 300 . The outer membrane permeability-increasing agents polymyxin B nonapeptide (3 micrograms/ml) and deacylpolymyxin B (1 microgram/ml) sensitized wild-type E . coli to azithromycin by factors of 10 and 30, respectively . Quantitatively very similar sensitization to the other macrolides took place . Polymyxin-resistant pmrA mutants of S . typhimurium displayed no cross-resistance to azithromycin . Proteus mirabilis mutants which were sensitized to polymyxin by a factor of > or = 300 to > or = 1,000 had a maximal two- to fourfold increase in sensitivity to azithromycin . These results indicate that azithromycin and the other new macrolides use the hydrophobic pathway across the outer membrane and that the intact outer membrane is an effective barrier against them . Furthermore, the results indicate that azithromycin, in contrast to polymyxin, does not effectively diffuse through the outer membrane by interacting electrostatically with the lipopolysaccharide.

J Hosp Infect, 1993 Feb, 23(2), 87 - 111
The antimicrobial activity in vitro of chlorhexidine, a mixture of isothiazolinones ('Kathon' CG) and cetyl trimethyl ammonium bromide (CTAB); Nicoletti G et al.; Chlorehexidine, two 4% chlorhexidine antiseptic handwashes ('Bioprep' and 'Hibiclens'), cetyl trimethyl ammonium bromide (CTAB) and isothiazolinones ('Kathon') were tested against Staphylococcus aureus, Micrococcus luteus, Escherichia coli, Serratia marcescens, Pseudomonas aeruginosa, Proteus vulgaris and Candida albicans . The activities measured were the minimum inhibitory concentration (MIC), minimum microbicidal concentration (MMC), rate of kill in water and broth, effect of organic soil, the development of microbial resistance on continuous exposure and agent bioavailability in media and formulation . 'Kathon' was the most active microbistatic agent showing maximal activity at low concentration, least inactivation by organic soil and media components and the lowest level of development of bacterial resistance . It was synergistic with chlorhexidine against S . marcescens and P . aeruginosa . Media, formulation components and organic soil affected the performance of chlorhexidine and CTAB . Chlorhexidine was more broadly active than CTAB but showed a greater reduction in activity in the presence of soil and engendered a greater level of bacterial resistance . It was more rapidly bactericidal to P . aeruginosa and S . marcescens than to S . aureus . Stable resistance to chlorhexidine and CTAB was developed by P . aeruginosa and S . marcescens, the latter showing the higher level of resistance . Chlorhexidine-resistant strains were also resistant to CTAB . The antiseptic formulations were more rapidly bactericidal than chlorhexidine alone but were otherwise of comparable activity . Mixtures of disinfectants, in particular a combination of chlorhexidine and a preservative level of 'Kathon', were more active than single disinfectants . The importance of standardization of media and test conditions and the use of chemically defined media for accurate and reproducible in-vitro testing of disinfectant activity is emphasized . Disinfection kinetics, expressed as time-kill curves, log reduction factors or decimal reduction times were shown to be valuable in differentiating microbistatic from microbicidal activity, showing the effects of dilution and soil on activity and indicating possible different mechanisms of action.

Antibiot Khimioter, 1993 Feb-Mar, 38(2-3), 49 - 55
{Sulbactam/ampicillin in the treatment and prevention of urologic diseases}; Perepanova TS et al.; Efficacy and safety of unasyn, a combination of sulbactam and ampicillin, was studied in the treatment of 66 patients with infections of the urogenital organs . The drug was administered intramuscularly, intravenously and orally . The treatment course averaged 7-14 days . The dose of the drug for the intravenous and intramuscular administration was 1.5-3 g 4 times a day and that for the oral administration was 0.75 g 2 times a day . The strains of gram-positive cocci, Escherichia coli and Proteus spp . proved to be highly sensitive to the drug: 80-83, 43 and 53 per cent of the sensitive strains respectively . 25-75 per cent of the strains showed beta-lactamase activity that was most frequently detected in Proteus spp . and Staphylococcus spp . The maximum concentrations of ampicillin and sulbactam determined by liquid chromatography were respectively 18 +/- 5.7 and 11 +/- 2.42 micrograms/ml in the blood and 700 and 350 micrograms/ml in the urine . A satisfactory bacteriological effect of the treatment was observed in 93 per cent of the cases . A complete elimination of the initial pathogens was stated in 57-73 per cent of the cases . No side effects were recorded.

FEMS Microbiol Lett, 1993 Jan 15, 106(2), 157 - 64
Cloning, heterologous expression, and sequencing of the Proteus vulgaris glnAntrBC operon and implications of nitrogen control on heterologous urease expression; Steglitz-Morsdorf U et al.; The glnAntrBC operon of Proteus vulgaris was cloned and heterologously expressed in Escherichia coli . The nucleotide sequence was determined . An open reading frame of 1407 bp was identified as the glnA gene and the deduced amino acid sequence showed 82% identity with the E . coli glutamine synthetase protein . Heterologous expression of the glnA gene in E . coli restored glutamine synthetase (GS) activity in a GS-negative mutant and a 52 kDa protein was detected and addressed as the GS subunit of P . vulgaris . Adjacent to the glnA gene the regulatory genes ntrB and ntrC were identified . Their coding regions comprised 1053 and 1452 bp, respectively, and the deduced gene products NRII (NtrB) and NRI (NtrC) shared 72% identity with the corresponding E . coli proteins . Heterologous expression in E . coli revealed only a 54 kDa protein which was shown to be NRI . NRII was not detectable using the methods employed.

Acta Microbiol Bulg, 1993, 29, 54 - 60
Adjuvant activity of the Escherichia coli WF table L-form cytoplasmic membranes; Ivanova E et al.; It was established that the stable E . coli WF+ L-form cytoplasmic membranes (CM) increase the antibody response in rabbit during experimental hyperimmunization with cells of Streptococcus pyogenes A49 and Proteus mirabilis D52 . Using the skin-induration test and the reaction for aggregation of macrophages in presence of homologous antigens it was established that CM increase the cell-mediated immunity of guinea-pigs to protein antigens of the same bacterial strains.

Scand J Infect Dis, 1993, 25(1), 85 - 91
The significance of polymicrobial growth in urine: contamination or true infection; Siegman-Igra Y et al.; Urine growing more than one organism is usually considered contaminated . During 1980-1984, among 198 episodes of urosepsis with at least one identical organism in blood and urine, there were 62 with polymicrobial growth from urine . The significance of the multiple growth from urine was confirmed in 12 episodes by the growth of more than one identical organism in blood and urine and in 21 episodes by repeated growth of the same mixture of organisms in multiple urine specimens . Escherichia coli had a higher tendency to invade blood stream than other Gram-negative organisms, such as pseudomonas and proteus . In specific populations with high risk of polymicrobial infection, multiple growth in urine should be carefully evaluated with appropriate colony count and identification of each isolate.

Hautarzt, 1993 Jan, 44(1), 19 - 22
{Encephalocraniocutaneous lipomatosis . A non-hereditary mosaic phenotype}; Happle R et al.; Encephalocraniocutaneous lipomatosis is a distinct neurocutaneous syndrome characterized by an extensive fatty tissue nevus of the scalp, protuberances of the cranial bones, lipodermoid of the conjunctiva, multiple intercranial lipomas, and porencephaly . A further case of this multisystem birth defect is reported . The patchy arrangement of lesions that is usually unilateral suggests a mosaic phenotype . The clinical criteria to distinguish this disorder from other mosaic neurocutaneous phenotypes, such as Schimmelpenning syndrome, Proteus syndrome, or Delleman syndrome, are outlined . To explain the origin of this nonhereditary genodermatosis, the concept of a lethal autosomal mutation that survives in a mosaic state is proposed.

J Pediatr Surg, 1993 Jan, 28(1), 5 - 10
Proteus syndrome: diagnosis and surgical management; Vaughn RY et al.; The congenital hamartomatous syndrome known as the "Proteus syndrome" (PS) manifests itself with regional giantism, lymphangiomatous hamartomas, and other variable features . Review of the medical literature shows approximately 50 cases reported to date . Since this syndrome has only recently been defined, the management of these patients has been speculative and often children are not treated . This report summarizes the characteristics of the PS and presents eight additional cases . All of the eight children had regional giantism with macrodactyly and skeletal hypertrophy . Asymmetrical leg length was pronounced in five children . All children had large lymphangiomas, the majority of which involved the trunk . Three of the children have been followed through adolescence, two into late childhood, and three into early childhood . In contrast to previous reports, we believe that early surgical reconstruction is necessary to reduce deformities due to the giantism and the large hamartomas . During extensive excisions, residual abnormal tissue is often needed in the reconstruction and it is not unusual for postoperative leakage of lymph to be prolonged . All of the children in this series have benefited both physically and emotionally from extensive surgical reconstruction.

Khirurgiia (Sofiia), 1993, 46(2), 29 - 31
{The modern diagnosis of stenosis and obstruction of the ureter}; Kumanov Kh et al.; Included in the study were 681 patients with stenosis and obstruction of the ureter (SOU), diagnosed at the Department of Urology, Clinical Center of Urology, University Aleksandrovska Hospital in Sofia for a period of 5 years . The diagnosis rested on clinical, laboratory, X-ray, radioisotopic, echographic, endoscopic and other investigations . Analysis of the clinical and laboratory data demonstrated an outstanding triad of clinical symptoms: pain (76.8 per cent), hematuria (74.0 per cent), dysuria (70.9 per cent) . The laboratory data confirmed the standpoint of other authors that most common is the urinary tract infection, followed in incidence by microhematuria, leukocyturia and hemoglobin content lower than 10 mg % . The most common causative agents of infection were E . coli (29.8 per cent) and Proteus (26.28 per cent) . The X-ray methods being used were excretory urography (76.8 per cent) and plain X-ray on kidney-ureter-bladder film (93.2 per cent of the patients) . Excretory urography furnished information on the cause, degree and location of SOU and on the effect upon the kidney . It helped to determine the approach to treatment--conservative transureteral or operative.

Tissue Cell, 1993, 25(1), 141 - 9
A possible signal-coupling role for cyclic AMP during endocytosis in Amoeba proteus; Prusch RD et al.; Cytoplasmic levels of cAMP in Amoeba proteus were measured utilizing radioimmunoassays under control conditions and when stimulated by inducers of either pinocytosis or phagocytosis . In control cells, cytoplasmic cAMP levels were approximately 0.39 pM/mg cells . When exposed to either chemotactic peptide or mannose which stimulate phagocytosis in the amoeba, there is a rapid doubling of the cAMP level within 45 sec of stimulation which then returns to the control level within 3-5 min . Theophylline prolongs the elevation of cytoplasmic cAMP in stimulated cells and is also capable of eliciting food vacuole formation in the amoeba . In addition isoproterenol also causes food vacuole formation in the amoeba as well as a large and prolonged increase in cytoplasmic cAMP levels . Inducers of pinocytosis (BSA and Na Cl) also elicit changes in cytoplasmic cAMP in the amoeba, but the response appears to differ from that elicited by inducers of phagocytosis in that the peak cAMP levels are broader and biphasic . It is concluded that cAMP plays a signal-coupling role during the early phases of both forms of endocytosis in Amoeba proteus.

Mol Microbiol, 1993 Jan, 7(1), 89 - 98
Cloning and molecular characterization of a gene involved in Salmonella adherence and invasion of cultured epithelial cells; Altmeyer RM et al.; Our laboratories have independently identified a gene in Salmonella choleraesuis and Salmonella typhimurium that is necessary for efficient adherence and entry of these organisms into cultured epithelial cells . Introduction of a mutated gene into several Salmonella strains belonging to different serotypes rendered these organisms deficient for adherence and invasion of cultured cells . This effect was most pronounced in the host-adapted serotypes Salmonella gallinarum, S . choleraesuis, and Salmonella typhi . The nucleotide sequence of this gene, which we have termed invH, encodes a predicted 147-amino-acid polypeptide containing a signal sequence . The InvH predicted polypeptide is highly conserved in S . typhimurium and S . choleraesuis, differing at only three residues . The invH gene was expressed in Escherichia coli using a T7 RNA polymerase expression system and a polypeptide of approximately 16,000 molecular weight was observed, in agreement with the predicted size of its gene product . Upon fractionation, the expressed polypeptide was localized in the bacterial membrane fraction . Southern and colony hybridization analyses indicated that the invH gene is present in all Salmonella strains tested (91 strains belonging to 37 serotypes) with the exception of strains of Salmonella arizonae . No homologous sequences were detected in Yersinia, Shigella, Proteus, and several strains of enteroinvasive and enteropathogenic E . coli . Downstream from the S . choleraesuis (but not S . typhimurium) invH gene, a region with extensive homology to the insertion sequence IS3 was detected.

Life Sci, 1993, 53(7), 547 - 53
External ions and direct membrane effects of enkephalins on Amoeba proteus; Mayers P et al.; We have shown that amphiphilic hormones like vasopressins and endorphins increase water permeability and activate the contractile vacuole (CV) in Amoeba by direct action on the plasma membrane . Using our standard CV assay, the effects of nine opioids, morphine, naloxone and 7 enkephalin derivatives, have been compared in normal, ion-containing growth medium (Chalkley's) and in glass-distilled water . While the absence of external ions does not affect the activity of molecules with net positive charges, opioids with no net charge are devoid of action in glass-distilled water . This shows that, in addition to amphiphilicity, which permits insertion into the lipid core of the membrane, electrostatic interactions with ions and with negative charges of phospholipids membrane and glycocalyx, the thick glycoproteic cell coat of Amoeba, are important in the direct action of these compounds.

Med Dosw Mikrobiol, 1993, 45(2), 237 - 40
{Biochemical differentiation of proteus strains from various clinical materials}; Jozefowicz-Piatkowska H et al.; The material consisted of 729 strain of Proteus isolated from clinical samples in three microbiological laboratories of city of Lodz region . Our of these strains, 466 were Proteus mirabilis, and remaining represented: P . penneri-13 strains, P . vulgaris (II biogroup)-56 and 54 strains which were not classifiable on the basis of biochemical properties and scheme elaborated by Hickman et al . for biogroups of P . vulgaris . The authors indicate feasibility of differentiation of P . vulgaris basing on biochemical tests as a supplementary method to other tests of intracellular differentiation of Proteus.

Med Dosw Mikrobiol, 1993, 45(2), 223 - 8
{Etiologic bacterial factors of infections in patients treated at the clinical anesthesiology ward and with intensive therapy}; Ziolkowski G et al.; Bacteriological investigations were carried on 264 patients treated in 1988-1990 . 1736 samples of biological materials were taken and it amounts to 6-7 samples from each patient . Most frequently isolated microorganisms were: Pseudomonas aeruginosa (15%), Proteus mirabilis (13%), Klebsiella pneumoniae (10%) and Staphylococcus aureus (10%) . Serological typing of Pseudomonas aeruginosa was performed according to Habs and domination of immunotype P16 (30%) was detected . Majority of isolated Klebsiella pneumoniae were not typable with basic and broadened phage set . One strain was susceptible to phages KI12 and KI27 . This phage type was not isolated in Poland before . Staphylococci were most frequently susceptible to group II phages (29%), additional phages (19%) and 15% were not typable with the phage set used . Isolated bacteria were in majority resistant to numerous antibiotics.

Ann Dermatol Venereol, 1993, 120(6-7), 445 - 7
{Proteus syndrome}; Hachich N et al.; We report the case of a 4-year old boy presenting with a polymalformative syndrome made of cutaneous and subcutaneous lesions associated with visceral and skeletal lesions . The cutaneous lesions consisted of 3 verrucous hamartomas, one haemangioma and one lymphangioma . The subcutaneous lesions were melting of panniculus adiposus, plantar tumefaction and diffuse lipomatosis of the peritoneal and retroperitoneal cavities . The skeletal lesions were uneven lower limbs and dorsal scoliosis . Atrophy of the intestinal villi was also found . The diagnosis of Proteus syndrome was made.

Yao Xue Xue Bao, 1993, 28(6), 477 - 80
{Synthesis and antibacterial action of 1-ethyl-6-fluoro-1,4-dihydro-4-oxo-7-(4-aroylthiocarbamoyl-1-piperaziny l)-3-quinoline carboxylic acids}; Jia XS et al.; Thirteen new 1-ethyl-6-fluoro-1,4-dihydro-4-oxo-7-(4-aroyl-thiocarbamoyl-1-piperazinyl)-3- quinoline carboxylic acids were prepared . Their structures were characterized by elemental analysis, IR, HNMR and MS spectra . Preliminary pharmacological tests indicated that some of compounds Ia-m possess strong inhibiting activity against Escherichia coli, Bacillus subtilis and Proteus at concentration of 100 micrograms/ml.

Wiad Lek, 1993 Jan-Feb, 46(1-2), 28 - 31
{Preliminary clinical evaluation of unasyn preparation in genitourinary tract infections}; Dutkiewicz S et al.; The preparation Unasyn Pfizer in tablets of 375 mg was used for 10 days in doses of 1 tablet twice daily in 31 patients of either sex with chronic genitourinary tract infection . For criterion of treatment efficacy, the lack of significant bacteriuria was accepted as well as regression of leukocyturia and clinical signs of infection . Cure was achieved in 24 patients, improvement was found in five patients, and the lack of therapeutic effect was observed in two cases . Unasyn is useful in the treatment of genitourinary tract infections, especially by Escherichia coli and Proteus species, and is convenient in dosage, non-toxic, and well tolerated by patients.

Med Dosw Mikrobiol, 1993, 45(1), 93 - 7
{Structural and immunologic studies of Proteus mirabilis 033 O-specific polysaccharide}; Cedzynski M et al.; O-specific polysaccharide was obtained by mild acid degradation of P . mirabilis 033 lipopolysaccharide (LPS) . It was found to contain N-acetyl-D-glucosamine, D-glucuronic acid and N-acetyl-L-fucosamine in a ratio 1:1:1 . On the basis of the data obtained from 13C-NMR and methylation analysis, the following structure of repeating unit was established: {formula: see text} Selective removal of the D-GlcA significantly decreased reactivity of 033 O-specific polysaccharide with homologous antiserum . This component was plays an immunodominant role . Cross reactivity between anti-033 serum and disaccharide alfa-L-FucNAc-beta-D-GlcNAc containing P . vulgaris 023 and S . arizonae 059 O-specific polysaccharides was also observed.

Med Dosw Mikrobiol, 1993, 45(1), 89 - 92
{Immunochemical studies of O-specific polysaccharide of Proteus penneri 42 lipopolysaccharide}; Sidorczyk Z et al.; O-specific polysaccharide was obtained an mild acid degradation of Proteus penneri strain 42 lipopolysaccharide and found to contain D-glucose, D-galacturonic acid and 2-acetamido-2-deoxy-D-glucose in molar ratio 2:1:1 . Methylation analysis showed that the polysaccharide is linear, one of the glucose residue is substituted at position 2, the second one and the residue of galacturonic acid at position 4, and the 2-acetamido-2-deoxy-D-glucose residue at position 3 . On the basis of non-destructive NMR analysis the following structure of repeat unit of the O-specific polysaccharide was established and confirmed independently by methylation analysis: -2)-beta-D-Glc-(1-->4)-beta-D-Glc-(1-->3)-beta-D-GlcNAc-(1-->4)-al fa-D-GalA-(1--> The serological investigation with application of P . penneri strain 42 anti O-serum has shown the activity of homologous preparations of LPS and PS, as well as cross-reactions with heterologous lipopolysaccharides from other Proteus strains.

Med Dosw Mikrobiol, 1993, 45(1), 85 - 7
{Immunochemical studies of O-specific polysaccharide from Proteus penneri 14 lipopolysaccharide}; Sidroczyk Z et al.; O-specific polysaccharide was obtained on mild acid degradation of Proteus penneri strain 14 lipopolysaccharide and found to contain equimolar of D-galactose, D-ribose, 2-acetamido-2-deoxy-D-glucose, N-(D-galacturonoyl)-L-alanine and 3-(Nacety-L-alanyl)-amido-3,6-dideoxy-D-glucose . On the basis of non-destructive NMR analysis it was concluded that repeat unit of the 0-specific polysaccharide of P . penneri 14 has the following structure: -2-beta-D- Quip3NAlaAc-(1-->4)-alfa-D-GalpAAla-(1-->2)-beta-D- Ribf-(1-->4)-beta-D-Galp-(1-->3)-beta-D--GlcpNAc-(1--> This structure was confirmed by structural elucidation of trisaccharide and disaccharide fragments prepared on mild acid hydrolysis of the polysaccharide . Immunodominant role of the partial structures of the pentasaccharide repeating unit in manifesting serological specificity of P . penneri 14 was discussed . Very weak cross-reactions of P . penneri anti-serum were observed with E . coli 0114 and Shigella boydii 08 LPS's, which showed some structural similarities . No cross-reaction with P . mirabilis 027 LPs was detected.

Med Dosw Mikrobiol, 1993, 45(1), 79 - 83
{Characterization of hemolytic activity of Proteus penneri}; Rozalski A et al.; Bacteria belonging to the genus Proteus synthesise two kinds of hemolysins HpmA and HlyA which represent "RTX proteins" . In previous papers we described the production of an extracellular HlyA hemolysin by some P . penneri strains . Now we are reporting on the synthesis by P . penneri, typical for P . mirabilis HpmA hemolysin . There were identified two P . penneri strains 5 and 37 in which both hpmA and hlyA regions are present . In two other strains P . penneri 13 and 44 only hlyA region was found, whereas in strain P . penneri 42 operon hpmA was identified . The production of HpmA hemolysin was revealed in the cases of P . penneri 5, 42 and P . mirabilis 03 and 1959 . The dynamics of HlyA hemolysin synthesis by P . penneri 44 was also investigated and its highest activity was observed during logarithmic phase of growth of bacterial culture . HlyA hemolysin was isolated from culture filtrate by precipitation with polyethylene glycol 4000 . The invasiveness of HpmA+ and/or HlyA+ P . penneri strains was also checked by use of mouse L929 fibroblasts . Both kinds of strains were able to penetrate tested cells . The invasion of L929 fibroblasts by strains producing HlyA hemolysin is accompanied by cytotoxic effect.

Med Dosw Mikrobiol, 1993, 45(1), 75 - 8
{Isolation and certain biological and immunologic properties of Proteus penneri strains from the European collection}; Sidorczyk Z et al.; The American Collection of 45 Proteus penneri strains was supplemented by 22 strains isolated in Poland and Germany . All strains exhibited typical smooth forms of bacteria . Susceptibility to antibiotics was determined and compared with the other P . penneri strains . 0-antigenic relatedness and serological similarity between strains in the whole Proteus penneri collection were discussed.

Med Dosw Mikrobiol, 1993, 45(1), 69 - 73
{Selected properties of strains of a new species of Proteus penneri from the second American collection}; Sidorczyk Z et al.; The second collection of the novel species Proteus penneri consists of 25 strains from which only two have shown rough from properties in the tests differentiating S and R variants of bacteria . The migration pattern of their lipopolysaccharides in gel electrophoresis was leader-like, typical for smooth organisms . 13 out of 25 lipopolysaccharide preparations showed strong-reactivity with anti-0 sera in semi-quantitative precipitation test . Serological similarity between the strains within species Proteus penneri is discussed.

Med Dosw Mikrobiol, 1993, 45(1), 65 - 8
{Further types of core lipopolysaccharides in Proteus}; Radziejewska-Lebrecht J et al.; Comparative analysis of the chemical composition of 11 core oligosaccharides isolated from lipopolysaccharides of the wild (S) and phenotypically rough (R) strains Proteus mirabilis (nine) and Proteus vulgaris (two) allowed to recognize three new types Proteus core, classified as IV, V, VI . All of them contained D-galactose and D-galactosamine in addition to common core constituents: D-glucose, D-galacturonic acid, L-glycero-D-manno-heptose, KDO, EtN described for Proteus core types I, II, III (6, 7, 8) . D-glucosamine was characteristic for Proteus core type VI whereas D-glycero-D-manno-heptose for types V and VI.

Vet Res Commun, 1993, 17(2), 77 - 84
Potentiation of the in vitro activity of some antimicrobial agents against selected gram-negative bacteria by EDTA-tromethamine; Farca AM et al.; The in vitro synergistic effects of combinations of EDTA-tromethamine and six antimicrobial agents (ampicillin, chloramphenicol, oxytetracycline, streptomycin, nalidixic acid and sulphadimethoxine) on clinically isolated strains of Pseudomonas aeruginosa, Proteus mirabilis and Escherichia coli were investigated . The antibacterial activity was assessed from the minimal inhibitory concentration for the antibiotics alone or in combination with EDTA-tromethamine . EDTA-tromethamine potentiated the antibacterial activity of ampicillin, chloramphenicol, oxytetracycline and streptomycin up to four-fold . There were no significant or consistent synergistic effects with nalidixic acid or sulphadimethoxine.

Neurochirurgie, 1993, 39(4), 241 - 7
{Epidermoid cyst of the 4th ventricle . Apropos of a case in a child and review of the literature}; Emery E et al.; A 6 year-old child was admitted for a recurrent bacterial meningitis at Proteus Morganii . She was treated with antibiotics . The C.T . Scanner showed a midline low-density lesion, with a mild annular contrast uptake in the posterior fossa . M.R.I . showed the lesion and revealed a skin-bone-dura fistula . The surgical resection was complete . It was an epidermoid tumor . Intracranial epidermoid tumors constitute about 1% of brain tumors and are considered to be congenital . Epidermoid tumors of the 4th ventricle are exceedingly rare in childhood . The authors reviewed the literature and discuss the pathogeny, the radiographic diagnosis and the treatment of these tumors.

Pneumonol Alergol Pol, 1993, 61(11-12), 610 - 6
{Pulmonary infections in patients with lung cancer during antineoplastic therapy}; Slupek A et al.; 162 pulmonary infection episodes were observed in 94 patients with lung cancer undergoing antineoplastic therapy . 80 (40%) episodes occurred during leukopenia . Elevation of leucocyte count was seen in 12 episodes only . Elevated body temperature was the only sign in 20 episodes, of which in 7 cases microorganisms were cultured from the blood . Purulent pulmonary infections were observed in 71 episodes, in 66 the causative agent was identified . Purulent urinary tract infections were observed in 29 episodes, of which in 28 the microorganisms were identified . A coexistent pulmonary and urinary tract infection was seen in 13 cases, of which in all the causative agent was identified . Purulent infections of the nasopharyngeal mucosal membranes were observed in 16 cases, while herpes zoster in 13 . The most often isolated organism in these cases were: Gram negative rods (E . coli, Klebsiella sp., Proteus sp., Hemophilus influenzae); less commonly Gram positive bacteria were isolated, mainly Staphylococcus aureus . Candida sp . was the most common fungus that was isolated from these patients . In four cases Candida was isolated from blood.

Microbiol Immunol, 1993, 37(12), 927 - 33
Serological reactivity of sera from scrub typhus patients against Weil-Felix test antigens; Amano K et al.; Sera from 17 patients of scrub typhus in the acute and convalescent phases were tested by indirect immunoperoxidase test, Weil-Felix (WF) test, enzyme-linked immunosorbent assay (ELISA), and immunoblotting . In the comparison of antibody titers between acute- and convalescent-phase sera, we recognized a parallelism of increment between the titers in WF test and titers of immunoglobulin M (IgM) in ELISA against Proteus mirabilis strain OXK-whole cells and OXK-lipopolysaccharides (Proteus OXK-LPS) . Furthermore, IgM antibodies from almost all of WF test-positive sera recognized LPS from Proteus OXK in immunoblotting . Based on these results, it was concluded that IgM antibody rather than IgG may participate in WF test, and that Proteus OXK-LPS may have one of antigenic epitopes common to the components of R . tsutsugamushi.

J Bacteriol, 1993 Jan, 175(2), 457 - 64
Proteus mirabilis MR/P fimbriae: molecular cloning, expression, and nucleotide sequence of the major fimbrial subunit gene; Bahrani FK et al.; Proteus mirabilis, a cause of serious urinary tract infection and acute pyelonephritis, produces several putative virulence determinants, among them, fimbriae . Principally, two fimbrial types are produced by this species: mannose-resistant/Proteus-like (MR/P) fimbriae and mannose-resistant/Klebsiella-like (MR/K) fimbriae . To isolate MR/P fimbrial gene sequences, a P . mirabilis cosmid library was screened by immunoblotting and by hybridization with an oligonucleotide probe based on the N-terminal amino acid sequence of the isolated fimbrial polypeptide, ADQGHGTVKFVGSIIDAPCS . One clone, pMRP101, reacted strongly with a monoclonal antibody specific for MR/P fimbriae and with the DNA probe . This clone hemagglutinated both tannic acid-treated and untreated chicken erythrocytes with or without 50 mM D-mannose and was shown to be fimbriated by transmission electron microscopy . A 525-bp open reading frame, designated mrpA, predicted a 175-amino-acid polypeptide including a 23-amino-acid hydrophobic leader peptide . The unprocessed and processed polypeptides are predicted to be 17,909 and 15,689 Da, respectively . The N-terminal amino acid sequence of the processed fimbrial subunit exactly matched amino acid residues 24 to 43 predicted by the mrpA nucleotide sequence . The MrpA polypeptide shares 57% amino acid sequence identity with SmfA, the major fimbrial subunit of Serratia marcescens mannose-resistant fimbriae.

Zh Mikrobiol Epidemiol Immunobiol, 1993 Jan-Feb, (1), 48 - 51
{The protective activity of a multicomponent vaccine made from the antigens of opportunistic microorganisms when administered orally}; Egorova NB et al.; Multicomponent vaccine VP-4, prepared from Streptococcus, Klebsiella, Proteus and Escherichia coli antigens, was tested for protective activity by oral administration to mice with experimental Klebsiella, Proteus and S . pneumoniae infections . Vaccine VP-4, when introduced orally (in 2-3 administrations of 2 mg), was found to produce a protective effect with respect to K . pneumoniae (the effectiveness index was equal to 5.7 and 4.3) . With respect to P . vulgaris, the effectiveness index was 2.7 (immunization was made in two oral administrations of 2 mg); in pneumococcal infection preliminary oral immunization with vaccine VP-4 in two administrations in a dose of 2-4 mg produced high protective effect . Thus, immunization with vaccine VP-4, introduced orally in comparatively small doses, proved to be effective in animal models used in the experiment.

