Proteus

Vutr Boles, 1989, 28(3), 77 - 81
{Chronic pyelonephritis in polycystic kidney}; Todorov V et al.; The characteristics of chronic pyelonephritis are studied in 37 patients out of a total of 53 patients with proved renal polycystosis . A group of 71 patients with chronic pyelonephritis selected at random are used as a control group . The frequency of chronic pyelonephritis among the patients with renal polycystosis is 69.8% . The difference between the mean age of the patients with renal polycystosis and chronic pyelonephritis and the patients with renal polycystosis without chronic pyelonephritis is 8.6 years . A significant difference is established between these two groups of patients concerning the frequency of symptomatic hypertension--89.2% for the patients with renal polycystosis and chronic pyelonephritis and 45% for the patients with uncomplicated renal polycystosis . A similar difference is established also for the renal failure--respectively 64.9% and 37.5% . The frequency of hypertension and chronic renal failure is lower in the control group of patients . 59% of the patients with renal polycystosis and chronic pyelonephritis have significant bacteriuria, E . coli and Proteus being the most frequently isolated bacteria but Pseudomonas shows the highest drug resistance . The isolated bacteria are most sensitive to nitroxoline and aminoglycoside antibiotics.

Vopr Pitan, 1989 Jan-Feb, (1), 36 - 9
{Experience in the use of anti-colibacillus and Proteus lactoglobulin as a supplement to milk products in diet therapy at a specialized childrens' collective}; Soboleva SV et al.; A new biologically active supplement (BAS) for infant food was tested at an Infant's Home . BAS-IG contains lactoglobulin, an immune preparation against colibacillus and Proteus . During the primary examination of the infants in the Infant's Home intestinal dysbacteriosis was revealed in 100% of the infants, clinical signs of dysbacteriosis were detected in 88.4% of the infants . Two successive courses of feeding the infants with products enriched with the new supplement resulted in a significant improvement of the microflora composition in them and in normalizing their clinical condition . At the same time positive changes in a number of immunological factors were recorded . The authors have recommended using BAS-IG for correction of dysbacteriosis in children at Infant's Homes.

Tsitologiia, 1989 Jan, 31(1), 85 - 96
{Enzymes of the phosphogluconate pathway in amebas}; Sopina VA et al.; Glucose-6-phosphate and 6-phosphogluconate dehydrogenases (G6PD and 6PGD) are revealed in Amoeba proteus by electrophoresis in polyacrylamide gels, thus proving the availability of the phosphogluconic pathway in amoebae . 6PGD is marked as a single band, and G6PD shows multiple banding . When an amoebic homogenate is obtained using Triton-100, a supplementary form of G6PD extracted from membranes of some cell organelles (presumably mitochondria) becomes apparent . Hexose-6-phosphate dehydrogenase seems to be absent and therefore all the G6PD forms found may be specific G6PDs proper.

Indian J Lepr, 1989 Jan, 61(1), 65 - 7
Bacteriology of infected hands and feet in leprosy patients; Abdulkadir S; 70 cases of infected hands and feet admitted to ALERT Hospital during 1986/1987 (3/10/86-5/5/87) were studied for the infecting organisms and the sensitivity of these organisms to available antibiotics . Single organisms were isolated in 56 cases (95%), two organisms were isolated in 3 cases (5%), no organisms were isolated in 11 cases (15.7%) . Proteus was the commonest organism . Most effective drug was Ampicillin . Three organisms isolated in 7 cases proved resistant to all drugs tested . The study shows that commonly available drugs are effective in the great majority of secondary infections in leprosy patients.

Retina, 1989, 9(4), 263 - 6
Late bacterial endophthalmitis following retinal detachment surgery; Duker JS et al.; We report two cases of late postoperative bacterial endophthalmitis that occurred following retinal detachment repair . Both patients presented months after their scleral buckling procedures with a subacute uveitis . Over a period of one to two weeks, the inflammation gradually increased, until the classic clinical appearance of fulminant bacterial endophthalmitis was present . In an effort to treat the infection, a pars plana vitrectomy was performed in both cases . At the time of vitreous surgery, intrusion of the scleral buckling elements into the globe was observed, suggesting a possible means of entry for the infectious agent . Removal of the buckling elements, repair of the scleral defects, and injection of intravitreal antibiotics were performed as therapeutic interventions . Vitreous cultures were positive in both cases for Proteus mirabilis . Postoperatively the retina remained attached in both instances, and, in one case, the visual acuity returned to 20/20.

J Hyg Epidemiol Microbiol Immunol, 1989, 33(4), 477 - 86
Aminoglycoside resistance patterns in clinical isolates of E . coli and Klebsiella sp . from Czechoslovakia and the United States; Navarova J et al.; Resistance of gram-negative bacilli to aminoglycoside antibiotics differs by region and country . Previous studies have demonstrated predominance of the nucleotidyltransferase ANL(2") as the mechanism of enzymatic resistance to gentamicin in the United States and many European countries (Federal Republic of Germany, Switzerland, Greece, Turkey) whereas the acetylating enzymes AAC(6') and AAC(3) were the principal causes of resistance to aminoglycosides in Japan and Chile . In the present comparison of 18 drug resistant isolates of E . coli and Klebsiella sp . from Czechoslovakia and the United States, with aminoglycoside-inactivating enzymes, ANT(2") characterized the most strains from both countries . In a higher number of isolates from Czechoslovakia however, the aminoglycoside resistance was mediated by AAC(3) . In the majority of strains a simultaneous occurrence of two gentamicin-inactivating enzymes i.e . ANT(2"), plus AAC (2'), or AAC(6') or AAC(3) was observed . In amikacin resistant E . coli strains the mechanism of resistance was represented by production of AAC(6') or AAC*--an acetyltransferase with uncommon substrate profile . In all E . coli and K . pneumoniae strains from the United States apart from ANT(2") also AAC(2') was detected . This represents a broadening of the host range of aac(2') gene, the occurrence of which has been limited only to Providencia and Proteus strains.

Rheumatol Int, 1989, 9(3-5), 223 - 8
Rheumatoid arthritis and Proteus: a possible aetiological association; Ebringer A et al.; The presence of specific anti-Proteus antibodies in active, rheumatoid arthritis (RA) patients, has been demonstrated by four different techniques: indirect bacterial agglutination, ELISA, Western blotting and immunofluorescence . Furthermore, anti-HLA-DR4 tissue typing sera have been shown to bind to Proteus microorganisms, thereby suggesting some molecular similarity or cross-reactivity between bacteria and HLA antigens . The concept is proposed that Proteus-reactive arthritis occurs during active phases of RA and tissue damage is mediated through immunological activity involving HLA antigens.

Med Dosw Mikrobiol, 1989, 41(2), 121 - 9
{Hemagglutinating properties of Proteus mirabilis strains isolated from clinical specimens}; Samet A et al.; Haemagglutinating properties of 345 P . mirabilis strains isolated from various clinical samples were determined . Red blood cells of different origin as human group 0, bovine, horse, sheep and rat were used for the study . For the detection of MS and MR/P haemagglutinins the haemagglutination reaction was run with and without D-mannose . On the other hand, for the detection of type MR/K haemagglutinins tanned human and bovine erythrocytes were used . The majority of tested strains (90.14%) was polyhaemagglutinating i.e . showed simultaneously the presence of two or three haemagglutinins . Only three strains of P . mirabilis (0.87%) did not agglutinate any of the erythrocytes used for the study . The majority of strains (95.83-100%) in specific groups of clinical materials showed the presence of MR/K+ while MR/P+ 45.45-93.75% of strains and MS+ 45.83-73.1% of tested strains . Out of P . mirabilis strains isolated from urine, faeces and blood the highest percentage possessed at the same time all three haemagglutinin types (MS+, MR/K+, MR/P+) or pattern MR/K+, MR/P+ . Bronchial isolates had usually pattern MR/K+ (31.82%) and strains isolated from skin possessed haemagglutinins of pattern MR/K+, MR/P+ (50%) and MS+, MR/K+, MR/P+ (43.75%) . Among strains expressing MR/P+ at 37 degrees C a great differentiation of spectrum activity against tested erythrocytes was seen . Undoubtedly, the majority of MR/P+ strains from specific groups of clinical materials (with the exception of urine) agglutinated sheep and horse erythrocytes with and without D-mannose . The majority of strains isolated from urine agglutinated sheep and bovine erythrocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Urol Int, 1989, 44(4), 210 - 7
Morphological lesions of the rat urinary tract induced by inoculation of mycoplasmas and other urinary tract pathogens; Larsson PA et al.; The effects on the urinary tract after inoculation of Ureaplasma urealyticum into the rat bladder were evaluated and compared to that seen after Mycoplasma hominis, Escherichia coli and Proteus mirabilis inoculation . The inoculation of the urease-producing organisms P . mirabilis and U . urealyticum were associated with the formation of struvite bladder stones and predominantly hyperplastic lesions of the bladder . The P . mirabilis inoculated rats also displayed marked pyelonephritis . A similar but much less pronounced reaction also occurred in the kidneys of some of the U . urealyticum inoculated rats . P . mirabilis could frequently be recultured . In contrast, this was not possible with U . urealyticum, but the organism was detected by scanning electron microscopy 2 weeks after the inoculation . Inoculation of M . hominis was associated with a few mild lesions of the bladder, but inflammatory lesions were not present in the kidneys . The study confirms the potential of Ureaplasma to form struvite stones in rat urinary tract . It also demonstrates that it can induce inflammatory changes in both bladder and kidney of rats without concomitant stone formation.

Scand J Urol Nephrol, 1989, 23(2), 131 - 6
The relation between urinary tract infections and stone composition in renal stone formers; Holmgren K et al.; During a seven-year period (1975-1981) a total of 1325 patients hospitalized for stone disease were studied as to the occurrence of positive urine cultures . Urinary stones from 535 surgically treated patients were analyzed with infrared spectrophotometry and the relationships between stone composition, level of surgery and bacteriological strains were studied . Positive urinary cultures were found in 34% of the surgically treated patients and in 21% of those not operated upon . Among the surgically treated patients with urinary tract infection (UTI) E . coli was the most frequent microorganism (35%), followed by Proteus (28%) . Patients with Proteus infection had the highest frequency of UTI episodes, most of which occurred before hospitalization . There was a higher frequency of magnesium ammonium phosphate (MAP) calculi among patients with Proteus infection than among those with non-Proteus infection, in whom no difference in stone composition was found . Patients infected with E . coli had more phosphate-containing stones (CaP+MAP) than non-infected patients . The highest frequency of oxalate calculi (CaOx+CaOx/CaP) was found among patients without infection . No E . coli infections were seen in male patients with CaP and MAP calculi . MAP stones were most often found in the kidney and oxalate stones in the ureter.

Chemotherapy, 1989, 35 Suppl 1, 8 - 14
Aztreonam in the treatment of urinary tract infections: a multicenter trial; Martelli A et al.; A multicenter trial involving several urologic units in Italy provided pooled data on 1,427 patients with urinary tract infections to evaluate the efficacy and safety of aztreonam, a new monobactam antibiotic . Microbiologic and clinical data were collected methodically in all cases . A majority of the patients (79.9%) were hospitalized during the study period, an associated pathology was noted in 29.1%, and 16.7% were receiving additional therapy . Aztreonam was administered by different routes and in different dosages according to the severity of the pathology . At the end of treatment, 93.6% of the patients showed a positive microbiologic response . Eradication percentages of the 6 main pathogens determined from cultures taken within the seventh day after the end of treatment were as follows: 93.9% for Escherichia coli (n = 415), 86.3% for Pseudomonas sp . (n = 207), 91.6% for Proteus sp . (n = 192), 89.8% for Providencia sp . (n = 59), 96.2% for Klebsiella sp . (n = 56), and 98.1% for Serratia sp . (n = 56) . Aztreonam was well tolerated . Of the 1,427 patients evaluated for safety, only 54 (3.8%) reported 55 adverse reactions, necessitating the withdrawal of therapy in 5 (0.2%) instances.

Pediatrie, 1989, 44(2), 97 - 101
{Neonatal Proteus mirabilis septicemia and cerebral abscess . Value of the assay of antibiotics in the puncture fluid}; Casadevall I et al.; The authors describe a case of neonatal Proteus mirabilis septicemia accompanied by cerebral abscess formation despite the presence of therapeutically effective antibiotic levels utilised to treat the disorder . The occurrence of such brain abscesses during the course of effective antibiotic therapy raises the question of the mechanism behind their formation . Cerebritis may occur very early in the clinical course of the infection without being due to failure of antimicrobial therapy.

Ann Biol Clin (Paris), 1989, 47(1), 29 - 34
{Correlation of the cause and composition of renal calculi . Value of morphologic and infrared analysis}; Normand M et al.; The morphological and infrared spectrophotometric analysis of the urinary stones of 300 patients have been reported in this article . Calculi are classified into six morphological types with their corresponding mineralogical natures . The type I (whewellite or C1) is pure in 18 p . cent of lithiasis, more often present in the center than on the surface, with hyperoxaluria in 81 p . cent . Calculi linked to piridoxilate intake (3 p . cent) have this composition . The type II (weddellite or C2) rarely pure, often associated with calcium phosphate are present in 47 p . cent of lithiasis, more often on the surface than in the center, and linked to hypercalciuria in 70 p . cent . The oxalates (C1 plus C2) are the most frequent components of calculi (75 p . cent) . The type IIIa and IIIb (anhydrous and dehydrated uric acid) are pure in 8 p . cent, mixed in 6 p . cent; due to hyperuraturia in 55 p . cent, due to urinary acid pH in 60 p . cent . The type IVa (carbapatite) is pure in 5 p . cent, mixed in 26 p . cent, linked to hypercalciuria in 40 p . cent . The types IVb and IVc (struvite plus carbapatite) are present in 12 p . cent, due to urinary infection (90 p . cent), linked to proteus (70 p . cent) . The type V (cystine) is rare, linked to hypercystinuria . The type VIa (1 p . cent) is made of proteins . The type VIb (2 p . cent) is composed of medications (triamterene, glafenine, antrafenine).

Ann Urol (Paris), 1989, 23(5), 453 - 5
{A case of a large pyelic calculus composed only of ammonium urate}; Thomas J et al.; The authors report a case of pure ammonium urate stone . It was a very large lightly radiopaque pelvic stone, which was extracted by pyelotomy and analysed by infra-red spectrography . The clinical history did not reveal a long history of chronic infections . The stone was diagnosed by urography performed after an acute urinary trad infection . Proteus mirabilis was found at one time, but only after the surgical operation . The blood and urinary laboratory check-up was normal . No case of such a large pure ammonium urate stone especially in adults, can be found in the literature . The pathogenesis is not obvious, and could not be explained without an abnormal urinary ammonia production during the development of the stone, but the lack of associated phosphate precipitation cannot be explained.

Urol Int, 1989, 44(6), 364 - 9
Experimental investigations on dissolution of incrustations on the surface of catheters; Hesse A et al.; On the basis of a standardized in vitro irrigation model, the incrustation behavior of catheters was investigated using collected urine with controlled contamination (Proteus, mirabilis) . Irrigation treatment with a NaCl solution did not effectively reduce incrustation compared to the control experiment . On the other hand, incrustations were definitively prevented or existing crystal deposits were largely dissolved with a citrate solution of pH 4.0 (Suby G) . Analytical investigations (infrared spectroscopy, scanning electron microscopy) of the deposits on the catheter revealed the presence of struvite (MgNH4PO4 x 6H2O), brushite (CaHPO4 x 2H2O) and carbonate apatite (Ca10{PO4} {CO3OH}6{OH}2).

Yao Xue Xue Bao, 1989, 24(9), 659 - 67
{Synthesis of 7 beta-(6-substituted-2-quinolone-3-acetamido)cephalosporins}; Chen QP et al.; A series of new 7 beta-(6-substituted-2-quinolone-3-acetamido)cephalosporins has been prepared by acylation of the 7 beta-amino group of 7-ADCA, 7-ACA, 7-ACT and 7-ACD with 6-substituted-2-quinolone-3-acetic acids . CDI (N,N'-Carbonyldiimidazole) method was mainly adopted and active ester method was also employed in the reactions . Isolation and purification were fulfilled with the combined methods of Sephadex LH-20 column chromatography and centrifugal TLC technique . Sixteen new cephalosporin derivatives were synthesized . Their structures have been confirmed by elemental analysis, IR and 1HNMR . The preliminary in vitro antibacterial tests showed that these new compounds exhibited high activity to gram-positive and some negative bacteria . Bacteriostasis of most of the compounds was equal to cefazolin and sodium penicillin G . Compound III3, III4, III8, III10 and III11 possessed higher activity on the resistant Staphylococcus aureus S22 and Proteus vulgaris OX19 than cefazolin and sodium penicillin G . Further biological evaluation for these compounds is expected to be carried out.

Khirurgiia (Sofiia), 1989, 42(4), 28 - 30
{Immunotherapy with Solco Urovac vaccine in chronic genitourinary infection}; Donovski L; Twenty five patients with chronic urogenital infections (cystitis, pyelitis and prostatitis) were treated with Solco urovak infection which is active against Escherichia coli, Proteus, Klebsiella and Streptococcus fecalis organisms . This microbial flora has been isolated from these patients and proved resistant to the conventional antibacterial agents . The vaccine was very well tolerated, gave no side reactions, but transient short lasting rise of the temperature to 38 degrees C . The bacteriologic control on the 6 . week after vaccination showed sterile urine in 68 per cent of the patients, no change in 20 per cent and recovery of other bacterial flora in 12 per cent . The vaccine is recommended for treatment of urinary tract infections caused by the microorganisms enumerated above.

Arch Microbiol, 1989, 152(2), 125 - 31
Ammonium assimilation in Proteus vulgaris, Bacillus pasteurii, and Sporosarcina ureae; Morsdorf G et al.; No active uptake of ammonium was detected in Proteus vulgaris, Bacillus pasteurii, and Sporosarcina ureae, which indicates that these bacteria depend on the passive diffusion of ammonia across the cell membrane . In P . vulgaris the glutamine synthetase-glutamate synthase (GS-GOGAT) pathway and glutamate dehydrogenase (GDH) were present, and these enzymes exhibited high affinities for ammonium . In B . pasteurii and S . ureae, however, no GS activity was detected, and GOGAT activity was only present in S . ureae . GDH enzymes were present in these two organisms, but showed only low affinity for ammonium, with apparent Km-values of 55.2 mM in B . pasteurii and 36.7 mM in S . ureae, respectively . These observations explain why P . vulgaris is able to grow at neutral pH and low ammonium concentration (2 mM), while B . pasteurii and S . ureae require high ammonium concentration (40 mM) and alkaline pH for growth.

