Arch Esp Urol, 1991 Apr, 44(3), 293 - 6 {Renal abscess . Medical treatment}; Ochoa Urdangarain O et al.; We report a case of renal abscess caused by gram negative pathogens, possibly Proteus mirabilis, that resolved with medical treatment . The infection was secondary to a purulent infection in the patient's left knee. Vet Med (Praha), 1991 Apr, 36(4), 213 - 23 {The effect of selected antibiotics on microorganisms contaminating boar ejaculate}; Mazurova J et al.; The occurrence of microorganisms, including their total counts in boar native ejaculates, was investigated in two stages; the objective of this investigation also was to determine contamination after the sperms were treated with diluents containing the antibiotics ampicillin, gentamycin, apramycin, cefoxitin, or antibiotic combinations penicillin + streptomycin, ampicillin + cefoxitin, gentamycin + cefoxitin and ampicillin + gentamycin . The representation of bacterial species and total counts of microbes in 1 ml diluted sperm stored at a temperature of about 18 degrees C were determined in 24, 48 and 72 h after dilution . The microorganisms were cultivated from all native ejaculates . Proteus sp . (63.3%) and Pseudomonas aeruginosa (51.5% of the total number of examined samples) were the most frequent species . The number of contaminated diluted ejaculates ranged from 12.5 to 95.8% in 24 h after dilution, from 12.5 to 98.5% in 48 h and from 16.8 to 95.8% of the total number of examined ejaculates in 72 h . The occurrence of microorganisms correlated mostly with the efficiency spectrum of the antibiotics or their combinations . The average counts of microorganisms in 1 ml of native ejaculate made 2,363,000 in stage I and 1,472,108 in stage II . The highest average counts in 1 ml of diluted sperm were found in ejaculates containing cefoxitin and apramycin . Gentamycin was the most effective antibiotic used as a sole component (average counts of microorganisms CPM in 1 ml were 416 in 24 h, 955 in 48 h and 2260 in 72 h after dilution); ampicillin and gentamycin were the most efficient combination (14--20--21) . This combination exerted very good effects also on Proteus sp . and Pseudomonas aeruginosa. Indian J Pathol Microbiol, 1991 Apr, 34(2), 81 - 7 Bacteriology of diabetic foot ulcers; Ramani A et al.; Seventy five diabetic foot ulcers were cultured using optimal aerobic and anaerobic microbiologic techniques . There were a total of 223 isolates (162 aerobes and 61 anaerobes) representing an average of 2.97 bacterial species per specimen . Mixed organisms were the most common isolates . Staphylococcus aureus was the commonest isolate being recovered in 60% of cases . Anaerobic organisms were isolated in 46 patients (61.33%) and the most frequent anaerobe isolated was Bacteroides fragilis . The other organisms predominantly isolated were Proteus, Klebsiella, Pseudomonas, Peptoccus and Clostridia . Antibiogram showed discouraging pattern with commonly used antibiotics . Metronidazole and gentamicin were the most effective antimicrobial agents against anaerobic and aerobic organisms respectively . Appreciation of the causative organisms in diabetic foot and their antibiotic sensitivity is essential for institution of appropriate antibiotic therapy. Can J Microbiol, 1991 Apr, 37(4), 325 - 8 Antigenic and immunogenic activity of flagella and fimbriae preparations from uropathogenic Proteus mirabilis; Legnani-Fajardo C et al.; The antigenic and immunogenic activities of fimbriae and flagella from three uropathogenic strains of Proteus mirabilis were compared . Flagella were obtained by mechanical treatment and fimbriae were isolated from cells by heat shock, ammonium sulfate precipitation, sodium deoxycholate and urea treatment, and gel filtration . Both preparations inoculated to mice demonstrated high antigenicity . Titers up to 1:80,000 were determined by an enzyme-linked immunosorbent assay either against the homologous or heterologous strains . When immunized mice were challenged with homologous or heterologous hematogenous infecting doses, a good cross protection was achieved only when fimbriae were used as antigens . Cross-reactivity found between the three fimbriae antisera, and the presence of common proteins in sodium dodecyl sulfate polyacrylamide gel electrophoresis patterns of fimbriae, should validate the study of these proteins to determine the existence of a shared adhesin. Biochimie, 1991 Apr, 73(4), 375 - 84 The recA-recBCD dependent recombination pathways of Serratia marcescens and Proteus mirabilis in Escherichia coli: functions of hybrid enzymes and hybrid pathways; Rinken R et al.; The physical maps of cloned recBCD gene regions of Serratia marcescens and Proteus mirabilis were correlated to genes located in this region . The genes thyA, recC, recB, recD and argA were organized as in Escherichia coli . The 3 rec genes code for the 3 different subunits of the RecBCD enzyme and produced enzymes promoting recombination and repair of UV damage in E coli . The recBCD-dependent stimulation of recombination at specific nucleotide sequences called Chi (Chi-activation) was determined in lambda red-gam-crosses . Chi-activation by the different RecBCD enzymes decreased in the order E coli greater than S marcescens greater than P mirabilis . In E coli cloned subunits genes from S marcescens and P mirabilis led to the formation of functional hybrid enzymes consisting of subunits from 2 or even 3 species . The origin of the RecC subunit present in the hybrid enzymes affected the degree of Chi-activation . Further, changes in Chi-activation occurred when the RecD subunit in the enzyme from E coli was replaced by RecD proteins from S marcescens or P mirabilis . This suggested that the RecD subunit determines not only whether or not Chi-activation is possible but also to which extent it occurs . Finally we have reconstituted recombination pathways of S marcescens and P mirabilis by combining the cloned recA and recBCD genes from these species in E coli deleted for recA and recBCD . Both pathways can efficiently promote recombination and repair . Studies are summarized which showed that levels of repair and recombination promoted by the recA-recBCD genes are mostly higher when the recA and recBCD genes came from the same species than from 2 different species (hybrid RecBCD recombination pathway) . The data are interpreted to provide evidence that in vivo the RecA protein co-operates with the RecBCD enzyme in recombination and repair of UV damage. Biochem Biophys Res Commun, 1991 Mar 15, 175(2), 387 - 93 Dihydrotetramethylrosamine: a long wavelength, fluorogenic peroxidase substrate evaluated in vitro and in a model phagocyte; Whitaker JE et al.; Dihydrotetramethylrosamine, a fluorogenic substrate for peroxidase, and its fluorescent oxidation product, tetramethylrosamine chloride, were evaluated . The substrate is colorless and nonfluorescent while the oxidized dye absorbs at 550 nm and emits at 574 nm in both methanol and water . In vitro assays demonstrated that the substrate was oxidized to the fluorophore by horseradish peroxidase in the presence of hydrogen peroxide . In vivo uptake and oxidation of the substrate by Amoeba proteus was characterized by the initial appearance of fluorescent phagocytic vacuoles with subsequent localization in vesicular organelles the size and shape of protozoan mitochondria . Similar staining patterns occurred in cells incubated with substrate, oxidized rosamine or rhodamine 123, a known mitochondrial stain. Klin Monatsbl Augenheilkd, 1991 Mar, 198(3), 190 - 4 {Postoperative infections in systemic immunocompromising diseases . A study of 6 patients}; Bialasiewicz AA et al.; Advances of therapeutic strategies in the management of critically ill patients have resulted in an increased life expectancy and more frequent presentations to ophthalmic surgeons . Six patients with postoperative endophthalmitis after elective intraocular surgery suffering from Sharp-syndrome, metastasizing antrum carcinoma, granulomatous vasculitis and immunosuppressive therapy, agranulocytosis, silico-tuberculosis and chronic lymphatic leukemia revealed traditionally pathogenic agents (Proteus mirabilis, P . aeruginosa, enterococci, coagulase-negative Staph) . Two patients had to be enucleated, one turned blind and three had a visual acuity 5/100 to 20/60 . In our hands prognosis for successful therapy in immunodeficient patients seems worse than in otherwise healthy persons . Painstaking evaluation of history, medical work-up, conjunctival swabs and application of bactericidal topical antibiotics preoperatively and perioperatively are particularly important in these patients. Hautarzt, 1991 Mar, 42(3), 186 - 8 {Proteus syndrome}; Maassen D et al.; Proteus syndrome is a rare congenital disorder in which the major clinical manifestations are skeletal deformities and hamartomatous tumors . The case of a 42-year-old woman with right hemihypertrophy, macrodactyly of the right hallux, extreme kyphoscoliosis and bilateral plantar connective tissue naevi is reported . Proteus syndrome is reviewed with reference to this patient. Eur J Epidemiol, 1991 Mar, 7(2), 159 - 65 Characterization of cell-bound and cell-free hemolytic activity of Proteus strains; Kaca W et al.; The relationship between growth condition and production of cell-bound hemolysin by Proteus mirabilis S1959 strain was investigated . Hemolytic activity was not dependent on type of medium, oxygen accessibility and was inhibited in presence of N-ethylmaleimide, different sera or trypsine . Cell-free hemolysin was released to the medium during stationary-death phases of growth of fluid Proteus mirabilis and vulgaris cultures. Mikrobiol Zh, 1991 Mar-Apr, 53(2), 59 - 62 {Induced bacterial chemiluminescence}; Zhiliaev NI et al.; Oxygen-peroxide-induced superweak luminescence of some microorganisms has been studied by means of the native chemiluminometer KhLM1Ts-01 . It is established that total chemiluminescence decrease in the bacteria as follows: Escherichia coli----Bacillus subtilis----Proteus vulgaris----Bacillus mycoides----B . licheniformis----Pseudomonas aeruginosa----Staphylococcus epidermidis----S . aureus----Serratia marcescens----Salmonella enteritidis . A hypothesis is put forward on a possible mechanisms of appearance of the superweak luminescence of bacteria and expediency to use chemoluminometry to differentiate microorganisms. Rev Clin Esp, 1991 Mar, 188(5), 246 - 8 {Septic pulmonary embolism, bacterial endocarditis and endocavitary pacemaker}; Gil J et al.; The number of patients carrying an endocavitary pacemaker is increasing every day . The presence of a foreign body in right cavities predisposes to the formation of thrombi that can be over infected from distal septic focci usually silent . When a pulmonary embolism is diagnosed in these patients, the initial study must include an echocardiographic exam in order to rule out the presence of an intracardiac thrombosis as the origin of the emboli . We present the case of a patient with and endocardiac pacemaker who was admitted with fever and repeated episodes of pulmonary embolism . Hemocultures were positive for proteus mirabilis and a electrocatheter thrombosis was demonstrated in bidimensional echocardiography . Proteus mirabilis was positive in cultures from the material obtained by cardiothomy and clinical evolution after surgery was satisfactory. Infection, 1991 Mar-Apr, 19(2), 106 - 9 Comparative in vitro activities of amoxicillin-clavulanate, ampicillin-sulbactam and piperacillin-tazobactam against strains of Escherichia coli and proteus mirabilis harbouring known beta-lactamases; Gatermann S et al.; Strains of Escherichia coli (N = 124) and Proteus mirabilis (N = 29) harboring known beta-lactamases were analyzed as to their susceptibility to ampicillin, amoxicillin, and piperacillin alone and in combination with sulbactam, clavulanate, and tazobactam . With TEM 1-producing E . coli, a correlation between specific beta-lactamase activity and the MIC of piperacillin and ampicillin-sulbactam was observed . These strains also showed significant differences in susceptibilities to the various combinations, suggesting that, at least in strains resistant to one combination, several beta-lactam/beta-lactamase inhibitor combinations should be tested in the laboratory . All combinations tested enhanced the activity of the beta-lactam towards TEM 1-producing E . coli, piperacillin-tazobactam being the most active . The drugs were less active to OXA 1 enzymes; solely with piperacillin-tazobactam 90% of strains were within the therapeutic range of the drug . Sulbactam acted synergistically to chromosomally encoded beta-lactamases, whereas amoxicillin-clavulanate was inactive . Piperacillin and piperacillin-tazobactam inhibited all strains producing chromosomally encoded beta-lactamases at concentrations within the therapeutic range of the drugs . In contrast, TEM 2 of P . mirabilis was not sensitive to ampicillin-sulbactam, but to the other combinations; here again piperacillin-tazobactam was the most active. Eur J Biochem, 1991 Feb 14, 195(3), 763 - 9 Dependence of lysozyme-catalysed solubilization of Proteus mirabilis peptidoglycan on the extent of O-acetylation; Dupont C et al.; The degree of peptidoglycan O-acetylation in 14 strains of Proteus mirabilis has been accurately determined by a procedure which employs the quantitation of mild-base-released acetic acid by HPLC, and the estimation of peptidoglycan concentration by cation-exchange amino acid analysis . The beta-D-N,6-O-diacetylmuramyl content of all isolated and purified peptidoglycans was ranged 20-52.8%, relative to the total muramic acid concentration . Each of the O-acetylated peptidoglycans was found to be resistant to solubilization by both human and hen egg-white lysozymes and for hen egg-white lysozyme, the extent of this resistance was dependent upon the degree of O-acetylation . The steady-state parameters, Km and V, for the hen-egg-white-lysozyme-catalysed solubilization of various peptidoglycan preparations were determined at pH 6.61 and 25 degrees C . Values of Km for the different peptidoglycan samples were found to increase with increasing O-acetylation, whereas with V no such relationship appeared to exist . An increase in the overall change in the standard Gibbs free energy of activation {delta(delta G#)}, a consequence of increasing O-acetylation, was observed, and is shown to result from the weaker affinity of the enzyme for the modified substrates. Klin Monatsbl Augenheilkd, 1991 Feb, 198(2), 94 - 8 {Perioperative risk of infection in cataract surgery}; Breitbach R et al.; The presence of bacteria during cataract surgery was studied on 71 consecutive patients . Lid and conjunctival smears were cultured 24 hours preoperatively . Additional conjunctival smears were harvested in the operating room before and after conjunctival disinfection by oxycyanate . Moreover, the whole irrigation fluid was collected under sterile condition and examined microbiologically . 