Acta Microbiol Hung, 1993, 40(4), 369 - 77
Mechanisms of antimotility action of tricyclic compounds in Proteus vulgaris; Ren JK et al.; Tricyclic compounds were able to inhibit the motility of Proteus vulgaris . The effectiveness of antimotility action was related to the physicochemical properties of the molecules, i.e . energy of HOMO, Log P, total surface . The antimotility action of the compounds was due to their reversible inhibition on the proton pump of the bacterium . Phosphate anion antagonized the antimotility, and potassium cation enhanced the action of phosphate anion on the antimotility effect induced by the agents . Glucose reversed the antimotility action of the compounds . Factors directly increasing the bacterial proton-motive force (PMF) could change bacterial motility and the antimotility action of the tricyclic compounds.

Med Dosw Mikrobiol, 1993, 45(1), 99 - 102
{Studies of epitope specificity of polyclonal antibodies against Proteus mirabilis R mutants}; Bartodziejska B et al.; The chemical structure of the following P . mirabilis R mutants lipopolysaccharide (LPS) were already established: R110/1959 (Ra), R4/028 (Rc) and R45/1959 (Re) . In this report we focus on P . mirabilis R5/O28, R13/1959 and R14/1959 and R14/1959 . The last one corresponds to Salmonella transient forms, and synthesis truncated core oligosaccharide lacking terminal DD-Hep and nevertheless substituted by T polysaccharide whose structure occurred to be similar to P . penneri 42 O-repeating unit . The knowledge of chemical structure of P . mirabilis R mutants lipopolysaccharides led us to the study of the epitope specificity of rabbit polyclonal R specific antisera . The results show strong structural and serological relatedness of LPS from P . mirabilis R110 and R13 . Antibodies against P . mirabilis R4 recognize in homologous LPS an epitope sharing oligosaccharide Glc-Hep . The serological studies revealed also close similarities of LPS from P . mirabilis R14 and P . mirabilis S1959, O28 as well as P . penneri 42 . These data indicate that polyclonal antibodies against P . mirabilis R14 are directed against four epitopes: two in T-polysaccharide (D-Glc-(beta 1,4)-D-Glc and terminal GalA residue) and two in core oligosaccharide (D-Glc-(alfa 1,6)-D-Glc and terminal GlcNAc residue) of lipopolysaccharide molecule.

J Bacteriol, 1993 Jan, 175(2), 465 - 73
Proteus mirabilis urease: transcriptional regulation by UreR; Nicholson EB et al.; Proteus mirabilis urease catalyzes the hydrolysis of urea, initiating the formation of urinary stones . The enzyme is critical for kidney colonization and the development of acute pyelonephritis . Urease is induced by urea and is not controlled by the nitrogen regulatory system (ntr) or catabolite repression . Purified whole-cell RNA from induced and uninduced cultures of P . mirabilis and Escherichia coli harboring cloned urease sequences was probed with a 4.2-kb BglI fragment from within the urease operon . Autoradiographs of slot blots demonstrated 4.2- and 5.8-fold increases, respectively, in urease-specific RNA upon induction with urea . Structural and accessory genes necessary for urease activity, ureD, A, B, C, E, and F, were previously cloned and sequenced (B . D . Jones and H . L . T . Mobley, J . Bacteriol . 171:6414-6422, 1989) . A 1.2-kb EcoRV-BamHI restriction fragment upstream of these sequences confers inducibility upon the operon in trans . Nucleotide sequencing of this fragment revealed a single open reading frame of 882 nucleotides, designated ureR, which is transcribed in the direction opposite that of the urease structural and accessory genes and encodes a 293-amino-acid polypeptide predicted to be 33,415 Da in size . Autoradiographs of sodium dodecyl sulfate-polyacrylamide gels of {35S}methionine-labeled polypeptides obtained by in vitro transcription-translation of the PCR fragments carrying only ureR yielded a single band with an apparent molecular size of 32 kDa . Fragments carrying an in-frame deletion within ureR synthesized a truncated product . The predicted UreR amino acid sequence contains a potential helix-turn-helix motif and an associated AraC family signature and is similar to that predicted for a number of DNA-binding proteins, including E . coli proteins that regulate acid phosphatase synthesis (AppY), porin synthesis (EnvY), and rhamnose utilization (RhaR) . These data suggest that UreR governs the inducibility of P . mirabilis urease.

Burns, 1992 Dec, 18(6), 448 - 51
Bacterial flora of burn wounds in Lagos, Nigeria: a prospective study; Atoyebi OA et al.; A prospective study of burn wound sepsis was carried out on 31 consecutive patients with fresh burns . Wound swab cultures were assessed at weekly intervals for 5 weeks . The study revealed that while 96.7 per cent of burn wounds were sterile on admission, bacterial colonization reached 80.6 per cent within the first week after admission . Although the Gram-negative organisms, as a group, were more predominant, Staph . aureus (38.2 per cent) was the most prevalent organism in the first week . It was however surpassed by Pseud . aeruginosa from the second week onwards . Anaerobes were conspicuous by their absence . Similarly, beta-haemolytic streptococcus was not isolated from any patient . Proteus mirabilis was unusually preponderant, forming 19.4 per cent of all isolates . The antibiotic sensitivity pattern showed resistance of most of the organisms to ampicillin . Only 15 per cent of staphylococci were sensitive to cloxacillin . Most of the organisms cultured (93.5 per cent) were sensitive to ceftazidime.

Crit Care Med, 1992 Dec, 20(12), 1677 - 80
Alterations in oropharyngeal flora in patients with a nasogastric tube: a cohort study; Thomas S et al.; OBJECTIVE: To determine whether or not the presence of a nasogastric tube causes a change in the bacterial flora in the oropharynx . STUDY DESIGN: Cohort (prospective) design with concurrent control . SETTING: General Surgical and Ear, Nose, and Throat Units of a tertiary care hospital . PATIENTS: Sixteen patients with and 14 patients without a nasogastric tube . INTERVENTIONS: Patients scheduled to undergo surgery under general anesthesia with endotracheal intubation were eligible for inclusion in the study . From these patients, a study cohort of 16 consecutive patients who were to have nasogastric tube intubation and 14 patients who were not to have nasogastric intubation were enrolled . All patients had a high oropharyngeal swab taken for bacteriologic culture just before surgery . The swab of the oropharynx for culture was repeated after 48 to 72 hrs . The type of organism grown was identified and compared between and within the two groups . RESULTS: There was a significant increase in the frequency of colonization of the oropharynx by pathogenic Gram-negative bacteria after 48 to 72 hrs of nasogastric intubation in comparison with the preintubation level (p < .01) as well as in comparison with the group that did not have nasogastric intubation (p < .001) . The pathogens included Pseudomonas, Klebsiella, Proteus and Escherichia coli . There was also a tendency for suppression of normal flora . There was no significant change in the flora of the control group of patients who did not have nasogastric intubation . The two groups were comparable with respect to age, gender, severity of underlying illness, and use of prophylactic perioperative antibiotics . CONCLUSIONS: The presence of nasogastric tubes in patients predisposes to colonization by Gram-negative pathogenic bacteria within 48 to 72 hrs.

Antibiot Khimioter, 1992 Dec, 37(12), 50 - 2
{Comparative effectiveness of antimicrobial action of antiseptics against pathogens of chronic purulent otitis media}; Palii GK et al.; Comparable antimicrobial and disinfecting action of decamethoxine and silver preparations on pathogens of chronic purulent otitis media (CPOM) was studied . The clinical isolates of staphylococci proved to be most sensitive to decamethoxine whose MBcC conformed to 16.5 micrograms/ml . The antimicrobial action on Proteus spp . and Pseudomonas aeruginosa was less pronounced . The required concentrations for bactericidal action on these pathogens were 69 and 93.5 micrograms/ml, respectively . The antimicrobial activity of the silver preparations such as poviargol, collargol and protargol was low . Depending on the microbial species, the bactericidal effect of the silver preparations was 12-235 times lower than that of decamethoxin . It was also shown that decamethoxin had a high disinfecting action on CPOM pathogens . It was noted that decamethoxin had a marked ability to increase the bactericidal action of poviargol (by 2-14 times) and its disinfecting action (by 2 times) on Proteus spp., E . coli and Ps . aeruginosa.

Hybridoma, 1992 Dec, 11(6), 765 - 77
Preparation and binding specificity of a monoclonal antibody recognizing 3-deoxy-D-manno-2-octulosonic acid (Kdo) in lipopolysaccharides of Re chemotype; Pedron T et al.; A mouse monoclonal antibody (MAb E1) was raised against the lipopolysaccharide (LPS) of the Re mutant R595 of Salmonella minnesota . This IgG3 antibody (MAb E1), unstable at low pH and low ionic strength, was purified by chromatography on QAE Sepharose A50 . The binding specificity of MAb E1 was characterized by direct and inhibition enzyme immunoassays, using natural LPSs from different strains and chemotypes, and synthetic analogs of LPS substructure of the 3-deoxy-D-manno-2-octulosonic acid (Kdo) and Lipid A regions . Among various LPSs, MAb E1 reacted exclusively with those of Re-chemotype . It recognized alpha-Kdo- monosaccharide and disaccharide structures present as non-reducing side chains in various Re-type LPSs and synthetic antigens . The antibody did not react with Lipid A or various lipids, and the presence of the lipid region was not necessary for the reaction . The recognition of the epitope was not reduced by the presence of a substituent at O-8 of one of the two Kdo units present in the Re LPS from Proteus mirabilis, but the reaction was inhibited by phosphorylation of O-4 of Kdo, by the proximity of core (heptose) or Lipid A (acylated glucosamine) residues, or by certain LPS-LPS interactions.

Cesk Epidemiol Mikrobiol Imunol, 1992 Dec, 41(6), 355 - 61
{Microbicidal effect of Lautercide, a new disinfectant}; Kneiflova J et al.; The authors tested the effect of a new disinfectant Lautericide produced by Qualichem Co . Neratovice which contains as the active agent acetate amine of coconut acid . For experiments standard methods were used and standard strains for testing of the following microbial strains: St . aureus, E . coli, Ps . aeruginosa, Proteus vulgaris, Serratia marcescens, Candida albicans, spores of Bacillus subtilis, M . tuberculosis, M . fortuitum, M . avium . As a model virus E . coli bacteriophage OX 174 was used . In concentrations from 0.04% to 0.5% and exposures from 2 to 10 minutes Lautercide exerted a bactericidal and fungicidal action . On spores of B . subtilis the preparation was ineffective even in a 10% concentration and 32-minute exposure . Devitalization of mycobacteria occurred after 15 min . action of Lautercide on M . tuberculosis and M . fortuitum, in M . avium in a 10% concentration in 60 min . Lautercide is ineffective against small resistant viruses without an integument . It is recommended to use Lautercide in a 1% aqueous solution for a one-stage disinfection combined with cleaning in the health services, veterinary medicine and in the field of communal hygiene . Before cleaning objects contaminated with infectious material, 5% Lautercide with 30 min . exposure is recommended . In disinfection of objects contaminated with mycobacteria it is recommended to use a 5% solution with 10-minute exposure for M . tuberculosis and M . fortuitum and a 10% solution for M . avium with 60-minute exposure.

Electrophoresis, 1992 Nov, 13(11), 852 - 4
Identification of gram-negative bacteria by isoelectric focusing of soluble cellular proteins; Margull A et al.; Strains of Escherichia coli, Pseudomonas aeruginosa and Proteus mirabilis, isolated from clinical specimens were disrupted by repeated freezing in liquid nitrogen and thawing at room temperature . The samples were separated by isoelectric focusing using polyacrylamide gels . The resulting protein patterns showed clear differences between the three species and made identification possible.

Ann Rheum Dis, 1992 Nov, 51(11), 1245 - 6
Sequence similarity between HLA-DR1 and DR4 subtypes associated with rheumatoid arthritis and proteus/serratia membrane haemolysins; Ebringer A et al.; Rheumatoid arthritis (RA) is found more often in subjects carrying the HLA-DR1 antigen and some subtypes of the HLA-DR4 antigen than in those without these antigens . Analysis of probes specific for HLA-DR4 has shown that amino acids encoding positions 69-74 (EQRRAA) of the beta chain indicates susceptibility to RA . A hexamer sequence of proteus haemolysin spanning residues 32-37 (ESRRAL) has been identified which resembles biochemically, and discriminates by charge, between HLA types associated with RA (DR1, Dw4, Dw14, Dw15), and those not linked with the disease (Dw10, Dw13).

Ann Rheum Dis, 1992 Nov, 51(11), 1242 - 4
P blood group phenotype, proteus antibody titres, and rheumatoid arthritis; Deighton CM et al.; The interrelationships between P blood group phenotype, proteus antibodies and rheumatoid arthritis (RA) were investigated in 140 patients with RA and 114 of their siblings who did not have RA . In the group with RA P2 subjects had significantly higher titres of proteus antibodies than P1 patients . This was not observed in the group without RA, or for antibodies to Escherichia coli . Although C reactive protein was the best predictor of proteus antibodies in the group with RA, the P blood group had an independent and significant influence . These observations suggest a testable model in which asymptomatic carriage of proteus in the urinary tract may lead to antibody production, which in turn may be important in the pathogenesis of RA.

Ann Rheum Dis, 1992 Nov, 51(11), 1206 - 7
Specificity of the proteus antibody response in rheumatoid arthritis; Deighton CM et al.; Antibodies to proteus were determined by indirect immunofluorescence in 146 serum samples from patients with rheumatoid arthritis (RA) . An autoantibody screen was performed in the same samples and in 52 of these antibody titres to the viruses influenza A, adenovirus, rubella, and parvovirus were determined . There was no significant correlation between proteus antibodies and any of the other antibodies tested . Dividing the samples into those from patients with active (C reactive protein > 10 mg/l) and inactive RA showed that the only antibodies to be significantly increased in active RA were the proteus antibodies . These observations suggest that the proteus antibody response in RA is specific.

J Protozool, 1992 Nov-Dec, 39(6), 671 - 7
Lysosomal membrane proteins of Amoeba proteus, as studied with monoclonal antibodies; Choi EY et al.; Monoclonal antibodies were prepared against lysosomal membrane proteins of amoebae and used to follow lysosome-phagosome fusion after induced phagocytosis . The specificity of antibodies was checked by indirect immunofluorescence microscopy, immunoelectron microscopy, and localization of the antigen in subcellular fractions . The antibody-recognized proteins started to appear on the membranes of phagolysosomes about 5 min after phagocytosis as detected by indirect immunofluorescence, and the intensity of fluorescence increased for up to 1 h . Results of injection experiments in which purified antibodies had been injected into living cells and probed by indirect fluorescence indicated that the antigens were located on the cytoplasmic side of the lysosomal membranes . Lysosomes fuse with phagosomes on the one hand but not with non-fusible vesicles such as symbiosomes on the other . The results support the view that a membrane component(s) of non-fusible vesicles somehow prevents lysosomes from fusing with them.

Infect Immun, 1992 Nov, 60(11), 4740 - 6
Ability of Proteus mirabilis to invade human urothelial cells is coupled to motility and swarming differentiation; Allison C et al.; Proteus mirabilis causes serious kidney infections which can involve invasion of host urothelial cells . We present data showing that the ability to invade host urothelial cells is closely coupled to swarming, a form of cyclical multicellular behavior in which vegetative bacteria differentiate into hyperflagellated, filamentous swarm cells capable of coordinated and rapid population migration . Entry into the human urothelial cell line EJ/28 by P . mirabilis U6450 isolated at different stages throughout the swarming cycle was measured by the antibiotic protection assay method and confirmed by electron microscopy . Differentiated filaments entered urothelial cells within 30 min and were 15-fold more invasive (ca . 0.18% entry in 2 h) than an equivalent dry weight of vegetative cells isolated before differentiation, which attained only ca . 0.012% entry in the 2-h assay . The invasive ability of P . mirabilis was modulated in parallel with flagellin levels throughout two cycles of swarming . Septation and division of intracellular swarm cells produced between 50 and 300 vegetative bacteria per human cell, compared with 4 to 12 intracellular bacteria after incubation with vegetative cells . Transposon (Tn5) mutants of P . mirabilis with specific defects in motility and multicellular behavior were compared with the wild-type for the ability to invade . Mutants which lacked flagella (nonmotile nonswarming) were entirely noninvasive, and those which were motile but defective in swarm cell formation (motile nonswarming) were 25-fold less invasive than wild-type vegetative cells . Mutants with defects in the coordination of multicellular migration and the temporal control of consolidation (cyclical reversion of swarm cells to vegetative cells) were reduced ca . 3- to 12-fold in the ability to enter urothelial cells . In contrast, a nonhemolytic transposon mutant which swarmed normally retained over 80% of wild-type invasive ability . Swarm cells and early consolidation cells were at least 10-fold more cytolytic than vegetative cells as a result of their high-level production of hemolysin.

Phlebologie, 1992 Nov-Dec, 45(4), 463 - 9
{Proteus syndrome . Expansion of the phenotype . Apropos of 3 pediatric cases}; Hulsmans RF et al.; In 1979 Cohen et Hayden and in 1983 Wiedemann et al . delineated a syndrome consisting of partial gigantism of the hands and/or feet, nevi, hemihypertrophy, subcutaneous tumors, macrocephaly or other skull anomalies and possible accelerated growth and visceral affections . Hitherto the literature pertaining to this syndrome consists of somewhat more than 100 cases of which some, that have been described previously or subsequently under other headings, were rediagnosed as being Proteus syndromes . Of these, more than half show vascular anomalies closely resembling those observed in the Klippel-Trenaunay syndrome, but in the Proteus syndrome appear to be more haphazardly distributed over the integument . We report 3 pediatric patients with the Proteus syndrome, all showing cutaneous angiodysplasias . These patients were initially diagnosed as suffering from "severe or atypical Klippel-Trenaunay syndrome" . In one of these, cardiac tumors were observed soon after birth which subsequently showed spontaneous involution and were therefore considered to be rhabdomyomas . In the Proteus syndrome cardiac pathology is rare, and cardiac tumors have not been described previously . Moreover, we observed umbilical hernia in two of our patients, a feature which has hitherto not been reported in patients with the Proteus syndrome . In all our patients a broad thoracic cage resembling a "body-builders chest", asymmetrical and disproportional macrodactyly and broad, flat feet were conspicuous . These broad, flat feet with macrodactyly and large spaces between the first and second digits were designed by the parents of one of our patient as "chimpanzee's feet" . Macrodactyly, "chimp's" feet and a broad thoracic cage are considered by us to be clinical hallmarks of the Proteus syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Chin Med J (Engl), 1992 Nov, 105(11), 934 - 9
Percutaneous debridement of complex pyogenic liver abscesses; Morettin LB et al.; The author's approach and technique in the treatment of complex liver abscesses that persisted or recurred following percutaneous drainage are described . Six patients were treated by percutaneous debridement using an instrument specially designed for that purpose . Four patients were chronically ill but stable, while the other two were septic, hypotensive and considered to be life threatened . All patients had primary pyogenic abscesses . Four had demonstrated mixed bacterial flora consisting of E . coli, Klebsiella, Proteus and gram-positive cocci and two were caused by E . coli only . Contrast enhanced CT of the abdomen in all cases revealed multiloculated or septated abscesses containing large central debris and peripheral shell or halo of compromised hepatic parenchyma . Debridement was successful in all cases, resulting in complete healing within 12 days . Follow-up for 1-4.5 years revealed no recurrences . Three cases of infected tumors of the liver were referred for treatment . CT findings in these cases demonstrated a well developed external capsule and internal septations, and the absence of a surrounding halo of compromised parenchyma distinguishes them from primary abscesses . This preliminary experience makes the authors to conclude that percutaneous debridement of pyogenic liver abscesses is a safe and curative procedure in selected cases of life-threatening chronic liver abscesses.

East Afr Med J, 1992 Nov, 69(11), 603 - 5
Bacteriuria in patients with glomerular diseases; McLigeyo SO et al.; In a comparative study of significant bacteriuria in an African population, 1.7% of 697 healthy subjects (10 females and 2 males) were found to have positive urine cultures . Of these, 5 subjects grew E . coli, 4 Klebsiella strains, 2 Staphylococcus aureus and 1 Serratia marcescens . Among 116 patients with glomerular disease, 15.5% (7 males and 11 females) yielded positive cultures . E . coli, Staph . aureus and Proteus species were commonly isolated organisms . There was a nine fold increase in prevalence of bacteriuria in patients with glomerular disease and in females, this correlated with the amount of protein lost per 24 hours . It is postulated that the presence of protein in urine per se favours bacterial growth and because of the high prevalence of bacteriuria in patients with glomerular disease, it is recommended that all such patients should be screened and treated appropriately.

Antonie Van Leeuwenhoek, 1992 Nov, 62(4), 319 - 20
Effects of some tricyclic psychopharmacons and structurally related compounds on motility of Proteus vulgaris; Molnar J et al.; A simple test for the evaluation of drugs interfering with bacterial motility was established with Proteus vulgaris . With this model, promethazine, 7-hydroxy-chlorpromazine, imipramine, 7,8-dioxochlorpromazine and acridine orange were shown to exert significant motility and swarming inhibitory action on Proteus vulgaris strains at subinhibitory concentrations . Quinidine enhanced the antimotility effect of promethazine . The antimotility effect of promethazine was synergized by proton pump inhibitors omeprazole and abscissic acid, but antagonized by extracellular potassium and sodium ions.

Rev Prat, 1992 Oct 15, 42(16), 2044 - 7
{Disseminated complex vascular malformations}; Enjolras O; Diffuse complex vascular malformations are sporadic or hereditary . They usually concern one type of vessel: capillary, venous or arterial (with AV fistula) . They involve skin, mucosal membranes and internal organs . They lead to a rich and heterogeneous symptomatology, depending on the lesional localizations . Five out of them are described: cutis marmorata, Rendu Osler disease, Bean syndrome, Maffucci syndrome, and Proteus syndrome.

J Biol Chem, 1992 Oct 5, 267(28), 19978 - 85
Characterization of the tryptophanase operon of Proteus vulgaris . Cloning, nucleotide sequence, amino acid homology, and in vitro synthesis of the leader peptide and regulatory analysis; Kamath AV et al.; The tryptophanase (tna) operon of Proteus vulgaris was cloned and characterized and found to be organized similarly to the tna operon of Escherichia coli . Both operons contain two major structural genes, tnaA and tnaB, that encode tryptophanase and a tryptophan permease, respectively . tnaA of P . vulgaris is preceded by a transcribed leader region, encoding a 34-residue leader peptide, TnaC, that contains a single tryptophan residue . The tnaC coding region also has a boxA-like sequence . Regulatory studies performed in P . vulgaris, and with a plasmid carrying the P . vulgaris tna operon in E . coli, established that expression of the Proteus operon was induced by tryptophan and was subject to catabolite repression . Site-directed mutagenesis studies established that translation of the tnaC coding region was essential for induction . Synthesis of the P . vulgaris leader peptide was demonstrated in an in vitro coupled transcription-translation system . Interestingly, the 5 amino acid residues of the TnaC peptide surrounding the sole tryptophan residue are identical in P . vulgaris and E . coli . We conclude that the tna operon of P . vulgaris is also regulated by tryptophan-induced transcription antitermination . Homology of tryptophanase and tryptophan permease of P . vulgaris to related proteins from other species is described.

East Afr Med J, 1992 Oct, 69(10), 587 - 90
Pathogens and antibiotic susceptibility profiles in the urinary tract; Onifade EO et al.; Of 2,780 specimens of midstream urine (MSU) collected from patients of Medical out-patient Unit of Lagos University Teaching Hospital (LUTH), and examined between March 1989 and February 1990, 780 (28.1%) had bacterial colony counts greater than 100,000 per ml . The commonest pathogens were E . coli, Klebsiella aerogenes, Proteus mirabilis, Pseudomonas aeruginosa . 9.8% of the infections were caused by Gram-positive bacteria while 6.0% were due to the fungus, Candida albicans and Candida species.

Chem Pharm Bull (Tokyo), 1992 Oct, 40(10), 2764 - 8
Inhibition of urease activity by dipeptidyl hydroxamic acids; Odake S et al.; A series of dipeptidyl hydroxamic acids (H-X-Gly-NHOH: X = amino acid residues) was synthesized, and the inhibitory activity against Jack bean and Proteus mirabilis ureases {EC 3.5.1.5} was examined . A number of H-X-Gly-NHOH inhibited Jack bean urease with an I50 of the order of 10(-6) M and inhibited Proteus mirabilis urease with an I50 of the order of 10(-5) M . The inhibition against Jack bean urease was more potent than that with the corresponding aminoacyl hydroxamic acids (H-X-NHOH).

Childs Nerv Syst, 1992 Oct, 8(7), 411 - 6
Management of brain abscess in children: review of 130 cases over a period of 21 years; Tekkok IH et al.; The data on 130 children with brain abscesses treated over 21 years (1970-1990) were analyzed retrospectively . The whole group included four infants . Chronic ear infection and cyanotic congenital heart disease were the most common predisposing factors . In infants, meningitis and/or ventriculitis were dominant in the etiopathogenesis . Cases were evaluated according to the treatment received and also according to time periods . More than half of the patients (n = 74) in this series were treated by primary or secondary excision . Computed tomography (CT) facilitated the diagnosis and helped the planning of treatment . Aspiration gained increasing credit after the advent of CT . Microorganisms could be identified in 54% of the cultured specimens . Staphylococci, streptococci and Proteus were the dominating microorganisms . Penicillin and chloramphenicol have long been the mainstay of antimicrobial therapy but have recently been replaced by third-generation cephalosporins and sulbactam-ampicillin combinations . Overall mortality was 15.5% but showed a decline from 30% in the pre-CT era to 6% in the last 5 years and to zero in the last three . Neither the location nor associated heart disease contributed to the mortality, but mortality among infants was as high as 50%.

Br J Urol, 1992 Oct, 70(4), 429 - 34
In vitro investigations into the formation and dissolution of infection-induced catheter encrustations; Hesse A et al.; Encrustations are the most frequent complications occurring with indwelling catheters and urine drainage systems . The conditions for bacterial infections, using synthetic urine and controlled contamination by Proteus vulgaris, were standardised by using an in vitro model . Crystal deposits on catheters were analysed by infra-red spectroscopy and scanning electron microscopy . The main components of deposits in all investigations were struvite (MgNH4PO4.6H2O) 60-70% and carbonate apatite (Ca10(PO4,CO3)6 (OH,CO3)2) 30-40% . Investigations as to the quality and quantity of encrustations confirmed the analysis . Irrigation treatment was carried out with physiological saline solution and citric acid solution (Suby G) to study and quantify the dissolution of crystal deposits . Regular irrigation with citric solution resulted in a 70% dissolution of encrustations and ensured free flow as ascertained by measuring flow rates.

Br J Urol, 1992 Oct, 70(4), 355 - 9
In vitro inhibition of struvite crystal growth by acetohydroxamic acid; Downey JA et al.; Struvite (MgNH4PO46H2O) crystals were produced by Proteus mirabilis growth in artificial urine, in the presence and absence of the urease inhibitor, acetohydroxamic acid (AHA) . In the absence of AHA, struvite crystals assumed an "X-shaped" or dendritic crystal habit due to rapid growth along their 100 axis . When AHA was present, crystal growth, as monitored by phase contrast light microscopy, was greatly slowed, and the crystals assumed an octahedral crystal habit . Scanning electron microscopy revealed that crystals grown in the presence of AHA were pitted on their surface . This pitting was absent in control samples . While most of this inhibition by AHA was due to lowered urease activity, some crystal growth inhibition occurred in struvite produced in the absence of urease activity through NH4OH titration of artificial urine . We conclude that while AHA is primarily a urease inhibitor, it may also disrupt struvite growth and formation directly through interference with the molecular growth processes on crystal surfaces.

Paraplegia, 1992 Oct, 30(10), 734 - 9
Postoperative wound infections following myocutaneous flap surgery in spinal injury patients; Garg M et al.; Severe pressure ulcers in patients with spinal cord injury are frequently treated by using musculocutaneous (m-c) flap surgery . There have been few studies of the use of perioperative antibiotics to prevent postoperative infection in this setting . We reviewed 74 m-c flap surgeries in 53 patients (41 male and 12 female) from October 1989 for one year . The sites involved were ischial (31), sacral (24), trochanteric (18), deltoid (2), olecranon (1) and posterior thigh (1) . An antibiotic was usually administered perioperatively for 5 days . Patients were followed for a median of 30 (8-96) weeks . Postoperative infections occurred at a median of 12 (4-25) days in 6 of 74 (8%) surgeries . The organisms cultured from the 6 infected wounds were: Bacteroides sp . (4), Proteus mirabilis (2), E . coli (2), MRSA (2), and others (6--each isolated once) . These results indicate that antibiotics did not prevent postoperative infection in approximately 8% of patients undergoing m-c surgery . The frequency of isolation of Bacteroides sp . from these infections suggests that anaerobic bacteria may persist in healing pressure ulcers and perioperative antibiotics might include coverage for anaerobic bacteria.

Appl Environ Microbiol, 1992 Oct, 58(10), 3437 - 40
Cloning of a creatinase gene from Pseudomonas putida in Escherichia coli by using an indicator plate; Chang MC et al.; A genomic library of Pseudomonas putida DNA was constructed by using plasmid pBR322 . Transformants of Escherichia coli in combination with Proteus mirabilis cells grown on creatinase test plates were screened for creatinase activity; transformants were considered positive for creatinase activity if a red-pink zone appeared around the colonies . One creatinase-positive clone was further analyzed, and the gene was reduced to a 2.7-kb DNA fragment . A unique protein band (with a molecular weight of approximately 50,000) was observed in recombinant E . coli by minicell analysis.

J Trop Med Hyg, 1992 Oct, 95(5), 327 - 30
The laboratory diagnosis of rickettsial diseases in Hong Kong; Bassett DC et al.; Indirect immunoperoxidase (IP) tests against antigens of Rickettsia typhi, R . sibirica and R . tsutsugamushi were carried out on serum samples from 10 patients known to have high titres against one or more Proteus OX antigens in the Weil-Felix (WF) test . The IP test confirmed rickettsial infection in nine of the 10 patients, giving unequivocal indications of the grouping of the infecting Rickettsia species and, in one instance, showing a diagnostic IgM titre in a specimen taken on day 3 of the patient's illness . IP tests confirmed four cases of spotted fever group rickettsial infection, three cases of urban or murine typhus and two of scrub typhus.