Urol Int, 1989, 44(4), 231 - 4
Effects of the pH and the urine infected by Escherichia coli and Proteus mirabilis on chromic catgut, polyglycolic acid and polyglactin 910: study in vitro; Hering FL et al.; In order to study the effects of the pH and the urine infected by Escherichia coli and Proteus mirabilis on chromic catgut, polyglycolic acid (PGA) and polyglactin 910 (P910), we divided the experiment into three steps . In the first step, the behavior of suture material immersed in sterile urine, urine infected by E . coli and urine infected by P . mirabilis and in culture environment infected by P . mirabilis was studied . The physical features were observed continuously up to the 6th day . In the second step, every element of the urea-splitting reaction was isolatedly studied , without the presence of bacterial agents . And in the last step, that reaction was mimetized in sterile environments and in environments with acid and alkaline pH . While the chromic catgut was kept integral in all the environments, the PGA and the P910 dissolved in urine infected by Proteus, which was caused by the ammonia resulting from the urea-splitting reaction . This dissolution was also observed in sterile environment (mimetization of the urea-splitting reaction by urease, with no Proteus) . The destruction of the sutures was not influenced by the pH variance.

Plasmid, 1989 Jan, 21(1), 71 - 8
Nucleotide sequence and characterization of a new insertion element, IS240, from Bacillus thuringiensis israelensis; Delecluse A et al.; The nucleotide sequence of two repeated sequences (RS) in opposite orientations flanking the 125-kDa toxin gene of Bacillus thuringiensis israelensis (C . Bourgouin et al., J . Bacteriol . 170, 3575-3583, 1988) is reported in this paper . The analysis of these sequences indicates that these two RS display characteristic features of bacterial insertion sequences (IS) and are therefore referred to as IS240 . IS240 B is 865 bp long and has two perfect terminal-inverted repeats of 16 bp; IS240 A is 99% identical to IS240 B . A long open reading frame encoding a polypeptide of 235 amino acids spans almost the entire sequence of both IS240 elements . Both the sequence of the inverted repeats and the putative transposases are homologous to IS26 of Proteus vulgaris, IS15-delta of Salmonella panama, IS431 of Staphylococcus aureus, and ISS1 of Streptococcus lactis.

Aten Primaria, 1989 Jan, 6(1), 3 - 6
{Audit of clinical records: clinico-microbiologic study of urinary infections in a team of primary care}; Blazquez Ballesteros ML et al.; To carry out an audit of clinical records in our center for the evaluation of the quality of care before the introduction of protocols, several prevalent conditions were selected, and among them urinary tract infections (UTI) . Another aim of the study was to evaluate the autochthonous flora responsible for UTI and its resistence to commonly used antimicrobials . A series of acceptable criteria and standards were set as quality controls, and the real index was found below the preselected one in all cases . The most commonly isolated organism was E . coli, followed by Proteus, which were resistent to trimetoprim-sulfamethoxazole in 56% and 71.4% of cases, respectively . Problems of organization and knowledge, and a high resistence rate to common antimicrobials were detected; the following were suggested as measures for improvement: introduction of a protocol, need for continuing education, reduction in the care demand, health education and improvement in the antibiotic policy.

Antibiot Khimioter, 1989 Jan, 34(1), 31 - 4
{Antagonistic action of Pseudomonas aeruginosa against Staphylococci, coliform bacilli and various types of Proteus}; Bel'skii VV et al.; Antagonistic activity of 2 fresh isolates and 3 collection strains of Pseudomonas aeruginosa against 177 microbial strains was determined with the method of late antagonism . Among the microbial strains there were 56 staphylococcal strains isolated from patents and carriers . 38 nontypable colon bacilli isolated from healthy persons, 59 enteropathogenic colon bacilli of various serogroups, 12 strains of Proteus and 12 colon bacilli, carriers of multiple drug resistance factors (R factors) . All the cultures were sensitive to the antagonistic action of 5 or at least 3 strains of Pseudomonas used in the study . The most active antagonists were the fresh isolates of Pseudomonas as compared to the collection strains . Among the staphylococci S . aureus proved to be the most resistant to the antagonistic action of Pseudomonas as compared to S . epidermidis, the same as the strains isolated from carriers as compared to the strains isolated from patients . As for the enteric bacilli the most resistant were the strains of Proteus . Acquiring of transmissive R factors by the colon bacilli markedly increased their sensitivity to the antagonistic action of Pseudomonas.

An Med Interna, 1989 Jan, 6(1), 19 - 22
{Urinary tract infection at the emergency service of a third level hospital}; del Valle Gutierrez FJ et al.; 104 patients with (UI) non-complicated urinary infection, diagnosed at the emergency department of a third level hospital, are presented . The median age (x +/- DE) was of 58.12 +/- 20, 48 years; 78 were female (73%) and 22 male . 81 had fever and/or micturitional syndrome, the rest of the patients were without symptoms . The most frequent germ was escherichia coli, which was isolated in 80 patients (84.6%) followed by proteus mirabilis in 9 patients (8.6%) and enterococo in 2 patients (1.9%), other differing germs were also isolated, one for each remaining case . The only active antibiotic "in vitro" for all the germs isolated was gentamicin; other showed varying resistance . The best effectivity "in vivo" was also obtained with gentamicin followed by cotrimoxazole, despite the resistance which was superior to cefalexin . There were no deaths reported during the ambulatory treatment . We concluded that non-complicated UI can be treated in an ambulatory regimen . The most effective antibiotic is gentamicin, cotrimoxazole being a valid alternative.

Medicina (B Aires), 1989, 49(4), 360 - 2
{Xanthogranulomatous pyelonephritis in an adolescent}; Lo Giudice A et al.; One case of xanthogranulomatous pyelonephritis diagnosed following nephrectomy is described, considering its outstanding characteristics such as male adolescent, right kidney, involvement with normal function and without pathological history for which there is no explanation to date . This disease usually occurs in women 60 years or older, suggesting a renal tumor . In 50% of the cases, urine cultures are positive for Escherichia coli or Proteus mirabilis; in accordance with different reports renal tissue cultures are positive in more than 90% . Malnutrition, calcification, urolithiasis and renal failure with hydronephrosis are common findings . The left kidney is more frequently involved . The etiology is unclear: many hypotheses are discussed, with malnutrition and peroxidase deficit as important causes.

West Afr J Med, 1989 Jan-Mar, 8(1), 29 - 34
Resistance patterns of bacterial isolates from wound infections in a university teaching hospital; Njoku-Obi AN et al.; A study of three hundred and sixty-five wound infections was carried out by aerobic and anaerobic methods . Sensitivity testing of the isolates was done by disc diffusion method . It was found that gram negative bacteria predominated in the aetiology of the would infections . In the post-operative would sample, 55.73% grew single bacteria spp., while 44.27% grew more than one spp . Most of the coliforms isolated showed marked resistance to some commonly used and relatively safe antibacterial agents . For example, Proteus mirabili which was most commonly isolated was resistant to Ampicillin (76.9%), Tetracycline (95.4%) and Cotrimoxazole (84.3%).

J Electron Microsc (Tokyo), 1989, 38(5), 382 - 8
Immunoelectron microscopy of Proteus vulgaris by the plasma polymerization metal-extraction replica method: differential staining of flagellar (H) and somatic (O) antigens by colloidal golds; Yamaguchi M et al.; Flagellar (H) and somatic (O) antigens of Proteus vulgaris were differentially stained with antibodies coupled to different sizes of colloidal gold particles, and the distribution of these antigens was visualized by the plasma polymerization metal-extraction replica (PMR) method . The H antigen, labeled with 5 nm colloidal gold, was almost exclusively located on the flagella, whereas the O antigen, labeled with 10 nm colloidal gold, was almost exclusively located on the bacterial body . The marker gold particles were clearly observed as electron-dense particles on the relatively low contrast background of three-dimensional replica image of the flagellated bacteria . Thus, the PMR method may prove to be a useful tool for studying the localization of multiple substances on the cell surface, at a high resolution and in three dimensions . The diameter of the flagella measured by the replica method was about 15 nm, close to the value obtained by negative staining (16 nm) . When treated with anti-flagellar (H) factor serum and protein A-gold, the diameter of flagella was significantly increased to about 35 nm . This increase in diameter was presumably caused by binding of immunoglobulins to H antigens of flagella.

Klin Wochenschr, 1988 Dec 15, 66(24), 1212 - 3
Boutonneuse fever transmitted by conjunctival inoculation; Diez Ruiz A et al.; We report three cases (two adult males and a 12-year-old child) of boutonneuse fever produced by inoculation of the conjunctival mucosa (probably through accidental entry of R . conorii fluid into the eyes through rubbing or splashing) . All three patients developed similar symptoms of disease, including high fever, headache, maculopapular exanthem, and conjunctivitis, and none had tache noire . Specific immunofluorescent antibodies appeared in these patients' serum mostly after the 2nd week; agglutinins to Proteus OX-19, OX-2 (Weil-Felix reaction) were found . Cure was obtained by oral tetracycline . Conjunctival inoculation of R . conorii producing boutonneuse fever is very rare; this report will probably be one of the first published in the medical literature.

J Theor Biol, 1988 Dec 7, 135(3), 323 - 41
Mathematical modelling of intercellular regulation causing the formation of spatial structures in bacterial colonies; Budriene EO et al.; Bacterial colonies may grow forming stable spatial, particularly circular, structures . For instance, motile bacteria Proteus vulgaris or Escherichia coli grown on agar under certain conditions may form concentric rings with the centre in the inoculation point (Russ-Munzer, 1935, Bact . Parasit Kde (Abt 1) 7, 214; Budriene, 1985, Dokl . Acad . Nauk SSR, 283, 470) . A similar picture can be observed in a different situation, i.e . when a lawn of non-motile Salmonella typhimurium bacteria is cultivated on a solid agar with the locally introduced substrate (Hoppensteadt & Jager, 1980, Lecture Notes in Biomath . 38, 68) . This paper describes a mechanism of bacterial interactions through a hypothetical mediator released by the organisms . A mathematical model has been built . Its analysis has shown that the selected laws of secretion and reception of the mediator can adequately account for the formation of circular structures in the case of both motile and non-motile bacteria.

Jpn J Antibiot, 1988 Dec, 41(12), 1965 - 71
{Clinical studies on sultamicillin fine granule in pediatric field}; Ishikawa J et al.; Pharmacokinetics, safety and effects on bacterial infection of sultamicillin (SBTPC) fine granule were evaluated in 17 children . The results obtained are summarized as follows . 1 . Pharmacokinetics in 3 children receiving a single dose of 10 mg per kg body weight were evaluated . The half-life of ampicillin (ABPC) was 1.38 +/- 0.14 hours and that of sulbactam was 0.93 +/- 0.26 hour . 2 . Fourteen cases, including 7 tonsillitis, 2 pharyngitis, 2 bronchitis, and 1 each of cystitis, scarlet fever and cellulitis were treated with SBTPC fine granule . The clinical efficacy rate was 100% . 3 . Bacteriological efficacies classified by causative organisms were evaluated in 5 children . Staphylococcus aureus was responsible in 3 cases, Streptococcus pyogenes in 1 case, Escherichia coli and Proteus mirabilis in 1 case . Eradication rate was 100% . SBTPC was more active than ABPC against ABPC-resistant strains and almost equal to or more active than cephalexin or cefaclor . 4 . The only abnormal laboratory test value observed was eosinophilia in 2 children . No side effects were recorded . From the above results it is concluded that SBTPC fine granule is one of first choices of effective, useful and safe antibiotics for the treatment of infections in pediatric field.

Antibiot Khimioter, 1988 Dec, 33(12), 926 - 9
{Rifampicin in the treatment of infections of non-tuberculous etiology}; Lobuseva AN et al.; Clinical efficacy of rifampicin, a semisynthetic broad spectrum antibiotic was estimated in 247 patients with purulent inflammations . It was shown advisable to use rifampicin intravenously in treatment of severe bronchopulmonary pathology, disorders of the bile excretion system, osteomyelitis, severe wound infections and in prophylaxis of postoperative purulent complications in cardiovascular surgery and other cases . High rifampicin sensitivity of staphylococci and streptococci belonging to various species was revealed . Rifampicin was found to be less active against gramnegative pathogens . The isolation frequency of rifampicin sensitive strains of E . coli, Proteus spp., Klebsiella spp . and P . aeruginosa amounted to 88.4, 52.1, 58.8 and 49.3 per cent respectively.

Burns Incl Therm Inj, 1988 Dec, 14(6), 497 - 9
Routine burns bacteriology and proteus; Parmar S et al.; On standard agar media Proteus spp . swarm rendering prompt detection of other organisms difficult . Methods for preventing this have been investigated and a simple system devised suitable for inclusion in routine burns bacteriological investigations . Its merits are discussed.

J Neurosurg, 1988 Dec, 69(6), 877 - 82
Brain abscesses in neonates . A study of 30 cases; Renier D et al.; Since the introduction of ultrasonography and computerized tomography (CT) scanning, brain abscesses are found more frequently in cases of neonatal meningitis and septicemia, particularly when the offending pathogen is Proteus . Thirty cases of brain abscess in neonates are reported, 27 of which were caused by Proteus species infections . Twenty infants had meningitis and 13 had septicemia . Most of the abscesses were enormous, and multiple abscesses were observed in 17 cases . The frontal region was involved in 22 cases (12 unilaterally and 10 bilaterally) . The ventricles were enlarged on the first CT scan in 13 cases . The abscesses were treated by aspiration and antibiotics in 25 cases, and by antibiotics alone in five . A shunt for hydrocephalus was necessary in 14 infants . Four infants died, three from the initial illness and one from a shunt complication . Sixteen children have seizures . Subsequent intelligence quotient (IQ) testing was performed in 22 children: eight (36%) have an IQ at or above 80 and eight have an IQ of less than 60 . In the 17 children followed for more than 2 years, the proportion with an IQ at or above 80 fell to 24% (four cases) . The absence of initial seizures, sterile cerebrospinal fluid, normal ventricles on CT scans, and early aspiration of the abscess seem to be factors portending a better prognosis in terms of epilepsy and mental sequelae.

J Mol Biol, 1988 Nov 20, 204(2), 309 - 29
Translational regulation of the spc operon in Escherichia coli . Identification and structural analysis of the target site for S8 repressor protein; Cerretti DP et al.; The spc ribosomal protein operon of Escherichia coli is feedback-regulated by ribosomal protein S8, a translational repressor . We have analyzed the region of the spc mRNA that is responsible for this regulation . First, we have established that the S8 target site on the mRNA is near the translation start site of the third gene encoding ribosomal protein L5 in the operon . This was done by constructing hybrid plasmids carrying spc operon ribosomal protein genes under lac transcriptional control, as well as their deletion derivatives, and carrying out both in vivo and in vitro protein synthesis experiments . Next, the secondary structure of this region was studied by analyzing 5' end-labeled RNA synthesized from the phage SP6 promoter using structure-specific nucleases . A secondary structure model consistent with the results was deduced with the aid of a computer prediction of RNA folding . In addition, we cloned and sequenced the corresponding region from Salmonella typhimurium, Proteus vulgaris and Serratia marcescens and found five "compensating" substitutions that support some of the deduced helical structures of mRNA . None of the base changes was inconsistent with the deduced secondary structure model . Finally, site-directed mutagenesis experiments have identified bases important for regulation, including two base-paired sites representing each of two helical regions . This has led to the conclusion that some specific nucleotide residues located between these two helical regions are directly involved in S8 recognition, and that the function of the two helical regions is to maintain the proper orientation of these nucleotide residues . Comparison of the structure of the S8 target site on the spc mRNA with the known S8 binding site on rRNA has revealed a striking similarity in both primary and secondary structures . In particular, primary sequences of rRNA conserved among distantly related bacterial species in this region is found to be identical with the sequences at the corresponding positions in mRNA . These results suggest that the same structural features of the S8 repressor protein are involved in the interaction with both 16 S rRNA and the mRNA target site.

Eur J Pediatr, 1988 Nov, 148(2), 122 - 5
Proteus syndrome versus Bannayan-Zonana syndrome: a problem in differential diagnosis; Bialer MG et al.; The Proteus syndrome (PS) and the Bannayan-Zonana syndrome (BZS) both have multiple hamartomata as prominent features . Hemihypertrophy, macrodactyly, exostoses, skin lesions, scoliosis, and sporadic occurrence are seen in PS, whereas patients with BZS have macrocephaly and related craniofacial findings . BZS has been observed in families as an autosomal dominant trait . Although the two syndromes can be distinguished in most patients, there are features in common to both that may pose a diagnostic dilemma in an isolated case . We report the case of a 3-year-old girl with macrocephaly, macrodactyly, and superficial and intra-abdominal hamartomata who illustrates the problem of differentiating between PS and BZS . We compare this patient and another recently reported patient with other published cases of PS and BZS . Patients with PS, in general, show more extensive systemic involvement, including skeletal and cutaneous manifestations . Macrocephaly, seen in all reported patients with BZS, is also found in 14% of patients with PS . Overlap among syndromes which include hamartomata as prominent features suggests that they might be etiologically or pathogenetically related . The present case also illustrates the usefulness of imaging techniques in the diagnosis of mixed mesodermal hamartomata.

Biochem J, 1988 Nov 1, 255(3), 971 - 5
Purification and characterization of three forms of glutathione transferase from Proteus mirabilis; Di Ilio C et al.; Three forms of glutathione transferase (GST) with pI values of 6.0, 6.4 and 7.3 were isolated from Proteus mirabilis AF 2924 by glutathione-affinity chromatography followed by isoelectric focusing, and their structural, kinetic and immunological properties were investigated . Upon SDS/polyacrylamide-slab-gel electrophoresis, all forms proved to be composed of two subunits of identical (22,500) Mr . GST-6.0 and GST-6.4 together account for about 95% of the total activity, whereas GST-7.3 is present only in trace amounts . Extensive similarities have been found between GST-6.0 and GST-6.4 . These include subunit molecular mass, amino acid composition, substrate specificities and immunological characteristics . GST-7.3 also cross-reacted (non-identity) with antisera raised against bacterial GST-6.0 . None of the antisera raised against a number of human, rat and mouse GSTs cross-reacted with the bacterial enzymes, indicating major structural differences between them and the mammalian GSTs . This conclusion is further supported by c.d . spectra.