24 hours preoperatively 61 of 71 patients had positive cultures of their lids and/or conjunctivae . 8 of them showed growth of pathogenous bacteria (7 staphylococcus aureus, 1 proteus mirabilis) . In the operating room before oxycyanate disinfection 5 patients were positive for staphylococcus aureus and 13 for coagulase negative staphylococci (none for proteus species) . After oxycyanate disinfection 4 residual conjunctival smears showed bacterial growth when cultured (3 coagulase negative staphylococci, 1 proteus mirabilis) . 22 of 71 collected irrigation fluids content few numbers of bacteria . One was positive for proteus mirabilis, 3 for staphylococci . The patient showing growth of proteus after oxycyanate disinfection and one of the patients with staphylococcus aureus positive irrigation fluid did not show this kind of micro-organism in any smear before . The authors conclude that preoperative cultures do not give real security about the presence or absence of bacteria during the operation. Klin Monatsbl Augenheilkd, 1991 Feb, 198(2), 87 - 93 {Preoperative microbiologic diagnosis before elective intraocular interventions and prevention of infection with tobramycin eyedrops . Results of a multicenter study}; Bialasiewicz AA et al.; Preoperative conjunctival smears of 313 asymptomatic patients before cataract surgery were evaluated in an open multi-center study in 10 German surgical eye care centers from May to August 1987 . 230 evaluable isolates of 198 patients (= 61.1%) on agar plates with a 48 h incubation period revealed 190 gram-positive (most frequent isolates: 62.2% coagulase negative Staph., 13.5% coagulase positive Staph.) and 40 gram negative agents (most frequent isolates: 3.0% Proteus sp., 2.2% Pseudomonas sp.) . Coinfections with gram-positive organisms were seen in 22%, and with gram-negative organisms in 9% of cases . Newly acquired potentially pathogenic bacteria were demonstrated after one day (5-8 drops 3 mg/ml Tobramycin (Tobramaxin; 1 x ointment in the evening 3 mg/100 mg Tobramycin (Tobramaxin} of topical prophylaxis in 6 of 115 (= 5.2%) previously negative and 22 of 198 (= 11%) previously positive conjunctival cultures . Coagulase negative Tobramycin sensitive Staph . persisted in 41 of 110 patients (= 37.3%) and coagulase positive Tobramycin-sensitive Staph . in 4 of 30 (= 13.3%) . Each of the gram-negative bacteria could be eliminated after one day of topical prophylaxis with Tobramycin eye drops and ointment in this study . The statistically determined elimination rate estimated for a one-day topical prophylaxis with Tobramycin in asymptomatic culture-positive persons was 77.5-89.8% (95% confidence interval/Pearson and Clopper) . The statistically determined probability for potentially pathogenic bacteria in a previously culture-negative patient after topical preoperative Tobramycin prophylaxis was 3.1-13.2% (95% confidence interval/Pearson and Clopper) . Thus, additional supportive antibiotic measures are to be taken pre- and perioperatively by the intraocular surgeon to minimize the risk of postoperative endophthalmitis. Antibiot Khimioter, 1991 Feb, 36(2), 14 - 7 {Experimental and clinical studies of drug regulation of the anti-lysozyme activity of microorganisms causing opportunistic infections}; Bukharin OV et al.; Experimental materials on choosing antibiotics for etiotropic therapy of opportunistic infections with an account of the regulating effect of the drugs on the ++anti-lysozyme activity of pathogens (the factor of intracellular parasitism) are presented . The in vitro data were applied to the clinical trials in 30 patients with chronic and acute pyelonephritis of the Proteus etiology and to 25 patients with chronic inflammatory diseases of Staphylococcus etiology . It was shown that the use of the antibiotics which lowered the ++anti-lysozyme activity of microorganisms promoted a more rapid disappearance of the disease clinical signs, increased 2- to 3-fold the terms of the remission and resulted in an increase in the number of the persons with complete remission (54.5 to 63.6 per cent) as compared to the use of the drugs which stimulated the pathogen property or were indifferent to it. Br J Urol, 1991 Feb, 67(2), 206 - 9 Paediatric urolithiasis in Greece; Androulakakis PA et al.; A group of 44 patients, aged from 10 months to 14 years, underwent surgery for urinary calculi over a 7-year period (1982-1989) . Eleven patients had bilateral or multiple calculi (total number of stones = 55, 20 of which were staghorn) . Metabolic disorders (n = 25) and Proteus urinary infection (n = 15) were the 2 factors most often associated with lithiasis . Of the 55 stones, 51 were removed by open surgery . Complete stone clearance was achieved in 29 of 36 kidneys . Follow-up periods in the remaining 7 renal units (with small residual fragments) ranged from 3.5 to 7.5 years (mean 6.2) and revealed stone recurrence in only 2 patients . Evaluation of childhood urolithiasis should include thorough metabolic investigation and sound surgical judgment; effective management requires prolonged post-operative follow-up. J Med Microbiol, 1991 Feb, 34(2), 73 - 81 Bacterial killing in vitro by abscess-derived neutrophils; Finlay-Jones JJ et al.; In the absence of antimicrobial therapy, bacteria such as Bacteriodes fragilis, Escherichia coli and Proteus mirabilis may persist within an intra-abdominal abscess in the presence of large numbers of neutrophils which, under optimal conditions in vitro, can readily phagocytose and kill the same bacterial strains . Neutrophils taken from abscesses induced by gram-negative bacteria such as those above contain viable organisms . On incubation in vitro in the presence of serum, these neutrophils kill the bacteria phagocytosed in the abscess poorly, if at all, yet can readily kill organisms added in vitro . To determine possible mechanisms that might explain this, we examined the bactericidal activity in vitro of neutrophils from a range of abscesses induced by one or two species of bacteria plus an abscess-potentiating agent, bran . The organisms studied were B . fragilis, E . coli, P . mirabilis and Staphylococcus aureus . The killing in vitro of E . coli and P . mirabilis, engulfed within an abscess, was significantly less than that of the same organisms when they were added to the in-vitro assay . In contrast, the killing of S . aureus was similar, whether engulfed in vivo or in vitro . However, S . aureus was less susceptible to phagocytosis and killing in vitro than P . mirabilis or E . coli, and the killing of S . aureus during in-vitro incubation of neutrophils that had engulfed the organism with in the abscess was similar to that of the gram-negative bacteria engulfed within the abscess.(ABSTRACT TRUNCATED AT 250 WORDS) Gastroenterology, 1991 Feb, 100(2), 489 - 93 A rodent model of cirrhosis, ascites, and bacterial peritonitis; Runyon BA et al.; We sought to develop a rodent model of spontaneous bacterial peritonitis and report here the preliminary results of carbon tetrachloride-induced cirrhosis in which ascites and bacterial peritonitis predictably develop . Of 41 rats that survived the initial carbon tetrachloride toxicity, 38 (92.7%) developed cirrhosis with ascites . Of these 38, 21 (55.3%) developed 24 episodes of ascitic fluid infection without iatrogenic colonization . No surgically treatable source of infection was identified at autopsy in any rat; therefore, the infections were presumed to be "spontaneous." Eight (50%) of the 16 rats with culture-positive ascitic fluid at postmortem examination also had spontaneous pleural fluid infection with the same organism . Escherichia coli and Proteus sp . were the organisms most commonly isolated . This rodent model of cirrhosis with ascites appears to be the first high-yield animal model of spontaneous bacterial peritonitis . Ascitic fluid infection in these rats resembles ascitic fluid infection in humans . This model will allow further investigation of the mechanisms of pathogenesis of ascitic fluid infection and provide insight into the prevention and treatment of spontaneous bacterial peritonitis and pleural fluid infection in patients with cirrhosis. Anaesthesia, 1991 Feb, 46(2), 126 - 8 Anaesthesia for Proteus syndrome; Pennant JH et al.; A 14-year-old boy with Proteus syndrome presented for orthopaedic surgery to his legs . No report in the literature exists on anaesthesia for this condition . Our patients posed airway problems that were managed by tracheal intubation under sedation using a fibreoptic bronchoscope . Anaesthesia was induced with thiopentone and maintained with nitrous oxide and isoflurane in oxygen . His lungs were ventilated mechanically throughout surgery, which was uneventful. Med J Aust, 1991 Jan 21, 154(2), 99 - 104 Flinders Island spotted fever: a newly recognised endemic focus of tick typhus in Bass Strait . Part 2 . Serological investigations; Graves SR et al.; Twenty-six cases of a spotted-fever-like illness have been identified on Flinders Island, Tasmania, over a 17 year period . These patients and 335 healthy persons from the island were investigated serologically using the Weil-Felix agglutination test (Proteus sp . antigens OX2, OX19, OXK) and rickettsia-specific microimmunofluorescence . The antigens used in these latter tests comprised one member of the typhus group (Rickettsia typhi) and three members of the spotted fever group (Rickettsia rickettsii, Rickettsia australis and Rickettsia conorii) . Patients with Flinders Island spotted fever showed a higher prevalence of positive reactions to the Weil-Felix tests (with OX2 and OX19 antigens) and a higher prevalence of positive results to rickettsia-specific serological tests (with the exception of antibodies to Rickettsia typhi) than did healthy persons; OX2 (36% v . less than 1%); OX19 (36% v . less than 1%); Rickettsia rickettsii (42% v . 1%); Rickettsia australis (46% v . 1%); Rickettsia conorii (42% v . 1%); Rickettsia typhi (4% v . 4%) . In seven of the 26 patients (27%) seroconversion was demonstrated by means of Weil-Felix tests, confirming recent infection . In six of these patients seroconversion was also demonstrated in rickettsia-specific tests . Although these results support the clinical evidence that the illness on Flinders Island is caused by a rickettsia of the spotted fever group, the aetiological agent remains to be isolated. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 1991 Jan-Feb, 32(1), 9 - 16 Urolithiasis in children; Ni YH et al.; A retrospective study of childhood urolithiasis was performed from July 1978 to December 1989 in the National Taiwan University Hospital . During the eleven years, fourteen patients aged from 1 to 16 years were enrolled . The male to female ratio was 10:4, but no sex predilection was found in seven children with bladder stone(s) (M:F = 4:3), Hematuria and pyuria were the commonest symptoms and signs . Bladder stone was the most frequently encountered stone while renal stone was the second . The underlying factors included urinary tract anomalies, and surgical intervention of the urinary tract and trauma . Proteus species was the most common bacterium isolated from the urine of stone patients . However, half of the patients' urine specimens were sterile . Calcium oxalate and struvite were the two main components of the stones irrespective of renal, ureteral, or bladder stone origin . Lithotomy, endourological removal, and extracorporeal shock wave lithotripsy were the major therapeutic procedures, but the last procedure might replace the others. Actas Urol Esp, 1991 Jan-Feb, 15(1), 40 - 2 {Penoscrotal gangrene: our series of cases}; Llopis B et al.; Ten cases of penoscrotal gangrene seen in our department over the last 8 years are presented . In 80% of patients causative factors of the gangrenous process were demonstrated and were equally distributed between urology and colorectal pathologies . The most commonly associated pathology was diabetes mellitus affecting up to 50% of our patients . Two or more germs were isolated from the necrotic-purulent material for cultures, mainly E . coli (90%) and Proteus mirabilis (50%) as aerobic organisms, and Bacteroides fragilis (40%) in the anaerobic group . Despite emergency surgical therapy and high doses of broad spectrum antibiotics, mortality in our series was about 20%. Proc Finn Dent Soc, 1991, 87(1), 183 - 8 Craniofacial characteristics of Proteus syndrome: two modes of abnormal