J Clin Microbiol, 1992 Oct, 30(10), 2632 - 7
Outer membrane protein profiles and multilocus enzyme electrophoresis analysis for differentiation of clinical isolates of Proteus mirabilis and Proteus vulgaris; Kappos T et al.; Outer membrane protein (MP) profiles and multilocus enzyme electrophoresis (MEE) analysis were used as tools for differentiating clinical isolates of Proteus spp . Fourteen distinct MP profiles were established by sodium dodecyl sulfate-urea polyacrylamide gel electrophoresis in 54 clinical isolates of Proteus spp . (44 strains identified as P . mirabilis and 10 strains identified as P . vulgaris) . Forty-one isolates of P . mirabilis and eight isolates of P . vulgaris were grouped within six and three MP profiles, respectively . The remaining P . mirabilis and P . vulgaris isolates had unique profiles . MEE analysis was used to further discriminate among the strains belonging to the same MP groups . Thirty-five distinct electrophoretic types (ETs) were identified among P . mirabilis isolates . The isolates of P . mirabilis from the four most common MP groups were subgrouped into 30 ETs . All of the P . vulgaris strains had unique ETs . The results suggest that upon biochemical classification of Proteus isolates as P . mirabilis or P . vulgaris, further differentiation among strains of the same species can be obtained by the initial determination of MP profiles followed by MEE analysis of strains with identical MPs.

J Pediatr Orthop, 1992 Sep-Oct, 12(5), 667 - 74
Musculoskeletal manifestations of Proteus syndrome: report of two cases with literature review; Stricker S; Proteus syndrome is a recently described hamartomatous condition characterized by macrodactyly, hemihypertrophy, subcutaneous (s.c.) tumors, epidermal nevi, and skull anomalies . Two new cases are described to illustrate the diagnostic features and the orthopedic problems associated with this rare syndrome . Review of available literature shows that 61 patients with proteus syndrome commonly develop macrodactyly, limb overgrowth, spinal deformity, hip dysplasia, genu valgum, exostoses, joint contractures, and hindfoot deformities.

J Urol, 1992 Sep, 148(3 Pt 2), 995 - 7
Composition of urinary calculi related to urinary tract infection; Ohkawa M et al.; The composition of 3,084 urinary calculi was determined using an infrared spectrophotometer . Mixed calcium oxalate-calcium phosphate stones were most frequently implicated . Of the urinary calculi analyzed 199 were associated with urinary tract infection . Escherichia coli was most frequently isolated (43 strains) and urease-producing organisms, such as Proteus mirabilis, were cultured from 40 patients . The core culture of 20 staghorn calculi yielded 15 isolates from 14 stones . There were 13 identical species isolated from the urine and stone specimens of 13 patients (65%), including 7 strains of P . mirabilis . These results suggest that cultures of urine specimens of urolithiasis patients, especially those with staghorn calculi, may help to elucidate the bacteriology of the stones.

Southeast Asian J Trop Med Public Health, 1992 Sep, 23(3), 510 - 3
Intracranial complications of chronic suppurative otitis media; Chotmongkol V et al.; Twenty-nine patients with chronic suppurative otitis media with intracranial complications are reviewed . The complications occurred predominantly in young patients with a mean age of 17 years . The most common complication was brain abscess (n = 20) . The others were meningitis (n = 3), subdural abscess (n = 3), perisinus abscess (n = 2) and otitic intracranial hypertension (n = 1) . The common pathogens were Gram-negative bacilli, especially Proteus and anaerobic organisms, respectively . The mortality rate was 7%.

J Clin Microbiol, 1992 Sep, 30(9), 2219 - 24
Polymerase chain reaction for detection of Leptospira spp . in clinical samples; Merien F et al.; A sensitive assay for Leptospira spp., the causative agent of leptospirosis, was developed on the basis of the polymerase chain reaction (PCR) . A 331-bp sequence from the Leptospira interrogans serovar canicola rrs (16S) gene was amplified, and the PCR products were analyzed by DNA-DNA hybridization by using a 289-bp fragment internal to the amplified DNA . Specific PCR products also were obtained with DNA from the closely related nonpathogenic Leptospira biflexa but not with DNA from other spirochetes, such as Borrelia burgdorferi, Borrelia hermsii, Treponema denticola, Treponema pallidum, Spirochaeta aurantia, or more distant organisms such as Escherichia coli, Staphylococcus aureus, Mycobacterium tuberculosis, and Proteus mirabilis . The assay was able to detect as few as 10 bacteria . Leptospira DNA was detected in urine from experimentally infected mice . In addition, the test was found to be suitable for diagnosing leptospirosis in humans . Cerebrospinal fluid and urine from patients with leptospirosis were positive, whereas samples from control uninfected patients were negative.

J Clin Microbiol, 1992 Sep, 30(9), 2441 - 6
Serological studies of antigenic similarity between Japanese spotted fever rickettsiae and Weil-Felix test antigens; Amano K et al.; Acute and convalescent-phase sera obtained from 10 patients infected with a Japanese strain of spotted fever group (SFG) rickettsia were tested by the indirect immunoperoxidase test, the Weil-Felix test, an enzyme-linked immunosorbent assay (ELISA), and immunoblotting . By the Weil-Felix test, the reactivity of these sera to the OX2 antigen was higher than those to the OX19 antigen, as is the case with sera from persons infected with other SFG rickettsiae . By ELISA, the titers of immunoglobulin M (IgM) antibodies against OX2 corresponded to the Weil-Felix test titers of these sera against OX2 but not to the titers obtained with IgG antibodies . The reactivity of the patient sera with the OX2 antigen in the Weil-Felix test was probably due to IgM antibodies against antigens which OX2 and SFG rickettsiae have in common . By immunoblotting tests, both IgG and IgM antibodies from the patient sera reacted with lipopolysaccharides from SFG rickettsiae and Proteus strain OX2 . These results may show that these lipopolysaccharides contain similar epitopes.

Circ Shock, 1992 Sep, 38(1), 63 - 73
Reactivity of monoclonal antibody E5 with endotoxin . II . Binding to short- and long-chain smooth lipopolysaccharides; Parent JB et al.; The murine monoclonal IgM antibody E5 has been shown to significantly reduce the mortality and morbidity of patients with Gram-negative sepsis in a multicenter randomized placebo-controlled clinical trial . The in vitro binding characteristics of monoclonal antibody (mAb) E5 were studied using highly purified smooth lipopolysaccharide (LPS) isolated from a variety of clinically relevant, wild-type Gram-negative bacteria . Using a sensitive antibody-capture assay which involves immobilized mAb E5 and a chromogenic Limulus amebocyte lysate (LAL) LPS-detection system, mAb E5 was shown to bind to all 15 smooth LPS preparations tested, including LPS isolated from Escherichia, Klebsiella, Proteus, Pseudomonas, Salmonella, Serratia and Yersinia species . When LPS was fractionated according to size by size-exclusion chromatography, mAb E5 was shown to bind to smooth LPS molecules that have long as well as short O-polysaccharide chains . These results confirm and extend those reported previously and demonstrate that the anti-lipid A mAb E5 binds specifically to a diverse spectrum of smooth LPS isolated from wild-type Gram-negative bacteria.

Antimicrob Agents Chemother, 1992 Sep, 36(9), 2030 - 6
In vitro antibacterial activities of tosufloxacin against and uptake of tosufloxacin by outer membrane mutants of Escherichia coli, Proteus mirabilis, and Salmonella typhimurium; Mitsuyama J et al.; The antibacterial activities of tosufloxacin and other quinolones against and apparent uptakes of tosufloxacin and other quinolones by outer membrane mutants of Escherichia coli, Proteus mirabilis, and Salmonella typhimurium were studied . The hydrophobicity of tosufloxacin was nearly equal to that of ofloxacin or lower than those of sparfloxacin and nalidixic acid . OmpF- and OmpC-deficient E . coli and 40-kDa porin-deficient P . mirabilis mutants were twofold more susceptible to tosufloxacin and sparfloxacin but two- to fourfold less susceptible to other quinolones than their parent strains . In S . typhimurium lipopolysaccharide-deficient (rough) mutants, the differences in susceptibility to tosufloxacin were similar to those to sparfloxacin and nalidixic acid . The apparent uptake of tosufloxacin by intact cells was increased in porin-deficient mutants compared with that by their parent strain . These results suggest that the permeation route of tosufloxacin across the outer membrane is different from that of other fluoroquinolones and that tosufloxacin may permeate mainly through the nonporin pathway, presumably phospholipid bilayers . However, this characteristic is independent of the hydrophobicity of the molecule.

J Bacteriol, 1992 Aug, 174(15), 5086 - 94
In vitro activation of the Serratia marcescens hemolysin through modification and complementation; Ondraczek R et al.; The hemolytic activity of Serratia marcescens is determined by two polypeptides, termed ShlA and ShlB . ShlA is synthesized as an inactive precursor (ShlA*) and secreted with the help of ShlB, which is located in the outer membrane . In this study, it is shown that a cell lysate containing ShlB as well as partially purified ShlB converted ShlA* to the active ShlA hemolysin . ShlA remained active after removal of ShlB by column chromatography . In contrast to the stable modification of ShlA* by ShlB, a reversible activation was achieved by adding to ShlA* an N-terminal fragment of ShlA (ShlA16), consisting of 269 amino acid residues of ShlA and 18 residues of the vector . The nonhemolytic ShlA16 complemented ShlA* only when it was synthesized in an ShlB-producing cell . A deletion derivative of ShlA*, lacking residues 4 to 117, was complemented by ShlA16 but not activated by ShlB . Activation of ShlA* by ShlB at 4 degrees C proceeded at a much slower rate than complementation by ShlA16 . It is concluded that ShlA* is modified by ShlB . ShlA16 modified by ShlB complements the missing modification of ShlA* in trans . Modification by ShlB occurs in the N-terminal part of ShlA*, which is also the reaction in vivo which results in active ShlA hemolysin in the culture supernatant . The HpmA hemolysin of Proteus mirabilis, which is very similar to ShlA, was also activated in vitro by ShlB and complemented by ShlA16.

J Bacteriol, 1992 Aug, 174(15), 5043 - 50
Production and characterization of a monoclonal antibody to the O-acetylated peptidoglycan of Proteus mirabilis; Gyorffy S et al.; A monoclonal antibody (PmPG5-3) specific for the O-acetylated peptidoglycan of Proteus mirabilis 19 was produced by an NS-1 myeloma cell line and purified from ascites fluid by a combination of ammonium sulfate precipitation and affinity chromatography . The monoclonal antibody (an immunoglobulin M) was characterized by a competition enzyme-linked immunosorbent assay to be equally specific for both insoluble and soluble O-acetylated peptidoglycan but weakly recognized chemically de-O-acetylated P . mirabilis peptidoglycan, the non-O-acetylated peptidoglycans from Escherichia coli and Bacillus subtilis, and the peptidoglycan monosaccharide precursors N-acetylglucosamine and N-acetylmuramic acid dipeptide . The monoclonal antibody did not react with D-alanine or lipopolysaccharide isolated from P . mirabilis . Based on this evidence, the binding epitope on the P . mirabilis peptidoglycan is predicted to be linear and to comprise the glycan backbone, including both the N- and O-acetyl moieties . Monoclonal antibody PmPG5-3 was used to localize the O acetylation of the P . mirabilis peptidoglycan by immunoelectron microscopy . Murein sacculi of P . mirabilis were heavily and randomly labelled with the immunogold, whereas very little labelling and no labelling were observed on the sacculi isolated from de-O-acetylated P . mirabilis and E . coli, respectively . Based on the apparent pattern of immunogold labelling, a physiological role for peptidoglycan O acetylation in P . mirabilis is proposed.

APMIS, 1992 Aug, 100(8), 734 - 6
Neonatal Proteus meningoencephalitis . Case report; Grahnquist L et al.; Proteus is an uncommon pathogen in neonatal meningitis and has, to our knowledge, not previously been described from Scandinavia . Our case illustrates the typical course of the disease when onset is within the first two weeks of life . The typical patient is a previously healthy, sometimes slightly preterm infant, who develops multiple brain abscesses and has a very poor prognosis . In cases with a later onset, factors predisposing for infection are common and the outcome is less severe . Our patient was a girl born at a gestational age of 36 full weeks, who was a little less alert than normal during the first three days and then became dramatically sick with convulsions and apnoeas . She died at the age of six days with severe brain damage.

Biochem Cell Biol, 1992 Aug, 70(8), 719 - 23
Virotoxins polymerize actin and induce membrane fragmentation in cytoplasmic preparations of Amoeba proteus; Gicquaud C et al.; Virotoxins and phalloidin are peptides that induce actin polymerization in vitro . We have compared the effect of five virotoxins and phalloidin on the ultrastructure of spread preparations of Amoeba proteus cytoplasm . Like phalloidin, the five virotoxins induce polymerization of cytoplasmic actin . Moreover, the virotoxins, but not phalloidin, induce membrane fragmentation in small spherical vesicles . We, therefore, conclude that these virotoxins may have another membrane-bound target besides actin.

Singapore Med J, 1992 Aug, 33(4), 359 - 61
Urinary tract infection in acute spinal cord injury; Menon EB et al.; Preservation of renal function and prevention of recurrent urinary tract infections is the ultimate goal of any method of neurogenic bladder management in spinal cord injury patients . METHOD--The hospital courses of fifty such patients admitted to our Rehabilitation Department from August 1989 to August 1990 were studied according to age, gender, spinal cord injury level, method of bladder drainage on admission and upon discharge, type of urinary tract infections and results of bladder management were documented . RESULTS--Forty-five men and ten women were studied . Mean age of males was forty and females, forty-two . The commonest cause of injury was road traffic accident followed by accidents at work place . Fifty-three percent had cervical cord injuries, thirteen percent thoracolumbar and sixteen percent lumbo sacral injuries . Seventy-eight percent had an indwelling foley catheter upon admission . Upon discharge eighty-two percent of spinal cord injury patients were able to void with/without tapping and compression . There were a total of one hundred and forty-three urinary tract infections in our study group . All positive urine cultures had greater than or equal to 100,000 CFU/ml . The commonest organisms causing urinary tract infection were Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Proteus mirabilis . CONCLUSION--For bacteria to produce disease in the urinary tract, they must gain access and colonise the uroepithelium, induce inflammation and tissue damage . The indwelling catheter provides a direct access to the uroepithelium, making bacteriuria and subsequent infection inevitable . Impaired voiding and sensation in spinal cord injury patients provides an excellent reservoir for the multiplication of bacteria, tissue invasion and recurrent urinary tract infection . Hence current methods of neurogenic bladder management have to focus on attaining a catheter-free status as soon as possible; relevant antibiotic therapy and careful attention to individual urinary tract problems to reduce morbidity and improve on spinal cord injury patient's future . Although spinal cord injury patients are described, the material covered is applicable to any type of neurogenic bladder dysfunction.

J Dermatol, 1992 Aug, 19(8), 477 - 80
Proteus syndrome: report of the first Japanese case with special reference to differentiation from Klippel-Trenaunay-Weber syndrome; Hagari Y et al.; This is the first report of a Japanese girl with Proteus syndrome . She presented with growth acceleration and precocious development of the left breast as well as macrodactyly, hemihypertrophy, a subcutaneous preaxillary mass, portwine stains, connective tissue nevi, and a depigmented macule . All these abnormalities were confined to the left side of her body . Although most of the manifestations fit those of Proteus syndrome, the presence of the portwine stains and hemihypertrophy also suggested Klippel-Trenaunay-Weber syndrome . The findings in our patient suggest that the most important characteristic distinguishing Proteus syndrome from Klippel-Trenaunay-Weber syndrome is the presence of functional abnormalities such as a growth spurt and precocious breast development . Proteus syndrome may be genetically different from the Klippel-Trenaunay-Weber syndrome.

Am J Ophthalmol, 1992 Jul 15, 114(1), 55 - 62
Six cases of scleritis associated with systemic infection; Hemady R et al.; Isolated scleritis (without keratitis) associated with infections is uncommon, and correct diagnosis and appropriate therapy for it are often delayed . Six patients with infection-associated scleritis were seen at our institution between May 1983 and May 1990 (these patients represented 4.6% of all patients with scleritis {six of 130 patients} in that period) . Three of these cases were associated with systemic infections . One was associated with syphilis, one was associated with tuberculosis, and one was associated with toxocariasis . Three cases resulted from local infections . One was associated with infection with Proteus mirabilis, one was associated with infection with herpes zoster virus, and one was associated with infection with Aspergillus . The Aspergillus infection developed after trauma and the P . mirabilis-induced infection developed after strabismus surgical procedures . Four of the six cases were initially misdiagnosed and inappropriately managed . Correct diagnosis was made seven days to four years after onset of symptoms . Review of systems, scleral biopsy, culture, and laboratory investigation were used to make the diagnosis . Differential diagnosis of scleritis must include infective agents.

Br J Ophthalmol, 1992 Jul, 76(7), 419 - 23
Endophthalmitis following extracapsular cataract surgery: a review of 32 cases; Heaven CJ et al.; Thirty two cases of endophthalmitis following extracapsular cataract surgery that had occurred within our department and had undergone intraocular diagnostic tap between May 1982 and May 1991 were reviewed . An infectious agent was identified in 20 cases (62.5%) . The commonest organism was Staphylococcus epidermidis (11 cases) (55%) . Proteus was the only gram negative organism identified (four cases) (20%) . Both of these organisms were associated with a favourable visual outcome . In the culture positive subgroup 15 eyes (75%) achieved a final acuity of 6/60 or better with 10 eyes (50%) gaining 6/12 or better . Thirteen (65%) of the culture positive cases were managed without vitreal intervention . Of these 11 (85%) achieved 6/60 or better with eight (62%) gaining 6/12 or better . It appears that when an endophthalmitis follows uncomplicated extracapsular cataract surgery delivery of antibiotic by the 'conventional' routes (topical, subconjunctival and systemic) is consistent with a favourable visual result in many cases . A modified anterior chamber diagnostic tap technique is described.

Am J Med Genet, 1992 Jul 1, 43(4), 662 - 8
Encephalocraniocutaneous lipomatosis and the Proteus syndrome: distinct entities with overlapping manifestations; McCall S et al.; We have studied three children with cutaneous (epidermal nevi), subcutaneous (lipomas, plantar skin thickening), vascular (hemangioma, lymphangioma), skeletal (osteoma, exostosis, localized hypertrophy), and neurological (hydrocephaly, lissencephaly, partial agenesis of the corpus callosum) developmental defects associated with the Proteus syndrome and related hamartoneoplastic conditions . We compared our findings in these three patients with those of 50 others with Proteus syndrome and nine with encephalocraniocutaneous lipomatosis (ECCL) reported in the literature . We found that Proteus syndrome and ECCL have distinct identities even though some clinical manifestations are shared by both and a few patients have manifestations of both conditions.

Nippon Saikingaku Zasshi, 1992 Jul, 47(4), 625 - 9
{Effect of pH on preferential antibacterial-activity of ethylenediaminetetraacetic acid (EDTA)}; Kida N et al.; Ethylenediaminetetraacetic acid (EDTA), a chelating agent, was examined for the antibacterial activity against 15 species of bacteria by treating with a 10mM solution at pH adjusted to 5.0, 7.0 or 9.0 . All bacterial species tested were classified into three groups; tentatively named the pH5 EDTA-sensitive group comprising Vibrio cholerae and Staphylococcus aureus, the pH9 EDTA-sensitive group comprising Escherichia coli and Pseudomonas aeruginosa and the EDTA-nonsensitive group comprising Proteus mirabilis . The EDTA-sensitivity grouping may be used as a tool for preferential decontamination of certain bacteria in live edible fishes, although further experiments are needed to characterize more strains and also species of bacteria.

J Antimicrob Chemother, 1992 Jul, 30(1), 57 - 66
Effects of cefaclor, cefetamet and Ro 40-6890 on inflammatory responses of human granulocytes; Scheffer J et al.; The effect of three cephalosporins (cefetamet, cefaclor and Ro 40-6890) upon human granulocytes and their ability to modulate the chemiluminescence response, phagocytose, kill bacteria and generate leukotrienes was studied . In the presence of the cephalosporins there was a significant increase in phagocytosis of Escherichia coli . The bactericidal activity of human granulocytes for several other bacteria was also enhanced . Cefetamet and cefaclor increased the chemiluminescence response of human neutrophils to Pseudomonas aeruginosa and Proteus mirabilis in contrast to Ro 40-68790, which decreased the chemiluminescence response . The cephalosporins decreased the synthesis of leukotrienes from human neutrophils after stimulation with Escherichia coli and Staphylococcus aureus . These data emphasize the immunomodulatory functions of various cephalosporins on cells involved in host defence.

East Afr Med J, 1992 Jul, 69(7), 366 - 9
Sickle cell leg ulcers in Ghana; Ankra-Badu GA; Twenty five (17 male, 8 Female) sickle cell disease patients with 30 leg ulcers were studied over a 3 year period (January 1985 to December 1987) to provide information on the pathogenesis, course and management . There were 23 patients with homozygous sickle cell and 2 patients with sickle cell haemoglobin C disease . The mean age was 28 years (range 15-44 years) . An antecedent history of trauma was obtained in 40% of the patients and 96% had a previous history of leg ulcer . The major site affected (93%) was the skin around the malleoli . In 68% of the patients a single organism was isolated and the commonest bacteria were Pseudomonas species, Staphylococcus aureus, Proteus species and B haemolytic streptococci . The major complications encountered were equinovarus deformity (36%) and chronic periosteitis (32%) . The main topical antimicrobial used was Eusol either alone (52%) or in combination with Metronidazole (32%) or honey (12%) . Complete healing occurred in 40% of patients, partial healing with deterioration in 16% and no significant change in 44% . Admission and bed rest were the best determinants of complete healing of the chronic ulcers.

Carcinogenesis, 1992 Jul, 13(7), 1075 - 81
Myeloperoxidase-enhanced formation of (+-)-trans-7,8-dihydroxy-7,8-dihydrobenzo{a}pyrene-DNA adducts in lung tissue in vitro: a role of pulmonary inflammation in the bioactivation of a procarcinogen; Petruska JM et al.; Several studies have indicated a correlation between the presence of inflammation and the development of cancer . The aim of our study was to determine if pulmonary neutrophils could transform the proximate respiratory carcinogen (+-)-trans-7,8-dihydroxy-7,8-dihydrobenzo{a}pyrene (B{a}P-7,8-diol), to an ultimate carcinogenic metabolite via myeloperoxidase (MPO) . To test this hypothesis, virus-free male DBA/2 mice were exposed by inhalation to the Gram-negative bacteria Proteus mirabilis for 1 h . For various time points post-exposure, bronchoalveolar lavage (BAL) was performed to determine total and differential cell counts, cellular MPO activity and production of superoxide . Twelve hours after the exposure, cellular activity of MPO as well as percentage and total number of polymorphonuclear leukocytes peaked and declined thereafter . At this same time point, cells from BAL exhibited increased release of superoxide, as measured by reduction of cytochrome c, after addition of soluble or particulate stimuli, 12-O-tetradecanoylphorbol-13-acetate (TPA) or opsonized zymosan respectively . These cells also elicited biotransformation of B{a}P-7,8-diol as evidenced by enhanced B{a}P-7,8-diol-derived chemiluminescence, tetraol formation and covalently bound adduct formation to exogenous DNA upon addition of TPA or opsonized zymosan . Moreover, the cell-free BAL fluid of infected mice contained substantial MPO activity in comparison to that of uninfected animals . Also, MPO enhanced the binding of B{a}P-7,8-diol to lung DNA in vitro . Unlike previous work emphasizing the potential roles of oxygen free radicals in tumor promotion, our results indicate a role of neutrophilic MPO in the initiation of carcinogenesis.

Aten Primaria . 1992 Jun 15;10(1):534, 536, 538.
{Urinary infections . Outpatient antibiotic sensitivity in the province of Girona}; Vinyes-Miralpeix i Gasso A et al.; OBJECTIVE . To discover the level of autochthonous urinary microflora and their sensitivity to antimicrobials, at the primary care level . DESIGN . A descriptive and retrospective study of a sequential sampling of urine cultures in primary care (during July, August and September, 1991) . SITE . Primary care in the Province of Girona . PATIENTS AND OTHER PARTICIPANTS . 700 individuals between one month and 91 years, with positive urine cultures . 19% men, 68% women, 13% not specified . MAIN MEASUREMENTS AND RESULTS . 76% of the urine cultures studied contained E . coli . The proportion of Proteus and Pseudomonas is higher in the pediatric group . We detected a low sensitivity in those with urinary pathologies to ampicillin and cotrimoxazole; lower sensitivity to pipemidic acid with regards to norfloxacin; and high sensitivity to first--and second-generation cephalosporins . CONCLUSIONS . Only the knowledge of the sensitivity of pathogenic germs to antimicrobials in a specific medium can allow us to use antibiotics rationally . Knowledge can be increased by working out prospective diagnostic and treatment procedures, which could substantially improve the delivery of primary care medicines.

Am J Infect Control, 1992 Jun, 20(3), 126 - 30
Potential for local and systemic bacterial infection in some occupational groups in Benin City, Nigeria; Hugbo PG et al.; BACKGROUND: Many Third World countries may not have adequate facilities for rapid sensitivity testing of antibiotics as an aid to diagnosis and chemotherapy . It may therefore be valuable to relate bacterial carriage on the skin to type of work a person does . METHODS: Given areas of skin in workers from 10 occupational groups were sampled . The bacteria obtained were analyzed after growth on appropriate media . The sensitivity profiles of potential pathogens isolated from these groups, as well as of those (Staphylococcus aureus only) isolated from patients with certified infections, were carried out and the results were analyzed . RESULTS: Staphylococcus aureus constituted the most widely and frequently isolated potential pathogen . Proteus mirabilis, Escherichia coli, and Klebsiella species were also frequent colonizers of skin . There was a statistical relationship between work type and overall prevalence of bacteria on skin (p less than 0.01) . Most isolates of the work groups were highly sensitive to gentamicin and cefuroxine but not to penicillin G, ampicillin, and trimethoprim plus sulfamethoxazole; isolates from infected persons were generally more resistant than were the community-acquired ones . CONCLUSIONS: A relationship may exist between the types of bacteria carried on the skin and the type of work in which a person is engaged.

J Urol, 1992 Jun, 147(6), 1624 - 6
Psoas abscess: case report and review of the literature; Gruenwald I et al.; Psoas muscle abscess is rare and presents a diagnostic challenge requiring a high index of suspicion . We report an unusual case of primary psoas abscess caused by Proteus mirabilis . Primary psoas abscess is most commonly present in children and is usually caused by Staphylococcus aureus . A total of 434 cases of psoas abscess has been reported . The subject is discussed noting the differences between primary and secondary cases, and emphasizing the importance of ultrasound and computerized tomography guided drainage of psoas abscess . A flow chart for the evaluation and management of primary and secondary abscess is presented, taking into consideration the success rate of the various methods of treatment described in the literature.

Infect Immun, 1992 Jun, 60(6), 2267 - 73
Proteinases of Proteus spp.: purification, properties, and detection in urine of infected patients; Loomes LM et al.; The proteinases secreted by pathogenic strains of Proteus mirabilis, P . vulgaris biotype 2, P . vulgaris biotype 3, and P . penneri were purified with almost 100% recovery by affinity chromatography on phenyl-Sepharose followed by anion-exchange chromatography . The proteinase purified from the urinary tract pathogen P . mirabilis, which we had previously shown to degrade immunoglobulins A and G, appeared as a composite of a single band and a double band (53 and 50 kDa, respectively) on sodium dodecyl sulfate-polyacrylamide gel electrophoresis . The other Proteus proteinases had similar patterns but slightly different mobilities . In each case all proteinase activity in culture supernatants was demonstrated by gelatin-sodium dodecyl sulfate-polyacrylamide gel electrophoresis to be associated with only the triple-band complex; all three bands were proteolytically active . The P . mirabilis proteinase was resistant to inhibitors of both serine and thiol proteinases but strongly inhibited by metal chelators, although it was not affected by phosphoramidon, an inhibitor of the thermolysin group of bacterial metalloproteinases . Active proteinase was detected in urine samples from P . mirabilis-infected patients; this is consistent with our detection of immunoglobulin A fragments of a size suggestive of P . mirabilis proteinase activity.

Ann Pediatr (Paris), 1992 Jun, 39(6), 375 - 80
{Posterior urethral valves in Senegalese children . Fourteen cases}; Fall I et al.; Fourteen pediatric cases of posterior urethral valves in patients aged 6 months to 14 years (with four infants and ten older children) are reported . The main symptoms were vesical, including dysuria, acute urinary retention and dribbling . One patient presented with diarrhea, vomiting and dribbling . Urethral valves were looked for as part of the evaluation for urinary lithiasis in one patient, and in another urinary lithiasis developed following the diagnosis of urethral valves . In half the cases, onset of symptoms occurred within one year of birth . Urethrocystography allowed to evidence the valves and to evaluate repercussions on the bladder including hyperplasia (7 cases) and diverticula (2 cases) . The intravenous urogram disclosed bilateral ureterohydronephrosis in eight cases . Pathogens recovered from the urine included Klebsiella (3 patients), Pseudomonas (4 patients), Proteus (one patient), and E . coli (one patient) . Most patients were treated by catheter lamination under antimicrobial therapy . Two patients died from renal failure . Results were considered satisfactory in nine cases with follow-ups ranging from 1 month to 4 years . Three patients were lost to follow-up . Early diagnosis is essential and management should rely mainly on endoscopic resection which reduces the length of the hospital stay and the risk of infection.