Chemioterapia, 1988 Oct, 7(5), 298 - 301
Effect of pefloxacin on adherence of Proteus-Providencia spp to squamous epithelial cells; Cellini L et al.; Pefloxacin, a new piperazinyl substituted quinolone derivative, reduced at sub-MICs (Minimal Subinhibitory Concentrations: four times lower than Minimal Inhibitory Concentrations) the in vitro adherence of Proteus-Providencia spp . to squamous epithelial cells obtained from the urinary tract . The decrease of adherence was about 30% and 50% after 1 h and, respectively, 16-18 h of incubation with pefloxacin . This finding suggests that pefloxacin may play a role in determining the in vivo adhesion of Proteus-Providencia spp . on the urinary tract and consequently the expression of bacterial pathogenic potency.

Chemioterapia, 1988 Oct, 7(5), 287 - 91
In vitro activity of pefloxacin compared with five other quinolones on nalidixic acid-resistant proteae species; Piccolomini R et al.; The in vitro activity of pefloxacin, a new fluoroquinolone, was compared with that of 5 other quinolone compounds (nalidixic and pipemidic acids, norfloxacin, ciprofloxacin, and ofloxacin) against 416 strains of Proteae spp . isolated from urine specimens of hospitalized patients with acute urinary tract infections (UTI) . Ciprofloxacin was the most active agent . Norfloxacin, ofloxacin, and pefloxacin were similarly active against Proteus strains (MIC90 = 0.39 microgram/ml) . Against Providencia spp . pefloxacin and norfloxacin showed similar activity (MIC90 = 3.12 micrograms/ml) . There is minimal discrepancy between minimum inhibitory concentrations and minimum bactericidal concentrations exhibited by the quinolones for all urinary tract pathogens tested . Our in vitro studies indicate that pefloxacin is an active antimicrobial agent and suggest that it will prove useful in the treatment of complicated urinary tract infections due to nalidixic acid-resistant Proteae spp.

Cell Biol Int Rep, 1988 Oct, 12(10), 849 - 55
Dissociation of membrane-cortex contacts in the hyalospheres of Amoeba proteus exposed to light-shade differences; Kwiatkowska EM et al.; The hyalospheres produced by a heat shock spontaneously separated successive sheets of the cortical actin layer from the plasma membrane and retracted them inward . This phenomenon was hampered or completely inhibited by 10(4) lux white light and restored in shade . The frequency of detaching the consecutive submembrane sheets was much higher in the shade than in full light . If the light-shade difference has been applied across a single hyalosphere, the detachment of cortical layer was initiated and continued in the shaded cell part . Sometimes it was followed by translocation of the hyaloplasm into the dark zone and a compensatory shift of the granuloplasmic core toward the bright area . Probably, the actin sheets which are detached in the frontal caps of normal locomoting amoebae react in the same way to positive or negative photic stimuli.

Am J Vet Res, 1988 Oct, 49(10), 1736 - 41
Bacterial population and histologic changes in dogs with perianal fistula; Killingsworth CR et al.; Ages of 44 dogs with perianal fistula, ranged from 6 months to 13 years (mean, 5.2 years) . German Shepherd Dogs and Irish Setters were statistically (P less than 0.01) over-represented compared with those breeds in a canine hospital population (n = 22,047) for the same period . There was a 2:1 male-to-female ratio, with 38 (86.4%) of dogs sexually intact and 6 (13.6%) of dogs neutered . Eleven types of bacterial organisms were recovered from deep perianal tissues of which Escherichia coli, Staphylococcus aureus, beta-hemolytic streptococci, and Proteus mirabilus were most common . Organisms were not recovered from 7 dogs . Of 93 isolates, 88.3% were susceptible to gentamicin, 80.5% to cephalothin, 79.2% to chloramphenicol, and 74% to trimethoprim-sulfamethoxazole . Fifty-one biopsy specimens from 44 dogs were classified as having early, intermediate-, and late-stage lesions based on the amount of fibrosis, severity of the inflammatory response, and, if present, depth of sinus tracts . In most biopsy specimens, all 3 stages were represented in the same histologic section . In 45 specimens, most inflamed lesions were in the dermis of the zona cutanea . Hidradenitis was present in 22 biopsy specimens and was associated with the formation of epithelial-lined sinus tracts.

J Antimicrob Chemother, 1988 Oct, 22 Suppl D, 219 - 21
Fleroxacin in single dose oral therapy of uncomplicated lower urinary tract infection; Kosmidis J et al.; A randomized comparative study was performed in twenty women with acute uncomplicated lower urinary tract infection (UTI) . They received a single oral dose of either fleroxacin 600 mg or amoxycillin 3 g . Pathogens were Escherichia coli (17), Proteus mirabilis (2) and Staphylococcus aureus (1) . A complete clinical and microbiological cure was observed in all patients of both groups . One patient in the fleroxacin group had gastric irritation . A single oral dose of fleroxacin may be suitable for the treatment of lower UTI even when it is due to organisms resistant to amoxycillin and other traditional oral antimicrobials.

J Antimicrob Chemother, 1988 Oct, 22(4), 429 - 35
Identification of a novel plasmid-encoded dihydrofolate reductase mediating high-level resistance to trimethoprim; Wylie BA et al.; A Proteus mirabilis strain, isolated in South Africa, carried a 79kb transferable plasmid (pUK672) which encoded high-level resistance to trimethoprim (minimum inhibitory concentration greater than 2048 mg/l) . The trimethoprim resistance was mediated by a dihydrofolate reductase which had completely different properties from any plasmid-encoded dihydrofolate reductase previously described . This enzyme has been designated type VI . The type VI enzyme is small (10,000 daltons) and is unstable in vitro . It is highly resistant to inhibition by both trimethoprim and methotrexate.

Pathol Biol (Paris), 1988 Oct, 36(8), 1011 - 5
{The frequency of isolating urinary infection germs at a community practice and their sensitivity to various antibiotics}; de Mouy D et al.; Nine hundred and thirty one urine's specimens of patients affected by urinary infection have been studied by pathology practising in different towns in France . The most frequently germs retrieved are: Escherichia coli 76%, Proteus mirabilis 12%, Klebsiella 5%, Staphylococcus epidermidis 2% . Were studied Gram negative rods sensibility to ampicillin (A), cephalosporin 1st generation (C), nalidixic acid (Nal), gentamicin (G), norfloxacin (Norf); Gram positive cocci resistance to oxacillin (Oxa), erythromycin (E), pristinamycin (P), gentamicin (G), norfloxacin (Norf) . For E . coli: the resistance was 24% A, 2% C1, 0.1% G, 4% Nal, 0.1% Norf . For Klebsiella: the resistance was respectively 96% A, 12% C1, 10% Nal, 18% G., 4% Norf . For P . mirabilis: 11% A, 3% C1, 0% Nal, 9% G, 0% Norf . E . coli strains cephalo R; Gram negative rods Genta R or quinolone R; staphylocoque oxa R or pristina R have been checked by HIA Begin microbiology laboratory . Discrepancies in results have been analysed . This study enabled the participants to improve their bacteriological technic, antibiogramm's reading, results' interpretation.

J Clin Microbiol, 1988 Oct, 26(10), 2161 - 6
Detection of genomic variation in Providencia stuartii clinical isolates by analysis of DNA restriction fragment length polymorphisms containing rRNA cistrons; Owen RJ et al.; Chromosomal DNA from 26 strains of Providencia stuartii isolated mainly in hospitals in the United Kingdom and reference strains of P . stuartii, P . rustigianii, and Proteus vulgaris were digested with the restriction endonucleases EcoRI and HindIII . After electrophoresis in agarose gels, the fragments were subjected to Southern blot hybridization analysis with a biotin-labeled cDNA probe transcribed from a mixture of 16S and 23S rRNA from P . stuartii NCTC 11800T . The pattern of bands (the rDNA fingerprint), which depended on restriction fragment length polymorphisms containing rRNA genes, was used as a measure of minor genomic variation within and between species . The P . stuartii clinical isolates had similar total digest patterns, but the rDNA fingerprints revealed some heterogeneity between strains, with EcoRI digests providing better strain discrimination than HindIII . Such rDNA fingerprints comprised between five and seven bands with sizes in the range of 5 to 28 kilobases . The 11 different EcoRI patterns were compared by numerical analysis, and several groups or subgroups of strains were identified . Over half (15 of 26) of the urease-negative isolates (subgroups Aa and Ab) had patterns that differed only by the presence or absence of a 25-kilobase band . Urease-negative strains from other clinical material were more heterogeneous in their patterns . No correlation was apparent between strain pattern group and urease production or geographic location of isolate . The P . stuartii rDNA fingerprints were quite distinct from those of allied Providencia and Proteus species and provided a more sensitive measure of minor genomic differences than total DNA digests did.

Am J Med, 1988 Sep 16, 85(3A), 17 - 23
A double-blind, multicenter, comparative study of the safety and efficacy of cefixime versus amoxicillin in the treatment of acute urinary tract infections in adult patients; Iravani A et al.; In this 31-site multicenter trial, 565 adult patients with urinary tract infections were randomly assigned to receive either a 10-day course of cefixime 400 mg once daily (n = 279) or amoxicillin 250 mg three times daily (n = 286) . Although all patients were included in the safety analysis, only 93 (33 percent) cefixime-treated and 99 (35 percent) amoxicillin-treated patients were fully evaluable for the efficacy analysis . One week after therapy, the evaluable patients treated with cefixime demonstrated a 90 percent clinical cure rate and a 92 percent eradication rate of the baseline pathogen . This compared with an 83 percent clinical cure rate and an 84 percent bacterial eradication rate in the amoxicillin-treated group . The most frequently isolated pathogen was Escherichia coli (80 percent) followed by Proteus mirabilis (10 percent) . One hundred thirty-seven (49 percent) of the 279 cefixime-treated and 126 (44 percent) of the 286 amoxicillin-treated patients reported at least one adverse experience during the study . Adverse reactions associated with cefixime were similar to those reported for other beta-lactam antibiotics . The most frequent adverse experiences reported by cefixime-treated patients were diarrhea (15 percent) and stool changes (12 percent) . Headaches (11 percent) and diarrhea (9 percent) were the most frequently reported adverse reactions by the amoxicillin-treated patients . Eleven cefixime-treated patients (3.9 percent) and 10 amoxicillin-treated patients (3.5 percent) discontinued therapy because of adverse experiences . Results of this study demonstrate that a once-daily regimen of cefixime is as safe and effective as a three-times-daily regimen of amoxicillin in the treatment of acute urinary tract infections . Although the incidence of bowel changes was somewhat higher in the cefixime treatment group, these events usually resolved when therapy was discontinued.

J Chromatogr, 1988 Sep 9, 430(2), 209 - 21
Studies of metabolites in diarrheal stool specimens positive for Klebsiella, Serratia, and Proteus spp . by frequency-pulsed electron-capture gas chromatography; Brooks JB et al.; Diarrheal stools from infants from which Klebsiella pneumoniae, Serratia liquefaciens, and Proteus mirabilis were isolated as possible causative agents of diarrhea were studied . These stools, along with control stool specimens which were collected from infants in the same village of Tamooh (near Cairo, Egypt), were analyzed by frequency-pulsed electron-capture gas chromatography (FPEC-GC) . Watery stools and formed stools, to which distilled water was added, were centrifuged, and the supernatant was extracted with organic solvents and derivatized with specific functional group reagents to form electron-absorbing derivatives of carboxylic acids, hydroxy acids, alcohols, and amines . Results from the study showed distinct differences in FPEC-GC profiles of stools positive for K . pneumoniae, S . liquefaciens, and P . mirabilis . The major differences found were that diarrheal stools from which K . pneumoniae was isolated contained acetoin, a hydroxy acid-labeled peak F, and an unidentified amine, peak A . S . liquefaciens diarrheal stools had FPEC-GC profiles like the controls with the exception that an amine, peak A, was detected . The diarrhel stools containing P . mirabilis produced a distinct amine profile.

Scanning Microsc, 1988 Sep, 2(3), 1775 - 90
Preparation of cultured and isolated cells for X-ray microanalysis; Zierold K et al.; Various electron microscopical preparation techniques are compared with regard to the preservation of the intracellular element distribution as determined by X-ray microanalysis in scanning and scanning transmission electron microscopy . By use of chemical agents for fixation and dehydration ions are redistributed and washed out . This is also true for freeze-substitution . Whole cells are prepared by cryofixation followed by freeze-drying . Interference of intracellular measurements by extracellular elements can be avoided by appropriate washing the cells before cryofixation . The washing medium has to be carefully selected in order to avoid distortions of the original intracellular element content . These problems are circumvented by the preparation of freeze-dried cryosections from cryofixed cells . This is demonstrated by data of the intracellular elemental composition in cultured cells (fibroblasts, Staphylococcus aureus bacteria) and in cells isolated from rat tissue (kidney papillary collecting duct and liver) . Cryofixation of a single cell in a defined functional state is illustrated by results obtained from streaming Amoeba proteus cells, cryofixed under light microscopical control . The main conclusion is that X-ray microanalysis of cells in functional states requires cryofixation and cryopreparation techniques which have to be adapted to the particular cell biological problem to be investigated.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Sep, (9), 70 - 5
{The safety of a vaccinal preparation made of bacteria of the genus Proteus: the absence of a mutagenic effect}; Volgareva GM et al.; The protein-lipopolysaccharide vaccinal preparation, obtained by the disintegration of microorganisms of the genus Proteus by means of hydrochloric hydroxylamine, has been tested for mutagenicity . Two tests have been used: (1) the count of reversion to histamine-dependence in Salmonella typhimurium cells, strains TA-98 and TA-100, intended for detecting mutations, such as read-through frame shift and, respectively, the change of nitrous bases in DNA; and (2) the count of structural aberrations in chromosomes and numeric karyotype changes on metaphase plates from the marrow of mice . In some of the tests the vaccine has shown mutagenic properties.

Bioorg Khim, 1988 Sep, 14(9), 1282 - 6
{The structure of O-specific polysaccharide of Proteus mirabilis 027 containing amino acids and phosphoethanolamine}; Vinogradov EV et al.; The following structure of the repeating unit of the Proteus mirabilis O27 O-specific polysaccharide was established: (formula; see text) where (formula; see text) is N-glucopyranuronoyl-L-lysine, (formula; see text) is N-galactopyranuronoyl-L-alanine . The polysaccharide was parially solvolysed with anhydrous HF and the resulting dephosphorylated tri- and tetrasaccharide with N-acetylglucosamine at the reducing end were studied by means of 1H and 13C NMR spectroscopy and (for methylated derivative of trisaccharide) mass-spectrometry . Smith degradation of the polysaccharide afforded linear polymer, and its structure was investigated by 13C NMR spectroscopy . The position of the ethanolamine phosphate group was determined by means of the analysis of the phosphorylation effects in the 13C NMR spectra of the linear and branched polysaccharides.

Am J Med, 1988 Aug, 85(2), 159 - 63
Recurrent gram-negative bacteremia; Mylotte JM et al.; PURPOSE: Recurrent gram-negative bacteremia is defined as two or more episodes of bacteremia occurring in the same patient with an infection-free interval between each episode . Our purpose was to identify patients with recurrent gram-negative bacteremia in order to define possible risk factors for its recurrence . PATIENTS and METHODS: During a recently completed prospective study of all episodes of gram-negative bacteremia at the Buffalo Veterans Administration Center between April 1, 1984, and May 31, 1987, 35 patients with 74 episodes of gram-negative bacteremia were identified . The following information was obtained from all 35 patients: age, service, date of hospital admission, date of the bacteremia, underlying diseases, initial antimicrobial therapy, focus of infection, the presence or absence of shock, antimicrobial susceptibility of the blood isolate, and outcome . RESULTS: All 35 patients were men, had a mean age of 69 years, and all had one or more underlying diseases; 45 percent had a malignancy . The duration of time between a pair of episodes was four weeks or more for 74 percent of 38 pairs of episodes . In 25 of 38 (66 percent) pairs of episodes, the focus of infection was the same; in 80 percent of these 25 pairs, the urinary tract was the focus . Overall, the urinary tract was the focus of gram-negative bacteremia in almost 50 percent . Escherichia coli was the single most common organism isolated (28 percent of all episodes), followed by Proteus mirabilis (17.5 percent) and Pseudomonas aeruginosa (17.5 percent) . Six of 35 (17 percent) patients died due to gram-negative bacteremia; five of these six had a respiratory tract focus of infection . CONCLUSIONS: In a population of veterans, recurrent gram-negative bacteremia was identified in almost 10 percent of all patients with gram-negative bacteremia during a 37-month study period . Recurrent gram-negative bacteremia most frequently occurred in the setting of underlying malignancy with the urinary tract as a common focus of infection . The mortality rate of 17 percent was similar to that of all patients with gram-negative bacteremia reported in previous studies.

J Urol, 1988 Aug, 140(2), 428 - 30
Adherence of urease-induced crystals to rat bladder epithelium following acute infection with different uropathogenic microorganisms; Grenabo L et al.; Apart from urine supersaturation with respect to struvite and calcium phosphate, crystal retention is considered to be necessary for the formation of infection stones . This study was performed to investigate the role of the mucous coat in rat bladders in the adhesion of sterile urease-induced crystals and to determine to what extent the adhesion was influenced by infection . Elimination of the mucous coat with 0.1 M HCl increased the adherence of crystals six times compared to that in bladders with an intact mucous coat . Infection with Proteus mirabilis, Escherichia coli, enterococci and Ureaplasma urealyticum increased the adherence six, five, four and two times, respectively . Injury to the mucous coat may thus be one mechanism by which microorganisms can contribute to the formation of infection stones in the urinary tract.