growth; Kreiborg S et al.; The dysmorphic growth patterns of the craniofacial skeleton are summarized in five patients with the Proteus syndrome . Two different modes of abnormal growth are present . One mode involves focal overgrowth of membrane bones, producing multiple hyperostoses which result in progressive craniofacial disfigurement and asymmetry . The second mode involves overgrowth of cartilage in the condyle, resulting in dentofacial asymmetry . The phenotype of the craniofacial skeleton results from both processes . In terms of appearance, the mode involving hyperostosis seems more dramatic in most cases than the mode involving cartilage. Chemotherapy, 1991, 37 Suppl 1, 39 - 48 Open randomized controlled parallel study of ofloxacin versus trimethoprim-sulfamethoxazole treatment of lower respiratory tract and urinary infections; De Simone C et al.; A total of 60 patients with lower respiratory tract or urinary tract infections were enrolled in an open, randomized, controlled, parallel study comparing 300 mg ofloxacin (OFX) b.i.d . with trimethoprim + sulfamethoxazole (TMP 800 mg + SMX 160 mg), 1 tablet, b.i.d . The signs and symptoms of low respiratory tract infection were cured in 12 patients (80%) of the OFX group and improved in 2 other patients (13%); at the end of therapy, the 2 germs that persisted were Streptococcus pneumoniae and Branhamella catarrhalis . Clinical cure was achieved in 13 patients (86%) in the TMP-SMX group, while 2 patients were considered as failures (14%); after therapy, the 3 organisms that persisted were 2 S . pneumoniae and 1 Pseudomonas aeruginosa . As far as urinary tract infections are concerned clinical cure and complete eradication of bacteria were achieved in 14 patients in the OFX group (93%); the germ that persisted was Escherichia coli (100,000 CFU), but the patient was asymptomatic . In patients of the TMP-SMX group the urinary infections were cured in 11 subjects (73%); the germs that persisted were 2 E . coli and 1 Proteus mirabilis . Adverse effects were reported for 3 patients (10%) in the OFX group and 4 patients (13%) in the TMP-SMX group . The measurement of serum and intracellular (polymorphonuclear cells and lymphocytes) levels of OFX and TMP-SMX and the assessment of the host's immunocompetence ruled out the possibility of any immunotoxicological side effect. Scand J Infect Dis, 1991, 23(1), 125 - 6 Aztreonam for treating meningitis caused by gram-negative rods; Kilpatrick M et al.; 10 patients with meningitis due to unusual gram-negative organisms (Pseudomonas, Proteus, Salmonella and Klebsiella) were effectively treated with aztreonam . A detailed history and a thorough physical examination combined with careful laboratory testing resulted in accurate diagnosis and cure of all patients. Br J Surg, 1991 Jan, 78(1), 105 - 8 Role of phenytoin in healing of large abscess cavities; Lodha SC et al.; The promotion of healing of large abscess cavities attained with topical phenytoin was evaluated in controlled studies of clinical and experimental wounds . In the clinical abscess cavities, phenytoin application in 20 patients compared with conventional treatment in 20 patients resulted in earlier separation of slough, decrease in oedema, control of pain and overall enhanced healing . The mean(s.d.) rate of reduction of wound area was 2.02(0.48) cm2/day in the phenytoin group versus 1.58(0.51) cm2/day in controls (P less than 0.05) on day 10, and 1.8(0.32) cm2/day versus 1.19(0.21) cm2/day (P less than 0.01) on day 20 . The mean volume reduction rates at both the 10th and 20th day were 0.48(0.01) cm3/day for phenytoin versus 0.32(0.04) cm3/day for controls; (P less than 0.005) . By day 20, 17 of the patients treated with phenytoin were rated as having healed completely, compared with only one of the controls . In a standardized guinea-pig model of the clinical abscess cavity, which included inoculation of the wound with Bacillus proteus and Klebsiella pneumoniae, an enhanced healing rate was also observed (at 7 days 0.40(0.05) cm2/day with phenytoin versus 0.21(0.08) cm2/day in controls; P less than 0.005) . All eight of the animals treated with phenytoin healed by day 21, compared with one of the eight controls . Biopsies of wounds treated with phenytoin showed less inflammation, no necrosis, and enhanced neovascularization, collagen deposition and fibroblast proliferation compared to controls . Bacterial colonies also decreased more rapidly with the use of phenytoin. Scand J Urol Nephrol, 1991, 25(3), 245 - 6 Nephrobronchial fistula . Case report; Kyriakopoulos M et al.; A 26-year-old woman presented with a six-year history of right staghorn calculus and pyonephrosis . Intravenous pyelography showed a non-functioning right kidney and chest radiography, an elevated right hemidiaphragm and fluid in the right costaphrenic space . At operation a nephrobronchial fistula was found, and nephrectomy and subdiaphragmatic drainage of the lung abscess was carried out . Culture of the pus grew Proteus mirabilis . The patient made an uneventful recovery and was discharged on the sixteenth day after operation. Urol Int, 1991, 46(4), 344 - 8 Single-dose fosfomycin trometamol (Monuril) versus multiple-dose norfloxacin: results of a multicenter study in females with uncomplicated lower urinary tract infections; de Jong Z et al.; The results of an open, randomized study comparing the efficacy and safety of Fosfomycin trometamol (Monuril), 3-gram single dose, and Norfloxacin (Noroxine 400), 400 mg twice daily for 5 days, are reported . Clinical and bacteriological assessments were performed before and 3-4 (short-term) and 25-30 days (long-term) after treatment . Only female patients with uncomplicated lower urinary tract infection were eligible for inclusion in the study: 33 cases were given Fosfomycin trometamol and 30 cases Norfloxacin . In the overall etiology, Escherichia coli (74% of the strains found), Proteus mirabilis (6%) and Klebsiella pneumoniae (6%) are highly predominant . With regard to bacteriological efficacy, the percentages of eradication in the two groups were similar: after the short-term test, 93.9% (31 of 33 patients) in the Fosfomycin trometamol group and 86.6% (26 of 30) in the Norfloxacin group, and after the long-term tests, 73.3% (22 of 30) in the Fosfomycin trometamol group and 77.89% (21 of 27) in the Norfloxacin group . There are no statistically significant differences . The duration of the reported side effects was significantly lower in the Fosfomycin trometamol group . The simplified dosage regimen (single dose) and its favorable benefit/risk ratio justifies the use of Fosfomycin trometamol as a treatment for uncomplicated urinary tract infections in female patients. Biosystems, 1991, 25(3), 205 - 12 Elevated levels of stress proteins associated with bacterial symbiosis in Amoeba proteus and soybean root nodule cells; Choi EY et al.; Obligatory bacterial endosymbionts of Amoeba proteus and symbiotic Bradyrhizobium japonicum bacteroids in soybean-root nodules contained large amounts of 67-kDa and 65-kDa proteins, respectively, antigenically related to groEL of E . coli and the 58-kDa heat-shock protein of Tetrahymena . Monoclonal antibodies against the 67-kDa protein recognized groEL analogs from several different organisms . The quantity of the stress protein in symbiotic B . japonicum bacteroids was augmented seven times that in the free-living counterparts . The increase in these proteins in endosymbionts, as determined by immunoblot techniques, indicated that intracellular symbiosis is a stress condition even when the symbiotic relationship is considered to be mutually beneficial . Mitochondria and chloroplasts may also be under a stressed condition like endosymbionts in view of the presence of heat-shock proteins in these cell organelles. Jpn J Antibiot, 1991 Jan, 44(1), 1 - 8 {Combination antibacterial effects between aztreonam and eight other antibiotics}; Nishino T et al.; In vitro interactions between aztreonam (AZT) and 8 other antibiotics were studied using the agar dilution checkerboard technique against 88 clinical isolates of Escherichia coli, Proteus vulgaris, Serratia marcescens and Pseudomonas aeruginosa . Combinations of AZT with 8 other antibiotics were generally additive or indifferent . Synergism was occasionally seen against S . marcescens or P . aeruginosa with AZT plus isepamicin (ISP) . Antagonism was observed only between AZT and latamoxef against P . vulgaris . In a phase-contrast microscopic study, synergistic effects between AZT and aspoxicillin or ISP were confirmed against E . coli 177 and P . aeruginosa 15846 . AZT in combination with ISP demonstrated a synergy against experimental urinary tract infection in mice caused by P . aeruginosa 15846 . We believe that combinations of several antibiotics with AZT should be considered for initial therapy of infections because synergism and additive action were observed and antagonism was rarely found in our study. J Clin Epidemiol, 1991, 44(2), 191 - 205 Rhythmic bacterial susceptibility to antibiotics at a large hospital; Nicolelis MA et al.; The in vitro susceptibility response of Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa to a set of antibiotics was investigated in a survey comprising 19,380 positive cultures over a period of 5 years in a large hospital environment . Four out of the five species (P . aeruginosa being the exception) presented a species-specific, drug-independent, rhythmic variation of their level of susceptibility to several antibiotics over the time of the study . The species-specific rhythmic responses were further characterized by spectral analysis, autocorrelation and cross-correlation functions . Through this analysis it was possible to rank the species according to their main period of oscillation . The longest period of oscillation was detected for S . aureus (38 months) . K . pneumoniae and E . coli presented intermediate values (25 and 23 months respectively), and P . mirabilis the shortest period of oscillation (11 months) . Species displaying long periods of oscillation tended to present very low levels of susceptibility, while species displaying short periods of oscillation usually presented the highest levels of susceptibility observed . Although some hospital environmental factors, such as drug consumption, were also analyzed, no correlation was found between them and the in vitro bacterial cyclic responses to antibiotics. Acta Otolaryngol, 1991, 111(3), 530 - 5 Chronic suppurative otitis media: complicated versus uncomplicated disease; Rupa V et al.; To determine prognostic factors in patients with chronic otitis media who develop suppurative complications, we performed a retrospective study of all patients with chronic suppurative otitis media who underwent mastoid surgery between the years 1981 and 1989 . Patients who developed complications were compared with those who did not with respect to six prognostic variables . The results indicated that patients with complications were younger (p less than 0.001), had shorter duration of ear discharge (p less than 0.001), were more likely to have pars tensa perforations (p less than 0.05), and had a higher degree of mastoid sclerosis in the operated and contralateral ears (p less than 0.001) . The presence of cholesteatoma and the sex of the patient were of no prognostic value . Bacteriology of CSF and pus specimens from patients who developed intracranial complications mostly revealed mixed flora (62.9%) . Proteus species was the most frequent isolate (34%) and anaerobes were present in 21.3% of specimens . Mastoid abscess occurred in more than half the patients in the complicated group . Brain abscess (57.4%) was the most frequent intracranial complication . On the basis of our findings we recommend that risk factors in patients with chronic suppurative otitis media be identified early to enable effective measures to be taken to eradicate the disease. Microbiol Immunol, 1991, 35(2), 87 - 97 In vitro and in vivo transferrable beta-lactam resistance due to a new plasmid-mediated oxyiminocephalosporinase from a clinical isolate of Proteus mirabilis; Watanabe Y et al.; A new plasmid-mediated beta-lactamase (FPM-1) with an isoelectric point of 7.2 and a molecular weight of 26,000 was found in a cefuroxime-resistant clinical isolate of Proteus mirabilis strain 6003 . FPM-1 can be classified as a type I oxyimino-cephalosporinase on the basis of its substrate specificity and inhibition pattern by clavulanic acid etc., and its conferred resistance on both the strain and transconjugants against most oxyme-type cephalosporins as well as the older ones but not against cefamycins and a few exceptional oxyme-type cephalosporins such as ceftizoxime, ceftazidime and cefixime . In a murine systemic infection model, only these FPM-1-stable drugs exhibited protective activity against the FPM-1-producing P . mirabilis 6003 similar to that against a nonproducing derivative strain . The FPM-1-mediated cefuroxime resistance in P . mirabilis 6003 was transferred to co-infected Escherichia coli 7004 at frequencies between 3.8 x 10(-3) and 4.0 x 10(-2) in a murine ascending urinary tract infection model . In the same infection model due to the FPM-1-producing E . coli transconjugant, FPM-1-stable cefixime was significantly more effective than FPM-1-labile cefteram pivoxil, although both drugs had similar therapeutic effect against its FPM-1-nonproducing counterpart strain. J Gynecol Obstet Biol Reprod (Paris), 1991, 20(3), 335 - 40 {Prenatal diagnosis of abdomino-pelvic cystic lymphangioma as part of proteus syndrome}; Tissot H et al.; Proteus syndrome is difficult to diagnose owing to its low incidence and to the late recognition of its identity, due to