Mol Microbiol, 1992 Jun, 6(12), 1583 - 91
Co-ordinate expression of virulence genes during swarm-cell differentiation and population migration of Proteus mirabilis; Allison C et al.; The uropathogenic Gram-negative bacterium Proteus mirabilis exhibits a form of multicellular behaviour termed swarming, which involves cyclical differentiation of typical vegetative cells into filamentous, multinucleate, hyperflagellate swarm cells capable of rapid and co-ordinated population migration across surfaces . We observed that differentiation into swarm cells was accompanied by substantial increases in the activities of intracellular urease and extracellular haemolysin and metalloprotease, which are believed to be central to the pathogenicity of P . mirabilis . In addition, the ability of P . mirabilis to invade human urothelial cells in vitro was primarily a characteristic of differentiated swarm cells, not vegetative cells . These virulence factor activities fell back as the cells underwent cyclical reversion to the vegetative form (consolidation), in parallel with the diagnostic modulation of flagellin levels on the cell surface . Control cellular alkaline phosphatase activities did not increase during differentiation or consolidation . Non-flagellated, nonmotile transposon insertion mutants were unable to invade urothelial cells and they generated only low-level activities of haemolysin, urease and protease (0-10% of wild type) . Motile mutants unable to differentiate into swarm cells were comparably reduced in their haemolytic, ureolytic and invasive phenotypes and generated threefold less protease activity . Mutants that were able to form swarm cells but exhibited various aberrant patterns of swarming migration produced wild-type activities of haemolysin, urease and protease, but their ability to enter urothelial cells was three- to 10-fold lower.(ABSTRACT TRUNCATED AT 250 WORDS)

Lik Sprava, 1992 Jun, (6), 122 - 4
{The antioxidant treatment of patients with acute intestinal infections due to gram-negative microorganisms}; Grutman MI et al.; It was established that administration of S . typhimurium lysate causes activation of the processes of free-radical oxidation . Introduction of unithiol in combination with magnesium sulfate returns the intensity of these processes to the initial level . Unithiol and alpha-tocopherol acetate protect the animals form lethal effects of S . sonnei lysate . Use of a combination of pharmacological agents consisting of unithiol, magnesium sulfate and alpha-tocopherol acetate in the treatment of patients with acute intestinal infections due to gram-negative pathogens (shigellae, salmonellae, proteus, klebsiellae, pseudomonas) resulted in decrease of the length of the intoxication and diarrhea syndrome, decrease of the frequency of repeat bacteria elimination and protracted forms of these infections, more rapid normalization of immune system functions.

Southeast Asian J Trop Med Public Health, 1992 Jun, 23(2), 312 - 7
Microbial flora in gut of Culex quinquefasciatus breeding in cess pits; Vasanthi V et al.; The number and types of microorganisms in the gut of Culex quinquefasciatus larvae varied considerably from one site of collection to another . Larval gut, in general, contained enormous number of bacteria, a few fungi and negligible number of actinomycetes which belonged to 15 bacterial, 6 fungal and 4 actinomycete genera, respectively . Bacillus sp., Staphylococcus sp . and Pseudomonas sp . among bacteria, Aspergillus among fungi and Streptomyces sp . among actinomycetes were frequently encountered . Escherichia, Proteus, Aspergillus and Streptomyces were the most abundant genera . Isolates of Bacillus, Pseudomonas, Shigella and Staphylococcus caused 100% mortality during the early instar of larval development . None of the fungal isolates effected 100% mortality while Nocardiopsis sp . among actinomycetes gave 100% mortality . One of the Escherichia isolate suppressed the adult emergence completely while 27 others, belonging to most of the genera found, suppressed significantly . Isolates of Aspergillus, Alternaria and Streptomyces inhibited the emergence of adults completely.

Lik Sprava, 1992 Jun, (6), 28 - 34
{Specific immune preparations for the prevention and treatment of suppurative-inflammatory diseases of Proteus etiology (a review of the literature)}; Nazarchuk LV; Literature data are analyzed on the possibility of designing vaccines Proteus agents for obtaining specific blood agents . Perspective are designs directed to investigation of the raw material base for obtaining allogenous anti-Proteus blood agents.

Med J Aust, 1992 May 4, 156(9), 650 - 1
A case of murine typhus in Queensland; Graves SR et al.; OBJECTIVE: To present a case of murine (endemic) typhus, the first to be reported within the last 30 years in Australia . CLINICAL FEATURES: A 17-year-old pregnant woman presented with a viral-like illness and later developed a spotted rash, fever and headache . INVESTIGATION AND OUTCOME: Sera taken on Day 7 and Day 30 of the illness showed seroconversion to Proteus OX19 (Weil-Felix) and to Rickettsia typhi (by immunofluorescence), indicating recent infection with Rickettsia of the typhus group . Her illness was clinically compatible with murine typhus . She responded well to erythromycin and delivered a normal infant at term . CONCLUSION: Infection with Rickettsia typhi (murine typhus) still occurs in Australia . It can be diagnosed by means of specific serological tests for rickettsial disease, which are superior to the non-specific Weil-Felix test.

Clin Ther, 1992 May-Jun, 14(3), 446 - 57
Ofloxacin versus trimethoprim/sulfamethoxazole in the treatment of uncomplicated urinary tract infection; Cox CE et al.; A multicenter randomized study was conducted to compare the efficacy and safety of ofloxacin with that of trimethoprim/sulfamethoxazole (TMP/SMX) in the treatment of uncomplicated urinary tract infection in adults . Patients were randomized to receive either oral ofloxacin 200 mg daily for three days (102 patients), or oral TMP/SMX 160 mg/800 mg twice daily for seven days (100 patients) . The pathogen was eradicated in 73 (97.3%) of the 75 evaluable patients receiving ofloxacin and in 66 (97.1%) of the 68 evaluable patients receiving TMP/SMX . The most frequently isolated pathogens were Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis . More urinary pathogens were susceptible to ofloxacin than to TMP/SMX, although this difference was not statistically significant . The clinical cure rate for patients receiving ofloxacin was 93.3%, with 4% improved and 2.7% failed . For patients receiving TMP/SMX, the clinical cure rate was 86.4%, with 12.1% improved and 1.5% failed . Side effects were reported by 29.7% of the patients receiving ofloxacin and by 40.4% of the patients receiving TMP/SMX . Drug-related adverse experiences, as determined by the investigators, occurred in 5% of the ofloxacin patients and in 15.2% of the TMP/SMX patients, a statistically significant difference . No patients receiving ofloxacin, compared with three patients receiving TMP/SMX, discontinued therapy because of an adverse reaction . These results indicate that short-course ofloxacin is as effective as TMP/SMX in the treatment of uncomplicated urinary tract infection . Ofloxacin therapy is also better tolerated than TMP/SMX.

Fiziol Zh, 1992 May-Jun, 38(3), 40 - 3
{Experimental substantiation of the possibility to obtain anti-Proteus plasma}; Nazarchuk LV et al.; The possibility to produce the anti-Proteus plasma is experimentally substantiated . It is determined that polyvalent Proteus antigen immunization permits producing blood immune preparation, that is the high-active anti-Proteus plasma . its antibodies belonging to the class of immunoglobulin G . The anti-Proteus plasma in liquid (at t = 6 degrees divided by 2 degrees C) and in frozen (at t = 20 degrees-5 degrees C) forms retains the specific activity for 3 days and 6 months, respectively.

Indian J Exp Biol, 1992 May, 30(5), 380 - 3
Lytic effect of Bacillus subtilis elastase on gram-positive and negative bacteria; Gupta M et al.; Elastase of B . subtilis 6a caused lysis of freshly grown cells of Gram-negative (Proteus vulgaris, Klebsiella pneumoniae, Salmonella typhi and Pseudomonas aeruginosa and Gram-positive (B . subtilis) bacteria . Heat killed and lyophilised Gram-positive and negative bacteria showed higher sensitivity to elastase . Both Gram-negative and Gram-positive bacteria were lysed maximally by elastase at pH 8.0 . At this pH, activity of elastase was maximum in Tris-HCl and glycine-NaOH buffers followed by Tris-maleate and cacodylate buffers.

Lik Sprava, 1992 May, (5), 53 - 7
{The diagnosis of acute pneumonia in respiratory viral infections}; Trinus EK et al.; Data are reported of 582 case records of patients with acute pneumonia of different influenza epidemic periods, results of a study of 175 lethal cases due to acute pneumonia, that complicated influenza in adults as well as experimental studies on reproduction of para-influenzal-staphylococcal, influenzal-Klebsiella and Proteus-influenzal infections . The study allowed to find out the causes of diagnostic difficulties, to establish the features of the course of acute pneumonia in patients with respiratory viral diseases to disclose the mechanisms of development of lung changes and make propositions facilitating early clinical diagnosis on the prehospital period.

Ann Acad Med Singapore, 1992 May, 21(3), 361 - 3
Community acquired urinary tract infections in Singapore: a microbiological study; Chan RK et al.; We studied 214 patients with culture proven community acquired infections . A total of 219 organisms were isolated, of which 68.2% were Escherichia coli, 10.1% Klebsiella sp and 5.5% Proteus mirabilis . Gram positive cocci accounted for 10.5% of organisms isolated . The majority of organisms isolated were sensitive to nalidixic acid (81.1%), nitrofurantoin (80.7%), cephalexin (74.7%) and trimethoprim-sulphamethoxazole (65.0%) . Resistance to ampicillin was common (49.8%), as such the use of ampicillin in community acquired urinary tract infections will result in a high failure rate.

Eur J Clin Microbiol Infect Dis, 1992 May, 11(5), 469 - 71
Inhibition of motility of Pseudomonas aeruginosa and Proteus mirabilis by subinhibitory concentrations of azithromycin; Molinari G et al.; Exposure to subinhibitory concentrations (4-8 micrograms/ml) of azithromycin resulted in loss of motility in Proteus mirabilis strains and a significant reduction of motility in Pseudomonas aeruginosa strains . Examination revealed that the loss of motility was due to a total absence of flagella in Proteus mirabilis while the poor motility observed in Pseudomonas aeruginosa was due to absence of flagella in the majority of the population . Since motility may be considered a pathogenicity trait in the two species, these results confirm the unusual ability of azithromycin to reduce the expression of virulence factors in gram-negative pathogens.

Am J Med, 1992 Apr 6, 92(4A), 71S - 74S
Comparison of the safety and efficacy of lomefloxacin and trimethoprim/sulfamethoxazole in the treatment of uncomplicated urinary tract infections: results from a multicenter study; Andrade-Villanueva J et al.; Lomefloxacin, a new difluorinated quinolone, and trimethoprim/sulfamethoxazole (TMP/SMX) were compared in the treatment of adults with uncomplicated urinary tract infections . The study was conducted as a multicenter, controlled, prospectively randomized, single-blind study in five countries (Argentina, Belgium, Brazil, Mexico, and Venezuela) . A total of 254 patients were enrolled: 129 in the lomefloxacin group and 125 in the TMP/SMX group . Patients received either 400 mg lomefloxacin orally once daily or 160 mg/800 mg TMP/SMX orally twice daily for 7-10 days . Escherichia coli and Proteus mirabilis were the pathogens most frequently isolated . At 5-9 days post-therapy, satisfactory bacteriologic results were noted in 98.4% of patients treated with lomefloxacin and in 95.8% of patients in the TMP/SMX group (p = 0.2153) . Clinical success 5-9 days post-therapy was noted in 99.2% of patients in the lomefloxacin group and in 98.3% of patients in the TMP/SMX group (p = 0.5138) . Adverse events probably related to treatment occurred in 6% of those treated with lomefloxacin and in 7% of patients treated with TMP/SMX . Once-daily oral lomefloxacin is a well-tolerated and effective treatment of uncomplicated urinary tract infections caused by susceptible pathogens.

Mikrobiyol Bul, 1992 Apr, 26(2), 131 - 8
{Microorganisms isolated from chronic suppurative otitis media and their antimicrobial sensitivities}; Dincer AD et al.; In this study mycologic and bacteriologic cultures were made in 100 patients who had chronic suppurative otitis media . We observed 58.8% pure, 35.3% mixed growth (more than one bacteria or bacteria and fungus) in the cultures . In pure cultures, we found mostly Proteus sp., S . aureus and Pseudomonas sp . respectively . In 134 bacteriologic cultures most frequently isolated bacteria was S . aureus (36.6%) . In Sabouraud agar, we found mostly Aspergillus sp . and Candida sp . (28.6%) . In antimicrobial sensitivity test, gram negatives were found to be sensitive mostly to ofloxacin (73.5%), pseudomonas was found to be sensitive mostly to tobramycin (70%) . In the staphylococci the antimicrobic which had the highest sensitivity rate was gentamicin (75.5%), but at the same time we observed 24.5% resistance to this antimicrobic agent . Following this respectively, ofloxacin 71.4% sensitivity 4.1% resistance, cefuroxime 69.4% sensitivity 10.2% resistance rate were detected.

Br J Rheumatol, 1992 Apr, 31(4), 241 - 5
Anti-Proteus antibodies in rheumatoid arthritis same-sexed sibships; Deighton CM et al.; One hundred and forty-two RA patients and 121 of their healthy same-sexed siblings were tested for antibodies (Abs) to Proteus mirabilis and Escherichia coli by indirect immunofluorescence . Eighty-five individuals had active RA (CRP greater than 10 mg/l) and 57 inactive RA . The anti-Proteus Ab titre in the active RA group was significantly higher than in the inactive RA and non-RA group (P less than 0.0001 in both cases) . Anti-Proteus Abs were significantly elevated in 30 individuals with active RA compared with their healthy HLA-identical same-sexed siblings (P less than 0.001) . In 42 HLA-DR4 positive and 15 HLA-DR4 negative active RA patients, the Ab titre was non-significantly higher in the former group . Anti-E . coli Abs were not significantly elevated in any of the groups . Longitudinal data on 36 RA patients demonstrated a significant positive correlation between changes in CRP and changes in anti-Proteus antibody titres (r = 0.52, P less than 0.001) . These observations require an explanation.

J Bacteriol, 1992 Apr, 174(7), 2172 - 7
Capsule structure of Proteus mirabilis (ATCC 49565); Beynon LM et al.; Proteus mirabilis 2573 (ATCC 49565) produces an acidic capsular polysaccharide which was shown from glycose analysis, carboxyl reduction, methylation, periodate oxidation, and the application of one dimensional and two-dimensional high-resolution nuclear magnetic resonance techniques to be a high-molecular-weight polymer of branched trisaccharide units composed of 2-acetamido-2-deoxy-D-glucose (N-acetyl-D-glucosamine), 2-acetamido-2,6-dideoxy-L-galactose (N-acetyl-L-fucosamine), and D-glucuronic acid, having the structure: {formula: see text} P . mirabilis 2573 also produces an O:6 serotype lipopolysaccharide in which the O-chain component has the same structure as the homologous capsular polysaccharide . This is the first report of a defined capsular polysaccharide in this bacterial genus.

Carbohydr Res, 1992 Mar 2, 225(2), 279 - 89
Synthesis of lysine-containing fragments of the Proteus mirabilis O27 O-specific polysaccharide and neoglycoconjugates therefrom; Chernyak AYa et al.; Amide-linked lysine mono- and di-uronic acid fragments of the O-specific polysaccharide from P . mirabilis O27 have been synthesised . N epsilon-Boc-L-lysine tert-butyl ester was condensed with 2-azidoethyl glycosides of glucuronic acid and beta-D-GlcpNAc-(1----3)-beta-D-GlcpA . Transformation of the products into 2-acrylamidoethyl glycosides, followed by deprotection using trifluoroacetic acid, gave the target monomers that were converted into high-molecular-weight copolymer-type neoglycoconjugates.

Exp Cell Res, 1992 Mar, 199(1), 174 - 8
Role of spectrin in Amoeba proteus, as studied by microinjection of anti-spectrin monoclonal antibodies; Choi EY et al.; Spectrin is a major protein accounting for about 5% of whole-cell proteins in Amoeba proteus, and the precipitation of spectrin by intracellular injection of purified anti-spectrin monoclonal antibodies has a profound effect on cell morphology, motility, and movement-related cell activities in amoebae . Thus, amoebae injected with anti-spectrin antibodies show drastic changes in their shape and movement, suggesting that amoeba spectrin plays an important structural role, unlike nonerythroid spectrins in other cells . However, precipitation of spectrin does not affect the distribution of F-actin in amoebae.

Mikrobiol Zh, 1992 Mar-Apr, 54(2), 81 - 7
{The mechanisms of Proteus mirabilis resistance to the bactericidal action of blood serum}; Parkhomenko LV et al.; When studying sensitivity of Proteus mirabilis to bactericide effect of blood serum the resistance to alternative way of the complement activation was found in a number of strains . The population of cells with morphologically determinable changes of the surface structures resistant to bactericide effect of the serum is formed as affected by the blood serum of the culture P . mirabilis . Proteus proteases capable to inactivate the complement components are one of the factors of P . mirabilis resistance to bactericide effect of the complement.

Infect Immun, 1992 Mar, 60(3), 1069 - 75
Modulation of effects of lipopolysaccharide on macrophages by a major outer membrane protein of Proteus mirabilis as measured in a chemiluminescence assay; Weber G et al.; Our previous studies have shown that a major protein isolated from purified cell walls of Proteus mirabilis (39-kDa protein) is a strong modulator of the specific immune responses to lipopolysaccharide (LPS) from this bacterium . When the protein is mixed with LPS before immunization of mice, the responses of antibody-producing cells specific for LPS are greatly enhanced and converted predominantly to the immunoglobulin G isotype . In the present study, the immunomodulating effects of the 39-kDa protein were tested at the level of interaction of LPS with macrophages . Activation of macrophages was determined by measuring the production of oxygen radicals in a chemiluminescence assay with lucigenin as the amplifier . LPS from P . mirabilis induced strong oxidative metabolism in both peritoneal and bone marrow-derived murine macrophages . These responses were inhibited in a dose-dependent manner by mixing LPS with increasing amounts of the protein . In contrast, bovine serum albumin and methylated bovine serum albumin enhanced the response of macrophages dramatically when complexed with LPS . The inhibiting activity of the 39-kDa protein was also observed with LPS from Escherichia coli K-12.

Zh Mikrobiol Epidemiol Immunobiol, 1992 Mar, (3), 36 - 9
{Epidemiological features of hospital purulent-septic infections in otolaryngological wards}; Eremin SR et al.; Prospective epidemiological observation in an otorhinolaryngological hospital has made it possible to distinguish the specific features of pyoseptic nosocomial infections . Such infections, appearing as cross re- and superinfections, are most frequently induced by staphylococci, as well as by Proteus and Pseudomonas aeruginosa . High risk groups include patients with purulent otitis and sinusitis, who have contacted infection through instruments in examination and dressing rooms . The main sources of infection are patients with pyoseptic infections of the ear and sinuses.

J Urol, 1992 Feb, 147(2), 333 - 6
Xanthogranulomatous pyelonephritis: experience in 36 cases; Chuang CK et al.; A retrospective study of 36 patients with xanthogranulomatous pyelonephritis who underwent nephrectomy at our hospital was performed . The disease occurred most frequently in middle-aged women with a history of recurrent urinary tract disorder . There were 2 cases of focal xanthogranulomatous pyelonephritis, 2 associated with emphysematous pyelonephritis, 2 that manifested as fistula formation between the colon or skin, and 1 with deep sinus formation into the hip joint that presented as septic arthritis . Flank pain and fever were the most frequent complaints . Escherichia coli (67%) and Proteus mirabilis (26%) were the most common organisms isolated from the voided urine, kidney and blood stream . Cephalothin plus gentamicin or tobramycin were the drugs of choice before surgical intervention.

J Indian Med Assoc, 1992 Feb, 90(2), 33 - 4
Bacteriology of wound infection: evaluation by surface swab and quantitative full thickness wound biopsy culture; Basak S et al.; A total of 171 cases of wounds of various aetiology were examined and screened bacteriologically for evidence of infection by surface swab culture and quantitative full thickness wound biopsy culture techniques . Staphylococcus pyogenes was the most frequently isolated (39.9%) single organism . Other organisms being Escherichia coli (26.1%), Pseudomonas aeruginosa (15.4%), klebsiella species (5.8%), Streptococcus pyogenes (4.9%), proteus species (4.8%) and coliform organism (3.1%) . Collectively the Gram-negative organisms were the majority among the isolated organisms . As indicator of wound infection, surface swab culture was found to be reliable in 72% cases when correlated with wound biopsy culture . The latter technique was found to be more consistently valuable (in 95% cases) both for regular assessment of the wounds as well as to judge the response to treatment.

J Int Med Res, 1992 Feb, 20(1), 87 - 93
Effectiveness of cefetamet pivoxil in the treatment of pyelonephritis in children; Toporovski J et al.; Cefetamet pivoxil was investigated in an open, randomized comparative study involving a total of 37 children with acute pyelonephritis, whose ages ranged from 2 to 14 years . The patients received either 10 mg/kg (n = 18) or 20 mg/kg (n = 8) cefetamet pivoxil twice daily, or 30-50 mg/kg amoxycillin/clavulanic acid three times daily (n = 11) for a period of 7-10 days . Escherichia coli was the main causative agent isolated in 28 (75.7%) of the patients; other pathogens included Proteus mirabilis (three patients) . Proteus species (one patient), Klebsiella pneumoniae (two patients), Pseudomonas diminuta (one patient) and mixed infections (three patients) . No differences in the overall treatment outcome could be observed between the treatment regimens used and, at the end of treatment, all pathogens were eradicated with neither relapse, nor persistence of the isolated pathogen, nor reinfection occurring . The clinical signs and symptoms had subsided in all patients at treatment end and the tolerability of the trial drugs was found to be satisfactory with no premature treatment withdrawal required . It is concluded that cefetamet pivoxil in the standard twice-daily dose of 10 mg/kg was equally effective and as well tolerated as 20 mg/kg cefetamet pivoxil given twice daily or 30-50 mg/kg amoxycillin/clavulanic acid given three times daily.

Ann Rheum Dis, 1992 Feb, 51(2), 233 - 7
IgA antibody response to klebsiella in ankylosing spondylitis measured by immunoblotting; Shodjai-Moradi F et al.; IgA antibodies to Klebsiella pneumoniae var oxytoca and Proteus mirabilis were measured in 66 patients with ankylosing spondylitis (AS) and 31 with rheumatoid arthritis (RA) and in 51 healthy control subjects, using an immunoblotting technique . The number of antigenic bands to klebsiella on nitrocellulose membrane was higher in 28 patients with active AS than in 38 patients with inactive AS, 31 patients with RA, and 51 healthy control subjects; comparatively smaller increases were found against proteus . In two patients with AS the synovial fluid and the corresponding serum sample showed an identical antibody pattern . Increases in IgA antibodies to klebsiella in patients with AS confirm previous studies using other techniques.

J Clin Microbiol, 1992 Feb, 30(2), 525 - 6
Modification of the methodology of stool culture for Salmonella detection; Ruiz J et al.; A total of 4,284 H2S-positive colonies isolated on salmonella-shigella agar and 4,350 isolated on Hektoen agar were flooded with 5 microliters of a reagent (MUCAP test; Biolife Italiana S.r.l., Milan, Italy) and observed after 3 to 5 min for the development of fluorescence produced in the presence of the C8 esterase enzyme . All of the 794 colonies isolated on salmonella-shigella agar and the 752 isolated on Hektoen agar and identified as positive for Salmonella spp . with conventional biochemical tests were found positive with the MUCAP test (the sensitivity was 100% and the negative predictive value was 100% for both media) . Moreover, only six isolates identified by conventional biochemical tests as Proteus vulgaris were MUCAP test positive (the specificity was 99.8% and the positive predictive value was 99.2% for both media) . On the basis of these results, we propose the use of the MUCAP test as a method for the screening of H2S-positive colonies and only subculturing on Kliger agar of those colonies which are MUCAP test positive . The MUCAP test is a rapid method for the presumptive detection of Salmonella spp . and reduces the work and material involved in testing.

Zh Mikrobiol Epidemiol Immunobiol, 1992 Feb, (2), 40 - 3
{The antigenic activity of vaccines made from opportunistic microorganisms in an experiment to immunize animals by oral and combined methods}; Efremova VN et al.; The results of the study of the antigenic activity of multicomponent vaccine consisting of staphylococcal, Klebsiella, Proteus, Escherichia coli antigens and staphylococcal monovaccine, introduced into rabbits and guinea pigs by different routes, are presented . As shown in this study, the multicomponent vaccine introduced orally in 5 administrations stimulated the production of antibodies to all components, but the intensity of antibody formation to each of them was different . Antibodies to E . coli antigen were found to be at the lowest level . Staphylococcal antigen, introduced orally both as the component of the multicomponent vaccine and as the monovaccine, ensured pronounced stimulation of the production of antistaphylococcal antibodies, not lower than that observed after subcutaneous injection . The comparative study of the activity of the multicomponent vaccine introduced by combined routes, oral-subcutaneous and subcutaneous-oral, showed the advantage of the former one.

J Leukoc Biol, 1992 Feb, 51(2), 129 - 32
In vivo testing confirms a blunting of the human cell-mediated immune mechanism during space flight; Taylor GR et al.; The cell-mediated immune (CMI) mechanism was evaluated in 10 space shuttle astronauts by measuring their delayed-type hypersensitivity response to seven common recall antigens . The Multitest CMI test system was used to administer antigens of tetanus, diphtheria, Streptococcus, Proteus, old tuberculin, Candida, and Trichophyton to the forearm 46 h before nominal mission termination; readings were conducted 2 h after landing . The mean number of reactions was reduced from 4.5 preflight to 3.0 inflight, and the mean reaction score was reduced from 21.4 to 13.7 mm inflight . The data presented suggest that the CMI system is still being degraded by space flight conditions on day 4 and that between day 5 and day 10, the depression maximizes and the system begins to adjust to the new conditions . The relation of these in vivo findings to previously reported in vitro results is discussed.

Kansenshogaku Zasshi, 1992 Feb, 66(2), 144 - 8
Proteus penneri isolated from the pus of a patient with epidural abscess; Li Z et al.; P . mirabilis and P . vulgaris are the two wellknown species in the genus Proteus . P . myxofaciens and P . penneri are recent additions to the genus . We isolated P . penneri from the pus of a patient with suppurative otitis media and an epidural abscess . The characteristics of the organism, including morphology, staining, physiology and biochemistry, were studied . Clinical microbiological laboratories should suspect P . penneri in the case of as Proteus strain that is negative for indole, salicin and esculin, but otherwise resembles P . vulgaris . Proteus penneri, formerly known as Proteus vulgaris indole-negative or as Proteus vulgaris biogroup 1, was named by Hickman et al in 1932 . Little information about human infection by this organism is available . In 1982, Hickman and co-workers studied 20 strain of P . penneri which were isolated from clinical specimens (urine, stool, etc.) in the USA . However, its clinical significance, until recently, was unknown . We isolated a strain of P . penneri from the pus of a patient with suppurative otitis media and an epidural abscess on June 10 and 15, 1989 . This paper concerns the problems encountered in identifying this organism and its clinical significance.

J Fam Pract, 1992 Feb, 34(2), 180 - 4
Comparison of three-day temafloxacin with seven-day ciprofloxacin treatment of urinary tract infections in women; Stein GE et al.; BACKGROUND . Temafloxacin is a new broad-spectrum arylfluoroquinolone antimicrobial with an extended serum half-life . METHODS . In this large, multicenter, double-blind clinical trial, 404 women with acute, uncomplicated urinary tract infections (UTI) were randomized to receive temafloxacin 400 mg once daily for 3 days, or ciprofloxacin 250 mg twice daily for 7 days . Clinical and microbiologic evaluations were repeated at 4 to 5 days after initiation of treatment, at the end of therapy, and at 5 to 9 days posttreatment . One hundred fifteen patients who received temafloxacin and 105 patients who received ciprofloxacin met the eligibility criteria for efficacy evaluation . The predominant urinary pathogens were Escherichia coli, Proteus mirabilis, and coagulase-negative staphylococci . No pretherapy isolate was resistant to either study drug . RESULTS . Bacteriologic eradication was observed in 112 (97%) of 115 women treated with temafloxacin and 101 (96%) of 105 women treated with ciprofloxacin . Clinical cure rates at 5 to 9 days posttreatment were 90% (the remaining 10% improved) with temafloxacin and 95% (the remaining 5% improved) with ciprofloxacin . Adverse effects associated with treatment occurred in 24 (12%) women who received temafloxacin and 31 (15%) women who received ciprofloxacin . Headache (2% with temafloxacin and 2% with ciprofloxacin), nausea (3% with temafloxacin and 6% with ciprofloxacin), and somnolence (4% with temafloxacin and 3% with ciprofloxacin) were reported most often . Only three and five patients who were treated with temafloxacin and ciprofloxacin, respectively, discontinued treatment because of adverse effects . CONCLUSIONS . In this study, a 3-day treatment regimen using a single daily 400-mg dose of temafloxacin was found to be as effective as a 7-day course of ciprofloxacin in women with acute uncomplicated UTI.

J Pediatr Orthop, 1992 Jan, 12(1), 106 - 13
Proteus syndrome: musculoskeletal manifestations and management: a report of two cases; Demetriades D et al.; The literature on clinical and roentgenographic findings of Proteus syndrome is reviewed . Two patients with Proteus syndrome who exhibited skeletal deformities and characteristic features such as limb length discrepancy, skin lesions, and soft tissue tumors are reported . Persistent difficulties in treating malformed spines and unequal legs, as well as unpredictable tissue reaction to trauma, are discussed.

Life Sci, 1992, 50(2), 137 - 45
Direct membrane effects of morphine and endorphins on Amoeba proteus; Mayers P et al.; Morphine, leu-enkephalinamide, met-enkephalin, alpha-neoendorphin and its Arg8 1-8 fragment increase contractile vacuole output in the freshwater Amoeba proteus at 18 microM . Significant effects of leu-enkephalin and naloxone are obtained at 180 microM . All compounds have reached their maximal activity at 720 microM . Alpha-neoendorphin and leu-enkephalin are inactive in the presence of isotonic, non-penetration sucrose, hence these compounds increase plasma membrane permeability to water . Results from molecular modeling show a clear correlation of activity with amphiphilicity, charge distribution and general flexibility of molecules . We conclude that, like previously-studied vasopressin analogues and non-hormonal amphiphilic peptides, active opioids embed themselves into the Amoeba plasma membrane, disrupting the lipid bilayer and increasing its permeability . In our Amoeba system, naloxone, a general morphine-like inhibitor, blocks active opioids as well as a vasopressin analogue . Naloxone, being less active than other tested amphiphiles, acts as a membrane stabilizer, protecting the lipid bilayer against the disruption action of more active compounds.