J Urol, 1988 Aug, 140(2), 254 - 6
Bacteriuria following extracorporeal shock wave lithotripsy of infection stones; Michaels EK et al.; Extracorporeal shock wave lithotripsy effectively pulverizes infected (struvite) renal calculi . However, after treatment minute residual fragments that may harbor bacteria and cause persistent bacteriuria remain in the renal collecting system for months . We investigated prospectively the incidence of persistent Proteus mirabilis bacteriuria after extracorporeal shock wave lithotripsy among 15 consecutive women with Proteus mirabilis urinary tract infections and struvite calculi . All patients received parenteral gentamicin for 3 to 8 days (mean 4.7 days) immediately before and after extracorporeal shock wave lithotripsy . Oral antimicrobials then were administered for 14 to 34 days (mean 25 days) . Ten patients have maintained a sterile urine or experienced urinary reinfection by other organisms during 8 to 19 months (mean 13 months) of subsequent bacteriological surveillance . Of these 10 patients 9 had residual fragments . Five patients had Proteus mirabilis bacteriuria after 1 to 7 months of surveillance, including 3 with residual fragments . The mean stone size, methods and duration of renal drainage procedures, and duration of antimicrobial therapy were similar for the 2 patient groups . Proteus mirabilis was isolated from the cultures of only 3 of 11 retrievable stone fragments . In contrast to intact infected renal calculi, residual stone fragments after extracorporeal shock wave lithotripsy often are susceptible to sterilization with antimicrobials.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Aug, (8), 3 - 7
{Morphologic characteristics of bacteria treated with human blood serum and immunoglobulin}; Bykov AS et al.; The electron microscopic study of ultrathin sections of bacterial cells treated with blood serum has revealed the presence of the immunoglobulin cover located on the cell wall and consisting of blood serum components . Staphylococci (strain Smith), studied with the use of ruthenium red, have been found to possess the capsule and the immunoglobulin cover located at its base . The immunoglobulin cover has proved to be more pronounced in gram-positive bacterial (actinomycetes, peptococci, staphylococci) and faintly pronounced in gram-negative bacteria (Bacteroides, Proteus, Pseudomonas, Escherichia).

J Bacteriol, 1988 Aug, 170(8), 3342 - 9
Proteus mirabilis urease: genetic organization, regulation, and expression of structural genes; Jones BD et al.; Proteus mirabilis, a cause of serious urinary tract infection, produces urease, an important virulence factor for this species . The enzyme hydrolyzes urea to CO2 and NH3, which initiates struvite or apatite stone formation . Genes encoding urease were localized on a P . mirabilis chromosomal DNA gene bank clone in Escherichia coli by deletion analysis, subcloning, Bal31 nuclease digestion, transposon Tn5 mutagenesis, and in vitro transcription-translation . A region of DNA between 4.0 and 5.4 kilobases (kb) in length was necessary for urease activity and was located within an 18.5-kb EcoRI fragment . The operon was induced by urea and encoded a multimeric, cytoplasmic enzyme comprising subunit polypeptides of 8,000, 10,000, and 73,000 daltons that were encoded by a single polycistronic mRNA and transcribed in that order . Seventeen urease-negative transposon insertions were isolated that synthesized either none of the structural subunit polypeptides, the 8,000-dalton polypeptide alone, or both the 8,000- and 10,000-dalton subunit polypeptides . The molecular weight of the native enzyme was estimated to be 212,000 by Superose-6 chromatography . Homologous sequences encoding the urease of Providencia stuartii synthesized subunit polypeptides of similar sizes and showed a similar genetic arrangement . However, restriction maps of the operons from the two species were distinct, indicating significant divergence.

Mol Gen Genet, 1988 Jul, 213(1), 99 - 104
Identification of the promoters directing in vivo expression of hemolysin genes in Proteus vulgaris and Escherichia coli; Koronakis V et al.; The hemolytic activity of Escherichia coli and Proteus vulgaris is determined by common contiguous genes encoding synthesis (hly C, hly A) and specific secretion (hly B, hly D) of active hemolysin . Nevertheless, the hly C-proximal DNA sequences directing production of the homologous hemolysins by the recombinant DNAs P . vulgaris pVU763-709 and E . coli pANN202-312 showed no extensive homology . Primer extension and S1 nuclease protection were used to define in the two sequences the 5' termini of hly transcripts synthesized in vivo and thus to infer the active hly promoters sequences . The E . coli hly C upstream region contained three separate promotors directing in vivo hly transcription, while the corresponding transcription of the P . vulgaris hly operon originated from a single distinct promotor, the -35 and -10 sequences of which formed part of an inverted repeat sequence . Elevated hemolytic activity caused by upstream Tn5 insertions in pVU763-709 resulted from increased transcription from this promotor.

Antibiot Khimioter, 1988 Jul, 33(7), 532 - 5
{Immunomodulating therapy of adjuvant disease in rats using cyclophosphamide in combination with prodigiozan--its effect on anti-infectious resistance}; Sibiriak SV et al.; The effect of immunomodulating therapy of adjuvant disease in rats with cyclophosphamide, prodigiozan and their combinations on infection resistance, weight of the lymphoid organs and leukocyte counts in peripheral blood, as well as the effect of prodigiozan on acute toxicity of cyclophosphamide in intact mice and mice exposed to the Freund's complete adjuvant (FCA) was studied . Prodigiozan did not increase acute toxicity of cyclophosphamide in the intact mice . It lowered the cyclophosphamide toxicity at the background of the FCA and decreased the levels of leukopenia induced by the immunosuppressor in the rats with adjuvant arthritis . It was shown on the models of local infectious inflammation caused by Proteus and lethal sepsis due to P . aeruginosa that the combined use of prodigiozan and cyclophosphamide resulted in correction of the infection resistance impairment induced by both the arthritis development and the immunosuppressor administration.

Antimicrob Agents Chemother, 1988 Jul, 32(7), 1073 - 7
Paradoxical antibacterial activities of beta-lactams against Proteus vulgaris: mechanism of the paradoxical effect; Ikeda Y et al.; Fifteen beta-lactam antibiotics were divided into four classes based on their antibacterial actions and beta-lactamase-inducing activities in Proteus vulgaris . One of these groups, which included cefmenoxime, ceftriaxone, cefuzonam, and cefotaxime, showed a clear paradoxical antibacterial activity against P . vulgaris . This group showed growth-inhibitory activity at relatively low concentrations, up to certain limits . These cephalosporins have, as a common moiety, an aminothiazolyl-oxyimino group in the 7-acyl side chain and have high beta-lactamase-inducing activities and low stabilities against the beta-lactamase . In a mutant strain incapable of inducing beta-lactamase, however, the paradoxical antibacterial activity was not observed . These findings suggest that beta-lactamase plays an essential role in the paradoxical antibacterial effect in P . vulgaris . We conclude that the induction of a large amount of beta-lactamase and the low stability against beta-lactamase may account for the paradoxical antibacterial activity in P . vulgaris.

Mol Biol (Mosk), 1988 Jul-Aug, 22(4), 992 - 8
{Detection of viral proteins during synthesis of defective phage of Proteus mirabilis D52 using the immunocolloid gold method}; Kretova AF et al.; We have applied the method of immunocolloidal gold in order to label the ribonuclear proteins of prokaryotic cells on isolated bacterial chromatosomes . In the process of protein synthesis it was possible to visualize a definite protein of defective phage D52 of Proteus mirabilis.

Minerva Med, 1988 Jun, 79(6), 447 - 9
{Skin reactions with ubiquitous multiple antigens as a test of survival in patients with inoperable bronchogenic carcinoma}; Giorgis GE et al.; Fifty-three patients suffering from inoperable, non-microcytoma, bronchogenic carcinoma in which a skin reaction with ubiquitous antigens (tetanus, diphtheria, streptococcus, tuberculin, proteus, tricophyton, candida) had been carried out were followed up to check on the possible relationship between skin reactivity and survival period . A significant correlation was found between the degree of positivity and duration of survival, with mean survival values greater than 69.1 weeks being observed in patients positive to five or more antigens . Among preliminary tests, it would therefore appear that skin reaction with ubiquitous may provide indications for predicting survival.

J Gen Microbiol, 1988 Jun, 134 ( Pt 6), 1699 - 705
A comparative study of the sugar composition of lipopolysaccharides isolated from Vibrio cholerae, 'Vibrio albensis' and Vibrio metschnikovii; Kondo S et al.; A comparative study was made of the quantitative sugar composition of lipopolysaccharides (LPS) isolated from Vibrio cholerae (O1 and non O1 groups), 'V . albensis', 'V . proteus' and V . metschnikovii . The amino sugars 4-amino-4,6-dideoxy-D-mannose (perosamine) and 2-amino-2,6-dideoxy-D-glucose (quinovosamine) were present exclusively in LPS isolated from S-form O1 group of V . cholerae regardless of serotype (i.e . Ogawa or Inaba) and biotype (i.e . classical or eltor) . Classical O1 group V . cholerae was distinguishable from eltor O1 group V . cholerae on the basis of the fructose content of the LPS: greater than 3% and less than or equal to 1%, respectively . Distinct differences in the sugar composition of LPS were observed between V . cholerae and 'V . albensis', 'V . proteus' and V . metschnikovii.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Jun, (6), 51 - 5
{ChemicaL and immunochemical characteristics of antigenic preparations from Staphylococcus aureus and Klebsiella pneumoniae as the components for an associated vaccine}; Shagam NL et al.; S . aureus aqueous extract and K . pneumoniae hydroxylamine vaccine were studied by means of chemical and immunochemical analytical techniques . The preparations were found to contain, respectively, 7.0% nad 53.5% of neutral monosaccharides, 6.5% and 0.7% of nucleic acids, as well as protein in approximately equal amounts (11.63-14.0%) . In experiment of immunodiffusion, immunoelectrophoresis and rocket immunoelectrophoresis in homologous systems with hyperimmune antimicrobial sera the preparations were characterized by serological heterogeneity . After their combination with Escherichia coli aqueous extract and Proteus hydroxylamine preparation their serological characteristics remaIned unchanged . The study of cross reactions of all components of the combined preparations with hyperimmune rabbit sera to the corresponding microorganisms revealed that only Klebsiella component of the combined vaccine reacted with all hyperimmune sera . The preparation of Proteus showed the lowest activity, it reacted only with hyperimmune sera to K . pneumoniae . Besides, no reaction of S . aureus component with sera to E . coli and no reaction of the preparation of E . coli with antistaphylococcal serum were observed.

Am J Surg, 1988 May 31, 155(5A), 91 - 5
A multicenter comparative study of cefotetan once daily and cefoxitin thrice daily for the treatment of infections of the skin and superficial soft tissue; Geckler RW et al.; To compare the effectiveness of cefotetan administered at 2 g once a day with cefoxitin at 1 or 2 g three times a day in the treatment of hospitalized patients with skin and superficial soft tissue infections, 194 patients from eight centers were enrolled in an open, randomized trial . Most of the 104 evaluable patients in the cefotetan group and 50 in the cefoxitin group were young men with community-acquired, moderate or severe cellulitis, or abscesses of the upper and lower extremities caused by Staphylococcus aureus, Streptococcus species, Escherichia coli, Proteus mirabilis, Bacteroides fragilis and other species of bacteroides, peptococcus species, and peptostreptococcus species . The mean duration of treatment was 7.5 days for cefotetan and 7.1 days for cefoxitin . A successful clinical response was achieved in 97 percent of the cefotetan patients and in 94 percent of the cefoxitin patients . Of the 88 and 39 bacteriologically evaluable patients in the cefotetan and cefoxitin groups, respectively, a satisfactory bacteriologic response occurred in 96 percent and 87 percent of the patients . No clinically significant changes in clinical laboratory determinations were noted . The incidence of adverse reactions in the cefotetan group (17 percent) was significantly different from that for the cefoxitin group (6 percent) (p less than 0.05); however, the incidence of treatment-related reactions was not significant and the events were mild . Discontinuation of therapy was necessary only in two patients in whom allergic-type reactions developed . A once-daily regimen of cefotetan was as effective as thrice-daily cefoxitin in this study in the treatment of primarily polymicrobial, moderate, or severe infections of the skin and superficial soft tissue.

Br J Urol, 1988 May, 61(5), 395 - 8
Recurrent and residual renal calculi in children; MacDonald I et al.; One hundred and thirteen children with non-metabolic urinary tract calculi were operated on between 1960 and 1983 . One hundred were followed up for 3 to 17 years (mean 8.2) . Seventeen children (15%) developed recurrent calculi after complete clearance at the initial operation and in 13 of these the stones recurred within 5 years . Proteus urinary infection was a constant feature of stone recurrence . Five patients required re-operation for removal of the recurrent calculus . Small residual caliceal fragments were left behind in 17 children but only 3 required surgical removal.

Rev Infect Dis, 1988 May-Jun, 10(3), 505 - 15
Ciprofloxacin: in vitro, experimental, and clinical evaluation; Thadepalli H et al.; Ciprofloxacin at a concentration of 2 micrograms/mL inhibited the growth of approximately 90% of 584 strains of aerobic bacteria isolated from cultures of blood drawn from septicemic patients . An increase in the inoculum size did not result in an increased MIC, but serial passages through media containing ciprofloxacin at sub-MIC levels increased the MIC for Escherichia coli, Klebsiella pneumoniae, and Proteus vulgaris . In experimental subcutaneous abscesses in the mouse model, ciprofloxacin was more active than cefotaxime against a mixed infection induced with E . coli and Bacteroides fragilis . Against mixed E . coli and Staphylococcus aureus infection, no significant differences were noted between the two drugs . In a double-blind, prospective, randomized clinical study, perorally administered ciprofloxacin was compared with intravenously administered cefotaxime in the treatment of skin and soft-tissue infections severe enough to require hospitalization . In 70 patients treated, the therapeutic efficacy of peroral ciprofloxacin was comparable to that of intravenous cefotaxime, with two differences: S . aureus infections responded less favorably to oral ciprofloxacin (62%) than to intravenous cefotaxime (90%), and aerobic gram-negative bacillary infections responded more favorably to ciprofloxacin (92%) than to cefotaxime (64%).

Arch Dis Child, 1988 May, 63(5), 556 - 7
Circumcision and periurethral carriage of Proteus mirabilis in boys; Glennon J et al.; Swabs were taken for culture from the periurethral area and urethral meatus in 124 uncircumcised and 60 circumcised boys . Proteus mirabilis was grown from 28 (22.6%) swabs from uncircumcised boys and from only one (1.7%) swab from circumcised boys . This supports the idea that the prepuce may be the source of proteus urinary tract infection.

Can J Microbiol, 1988 May, 34(5), 588 - 93
Further studies of swarmer cell differentiation of Proteus mirabilis PM23: a requirement for iron and zinc; Jin T et al.; Proteus mirabilis PM23, unlike other motile strains of the species, differentiates in rich fluid media to form nonseptate filaments resembling the swarmer cells formed on solid media . The swarming activity of PM23 is greater than that of the other strains on solid media and it grows faster than another strain, IM47, in differentiation-supporting broth . This faster growth is not exhibited in broth that does not support differentiation . The differentiation of PM23 in brain-heart infusion broth occurs over a wide range of pH and temperature . Inhibitors of swarming on agar plates (p-nitrophenylglycerol and boric acid) and three chelating agents (EDTA, sodium cyanide, and sodium diethyldithiocarbamate) stop differentiation both on plates and in brain-heart infusion broth; however, EGTA is not effective even at 10 mM (10 times the minimum inhibitory concentration of EDTA) . The inhibitory mechanisms of p-nitrophenylglycerol and boric acid are different from that of the chelating agents . The timing of EDTA inhibition suggests generation of a "signal" to differentiate after about 2 h growth . Prevention of differentiation by addition of Fe2+ and Zn2+ up to near the time that differentiation should appear suggests that these cations have a crucial involvement in the process of initiation . However, they are not effective as additives in allowing differentiation to occur in defined media or even nutrient broth; the further addition of nucleotides or cAMP was equally ineffective.

Am J Ophthalmol, 1988 Apr 15, 105(4), 361 - 5
Microbial keratitis associated with contaminated ocular medications; Schein OD et al.; We studied seven cases of severe gram-negative microbial keratitis associated with the use of contaminated topical ocular medications . Five cases involved Pseudomonas aeruginosa, one involved Serratia marcescens, and one involved Proteus mirabilis . In each case the same organism was cultured from corneal scrapings and from the medication . Either prednisolone acetate (one case) or timolol maleate (seven cases) was implicated in all instances.

Eur J Cell Biol, 1988 Apr, 46(1), 200 - 6
Possible regulation of cation-induced pinocytosis in Amoeba proteus by phospholipase A; Josefsson JO et al.; We have studied the effects of exogenous phospholipids and compounds which are known to alter the activity of phospholipase A (PLA) on Ca2+-dependent, Na+-induced pinocytosis in Amoeba proteus . The PLA-inhibitors mepacrine, p-bromophenacyl bromide (pBPB) and Rosenthal's inhibitor depressed pinocytosis . Normal pinocytotic intensity was restored by the addition of Ca2+ or picomolar concentrations of lysolecithin . Very low concentrations of lysophospholipids and different molecular species of lecithins increased the capacity for pinocytosis in starved amoebae . The effect of the lecithins but not of the corresponding lysolecithins was abolished by PLA-inhibitors . Also, the restoration of the pinocytotic capacity of starved amoebae by melittin and mastoparan, which are known to stimulate PLA, was inhibited by mepacrine and pBPB . Isolated amoeba plasma membranes contain phospholipase A1 and A2 activity and the amoebae secrete a lipid (PRF, pinocytosis regulating factor) which has lysolecithin-like effects on pinocytosis . The enzyme activities and the release of PRF were markedly decreased by the PLA-inhibitors . Our observations support the hypothesis that PRF is a lysophospholipid that may constitute a signal for the formation of pinocytotic channels in the initial stages of pinocytosis . The phospholipase A activity of the amoeba must therefore be assigned an important role in the regulation of the Ca2+-dependent, cation-induced pinocytosis.

Carbohydr Res, 1988 Apr 1, 175(1), 59 - 75
A computer-assisted structural analysis of regular polysaccharides on the basis of 13C-n.m.r . data; Lipkind GM et al.; A computerised approach to the structural analysis of unbranched regular polysaccharides is described, which is based on an evaluation of the 13C-n.m.r . spectra for all possible primary structures within the additive scheme starting from the chemical shifts of the 13C resonances of the constituent monosaccharides and the average values of the glycosylation effects . The analysis reveals a structure (or structures), the evaluated spectrum of which resembles most closely that observed . The approach has been verified by using a series of bacterial polysaccharides of known structure and, in combination with methylation analysis data, for the determination of the presently unknown structures of the O-specific polysaccharides from Salmonella arizonae O59 and O63, and Proteus hauseri O19.

