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 immuno