Int Urol Nephrol, 1992, 24(2), 109 - 12
Calculous pyelonephritis; Koga S et al.; The authors report on 48 patients with calculous pyelonephritis . Urinary obstruction was caused by renal calculi in 21 patients and ureteral calculi in 27 . Urine cultures were positive in 87.5% and bacteremia was seen in 70% . The common organisms in urine and blood culture were E . coli, Proteus and Klebsiella . Septic shock occurred in 10 (20.8%) out of 48 patients . Calculous pyelonephritis with urinary obstruction is a very serious condition.

Acta Physiol Scand, 1992 Jan, 144(1), 89 - 99
Reversal by concanavalin A of the inhibitory effects of extracellular Ca2+ on pinocytosis in Amoeba proteus; Johansson P et al.; When Concanavalin A, 1-20 micrograms ml-1 binds to the surface of Amoeba proteus the cell's response to Ca2+ and to cationic inducers of pinocytosis is strikingly altered . Separately, Concanavalin A and Ca2+ are weak inducers but their combined effects are intense pinocytosis and suppression of the normal inhibitory effect of Ca2+ on cation-induced pinocytosis . At high concentrations (greater than 25 micrograms ml-1) the lectin increases cellular uptake and binding of 45Ca in the cell surface but the ionic permeability and the potential of the cell membrane are little changed by treatment with Concanavalin A . Subsequent addition of Ca2+ starts the pinocytic cycle and causes a fivefold increase of the membrane resistance without depolarizing the cell . Neither a rise of free intracellular calcium nor an influx of 45Ca precedes formation of pinocytotic channels when Con A is applied to cells in the presence of calcium . All effects of Concanavalin A are blocked by alpha-methylmannoside while succinyl-Concanavalin A is without effects on pinocytosis . These findings suggest that crosslinking of cell surface carbohydrates reverses calcium inhibition of pinocytosis and increases the cell's pinocytotic response to cations without modifying either the bioelectrical effects or the intracellular free concentration of calcium.

Microbios, 1992, 69(278), 67 - 75
Adhesion of Proteus mirabilis and Proteus vulgaris to uroepithelial cells following exposure to various antimicrobial agents; Tullio V et al.; The effect of subinhibitory concentrations of netilmicin, ceftriaxone, cefotaxime, aztreonam and piperacillin on the adherence of Proteus species to uroepithelial cells was examined . Bacterial adhesion to human uroepithelial cells, measured microscopically, was affected by all five antibiotics but to different extents . The most effective was netilmicin . There was a correlation between the decreased rate of bacterial attachment and morphological changes in the drug-exposed bacteria.

Perit Dial Int, 1992, 12(2), 211 - 3
Management of refractory peritonitis to maintain the peritoneum for subsequent dialysis; Shusterman NH et al.; Peritonitis and its sequelae remain major clinical problems in treating peritoneal dialysis (PD) patients . One of these sequelae is the formation of intra-abdominal adhesions, preventing a patient from returning to peritoneal dialysis after a Tenckhoff catheter is removed for refractory peritonitis . We have recently applied a technique that appears to reduce the incidence of this severe complication . When it is determined that a catheter will be removed for refractory peritonitis, hourly peritoneal dialysis exchanges are performed for 12 hr prior to surgery . Postoperatively, the abdomen is rested for 48 hr, after which a temporary peritoneal dialysis catheter is placed at the bedside and hourly exchanges (with antibiotics) are performed for 2-3 days or until the dialysis fluid white blood cell count improves . Then the temporary catheter is removed and the abdomen is rested until the Tenckhoff catheter is replaced in 10-14 days . We treated 5 consecutive patients with refractory peritonitis (2 Pseudomonas, 1 Proteus, 1 Candida, 1 S . aureus) with this technique . All 5 patients were able to return successfully to peritoneal dialysis . At our institution over the past five years, 9 patients with refractory peritonitis due to the same organisms have had their catheters removed . Only 5 (56%) were able to return to PD . Although preliminary, our technique holds promise for those patients wishing to return to peritoneal dialysis after having a catheter removed for refractory peritonitis.

J Gen Microbiol, 1992 Jan, 138 ( Pt 1), 31 - 8
Recombination and UV resistance of Escherichia coli with the cloned recA and recBCD genes of Serratia marcescens and Proteus mirabilis: evidence for an advantage of intraspecies combination of P . mirabilis RecA protein and RecBCD enzyme; de Vries J et al.; In Escherichia coli, constituents of the main recombination pathway are provided by the genes recA (RecA protein) and recBCD (RecBCD enzyme) . Recombination in conjugation experiments and repair of UV damage of E . coli mutants deleted for recA, for recBCD or for recA plus recBCD were restored, although to different degrees, by the cloned recA and recBCD genes from Serratia marcescens or Proteus mirabilis . When both recombination enzymes were from the same species, repair and recombination efficiencies had the order E . coli greater than S . marcescens greater than P . mirabilis . However, the P . mirabilis recA plus recBCD genes resulted in higher levels of repair and recombination than those obtained with one component from P . mirabilis (recA or recBCD) and the other from E . coli or S . marcescens . The data provide evidence for the similarity of RecABCD pathways of recombination among enteric bacteria and suggest an in vivo advantage of an intraspecies combination of P . mirabilis RecA protein and RecBCD enzyme over interspecies combinations . This could point to a cooperation between these basic recombination enzymes . The molecular processes which could be involved are discussed.

J Gen Microbiol, 1992 Jan, 138 ( Pt 1), 147 - 54
Purification and characterization of a tryptic peptide of Borrelia burgdorferi flagellin, which reduces cross-reactivity in immunoblots and ELISA; Rasiah C et al.; In man the early immune response in Lyme disease is primarily directed against the endoflagellin antigen . Isolated flagellar protein of Borrelia burgdorferi suggests itself as a suitable test antigen . However, cross-reactivity between flagellins of B . burgdorferi, Escherichia coli, Bacillus subtilis, Proteus mirabilis and Salmonella typhimurium was demonstrated by immunoblotting and ELISA with polyclonal rabbit-hyperimmune-sera . Tryptic cleavage of recombinant B . burgdorferi 41 kDa flagellin, expressed in E . coli, produced a peptide fragment which was recognized exclusively by antisera to Borrelia species . This peptide was designated as the 14 kDa fragment due to its migratory behaviour in SDS-PAGE . The fragment is part of the variable region of the flagellin, as proven by amino acid sequencing . The flagellin peptide was employed as an antigen in ELISA and immunoblot assays, testing the polyclonal sera mentioned above . The specificity was superior to that obtained with the intact recombinant flagellin.

Fiziol Zh, 1992 Jan-Feb, 38(1), 117 - 20
{The natural anti-Pseudomonas aeruginosa and anti-Proteus immunity of the suitable donor population}; Nazarchuk LV; The natural anti-pyocyanic and anti-Proteus immunity of donorable population of Kiev before the accident at Chernobyl Atomic Power Plant has been studied . Blood serums of 3024 deliberately non-immunized persons have been studied . It is determined that there are natural anti-pyocyanic and anti-Proteus antibodies in blood serum of people with different group belonging during the all periods of a year (by ABO system) . The anti-pyocyanic and anti-Proteus antibodies of high titers in blood serum are found in summer most frequently.

Urol Res, 1992, 20(2), 177 - 81
Protection by a polyvalent vaccine against challenge infection and pyelonephritis; Kruze D et al.; The protective effect of immunization with a polyvalent vaccine (SolcoUrovac) was studied in the mouse and the rat . The i.m . immunization increased the resistance of mice to challenge infection with all homologous strains of bacteria . The LD50 values for E . coli, Proteus mirabilis and Streptococcus were 3.5-4.5 times and that of Klebsiella as much as 600 times that in nonimmunized mice . Protection against challenge with heterologous E . coli was also achieved and persisted for about 20 weeks . Immunization with the vaccine also provided marked protection against pyelonephritis in rats . Kidneys with abscesses were seen only one-third as often as in controls, and the size of the individual abscesses was substantially smaller in the vaccinated animals . Based on the quantity of bacteria in the kidneys it was postulated that the vaccination increased the clearance of bacteria.

J Child Neurol, 1992 Jan, 7(1), 29 - 34
Epidermal nevus syndrome: subgroup with neuronal migration defects; el-Shanti H et al.; Epidermal nevus syndrome is one of the sporadic congenital hamartoses in which neurologic abnormalities have been frequently reported . We report two cases with severe primary brain involvement, seizures, mental retardation, and facial hemihypertrophy . We emphasize the superiority of magnetic resonance imaging over other radiographic studies in outlining the primary central nervous system anomalies associated with this syndrome . Although attempts were made to distinguish between several variants of epidermal nevus syndrome, it is clear that these are one entity . Proteus syndrome, encephalocraniocutaneous lipomatosis, and epidermal nevus syndrome have several overlapping phenotypic features . We suggest that they represent a phenotypic continuum, which in turn suggests a common pathogenetic process . While the cause of these syndromes is unknown, observations point to a somatic mutation leading to variable patterns of mosaicism.

J Hand Surg {Am}, 1992 Jan, 17(1), 32 - 4
Proteus syndrome; Barmakian JT et al.; Proteus syndrome is a rare congenital disorder that is characterized by a wide variety of deformities including macrodactyly . Skin and soft tissue lesions are common; they may increase in size as the child develops and may assume tremendous proportions . The syndrome is often mistaken for other more commonly recognized conditions such as neurofibromatosis . Unlike neurofibromatosis, the soft tissue masses in Proteus syndrome are not nerve tumors but, rather, are hamartomas composed primarily of lipomatous tissue . The hand surgeon should be aware of this condition when evaluating a child with macrodactyly.

Infection, 1992, 20 Suppl 1, S18 - 21
Cefodizime given once daily for the treatment of upper urinary tract infections and complicated lower urinary tract infections; Hofstetter AG; The efficacy of cefodizime (CDZ) in upper urinary tract infections (UUTI) and complicated lower urinary tract infections (LUTI) was assessed by analysis of the combined results of five clinical trials . Doses of CDZ 1 g i.m . daily, 1 x 2 g i.v . or i.m . and 2 x 2 g i.v . were investigated; comparative agents were cefuroxime 3 x 1.5 g and ceftizoxime 1 x 2 g . Median duration of treatment was seven days . A total of 544 patients, 61% of whom had UUTI, entered the studies . Four hundred twenty-two patients were evaluable clinically and 375 bacteriologically . The most frequent pathogen at baseline was Escherichia coli, followed by Proteus mirabilis, Klebsiella spp . and Staphylococcus aureus . Both clinical and bacteriological cure rates were above 90% in all study groups . The dosage of 1 x 2 g CDZ is recommended for the treatment of UUTI and complicated LUTI.

Arch Immunol Ther Exp (Warsz), 1992, 40(1), 89 - 92
Serological characterization of Proteus penneri species novum; Zych K et al.; Serological characterization of the first collection of the 20 Proteus penneri strains is presented . All anti-0 sera were examined in microagglutination, semi-quantitative precipitation and passive hemagglutination tests . Some P . penneri lipopolysaccharides showed strong cross-reactivity in passive hemagglutination additionally confirmed by inhibition in this test . Serological similarity between species within genus Proteus is discussed.

Ann Urol (Paris), 1992, 26(5), 319 - 23
{Staghorn calculi in children . 32 cases}; Chaabouni MN et al.; The authors report thirty-two cases of children with staghorn calculi treated in the department of urology H . Bourguiba, Hospital of Sfax . Such calculi are frequently seen in young boys over the age of 6 years . Urinary tract infection by Proteus is the main etiologic factor of lithogenesis . Surgical treatment, still the most advocated, is laborious; it must ensure complete stone removal, while protecting renal function.

Urol Res, 1992, 20(6), 393 - 7
Effects of bacteria involved with the pathogenesis of infection-induced urolithiasis on the urokinase and sialidase (neuraminidase) activity; du Toit PJ et al.; It has been hypothesized that urinary urokinase and sialidase may play a role in urolithiasis . If these theories have substance it is to be expected that microorganisms may also affect these enzymes, since the association between urinary tract infection and renal stone formation is well known . It is generally assumed that Proteus mirabilis and Staphylococcus albus, which produce the urea-splitting enzyme urease, are responsible for stone formation . However, the importance of non-urease-producing microorganisms (Escherichia coli and Enterococcus) in urolithiasis is unclear . Spectrophotometric studies were therefore devised to clarify this problem . Microorganisms associated with infection-induced stones (Proteus mirabilis and Escherichia coli) respectively inhibited the urokinase and stimulated the sialidase activity . In contrast, microorganisms which were not associated with infection stones (Bacillus subtilis) had significantly less effect on urokinase and sialidase activity . This study may explain infection-induced stone formation and could open a completely new line of research.

Vaccine, 1992, 10(12), 817 - 23
Immunomodulatory action of propolis: IV . Prophylactic activity against gram-negative infections and adjuvant effect of the water-soluble derivative; Dimov V et al.; The efficacy of the water-soluble derivative (WSD) of natural propolis (bee glue) was examined for augmentation of host resistance against experimental infections caused by Gram-negative pathogens (Klebsiella pneumoniae, Proteus vulgaris, Escherichia coli, Pseudomonas aeruginosa) . The substance was found to induce significant non-specific protection, but did not inhibit the in vitro growth of the same strains . Pretreatment with WSD prior to the standard scheme for tumour necrosis factor (TNF) induction (BCG and two weeks later lipopolysaccharide (LPS)) provoked an interval-dependent reduction in the lytic capacity of serum against L 929 target cells . The replacement of the triggering or priming signal with WSD markedly increased TNF production . In vivo administration of WSD led to a rapid and route-dependent change in the alternative complement pathway haemolysis . The alteration in C1q complement component and total protein synthesis, and also in nitroblue tetrazolium reduction, suggests that macrophage activation makes a major contribution to the capacity of WSD to prevent infections.

Basic Life Sci, 1992, 59, 717 - 28
Polyphenols from Bulgarian medicinal plants with anti-infectious activity; Ivancheva S et al.; Three Bulgarian medicinal plants--Geranium macrorrhizum L . and G . sanguineum L . (Geraniaceae), and Epilobium hirsutum L . (Onagraceae) were analyzed phytochemically . Different polyphenols like flavonoids and tannis have been found to be principal constituents of the plants . A series of water or alcohol extracts was obtained, and their anti-infectious activity was tested . A significant inhibitory effect of water-alcohol extract and of four fractions from the polyphenolic mixture of E . hirsutum on the reproduction of influenza viruses in vitro, in ovo, and in vivo was established . Four extracts from G . macrorrhizum and three extracts from G . sanguineum were studied for in vitro inhibition of the growth of some Gram-negative bacteria (Klebsiella pneumoniae, Proteus vulgaris, Escherichia coli, Pseudomonas aeruginosa), Gram-positive bacterium (Staphylococcus aureus), and fungus (Candida albicans) . Some geranium extracts caused a strong increase of the survival rate in an infection with K . pneumoniae in mice . Augmentation of the nonspecific host resistance in relation to the influence of the extracts on the classical complement activation pathway was also studied.

Zh Mikrobiol Epidemiol Immunobiol, 1992 Jan, (1), 33 - 6
{The antibacterial immunity of people under dynamic observation in an altered radiation situation}; Bidnenko SI et al.; The comparative study of the isolation rate, level, antigenic and class specificity of serum antibodies to the causative agents of purulent septic infections (Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis) and acute enteric infections in healthy adults with different ABO blood groups before (836 persons) and after (1,429 persons) the catastrophe at the Chernobyl nuclear power station was made . The study revealed the fact that the genesis of antibodies directed against different microorganisms can be stimulated without additional antigenic challenge in the form of disease or immunization, which was definitely indicative of the influence of small radiation doses in Kiev on the humoral immunity of the population . The multifactor character of the dependence of antibacterial antibody formation under altered radiation conditions on the specific features of the infective agent and the intensity of its circulation among the population, individual immune responsiveness of the body and concrete radiation conditions was established.

Urol Nefrol (Mosk), 1992 Jan-Feb, (1-3), 28 - 32
{Telelithotripsy in the treatment of staghorn nephrolithiasis in children using the URAT-P lithotriptor}; Dzeranov NK et al.; The paper presents the results of telelithotripsy monotherapy for 34 staghorn stones in 32 nephrolithiasis children carried out at the RSFSR Research Institute of Urology, Moscow . Commonest manifestations of the disease were leukocyturia (87.5% of cases) and Proteus bacteriuria (31.8% of cases) . Basing on roentgenological findings, the stones were classified into 3 groups: initial (K1), incomplete (K2) and complete (K3) . All the children underwent treatment on Soviet lithotriptor "URAT-P" under a delicate regime using different techniques of disintegration which started from the periphery and advanced to the pelvic part of the calculus . No pretreatment drainage of the pelvicaliceal system was performed . The intended staged disintegration of the stones was achieved in 94.2% of cases at 2.4 sessions, on the average, and overall number of impulses 1973.1 per each stone . At discharge 76.4% of the children were free of the main mass of the stone dust . Acute pyelonephritis which appeared the most frequent postoperative complication developed in 7.8% of the patients one of which required open nephrostomy and one percutaneous puncture nephrostomy . Other cases were treated by specific antimicrobial therapy . Complete series of investigations in the postoperative period did not reveal any intra- or pararenal hematomas . Radioisotopic renography revealed improvement in renal function in 62% of cases in early postoperative follow-up . Thus, 93.8% of children with stag-horn stones were spared of traumatic operative intervention or invasive manipulations . This makes the method of telelithotripsy a valuable therapeutic tool in childhood staghorn nephrolithiasis.

Schweiz Arch Tierheilkd, 1992, 134(7), 341 - 8
{Bacteriology and mycology of otitis externa in dogs}; Bornand V; The bacterial and fungal flora of 1118 ears of dogs with otitis externa and 100 ears of healthy control dogs were studied in order to isolate the causative agents . The yeast Malassezia pachydermatis (56%) was by far the most common organism in otitic dogs followed by the bacteria Staphylococcus intermedius (23%), Pseudomonas aeruginosa (12%), Proteus spp . (6%) and Streptococcus canis (5%) . A statistical analysis of observed results showed that the incidence of these organisms is significant in otitic dogs . Many strains of S.intermedius, P.aeruginosa and Proteus spp . are resistant to antimicrobial agents commonly used to treat otitis externa . Therefore an antimicrobial susceptibility testing was performed using "Cobas Bact" for these bacterias . Furthermore, 80 strains of M.pachydermatis were submitted to identification-kits (API 20 CAUX, API STAPH, Cobas Micro) . The observed results showed that an identification with these tests was not possible.

Adv Perit Dial, 1992, 8, 234 - 7
Imipenem versus netilmicin and vancomycin in the treatment of CAPD peritonitis; Merchant MR et al.; Imipenem/cilastatin is a new thienamycin antibiotic with a broad bactericidal spectrum . We undertook a prospective randomised study to compare the safety and efficacy of intraperitoneal (IP) imipenem/cilastatin (2 gm daily) {group A; 21 patients, mean age 49.2 years} with a combination of IP netilmicin and vancomycin (500 and 60-100 mg daily resp.) {group B; 20 patients, mean age 55.2 years} in CAPD peritonitis . Each patient underwent 4 daily CAPD exchanges with antibiotics in alternate exchanges . The causative organisms were similar in both the groups as was the duration of therapy (gr.A: 6.8 +/- 0.27 days; gr.B: 7.2 +/- 0.51 days; p = NS) . Complete cure was marginally better with imipenem/cilastatin (gr.A; 94.1%, gr.B: 83.3%) with less relapses (gr.A: 1 episode; gr.B: 3 episodes) . One episode in gr.A (S . aureus) and 2 in gr.B (Yeast & Proteus) failed to resolve and required catheter removal . Two gr . A patients developed generalised convulsions which settled after discontinuation of the drug . Whilst the results show no significant difference in the outcome in the two groups, the use of IP imipenem would offer a possible advantage as a single antibiotic . Larger experience is needed before imipenem can be recommended as a 'blind' first line agent for CAPD peritonitis.

Acta Virol, 1992 Jan, 36(1), 67 - 72
The reactivity between rickettsiae and Weil-Felix test antigens against sera of rickettsial disease patients; Amano K et al.; Of the sera which were positive to Rickettsia tsutsugamushi by indirect immunoperoxidase test, approximately 80% sera were positive to a Proteus OXK antigen by Weil-Felix test at 10 or more days after the onset of fever, while only 10% sera were positive within 9 days from the onset of fever . In ELISA using the OXK antigen, almost all of the paired sera of tsutsugamushi disease (TD) patients increased on the IgM antibody titres with the rise of their titres by Weil-Felix test, whereas the IgG antibody titres of these sera were unrelated with the titres of Weil-Felix test . We suspect that the reactivity of TD patients sera to the OXK antigen in Weil-Felix test was derived from the reactivity of the IgM antibody against the OXK antigen common with R . tsutsugamushi . The patient sera infected with a Japanese isolate of spotted fever group rickettsia (SFGR) cross-reacted with the Thai Tick Typhus (TTT) strain of SFGR by indirect immunoperoxidase test . In Weil-Felix test, the reactivity of these sera to OX2 antigen were higher than that to OX19 antigen, like the sera infected with other SFGR, except of R . rickettsii . These sera also reacted with TTT and OX2 antigens by ELISA . The titres of IgM antibody against OX2 antigen in the sera in ELISA were in parallel with the titres of the sera against OX2 antigen in Weil-Felix test, but not the titres of IgG antibody . We suggest that the reactivity of the patient sera infected with SFGR to OX2 antigen of Weil-Felix test is dependent on the IgM antibody.

Przegl Lek, 1992, 49(12), 403 - 5
{Mastoiditis--a forgotten disease?}; Spodaryk M et al.; The symptoms and clinical course of latent mastoiditis in 18 . children treated in Polish-American Children's Hospital in Cracow were presented . The ultimate diagnosis of mastoiditis was based on typical findings on antrotomy and the presence of granulation on histology of the tissue obtained during the operation . The main symptoms of latent mastoiditis were: a lack of appetite, chronic or recurrent fever and failure to thrive . 11 children (61%) had experienced more than 3 episodes of acute otitis media before the diagnosis of mastoiditis was established . Bacteria most commonly isolated from the middle ear were those of Staphylococcus, Streptococcus and Proteus species . Radiograms of mastoid processes were negative in up to 45% of those children . The mean duration of antibiotic therapy was 10.7 weeks . After antrotomy complete dissolution of symptoms were observed in 14 patients (78%) . It is concluded, that in the presence of symptoms suggesting latent mastoiditis, the possibility of antrotomy, which may shorten the period of ineffective antibiotic therapy, should be considered earlier.

Tsitologiia, 1992, 34(11-12), 93 - 101
{Cytofluorimetric research on the changes in the DNA content in the nuclei of Amoeba proteus during prolonged starvation and after refeeding}; Makhlin EE; Dividing amoebae were manually selected from the culture of Amoeba proteus, and so groups of synchronously dividing (synchronized) amoebae were obtained . These synchronized amoebae were maintained without food . In spite of starvation, individual amoebae in some particular groups were seen to divide, whereas in other groups of amoebae there was no division at all . The starving amoebae died not earlier than 2 weeks after the last division . A relative DNA content in isolated nuclei has been determined cytofluorometrically for each of 6 groups of synchronized starving amoebae, unable to divide . The nuclei were isolated in different intervals after division (after the feeding was ceased): 1.0-1.5 h, 1 day and up to 13 days with 1-2 day intervals . In the all groups of amoebae DNA synthesis occurred on the first 1-2 days after division . The nuclear DNA content in amoebae of 3 groups increased more than two-fold as compared with the 1 h level, in other 3 groups the nuclear DNA content did not exceed the doubled 1 h level, but probably exceeded the doubled postmitotic level . Later on, the nuclear DNA content in starving amoebae of each group was seen to decrease by 16-20% . Amoebae of 3 of the 6 groups were given the food organisms (Tetrahymena pyriformis) 8 days after division (after cessation of feeding) . 2-3 days after refeeding some of these amoebae divided, and the nuclear DNA content of the refed amoebae proved to be higher than that in amoebae that continued to starve . It is suggested that the decrease of DNA content in the nuclei of starving amoebae and the increase of DNA quantity in the nuclei of refed amoebae may result from degradation and induction of synthesis of specific extra DNA synthesized in amoeba nuclei during each cell cycle.

Przegl Lek, 1992, 49(7), 213 - 5
{Comparative in vitro susceptibility of clinical bacterial isolates to pefloxacin and 14 antibiotics}; Dolna I et al.; In vitro activity of pefloxacin against 782 bacterial strains isolated from hospitalized patients (July-September 1991) in Wroclaw was compared with that of 14 antibiotics (4 aminoglycosides and 10 beta-lactamase) . The most susceptible to pefloxacin were: Staphylococcus epidermidis (96.0%), Klebsiella (94.4%), Proteus mirabilis (93.8%) and Escherichia coli (92.7%) . The least susceptible proved to be: nonfermentative Gram-negative rods (46.5%), and among them Pseudomonas aeruginosa (19.3% weakly sensitive, 0% sensitive strains) . It was found that over 80% of Gram-negative rods were susceptible to pefloxacin, amikacin, netilmicin, cefotaxime and ceftriaxone . The most active against staphylococci were netilmicin (92.6%), pefloxacin (89.4%) and amikacin (82.5%).

Med Dosw Mikrobiol, 1992, 44(1-2), 35 - 40
{Role of bacterial metabolism in transformation of non-mutagenic compounds into mutagens . II . Participation of bacteria producing urease in degradation of pesticides--urea derivatives}; Szarapinska-Kwaszewska J et al.; Participation of bacteria producing urease: Proteus mirabilis and Staphylococcus epidermidis in degradation of pesticides--urea derivatives, was investigated . Four new compounds were studies: N-/(3-trifluoromethyl)phenyl/N'-(2-cyanoethyl)-urea (IPO 6584), N-(4-chlorophenyl)-N'-(2-hydroxyethyl)-N'-ethylurea (PO 6236), N-(4-chlorophenyl)-N'-(2-hydroxyethyl), N'-propyl-urea (IPO 6237), N-(2-hydroxyethyl), N-methyl-N'-(3,4 dichlorophenyl)-urea (IPO 3102), pesticide reference standard--thiram fungicide--tetramethyl-bis-thiocarbamyl disulfide, and rodenticide-alpha-naphthylthiourea (ANTU) . Investigated compounds were incubated with cells of P . mirabilis 4508 ans S . epidermidis CCM 2448 and commercial preparation of urease from beans . Mutagenicity of resulting metabolites was then studies by the Ames test . All compounds were decomposed by bacteria used in this study, as well with beans urease with different activity . Reaction products did not exhibit mutagenic activity for test strains S . typhimurium his- TA97a, TA98, TA100 and TA102.

Infection, 1992, 20 Suppl 4, S296 - 301
Spectrum and susceptibility of pathogens causing acute uncomplicated lower UTI in females and its correlation to bacteriologic outcome after single dose therapy with fosfomycin trometamol versus ofloxacin/co-trimoxazole; Naber KG et al.; In a multicentric study comparing oral single-dose therapy of fosfomycin trometamol (3 g as fosfomycin) versus co-trimoxazole (1.92 g) or ofloxacin (200 mg) as many as possible of the pathogens were sent to and analysed in a central laboratory . The pathogens were identified and minimal inhibitory concentrations (MIC) of fosfomycin, trimethoprim alone and in combination with sulfamethoxazole, ofloxacin, ampicillin, amoxicillin combined with clavulanic acid, and cephadroxil were determined . The eradication of pathogens (cfu < 10(3)/ml at one week after single-dose therapy) was analysed according to species and MIC of the antibiotic used . Urine cultures of 349 patients were analysed . Escherichia coli was the predominating species followed by staphylococci and Proteus mirabilis . Enterococci were mostly found in mixed culture . Baseline pathogens of monoinfections were eradicated in 87.1%, in 88.9% and in 86.4% of 284 patients treated with fosfomycin trometamol, co-trimoxazole and ofloxacin, respectively . The MICs of the five antibacterial agents and the two antibiotic combinations for 253 baseline pathogens showed that of the E . coli strains none was resistant to ofloxacin, three (MIC = 128 mg/l) were resistant to fosfomycin, 3.6% to co-trimoxazole, 6.2% to trimethoprim, 8.8% to ampicillin, and 5.7% to amoxicillin/clavulanic acid . The eradication rates according to the MICs of the corresponding drugs showed equally good eradication rates for fosfomycin up to an MIC of 64 mg/l . Above this level two out of three strains were also eradicated by fosfomycin trometamol . For co-trimoxazole and ofloxacin no intermediately sensitive or resistant strains were found . Within the range of MICs found there were equally good eradication rates for both antibacterial agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Eye, 1992, 6 ( Pt 5), 469 - 72
Aqueous kinetics of sisomicin sulphate; Desai S et al.; Sisomicin sulphate is a new-generation aminoglycoside with a broad spectrum of antimicrobial activity that includes Pseudomonas aeruginosa . It is superior to gentamicin against indole-negative Proteus and some resistant strains of Pseudomonas . The ocular pharmacokinetics of sisomicin have not been explored . We used the agar diffusion technique of microbial assay to determine the aqueous penetration and bioavailability of a subconjunctivally placed standard dose of 20 mg/0.4 ml of sisomicin sulphate in 20 human volunteers undergoing elective cataract surgery . A peak concentration of 16.4 mg/l was found in the aqueous humour 78 minutes after injection, which is 65 times the minimum inhibitory concentration for Pseudomonas . The antibiotic was bioavailable up to 1203 minutes after injection in a concentration of 0.9 mg/l, which easily covers the minimum inhibitory concentration of Staphylococcus aureus and Pseudomonas . The antibiotic disappears from the aqueous humour at the 1434 minute interval (approximately 24 hours) . The elimination half-life (t1/2 of sisomicin was determined to be 5.16 hours (K = 0.134/hour) and the aqueous clearance was 2.87 microliters/min.