J Clin Microbiol, 1988 Apr, 26(4), 791 - 3
New plate medium for screening and presumptive identification of gram-negative urinary tract pathogens; Thaller MC et al.; A new selective, differential plating medium to screen the common gram-negative urinary tract pathogens is described . The medium combines adonitol fermentation, phenylalanine deaminase, and beta-glucuronidase tests and allows the indole and cytochrome oxidase tests to be performed directly from the plates . High-level agreement with individual conventional tests was recorded in comparative studies with 504 cultures of gram-negative rods . There was 100% agreement, except for the Providencia spp . indole spot test (61.6% agreement) . Adonitol fermentation by Providencia species could not be determined . Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa were identified with a high efficiency (100, 85.7, 83.5, and 100% agreement, respectively) without further testing . There was 96% overall agreement for the 267 infected urine samples tested.

Antibiot Khimioter, 1988 Apr, 33(4), 294 - 7
{Dynamics of drug resistance in Proteus mirabilis cultures 1970-1985}; Shvidenko IG; Resistance of 669 clinical strains of Proteus mirabilis to 18 chemotherapeutic drugs was studied in dynamics within 1970-1985 . An increase in the number of cultures resistant to ampicillin and carbenicillin was noted while the number of cultures resistant to cephalosporines did not change . Within the period from 1970 to 1975 there was observed a marked increase in the number of Proteus strains resistant to aminoglycoside antibiotics . After that period their number gradually lowered and in 1985 reached the level of 1970 . Beginning from 1973 there were observed a decrease in the number of Proteus chloramphenicol resistant strains and simultaneous occurrence of cultures sensitive to this antibiotic . The predominating number of the tested strains preserved during the whole observation period their resistance to tetracycline, doxycycline, rifampicin, novobiocin, furazolidone and furagin . No increase in the number of Proteus strains with multiple drug resistance including those resistant to 5-7 drugs was noted in the observation periods of 1970-1975, 1980 and 1985 . The most frequent were Proteus strains resistant to 2-4 drugs . Among them cultures resistant to chloramphenicol and aminoglycoside antibiotics of the first generation predominated . Grouping of the strains by the same resistance spectra provided dividing the rested cultures of Proteus mirabilis into 69 variants.

Br J Urol, 1988 Apr, 61(4), 363 - 4
Intravesical migration of Lippes loop with stone formation; Sasidharan K et al.; PIP: A case is described of a 47-year old multipara, presenting with dysuria and frequency . Urinalysis showed pus and Proteus mirabilis infection, and radiography revealed the presence in the bladder of 2 stones joined together by a migrated and entrapped Lippes loop, which had been inserted 14 years previously, after the birth of her 5th child .

Am J Med Genet, 1988 Apr, 29(4), 777 - 82
Further diagnostic thoughts about the Elephant Man; Cohen MM Jr; Further evidence for a diagnosis of the Elephant Man's condition is reviewed . It is known that the Elephant Man had "mocassin" lesions, hyperostoses of the skull, and absence of cafe-au-lait spots, all of which are characteristic of Proteus syndrome . Recently, questions have been raised about his skeletal findings and their relevance to neurofibromatosis . However, other skeletal diagnoses have been entertained, including Maffucci syndrome, Paget's disease of bone, pyarthrosis, and fibrous dysplasia . These diagnostic possibilities are discussed and evaluated critically . It is concluded that the skeletal findings are most consistent with Proteus syndrome and coincidental hip disease secondary to childhood trauma.

Biochem J, 1988 Mar 15, 250(3), 917 - 20
Proteus mirabilis urease . Partial purification and inhibition by boric acid and boronic acids; Breitenbach JM et al.; Urease was purified 800-fold and partially characterized from Proteus mirabilis, the predominant microorganism associated with urinary stones . Boric acid is a rapid reversible competitive inhibitor of urease . The pH-dependence of inhibition exhibited pKa values of 6.25 and 9.3, where the latter value is probably due to the inherent pKa of boric acid . Three boronic acids also were shown to inhibit urease competitively.

Eur J Biochem, 1988 Mar 15, 172(3), 535 - 41
Structural studies on the core and lipid A region of a 4-amino-L-arabinose-lacking Rc-type mutant of Proteus mirabilis; Radziejewska-Lebrecht J et al.; The structure of the 4-amino-L-arabinose-lacking lipopolysaccharide of the Proteus mirabilis Rc-type mutant R4, derived from wild-type O28, was elucidated . The lipopolysaccharide core structure has previously been partially characterized . The linkage between heptose and deoxyoctulosonic acid(dOclA) is now reported, as well as the structure of the lipid A moiety of this mutant strain . Besides the tentative identification of an alpha-linked glucosamine disaccharide in the lipid A backbone accompanying the usual beta 1----6-linked glucosamine-disaccharide, the only significant structural variation to previous studies was the lack of substitution of the C-4' phosphate by 4-amino-L-arabinose . In addition, the substitution at C-8 of one dOclA unit by 4-amino-L-arabinose, previously reported for the R45 mutant of P . mirabilis 1959, is lacking in this R mutant . Also in addition to previous findings, the terminal unit of heptose was found to be substituted at C-7 with phosphorylethanolamine (PEtN) and not only with phosphate, although this substitution is not complete as demonstrated by the relevant signals in 31P-NMR . Additional studies with the wild-type strain P . mirabilis O28 revealed the presence of 4-amino-L-arabinose in both the core and the lipid A regions suggesting that the R4 mutant is defective in the biosynthesis of this amino sugar rather than in its transfer . Otherwise the lipid A regions of the mutant and the wild-type strain show no structural differences . The following formula is proposed for the lipopolysaccharide of 4-amino-L-arabinose-lacking mutant R4/O28 P . mirabilis: (Formula; see text)

Arch Surg, 1988 Mar, 123(3), 366 - 8
Septicemia from biliary tract infection; Siegman-Igra Y et al.; One hundred four strains of microorganisms were isolated from the blood in 76 episodes of septicemia originating from biliary tract infection . The 70 patients involved included 40 with acute cholecystitis without previous surgery, 17 with cholangitis following previous surgery, and 13 patients with malignant disease, with or without previous surgery . The most common organisms were Escherichia coli, Klebsiella, Streptococcus, and Proteus . Various streptococci, most of them from group D, were involved in 21% of the episodes . Twenty-five patients underwent surgery following the bacteremia . In ten of 12 operations performed shortly after the septicemia, bile culture yielded the same organism(s) as in the blood . The types of organisms in blood, and especially the important role of streptococci, must be taken into consideration when choosing antibiotics for therapy for and prevention of biliary septicemia.

J Pediatr Ophthalmol Strabismus, 1988 Mar-Apr, 25(2), 99 - 102
Proteus syndrome: ocular complications; Burke JP et al.; Proteus syndrome is a recently recognized hamartoneoplastic malformation syndrome of uncertain etiology and variable expression, whose cardinal manifestations are pigmented nevi, hemihypertrophy, macrodactly, lipomata, and cerebroid-gyriform configuration of the skin on the soles of the feet . The characteristic features may be present at birth but become more apparent with time . In the past this syndrome has been confused with other overgrowth disorders such as neurofibromatosis, Klippel-Trenaunay-Weber syndrome, Maffucci syndrome, and Bannayan syndrome . The ophthalmic features of the proteus syndrome require clarification . We review the ocular findings in 16 previously described cases and describe the findings unique to our patient, in particular, unilateral epibulbar and suspected posterior segment hamartomas.

J Bacteriol, 1988 Mar, 170(3), 1412 - 4
Cloning of the recB, recC, and recD genes from Proteus mirabilis in Escherichia coli: in vivo formation of active hybrid enzymes; Weichenhan D et al.; We cloned chromosomal DNA fragments from Proteus mirabilis which complement recBCD deletion mutants of Escherichia coli by restoring (i) recombination proficiency in conjugation, (ii) normal resistance to UV irradiation, and (iii) ATP-dependent exonuclease activity for duplex DNA . The data indicate that the order of the genes thyA, recC, recB, recD, and argA is similar in both P . mirabilis and E . coli . Hybrid enzymes formed in vivo were active in repair and recombination.

J Bacteriol, 1988 Mar, 170(3), 1027 - 33
Multiple proteins encoded within the urease gene complex of Proteus mirabilis; Walz SE et al.; Chromosomal DNA fragments from a uropathogenic isolate of Proteus mirabilis were inserted into the cosmid vector pHC79 to construct a genomic library in Escherichia coli HB101 . A urease-positive recombinant cosmid, designated pSKW1, was recovered . Sequential recombinant manipulation of pSKW1 yielded a 10.2-kilobase plasmid, designated pSKW4, which encoded three urease isozymes with electrophoretic mobilities identical to those of the donor P . mirabilis strain . Plasmid pSKW4 gene sequences encode seven proteins designated 68K (apparent molecular weight, of 68,000), 28K, 25K, 22.5K, 18.5K, 7.5K, and 5.2K within the limits of the urease gene complex . Insertion mutations in genes encoding the 68K, 28K, 25K, 22.5K, 7.5K, and 5.2K proteins resulted in complete or partial (22.5K) loss of urease activity . There was no reduction in urease activity when the gene encoding the 18.5K protein was inactivated.

Pediatr Dermatol, 1988 Feb, 5(1), 14 - 21
Cutaneous manifestations of the Proteus syndrome; Viljoen DL et al.; The Proteus syndrome is a rare disorder in which the major manifestations are skeletal overgrowth, digital hypertrophy, exostoses of the skull, and hamartomatous tumors . Numerous skin lesions also occur . We treated six individuals, all of whom had the features unique to this syndrome of marked hypertrophy of the skin of the soles . The palms were similarly involved in two patients . Light microscopy of biopsy material from thickened areas of the soles showed elongation of the cytoplasm of the basal cells . Large epidermal nevi were present in three persons, as were linear macular lesions with areas of depigmentation and hyperpigmentation.

Antibiot Khimioter, 1988 Feb, 33(2), 131 - 4
{Effectiveness of prodigiozan, methyluracil and levamisole in experimental infection after administration of non-steroidal anti-inflammatory drugs}; Bogdanova ASh et al.; The effect of nonsteroid antiinflammatory drugs (NAID) such as voltaren, acetylsalicylic acid, indometacin and naproxen on the efficacy of immunostimulators in treatment of infections caused by Proteus and Staphylococcus was studied . It was shown that except naproxen the NAID were capable of decreasing resistance to Proteus infections . Acetylsalicylic acid increased resistance to staphylococcal infections . The rest of the drugs did not change it . Prodigiozan increased resistance to the infections at the background of the NAID . However, volteran and indometacin lowered its effect in infections caused by Proteus . Levamisol stimulated resistance of mice to the infections at the background of volteran and increased resistance to Proteus infections lowered by acetylsalicylic acid . Methyluracyl was not able to increase resistance to the infections at the background of the NAID . It only increased resistance to Proteus infections lowered by acetylsalicylic acid . Levamisol and methyluracyl did not as a rule increase efficacy of antibiotic therapy at the background of the NAID.

Allergy, 1988 Feb, 43(2), 109 - 12
Cell-mediated immunity assessed by skin testing (Multitest) . II: Correlation between responses from arm and back; Moesgaard F et al.; In 60 healthy adult volunteers and 58 patients with gastrointestinal disease a test system (Multitest) consisting of a plastic disposable multiple-puncture device capable of simultaneously applying seven delayed-type hypersensitivity antigens and a glycerin/saline diluent (negative control) was assessed . The Multitest device was applied on both the inner side of the forearm and on the back for assessment of cell-mediated immunity (CMI) . The antigens used were two toxoids, tetanus and diphtheria, three bacterial antigens, Streptococcus, tuberculin and Proteus and two fungal antigens, Candida and Trichophyton . A scoring system based on both number and size of positive response revealed a median "score" on arm and back of 19 mm and 14 mm respectively, in the healthy volunteers and a median "score" of 12 mm and 8 mm respectively in patients with gastrointestinal disease . In both groups a significant difference was found between back and arm (P less than 0.01) . The coefficient of determination (r2) shows that only 64% of the variability in scores on the back is explained by the regression line . Therefore, scores obtained from tests on the back cannot be interpreted with reference to normal values originating from tests applied to the inner side of the forearm.

Clin Invest Med, 1988 Feb, 11(1), 10 - 5
A positive response to any of seven intradermal antigens predicts favorable outcome in patients hospitalized with community-acquired pneumonia; Marrie TJ et al.; We used the commercially available Multitest (R) CMI to assess the response of 100 adults hospitalized with community-acquired pneumonia to the following seven antigens: tetanus toxoid, diphtheria toxoid, Streptococcus, Proteus, tuberculin, Candida, and trichophyton . Thirty-one of the patients responded to one or more of these antigens and survived their acute illness . Of the Multitest (R) CMI negative patients, 49 lived and 20 died . A comparison of the three groups revealed that the 31 patients with positive tests were significantly younger and had a higher mean serum albumin than did those with negative tests who died . Multivariate analysis revealed that a positive Multitest (R) CMI and the albumin level were independent predictors of survival . A positive Multitest (R) CMI identified a less seriously ill group of patients as evidenced by 100% survival, by a very low rate of complications (0.18/patient), and by less utilization of resources (fewer hemograms and chest radiographs) . Thus a positive Multitest (R) CMI may identify patients who could be discharged earlier, and a negative test should target its patients for more aggressive therapy.

Chemioterapia, 1988 Feb, 7(1), 24 - 8
Treatment of experimental cystitis in the rat with a single dose of fosfomycin trometamol; Dubini F et al.; The therapeutic effectiveness of a single oral dose (60 and 200 mg/kg body weight) of fosfomycin trometamol (FT), norfloxacin, trimethoprim sulfamethoxazole (Bactrim) and pipemidic acid against experimental cystitis in the rat were compared . Infections were produced with clinical isolates of Klebsiella pneumoniae, Proteus mirabilis and Escherichia coli in a total of 135 Sprague-Dawley albino rats . Oral treatment with all four drugs consistently lowered the numbers of CFU in bladder tissue, especially E . coli and P . mirabilis . Fosfomycin trometamol appeared to be as effective as norfloxacin for treatment of E . coli cystitis even thoughs its minimal inhibitory concentration (MIC) in vitro is 100 times greater than that of the quinolonic antibiotic . Fosfomycin trometamol, pipemidic acid and Bactrim were equally effective against P . mirabilis infection, but FT was less active than norfloxacin or Bactrim for treatment of K . pneumonia cystitis . In conclusion, single dose treatment with fosfomycin trometamol was effective for treatment of experimental cystitis in the rat and might, by extrapolation, be of use in clinical practice for single dose treatment of uncomplicated urinary tract infections.

Chemioterapia, 1988 Feb, 7(1), 15 - 9
Antibacterial activity in human urine of fosfomycin trometamol in an in vitro model of the urinary bladder; Dubini F et al.; The urinary concentrations of fosfomycin trometamol, norfloxacin, pipemidic acid and cotrimoxazole were studied at various times after oral administration of drugs in healthy volunteers . Using the same urine, the bactericidal activity of four antimicrobial agents against Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae in an in vitro model simulating the treatment of bacterial cystitis was also evaluated . The results obtained show that very high concentrations of the drugs were achieved in urine particularly after the oral administration of the fosfomycin trometamol . In the bladder model bactericidal activity of fosfomycin trometamol, norfloxacin and pipemidic acid were higher than that of cotrimoxazole; no resistant mutants to drugs were selected over a period of 24 h.

Eur J Clin Microbiol Infect Dis, 1988 Feb, 7(1), 107 - 13
Role of intestinal anaerobic bacteria in colonization resistance; Wells CL et al.; The purpose of this study was to clarify the role of the intestinal anaerobe bacteria in colonization resistance . Germfree mice were associated with Escherichia coli C25 and either (a) no other species; (b) enterococcus; (c) Escherichia coli M14 and Proteus mirabilis, or (d) Bacteroides fragilis and Bacteroides vulgatus . All species colonized the cecum in high numbers, but only enterococcus significantly limited the translocation of Escherichia coli C25 to mesenteric lymph nodes . However, the overall translocation rates were similar in all groups and ranged from 60% to 100%, due to translocation of other intestinal flora in addition to Escherichia coli C25 . Conventionally reared mice were given either streptomycin, bacitracin/streptomycin or metronidazole which selectively eliminated facultative gram-negative bacteria, nearly all bacterial species or strictly anaerobic bacteria respectively . Only metronidazole significantly increased the rates of translocation of normal intestinal bacteria into mesenteric lymph nodes . Cohort groups of mice were then orally inoculated with drug resistant Escherichia coli C25, which actively colonized the cecum of all drug treated mice and translocated to the mesenteric lymph nodes of approximately half the streptomycin and metronidazole treated mice and nearly all the bacitracin/streptomycin treated mice . These results indicate that anaerobic bacteria play a pivotal role in limiting the translocation of normal intestinal bacteria, but that other bacterial groups also have a role in preventing the intestinal colonization and translocation of potential pathogens.

J Urol (Paris), 1988, 94(3), 133 - 6
{Treatment of staghorn calculi by percutaneous nephrolithotomy . Apropos of 18 cases}; Viville C; This series involves 19 kidneys treated by the same operator . The predominance of women (14/18) and of proteus urinary infection (11) was identical to other published series . 13/19 calculi with complete staghorn calculi occupying the renal pelvis and the 3 calyceal groups . 7 patients had a past history of 15 lombotomies for staghorn calculus . PCLN was carried out under fluoroscopic visualisation only, in 13 cases with one single channel, in 4 cases with two channels and in 3 cases with three channels . One operative phase was sufficient in 9 kidneys, two in another 9, whilst one kidney required 3 . The mean duration of irradiation was 20 minutes (as against 12 minutes for the entire series of 135 CNL of the same operator) . The post-operative course was uneventful apart from late hematuria which required no particular surgical management . 14/19 kidneys (73.6%) were totally cleared of their calculi . For the other 5 kidneys, two were treated by extracorporeal lithotripsy, with one success, two were lost to follow-up, including one after refusal of a third PCNL, and one will shortly be retreated by PCNL . After analysis of the literature compared with his own experience, the author considers that approximately 90% of staghorn calculi (large portion in pelvis, small calyceal portions, wide calyceal branches) can be treated by PCNL alone or completed by ECL and that some 10% of staghorn calculi (small pelvis portion, large extensively branched calyceal portions, narrow calyceal branches) still require traditional surgery.