polymorphous border diseases and to the polymorphous lesions which characterize . The authors report a prenatal diagnosis of abdominal and pelvic cystic lymphangioma as part of proteus syndrome. EXS, 1991, 58, 95 - 105 DNA fingerprinting: the utilization of minisatellite probes to detect a somatic mutation in the proteus syndrome; Schwartz CE et al.; Syndromes with localized or segmental abnormalities have been proposed to be the result of a somatic mutation leading to the presence of somatic mosaicism in the tissue . The Proteus syndrome, with its hemihypertrophy, macrodactyly and exostoses, has features which would indicate that the phenotype results from such events . The success of utilizing DNA fingerprint probes to detect somatic mutations in cancer raised the possibility that a similar approach might be successful in an investigation of two patients with the Proteus syndrome . Single band differences were detected with the probe 33.6 in a pair of monozygotic twins discordant for Proteus and in a comparison of tissue from normal and affected areas in another patient . These findings would appear to confirm the hypothesis that the Proteus syndrome results from a somatic mutation . Furthermore, the results indicate that DNA fingerprinting may offer a valuable technique for identifying probes for investigations of similar syndromes. Acta Microbiol Hung, 1991, 38(3-4), 315 - 20 Pathogenic Escherichia coli O157:H7 and their detection; Pawelzik M; Enterohaemorrhagic Escherichia coli O157:H7 is of major concern to the food industry due to high pathogenicity of this foodborne organism . For the detection of these bacteria a special agar medium with a fluorogenic substrate has been developed . The medium uses the characteristics of this E . coli serotype not to ferment sorbitol and not to produce beta-glucuronidase . In contrast, approximately 96% of all other strains of E . coli are sorbitol-positive and nearly all of them are beta-glucuronidase-positive . For discrimination between Proteus and E . coli O157:H7 which are both sorbitol- and beta-glucuronidase-negative, sodium thiosulphate and ferrio ammonium citrate were added . This leads to a brownish colour of the Proteus colonies due to their production of hydrogen sulphide . Growth of the gram-positive flora was inhibited by the addition of sodium deoxycholate. J Urol (Paris), 1991, 97(6), 269 - 77 {Long ureteral ammonium-magnesium phosphate (struvite) and calcium phospho-carbonate calculi}; Thomas J et al.; The authors report about 12 cases of long ureteral calculi, 16 to 39 mm in size, observed over 10 years . They were all made of a mixture of ammonium-magnesium phosphate and calcium phosphocarbonate . Infection was the revealing symptom, either in the form of simple bacteriuria or as acute pyelonephritis or sepsis . These calculi, found in a lumbar or pelvic location, were very long, radiopaque but with a moderate radiological density, homogeneous and have regular contours . They were straight, sometimes slightly bent, rarely (one case out of 12) arciform . In 11 of 12 cases, the affected patient was female . In most cases, the urine was infected by Proteus mirabilis . In spite of their size, the calculi caused total obstruction in 3 of 12 cases only . They were or were not associated to ipsilateral coral calculi of the same chemical type . Destruction was easily achieved with physical agents . The etiological, radiological and therapeutic characteristics of these calculi give them a specific place among ammonium-magnesium phosphate calculi. Genet Couns, 1991, 2(2), 93 - 101 Proteus syndrome in 7 patients: clinical and genetic considerations; Lacombe D et al.; The Proteus syndrome is a congenital hamartomatous disorder delineated in 1983 . Because of its polymorphic appearance, the syndrome was named after the greek god Proteus whose name means much less than the polymorphous much greater than . Major clinical findings include hemi hypertrophy, macrodactyly, exostoses, scoliosis, epidermal nevi, haemangiomas, deeply rugated soles of the feet and a variety of deep and subcutaneous masses . We report on 7 new cases of Proteus syndrome . All reported cases have been sporadic . Therefore this syndrome could be due to the action of a dominant lethal gene surviving by mosaicism. Acta Physiol Hung, 1991, 77(3-4), 225 - 30 Vaccina treatment in some hospital infections; Kovats T et al.; Phenol-treated vaccine was prepared from the usual hospital strains and patients with colorectal cancer were immunized intramuscularly 7-10 days prior to the operation . The efficiency of the vaccine treatment was judged by the incidence of wound infections . The best results were obtained in patients whose previously estimated immunoreactivity was strong or normal . Immunospecificity could not be detected in the above treatment . The frequent and inappropriate use of antibiotics in hospitals increases the number of resistant hospital bacterial strains . Apart from Staphylococci and Streptococci, different Gram-negatives--such as Klebsiella, Serratia, Pseudomonas, Proteus and E . coli strains--have been found in the hospitals and in the patients . Due to the resistance, it is difficult to find antibiotics against them . This fact puts forward the possibility of immunization especially by vaccination. Drugs, 1991, 42 Suppl 3, 41 - 50 Review of clinical experience in the United States with cefpodoxime proxetil in adults with uncomplicated urinary tract infections; Cox CE et al.; Two controlled United States trials compared the safety and efficacy of cefpodoxime proxetil (100mg twice daily) with either cefaclor (250mg 3 times daily) or amoxicillin (250mg 3 times daily) in patients with uncomplicated urinary tract infections . Treatment duration was 7 days . 307 of 762 patients treated with cefpodoxime proxetil, 99 of 190 treated with cefaclor, and 57 of 185 treated with amoxicillin were evaluable for efficacy . 311, 99 and 59 pathogens were isolated from cefpodoxime proxetil, cefaclor and amoxicillin patients, respectively, the most common pathogens being Escherichia coli, Klebsiella spp., Proteus mirabilis, and Staphylococcus saprophyticus . Bacteriological cure rates were 80% (247/307), 82% (81/99) and 70% (40/57) for cefpodoxime proxetil, cefaclor and amoxicillin, respectively . Respective clinical cure rates were 79% (242/307), 79% (78/99) and 72% (41/57) . Cefpodoxime proxetil was well tolerated, and there was no significant difference between the groups in the overall incidence of adverse experiences . Thus, cefpodoxime proxetil is efficacious and safe in the treatment of patients with uncomplicated urinary tract infections and compares favourably with cefaclor and amoxicillin. Lab Delo, 1991, (7), 58 - 61 {Serotyping of Proteus using a rapid system}; Bidnenko SI et al.; A rapid method for Proteus serologic typing is suggested, based on Soviet commercial diagnostic adsorbed type sera . The rapid system involves replacing two-staged typing with one-staged, making use of polyvalent sera constructed by uniting 8-9 type sera according to the suggested schemes . O- and H-antigens are types in accordance with special tables . Fifteen O-antigens and 4 H-antigens, whose total incidence among Proteus clinical strains is under 2 percent, cannot be typed with the use of this system . The suggested rapid system is suggested as a rapid simple method for typing Proteus clinical strains in intricate epidemiologic situations. Lab Delo, 1991, (5), 47 - 50 {Stable erythrocyte reagents for detecting antigen-binding lymphocytes}; Deriabin PN et al.; Fixation of native chicken red cells with a solution containing 14.4 percent of acetate aldehyde and 0.85 percent of NaCl (pH 7.0-7.2) permitted preparation on the basis of these red cells of stable immunoreagents for the detection of antigen-fixing lymphocytes using any (optimal for the antigen used) procedure . Experiments have demonstrated a high efficacy of detecting staphylococcal, proteus, or Ps . aeruginosa etiology of pyoinflammatory and septic conditions in indirect rosette formation test with the developed immunoreagents . The levels of the detected antigen-fixing lymphocytes varied in the patients from 0.7 to 8.0 percent, the mean value being 2.1 +/- 0.1 percent. Urol Res, 1991, 19(5), 301 - 4 Ability of uropathogens to bind to Tamm Horsfall protein-coated renal tubular cells; Hawthorn LA et al.; Epithelial cells were isolated from a healthy human kidney and found to be of normal, renal tubular origin . The cells were maintained in tissue culture and found to secrete Tamm Horsfall protein (THP) . Three strains of uropathogenic Escherichia coli, and one each of Proteus mirabilis and Pseudomonas aeruginosa were found to adhere to the THP-coated tubular cells . Extraneous THP bound to all the organisms except P fimbriated E . coli, and caused a reduction in the adhesion of type 1 fimbriated E . coli and P . mirabilis to the renal cells . However, irrespective of reduced adhesion in three of five strains tested, there was adequate evidence to indicate that THP does not competitively exclude all uropathogenic adhesion . On the contrary, its presence on renal cells may act to mediate bacterial colonization. Pharm Weekbl Sci, 1990 Dec 14, 12(6A), 284 - 8 Vaginal hysterectomy: cefuroxime, metronidazole or both? Kauer FM, Wijma J, Manson WL. A randomized double-blind prospective study on the efficacy of single-dose antibiotic prophylaxis compared cefuroxime versus metronidazole versus the combination of both agents in vaginal hysterectomy . Overall antibiotic prophylaxis was effective in abscess prevention (one abscess in 68 patients) . In the metronidazole group a significantly higher grade of morbidity was observed: febrile morbidity 41% versus 4% in the two other groups; bacteriuria 73% versus 17% in the cefuroxime group, versus 13% in the combined group; urinary tract infection 23%, versus 0% in the two other groups; post-operative prescription of antibiotics 41%, versus 0% in the two other groups . Febrile morbidity and bacteriuria correlated positively with Escherichia coli and Proteus spp . These micro-organisms were recovered significantly more often from the vagina of patients in the metronidazole group . Cefuroxime was successful, metronidazole failed in the prevention of minor morbidity . We could not observe any effect from the addition of metronidazole to the cefuroxime prophylaxis. Ann Pediatr (Paris), 1990 Dec, 37(10), 657 - 62 {Xanthogranulomatous pyelonephritis in children . Apropos of 8 cases}; Mhiri MN et al.; Eight pediatric cases of the diffuse form of xanthogranulomatous pyelonephritis are reported . These patients were selected among 17 with destruction of one kidney . Clinical symptoms were suggestive of a tumor in some instances . However, an infectious etiology was strongly suggested by the presence of a renal lithiasis in seven cases (including five staghorn stones) and of a urinary tract infection in six cases (usually caused by a Proteus) . Nephrectomy was performed in every case. Infect Immun, 1990 Dec, 58(12), 4004 - 10 Functional activity of individual abscess neutrophils from mice; Kenny PA et al.; In the absence of antibiotic therapy, viable bacteria can persist within intra-abdominal abscesses in mice for at least 10 weeks . The mechanisms contributing to this survival are unknown, but abscess-derived neutrophils have impaired abilities to kill, in vitro, organisms engulfed in vivo . In order to determine whether subpopulations of abscess neutrophils might be discernible on the basis of phenotypic or functional criteria, cells from murine intra-abdominal abscesses were examined for phagocytic activity, CR3 expression, and H2O2 production in response to soluble and particulate stimuli . With respect to phagocytosis of Proteus mirabilis, abscess cells were no less efficient than peritoneal exudate neutrophils; no significant subpopulation of cells was incapable of phagocytosis in the presence of normal mouse serum . Using flow cytometry to examine abscess neutrophils for CR3 expression, we found that no subpopulations of cells were observed with unstimulated cells or with cells incubated with either phorbol 12-myristate 13-acetate or bacteria and serum . Intracellular H2O2 levels were measured by using the probe 2',7'-dichlorofluorescin diacetate . In general, incubation with phorbol 12-myristate 13-acetate resulted in similar increases in H2O2 production in all cells of the population . However, stimulation with bacteria and serum revealed a variable but consistent, poorly responsive subpopulation of neutrophils in abscess cell populations . Cell-sorting experiments showed that cells from the poorly responsive section of the FACS profile contained significantly higher numbers of abscess-derived bacteria, suggesting the presence of a subpopulation of viable abscess neutrophils harboring persisting viable bacteria. Jpn J Antibiot, 1990 Dec, 43(12), 2094 - 101 {Bacterial combination effect between carumonam and eight other antibiotics}; Obana Y et al.; In vitro interactions between carumonam (CRMN) and 8 other antibiotics were studied using the agar dilution checkerboard technique against 88 clinical isolates of Escherichia coli, Proteus vulgaris, Serratia marcescens and Pseudomonas aeruginosa . Combinations of CRMN with 8 other antibiotics were generally additive or indifferent . Synergism was found against S . marcescens or P . aeruginosa with CRMN plus fosfomycin, gentamicin (GM) or dibekacin . Antagonism was not observed with CRMN plus any of the 8 other antibiotics tested . In a phase-contrast microscopic study, the synergism of CRMN in combination with GM were confirmed against P . aeruginosa 15846 . CRMN in combination with GM demonstrated a in vivo synergy against