Arch Inst Pasteur Alger, 1992, 58, 161 - 8
{Efficiency of inhibitors (phenylethanol, nalidixic acid, sodium azide)in the isolation of strictly anaerobic bacteria from a polymicrobial specimen}; Merad AS et al.; The efficacy of inhibitors (PEA, Ac Nal, Az de Na) in the isolation of strict anaerobes in polymicrobial sample . The efficacy of three inhibitors to select strict anaerobic bacteria in the polymicrobial sample had been studied . First step: The most frequent anaerobes encountered in the infections are isolated in the agar Columbia containing the different inhibitors . This step allowed us to check the inhibition of the germ we have to isolate . Next step: polymicrobial mixtures were made . The composition of which is very similar to the samples we receive in the laboratory . The swarming Proteus is the facultative anaerobic germ which gives us difficulties when isolating strict anaerobic bacteria . Then, the different mixtures were isolated separately in the agar in which the inhibitors were added . The plates containing Azide of Na and PEA gave us the best results.

J Mol Biol, 1991 Dec 5, 222(3), 451 - 3
Purification, crystallization and preliminary X-ray diffraction studies of the PvuII endonuclease; Athanasiadis A et al.; The PvuII endonuclease (PvuIIR) is a restriction enzyme from a type II restriction-modification system of Proteus vulgaris coded on plasmid pPvu1 . The protein recognizes the DNA sequence 5' CAG'CTG 3' and shows no sequence homology to other restriction enzymes . This makes PvuIIR an interesting subject for structural determination . A purification procedure was developed that yields milligram quantities of the PvuIIR from plasmids expressed in the Escherichia coli strain HB101 . The protein was crystallized using ammonium sulphate as precipitant . The crystals are orthorhombic, space group P2(1)2(1)2 with cell dimensions: a = 84.2 A, b = 106.2 A, c = 46.9 A . The asymmetric unit contains one PvuIIR dimer . Diffraction extends to 2.3 A, so the crystals may permit structural determination at atomic resolution.

Clin Rheumatol, 1991 Dec, 10(4), 395 - 400
Acute anterior uveitis, arthritides and enteric antigens; Szanto E et al.; One hundred and fourteen patients with acute anterior uveitis were studied for the presence of the HLA-B27 tissue type, the prevalence of spondylitis and arthritis and the occurrence of gastro-intestinal and urogenital infections or diarrhoeal illness in the history . Eighty-seven (76%) were B27+ and 27 (24%) B27- . Forty-two (48%) of the B27+ group had ankylosing spondylitis (AS); 13 (30%) of them were females . Sacroilitis (SI) with no spinal involvement was present in 21 patients (24%), 13 (61%) males and 8 (38%) females . Peripheral arthritis occurred in 6 patients . Thus, 68 (78%) of the HLA-B27+ positive patients had inflammatory spinal and/or joint disease, compared with 1 (4%) of the HLA-B27- group (p less than 0.001) . The AS diagnosis was unknown previous to our examination in 31% of the males and 54% of the females, and SI was undiscovered in 61% of the males and 62% of the females . The occurrence of acute enteric infections was significantly increased in the B27+ AAU group, compared with the B27- patients and the patients reported exacerbation of AAU in connection with episodes of diarrhoea . An increased occurrence of urogenital infections was shown only in co-comparison with the males of the B-27+ AAU group . Thirty-three out of 47 AAU patients assayed by enzyme immuno-assay (EIA) for the quantification of IgM, IgA and IgG antibodies against Klebsiella pneumoniae, E coli, and Proteus mirabilis had significantly raised antibody titres against one or more of the antibodies studied, as compared to 62 healthy controls.(ABSTRACT TRUNCATED AT 250 WORDS)

J Gen Microbiol, 1991 Dec, 137 ( Pt 12), 2753 - 9
Composition of the outer membrane of Proteus mirabilis in relation to serum sensitivity in progressive stages of cell form defectiveness; Siegmund-Schultze N et al.; A serum-resistant strain of Proteus mirabilis was used to determine whether changes in the composition of surface components could be detected following induction of progressive stages of cell form defectiveness by beta-lactam antibiotics . The critical stage was the conversion from filaments to the spheroplast form, which was accompanied by increased susceptibility to the bactericidal action of human serum . Inner and outer membranes of the bacterium, its filament form and its spheroplast form were separated by sucrose density-gradient centrifugation after digestion of peptidoglycan, followed by osmotic lysis of the cells . Outer membranes of the bacterial and the filament forms sedimented at the same density, whilst the outer membrane fraction of the spheroplast form sedimented in a region of lesser density . In addition, the amounts of two major outer-membrane proteins as well as the O-polysaccharide content of the lipopolysaccharide were reduced in the spheroplast form . These results indicate a general disorganization in structure and assembly of components in regard to their interactions with one another in the outer membrane of the spheroplast form.

J Antimicrob Chemother, 1991 Dec, 28(6), 827 - 36
Active efflux of ofloxacin by a highly quinolone-resistant strain of Proteus vulgaris; Ishii H et al.; A clinical isolate of Proteus vulgaris, strain 881051, highly resistant to ofloxacin (MIC for ofloxacin; 800 mg/L) possessed three types of resistance mechanisms to ofloxacin . The supercoiling activity of DNA gyrase from this strain was barely inhibited by ofloxacin, the ID50 value of ofloxacin against the enzyme was 2700 times higher than that against the enzyme from a susceptible strain, P . vulgaris 08602 . In the outer membrane of this resistant strain, no porin protein of 37 kDa was detectable . In the presence of carbonylcyanide m-chloro-phenylhydrazone (CCCP), we found that the accumulation of ofloxacin in the cells of strain 881051, treated with the drug, was about 40-fold higher than that in the absence of CCCP . The CCCP-induced increase in the intracellular drug was 10 and 30 times higher than those in strain 880561 (a moderately resistant strain, MIC 50 mg/L) and 08602 (a fully sensitive strain), respectively . Simultaneous treatment of the strain 881051 with ofloxacin and CCCP resulted in bactericidal synergy . These results indicated that in addition to alterations of DNA gyrase and outer membrane proteins, the active efflux, as the third mechanism, could operate the resistance of strain 881051 to ofloxacin.

J Infect Dis, 1991 Dec, 164(6), 1173 - 9
Pathogenesis of intraabdominal abscess formation: abscess-potentiating agents and inhibition of complement-dependent opsonization of abscess-inducing bacteria; Finlay-Jones JJ et al.; Bacteroides fragilis and Escherichia coli are synergistic in the production of intraabdominal abscesses . However, these bacteria initiate abscess formation only when inoculated with an agent such as autoclaved colonic contents (ACC) or bran (a fiber analogue) . The mechanism of action of the abscess-potentiating agent was studied . Opsonins in normal mouse serum were determined for phagocytic killing by murine neutrophils of B . fragilis and E . coli . Opsonization required fixation of complement by the alternative pathway . ACC (0.2 mg/ml) and bran (1.0 mg/ml) inhibited phagocytic killing of Proteus mirabilis in the presence of normal but not immune serum . Assay of the alternative pathway of complement activation indicated that both bacterial components and abscess-potentiating agents in an abscess-inducing mixture activated complement . These findings suggest that abscess-potentiating agents inhibit opsonization and therefore the subsequent phagocytic killing of bacteria in the nonimmune host.

Med Clin (Barc), 1991 Nov 16, 97(17), 641 - 4
{Cerebral abscess in a general hospital . Analysis of 66 consecutive cases}; Gomez J et al.; BACKGROUND: Analysis of the epidemiologic characteristics of cerebral abscesses and comparison with 2 therapeutic schedules . METHODS: The clinical history of 66 patients with cerebral abscesses admitted over 14 years in the Neurosurgical Ward of the Virgen de la Arrixaca Hospital in Murcia were reviewed . Two therapeutic groups were designed of 33 and 31 patients respectively treated with classical or modern schedules and clinical efficacy was evaluated . RESULTS: Infections in the ORL area, craneoencephalic trauma, and brain surgery were the predisposing factors in 63% of the cases . The most frequent symptoms were migraine, fever, and alteration of consciousness in 75, 68 and 68% respectively . The most frequent locations were the temporal (36%), parietal (26%) and frontal lobes (23%) . Microbiological studies were positive in 75% of the patients with the most frequent microorganisms being group A Streptococcus, Proteus mirabilis, Staphylococcus aureus and anaerobes . Mortality was 14% . Twenty-two percent of the patients had neurological sequelae . The rate of mortality was significantly associated to age greater than 40 years, fatal underlying disease, coma, initial clinical criteria and inadequate antibiotic treatment . The combination of cephotaxime-metronidazole was significantly associated to greater cure in comparison with the classical antibiotic combination although no significant differences were found in either the rate of mortality or relapse . CONCLUSIONS: The combination of cephotaxime-metronidazole may constitute an interesting advance in the treatment of these processes . The epidemiological data obtained confirm those of larger series.

Ugeskr Laeger, 1991 Nov 11, 153(46), 3247 - 8
{Renal calculi in an infant}; Lauesen NE; Urinary concretions, particularly in the upper urinary tract, occur in otherwise healthy children in connection with Bacillus Proteus urinary infections . In other European countries, this occurs in 40-70% while, on the other hand, it is particularly rare in Scandinavia . A case of obstructing pelvic concretion in a boy aged three months is presented . This is the youngest case which could be found in the literature . Pyelolithotomy was performed and the child has been free from recurrence for six years . At the commencement of the disease, pain due to renal calculi may be misinterpreted as being due to three-months intestinal colic . Formation of calculi is presumed to be due the ability of Bacillus Proteus to form urease . The frequency of recurrences is 3-8% and is lowest if the urine can be maintained sterile for the first three months after removal of the stone.

J Bacteriol, 1991 Nov, 173(21), 7038 - 41
Nucleotide sequence and characterization of a carbenicillin-hydrolyzing penicillinase gene from Proteus mirabilis; Sakurai Y et al.; The structural gene of a carbenicillinase was cloned from the chromosomal DNA of Proteus mirabilis GN79 . This gene codes for a protein of 270 amino acids . Alignment of the amino acid sequence with those of known beta-lactamases revealed that the enzyme is a novel class A beta-lactamase with a unique conserved triad, RTG . By using a DNA fragment of the structural gene, a lack of cross hybridization was confirmed between the DNA probe and total DNAs from natural isolates of P . mirabilis, suggesting that the carbenicillinase may not be a species-specific beta-lactamase of P . mirabilis.

Mikrobiol Zh, 1991 Nov-Dec, 53(6), 78 - 82
{The characteristics of the initial link in the intestinal lesion by opportunistic Proteus mirabilis bacteria}; Koval'chuk VK et al.; Interaction of Proteus mirabilis with the intestine epithelium in white mongrel mice has been studied by means of bacteriological, toxicological and electron microscopic methods . Introduction of the agar culture of bacteria to the intestine lumen has permitted finding its general toxic action on enterocytes and other cell elements of epithelium which was accompanied by a potentiation of the striated margin membrane degradation but caused no destruction of cells . A damaging factor of protei was connected with the thermostable large-molecular fraction of cultural fluid of bacteria and its action was traced at the first hours of the bacterial contact with the mucous surface of thin intestine . Preliminary weakening of protective barriers of the intestine mucosa permitted protei to penetrate deep into the tissue through the intercellular slots . Colonization of the intestine lumen wall zone by the proteus is a necessary condition of the above-mentioned changes.

Antibiot Khimioter, 1991 Nov, 36(11), 5 - 8
{Taxonomic characteristics of soil Mycobacteria and their antibiotic properties}; Obgol'steva IO et al.; Morphological, cultural and chemotaxonomic properties of 12 gram-positive soil cultures isolated were studied by using a test system developed for screening the organisms producing broad-spectrum antibiotics among Nocardiaforms (Coryneforms) . The cultures were found to belong to Actinomycetales, Nocardioforms, Mycobacteriaceae and Mycobacterium . The saprophytic rapidly growing soil mycobacteria showed antibiotic activity against a large number of gram-positive and gram-negative test microbes including those belonging to Pseudomonas and Proteus resistant to the majority of the antibiotics currently used in medicine.

Antibiot Khimioter, 1991 Nov, 36(11), 37 - 40
{Prolonged antibacterial action of polymer coated suture materials}; Aleksandrov KR et al.; The antimicrobial activity of capromed, a surgical polymer-coated sutural material containing dioxidine, quinoxidine or gentamicin was studied in vitro and in vivo . Capromed was shown to be active against the hospital strains of S . aureus, E . coli, Proteus spp., Klebsiella spp . and P . aeruginosa . The antimicrobial activity of ADH and AG threads was preserved for 3 to 4 days after implantation . The DH-2 and G-2 threads preserved their activity for 6 to 7 days . It was concluded that the duration of thread antimicrobial activity depended on the properties of the polymer coating the thread . Capromed was applied to 280 operation wounds in 275 patients . There was no wound suppuration in the group of patients after pure operations (n = 62) . In the group of patients after conditionally pure operations (n = 130) suppuration was observed in 2 patients (1.3 per cent) . In patients with contaminated wounds (n = 88) suppuration in 5 of them (5.7 per cent) was recorded . The total number of the purulent complications after using capromed in surgical operations amounted to 2.5 per cent . In the control group purulent complications were stated in 8.2 per cent of the cases.

Med Hypotheses, 1991 Nov, 36(3), 269 - 72
Bacterial colonization behaviour: a new virulence strategy in urinary infections?
McLean RJ, Nickel JC.
The urinary bladder resists bacterial colonization and infection by a number of mechanisms, one of which involves the sloughing of colonized uroepithelial cells . Pathogens which thus become detached from bladder tissue are rapidly eliminated upon voiding of urine . During a recent study of bacterial colonization by the urinary pathogen, Proteus mirabilis, we noted that it colonized glass surfaces such that organisms became widely and evenly dispersed over the surface . In contrast, Pseudomonas fluorescens, a non-pathogen in the urinary tract, did not disperse over the surface but colonized and grew in such a manner as to form small clumps or microcolonies . Other investigators have also shown that Escherichia coli, a common urinary pathogen, initially colonizes bladders in a random, widely-dispersed fashion . We propose that successful bladder pathogens will predominantly adopt colonization behaviour that enables them to widely disperse over bladder tissue and, in so doing, avoid being cleared by the desquamation of uroepithelial cells . Colonization behaviour would therefore represent a previously uncharacterized virulence strategy.

J Med Genet, 1991 Nov, 28(11), 781 - 5
Transmission of Proteus syndrome from father to son?
Goodship J, Redfearn A, Milligan D, Gardner-Medwin D, Burn J.
We present a male infant with cranial hemi-hypertrophy, a lymphangioma, a lipoma, and epidermal naevi . A diagnosis of Proteus syndrome was made . His father had had a large lymphangioma resected from the right side of the face as a child . We propose that Proteus syndrome has been transmitted from father to son.

J Appl Bacteriol, 1991 Nov, 71(5), 467 - 76
Typing of Proteus mirabilis from clinical sources by computerized analysis of electrophoretic protein patterns; Holmes B et al.; Seventy-five strains of Proteus mirabilis (mainly of human origin) were characterized by one-dimensional SDS-PAGE of cellular proteins . The strains came from various countries; 24 were from urine, 17 from faeces (including one from a dog and one from a monkey), 12 from the respiratory tract (including nine from sputum), four from a cerebral abscess, 12 from miscellaneous sources and six from unknown sources . The protein patterns, which contained 45 to 50 discrete bands, were highly reproducible . The patterns of the 75 P . mirabilis cultures plus those of the type strains of six Proteus and Providencia species were used as the basis for two numerical analyses . In the first, which included all the protein bands, the P . mirabilis cultures formed nine clusters at the 85% S level . In the second analysis, in which the principal protein bands (in the 34.0-44.6 kDa range) were excluded, 74 of the 75 cultures of P . mirabilis formed a single cluster at the 77% S level distinct from the six Proteus and Providencia reference strains . The P . mirabilis strain which failed to cluster with the others had a background band pattern typical of the species in the lower molecular weight region but appeared to be less typical in the heavier bands . It is concluded that high resolution PAGE combined with computerized analysis of protein patterns provides the basis for typing clinical strains of P . mirabilis . Reference strains of each of the nine PAGE types identified are available from NCTC for inclusion in future studies.

Br J Urol, 1991 Nov, 68(5), 541 - 2
Urinary stone formation in children with prenatally diagnosed uropathies; Rickwood AM et al.; Among a series of 312 patients with prenatally diagnosed uropathies, 4 male children developed urinary calculi at ages varying from 2 to 5 years . All had upper urinary tract dilatation not associated with vesicoureteric reflux or with renographically defined obstruction; 3 followed Proteus urinary infections . Strategies for prevention are discussed.

J Clin Microbiol, 1991 Nov, 29(11), 2559 - 65
Immunoblot studies to analyze antibody to the Rickettsia typhi group antigen in sera from patients with acute febrile cerebrovasculitis; Hechemy KE et al.; In 1986, an unusual syndrome of acute febrile cerebrovasculitis in the Piedmont Region of Virginia was reported . All patients had encephalopathy and prior exposure to both a sylvan environment and flea-infested animals . The initial serological studies suggested a rickettsial origin, corroborating clinical, epidemiological, and histopathological findings . Sera from four of five patients were subsequently studied by immunoblotting . Unabsorbed and absorbed sera were tested with electrophoresed and electroblotted Rickettsia typhi, Legionella bozemanii, and Proteus vulgaris OX19 antigens . The unabsorbed sera reacted with all three antigens . The P . vulgaris- and L . bozemanii-absorbed sera reacted with R . typhi only and without significantly less intensity . In contrast, the reactivity of R . typhi-absorbed sera was significantly lower with all three antigens . These results indicate that these patients had specific antibodies to a typhus group antigen . Although our findings suggest that a rickettsia of the typhus group may have caused this syndrome, no definitive diagnosis could be achieved because a rickettsial organism was not isolated.

J Mol Biol, 1991 Oct 20, 221(4), 1075 - 7
Crystallization and crystal packing of Proteus mirabilis PR catalase; Jouve HM et al.; The tetrameric catalase from Proteus mirabilis PR (EC 1.11.1.6), known to bind NADPH, has been crystallized by the hanging-drop method in a form apparently depleted in dinucleotide . The crystals belong to the hexagonal space group P6(2)22 with a = b = 111.7 A, c = 248.8 A . There is one subunit in the asymmetric unit . Data were collected to 2.9 A at the L.U.R.E . (Orsay) synchrotron radiation facility . The tetramers have been located in the crystal, centered on the site (1/2, 0, 0) with 222 symmetry.

J Bone Joint Surg Am, 1991 Oct, 73(9), 1281 - 94
Osteomyelitis in patients who have sickle-cell disease . Diagnosis and management; Epps CH Jr et al.; Fifteen patients who had sickle-cell disease and osteomyelitis (affecting thirty bones) were treated with operative decompression and parenteral administration of antibiotics between 1973 and 1988 . Organisms were isolated on culture of specimens of bone from all fifteen patients . Parenteral antibiotic therapy was continued for a minimum of six weeks after operative decompression . The osteomyelitis resolved in twenty-nine (97 per cent) of the thirty affected bones after follow-up ranging from two to fifteen years . With their compromised immune status and poor circulation of blood in bone, patients who have sickle-cell disease and osteomyelitis are prone to have complications . In our series, the complications included an adhesive pericapsulitis of the shoulder in two patients, avascular necrosis of the humeral head in one, and a pathological fracture of the femur in one . In four of the fifteen patients, chronic osteomyelitis persisted, but in three of the four, the infections of bone healed six to fourteen months after the initial operative decompression . Staphylococcus aureus was isolated on culture of specimens of bone from eight to the fifteen patients; Salmonella, from six; and Proteus mirabilis, from one . Although Salmonella has been cited as the principal causative organism of osteomyelitis in patients who have sickle-cell disease, in our experience Staphylococcus aureus was the most common infecting organism . Therefore, Salmonella may not be the most common cause of osteomyelitis associated with sickle-cell disease in all countries or in all areas of a particular country.

J Med Microbiol, 1991 Oct, 35(4), 203 - 7
The production and activity in vivo of Proteus mirabilis IgA protease in infections of the urinary tract; Senior BW et al.; Immunoblotting of urine from 21 patients of both sexes and of wide age range who had a Proteus mirabilis urinary tract infection (UTI) showed that 14 (64%) specimens contained immunoglobulin A (IgA) . In nine (64%) of these the IgA heavy chain had been degraded to fragments of a size identical to those formed when purified IgA was degraded by pure P . mirabilis protease . Urine from patients with clinical evidence of upper UTI contained fragmented IgA and in some of these urine samples P . mirabilis protease activity was detectable . Urine infected with a non-proteolytic strain contained only intact IgA . It is concluded that P . mirabilis IgA protease is produced and is active during infections of the urinary tract.

APMIS, 1991 Oct, 99(10), 956 - 60
Characteristics of spontaneously agglutinating Proteus mirabilis strains from bacteriuric patients; Krajewska-Pietrasik D et al.; Out of 210 Proteus mirabilis isolates from bacteriuric patients a total of eight spontaneously agglutinating strains were found . SDS-PAGE analysis of their lipopolysaccharides (LPS), the separation of polysaccharide fractions (PS) by gel filtration, and chemical characterization of PSs were performed . Out of the eight strains one S form and one mutant classified as Rc were detected . The remaining six strains were recognized as Ra and intermediate forms . When tested in a hematogenous infection model in mice, the P . mirabilis Rc mutant survived in kidneys for at least two weeks, while the Re mutant used as control was eliminated within 20 h after the challenge . These data indicated that strains of P . mirabilis may be pathogenic even if they express very incomplete LPS.

J Bacteriol, 1991 Oct, 173(19), 6279 - 88
Proteus mirabilis mutants defective in swarmer cell differentiation and multicellular behavior; Belas R et al.; Proteus mirabilis is a dimorphic bacterium which exists in liquid cultures as a 1.5- to 2.0-microns motile swimmer cell possessing 6 to 10 peritrichous flagella . When swimmer cells are placed on a surface, they differentiate by a combination of events that ultimately produce a swarmer cell . Unlike the swimmer cell, the polyploid swarmer cell is 60 to 80 microns long and possesses hundreds to thousands of surface-induced flagella . These features, combined with multicellular behavior, allow the swarmer cells to move over a surface in a process called swarming . Transposon Tn5 was used to produce P . mirabilis mutants defective in wild-type swarming motility . Two general classes of mutants were found to be defective in swarming . The first class was composed of null mutants that were completely devoid of swarming motility . The majority of nonswarming mutations were the result of defects in the synthesis of flagella or in the ability to rotate the flagella . The remaining nonswarming mutants produced flagella but were defective in surface-induced elongation . Strains in the second general class of mutants, which made up more than 65% of all defects in swarming were motile but were defective in the control and coordination of multicellular swarming . Analysis of consolidation zones produced by such crippled mutants suggested that this pleiotropic phenotype was caused by a defect in the regulation of multicellular behavior . A possible mechanism controlling the cyclic process of differentiation and dediferentiation involved in the swarming behavior of P . mirabilis is discussed.

Infect Immun, 1991 Oct, 59(10), 3778 - 86
Efficacy of a Proteus mirabilis outer membrane protein vaccine in preventing experimental Proteus pyelonephritis in a BALB/c mouse model; Moayeri N et al.; A BALB/c mouse model of nonobstructive, ascending Proteus mirabilis pyelonephritis was characterized bacteriologically, histologically, and serologically from 3 to 28 days . Intravesicular administration of 2 X 10(8) P . mirabilis K7 resulted in the septic death of 9 (16%) of 57 mice by day 15 . Among the survivors, K7 colonized the kidneys in great numbers until day 21 . Histological examination of the kidneys revealed acute inflammation which was characterized by neutrophil infiltration by day 3, renal necrosis by day 7, and fibroblastic infiltration by day 14 which persisted at least until day 28 . The immunoglobulin G response to the outer membrane proteins (OMP) was assessed by enzyme-linked immunosorbent assay and Western blotting (immunoblotting) . Anti-OMP immunoglobulin G antibodies were detected as early as day 7, and the reciprocals of their titers rose progressively up to day 28 (i.e., greater than or equal to 500) . This model was also used to assess the efficacy of OMP and lipopolysaccharide (LPS) immunization in preventing renal infection . K7 OMP or LPS (100 micrograms) preparations were administered intramuscularly in Freund's complete adjuvant . After 2 weeks, mice were intravesicularly challenged with 2 X 10(8) bacteria of the homologous K7 strain or one of four heterologous strains . Compared with the saline-immunized control group and K7 LPS-immunized mice, K7 OMP recipients were protected from death when challenged by homologous or heterologous strains . In addition, K7 OMP recipients were protected (P less than 0.003) from subsequent renal infection when challenged by the K7 strain and had more rapid bacterial renal clearance when challenged by three of four heterologous strains . OMP recipients produced antibodies which bound major OMP moieties (viz., 36- to 39-kDa cell wall constituents) as assessed by Western blotting . These results support the concept that immunization with selected bacterial protein surface coat constituents can prevent uromucosal infection by interfering with colonization or renal injury.

Infect Immun, 1991 Oct, 59(10), 3360 - 5
Proteus mirabilis urease: use of a ureA-lacZ fusion demonstrates that induction is highly specific for urea; Nicholson EB et al.; Proteus mirabilis, a common agent of nosocomially acquired and catheter-associated urinary tract infection, is the most frequent cause of infection-induced bladder and kidney stones . Urease-catalyzed urea hydrolysis initiates stone formation in urine and can be inhibited by acetohydroxamic acid and other structural analogs of urea . Since P . mirabilis urease is inducible with urea, there has been some concern that urease inhibitors actually induce urease during an active infection, thus compounding the problem of elevated enzyme activity . Quantitating induction by compounds that simultaneously inhibit urease activity has been difficult . Therefore, to study these problems, we constructed a fusion of ureA (a urease subunit gene) and lacZ (the beta-galactosidase gene) within plasmid pMID1010, which encodes an inducible urease of P . mirabilis expressed in E . coli JM103 (Lac-) . The fusion protein, predicted to be 117 kDa, was induced by urea and detected on Western blots (immunoblots) with anti-beta-galactosidase antiserum . Peak beta-galactosidase activity of 9.9 mumol of ONPG (o-nitrophenyl-beta-D-galactopyranoside) hydrolyzed per min per mg of protein, quantitated spectrophotometrically, was induced at 200 mM urea . The uninduced rate was 0.2 mumol of ONPG hydrolyzed per min per mg of protein . Induction was specific for urea, as no structural analog of urea (including acetohydroxamic acid, hydroxyurea, thiourea, hippuric acid, flurofamide, or hydroxylamine) induced fusion protein activity . These data suggest that induction by inactivation of UreR, the urease repressor protein that governs regulation of the urease operon, is specific for urea and does not respond to closely related structural analogs.

J Chemother, 1991 Oct, 3(5), 283 - 8
The incidence and beta-lactam resistance of Proteus vulgaris in hospital infections: the last decade; Gomez-Alferez A et al.; During the period of 1980-1990, 581 Proteus vulgaris strains were obtained in a general hospital . They were considered as the significant isolate in 0.6% of soft tissue infections, 0.6% of urinary tract infections and in 0.2% of bacteremic episodes . Sixty-three percent of the 393 tested strains showed resistance to ampicillin, cefazolin and cefamandole or cefuroxime . About 7% were susceptible to all beta-lactam drugs, and showed a very low beta-lactamase activity and 5% of the strains showed a phenotype of resistance including ampicillin, carbenicillin-ticarcillin, cefazolin and cefamandole or cefuroxime, and presented increased chromosomal beta-lactamase activity . Cefotaxime-resistance was detected in 2% of the isolates which appeared in the period 1987-1990.

Zh Mikrobiol Epidemiol Immunobiol, 1991 Oct, (10), 45 - 7
{The effect of immunotherapy with cell-free vaccines made from the antigens of opportunistic microorganisms on the dynamics of DNA antibody formation}; Egorova NB et al.; The sera of patients subjected to immunotherapy with staphylococcal vaccine and with multicomponent vaccine (i.e . the mixture of the antigenic preparations of Staphylococcus aureus, Klebsiella pneumoniae, Proteus vulgaris, Escherichia coli) were studied by the method of the enzyme immunoassay on the basis of cattle spleen DNA . Immunotherapy with staphylococcal vaccine was given to patients with dermal diseases, chronic obstructive bronchitis and pulmonary abscess . Multicomponent vaccine was introduced to patients with the infectious allergic form of bronchial asthma, moderate or severe . Immunotherapy with both preparations under study was shown to produce no accumulation of antibodies to native and denatured DNA.

Zh Mikrobiol Epidemiol Immunobiol, 1991 Oct, (10), 2 - 5
{The characteristics of the contact of proteolytic strains of Proteus mirabilis and Klebsiella pneumoniae with enterocytes in vivo}; Koval'chuk VK et al.; The relationships of opportunistic P . mirabilis and K . pneumoniae, both having proteolytic properties, with enteric cells in white mice have been studied on a ligated intestinal loop, used as an experimental model, by electron microscopy . This investigation has shown that the strains under study are capable of damaging the membrane of the jagged edge of enteric cells at the distance of the spread of proteolytic metabolites . This damage is reversible, presenting as compensatory protective reaction of the cells.

J Inorg Biochem, 1991 Oct, 44(1), 55 - 63
Synthesis, antimicrobial, and antitumor activity of a series of palladium(II) mixed ligand complexes; Khan BT et al.; Mixed ligand complexes of cisdichloromethioninepalladium(II) with 2-mercaptopyrimidine and 2-aminopyrimidine were synthesized and characterized by elemental analysis, conductivity data, infrared, and 1H NMR and 13C NMR spectra . In these mixed ligand complexes methionine coordinates to palladium through amino nitrogen and sulphur, thus leaving a free carboxylic acid group . The pyrimidine ligand coordinates to metal ion through N3 . Mixed ligand complexes of cisdichloroethioninepalladium(II) with cytosine and guanosine were synthesized and characterized earlier . All the above mixed ligand complexes were screened for antimicrobial activity against Vibrio parahaemolyticus, Pseudomonas aeruginosa, Proteus vulgaris, Escherichia coli, Shigella flexnerri, Salmonella typhii, Klebsella pneumoniae, and Vibrio cholerae . It was found that complexes {Pd(meth)Cl2}: {Pd(meth)(2merpy)Cl}Cl; {Pd(meth)(2ampy)Cl}Cl; {Pd(ethio)Cl2}; {Pd(ethio)(cyt)Cl}Cl; and {Pd(ethio)(guo)Cl}Cl showed broad spectrum antimicrobial activity against all the human pathogens tested, however {Pd(meth)(2merpy)Cl}Cl eliminated plasmid with 100% frequency . These complexes have also been screened in vitro for antitumor activity against Hela (Epidermoid Carcinoma Cervix) and CHO cell lines . An excellent correlation between the antitumor activity of Pd(II) complexes and their ability to cure plasmids exists.