J Antimicrob Chemother, 1988 Jan, 21(1), 41 - 8
Interactions between antibacterial agents of the quinolone group and nitrofurantoin; Shah S et al.; Plate diffusion tests showed that nitrofurantoin antagonized the activity of nalidixic acid, norfloxacin, ciprofloxacin and enoxacin against many Gram-negative bacilli, including all Proteus mirabilis and Klebsiella aerogenes strains tested . No interaction was exhibited when nitrofurantoin and the newer quinolones were tested against Pseudomonas aeruginosa, staphylococci or streptococci . Antagonism was not reliably demonstrated in chessboard titrations, especially with the newer quinolones . Continuous turbidimetric monitoring revealed that antagonism in Pr . mirabilis was associated with abolition of the bacteriolytic response to quinolones and parallel viable counts established that the bactericidal effect of quinolones was suppressed . Apparent potentiation of the effect of nitrofurantoin by nalidixic acid and other quinolones against Pr . mirabilis appeared to be caused by inhibition of swarming into the nitrofurantoin inhibition zone.

Acta Microbiol Hung, 1988, 35(1), 49 - 54
Bacterial translocation in dianhydrodulcitol-treated mice; Anderlik P et al.; Escherichia, Proteus, Klebsiella and Streptococcus strains were isolated from mesenteric lymph nodes, spleens and livers of conventional mice treated with dianhydrodulcitol (DAD), indicating that intestinal bacteria had appeared in organs usually containing no bacteria . The frequency of bacterial translocation showed direct relation to the dose of the drug and appeared simultaneously with the spleen atrophy caused by DAD.

Microbiol Immunol, 1988, 32(2), 119 - 30
Nature of monocyclic beta-lactam antibiotic Nocardicin A to beta-lactamases; Kojo H et al.; Nocardicin A is the antibiotic which was first found to possess a monocyclic beta-lactam ring . This antibiotic was inactivated by the cleavage of its beta-lactam ring . The direct spectrophotometric assay was applied to measure the rate of enzymatic hydrolysis of Nocardicin A . Nocardicin A was highly stable to both chromosomal and plasmid-mediated beta-lactamases . Of the nine beta-lactam antibiotics including cefoxitin and cefuroxime, Nocardicin A was the most stable to the beta-lactamases tested excluding those from Klebsiella oxytoca and Proteus vulgaris . The latter broad-spectrum beta-lactamases hydrolyzed Nocardicin A rather intensively . Extreme stability of Nocardicin A to beta-lactamases was suggested to be due to the combination of its low affinity to the enzymes and stabilization of its monocyclic beta-lactam ring . Nocardicin A was shown to have inducing ability toward beta-lactamases.

Infection, 1988, 16 Suppl 1, S48 - 50
Is pelvic inflammatory disease an indication for treatment with ciprofloxacin?
Hagele D, Chysky V.
This pilot study was carried out on 23 gynaecological patients suffering from salpingitis, salpingitis and pelviperitonitis, Douglas' abscess, and vaginal stump abscess . 21 courses were evaluable for clinical efficacy . The diagnoses had been established mainly by pelviscopy and by clinical gynaecological examinations . The dosage was 2 X 500 mg ciprofloxacin orally every 12 h for 7.6 (5-11) days . Cervical smears collected before therapy revealed the most common pathogens to be Escherichia coli and staphylococci, followed by Proteus mirabilis and streptococci . Clinically ciprofloxacin produced a complete cure in 16 patients (76%), and a clear improvement in four patients (19%) . One patient left hospital before completing the therapy . Laboratory tests did not reveal any pathological findings, and ophthalmological examinations (fundoscopy, visus, colour perception) on 16 patients, before and after treatment, likewise did not show any changes . In one patient, therapy had to be discontinued after three days because of pruritic exanthema and vertigo . A second patient complained of strong pain behind the eyes and headache . In both patients these symptoms disappeared completely on discontinuation of treatment . The study showed clinical efficacy of orally administered ciprofloxacin in pelvic inflammatory disease.

Urologe A, 1988 Jan, 27(1), 61 - 7
{Experimental comparison of Maxon and chromic catgut in suturing of the urinary bladder}; Osterhage HR et al.; The new monofile absorbable suture material Maxon was compared with Chromic catgut in bladder suturing in rabbits . Comparisons were made after 1, 2, 4, 8 and 12 weeks . The rate of stone formation was mainly determined by the suture technique used and not so much by the suture material . This was demonstrated by the low number of stones formed after using extramucosal suturing technique . Once a suture, be it Maxon or Chromic catgut, comes in contact with urine, concrements may form and the new monofile properties of Maxon do not offer any advantages here . On the other hand, Maxon does not enhance stone formation either . E . coli or Proteus infections did not influence formation of stones . The histological examinations showed Maxon to cause fewer inflammatory reactions . Sutures with Chromic catgut caused inflammation of the bladder wall, subsiding after 4 weeks . An existing urinary infection did not appear to influence the inflammatory process . Maxon offers an advantage over Chromic catgut in extramucosal sutures causing fewer inflammatory reactions.

Infect Immun, 1988 Jan, 56(1), 51 - 3
Killing of Proteus mirabilis by polymorphonuclear leukocyte granule proteins: evidence for species specificity by antimicrobial proteins; Shafer WM et al.; Low-molecular-weight (Mr, ca . 3,800) polypeptides containing human defensins HNP-1 and HNP-2 (T . Ganz, M . S . Selsted, D . Szlarek, S . L . Harwig, K . Daher, D . F . Bainton, and R . I . Lehrer, J . Clin . Invest . 76:1427-1434, 1985) prepared in our laboratory from acid extracts of human polymorphonuclear granulocyte granules and purified human defensins were found to exert potent bactericidal action against Proteus mirabilis . The antimicrobial action of the extracts of human polymorphonuclear leukocytes granules against P . mirabilis appears to be due to the presence of the defensins . Because P . mirabilis resists the antimicrobial action of other granule proteins, we interpret the present results to mean that the various antimicrobial proteins display species specificity in their microbicidal action.

Z Hautkr, 1988, 63 Suppl 4, 104 - 7
{Climate therapy and change in cellular immunity}; Drosner M; The cell-mediated immunity was investigated by delayed hypersensitivity reactions on recall antigens (tetanus, diphtheria, streptococci, tuberkulin, candida, trichophyton, proteus/Multitest-Merieux) in 56 patients with atopic dermatitis (34 females, 22 males) under mountain-climatic therapy (Davos, 5118 ft) . The testscore of 7.9 mm (females 8.2/males 7.5) was lowered in comparison to the normals within the literature (females 15.4/males 21.0) . Anergy was found in 8.8% in females (normal 4%) and in 9.1% in males (0.4%) . After treatment the score raised up to 9.9 mm (25.3%, p less than 0.005), more obvious in males (29.3%/9.7 mm) than in females (22.0%/10.0 mm) . The mean number of positive skin-reactions raised from 2.0 to 2.6 (p less than 0.001) . These data let assume an influence of mountain-climatic therapy on the cell-mediated immunity.

Brain Behav Evol, 1988, 32(5), 277 - 80
Behavioral evidence and supporting electrophysiological observations for electroreception in the blind cave salamander, Proteus anguinus (Urodela); Roth A et al.; Conditioning experiments revealed that Proteus perceives a back-and-forth moving (approximately 1 Hz) direct-current field and its polarity . Minimum behavioral thresholds occurred at a current density of 0.15 microA/cm2, corresponding to a voltage gradient of 0.5 mV/cm . Recordings from afferent nerve fibers showed that ampullary electroreceptors in Proteus respond as do other nonteleost receptors, i.e . with an increase in discharge rate to cathodal current and a decrease to anodal current (threshold: approximately 1 mV/cm).

Arkh Patol, 1988, 50(11), 54 - 60
{Kidney morphology in hemolytic-uremic syndrome}; Khodasevich LS et al.; Morphology of the kidneys in hemolytic-uremic syndrome is considered basing on autopsy findings obtained for 3 infants with 5-17-day history of acute renal failure . A newborn infant of 17 days developed the disease after feto-fetal hemotransfusion when macerated fetus-donor hemolysis products entered the circulation of the fetus-recipient through monochorionic placenta . The second case in an infant of 6 months was due to ADTP Vaccine . The last infant aged 16 months manifested the syndrome in the presence of Proteus-induced ulcerative colitis . Varying in etiology, renal morphology exhibited similar features: fibrin deposits in the lumens of glomerular capillary loops, afferent glomerular arterioles and intrarenal arteries; fibrinoid necrosis of the wall in the arterioles . The renal affection ranged from acute thrombotic glomerulonephritis to cortical necrosis, these variations being dependent on the degree of thrombogenesis, caliber of impaired intrarenal vessels and time from the onset of acute renal failure.

Neurofibromatosis, 1988, 1(5-6), 260 - 80
Understanding Proteus syndrome, unmasking the elephant man, and stemming elephant fever; Cohen MM Jr; Four patients with Proteus syndrome are reported; 3 of the 4 died of unusual causes . Current findings of the syndrome are reviewed, and the present state of its delineation is assessed with emphasis on what is known about natural history . Differential diagnosis includes neurofibromatosis, Klippel-Trenaunay-Weber syndrome, Maffucci syndrome, epidermal nevus syndrome, and the combination of Bannayan-Zonana syndrome, Riley-Smith syndrome, and Ruvalcaba-Myhre syndrome, now thought to constitute a single disorder . Conditions that may possibly overlap with Proteus syndrome--encephalocraniocutaneous lipomatosis and Thanos syndrome--receive special attention . Various suggested diagnoses for the elephant man's disorder are evaluated, and it is concluded that he suffered from Proteus syndrome, not neurofibromatosis . Finally, the psychosocial significance of elephant fever (EF) is discussed, and a plea is made for taking the EF out of NF.

Acta Microbiol Hung, 1988, 35(4), 423 - 8
Characterization of multiply resistant Proteus mirabilis isolates in Hungary; Konkoly Thege M et al.; According to a survey on tendencies of antibiotic resistance in Hungary (1974-1983), the emergence of multiresistant (MR) Proteus mirabilis isolates is a new phenomenon . A total of 60 strains resistant to 11-16 antibiotics were collected from various specimens and geographical locations . Except for cefoperazone, third generation cephalosporins, amikacin, netilmicin and ofloxacin were effective in vitro against multiply resistant P . mirabilis isolates . Out of them 62% belonged to O18, a serogroup not shown in early studies in Hungary; moreover, in serogroup-distribution the present collection differed sharply from isolates examined in 1956 . All but two strains produced the same aminoglycoside-modifying enzyme ANT (2"), and all of them proved beta-lactamase positive in nitrocephin test . All multiresistant strains harboured 2-4 plasmids, whereas the sensitive isolates had no plasmids . The presence of two plasmids (62 and 22 Mdal) occurring in 85% of the isolates was a characteristic feature of the multiresistant P . mirabilis isolates . In contrast to these plasmids some other ones (17.5, 103 and 113 Mdal) could be transferred to Escherichia coli recipient . There was no relationship between plasmid profiles, serogroups and resistance patterns.

Arch Immunol Ther Exp (Warsz), 1988, 36(2), 161 - 6
Phagocytosis and killing of Listeria by guinea pig macrophages and neutrophils; Rudnicka W et al.; The rate of the phagocytosis and intracellular killing of Listeria monocytogenes by guinea pig macrophages and neutrophils in vitro was determined . The anti-bacterial activity of the phagocytes against virulent Listeria monocytogenes was compared with their activity against avirulent strain of Listeria and Proteus mirabilis . It is suggested that the contribution of the macrophages and the neutrophils to anti-bacterial protection can depend on physiological state of bacteria.

Urol Res, 1988, 16(5), 381 - 4
The in-vitro assessment of a collagen/vicryl (polyglactin) composite film together with candidate suture materials for potential use in urinary tract surgery . III . Adherence of bacteria to the material surface; Gemmell CG et al.; A Collagen/Vicryl (Polyglactin) composite membrane (developed for use in urinary tract surgery) has been incubated in cultures of radioactively labelled urinary tract pathogens vis Escherichia coli, Staphylococcus epidermidis, and Proteus mirabilis for up to 1 h . For comparison, collagen film, Vicryl mesh, and a number of absorbable and non-absorbable sutures were similarly tested . Following incubation, samples were also examined by scanning electron microscopy . Under the experimental conditions employed, only minimal adherence of the micro-organisms to the collagen coated Vicryl mesh, its two individual components, as well as Vicryl and nylon sutures was observed . Significantly greater numbers of bacteria, however, adhered to silk and Chromic Catgut . The results suggest that adherence of microorganisms to the prosthesis even in infected urine is unlikely to develop into a microcolony of bacteria . However, it should be emphasised that great care must be exercised when extrapolating from the in-vitro to the in-vivo situation.

Scand J Infect Dis, 1988, 20(4), 421 - 4
Variable in vitro activity of cefaclor, cephalothin and cefadroxil against Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis; Larsson P et al.; The in vitro activity of cefaclor, cephalothin and cefadroxil to 50 Escherichia coli, 23 Klebsiella pneumoniae and 20 Proteus mirabilis strains was tested with the disc diffusion and microdilution plate techniques . Cefaclor was more active than cefadroxil, while cephalothin was intermediate . The differences seriously affected the classification into the routine SIR system . For susceptibility testing we question the use of cephalothin as a class representative of oral cephalosporins.

J Hyg Epidemiol Microbiol Immunol, 1988, 32(2), 227 - 31
Lecithinase activity of Proteus vulgaris; Postupa R et al.; Lecithinase production is described as a new biochemical property of P . vulgaris strains grown in a selective agar medium containing brilliant green, crystal violet and lecithin (BCL agar), the authors' own modification of egg-yolk culture medium . By using this BCL agar as a medium inhibiting the swarming growth of P . vulgaris cultures the authors succeeded in identifying 12 lecithinase-positive strains among the P . vulgaris isolates obtained from patients with Crohn's disease . Of 50 P . mirabilis strains tested in parallel none gave the positive test for lecithinase production in this medium.

Int Rev Cytol, 1988, 112, 67 - 96
Membrane oligosaccharides: structure and function during differentiation; Mann PL; Recent results gathered by normal light microscopy, immunocytochemistry, fluorescent-analog cytochemistry, and electron microscopy have allowed an improved interpretation of ameboid movement and related phenomena . 1 . The contractile system responsible in Amoeba proteus for the generation of motive force for protoplasmic streaming and a large variety of dynamic activities is represented mainly by a thin cortical filament layer at the cytoplasmic face of the cell membrane (Fig . 18I) . During normal locomotion this layer exhibits a distinct structural and physiological polarity with three different zones: a zone of reformation at the front (A), a zone of contraction in the intermediate cell region (B), and a zone of destruction at the uroid (C) . 2 . Two types of filaments participate in the formation of the cortical layer: (1) randomly distributed thin (actin) filaments exhibiting a parallel orientation in the anterior (Fc1) and a disordered arrangement in the intermediate and posterior cell region (Fc2; see also Fig . 17b), and (2) thick (myosin) filaments in close association with F-actin and mostly restricted to the intermediate and posterior cell region (Fc2) . 3 . The internal hydraulic pressure generated by localized active contraction of the cortical layer is transmitted to the endoplasm via the cell membrane and converted into directed streaming by a gel-sol gradient of decreasing viscosity between the uroid and the front . Calcium ions, ATP, and regulative proteins (profilin and a kinase) play an essential role in controlling both the interaction of actin and myosin and the sol-gel state of the cytoplasmic matrix . 4 . Any alterations externally induced in the polarity of the cortical filament system by chemical or physical stimulation and inhibition cause immobilization of the amebas (Fig . 18II) with characteristic changes in (1) cell shape (spherulation and cell flattening), (2) membrane dynamics (cytotic and cytokinetic activities), and (3) cytoplasmic organization (hyalogranuloplasmic separation) . pseudopodial tip (Fig . 18III, b----c, d----e), (3) destruction of the old layer at the hyalogranuloplasmic border (Fig . 18III, c,e), and (4) alternate solation (Fig . 18III, b and d) and gelation (Fig . 18III, c and e) of the hyaloplasm between the layer and the plasma membrane . The retraction of pseudopodia is accomplished by a local contraction of the cortical layer in conjunction with a simultaneous gel-sol transformation of the ectoplasmic cylinder . 6 . The expression of a rather complex cytoskeleton which is composed not only of microfilaments and associated proteins, but also of intermediate- and microtubularlike structures has to be considered in future

Br J Rheumatol, 1988, 27 Suppl 2, 90 - 4
Antibodies to Proteus in rheumatoid arthritis; Rogers P et al.; Increased levels of Proteus antibodies were found in patients with rheumatoid arthritis and coeliac disease, when compared to normal controls or patients with SLE and sarcoidosis.

Br J Rheumatol, 1988, 27 Suppl 2, 86 - 9
Antibodies to Klebsiella and Proteus microorganisms in ankylosing spondylitis and rheumatoid arthritis patients measured by ELISA; Khalafpour S et al.; Antibodies to Klebsiella oxytoca and Proteus mirabilis in 21 active ankylosing spondylitis (AS), 13 active rheumatoid arthritis (RA), 19 inactive RA patients and 18 healthy controls were measured using enzyme-linked immunosorbent assay (ELISA) . Elevated anti-Klebsiella antibodies were demonstrated in active AS patients compared to active RA (p less than 0.01), inactive RA patients (p less than 0.001) and controls (p less than 0.005) . When measuring antibodies to Proteus, active RA patients showed higher levels of antibodies compared to active AS patients (p less than 0.005) and healthy controls (p less than 0.05) . Further investigations are required to assess the role of Klebsiella and Proteus microorganisms in AS and RA respectively.

Br J Rheumatol, 1988, 27 Suppl 2, 72 - 85
Klebsiella antibodies in ankylosing spondylitis and Proteus antibodies in rheumatoid arthritis; Ebringer A et al.; Antibodies to Klebsiella, but not to other bacteria, have been shown to be present in patients with active ankylosing spondylitis (AS) by seven different techniques . Antibodies to Proteus, but not to E . coli or Klebsiella, have been shown to be present in patients with active rheumatoid arthritis (RA) by three different techniques . It is suggested AS and RA are forms of reactive arthritis, to Klebsiella and Proteus respectively, probably mediated by cross-reactivity to HLA antigens.