experimental urinary tract infection caused by P . aeruginosa 15846 in mice . We think that combinations of several antibiotics with CRMN should be appropriate for initial therapy of infections because no antagonism appeared to occur with other antibiotic agents. Zh Mikrobiol Epidemiol Immunobiol, 1990 Dec, (12), 3 - 6 {The phospholipases of Proteus mirabilis}; Parkhomenko LV et al.; The method of screening Proteus for phospholipase activity has been worked out . The study of isolated clones of the same strain, used as an example, has revealed that clones differing in their phospholipase activity also differ in virulence and in some parameters of interaction in the host-parasite system . P . mirabilis phospholipases are supposed to be of importance as one of the factors contributing to the invasive properties of these microorganisms at the stage of overcoming the epithelial cell barrier of mucous membranes. J Endod, 1990 Dec, 16(12), 566 - 9 In vitro bacterial penetration of coronally unsealed endodontically treated teeth; Torabinejad M et al.; Forty-five root canals were cleaned, shaped, and then obturated with gutta-percha and root canal sealer, using a lateral condensation technique . The coronal portions of the root filling materials were placed in contact with Staphylococcus epidermidis and Proteus vulgaris . The number of days required for these bacteria to penetrate the entire root canals was determined . Over 50% of the root canals were completely contaminated after 19-day exposure to S . epidermidis . Fifty percent of the root canals were also totally contaminated when the coronal surfaces of their fillings were exposed to P . vulgaris for 42 days. J Antimicrob Chemother, 1990 Dec, 26(6), 803 - 12 Trimethoprim, sulphamethoxazole, bacterial adhesion and polymorphonuclear leucocyte function; Emmanouilides CE et al.; Culturing Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae in the presence of subinhibitory concentrations (1/4 MIC) of trimethoprim, sulphamethoxazole or their combination, resulted in reduced adherence of all the above strains . The number of phagocytosed bacteria pre-exposed to subinhibitory concentrations of the above antibiotics was not significantly changed, but a significant increase of bactericidal activity of the polymorphonuclear leucocytes was observed . Furthermore, filtrates of K . pneumoniae and P . mirabilis grown in the presence of trimethoprim alone or in combination with sulphamethoxazole induced an increased chemotactic response of human polymorphonuclear leucocytes. An Esp Pediatr, 1990 Dec, 33(6), 563 - 5 {Xanthogranulomatous pyelonephritis in infancy and childhood . Report of two cases}; Bertolotti A et al.; We are reporting 2 cases of xanthogranulomatous pyelonephritis in boys of 7 and 2 year-old . The inflammatory lesion had extended to perirenal tissues and appeared as a lumbar abscess in case 1 . The kidneys affected were diffusely compromised by the lesion . Both cases showed Proteus mirabilis after microbiologic cultures . Definitive diagnosis was done by pathology examination . Nephrectomy was curative. Kansenshogaku Zasshi, 1990 Dec, 64(12), 1499 - 506 {Studies on the sub-MIC of beta-lactam antibiotics--bactericidal activity in compromised host's serum}; Yotsuji A et al.; Bactericidal activity in compromised host's serum i.e . patients with cancer, the elderly, diabetes, was stronger than that in normal serum against Proteus mirabilis (P . mirabilis) but was weaker against Klebsiella pneumoniae (K . pneumoniae) . Against Escherichia coli (E . coli), bactericidal activity on serum of patients with cancer was weaker in the following order, that in elderly serum, that in diabetic serum . Against Proteus vulgaris (P . vulgaris), bactericidal activity in elderly serum was similar to that in normal serum but was stronger than that in serum of patients with cancer . Against Pseudomonas aeruginosa (P . aeruginosa) and Staphylococcus aureus (S . aureus), bactericidal activity in elderly serum and diabetic serum was similar to that in normal serum but was weaker than that in serum of patients with cancer . Piperacillin showed bactericidal activity in nutrient broth, normal serum and compromised host's serum at a concentration of 1/4 MIC against E . coli, P . mirabilis and P . aeruginosa . Aspoxicillin showed bactericidal activity in nutrient broth, and bactericidal or bacteriostatic activity in normal serum and serum of patients with cancer against E . coli and P . aeruginosa . While cefazolin and cefmetazole slightly inhibited the growth of bacteria in nutrient broth, they showed hardly any bactericidal activity in normal serum and compromised host's serum. Klin Med (Mosk), 1990 Nov, 68(11), 75 - 7 {Initial experience with prophylactic Proteus vaccine immunization in an emergency clinic}; Zdanovskaia LK et al.; As early as the first 24 hours since a severe isolated locomotor trauma the patients were immunized with Proteus vaccine . Such vaccination is shown to stimulate the production of serum specific antibodies, to reduce contamination of the wound with gram-negative agents, to shorten hospital stay and healing of the wound versus subjects vaccinated with staphylococcal anatoxin and nonimmunized patients. Rozhl Chir, 1990 Nov, 69(11), 718 - 25 {Cooperation between the urologist and microbiologist in the diagnosis and treatment of sepsis . II . The most common microbial species and their sensitivity to antimicrobial drugs in sepsis at the Urologic Clinic of the Medical School Hospital}; Moravkova M et al.; The authors investigated the spectrum of aetiological agents and their sensitivity to antimicrobial substances in 52 patients with septicaemia at the Urological Clinic in Hradec Kralove during 1984-1987 . They found a predominating number of Gram-negative bacteria (82%) . The most frequent agent producing sepsis was Klebsiella pneumoniae (19X), its source were in 52% the urinary pathways and 16% the cannula in the subclavian vein . In nine instances the aetiological agent was Escherichia coli and 5 times Proteus mirabilis . The above microorganisms are the most important pathogenic organisms of the urinary pathways . In all cases of bacteriaemia urosepsis was involved . The source of sepsis caused by Pseudomonas aeruginosa (7X) was in 43% the urinary tract, in particular in conjunction with instrumental procedures and in 14% a cannula in the subclavian vein . The most effective antimicrobial substance in Gram-negative bacteraemia in the investigated group was amicacin (100%); high sensitivity was recorded also in colistin . In Gram-positive bacteriaemia, where most frequently enterococci were isolated (6X), ampicillin and vancomycin were most effective. Mikrobiol Zh, 1990 Nov-Dec, 52(6), 83 - 6 {A method for determining the sensitivity of the causative agents of suppurative infection to iodopiron}; Litovchenko PP et al.; Bacterial suspensions of cultures (10(7) PFU) of pathogenic Staphylococcus, vulgar Proteus and pyocyanic bacterium are resistant to 2.9-46.87 mg per disc of iodopyron in 100% of cases . Sensitivity of 32 and 100% of cultures of pyocyanic bacteria (of 25 under study) being in the suspension (10(5) PFU) to 11.71 and 23.43-9.375 mg of idopyron, respectively, in a hole has been established . To determine sensitivity of pyocyanic bacteria to iodopyron it is suggested to use the procedure of adding of 11.71 mg of the preparation (water solution) to the holes in MPA. Kansenshogaku Zasshi, 1990 Nov, 64(11), 1416 - 24 {Study on new quinolone-resistant strains isolated from urine--annual changes of its frequency and the relation to drug volume}; Chujoh T et al.; There is concerned that the new quinolone-resistant strains have increased along with its widespread usage . We analysed the annual changes in frequency of ofloxacin-resistant strains isolated from urine in the past four years at two different types of hospitals, department of urology in Sapporo Medical College and Muroran City Hospital, since the usage of these agents seem to be related to the annual changes of the frequencies . The results were summarised as follows: 1) In the two hospitals, drug volume of the new quinolones had been increased, in particular, the past six years from 1984 . 2) The annual changes in frequency of ofloxacin-resistant Staphylococcus aureus have been increasing from 0 to 41.2 percent in Sapporo Medical College and 16.7 to 96.7 percent in Muroran City Hospital . The frequency of ofloxacin-resistant Pseudomonas aeruginosa also have been increasing from 24 to 66.7 percent in Sapporo Medical College and 37.5 to 81.8 percent in Muroran City Hospital . 3) The frequency of ofloxacin-resistant indole positive Proteus spp . and Serratia marcescens for four years at Sapporo Medical College (indole positive Proteus spp.: 0-1.8 percent, Serratia marcescens: 10-43 percent) was very different from that at Muroran City Hospital (indole positive Proteus spp.: 65-82 percent, Serratia marcescens: 71-100 percent) . The difference seems to be caused by the hospital acquired infection. J Urol, 1990 Nov, 144(5), 1267 - 71 Influence of chondroitin sulfate, heparin sulfate, and citrate on Proteus mirabilis-induced struvite crystallization in vitro; McLean RJ et al.; Struvite crystals were produced by Proteus mirabilis growth in artificial urine, in the presence of a number of naturally occurring crystallization inhibitors . The use of phase contrast light microscopy enabled the effects of added chondroitin sulfate A, chondroitin sulfate C, heparin sulfate, or sodium citrate, on struvite crystal growth rates to be rapidly monitored as changes in crystal habit . Struvite crystals formed as a consequence of the urease activity of P . mirabilis under all chemical conditions . In the absence of inhibitor, early crystal development was marked by large quantities of amorphous precipitate, followed immediately by the appearance of rapidly growing X-shaped or planar crystals . Addition of the glycosaminoglycans, chondroitin sulfate A, chondroitin sulfate C, or heparin sulfate to the artificial urine mixture had no effect on the rate of crystal growth or appearance . When sodium citrate was present in elevated concentrations, crystal appearance was generally slowed, and the crystals assumed an octahedral, slow growing appearance . None of the added compounds had any influence on bacterial viability, pH, or urease activity . It is therefore likely that the inhibitory activity displayed by sodium citrate might be related to its ability to complex magnesium or to interfere with the crystal structure during struvite formation . From these experiments it would appear that citrate may be a factor in the natural resistance of whole urine to struvite crystallization. Antibiot Khimioter, 1990 Nov, 35(11), 51 - 4 {Ciprofloxacin in the treatment of infections in oncology patients}; Dronova OM; Treatment of infectious complications with ciprofloxacin in 65 patients provided good and satisfactory results in 67.7 and 20.0 per cent of the cases, respectively . The drug was efficient in sepsis, urogenital infections, respiratory infections and postoperative purulent complications . Ciprofloxacin showed a broad antibacterial spectrum . 96.3 per cent of the isolates belonging to aerobic organisms causing purulent inflammatory processes, including those with high antibiotic resistance levels, such as Pseudomonas spp., Proteus spp., Klebsiella tribe and Staphylococcus aureus were sensitive to the drug . In its antibacterial spectrum ciprofloxacin was similar to ofloxacin . The advantage of ciprofloxacin is its possible use not only orally but also intravenously . Adverse reactions to ciprofloxacin were observed in 5 (7.7 per cent) out of the 65 patients . In two cases discontinuation of the drug use was required . The use of ciprofloxacin in treatment of infectious complications in oncological patients is promising. Res Microbiol, 1990 Nov-Dec, 141(9), 1139 - 49 Nucleotide sequences of 16S rRNA from ten Serratia species; Dauga C et al.; Comparison of 16S ribosomal ribonucleic acid (rRNA) sequences has emerged as a powerful tool for bacterial phylogeny . However, earlier studies often only included one or a few species per genus, and it is not sure whether the rRNA sequences could discriminate closely related species . The genus Serratia is composed of ten species, some being up to 60% related by DNA hybridization . The reverse transcriptase/primer extension method was used to determine 1,492 to 1,509 nucleotides in each of ten Serratia 16S rRNA sequences . All rRNA sequences determined were unique . The phylogenetic tree obtained with the neighbour-joining method showed a cluster of Serratia species distinct from both Escherichia coli and Proteus vulgaris . S . fonticola--whose position in the genus Serratia is questioned--was clearly included in the Serratia branch and grouped within the psychrophilic Serratia species . Variable regions in the Serratia rRNA molecules were identified and could serve as the basis for a specific probe design. Eur J Pediatr, 1990 Nov, 150(1), 37 - 9 Screening for delayed-hypersensitivity in Italian children: multicentric study by multitest skin testing; Bardare M et al.; The Multitest skin test allows the simultaneous intradermal application of seven standardized recall antigens in a reproducible manner . Response reading is based on a scoring system that distinguishes between normal and diminished delayed hypersensitivity (DH) . To determine incidence and size of DH responses for each antigen in relation to age and sex in healthy Italian children, a multicentric study was performed on a representative paediatric population of 491 subjects (285 males and 296 females) aged from 4 months to 16 years . In both sexes DH reactivity as