Kansenshogaku Zasshi, 1991 Oct, 65(10), 1304 - 8
{Spheroplast formation in clinical isolates of gram-negative bacteria by beta-lactam antibiotic in the presence of Ca2+ or Mg2+}; Tada Y et al.; Induction to cell wall-deficient bacteria has been suggested to be a cause of intractable and opportunistic infection after chemotherapy . Spheroplast formation by beta-lactam antibiotic in not so high osmotic pressure was investigated in six species of gram-negative bacteria . Some species of gram-negative bacteria were induced to form spheroplast at a high rate by 1:10 concentration of ceftizoxime in the presence of Ca2+ or Mg2+ . Especially in 38% of Proteus mirabilis and P . vulgaris, more than 40% of the original cells were induced to form spheroplast by ceftizoxime in a medium supplemented with 40 mM Ca2+ . The same formation rate was also found in 22% of Serratia marcescens . Formation rates in the drug sensitive strains of S . marcescens were enhanced as the drug concentration increased . Ca2+ was more effective in spheroplast formation than Mg2+.

Arch Fr Pediatr, 1991 Oct, 48(8), 559 - 61
{Neonatal proteus mirabilis adrenal gland abscess}; Francois A et al.; The authors describe a case of unilateral adrenal abscess in a neonate, which was diagnosed at 13 days of age by abdominal ultrasonography . The newborn presented with persistent high white blood cells after Proteus mirabilis omphalitis . Magnetic resonance imaging and needle aspiration confirmed the diagnosis . This is the second case of Proteus mirabilis neonatal adrenal abscess reported in the literature . Percutaneous drainage allowed complete recovery.

Infect Immun, 1991 Oct, 59(10), 3574 - 80
Proteus mirabilis flagella and MR/P fimbriae: isolation, purification, N-terminal analysis, and serum antibody response following experimental urinary tract infection; Bahrani FK et al.; Urinary tract infection with Proteus mirabilis may lead to serious complications, including cystitis, acute pyelonephritis, fever, bacteremia, and death . In addition to the production of hemolysin and the enzyme urease, fimbriae and flagellum-mediated motility have been postulated as virulence factors for this species . We purified mannose-resistant/proteuslike (MR/P) fimbriae and flagella from strains CFT322 and HU2450, respectively . Electron microscopy revealed highly concentrated preparations of fimbriae and flagella . Fimbrial and flagellar structural subunits were estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis to be 18.5 and 41 kDa, respectively . N-terminal sequencing revealed that 10 of the first 20 amino acids of the major MR/P subunit matched the sequence of the P . mirabilis uroepithelial cell adhesin N terminus and 11 of 20 amino acids matched the predicted amino acid sequence of the Escherichia coli P fimbriae structural subunit, PapA . In addition, 90 and 80% homologies were found between the first 20 amino acids of P . mirabilis flagellin and those of Salmonella typhimurium phase-1 flagellin and the E . coli hag gene product, respectively . An enzyme-linked immunosorbent assay using purified antigens showed a strong reaction between the MR/P fimbriae or flagella and sera of CBA mice challenged transurethrally with P . mirabilis . A possible role for MR/P fimbriae in the pathogenesis of urinary tract infection is supported by (i) a strong immune response to the antigen in experimentally infected animals, (ii) amino acid sequence similarity to other enteric surface structure, and (iii) our previously reported observation that MR/P fimbriae are expressed preferentially as the sole fimbrial type in human pyelonephritis isolates.

Lab Anim Sci, 1991 Oct, 41(5), 451 - 5
Mouse models of short- and long-term foreign body in the urinary bladder: analogies to the bladder segment of urinary catheters; Johnson DE et al.; Catheter-associated bacteriuria is the most common infection occurring in hospitals, where urethral catheters are generally in place for a few days, and in nursing homes, where catheters may be in place for months or years . We developed murine models with intrabladder urinary catheters for studying complications of bacteriuria in short- and long-term catheterization . In the short-term model, a catheter segment was inserted transurethrally and lay free within the bladder lumen . Half of the animals expelled segments during a 2-to-7-day period, durations similar to catheterizations in hospitalized patients . For studies of long-term catheter use, the catheter segment was secured within the bladder by a single suture for up to 12 months . Antibiotics administered for 7 days after catheter placement and housing mice in cages with wire screen floors reduced spontaneous bacteriuria to an acceptably low incidence rate of only 7% . Proteus mirabilis bacteriuria of high concentration provoked the same complications that are common in patients with long-term catheters: acute pyelonephritis, chronic renal inflammation, and struvite stone formation . These models allow inoculation of the bacteria of interest and are suitable for studies of short- and long-term foreign body-associated bacteriuria and its complications.

J Bacteriol, 1991 Oct, 173(19), 6289 - 93
Transposon mutagenesis in Proteus mirabilis; Belas R et al.; A technique of transposon mutagenesis involving the use of Tn5 on a suicide plasmid was developed for Proteus mirabilis . Analysis of the resulting exconjugants indicated that Tn5 transposed in P . mirabilis at a frequency of ca . 4.5 x 10(-6) per recipient cell . The resulting mutants were stable and retained the transposon-encoded antibiotic resistance when incubated for several generations under nonselective conditions . The frequency of auxotrophic mutants in the population, as well as DNA-DNA hybridizaiton to transposon sequences, confirmed that the insertion of the transposon was random and the Proteus chromosome did not contain significant insertional hot spots of transposition . Approximately 35% of the mutants analyzed possessed plasmid-acquired ampicillin resistance, although no extrachromosomal plasmid DNA was found . In these mutants, insertion of the Tn5 element and a part or all of the plasmid had occurred . Application of this technique to the study of swarmer cell differentiation in P . mirabilis is discussed.

J Urol, 1991 Sep, 146(3), 728 - 32
Extracorporeal shock wave lithotripsy for struvite renal calculi: prospective study with extended followup; Michaels EK et al.; To clarify the significance of retained stone particles after extracorporeal shock wave lithotripsy (ESWL) for struvite renal calculi we followed 22 otherwise healthy women for 16 to 52 months (mean 39 months) . Each patient had persistent Proteus mirabilis bacteriuria before ESWL and received a standardized regimen of antimicrobial therapy in the perioperative period only . Of the 22 patients 19 (86%) were cured of the persistent bacteriuria . Of these 19 patients 16 had retained stone particles at the beginning of surveillance and 10 had retained particles at last followup . None of the particles produced symptoms or enlarged . However, 1 of the patients who was rendered stone-free had a P . mirabilis reinfection at 20 months and a new stone developed . Of the 22 patients 3 (14%) had continued persistent P . mirabilis bacteriuria after ESWL . Two patients were subsequently cured of the infection with antibiotics alone (1), and with antibiotics and extraction of a new ureteral stone (1) . The remaining patient had expansion of retained stone particles after 51 months of surveillance . We conclude that a stone-free kidney is an unrealistic objective of ESWL monotherapy for struvite renal calculi . However, the treatment usually will eradicate the accompanying persistent bacteriuria and sterile stone particles will not enlarge during the first 2 to 4 years after treatment.

J Am Acad Dermatol, 1991 Sep, 25(3), 550 - 6
How many epidermal nevus syndromes exist? A clinicogenetic classification; Happle R; The term epidermal nevus syndrome is not suitable to describe an entity because there are different birth defects associated with epidermal nevi . A new classification is proposed to distinguish three well-defined syndromes, each recognizable by a different type of nevus . The sebaceous nevus syndrome and the Proteus syndrome are most likely due to autosomal lethal mutations and therefore always occur sporadically, whereas the CHILD syndrome can be transmitted from a mother to her daughter as an X-linked dominant, male-lethal trait . Moreover, the nevus comedonicus syndrome can be regarded as an entity closely related to this group of disorders . It may represent another autosomal lethal mutation that survives by mosaicism . In addition, several less well-defined phenotypes associated with epidermal nevi are reviewed . Some of them are regarded as entities in limbo.

J Am Acad Dermatol, 1991 Sep, 25(3), 447 - 62
Skin and bones . II; Orlow SJ et al.; Skin disorders in which a radiograph may detect associated bony changes or abnormalities of calcification are discussed . They are grouped into eight categories: (1) inherited diseases (e.g., alkaptonuria, neurofibromatosis); (2) congenital disorders (e.g., Sturge-Weber and Proteus syndromes); (3) inflammatory conditions (e.g., dermatomyositis, sarcoidosis); (4) infections (e.g., dental sinus, syphilis); (5) neoplasias (e.g., histiocytosis, mastocytosis); (6) drug- and environment-induced (e.g., acroosteolysis, retinoid toxicity); (7) calcinosis cutis; and (8) osteoma cutis . The first part of this review, published in the August 1991 issue of this JOURNAL, dealt with the first two categories; part II discusses categories 3 through 8.

J Urol, 1991 Sep, 146(3), 733 - 6
Bacteremia during extracorporeal shock wave lithotripsy of renal calculi; Muller-Mattheis VG et al.; An increasing incidence of bacterial endocarditis has been observed since the beginning of the last decade . An explanation for this fact is the expansion of diagnostic and therapeutic procedures in diverse medical disciplines . In a clinical study performed on 49 consecutive patients undergoing extracorporeal shock wave lithotripsy a 14.3% rate of bacteremia was detected during treatment . The bacterial spectrum consisted of gram-positive cocci, gram-negative cocci, Bacteroides capillosus and Proteus mirabilis . In principle, these results do not call for an antibiotic prophylaxis . Nevertheless, according to the recommendations of the American Heart Association and the Deutsche Gesellschaft fur Herz- und Kreislaufforschung, patients with a cardiac risk predisposing to bacterial endocarditis must receive perioperative antibiotic prophylaxis.

East Afr Med J, 1991 Sep, 68(9), 679 - 85
Otitis media in Sudanese children: presentation and bacteriology; Hussain MA et al.; Two hundred Sudanese children (105 males, 95 females) with otitis media (OM) were studied . Their age range was from 3 months to 15 years, with 41.5% being below 2 years of age . The presenting symptoms included ear discharge in 96% and pyrexia in 26.5% of patients . Ear ache and itching were reported in 22.5% and 7.0% respectively and impaired hearing in 7.0% . Bacterial pathogens were isolated from 115 (70.1%) of 164 cultures from children with chronic discharging ears . Organisms isolated in order of frequency were: Proteus species, Klebsiella with other coliforms, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli . Sixty of 84 (71.4%) cultures from children with acute OM grew pathogenic bacteria . Staphylococcus aureus and Klebsiella with other coliforms were the commonest pathogens . Proteus species and Pseudomonas aeruginosa were less frequent but beta-haemolytic Streptococcus, Streptococcus pneumoniae and Escherichia coli were the least common . Antibiotic sensitivity results show that the majority of isolates from children with discharging ears were sensitive to Gentamicin, followed by Co-trimoxazole and Streptomycin . The majority of organisms showed poor sensitivity to Ampicillin and Penicillin . The results of this study show that cotrimoxazole is the drug of choice for treating children with OMPIP: 200 Sudanese children (105 males, 95 females) with otitis media (OM) were studied . They ranged in age from 3 months-15 years, with 41.5% under the age of 2 . The presenting symptoms included ear discharge in 96% and pyrexia in 26.5% . Earache and itching were reported in 22.5% and 7.0%, respectively, and 7.0% experienced impaired hearing . Bacterial pathogens were isolated from 115 (70.1%) of 164 cultures from children with chronically discharging ears . Organisms isolated in order of frequency were: proteus species, Klebsiella with other coliforms, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli . 60 of 84 (71.4%) cultures from children with acute OM grew pathogenic bacteria . Staphylococcus aureus and Klebsiella with other coliforms were the most common pathogens . Proteus species and Pseudomonas aeruginosa were less frequent but beta-hemolytic Streptococcus, Streptococcus pneumoniae, and Escherichia coli were the least common . Antibiotic sensitivity results show that the majority of isolates from children with discharging ears were sensitive to Gentamicin, followed by cotrimoxazole and streptomycin . The majority of organisms showed poor sensitivity to ampicillin and penicillin . The results of this study show that cotrimoxazole is the drug of choice for the treatment of children with OM . author's modified

Fiziol Zh, 1991 Sep-Oct, 37(5), 81 - 7
{Experimental study of polyvalent proteus antigen immunogenicity}; Nazarchuk LV et al.; The experiments on 52 rabbits have been carried out to show the possibility to use Proteus antigen with high content of H-component (H1; H2; H3 Proteus antigens are most frequently found) for active immunization to make highly specific humoral immunity . The optimal scheme of immunization consists of 3 subcutaneous injections in doses of 0.25-0.25-0.5 mg of antigen within 7 days intervals and 0.25 mg dose of single revaccination . The duration of cycle immunization is 14 days.

Indian J Med Res, 1991 Sep, 93, 289 - 92
Induction of L-asparaginase synthesis in Vibrio proteus; Sinha A et al.; Studies on L-asparaginase synthesis in V . proteus showed increased synthesis in cultures grown under conditions of moderate aeration (P less than 0.005) after oxygen had been used up from the medium . Addition of sodium lactate to the medium at a concentration of 80 mu mole/ml, stimulated L-asparaginase synthesis (2.2 times over control) in moderately-aerated cultures (P less than 0.001) . The substrate L-asparagine induced enzyme synthesis when growth conditions were made anaerobic or lactate was incorporated into the medium (3.8 times increased enzyme synthesis over control).

Zh Mikrobiol Epidemiol Immunobiol, 1991 Sep, (9), 54 - 6
{An experimental study of a lactoglobulin preparation against opportunistic bacteria and salmonellae}; Soboleva SV et al.; A preclinical study of seven batches of lactoglobulin, a new biological preparation against opportunistic bacteria and salmonellae, has been carried out . High antibacterial activity of the preparation with respect to the virulent forms of Salmonella typhimurium, Salmonella enteritidis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus vulgaris, Proteus mirabilis has been established . The preparation has been shown to be safe and nontoxic . The 4-year term of its storage at a temperature of 6 degrees +/- 4 degrees C has been substantiated.

J Ethnopharmacol, 1991 Sep, 34(2-3), 235 - 46
Use of an Amoeba proteus model for in vitro cytotoxicity testing in phytochemical research . Application to Euphorbia hirta extracts; Duez P et al.; Amoeba proteus is proposed as a low-cost multi-purpose biochemical tool for screening and standardizing cytotoxic plant extracts with possible application in the laboratories of developing countries . Advantages and limitations of this test are examined and different mathematical treatments (probit analysis versus curve fitting to Von Bertalanffy and Hill functions) are investigated . Known anti-cancer (doxorubicin, daunorubicin, dacarbazine, 5-fluorouracil) and antiparasitic (emetine, dehydroemetine, metronidazole, cucurbitine, chloroquine) drugs were tested using this method and only metronidazole appeared inactive . Application of this model to Euphorbia hirta established that a 100 degrees C aqueous extraction of fresh aerial parts allows efficient extraction of active constituents and that drying the plant material before extraction considerably reduces activity.

Clin Chim Acta, 1991 Aug 30, 200(2-3), 107 - 17
Pyrophosphate inhibition of Proteus mirabilis-induced struvite crystallization in vitro; McLean RJ et al.; Struvite (MgNH4PO4.6H2O) crystals, the major mineral component of infectious urinary calculi, were produced in vitro by growth of a clinical isolate of Proteus mirabilis in artificial urine . P . mirabilis growth and urease-induced struvite production were monitored by phase contrast light microscopy and measurements of urease activity, pH, ammonia concentrations, turbidity, and culture viability . In the absence of pyrophosphate, struvite crystals appeared within 3-5 h due to the urease-induced elevation of pH and initially assumed a planar or 'X-shaped' crystal habit (morphology) characteristic of rapid growth . When pyrophosphate was present, initial precipitation and crystal appearance were significantly impaired and precipitates were largely amorphous . When crystals did appear (usually after 7 or 8 h) they were misshapen or octahedral in shape indicative of very slow growth . X-ray diffraction and Fourier transform infrared spectroscopy (FTIR) identified all crystals as struvite . Trace contaminates of carbonate-apatite (Ca10(PO4)6CO3) or newberyite (MgHPO4.H2O) were produced only in the absence of pyrophosphate . P . mirabilis viability and culture pH elevation were unaffected by the addition of pyrophosphate, whereas urease activity and ammonia concentrations were marginally reduced . Struvite could also be produced chemically by titration of the artificial urine with NH4OH . If pyrophosphate was present during titration, the same inhibitory effect on crystal growth occurred, so it is unlikely that urease inhibition is important . Lowering of pyrophosphate concentration from 13-0.45 mumol/l did not reduce its inhibitory activity so it is unlikely to act by chelating free Mg2+ . We propose that pyrophosphate inhibits struvite growth principally through direct interference with the chemical mechanisms involved in crystal nucleation and growth, because of its effectiveness at very low concentrations.

Eur J Biochem, 1991 Aug 15, 200(1), 195 - 201
Structural and immunochemical studies of O-specific polysaccharide of Proteus vulgaris 5/43 belonging to OX19 group (O-variants); Vinogradov EV et al.; O-specific polysaccharide was obtained on mild acid degradation of lipopolysaccharide of Proteus vulgaris 5/43 belonging to OX19 (O-variants) . It was found to contain D-glucose, 2-acetamido-2-deoxy-D-glucose, and 2-acetamido-2,6-dideoxy-L-glucose (QuiNAc, N-acetyl-L-quinovosamine) in the ratio of about 1:2:1, the last-named sugar being rather uncommon for bacterial antigens . A computer-assisted 13C-NMR-based analysis, methylation analysis, and selective cleavage with anhydrous hydrogen fluoride and dilute hydrochloric acid were applied for structural elucidation of the polysaccharide and the following structure was established:----2)-beta-D-Glcp-(1----6)-alpha-D-GlcpNAc-(1----3)- alpha-L-QuipNAc-(1----3)-beta-D-GlcpNAc-(1---- . Serological studies of the O-antigen and oligosaccharides derived therefrom revealed the importance of the trisaccharide fragment beta-D-Glcp-(1----6)-alpha-D-GlcpNAc-(1----3)-alpha-L- QuipNAc in manifesting the antigenic specificity . Serological cross-reactions were demonstrated between lipopolysaccharides of P . vulgaris 5/43, 8/44, and OX19 strains.

Eur J Cell Biol, 1991 Aug, 55(2), 262 - 71
Visualization and measurement of calcium transients in Amoeba proteus by fura-2 fluorescence; Gollnick F et al.; A fura-2 microspectrofluorimeter was used to visualize and measure intracellular calcium transients in normal locomoting and experimentally treated Amoeba proteus . The results show that subcellular heterogeneities of cytosolic free calcium, {Ca2+}i, correlate in time and distribution with characteristic patterns of protoplasmic streaming and ameboid movement . In detail, calcium ions have a dual effect by regulating both the contractile activities of the actomyosin cortex and the rheological properties of the cytoplasmic matrix . A high resting {Ca2+}i of 1.5 to 2.0 x 10(-7) M in the uroid region or in retracting pseudopodia is associated with the transformation of rigid ectoplasmic gel into fluid endoplasmic sol, and a low {Ca2+}i of 10(-9) to 10(-8) M in the front region or in extending pseudopodia with the re-transformation of endoplasmic sol into ectoplasmic gel . Locally increased peripheral {Ca2+}i accumulations higher than 10(-7) M are also observed at places where the actomyosin cortex is known to generate motive force by contraction, i.e., in the intermediate region of orthotactic amebas or in large pseudopodia of polytactic cells . External application of 30 mM KCl abolishes the intracellular Ca2+ gradient such that {Ca2+}i attains a uniform distribution and a maximum concentration of 2 x 10(-7) M; as a consequence, cells can show a transient loss of their locomotor activity and polarity by undergoing spherulation and total contraction . On the other hand, high external Ca2+ concentrations in the range of 100 mM stabilize the bipolar cellular organization, enhance the movement velocity and induce the propagation of Ca2+ waves repeatedly running from the uroid to the front region . The significance of external ions for signal transmission and the control of dynamic activities as well as the origin and fate of calcium participating in the observed transients are discussed.

J Am Acad Dermatol, 1991 Aug, 25(2 Pt 1), 205 - 21
Skin and bones . I; Orlow SJ et al.; Skin disorders in which a radiograph may detect associated bony changes or abnormalities of calcification are discussed . They are grouped into eight categories: (1) inherited diseases (e.g., alkaptonuria, neurofibromatosis); (2) congenital disorders (e.g., Sturge-Weber and Proteus syndromes); (3) inflammatory conditions (e.g., dermatomyositis, sarcoidosis); (4) infections (e.g., dental sinus, syphilis); (5) neoplasias (e.g., histiocytosis, mastocytosis); (6) drug- and environment-induced (e.g., acroosteolysis, retinoid toxicity); (7) calcinosis cutis; and (8) osteoma cutis . Part I of our review discusses the first two categories.

J Am Acad Dermatol, 1991 Aug, 25(2 Pt 2), 377 - 83
Proteus syndrome . Ultrastructural study of linear verrucous and depigmented nevi; Nazzaro V et al.; Proteus syndrome is a rare hamartomatous disorder characterized by multifocal overgrowths that can involve any structure of the body . Clinical manifestations include macrodactyly, hemihypertrophy, subcutaneous masses, exostosis, cerebroid thickening of palms and soles, and linear skin lesions . About 50 cases have been described, but the ultrastructural features of the linear skin lesions have not been characterized . We describe the clinical, histologic, and ultrastructural findings for a 30-year-old patient who had a mild form of Proteus syndrome with linear lesions characterized by a mixed pattern of hyperkeratosis and depigmentation . Light microscopy of the linear nevus showed acanthosis and hyperorthokeratosis . Electron microscopy revealed extensive vacuolation at the interface between melanocytes and keratinocytes, with large aggregations of densely packed granules in the intercellular space . Melanocytes showed only slight degenerative changes . An immunohistochemical study of the expression of epidermal growth factor receptors revealed no significant abnormalities.

Br J Urol, 1991 Aug, 68(2), 195 - 8
Clinical patterns of paediatric urolithiasis; Diamond DA; A series of 270 paediatric stone patients was studied retrospectively according to the clinical pattern of urolithiasis (age and sex, stone location, stone analysis, recurrence rate) and aetiology of stone disease (infection, anatomical, metabolic or idiopathic) . Infection stones occurred earliest and more commonly in males and were usually upper tract struvite calculi related to Proteus infection . Anatomical stones were most commonly associated with pelviureteric junction (PUJ) obstruction and had a high recurrence rate, despite surgical correction of obstruction . Idiopathic stones most resembled those found in adult urolithiasis by virtue of occurring latest, being sited in the ureter more often and being more frequently composed of calcium oxalate . Metabolic stones were most frequently calcium phosphate or cystine and virtually all were renal . They comprised the smallest group but had the highest recurrence rate.

Urology, 1991 Aug, 38(2), 145 - 51
Treatment of staghorn calculi with extracorporeal shock-wave lithotripsy and percutaneous nephrolithotomy; Gleeson M et al.; Between August 1983 and August 1987, 72 staghorn calculi were treated in 66 patients . Treatment was with percutaneous nephrolithotomy (PCNL) in 30, extracorporeal shock-wave lithotripsy (ESWL) in 18, combination PCNL-ESWL in 23, and nephrectomy in 1 . Complications occurred in 59 percent of patients and were twice as common after PCNL as after ESWL . Radiologic follow-up on 69 kidneys (97%) showed 58 percent were stone-free, 15 percent had residual sand or matchheads less than 5 mm, 17 percent had residual fragments of 5-15 mm, and 10 percent had greater than 15 mm residual stone burden . With a mean follow-up of thirty months, 2 of 40 stone-free patients had persistent asymptomatic Proteus urinary tract infections, and 4 of 22 patients with residual calculi less than or equal to 15 mm required additional operative treatment.

J Med Microbiol, 1991 Aug, 35(2), 107 - 10
An improved selective medium for the isolation of Escherichia coli O157; Chapman PA et al.; Sorbitol-MacConkey medium has become widely used for the isolation of verotoxigenic (VT+) Escherichia coli O157 . However, many organisms other than VT+ E . coli O157, especially other serogroups of E . coli and Proteus spp., may not ferment sorbitol, and thus may be confused initially with VT+ E . coli O157 . Rhamnose is not fermented by VT+ E . coli O157, but is by most sorbitol non-fermenting E . coli of other serogroups . Cefixime is a cephalosporin antibiotic that is more active against Proteus spp . than against E . coli . Inclusion of rhamnose and cefixime in sorbitol-MacConkey agar improves its selectivity for the isolation of VT+ E . coli O157.

J Bacteriol, 1991 Aug, 173(15), 4618 - 24
In vitro synthesis and O acetylation of peptidoglycan by permeabilized cells of Proteus mirabilis; Dupont C et al.; The synthesis and O acetylation in vitro of peptidoglycan by Proteus mirabilis was studied in microorganisms made permeable to specifically radiolabelled nucleotide precursors by treatment with either diethyl ether or toluene . Optimum synthesis occurred with cells permeabilized by 1% (vol/vol) toluene in 30 mM MgCl2 in in vitro experiments with 50 mM Tris-HCl buffer (pH 6.80) . Acetate recovered by mild base hydrolysis from sodium dodecyl sulfate-insoluble peptidoglycan synthesized in the presence of UDP-{acetyl-1-14C}N-acetyl-D-glucosamine was found to be radioactive . Radioactivity was not retained by peptidoglycan synthesized when UDP-{acetyl-1-14C}N-acetyl-D-glucosamine was replaced with both unlabelled nucleotide and either {acetyl-3H}N-acetyl-D-glucosamine or {glucosamine-1,6-3H}N-acetyl-D-glucosamine . In addition, no radioactive acetate was detected in the mild base hydrolysates of peptidoglycan synthesized in vitro with UDP-{glucosamine-6-3H}N-acetyl-D-glucosamine as the radiolabel . Chasing UDP-{acetyl-1-14C}N-acetyl-D-glucosamine with unlabelled material served to increase the yield of O-linked {14C}acetate, whereas penicillin G blocked both peptidoglycan synthesis and {14C}acetate transfer . These results support the hypothesis that the base-labile O-linked acetate is derived directly from N-acetylglucosamine incorporated into insoluble peptidoglycan via N----O transacetylation and not from the catabolism of the supplemented peptidoglycan precursors followed by subsequent reactivation of acetate.

Mol Microbiol, 1991 Aug, 5(8), 1975 - 82
Closely linked genetic loci required for swarm cell differentiation and multicellular migration by Proteus mirabilis; Allison C et al.; The pathogenic bacterium Proteus mirabilis exhibits a form of multicellular behaviour called swarming migration . This involves the differentiation of vegetative cells at the colony margin into swarm cells which are long, aseptate, multinucleate, hyper-flagellated filaments able to undergo repeated cycles of co-ordinated population migration and consolidation (reversion to vegetative cells) . Transposon mutagenesis of uropathogenic P . mirabilis strain U6450 with Tn5 generated 4860 chromosomal insertions and, of these, 75 (1.6%) caused visibly abnormal swarming behaviour, indicating that at least 45 genes are involved in directing motility, cell differentiation and multicellular behaviour . While about one fifth of the swarm-defective mutants lacked flagella and were non-motile non-swarming (NMNS) the majority were normally flagellated and motile but were unable to form swarm cells (motile non-swarming, MNS), or were motile and able to form swarm cells but displayed aberrant patterns of multicellular migration (dendritic swarming, DS) or consolidation (frequent and infrequent consolidation, FC and IC) . Restriction enzyme mapping of representative mutant DNAs by Southern hybridization with transposon DNA probes identified eight different mutated genetic loci within the five phenotypic classes . Subsequent Southern analysis of large restriction fragments separated by pulsed-field electrophoresis showed that these eight mutated loci required for motility, cell differentiation and multicellular migration were clustered on a region of DNA spanning approximately 8% of the 4.2 mbp P . mirabilis chromosome . Further linkage analysis showed that the DS locus involved in the ordered migration of the swarm cell population mapped separately from two main clusters of swarm loci, one cluster containing, within 112 kbp, genetic determinants of motility (NMNS) and also differentiation into swarm cells (MNS1, MNS2), and a second within a neighbouring 95 kbp DNA sequence containing three loci involved in the control of consolidation (FC, IC1, IC2).

Genetika, 1991 Aug, 27(8), 1410 - 22
{Control of genetic consequences of vaccinations: electron microscopic analysis of murine synaptonemal complexes}; Volgareva GM et al.; The ability of two inactivated bacterial vaccines, from Proteus vulgaris and Klebsiella pneumoniae, to injure synaptonemal complexes (SCs) was studied by means of electron microscopy . The preparations were given intraperitoneally to C57BL/6J male mice during five successive days and testes were fixed 24 h after the last injection . Cyclophosphamide was used for positive control . The vaccine from Klebsiella given at subtoxic dose, which was about 200 times higher that that given to people during vaccinations, induced the 10-fold rise in the frequency of SC abnormalities in murine 1-storger spermatocytes . Breaks of SCs and of single lateral elements of SCs predominated over other types of vaccine-induced anomalies . According to the preliminary data, vaccine from Proteus at subtoxic dose showed no damaging SC activity . The results of the given study are discussed in connection with the negative data obtained earlier when genotoxicity of these two vaccines had been studied in the Ames test, in routine investigations of bone marrow metaphases of vaccinated mice as well as under light microscopy of their SCs.

Nurs Stand, 1991 Jul 24-30, 5(44), 26 - 8
Chronic urinary catheter blockage; Kohler-Ockmore J; Catheter blockage is a common complication of long-term urinary catheterisation which causes distress to the patient and presents management problems for both nursing and medical practitioners . Jennifer Kohler-Ockmore's study aimed to investigate some of the factors which may cause catheter blockage and how they may be overcome . Fifty-four patients, resident in the community, were monitored over a period of six months . The findings revealed that patients were divided into two groups, those with and those without catheter blockage . The only factors identified which differentiated these patients were urinary pH and the incidence of proteus organisms in the urine . The presence or history of bladder stones was also noted among patients who presented with chronic episodes of blockage.