Ann Dermatol Venereol, 1988, 115(8), 797 - 800
{Gram-negative bacteria folliculitis}; Poli F et al.; Gram-negative folliculitis was first described in 1968 and had since given rise to numerous publications . To our knowledge, no case has yet been published in France, although we observed 6 of them in 12 months . Between March, 1985 and March, 1986, samples of pus for bacteriological examination were obtained from all our patients with acnea vulgaris resistant to the standard treatment (i.e . oral tetracycline combined with topical applications of tretinoin or benzoyl peroxide), thus enabling us to detect patients who had a Gram-negative bacillus (GNB) in at least one pustule . Inflammatory and painful episodes were noted in every case . Tetracyclines, initially effective, gradually lost their activity . The lesions were always limited to the face and consisted of: either superficial small pustules located in the naso-labial line and on the upper lip and chin, associated with inflammatory papulopustular lesions of the cheeks and perioral region; or deeply sited and painful nodules of the cheeks . Various GNBs of the lactose-fermenting Gram-negative rod group were isolated from the superficial lesions, and a Proteus mirabilis strain from the deep lesions . The GNB was never found in all samples but only in 1 to 3 pustules . Four patients were treated with antibiotics proved to be active in vitro against the responsible organisms, and their lesions disappeared within a fortnight . Two patients were given isotretinoin in doses of 1 mg/kg/day with a satisfactory result after 2 and 3 months respectively . The prevalence of Gram-negative folliculitis is probably underestimated . The clinical picture is stereotyped . GNBs are found in some pustules but rarely in all.(ABSTRACT TRUNCATED AT 250 WORDS)

Reprod Nutr Dev, 1988, 28(3B), 721 - 31
{Hormonal determination of the differentiation of striated skeletal muscle in urodele amphibians}; Chanoine C et al.; In the urodelan amphibian Pleurodeles waltlii, spontaneous external metamorphosis was correlated with an increase in the serum level of thyroxine (T4) . Within the same period, a change occurred in the myofibrillar ATPase profile of the dorsal skeletal muscle; fibres of larval type were gradually replaced by transitional fibres (type IIC), then by adult fibres of the types I, IIA, and IIB . Likewise, a myosin isoenzymic transition was observed . In larval animals, myosin electrophoresis revealed 3 bands corresponding with isoforms having identical heavy chains (MHC), but different light chains (MLC) . In the course of metamorphosis, the 3 larval isomyosins were replaced by 3 isoforms having the adult type MHC and different motility . In a related neotenic species, Ambystoma mexicanum, no spontaneous anatomic metamorphosis occurred; at the time it should theoretically take place, the serum T4 level remained low . The ATPase profile was modified, but transitional fibres that replaced the initial larval types appeared to be persistent, and adult fiber types appeared only in a small amount . Myosin isoenzymic transition was also incomplete, larval isoforms were still distinguished in the neotenic adults . Similar persistence of larval characters was observed in adult Proteus anguinus, a perennibranch that never undergoes anatomical metamorphosis . Experimental hypothyroidian Pleurodeles waltlii displayed no external metamorphosis, only the larval fibre types and isomyosins were detected in those animals . External metamorphosis was induced in Ambystoma mexicanum by a triiodothyronine treatment . A complete myosin isoenzymic transition was observed in metamorphosed animals . These results tend to indicate that a moderate increase in the level of thyroid hormones is sufficient to determine the production of the adult type MHC molecules and the differentiation of the corresponding myofibrillar types in the skeletal dorsal muscle of amphibians, while a marked increase would be necessary for repressing the initial larval feature.

Ann Otolaryngol Chir Cervicofac, 1988, 105(8), 635 - 41
{Clinical efficacy of Auricularum compared with its bacteriologic efficacy in vitro}; Freche C et al.; We compared the clinical efficacy of Auricularum to its bacteriological efficacy in 36 patients with a chronic middle ear disease . The clinical study confirms the very good efficacy of Auricularum with an improvement rate equal to 81% and 69.4% of "very good" results . The bacteriological study confirms the usual sensitivity of gram-negative bacilli (except the Proteus) to polymyxine B, the sensitivity of gram-positive germs to tetracycline for 60% of them and the sensitivity of fungus (isolated only once) to nystatine . Moreover, the bacteriological study shows that Auricularum with a concentration more or equal to 0.1 ml inhibits every germ, including the well-known resistant germs . This concentration of 0.1 ml corresponds to 2 drops of the drug in suspension and is less than the recommended dosage . This finding proves the very good efficacy of Auricularum in chronic middle ear diseases, including the ones due to usual resistant germs to the two antibiotics (polymyxine B and oxytetracycline) enclosed in the drug composition.

Acta Derm Venereol, 1988, 68(3), 240 - 4
Bacteria in ulcera crurum; Kontiainen S et al.; Bacterial cultures derived from 432 chronic leg ulcers were analysed retrospectively to determine which bacteria are most commonly found in these ulcers . The study covered a 2-year period . Two-thirds of the patients were over 70 years of age . Staphylococcus aureus was found in nearly half of the ulcers studied, Pseudomonas sp . in one-third, pyogenic streptococci and enterococci in every fifth and Proteus sp . in every tenth . The frequency by which pyogenic streptococci were isolated was about 10 to 20 times as high as previously reported . Obligate anaerobic bacteria were also frequently isolated . The sensitivity of the isolates from the second year to antimicrobial agents likely to be chosen if systemic therapy were required is also reported . The results are discussed in relation to previous findings.

Pharm Weekbl Sci, 1987 Dec 11, 9 Suppl, S30 - 2
Comparative activities of five antimicrobial agents in experimental Proteus pyelonephritis in mice; Peerbooms PG et al.; Five antimicrobial agents, ciprofloxacin, ticarcillin, piperacillin, aztreonam and gentamicin, were compared both in vitro (MIC's, time-kill studies) and in vivo, in the treatment of experimental Proteus mirabilis pyelonephritis in mice . In the treatment of the pyelonephritis, ciprofloxacin was clearly superior to the other agents, both with respect to the percentage of sterile kidneys after treatment as with respect to the mean numbers of bacteria per kidney . The results can only be partially explained by the in vitro activities of the different antibiotics.

Arch Fr Pediatr, 1987 Dec, 44(10), 871 - 4
{Cerebral abscess caused by Proteus mirabilis in the neonatal period}; Carre M et al.; Eight cases of cerebral abscesses due to Proteus mirabilis in the newborn period are reported . The authors emphasize the insidiousness of the clinical features, and the use of ultrasound screening for an early recognition, essential for the therapeutic results.

Acta Pathol Microbiol Immunol Scand {B}, 1987 Dec, 95(6), 347 - 50
Ascending urinary tract infections in rats induced by Staphylococcus saprophyticus and Proteus mirabilis; Hjelm E et al.; Ascending pyelonephritis was induced by Staphylococcus saprophyticus and Proteus mirabilis both by inoculating the organisms separately and in combination into rat bladders . Bacterial cultures of tissue homogenates showed that pyelonephritis by both bacteria occurred significantly more often in rats where the two organisms were instilled concomitantly, suggesting a synergistic virulence between the two species . The antibody response to the different organisms was the same either the bacteria were instilled separately or in combination.

Zh Mikrobiol Epidemiol Immunobiol, 1987 Dec, (12), 57 - 61
{Immunological activity of a Proteus vaccine administered to volunteers simultaneously with a pyoimmunogen and adsorbed staphylococcal anatoxin}; Levina LA et al.; The comparative study of the immunological activity of Proteus vaccine prepared from soluble antigenic complexes was made after the immunization of volunteers with this vaccine used in the form of a single preparation and in combination with pyoimmunogen (Pseudomonas aeruginosa vaccine) and/or adsorbed staphylococcal toxoid . The injection of the vaccine in the form of a single preparation and in different combinations increased the ingestion of Proteus cells by neutrophils . The injection of Proteus vaccine simultaneously with pyoimmunogen and staphylococcal toxoid ensured the intensive phagocytosis of staphylococci . All combinations with Proteus vaccine, used in this investigation, stimulated the intensive formation of antibodies to Proteus vaccine strain and Re-glycolipid . Proteus vaccine introduced in combination with adsorbed staphylococcal toxoid essentially stimulated the synthesis of anti-alpha-staphylolysin.

Kidney Int, 1987 Dec, 32(6), 884 - 8
Trimethoprim-sulfamethoxazole in cyst fluid from autosomal dominant polycystic kidneys; Elzinga LW et al.; Cyst infection in patients with autosomal-dominant polycystic kidney disease (ADPKD) is often refractory to therapy, in part because of the limited entry of commonly used antibiotics into cyst fluid . To study the efficacy of trimethoprim-sulfamethoxazole in cyst infection, cyst fluid was obtained by percutaneous aspiration or at surgery from eight patients with ADPKD receiving trimethoprim-sulfamethoxazole . Cysts were categorized as nongradient or gradient by cyst-fluid sodium concentration . Trimethoprim-sulfamethoxazole concentrations within cysts were determined and cyst fluid inhibitory and bactericidal titers were assessed in vitro against Escherichia coli, Proteus mirabilis and Streptococcus fecalis . The mean cyst fluid trimethoprim and sulfamethoxazole concentrations were 15.2 micrograms/ml and 42.5 micrograms/ml, respectively . Preferential accumulation of trimethoprim was observed in gradient cysts, exceeding serum levels more than eightfold . Sulfamethoxazole penetrated cysts to a lesser extent, with concentrations ranging from 10 to 70 percent of the serum level . Cyst fluid sampled prior to trimethoprim-sulfamethoxazole administration (control) demonstrated no antibacterial activity, while cyst fluid inhibitory and bactericidal titers following antibiotic administration were 1:32 or greater in most instances . These studies indicate that trimethoprim-sulfamethoxazole is likely to be efficacious in the treatment of cyst infection in polycystic kidneys.

Comput Appl Biosci, 1987 Nov, 3(4), 325 - 31
PROTEUS: a suite of programs for prediction of structural features of proteins using an Apple IIe; Pascarella S et al.; We have implemented several algorithms, developed by various authors for predicting structural features of proteins from their primary structure, on an Apple IIe and collected them in a suite, named PROTEUS . This suite incorporates: (i) methods for predicting secondary structure; (ii) the algorithm for computing the hydropathy profile using one out of five available sets of parameters; (iii) the algorithms for calculating the hydrophobic moment plot; and (iv) for performing the amphipathic analysis using one out of four available sets of parameters . The suite has a utility program for storing on a disk the sequence to be analysed . As an example, we applied some of the methods included in PROTEUS to predict the structure of a mitochondrial leader peptide . The results suggest the occurrence of structural features possibly related to the import of proteins into mitochondria.

Antimicrob Agents Chemother, 1987 Nov, 31(11), 1768 - 74
Comparative antibacterial activities of temafloxacin hydrochloride (A-62254) and two reference fluoroquinolones; Hardy DJ et al.; The in vitro and in vivo properties of a new 1-difluorophenyl-6-fluoroquinolone, temafloxacin hydrochloride (A-62254), were compared with those of difloxacin and ciprofloxacin . Temafloxacin hydrochloride was as active as ciprofloxacin and difloxacin against staphylococci and as active as ciprofloxacin and 2 twofold dilutions more active than difloxacin against streptococci . Against gram-negative enteric bacteria and Pseudomonas aeruginosa, temafloxacin hydrochloride was 2 twofold dilutions more active than difloxacin but 2 to 4 twofold dilutions less active than ciprofloxacin . The MICs of temafloxacin hydrochloride and difloxacin were increased by 2 to 5 twofold dilutions in urine at pH 6.5 compared with 4 to 5 twofold-dilution increases in the MICs of ciprofloxacin . The MICs of temafloxacin hydrochloride, difloxacin, and ciprofloxacin were increased by 1 to 3 twofold dilutions in serum . The MICs of temafloxacin hydrochloride, difloxacin, and ciprofloxacin were the same or within 1 to 2 twofold dilutions at pHs 6.5, 7.2, and 8.0 . When administered orally in mouse protection tests, temafloxacin hydrochloride was as active as difloxacin and 5 to 10 times more active than ciprofloxacin against infections with Staphylococcus aureus and streptococci . Against infections with gram-negative enteric bacteria and P . aeruginosa, temafloxacin hydrochloride was as active as difloxacin and ciprofloxacin . Temafloxacin hydrochloride was three times less active than difloxacin but was five times more active than ciprofloxacin against infections with Salmonella typhimurium . Temafloxacin hydrochloride was as active as difloxacin and ciprofloxacin against P . aeruginosa and Proteus mirabilis pyelonephritis in mice . The peak serum concentration and serum half-life of temafloxacin hydrochloride in mice were approximately one-half and one-sixth, respectively, that of difloxacin after oral administration . The peak serum concentration of temafloxacin hydrochloride in mice after oral administration was six times higher than that of ciprofloxacin, and the serum half-life was equal to that of ciprofloxacin.

Antibiot Med Biotekhnol, 1987 Nov, 32(11), 850 - 5
{Sensitivity to beta-lactam and aminoglycoside antibiotics of clinical Proteus strains as dependent upon on their species classification and the source of their isolation}; Shvidenko IG; Sensitivity of 130 Proteus clinical strains was studied . Among beta-lactam antibiotics cefotaxime showed marked advantages with respect to various Proteus species . All the isolates of Proteus mirabilis were sensitive to cefuroxime . Cefamezin and cephapirin were inferior by their activity to cefotaxime and cefuroxime . They were characterized by close antibacterial activity and almost complete cross resistance . Ampicillin and carbenicillin proved to be the least efficient among the tested beta-lactam antibiotics . Isolates of Proteus vulgaris and Proteus penneri were more resistant to the penicillins and cephalosporins than the cultures of Proteus mirabilis . Sensitivity of separate Proteus species to gentamicin, tobramycin, sisomicin and amikacin was close . No cross resistance to the aminoglycosides was detected . Studies on the effect of different doses of the antibiotics revealed pronounced heterogeneity of Proteus by the feature of sensitivity to the tested antibiotics . The level of the heterogeneity was not the same for separate antibiotics . Cultures of Proteus mirabilis resistant to ampicillin, carbenicillin, cefamezin and cephapirin were more frequent in patients with urogenital infections as compared to patients with intestinal infections and suppurative-inflammatory processes of other localization.

Am Rev Respir Dis, 1987 Nov, 136(5), 1207 - 12
Erythromycin-induced suppression of pulmonary antibacterial defenses . A potential mechanism of superinfection in the lung; Nelson S et al.; Erythromycin is a broad-spectrum antibiotic commonly used in patients with respiratory infections . Certain of these patients become colonized with new microorganisms and develop superinfections . Antibiotics have a number of effects other than simply killing or inhibiting the growth of bacteria and may have direct effects upon host cells, including phagocytes . In vitro and in vivo studies have demonstrated that erythromycin decreases polymorphonuclear leukocyte (PMN) directed migration . To test the hypothesis that erythromycin inhibits normal PMN migration into the alveoli in response to a bacterial challenge, mice were challenged by aerosol inhalation with Proteus mirabilis or Staphylococcus aureus and injected intravenously with erythromycin (50 or 100 mg/kg) . Pulmonary bactericidal activity and total lavaged lung cell and differential counts were determined 4 h after bacterial challenge . In control mice, only 24 +/- 2% of the initial inoculum of P . mirabilis was viable at 4 h . At a dose of 100 mg/kg, lung defenses after erythromycin were ablated, allowing the proliferation of P . mirabilis to 113 +/- 5% of the initial inoculum . The number of PMN obtained by lavage after P . mirabilis challenge was also inhibited by erythromycin in a dose-dependent manner . In untreated animals, 5.0 +/- 0.2 x 10(6) PMN were recovered as compared with 3.1 +/- 0.4 x 10(6) and 1.1 +/- 0.3 x 10(6) with increasing doses of erythromycin . Intrapulmonary bactericidal activity against S . aureus was not impaired by erythromycin.(ABSTRACT TRUNCATED AT 250 WORDS)

J Med Microbiol, 1987 Nov, 24(3), 233 - 40
R-plasmid RP1 increases sensitivity of Proteus mirabilis to normal body defences; Onaolapo JA et al.; The bactericidal action of non-immune whole blood on Proteus mirabilis was increased when the bacteria contained the R-plasmid RP1 . This effect was due mainly to increased phagocytosis . Iron-depleted stationary-phase cells were more sensitive than carbon-depleted cells . The contribution of serum was usually negligible but was increased during a minor non-specific infection . Most plasmid-containing phenotypes were more sensitive than were those without plasmids but there were considerable differences between stationary and exponentially-growing cells . The R-plasmid-mediated increase in sensitivity to phagocytosis may be due in part to the presence of additional glycosylated proteins in the outer membrane.

J Med Microbiol, 1987 Nov, 24(3), 227 - 32
R-plasmid RP1 promotes adhesion of gram-negative bacteria to medical prostheses and glass; Onaolapo JA et al.; The presence of R-plasmid RP1 increased the adhesion of chemostat-grown iron- and carbon-limited Proteus mirabilis to the surfaces of various medical prostheses and to glass . Similar results were obtained with iron-limited Pseudomonas aeruginosa and anaerobically-grown Escherichia coli . Changes in the surface properties of P . mirabilis indicated that the R-plasmid-mediated increase in negative charge was one of the factors that promoted adhesion.

J Gen Virol, 1987 Nov, 68 ( Pt 11), 2909 - 12
A physical analysis of the prophage of Proteus mirabilis PM5006; Steyn AC et al.; Proteus mirabilis phage 5006M was investigated as a prophage by DNA hybridization . A physical map of the prophage was established and the site of integration was localized on the phage genome . Older reports that the phage is cryptic in P . mirabilis could not be verified.

Eur J Biochem, 1987 Oct 15, 168(2), 269 - 73
Isolation and structural characterization of an 8-O-(4-amino-4-deoxy-beta-L-arabinopyranosyl)-3-deoxy-D-manno- octulosonic acid disaccharide in the lipopolysaccharide of a Proteus mirabilis deep rough mutant; Sidorczyk Z et al.; On short treatment of the lipopolysaccharide of a deep rough mutant of Proteus mirabilis (strain R45) with hydrochloric acid (0.01 M, 10 min, 100 degrees C) a compound was released which, on high-voltage paper electrophoresis, migrated slightly to the cathode (MGlcN = 0.19) and which stained with ninhydrin, alkaline silver nitrate and in the thiobarbituric acid assay . After purification and derivatization, its chemical structure was identified by combined gas-liquid chromatography/mass spectrometry and two-dimensional shift-correlated proton nuclear magnetic resonance spectroscopy as 8-O-(4-amino-4-deoxy-beta-L-arabinopyranosyl)-3-deoxy-D-manno-octu losonic acid . This disaccharide was also present in a wild-type strain of P . mirabilis.