measured by score and number of positive responses increased significantly with age . The incidence of anergy was 8.8% for the whole population and decreased significantly with age in both sexes . Incidence of positive responses was highest for tetanus and diphteria toxoids, intermediate for Candida, Proteus and Streptococcus, and lowest for tuberculin and Trichophyton antigens . There was no significant difference between sexes in the incidence of positive response to each antigen. Vestn Oftalmol, 1990 Nov-Dec, 106(6), 18 - 20 {A new method of sterilization of donor eyes}; Kasparov AA et al.; Microbiologic examinations of 200 pairs of donor eyes have revealed Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, and Proteus infection of 124 pairs of eyes (62 percent) . Sensitivities of the isolated microorganisms to various antibacterial drugs was examined . Gentamicin and chlorhexidine proved to be the most effective in respect of the microorganisms isolated from cadaveric eyes . These results enabled the authors suggest a new method for donor eyes sterilization, consisting in placing the donor eyes in aqueous solution of chlorhexidine (0.05 percent) and gentamicin (0.0125 percent) for 10 min immediately before surgery . This method was tried with 300 pairs of cadaveric eyes . Its high efficacy was confirmed by the absence of postoperative complications induced by infection transmission via the transplant . Early infectious complications were recorded in 8 patients of the reference group, where the transplants were sterilized routinely; in 4 cases it was a P . aeruginosa infection. J Antimicrob Chemother, 1990 Nov, 26 Suppl C, 111 - 6 Efficacy and tolerance of cefodizime in the treatment of acute pyelonephritis; Kourilsky O; The efficacy and tolerance of cefodizime in the treatment of acute pyelonephritis were evaluated in an open, international, multicentre study . In total, 128 patients were treated with 1 g cefodizime bd iv or im for a mean of 8.3 days . Underlying urinary tract abnormalities were present in 35% of cases . The most frequently isolated bacteria were Escherichia coli (79/97 evaluable cases) and Proteus mirabilis (8/97 evaluable cases) . The overall clinical and bacteriological success rate was 89.7% (87/97) . The drug was well tolerated, with only a few mild and transitory adverse events . Tolerance at the site of injection was good in 97.5% (78/80) of those treated iv, and 79% (38/48) of those treated im . Three patients had skin reactions which were probably related to cefodizime . Alterations of laboratory parameters were seen transiently in five patients (3.9%) . Cefodizime is effective and well tolerated in the treatment of acute pyelonephritis. Farmakol Toksikol, 1990 Nov-Dec, 53(6), 33 - 6 {The effect of catecholaminergic agents on the efficacy of immunostimulants}; Shigaev NI et al.; The influence of combinations of immunostimulants (prodigiosin, methyluracil, levamisole) and catecholaminergic agents (dopamine, haloperidol, noradrenaline, phentolamine, isoproterenol, propranolol) on the results of antibiotic therapy of acute generalized Proteus infection and primary immune response to ram erythrocytes was studied on outbred albino mice . It was established that the agents influencing dopaminergic, alpha- and beta-adrenergic receptors can in some cases change the efficiency of the studied immunostimulants . The direction and degree of their action depend on the administration schedule. Khirurgiia (Mosk), 1990 Oct, (10), 21 - 4 {Microbiological and immunological indicators in patients with acute cholecystitis}; Perfil'ev DF; The causative agents of acute destructive cholecystitis and wound complications are various pyogenic bacteria including staphylococci, enterococci, Escherichia, Proteus, and anaerobes among which certain varieties, serogroups, and phagocytes predominate . Most bacteria, with the exception of anaerobes, are resistant to penicillin, streptomycin, and chlortetracycline but retain sensitivity to antibiotics of the neomycin series and other chemotherapeutic agents . In most patients with phlegmonous cholecystitis specific antibodies accumulated in the blood during the disease irrespective of one another, while the intensity of their increase was determined by the duration of treatment and the patients' age . The dynamics of changes of the specific antibody titres may confirm the etiology of cholecystitis and be an indirect sign of the prognosis of the disease. J Biomed Mater Res, 1990 Oct, 24(10), 1325 - 32 The effect of protein and urine on uropathogen adhesion to polymer substrata; Hawthorn L et al.; Uropathogenic adhesion was measured using a range of polymer materials with differing surface tension properties . Experiments were carried out in the presence of phosphate buffered saline (controls), Tamm Horsfall protein (THP), and human urine with quantitation by image analysis . The results showed that THP did not bind to the polymer materials and therefore did not act as a receptor surface for type 1 fimbriated Escherichia coli . However, the THP did interfere with adhesion by binding directly to these organisms as well as to Pseudomonas aeruginosa, Staphylococcus epidermidis, and, to a lesser extent, Proteus mirabilis . Incubation of the uropathogens in THP and urine resulted in altered adhesion profiles to polymer surfaces, with no single trend apparent . The results emphasize that fluid components, particularly proteins, and substratum surface tension influence bacterial adhesion to biomaterials. Gen Comp Endocrinol, 1990 Oct, 80(1), 24 - 32 The amphiphilic action of vasopressin and analogues on the plasma membrane of Amoeba proteus; Mayers P et al.; Arginine (AVP) and lysine vasopressin induce a weak but statistically significant increase in the water permeability of Amoeba proteus plasmalemma . Vasotocin and deaminovasopressin, which share the hydroosmotic properties of AVP on classical vertebrate systems, are without effects on Amoeba while SKF 101926, a synthetic AVP antagonist, is even more effective than the parent compound . Theophyllin and dibutyryl-cAMP do not affect AVP action on Amoeba . Lithium, oxytocin, and carbachol are also without effect . Thus, it is unlikely that either V2 (cAMP) or V1 (phosphatidylinositol choline) receptors are involved . A clear correlation has been found between the amphiphilic character of tested peptides and their effect on Amoeba water permeability . Classical amphiphilic peptides, melittin, mastoparan, and fragment 1-8 of alpha-neoendorphin, also increased water permeability in Amoeba . It is known that vasopressin can interact with artificial lipid membranes, increasing their permeability to water . We propose that amphiphilic members of the AVP family interact directly with the lipid phase of the Amoeba membrane . Their incorporation within the lipid bilayer may cause local disruptions or may create micellar water channels as shown for other amphiphilic proteins . Our observations provide a model for the early evolution of peptide hormone systems, preceding the appearance of specific membrane receptors and associated second messenger amplifying mechanisms. No Shinkei Geka, 1990 Oct, 18(10), 975 - 8 {Abscess of the abdominal wall following penetration of the descending colon: a rare complication of a ventriculoperitoneal shunt}; Ogasawara K et al.; A case of abscess of the abdominal wall associated with a ventriculoperitoneal (V-P) shunt following penetration into the descending colon is reported . A 49-year-old male was diagnosed as having hypertensive intracerebellar hematoma with hydrocephalus, and he was treated by V-P shunt . One year later he experienced left hypochondrial pain with rebound tenderness during a period of one week . He was doing well until 4 years and 10 months after, when barium enema examination and colonoscopy incidentally demonstrated that the abdominal catheter had penetrated into the descending colon . However, he had no symptoms . He remained in good health during a period of observation . A year later he was readmitted to our department with an abscess of the abdominal wall . Plain radiograph of the abdomen demonstrated disconnection of the shunt catheter and it was thought that the abdominal catheter had been passed via the rectum . At operation a subcutaneous abscess was found and cultures grew proteus mirabilis . We discussed the mechanism of the developing of the abscess on the abdominal wall following penetration of the bowel . It is believed that abscess of the abdominal wall may occur due to spontaneous extraction of a previously inserted shunt catheter which has penetrated into the bowel. Protein Eng, 1990 Oct, 4(1), 87 - 97 Effects of engineered salt bridges on the stability of subtilisin BPN'; Erwin CR et al.; Variants designed using PROTEUS have been produced in an attempt to engineer stabilizing salt bridges into subtilisin BPN' . All the mutants constructed by site-directed mutagenesis were secreted by Bacillus subtilis, except L75K . Q19E, expressed as a single variant and also in a double variant, Q19E/Q271E, appears to form a stabilizing salt bridge based on X-ray crystal structure determination and differential scanning calorimeter measurements . Although the double mutant was found to be less thermodynamically stable than the wild-type, it did exhibit an autolytic stability about two-fold greater under hydrophobic conditions . Four variants, A98K, S89E, V26R and L235R, were found to be nearly identical to wild-type in thermal stability, indicative of stable structures without evidence of salt bridge formation . Variants Q271E, V51K and T164R led to structures that resulted in varying degrees of thermodynamic and autolytic instability . A computer-modeling analysis of the PROTEUS predictions reveals that the low percentage of salt bridge formation is probably due to an overly simplistic electrostatic model, which does not account for the geometry of the pairwise interactions. Infect Immun, 1990 Oct, 58(10), 3330 - 6 Tissue-binding affinity of Proteus mirabilis fimbriae in the human urinary tract; Sareneva T et al.; Binding characteristics of the two major fimbrial hemagglutinin types of uropathogenic Proteus mirabilis were determined in frozen sections of human kidney and in exfoliated uroepithelial cells . P . mirabilis 3087, which expresses the MR/P fimbriae, adhered avidly to the tubular epithelial cells of the kidney and also to the epithelial cells of urinary sediment . No adhesion to glomerular or peritubular elements of the kidney was detected . Indirect immunogold silver staining also showed that the purified MR/P fimbriae recognized the same kidney domains . Adhesion of strain 3087 to uroepithelial cells was completely inhibited by Fab fragments of antibodies against the purified MR/P fimbriae . A completely different tissue-binding pattern was exhibited by the MR/K fimbriae of P . mirabilis 2456 . In the kidney, the MR/K fimbriae bound strongly to the Bowman's capsule of the glomeruli and to the tubular basement membranes . A weak binding to glomerular mesangium and tubular epithelial cells was also seen . Strain 2456 did not adhere to epithelial cells of urinary sediment . Analysis of normal human urine showed that it contains low-molecular-weight molecules capable of inhibiting the binding of the MR/P fimbriae; no urinary inhibitors could be detected for the MR/K fimbriae . Poor in vivo binding capacity to intact human uroepithelial cells may be an important factor in explaining the relatively low pathogenicity of P . mirabilis in healthy hosts. Gene, 1990 Sep 28, 94(1), 77 - 82 Molecular analysis of the Bacteroides fragilis recA gene; Goodman HJ et al.; The nucleotide sequence of a 2.5-kb DNA segment containing the Bacteroides fragilis recA gene was determined . The coding region of the recA gene specifies a protein of 318 amino acids . The RecA protein of B . fragilis shows significant homology with that of Escherichia coli, Thiobacillus ferrooxidans, Pseudomonas aeruginosa and Proteus mirabilis . No SOS box characteristic of LexA-regulated promoters could be identified in the 5'-noncoding region of the B . fragilis recA gene . Promoter activity of the cloned recA gene in E . coli was located within a 113-bp fragment of the B . fragilis DNA by in vitro construction of operon fusions with a promoterless lacZ gene . The transcription start point for this gene in B . fragilis was determined by primer extension analysis. Antibiot Khimioter, 1990 Sep, 35(9), 42 - 5 {Spectrum of pathogens in hospital infections in onco-urologic patients and their sensitivity to antibacterial drugs}; Dronova OM; Retrospective examination of case records and laboratory findings related to 155 patients discharged from the Urological Department of the All-Union Oncology Research Centre, Academy of Medical Sciences of the USSR within a period of 3 months showed that 41.9 per cent of the oncourological patients had infectious processes requiring antibacterial therapy . Among 80 infectious episodes 62 or 77.5 per cent were of intrahospital origin . There was a relationship of the frequency of the infections to localization of the tumor process, a patient's age, the treatment character and some diagnostic and treatment procedures . 