FEMS Microbiol Lett, 1991 Jul 15, 66(1), 101 - 5
Purification of a GSH-affinity binding protein from Bacteroides fragilis devoid of glutathione transferase activity; Piccolomini R et al.; An affinity binding protein from the cytosolic fraction of Bacteroides fragilis was purified by using epoxy activated-Sepharose 6B resin immobilized with GSH or with hexyl-GSH . This protein showed a subunit molecular mass (22 kDa) similar to that of glutathione transferase purified from Proteus mirabilis (22.5 kDa) . However, the affinity binding protein of Bacteroides fragilis, unlike the GSH-affinity binding protein of Proteus mirabilis, was devoid of the capacity to conjugate GSH to the most commonly used glutathione transferase substrates . The GSH-affinity binding protein of Bacteroides fragilis was also antigenically different from the GSH-affinity bound protein of Proteus mirabilis . It was concluded that the anaerobic microorganism is not able to express glutathione transferase even though it contains a GSH-affinity binding protein with a structural characteristic reminiscent of aerobic glutathione transferase.

J Bacteriol, 1991 Jul, 173(14), 4318 - 24
Evidence for N----O acetyl migration as the mechanism for O acetylation of peptidoglycan in Proteus mirabilis; Dupont C et al.; O-acetylated peptidoglycan was purified from Proteus mirabilis grown in the presence of specifically radiolabelled glucosamine derivatives, and the migration of the radiolabel was monitored . Mild-base hydrolysis of the isolated peptidoglycan (to release ester-linked acetate) from cells grown in the presence of 40 microM {acetyl-3H}N-acetyl-D-glucosamine resulted in the release of {3H}acetate, as detected by high-pressure liquid chromatography . The inclusion of either acetate, pyruvate, or acetyl phosphate, each at 1 mM final concentration, did not result in a diminution of mild-base-released {3H}acetate levels . No such release of {3H}acetate was observed with peptidoglycan isolated from either Escherichia coli incubated with the same radiolabel or P . mirabilis grown with {1,6-3H}N-acetyl-D-glucosamine or D-{1-14C}glucosamine . These observations support a hypothesis that O acetylation occurs by N----O acetyl transfer within the sacculus . A decrease in {3H}acetate release by mild-base hydrolysis was observed with the peptidoglycan of P . mirabilis cultures incubated in the presence of antagonists of peptidoglycan biosynthesis, penicillin G and D-cycloserine . The absence of free-amino sugars in the peptidoglycan of P . mirabilis but the detection of glucosamine in spent culture broths implies that N----O transacetylation is intimately associated with peptidoglycan turnover.

J Inorg Biochem, 1991 Jul, 43(1), 17 - 27
Palladium, platinum, cadmium, and mercury complexes with neutral isoorotic and 2-thioisoorotic acids: IR and NMR spectroscopies, thermal behavior and biological properties; Hueso-Urena F et al.; Seven complexes containing neutral isoorotic and 2-thioisoorotic acids, as well as thiocyanate and chloride anions as lignands, have been synthesized and characterized by means of both spectral (IR, 1H, and 13C NMR) and thermal (TG and DSC) methods, as well as conductivity measurements . Spectral data suggest that any binding metal-ligand mode for uracil derivatives is not easy to propose . Therefore, isoorotic ligands must link through some oxygen atom . Likewise, 2-thioisoorotic acid seems to be {N,S} bonded in Pd(II) and Pt(IV) complexes, whereas for Hg(II) complex a distorted tetrahedral HgCl2S2 structure has been proposed . In the cadmium complex, the metal ion exhibits a CdCl2O2 coordination sphere . Antimicrobial activities of the complexes against Pseudomonas sp, E . coli, Proteus sp, Salmonella sp, Micrococcus sp, Staphylococcus sp, Bacillus sp and Candida sp were performed as a previous step in the study of their biological activity.

Gaoxiong Yi Xue Ke Xue Za Zhi, 1991 Jul, 7(7), 369 - 75
{Diabetic foot infections: a preliminary report}; Tseng LN et al.; Foot infection is a common cause of hospitalization for diabetic patients . Our study aimed to analyze patients' age, sex, the primary sites of infection, presenting features, outcome, bacteriologic studies and their clinical significance in diabetic foot infections . The age of our diabetic patients with foot infections ranged from 43 to 82 years, with a mean of 62.5 years; fifty-two of them were males and twenty-eight were females . The male to female ratio was 1.9:1, but there was no statistically significant difference between the sexes (p greater than 0.05) . The commonest age group was the seventh decade of life (47.5%), followed by the sixth decade (32.5%) . The commonest primary site of infection was the toes (53.8%), followed by foot area other than toe (25%) and the leg area was the least frequent (21.2%) . Cellulitis combined with other foot lesions presented in 78.8% of these patients, foot ulcers in 75% of them, gangrenous change in 68%, necrotizing cellulitis or fasciitis in 16.3%, abscess formation in 12.5% and osteomyelitis in 7.5% . The legs were amputated in 53 patients (66.3%), usually below the knee (in 47.5%) . We found that patients with a long history of DM had statistically significantly higher rate of amputation (p less than 0.01) than patients with only a brief history . Bacterial cultures from the infected foot lesions yielded numerous organisms in 58.8% of cases and a single organism in 31.1% of cases . Proteus mirabilis was the commonest organism isolated, followed by E . coli, Pseudomonas aeruginosa . The commonest month of the onset of diabetic foot infection was January, followed by February.

APMIS, 1991 Jun, 99(6), 499 - 506
Properties of a deep Proteus R mutant isolated from clinical material; Krajewska-Pietrasik D et al.; Some biological features of a deep P . mirabilis 17301 R mutant isolated from the urine of a patient with chronic UTI were studied and compared with similar features of P . mirabilis S forms and five induced Proteus R mutants of different chemotypes . There were no differences in lethal toxicity and adhesion to human uroepithelial cells . Of all the R mutants tested, two of them, 17301 and R4, exhibited strong cell-bound hemolytic activity . The P . mirabilis R 17301 was characterized as the most invasive (tested in L929 mouse fibroblasts) compared to the other Proteus S and R forms . The structure of PS from a clinical R mutant investigated and the results of serological studies prove that this mutant belongs to the Rc chemotype.

Infect Immun, 1991 Jun, 59(6), 2036 - 42
Cytotoxicity of the HpmA hemolysin and urease of Proteus mirabilis and Proteus vulgaris against cultured human renal proximal tubular epithelial cells; Mobley HL et al.; Proteus mirabilis, a common agent of nosocomially acquired and catheter-associated bacteriuria, can cause acute pyelonephritis . In ascending infections, bacteria colonize the bladder and ascend the ureters to the proximal tubules of the kidney . We postulate that Proteus species uses the HpmA hemolysin and urease to elicit tissue damage that allows entry of these bacteria into the kidney . To study this interaction, strains of Proteus mirabilis and P . vulgaris and their isogenic hemolysin-negative (hpmA) or isogenic urease-negative (ureC) constructs were overlaid onto cultures of human renal proximal tubular epithelial cells (HRPTEC) isolated from kidneys obtained by immediate autopsy . Cytotoxicity was measured by release of soluble lactate dehydrogenase (LDH) . Two strains of P . mirabilis inoculated at 10(6) CFU caused a release of 80% of total LDH after 6 h, whereas pyelonephritogenic hemolytic Escherichia coli CFT073 released only 25% at 6 h (P less than 0.012) . Ten P . mirabilis isolates and five P . vulgaris isolates were all hemolytic and cytotoxic and produced urease which was induced by urea . The HpmA hemolysin is apparently responsible for the majority of cytotoxicity in vitro since the hemolysin-negative (hpmA) mutants of P . mirabilis and P . vulgaris were significantly less cytotoxic than wild-type strains . P . mirabilis WPM111 (hemolysin negative) was used to test the effect of urease-catalyzed urea hydrolysis on HRPTEC viability . In the presence of 50 mM urea, WPM111 caused the release of 42% of LDH versus 1% at 6 h in the absence of substrate (P = 0.003) . We conclude that the HpmA hemolysin of Proteus species acts as a potent cytotoxin against HRPTEC . In addition, urease apparently contributes to this process when substrate urea is available.

Nebr Med J, 1991 Jun, 76(6), 161 - 5
A microbiologic survey of long term care urinary catheters; Daly PB et al.; Culture and sensitivity data were collected on over 500 isolates from indwelling urinary catheters in 23 Nebraska long-term care facilities . Four percent of all nursing home patients had indwelling urinary catheters . The prevalence of bacteriuria in catheterized patients was 79%., and the most frequent isolates were E . coli, Proteus mirabilis, and Enterococcus species . Thirteen percent of catheterized patients were receiving systemic antibiotics, and 85% had at least one urinary bacterial isolate resistant to the antibiotic being administered . Antibiotic resistance correlated positively with a number of factors in the long-term care institutions, including size and skill level.

Can J Microbiol, 1991 Jun, 37(6), 419 - 24
Cell-free and cell-bound hemolytic activities of Proteus penneri determined by different Hly determinants; Lukomski S et al.; A collection of 45 Proteus penneri strains was characterized with respect to their hemolytic activity and representative cell-free or only cell-bound hemolysin possessing strains were chosen for further study . Extracellular Proteus penneri hemolysin, which was investigated earlier by hybridization, reacted with monospecific antiserum against alpha-hemolysin of Escherichia coli . In this paper we also show, using the colony hybridization technique, that the alpha-hemolysin-like determinant is widely distributed among Proteus penneri strains . Because one of the strains tested, which expressed a high activity of cell-bound hemolytic factor, did not carry such a Hly determinant, the presence of a second hemolysin is postulated . We cannot demonstrate any difference in hybridization patterns of alpha- and beta-hemolytic Proteus penneri strains and accumulation of the toxin molecule inside the cells was also not observed . The existence of another control mechanism, external to the hly operon, for hemolysin gene is suggested.

Antibiot Khimioter, 1991 Jun, 36(6), 21 - 5
{The use of ampicillin/sulbactam (Unasyn) in treating inflammatory urological diseases}; Perepanova TS et al.; Unasyn is a combination of ampicillin, a bactericidal antibiotic, and sulbactam, an inhibitor of beta-lactamases . It was used in treatment of 36 patients with urogenital infections . The combination was administered intravenously and in the main intramuscularly . The treatment course amounted to 7-10 days . The average daily dose was 6 to 9 g . 22 patients with acute nonocclusive pyelonephritis were treated with the combination and its clinical and bacteriological efficacy was stated in 95 per cent of the cases . An excellent clinical effect of the combination was observed in 6 patients with acute epididymitis . A clinical improvement was also observed in the treatment of the patients with acute prostatitis and chronic renal infections . Unasyn proved to be a highly efficient antibacterial combination with regard to gram-positive flora and colon bacilli as representatives of gram-negative organisms . Satisfactory results were also stated in the treatment of infections caused by Proteus spp . Complete elimination of the pathogen was achieved in 57.7 per cent of the cases . No adverse reactions to Unasyn except pain in the site of the injection were recorded.

Zh Mikrobiol Epidemiol Immunobiol, 1991 Jun, (6), 50 - 2
{The mutagenicity of a new multicomponent vaccine made from the antigens of Klebsiella pneumoniae, Staphylococcus aureus, Proteus vulgaris and Escherichia coli}; Volgareva GM et al.; Inactivated bacterial vaccine, containing K . pneumoniae, S . aureus, P . vulgaris and E . coli antigenic complexes were tested for mutagenicity in the test described by Ames et al . and in vivo, in experiments on mice . In Salmonella typhimurium cells, strain TA-98 and TA-100, the preparation (5-75 mg/ml) did not increase the frequency of reversions and histidine-independence either in direct experiments or after metabolic activation with rat liver homogenate . In experiments on mice the vaccine (3.3 mg/kg and 33 mg/kg) did not induce chromosomal anomalies in spermatogonia . In all experiments the mutagens used for positive control produced a mutagenic effect.

J Chromatogr, 1991 May 24, 545(1), 189 - 95
Use of chromatofocusing for separation of beta-lactamases . IX . Analytical chromatofocusing for the separation of a chromosomal cephalosporinase from Proteus vulgaris 1028; Gal S et al.; Simultaneous purification and isoelectric point (pI) determination was carried out at analytical scale of the chromosomal cephalosporinase from the Proteus vulgaris 1028 strain . Comparison of the enzyme to the purification results with m-aminophenylboronic acid-agarose affinity chromatography with sodium dodecyl sulphate-polyacrylamide gel electrophoresis revealed that minute amounts of accompanying proteins having identical pI values but different molecular masses were found in the chromatofocused preparation . The molecular mass of the enzyme was 24,000 dalton . The pI was found to be 8.3.

Vet Rec, 1991 May 11, 128(19), 440 - 2
Bacterial flora of the uterus of cows after calving on two hygienically contrasting farms; Noakes DE et al.; Intrauterine swabs were obtained from cows after calving on two commercial dairy herds with contrasting hygienic environments and incidence of leucorrhea, and cultured aerobically and anaerobically . Of 26 cows with a normal calving and puerperium, eight of 14 (57 per cent) were sterile on farm B where hygiene was poor, compared with five of 12 (42 per cent) on farm A where hygiene was better . Two cows on farm B retained their placentas and subsequently developed metritis/endometritis . Actinomyces pyogenes was the commonest bacterial isolate and Fusobacterium nucleatum, Proteus mirabilis and Bacteroides melaninogenicus were also frequently observed . Similar isolates were obtained from cows on farm B with parturient or puerperal disorders . The contrasting hygienic environments had no influence on either the quantitative or qualitative uterine bacterial flora . Thus, the difference in the incidence of endometritis must have been due to factors other than hygiene.

Br J Surg, 1991 May, 78(5), 617 - 9
Groin wound infection after arterial surgery; Newington DP et al.; Fifty-six patients, 30 with superficial and 19 with deep groin wound infections, and seven with lymph fistulae with positive cultures within 30 days of arterial surgery, were identified after 661 operations (873 groins at risk) between September 1984 and August 1988 . The commonest infecting organisms were Staphylococcus aureus, Pseudomonas aeruginosa and Proteus spp . In 33 patients the infection settled completely after treatment with culture specific antibiotics . These were given intravenously then orally for up to 6 weeks . Sixteen patients required debridement and excision of necrotic wound edges, including one who had an antibiotic infusion into the wound . Graft excision was performed in seven patients of whom five received an extra anatomic bypass . The need for graft excision was much greater (six versus one) for Dacron and/or polytetrafluoroethylene than for vein . In two lymph fistulae sartorius transposition and wound resuture were used . All groins healed, though three extremities were ischaemic following occlusion of the bypass . There were two deaths, one from myocardial infarction and one from pulmonary embolism and no major amputations . These results suggest that most infective groin problems may be successfully managed conservatively and that radical graft excision is only necessary for a few intractable cases.

Carcinogenesis, 1991 May, 12(5), 943 - 6
Increased urinary nitrosamine excretion in paraplegic patients; Tricker AR et al.; An increased risk of bladder cancer is a recognized complication in spine-injured patients undergoing long-term urethral catheterization to preserve renal function . Aerobic cultures from 28 of 30 paraplegic patients showed complex bacterial flora containing nitrate-reducing organisms (Escherichia coli, Proteus and Klebsiella spp.) . Urine samples from 29 paraplegic patients were also found to contain volatile nitrosamines . Mean N-nitrosamine excretion levels were 0.65 +/- 0.69 micrograms/day N-nitrosodimethylamine, 0.25 +/- 0.44 micrograms/day N-nitrosopiperidine and 0.39 +/- 0.50 micrograms/day N-nitrosopyrrolidine . A mean urinary nitrite excretion of 10.4 +/- 13.2 mg/day was found in 24 out of 30 paraplegic patients . In the sterile urine of control volunteers (medical staff attending the paraplegic patients and in-patients from other wards of the hospital), no urinary excretion of volatile N-nitrosamines and nitrite was found . The results clearly demonstrate a bacterially mediated in vivo formation of N-nitroso compounds in the urinary tracts of paraplegic patients which may be an important etiological risk factor for bladder cancer in this patient group.

Paraplegia, 1991 May, 29(4), 222 - 32
Intermittent urethral self-catheterisation: long term results (bacteriological evolution, continence, acceptance, complications); Kuhn W et al.; Forty six (9%) out of 520 patients from the years 1976 to 1982 who used intermittent urethral self-catheterisation (IUSC) as the method of bladder drainage at the moment of discharge from the Swiss Paraplegic Centre of Basel were analysed during their rehabilitation period, on discharge, 3, 6 months later and again 5 years later regarding bacteriological changes and urinary tract infections, behaviour of some problem germs such as Proteus, Klebsiella and Pseudomonas, sterile versus clean catheterisation, catheterisation frequency, complications, continence and acceptance of this method . Only 22 patients continue IUSC, 5 have died, 6 use indwelling catheters and 13 are voiding their neurogenic bladder with other methods . Average time on IUSC was 6.6 years (0.5-13 years) in the women's group and 4.6 years (0.5-12 years) in the men's group . Of the remaining 22 patients on IUSC, 23% have sterile urines, 36.5% are infected with E . coli and Enterococci, 4.5% with Staphylococci and the remaining 36% still show the problem germs Pseudomonas (4.5%), Proteus (13.5%) and Klebsiella (18%), but there was a reduction from 19 cases with problem germs in 1983 to 11 cases in 1988 . In 1988 5% women and 4% men changed from sterile to clean IUSC (2 out of 11 men using the same catheter for at least 1 week and 2 out of 10 women) . The complication rate was astonishingly low during IUSC: being only 4.3% (2 male patients, one with stricture of the urethra and epididymitis, one with autonomous dysreflexia with bladder overdistension) . No anti-cholinergic or alpha-stimulating agents were used nor continuous antibiotic-prophylaxis and only in one female patient was a bladder denervation procedure performed . No deterioration of the upper urinary tract was observed . The degree of continence remained stable throughout the follow-up, and the same applies to the acceptance of IUSC . The authors conclude that IUSC can be of great help in neuropathic bladder rehabilitation provided that the patients are properly selected, motivated and well instructed and followed throughout the years.

Vrach Delo, 1991 May, (5), 35 - 8
{Dynamic anti-Proteus immunity in plasma donors during plasmapheresis}; Nazarchuk LV et al.; A study is presented of homeostasis in 18 volunteer donors after immunisation with Proteus vaccine and in the dynamics of subsequent plasmapheresis for 12 months . It was shown that as a result of anti-Proteus immunisation there occurs an increase of the titer of anti-Proteus antibodies in the blood serum which was maintained at a high level in the course of plasmapheresis for three months . Indices of the peripheral blood, urine, liver function, humoral unspecific and cellular immunity were within normal levels . The blood of donors immunized with Proteus vaccine is a source of obtaining anti-Proteus plasma--an immune allogenous preparation for complex treatment of patients with severe forms of diseases of Proteus etiology.

Exp Lung Res, 1991 May-Jun, 17(3), 547 - 58
Suppression and recovery of the alveolar macrophage phagocytic system during continuous exposure to 0.5 ppm ozone; Gilmour MI et al.; Short-term exposures to ozone (O3) are known to impair pulmonary antibacterial defenses and alveolar macrophage (AM) phagocytosis in a dose-related manner . To determine the effect of prolonged O3 exposure, Swiss mice were exposed continuously to 0.5 ppm O3 . At 1, 3, 7, and 14 days, intrapulmonary killing was assessed by inhalation challenge with Staphylococcus aureus or Proteus mirabilis and by comparing the number of viable bacteria remaining in the lungs at 4 h between O3-exposed and control animals . To evaluate the effects of O3 on the functional capacity of the AMs, Fc-receptor mediated phagocytosis was assessed . Ozone exposure impaired the intrapulmonary killing of S . aureus at 1 and 3 days; however, with prolonged exposure, the bactericidal capacity of the lungs returned to normal . This trend of an initial suppression followed by recovery was reflected in the phagocytic capacity of the AMs . In contrast to S . aureus, when P . mirabilis was used as the challenge organism, O3 exposure had no suppressive effect on pulmonary bactericidal activity, which correlated with an increase in the phagocytic cell population in the lungs . Morphologic examination of the lavaged macrophages showed that after 1 day of O3 exposure, the AMs were more foamy, and contained significantly more vacuoles . There was also a significant increase in binucleated cells at 3 days . These studies demonstrate that continuous exposure to O3 modulates AM-dependent lung defenses and points to the importance of the challenge organism and exposure protocol in establishing the adverse effect of O3.

Cesk Epidemiol Mikrobiol Imunol, 1991 May, 40(3), 129 - 36
{Classification of sensitive and resistant strains based on the degree of antibiotic growth inhibition}; Urbaskova P et al.; The course of growth suppression of sensitive strains depends on the type of antibiotic . Based on the kinetics of the early growth phase in the microculture when the inoculum is relatively concentrated it is possible to divide in the presence of the antibiotic the Gram negative fermenting rods into sensitive and resistant strains already within five hours . Data obtained by automated photometric assessment at selected intervals were processed by the aggregation method using a block distance as the coefficient of similarity . Ampicillin, ticarcillin, gentamicin, tetracycline and colistin readily discriminate sensitive and resistant strains, consistent with the minimal inhibitory concentration . Cefazolin, cefoxitin and chloramphenicol differentiate readily sensitive strains . Slowly growing sensitive strains of Proteus mirabilis and Serratia marcescens may appear to be resistant.

Tidsskr Nor Laegeforen, 1991 Apr 20, 111(10), 1230 - 2
{Neonatal conjunctivitis in a nursery and a neonatal unit}; Solberg R et al.; After Crede prophylaxis was abandoned at our hospital in 1984 scrupulous clinical surveillance of all neonates for conjunctivitis, and bacterial cultures from purulent eye discharge, have become routine . During the two-year period 1 March 1987 to 28 February 1989, testing for Chlamydia trachomatis (EIA-technique) was added in all infants with clinical conjunctivitis . During the period concerned there were 332 cases of conjunctivitis among 4,520 live born infants, an incidence of 7.3% . The incidence was higher for infants staying in the nursery (8.2%) than for those admitted to the neonatal unit (3.5%) (p less than 0.01) . 90% of the infections were diagnosed during the first week of life . 468 isolates were identified by routine bacteriological investigation, 452 gram-positives (96.6%), and 16 gram-negatives (3.4%) . The following strains were found: Staphylococcus aureus 171 (51.5% of the patients), Staphylococcus epidermidis 153 (46.1%), Streptococcus viridans 106 (31.9%), diphteroids 11 (3.3%), beta-hemolytic streptococci seven (2.1%), Streptococcus pneumoniae two (0.6%), enterococci two (0.6%), Hemophilus influenzae six (1.8%), Escherichia coli five (1.5%), Proteus two (0.6%) and Branhamella catarrhalis one (0.3%) . Not a single case of gonococcal ophthalmia was diagnosed . Positive tests for Chlamydia were found in 13 infants (3.9% of all infants with conjunctivitis), an incidence of 0.3% for the whole population of live born infants . Six of the chlamydia infections (46%) occurred within the first week of life . Expenses for chlamydia testing were estimated to be NOK 1,020 per positive test . Preventing conjunctivitis in our nursery and neonatal unit calls for strategies to protect newborn infants from colonization with pathogenic bacteria, especially S . aureus.(ABSTRACT TRUNCATED AT 250 WORDS)

Eur J Biochem, 1991 Apr 10, 197(1), 93 - 103
The structure of the O-specific polysaccharide chain of Proteus penneri strain 16 lipopolysaccharide; Vinogradov EV et al.; O-Specific polysaccharide was obtained by mild acid degradation of Proteus penneri strain 16 lipopolysaccharide and found to contain D-glucose, D-glucuronic acid, 2-acetamido-2-deoxy-D-glucose, and 3,6-dideoxy-3-{(R)-3-hydroxybutyramido}- D-galactose in the ratio of 2:1:1:1 as well as a small proportion of O-acetyl groups . On the basis of one-dimensional 1H-NMR13C-NMR and NOE spectroscopy, two-dimensional homonuclear-shift-correlated spectroscopy with one-step and two-step relayed coherence transfer and heteronuclear 1H/13C NMR shift-correlated spectroscopy, it was concluded that the O-specific polysaccharide of P . penneri strain 16 has the following structure: (formula; see text) This structure was confirmed by methylation analysis and structural analysis of a linear tetrasaccharide fragment prepared by cleavage of the polysaccharide with anhydrous hydrogen fluoride followed by conversion of the alpha-tetrosyl fluoride obtained in to the corresponding free oligosaccharide and alditol . O-Acetyl groups were tentatively located at position 3 of the glucuronic acid residue and at position 4 of the 6-substituted glucose residue, the degree of acetylation being less than 20% of the total . Cross-reactions of P . penneri strain 16 anti-(O-specific polysaccharide) antiserum with lipopolysaccharides from several other Proteus strains and the role of 3,6-dideoxy-3-(R)-3-hydroxybutyramido-D-galactose in the serological specificity of P . penneri strain 16 are discussed.

Biochim Biophys Acta, 1991 Apr 8, 1077(2), 141 - 6
Purification and characterization of a novel glutathione transferase from Serratia marcescens; Di Ilio C et al.; Four forms of glutathione transferase were resolved from the cytosol of Serratia marcescens CIP 6755 by GSH-affinity chromatography followed by isoelectric focusing . The major isoenzyme, named Sm-GST-7.3, is composed of two subunits each with a molecular mass of 22 kDa and has an isoelectric point at pH 7.3 . Sm-GST-7.3, appears to be distinct from Pm-GST-6.0, previously characterized from Proteus mirabilis AF 2924 as indicated by its substrate specificity, immunological reactivity, subunit molecular mass as well as by its N-terminal amino acid sequence . None of the antisera raised against a number of human, rat and mouse GSTs cross-reacted with Sm-GST-7.3 indicating major structural differences between them and bacterial GST . This is further supported by the fact that the N-terminal sequence of Sm-GST-7.3 also differs significantly from the known sequences of mammalian GSTs of alpha, mu and pi classes . In addition, comparison with the known N-terminal amino acid sequences of helminth, plant and insect GSTs demonstrate that the latter enzymes are distantly related (less than 25% identity) to the Sm-GST-7.3 . Immunoblotting experiments performed with antisera raised against Sm-GST-7.3 indicate that a GST immunologically identical to Sm-GST-7.3 is present in a number of other bacterial strains . All together the results obtained suggest that Sm-GST-7.3 is distinct from any known GST, including microbial and mammalian GSTs.

Chem Pharm Bull (Tokyo), 1991 Apr, 39(4), 894 - 6
Evaluation of effects of novel urease inhibitor, N-(pivaloyl)glycinohydroxamic acid on the formation of an infection bladder stone using a newly designed urolithiasis model in rats; Satoh M et al.; By using our new infection stone model of a rat, we evaluated the effect of a novel urease inhibitor, N-(pivaloyl)glycinohydroxamic acid (P-GHA), on the formation of an infection bladder stone . The oral dosing of P-GHA significantly inhibited the elevation of the urinary ammonia level of rats having the urinary tract infection with Proteus mirabilis . A short term regimen (7 d, 730 +/- 38 mg/kg) with P-GHA significantly inhibited the development of the infection bladder stone . Furthermore, a long term combination regimen (11 d) of P-GHA and aminobenzylpenicillin markedly inhibited the development of the infection bladder stone, and also caused a very slight renal impairment to the rats tested in contrast with the method of Vermeulen et al . Our infection stone model in rats, therefore, seems to be useful for the evaluation of therapeutic agents in long term examinations.

Antibiot Khimioter, 1991 Apr, 36(4), 26 - 8
{Sodium sulfapyridazine in new delayed-action bases for the treatment of bacterial conjunctivitis}; Maichuk IuF et al.; Possible preparation of 10 per cent sodium sulfapyridazine ophthalmic drops containing aubazidan, a microbial polysaccharide, providing prolongation of the drops action and stability on the storage was studied . The pharmacokinetic studies showed that aubazidan which is a natural polymer provided high prolongation of the sulfapyridazine effect in the tissues of the anterior part of the eye in rabbits . The prolonged effect was similar to the previously observed effect of the solutions containing synthetic polymers such as 1 per cent polyacrylamide and polyvinyl . Satisfactory tolerance by the rabbit eye tissues of 6-fold daily instillations of the 10 per cent sodium sulfapyridazine solution with aubazidan for the observation period of 1 month was stated . When stored in vials the 10 per cent sodium sulfapyridazine ophthalmic drops with 0.5 per cent of aubazidan preserved the stability for 24 months with respect to the colour, transparency, viscosity, pH and drug content . It was demonstrated with using the agar diffusion method and Staphylococcus aureus, Proteus vulgaris, Escherichia coli and Pseudomonas aeruginosa as the test cultures that sodium sulfapyridazine completely preserved its antimicrobial activity in the presence of aubazidan . The data suggested that clinical trials of the 10 per cent sodium sulfapyridazine solution with 0.2-0.5 per cent of aubazidan were promising in prevention and therapy of bacterial conjunctivitis.

J Chemother, 1991 Apr, 3(2), 121 - 5
Intravenous ciprofloxacin for the treatment of severe infections; Santini C et al.; Intravenous ciprofloxacin at a daily dosage of 400 mg divided in two doses was administered to 19 patients with severe infections caused by ciprofloxacin-susceptible bacteria . These infections included: 11 surgical would infections, 5 soft tissue infections, 2 respiratory tract infections, 1 urinary tract infection . The offending pathogens were: 8 coagulase-negative staphylococci, 3 Staphylococcus aureus, 3 Pseudomonas aeruginosa, 2 Proteus spp., 1 Escherichia coli, 1 Branhamella catarrhalis, 1 Klebsiella ozenae and 1 Serratia liquefaciens . Overall, 17 of 19 infections (89%) showed a satisfactory clinical response to trial therapy (15 cures and 2 improvements) . Microbiological eradication was observed in 17 out of 20 isolated pathogens . Emergence of resistance to ciprofloxacin occurred in 1 coagulase-negative Staphylococcus and was associated with clinical failure . No side effects were observed . We conclude that intravenous ciprofloxacin may represent efficacious and safe therapy of severe infections; however close microbiological monitoring seems to be necessary to evaluate the emergence of resistance during quinolone therapy.

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