70 per cent of the hospital infections were urinary and 15 per cent referred to suppuration of the operative wounds . The predominant causative agents of the complications were Pseudomonas spp., Klebsiella tribe, Proteus spp . and Enterococci with the highest levels of resistance to antibacterial drugs . The drugs of choice for treating the infections in that group of the patients were ofloxacin and cefotaxime . Aminoglycosides, semisynthetic penicillins, cephalosporins and urological antiseptics were used in accordance with antibioticograms . In the treatment of severe gram-negative infections dioxydin was used . Since hospital infections in oncourological patients are usually caused by hospital multiple resistant strains of microorganisms, often present in associations, the adequate antibacterial therapy requires constant bacteriological surveillance providing not only the choice of the most efficient drug but also early correction of the therapy after the pathogen change. Jpn J Antibiot, 1990 Sep, 43(9), 1530 - 7 {Susceptibilities of uropathogenic bacteria to ampicillin, cefazolin, cefmetazole and gentamicin . Nine-year survey of changing patterns of susceptibilities}; Igari J et al.; We analyzed antibiotic susceptibilities of urinary isolates of Escherichia coli, Klebsiella spp., Proteus mirabilis, and Indole (+) Proteus group to ampicillin (ABPC), cefazolin (CEZ), cefmetazole (CMZ) and gentamicin (GM) in 69 laboratories in 1988 and also studied changing patterns of susceptibilities from 1980 to 1988 . Minimal inhibitory concentrations were determined using the agar dilution method (MUELLER-HINTON agar, BBL) with inoculation of 10(6) cfu/ml of bacteria . Ninety to 99% of the strains of E . coli, Klebsiella spp . and P . mirabilis were inhibited at a concentration of 6.25 micrograms/ml of CEZ and CMZ and of 1.56 micrograms/ml of GM . Approximately 80% of the strains of Indole (+) Proteus group were inhibited at concentrations of 6.25 micrograms/ml of CMZ and of 1.56 micrograms/ml of GM . However, resistance to ABPC and CEZ was high, with 83% and 81% of the strains being not inhibited at a concentration of 50 micrograms/ml of ABPC and CEZ, respectively . No significant changes in susceptibilities of the 4 bacteria to the above 4 antibiotics were observed over the 9 year period . No increase was found in the incidence of the resistant strains of the 4 bacteria to CMZ and GM, nor of E . coli and Klebsiella spp . to CEZ. Gene, 1990 Sep 1, 93(1), 27 - 34 Nucleotide sequence of a Proteus mirabilis DNA fragment homologous to the 60K-rnpA-rpmH-dnaA-dnaN-recF-gyrB region of Escherichia coli; Skovgaard O; A 6.5-kb DNA fragment from Proteus mirabilis hybridized to the Escherichia coli dnaA gene . This DNA fragment was cloned and the nucleotide (nt) sequence determined . The fragment is homologous to a region of the E . coli chromosome containing a part of the gene encoding a 60-kDa membrane-associated protein (60K), the rnpA-rpmH-dnaA-dnaN-recF genes, and the N-terminal part of the gyrB gene . The degree of homology is variable: the amino-acid (aa) sequence of a part of the 60K protein and a part of the DnaA protein is only minimally conserved, whereas the C-terminal 148 aa of DnaA are identical in the two species . The conservation of the nt sequence between the rnpA gene and the gene encoding the 60K protein suggests that this region encodes a hitherto unrecognized protein . The ORF for this protein partially overlaps the 3' end of the rnpA structural gene, and the degree of conservation suggests that this gene is important for these bacteria. Urol Nefrol (Mosk), 1990 Sep-Oct, (5), 49 - 54 {The characteristics of the chemical composition and structure of urinary stones and their prevalence in the cities of Moscow, Berlin and of the Kirghiz SSR}; Schubert G et al.; The authors studied the features of urolithiasis in three different geographical regions: Moscow, the Kirghiz SSR, and Berlin from the findings of examination of the composition and structure of uroliths removed by operation or passed spontaneously, (602 concrements from Moscow, 10,000 from Berlin, and 127 from Kirghizia) . X-ray diffraction measurement, infrared spectrophotometry, and polarizing microscopy were conducted to analyze the composition and structure of the stones . Complex biochemical examination was carried out in patients from Moscow and Kirghizia . According to the results of the study, the following features of urolithiasis are common in the studied regions: (1) prevalence of oxalate lithiasis on the whole, which points to the principal role of metabolic factors in lithogenesis; (2) approximately similar amounts of apatite carbonate crystals in the uroliths; (3) certain similarity in composition of concrements from Berlin and Kirghizia . The most essential differences are: (1) the frequency of renal oxalate stones is highest in Berlin and lowest in Moscow . The prevalent types of calcium oxalate stones are: whewellite of concentric structure (linked with hyperuricemia) in Kirghizia; whewellite of small randomly orientated crystals (linked with hypercalciuria) and stones with signs of transformation of weddellite to whewellite in Moscow; (2) lesser distribution of phosphate lithiasis in Berlin than in Kirghizia and particularly in Moscow . Prevalence of struvite crystals in stones from Moscow, the formation of which is linked with the vital activity of Proteus and E . coli; (3) higher distribution of urate lithiasis in Moscow and particularly in Kirghizia where significant metabolic risk factors of lithogenesis were revealed. Arch Ital Urol Nefrol Androl, 1990 Sep, 62(3), 361 - 8 {Enoxacin in the treatment of male genital infections in patients with antisperm autoimmune pathology}; Lombardo F et al.; Anti-sperm antibodies are frequently present in patients bearing infections of the genital tract and a cause-effect relationship is suspected in these two pathological conditions . In an open, uncontrolled study, the Authors tested the therapeutical effect on both autoimmune anti-sperm and infectious genital tract diseases . Thirty patients, age 30.3 +/- 3.6 years (mean +/- D.S.; range 25-42), were admitted to the study . In all patients the clinical diagnosis was confirmed by a positive sperm culture for enoxacin sensitive germs . Eleven out of 30 patients (36.7%) were also found to be positive by both immunofluorescence and immunoenzymatic tests for Chlamydia Trachomatis at the beginning of the study . At day 0 (first menstrual cycle day of the patients' partner) enoxacin treatment (300 mg twice daily) was started with the patients and their partners for a period of 30 and 12 days respectively . Sperm culture and both the above mentioned tests for Chlamydia Trachomatis were subsequently repeated on day 5 of therapy (first control) and at 1, 3, 6 and 12 months (2nd, 3rd, 4th, and 5th controls respectively) after the end of treatment . Statistical analysis of the results was performed by both Dunnett and Chi-square tests as appropriate . Isolated germs from pre-treatment sperm culture were classified as Enterococcus (17/30 cases: 56.7%) E . Coli (8/30: 26.6%), Klebsiella (2/30: 6.6%) and St Albus, Proteus and Enterococcus-Klebsiella coinfections (1/30 cases: 3.3% each).(ABSTRACT TRUNCATED AT 250 WORDS) Rev Inst Med Trop Sao Paulo, 1990 Sep-Oct, 32(5), 313 - 8 {Lymphatic cutaneous rickettsiosis caused by Rickettsia conorii in Uruguay}; Conti-Diaz IA et al.; Three autochthonous cases of cutaneous-ganglionar rickettsiosis transmitted by dogs ticks (Amblyomma maculatum in one of them) are reported . Two of the three cases were undoubtely produced by Rickettsia conorii according to the results of the specific indirect immunofluorescence technique IEF-IgM anti R . conorii . A third case is included due to the clinical epidemiological similarity, the positive serum reactivity with Proteus O x 19 and the rapid response to tetracycline . Autochthonous rickettsiosis by R . conorii has not been previously registered in the American area what confers special interest to this communication . The search of the disease in the other countries of the region is suggested. Srp Arh Celok Lek, 1990 Sep-Oct, 118(9-10), 411 - 4 {Etiopathogenesis of the inflammation process and the incidence of urinary tract infections}; Bozanic K; Etiopathogenesis of inflammatory processes of the urinary tract, mainly of obstructive uropathy and chronic pyelonephritis, is reviewed . The most frequent cause of obstruction is renal calculosis; in the pathogenesis of chronic pyelonephritis the following factors are of great importance: renal and urethral anomalies, renal stones, pregnancy, bladder instrumentation as catheterisation, etc . We analyzed 2101 random by selected hospital patients and found significant bacteriuria in 740 (35 p.c.) of them . The most frequent cultured bacteria which caused urinary infection were: Proteus strains (29.3 p.c), E . coli (27.5 p.c.) and Pseudomonas aerug . (13,6 p.c.) Significant bacteriuria was more frequent in men than in women, but E . coli was more frequent in women (71.5 p.c.) . Proteus, Pseudomonas and Klebsiella were more frequent in men . It should be noted that the majority of patients with positive urinary cultures were subjects treated at the Urology Department; and that men prevailed . This is the reason why our results related to the causing bacteria differed from those found in general population. Infect Immun, 1990 Sep, 58(9), 2895 - 905 Cloning, partial sequence, expression, and antigenic analysis of the filamentous hemagglutinin gene of Bordetella pertussis; Delisse-Gathoye AM et al.; The gene coding for the filamentous hemagglutinin (FHA), one of the main factors involved in mediating adherence of Bordetella pertussis to ciliated host cells, was cloned in Escherichia coli, and the 3,500-base-pair nucleotide sequence encoding the amino-terminal region was determined . Molecular cloning, together with the characterization of recombinant FHA-related proteins produced in E . coli, revealed that the primary translation product is a protein of about 370 kilodaltons (kDa) . The mature 220-kDa FHA polypeptide secreted by B . pertussis is most probably generated by proteolytic processing that eliminates a carboxy-terminal portion of about 150 kDa . The 1,087 amino-terminal residues of the predicted FHA sequence showed a number of remarkable features . Extensive homology to the Serratia marcescens and Proteus mirabilis hemolysin proteins was found between amino acids 91 and 205 of the FHA sequence, suggesting involvement of this FHA domain in host cell binding or secretion of FHA from B . pertussis . In addition, two regions containing repetitive amino acid sequences were identified . One region, extending from residues 382 to 664, was formed by six repeats, and a second, extending from residues 701 to 912, contained three repeats . The reactivities of several recombinant FHA-derived proteins with a panel of monoclonal antibodies identified at least four epitopes composing an immunoreactive domain present in the carboxy-terminal moiety of the mature FHA. Am J Med Genet, 1990 Aug, 36(4), 511 - 2 Ambiguous genitalia in the Proteus syndrome; Frydman M et al.; An 11-year-old girl was followed up since birth because of hemihypertrophy of the left leg and thigh, multiple pigmented nevi and subcutaneous tumors typical of the Proteus syndrome . Because of clitoromegaly and scrotal-like hypertrophy of the labia majora, she had an endocrine evaluation the results of which were normal . The findings are thought to represent local genital hypertrophy . Ambiguous genitalia have to be added to the phenotype of the Proteus syndrome. Zh Mikrobiol Epidemiol Immunobiol, 1990 Aug, (8), 49 - 53 {The enterotoxigenic capacity of hemolysin-producing strains of Proteus isolated in acute intestinal infections in children}; Gabidullin ZG et al.; The capacity of P . mirabilis and P . vulgaris strains isolated in acute enteric infections in children for producing enterohemolysin, a new type of hemolysin, has been shown . The relationship between the capacity of Proteus cultures for producing enterohemolysin and their capacity for inducing toxic secretory reaction on a ligated loop on the small intestine of rabbits in the absence of known thermostable and thermolabile antitoxin in bacteria. J Antimicrob Chemother, 1990 Aug, 26(2), 185 - 92 Antibacterial effect of meropenem and imipenem on Proteus mirabilis; Yourassowsky E et al.; Phase-contrast microscopy, killing-curves and turbidimetric growth-curves were used in a comparative study of the antibacterial effects of a new carbapenem, meropenem (SM 7338) and imipenem on five strains of Proteus mirabilis . Despite the low MIC (0.2 mg/l) of imipenem for the five strains included in our study, the MBC remained relatively high (4.4 mg/l) . During the first few hours of incubation, imipenem induced large lemon-shaped cells while the turbidity increased without substantial changes in culture viability . Later, most of the cell-wall deficient bacteria generated small spheroplasts until the antibiotic concentration exceeded 32 times the MIC . The MIC of meropenem was lower (0.03 mg/l) with an MBC (0.08 mg/l) very close to the MIC . Meropenem also induced large bodies but these cell-wall deficient bacteria did not generate small round bodies as observed with imipenem . In conclusion, imipenem produced in strains of Pr . mirabilis an amdinocillin-like change in cell morphology, responsible for the discrepancies observed between MIC and MBC . This effect was not observed with meropenem. Clin Genet, 1990 Aug, 38(2), 139 - 44 The Proteus syndrome: association with nephrogenic diabetes insipidus; Hotamisligil GS et al.; In this report we present the first case of Proteus syndrome associated with nephrogenic diabetes insipidus . The case is a 9-month-old girl, with macrodactyly of both feet and left hand, syndactyly of the 3rd and 4th fingers of the left hand, soft tissue masses in the paravertebral and gluteal regions, and a hyperpigmented epidermal nevus with hyperkeratosis on the left half of the body. J Mol Evol, 1990 Aug, 31(2), 71 - 80 Switches in species-specific codon preferences: the influence of mutation biases; Shields DC; A model of synonymous codon usage is developed in which the most frequent codons are selectively advantageous because of their coadaptation with tRNA abundances . Random drift opposes the progress of this coevolution by pushing codon frequencies in the direction of the frequency that would result from mutation in the absence of selection . It is predicted that, within a certain range, an increased mutation bias away from an advantageous codon has little influence on its usage in highly expressed genes . However, a subsequent small increase in mutation bias over a critical range leads to a large reduction in the frequency of the codon . The switch in preference from one synonym to another is a sharp transition, with no stable intermediate state in which neither codon is advantageous . Codon usage patterns were compared among three related bacterial species of differing genomic G & C contents, Escherichia coli, Serratia marcescens, and Proteus vulgaris . It was found that although changes in mutation biases do not always result in switches in codon preferences, some switches have occurred in the direction of species-specific mutation biases . Fluctuating mutation biases may therefore be the main cause of differences between species in their codon preferences. J Urol, 1990 Aug, 144(2 Pt 1), 264 - 9 Bacterial adherence to urethral catheters; Roberts JA et al.; Closed sterile catheter drainage has markedly reduced the incidence of nosocomial urinary tract infections . Infections that occur during closed drainage must ascend by colonizing the catheter or urethra . Our study compared adherence by different bacterial species to different catheter surfaces . We found no bacteria adhering to the hydrophilic catheter surface . Of the gram-negative bacteria Proteus mirabilis showed the greatest adherence to the other catheters and it, like most bacteria, showed the most marked adherence to the red rubber catheter. Enzyme Microb Technol, 1990 Aug, 12(8), 596 - 602 Coenzymatic properties of low molecular-weight and macromolecular N6-derivatives of NAD+ and NADP+ with dehydrogenases of interest for organic synthesis; Ottolina G et al.; The catalytic activity, expressed as Km and Vmax values, of 16 enzymes of practical interest with the macromolecular coenzymes poly(ethylene glycol)-N6-(2-aminoethyl)-NAD+ and poly(ethylene glycol)-N6-(2-aminoethyl)-NADP+ and their low molecular weight precursors N6-(2-aminoethyl)-NAD+ and N6-(2-aminoethyl)-NADP+, was investigated . The enzymes examined are of direct interest for organic synthesis (i.e . alcohol dehydrogenase from yeast, horse liver, or Thermoanaerobium brockii, lactic dehydrogenase, and several hydroxysteroid dehydrogenases) or are used for the regeneration of NAD+, NADP+, NADH, or NADPH (i.e . glutamate dehydrogenase from liver or Proteus, formate dehydrogenase, glucose dehydrogenase, and malic enzyme) . The cycling efficiency of poly(ethylene glycol)-N6-(2-aminoethyl)-NADP+ was examined with coupled-enzymes or coupled-substrates systems . Poly(ethylene glycol)-N6-(2-aminoethyl)-NAD+ and, even more so, poly(ethylene glycol)-N6-(2-aminoethyl)-NADP+ were excellent coenzymes with several dehydrogenases . In addition, the coenzymatic properties of N6-(3-sulfonatopropyl)-NAD+, an NAD+ derivative carrying a strong anionic group, were compared with those of the newly synthesized N6-(2-hydroxy-3-trimethylammonium propyl)-NAD+, an NAD+ derivative carrying a strong cationic group . It was expected that the presence of the sulfonic or quaternary ammonium group would enhance the residence time of the coenzyme inside continuous-flow reactors if membranes with anionic or cationic groups, respectively, were used. J Clin Microbiol, 1990 Jul, 28(7), 1645 - 6 Bacteremia and subcutaneous abscess caused by Proteus penneri in a neutropenic host; Engler HD et al.; Proteus penneri bacteremia and concomitant subcutaneous infection developed in a neutropenic patient with acute lymphocytic leukemia . The skin infection occurred while the patient was being treated empirically with cefoperazone and metronidazole . This case demonstrates the invasive potential of this microorganism in the proper setting. Zh Mikrobiol Epidemiol Immunobiol, 1990 Jul, (7), 74 - 8 {Proteus peritonitis-bacteremia in mice--a model for studying postvaccinal Proteus immunity}; Zaitsev EV et al.; The dynamics of the formation of postvaccinal immunity after immunization with preparations obtained with the use of hydroxylamine (HA) preparations from Proteus strains of different O serogroups, Salmonella minnesota Re-mutant and the common antimicrobial antigen isolated from Escherichia coli 14 has been studied on mice with Proteus peritonitis-bacteremia used as a model . The study has revealed that intraperitoneal immunization with Proteus HA preparations stimulates the phagocytic activity of peritoneal mononuclear cells in mice and induces an increase in the titers of specific O antibodies . Proteus antigens ensure the formation of anti-Proteus immunity, preventing the death of the animals from peritonitis-bacteremia . The protection of mice from such infection resulting from the injection of the common antigens of gram-negative bacteria is considerably less . These data are indicative of the possibility of using Proteus peritonitis-bacteremia as a model for the study of the protective potency of Proteus vaccines. Scand J Prim Health Care, 1990 Jul, 8(2), 81 - 3 The diagnosis of bacteriuria during pregnancy; Lorentzon S et al.; Three diagnostic tests, Nitur, Urobact, and Uricult, were evaluated in the detection of bacteriuria in 865 pregnant women . As reference method agar culture was performed . Heavy growth (greater than 10(5) CFU/ml) of urinary tract bacteria was considered a true positive result and demonstrated in 58 (6.7%) of the women, 14 of whom had gram-negative rods . The sensitivity of the nitrite test was extremely low (0.13) . The test gave negative results in eight of 17 specimens yielding heavy growth of Escherichia coli or Proteus mirabilis . Although the Urobact test was highly sensitive as regards gram-negative infection, it had an unacceptably low (0.27) predictive value in positive tests . The sensitivity of the Uricult test was low (0.35) in this study . The predictive value (0.50) of a positive test result may be acceptable, since just over half of the false positive results were explainable by moderate growth of urinary tract pathogens (10(4)-10(5) CFU/ml) . It is argued that semi-quantitative urine culture may be preferable to the rapid diagnostic methods studied for the screening of bacteriuria in pregnant women. Cesk Epidemiol Mikrobiol Imunol, 1990 Jul, 39(4), 237 - 41 {The effect of glutaraldehyde on mycobacteria and on selected types of bacteria}; Slosarek M et al.; The author tested the action of 2% alkalinized glutaraldehyde on Mycobacterium tuberculosis, M . kansasii, M . avium, M . xenopi and M . fortuitum, as well as Staphyloccocus aureus, Escherichia coli, Pseudomonas aeruginosa, Proteus vulgaris, Bacillus cereus, B . megatherium and B . subtilis . After 5-minute exposure devitalization of M . tuberculosis, M . kansasii and vegetative forms of the tested bacteria occurred . A sporicide effect was recorded already after 30 minutes or after more than 120 minutes . Most resistant were potentially pathogenic M . fortuitum, M . xenopi and M . avium where the disinfectant effect (a drop of CFU by 99.99%) was recorded after 7-63 minutes and their complete devitalization occurred after 3 (M . fortuitum) to 20 hours' (M . avium) action . The author recommends therefore exposure for 24 hours for sterilization of objects contamined with the above species of mycobacteria . This pertains in particular to instruments which cannot be sterilized by heat (endoscopes, bronchoscopes, sigmoidoscopes etc.), used in the diagnosis of mycobacterioses in patients with compromised immunity, e.g . in AIDS. Mikrobiologiia, 1990 Jul-Aug, 59(4), 704 - 7 {Joint culturing of Streptococcus lactis, strain MGU with Proteus vulgaris and Bacillus mesentericus}; Kozlova IuI et al.; Nisin synthesis by Streptococcus lactis, strain MGU, grown as a combined culture together with Proteus vulgaris and Bacillus mesentericus under stationary conditions or with stirring does not depend on the quantity of inoculated associated cells . Nisin synthesis in the combined culture drops down by 10-20% at the initial pH 7.5 of the growth medium which is unfavourable for S . lactis producing nisin . The level of nisin biosynthesis does not rise when the pH of the medium is adjusted (either naturally or artificially) to 6.6-6.8 in the presence of glucose and yeast autolysate . S . lactis inhibits the growth of B . mesentericus when grown together with it whereas P . vulgaris inhibits the growth of S . lactis in their combined culture. J Biol Chem, 1990 Jun 5, 265(16), 9464 - 9 Purification and characterization of urease from Helicobacter pylori; Dunn BE et al.; Urease was purified 112-fold to homogeneity from the microaerophilic human gastric bacterium, Helicobacter pylori . The urease isolation procedure included a water extraction step, size exclusion chromatography, and anion exchange chromatography . The purified enzyme exhibited a Km of 0.3 +/- 0.1 mM and a Vmax of 1,100 +/- 200 mumols of urea hydrolyzed/min/mg of protein at 22 degrees C in 31 mM Tris-HCl, pH 8.0 . The isoelectric point was 5.99 +/- 0.03 . Molecular mass estimated for the native enzyme was 380,000 +/- 30,000 daltons, whereas subunit values of 62,000 +/- 2,000 and 30,000 +/- 1,000 were determined . The partial amino-terminal sequence (17 residues) of the large subunit of H . pylori urease (Mr = 62,000) was 76% homologous with an internal sequence of the homohexameric jack bean urease subunit (Mr = 90,770; Takashima, K., Suga, T., and Mamiya, G . (1988) Eur . J . Biochem . 175, 151-165) and was 65% homologous with amino-terminal sequences of the large subunits of heteropolymeric ureases from Proteus mirabilis (Mr = 73,000) and from Klebsiella aerogenes (Mr = 72,000; Mobley, H . L . T., and Hausinger, R . P . (1989) Microbiol . Rev . 53, 85-108) . The amino-terminal sequence (20 residues) of the small subunit of H . pylori urease (Mr = 30,000) was 65 and 60% homologous with the amino-terminal sequences of the subunit of jack bean urease and with the Mr = 11,000 subunit of P . mirabilis urease (Jones, B . D., and Mobley, H . L . T . (1989) J . Bacteriol . 171, 6414-6422), respectively . Thus, the urease of H . pylori shows similarities to ureases found in plants and other bacteria . When used as antigens in an enzyme-linked immunosorbent assay, neither purified urease nor an Mr = 54,000 protein that co-purified with urease by size exclusion chromatography was as effective as crude preparations of H . pylori proteins at distinguishing sera from persons known either to be infected with H . pylori or not. J Med Genet, 1990 Jun, 27(6), 399 - 402 Proteus syndrome: report of a case with severe brain impairment and fatal course; Rizzo R et al.; A patient with Proteus syndrome is reported . He had hemihypertrophy, bilateral hypertrophy of the third fingers, skin anomalies, and varicosities, as well as mental retardation, seizures resistant to anticonvulsant treatment, and a very severe course with death at the age of 2 years. Infect Immun, 1990 Jun, 58(6), 1861 - 9 Cytotoxic activity of the Proteus hemolysin HpmA; Swihart KG et al.; We previously showed that hpmA is the hemolysin determinant most commonly found among Proteus isolates . To assess the potential contribution of HpmA to virulence, we first characterized the toxic activities of this hemolysin . Hemolytic activity was present in total cell cultures and cell-free supernatants of Proteus clinical isolates as well as Escherichia coli containing cloned hpm genes . HpmA also possesses cytotoxic activity which was detected by a chromium release assay against a variety of target cell lines (Daudi, Raji, T24, U937, and Vero) . Analysis of the dose response of bacterial cells against both T24 cells and erythrocytes showed that E . coli containing cloned hpm genes was 30-fold more cytotoxic than Proteus mirabilis BA6163 . Also, 10(5)-fold more bacterial cells were needed to lyse T24 cells than to lyse erythrocytes . HpmA- mutants of two Proteus strains in which the central portion of hpmA was deleted were constructed . These HpmA- mutants, which have lost the hemolytic and cytotoxic activities exhibited by their respective parent strains, demonstrate that HpmA is needed for both of these activities . In an ascending model of murine urinary tract infection, the hpmA mutant strain WPM111 behaved no differently from its parent strain, BA6163, with respect to either the level of kidney colonization or histopathological changes in the kidney . However, WPM111 had a sixfold higher 50% lethal dose than BA6163 when injected intravenously into C3H mice. Infect Immun, 1990 Jun, 58(6), 1853 - 60 The HpmA hemolysin is more common than HlyA among Proteus isolates; Swihart KG et al.; Two different hemolysins, HpmA and HlyA, have been reported in Proteus spp . To study the distribution of these hemolysins among Proteus strains, isolates from various infections and normal feces were screened for hemolysin production . All 63 Proteus mirabilis strains and 23 of the 24 Proteus vulgaris strains produced a calcium-independent hemolytic activity detectable in cell-free supernatants . The calcium-independent activity was due to HpmA; this activity correlated with the presence of hpmA sequences and the production of an extracellular 166-kilodalton (kDa) protein that reacted with anti-HpmA antiserum . HpmA- mutants, constructed by deletion of the central portion of the hpmA gene, did not produce the 166-kDa protein and were no longer hemolytic when compared with t