Jpn J Antibiot, 1987 Oct, 40(10), 1809 - 19
{Studies on antibacterial activity of flomoxef and its distribution to serum and intraperitoneal exudate in surgery}; Yokoyama T et al.; 1 . Bacteria detected in cases of acute abdominal ailments encountered in the first department of surgery at Hiroshima university and its related facilities during the recent 4 and a half years were reviewed and the antibacterial activities of flomoxef (FMOX, 6315-S) against these isolates were investigated . As a result, this antibiotic was found to show very high activities against Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Klebsiella pneumoniae and Proteus spp . 2 . One gram of FMOX dissolved in 100 ml of physiological saline was administered by intravenous drip infusion during operation and its concentrations in serum and intraperitoneal exudate were determined . The intraperitoneal exudate concentration exceeded the serum concentration in 2 hours after the completion of the drip infusion and, reached high enough concentration to be effective against susceptible bacteria with MICs about 12.5 micrograms/ml . The above results suggested that the new cephem antibiotic FMOX for injection should be sufficiently effective against acute peritonitis.

Mikrobiyol Bul, 1987 Oct, 21(4), 279 - 83
{Susceptibility of some bacteria isolated from clinical samples to third-generation cephalosporins}; Willke A et al.; In this study, we evaluated the susceptibility of some Staph . aureus, Staph . epidermidis, E . coli, Klebsiella, Proteus, Pseudomonas strains to third-generation cephalosporins in-vitro by disk diffusion technique which are in use in Turkey . These bacteria isolated from various clinical samples at the bacteriology laboratory in Ibni Sina hospital between January 1986-January 1987 . The antibiotics used in this study are ceftizoxime, cefotaxime, ceftriaxone, cefoperazone . According to the results of this study, it can be said that cefotaxime is the most effective third-generation cephalosporin against all these bacteria by testing in-vitro.

Z Urol Nephrol, 1987 Oct, 80(10), 595 - 600
{Value of antibacterial therapy in chronic obstructive urinary tract infections}; Hofmann W et al.; On the basis of a clinical study an analysis about 86 patients with obstructing bilateral nephrolithiasis and chronic obstructive infection of the urinary tract is elaborated . In order to illustrate the change of resistance of the causative agents during a period of 10 years (1973-1982) two separated 5-year analyses are compared . It is made evident that the relations of sensitivity to seven chemotherapeutic drugs in Coli, Proteus and Pseudomonas infections have changed in favour of increasing resistances of causative agents . The results obtained are an expression of the unstableness of antibiotic therapies under palliative purpose when urological basic diseases are not removed . From the analysis the demand for changing the general problems of obstructive pyelonephritis without possible operative sanation becomes evident . early diagnosis and treatment of predisposing factors are the two keystones of our efforts, when the chronic obstructive infection of the urinary tract by resistant causative agents shall not remain a therapeutic problem in the same measure as hitherto.

Cancer, 1987 Oct 1, 60(7), 1462 - 4
Acute gangrene of the scrotum and penis in four hematologic patients . The usefulness of hyperbaric oxygen therapy in one case; Radaelli F et al.; We describe four cases of Fournier's gangrene complicating the postchemotherapy aplastic phase (polymorphonuclear cells {PMN} less than 500/microliter) in three patients with acute leukemia and one patient with non-Hodgkin's lymphoma . Blood and local cultures from two patients contained Pseudomonas aeruginosa, and local cultures from another patient grew both P . aeruginosa and Proteus rettgeri . Early recognition and aggressive antibiotic and surgical treatment with granulocyte recovery were fundamental factors in resolution of the gangrene in three of the four patients . Hyperbaric oxygen therapy, never reported in hematologic patients, was also very useful in one patient in whom the clinical course was particularly acute.

J Urol, 1987 Oct, 138(4), 913 - 5
In vitro comparison of the properties of polydioxanone, polyglycolic acid and catgut sutures in sterile and infected urine; el-Mahrouky A et al.; The effect of immersion in sterile urine, infected urine and plasma on the breaking strength and stiffness of polydioxanone (PDS), polyglycolic acid (PGA) and chromic catgut was studied . Tests were done under closely controlled conditions with immersion periods varying from zero to ten days . The breaking strength and stiffness of the three suture materials was not significantly changed by immersion in plasma for periods up to ten days . In sterile urine, PDS lost all of its strength after three days of immersion while PGA lost 64% of its initial breaking strength after ten days . Catgut maintained its strength over the ten day study period . In E . coli-infected urine, PDS lost all of its strength in six days while PGA lost 71% and catgut 8% after ten days . In proteus-infected urine, PDS and PGA lost all their breaking strength after one day of immersion while catgut lost 5.8% of its initial strength after 10 days . Corresponding decreases in stiffness were also observed.

Eur J Biochem, 1987 Sep 15, 167(3), 481 - 8
Nucleotide sequence and comparative analysis of the frd operon encoding the fumarate reductase of Proteus vulgaris . Extensive sequence divergence of the membrane anchors and absence of an frd-linked ampC cephalosporinase gene; Cole ST; The fumarate reductase of Escherichia coli is a bioenergetically important membrane-bound flavoenzyme consisting of four subunits . A and B comprise a membrane-extrinsic catalytic domain whereas C and D are hydrophobic polypeptides which link the catalytic centres to the electron-transport chain . The nucleotide sequence of the frd operon encoding the fumarate reductase of the distantly related bacterium, Proteus vulgaris has been determined and used to predict the primary structures of the respective subunits . Extensive amino acid sequence identity (greater than 80%) was found between the fumarate reductase A and B subunits of P . vulgaris and E . coli . In contrast, the primary structures of the P . vulgaris and E . coli C and D proteins are much less closely related (about 60% homology) although the overall hydrophobicity of their three membrane-spanning segments has been conserved . In most enteric bacteria, the frd operon is followed by genes, ampR and/or ampC, required for the genetic regulation and biosynthesis of a cephalosporinase . The corresponding region of the P . vulgaris genome is occupied by an operon (orf A'BCD) containing at least four genes which are clearly unrelated to the ampC system . Intriguingly the primary structures of the OrfA and OrfD proteins suggest that, like fumarate reductase, they may be components of a membrane-bound enzyme complex involved in energy metabolism.

Diabetes Res, 1987 Sep, 6(1), 5 - 8
In vivo determination of cell mediated immune response in diabetic patients using a multiple intradermal antigen dispenser; Pozzilli P et al.; The in vivo cell mediated immune response using a multiple intradermal antigen dispenser (Multitest) was evaluated in 99 diabetic patients (24 Type I and 75 Type II) and in 50 age matched normal subjects . Seven different antigens (tetanus, diphteria, streptococcus, tubercoline, candida, trichophyton, proteus and a glycerine control) were applied in the forearm and the induration for the antigens tested was measured 48 hours later . A score was calculated adding the arithmetic means obtained with each single antigen . Overall we did not find major differences between diabetic patients and controls except Type I patients of shorter duration (less than 5 years) having a reduced response (p less than 0.05) and both Type I and Type II patients showing an elevated response to candida antigen (p less than 0.001) . No correlation was found between the intradermal response and metabolic control . As the intradermal test is a model for delayed type of hypersensitivity, these data suggest that the in vivo lymphocyte to lymphocyte cooperation in patients with long standing diabetes is not impaired.

J Gen Microbiol, 1987 Sep, 133 ( Pt 9), 2401 - 9
Cloning and expression in Escherichia coli of Proteus vulgaris genes for 16S ribosomal RNA; Niebel H et al.; In contrast to the established systems of plasmid-coded homologous ribosomal DNA (rDNA) cistrons in Escherichia coli little is known about the fate of heterologous rRNA . In order to study expression of foreign rDNA, rRNA cistrons from Proteus vulgaris were cloned in phage vector Charon 35, subcloned in pBR322 and transformed in E . coli . The inserts of two clones (pPM2 and pPM14) were characterized by restriction analysis and Southern hybridization . Each of them harboured a complete rrn cistron . The location of rRNA genes of clone pPM2 was also verified by R-loop analysis . The 5' flanking region of the 16S rRNA of pPM2 was sequenced and compared to the E . coli counterparts . High-level homologies exist in the functional parts of this region, e.g . promoters, box A and RNAase III recognition site . The copy number of pPM2 and pPM14 was estimated to be 8 and 10, respectively . Clones showed a markedly reduced growth rate (generation time about 57 to 70 min) as compared to the non-transformed cells (generation time 40 min) . rDNA cistrons of P . vulgaris were properly expressed and the transcripts are processed as demonstrated by the presence of 16S rRNA from P . vulgaris in both ribosomes and 30S ribosomal subunits isolated from the transformed E . coli cells . The fraction of heterologous rRNA in ribosomes was about 25%.

Kidney Int, 1987 Sep, 32(3), 329 - 34
Endotoxin provocation of experimental renal cystic disease; Gardner KD Jr et al.; Germ free rats provide a unique model in which to assess biological response to environment . In 48 germ-free male, Sprague-Dawley rats we examined the consequences of oral exposure to nordihydroguaiaretic acid (NDGA), a nephrotoxin; to Staphylococcus epidermidis and bacillus species, non-endotoxin-containing bacteria; to Escherichia coli and Proteus mirabilis, endotoxin-containing bacteria; and injected E . coli endotoxin on peripheral leukocyte counts and renal morphology . Morphological changes were evaluated by light microscopy and scored blindly on a 0 to 4+ scale for 15 parameters of renal structure . Means of these renal "pathology scores" correlated with counts of polymorphonuclear leukocytes and lymphocytes in the peripheral blood . The highest counts and scores were found in rats given NDGA and exposed to endotoxin, either by injection or by oral feeding of endotoxin-containing bacteria . Counts and scores were lower in the absence of endotoxin and with non-endotoxin-containing bacteria, given alone or in combination with either NDGA or endotoxin . Results exclude bacterial colonization and intrarenal accumulation of NDGA as causes of nephropathy . They indicate that endotoxin and NDGA act synergistically to provoke renal damage in the germ free NDGA-fed rat and suggest that leukocytes are involved in the process.

J Med Microbiol, 1987 Sep, 24(2), 175 - 80
Proteus mirabilis strains of diverse type have IgA protease activity; Senior BW et al.; A strain of Proteus mirabilis associated with chronic urinary tract infection was found to produce an EDTA-sensitive IgA protease that cleaved the IgA heavy chain into two fragments at sites different from those attacked by other microbial IgA1 proteases . Another 14 P . mirabilis strains of diverse type and from various clinical conditions also produced a similar IgA protease . This enzyme may be a virulence determinant of P . mirabilis.

Plasmid, 1987 Sep, 18(2), 120 - 6
Cloning and expression of the gene(s) for chromosome-mediated beta-lactamase production of Proteus vulgaris in Escherichia coli; Maejima T et al.; The gene(s) for chromosome-mediated beta-lactamase production of Proteus vulgaris GN7919 was cloned into a unique EcoRI site of pACYC184 as an insert of a 14.2-kb fragment, which was further digested into two fragments with EcoRI, 4.9 and 9.3 kb . The restriction enzyme digestion pattern of the recombinant plasmid, designated pMS182, had no similarity to those of other chromosomal beta-lactamase genes cloned from gram-negative bacteria . Plasmid pMS182 enabled host Escherichia coli ML4953 to inducibly produce beta-lactamase which was identical to that of the parent P . vulgaris in substrate profile, molecular weight, and reactivity to antiserum raised against P . vulgaris GN7919 beta-lactamase . The pMS182-harboring E . coli were highly resistant to beta-lactam antibiotics, possibly based on inducible production of beta-lactamase.

Appl Environ Microbiol, 1987 Aug, 53(8), 1944 - 6
The action of sodium deoxycholate on Escherichia coli; D'Mello A et al.; Sodium deoxycholate is used in a number of bacteriological media for the isolation and classification of gram-negative bacteria from food and the environment . Initial experiments to study the effect of deoxycholate on the growth parameters of Escherichia coli showed an increase in the lag time constant and generation time and a decrease in the growth rate constant and total cell yield of this microorganism . Cell fractionation studies indicated that sodium deoxycholate at levels used in bacteriological media interferes with the incorporation of {U-14C}glucose into the cold-trichloroacetic acid-soluble, ethanol-soluble, and trypsin-soluble cellular fractions of E . coli . Finally, sodium deoxycholate interfered with the flagellation and motility of Proteus mirabilis and E . coli . It would appear then that further improvement of the deoxycholate medium may be in order.

Toxicology, 1987 Aug, 45(2), 185 - 91
A highly sensitive bacterial assay for toxins based on swarming inhibition, and comparison with the cup plate assay based on growth inhibition; Lenz P et al.; The motility inhibition of the swarming bacteria Proteus mirabilis and Azospirillum brasilense was found to be an appropriate parameter to indicate toxic effects caused by some mycotoxins, lactones and anhydrides of dicarboxylic acids . If these substances are in contact with the motile bacteria the following phenomena can be observed: at a certain toxin concentration the swarming of the bacteria is inhibited . If the concentration is increased the swarming ceases, and at still higher concentrations the bacteria are inactivated . In some instances swarming is stimulated at very low toxin doses . The sensitivity of this assay is comparable to the cup plate assay based on growth inhibition with Bacillus thuringiensis {Lenz, P . et al., Toxicology, 40 (1986) 199, Boutibonnes et al., Pharmacology, 11 (1983) 430} and in some cases it is even higher.

Jpn J Antibiot, 1987 Jul, 40(7), 1311 - 6
{Fundamental study of piperacillin sodium in term and premature neonates}; Watanabe T et al.; Piperacillin sodium (PIPC) is a semisynthetic penicillin displaying high antibacterial activities against Gram-positive and Gram-negative bacteria including Pseudomonas sp., Proteus sp., etc . It acts bactericidally and is stable against beta-lactamases . The usefulness of PIPC in the treatment of infections in mature and premature neonates was investigated and the following results were obtained . The pharmacokinetics (half-life, distribution volume, total body clearance) of PIPC after 50 mg/kg intravenous drip infusion in 10 cases of neonates were examined . Relationship between T1/2 and hours after birth was clearly determined . Adverse effects and abnormality in laboratory test values were not observed . It is considered from the above results that PIPC may be an useful antibacterial agent for the treatment of infections in neonates.

Jpn J Antibiot, 1987 Jul, 40(7), 1299 - 310
{Clinical study of astromicin administered by intravenous drip infusion against chronic complicated urinary tract infections}; Suzuki K et al.; Astromicin (ASTM) was administered by intravenous drip infusion (i.v.d.) to 22 patients with chronic complicated urinary tract infections and the clinical efficacy and safety of this drug were evaluated . The overall clinical efficacy rate obtained was 71.4% (excellent 6; moderate 9) of 21 evaluable cases by the UTI committee's criteria . Concerning the response on clinical isolates, the drug was highly effective especially against strains of Escherichia coli, indole positive Proteus and Serratia marcescens . It was not effective, however, against 2 strains of Pseudomonas aeruginosa . As for adverse reactions, there was one case which complained of headache on the 3rd day after starting treatment . In this case the drug administration was discontinued at the 5th day . The symptom disappeared within 24 hours without any treatment . No any other adverse reactions were noted . With regard to clinical test values for peripheral blood, liver and renal functions, no abnormality was observed in any of the cases treated with the drug . In conclusion, ASTM was found to be a highly effective and safe drug when administered by intravenous drip infusion in the treatment of chronic complicated urinary tract infections.

Microbiologica, 1987 Jul, 10(3), 291 - 9
Adhesive properties of Proteus genus related to antimicrobial agents resistance; Cellini L et al.; The in vitro attachment of 49 Proteus spp . to human urinary tract epithelial cells was determined . The antibacterial spectrum to all species of the Proteus isolates from hospitalized patients was measured against the most common antibiotics (Amikacin, Cefamandole, Cefoxitin, Ceftriaxone, Cephalothin, Kanamycin, Nalidixic acid, Oxolinic acid, Pipemidic acid, Piromidic acid, Tobramycin) . 18 of them were multiresistant and the other 31 expressed susceptibility to the above antibiotics . Bacterial adherence to uroepithelial cells was studied in relation to susceptibility on antibiotics . The mean of bacteria per cell for the 31 strains grouped as susceptible was 20.2 and for the 18 strains grouped as resistant the mean was 55.1 . Our results demonstrate a significant relationship between bacterial adhesion and antibiotic susceptibility pattern by Student's t test (P less than 0.01).

J Urol, 1987 Jul, 138(1), 14 - 7
Urinary lithiasis in the black population: an epidemiological study and review of the literature; Sarmina I et al.; A retrospective review of 199 black patients with urinary calculi and review of the census figures of the index hospitals revealed that white patients had urinary calculi 3 to 4 times as often as black subjects . The black male-to-female ratio was 1 to 1.55 compared to a ratio for white patients of 2.3 to 1 . Calculi in black male subjects occur at a younger age than in black or white female or white male patients . The most common organisms cultured in black patients with stones were Escherichia coli and Proteus mirabilis . In contrast to the white population the most common type of stone formed in black patients was struvite/carbonate apatite . Stones of this type accounted for a third of all stones in male and 44 per cent in female subjects . We conclude that nephrolithiasis is an uncommon but not rare disease in the American black population.

Int J Artif Organs, 1987 Jul, 10(4), 239 - 40
Antibiotic treatment of chronic central venous hemodialysis catheter infection without catheter removal; Domoto DT et al.; Most catheter or shunt infections in hemodialysis patients require the removal of the access before the infection is eradicated . A hemodialysis patient is reported who had multiple previous vascular accesses which failed and thus who had very limited sites for future access placement . When a recurrent Proteus mirabilis catheter infection occurred, a 6-week course of ampicillin intraluminal and tobramycin systematically, eradicated the infection and thus the central venous catheter was salvaged . Serum bactericidal levels with these two antibiotics were obtained early in the course and supported the continued use of antibiotics alone to treat the infection.

J Clin Microbiol, 1987 Jul, 25(7), 1312 - 3
Inhibition of growth and swarming of Proteus mirabilis and Proteus vulgaris by triclosan; Firehammer BD; The MICs of triclosan (2,4,4'-trichloro-2'-hydroxydiphenyl ether) and the effect on swarming were determined for 35 isolates of Proteus mirabilis and 7 isolates of P . vulgaris of animal origin . Both species were susceptible to the antimicrobial agent, and growth of all but one isolate was inhibited by less than 1 microgram/ml in broth and on agar without blood . Swarming was inhibited at triclosan concentrations two- to fourfold less than the MICs . Higher concentrations were required with blood agar than with plain agar for inhibition of growth and swarming.

J Immunol Methods, 1987 Jun 26, 100(1-2), 223 - 33
Functional neutrophils from long-term murine bone marrow cell cultures; Hart PH et al.; Murine bone marrow cell cultures that had been established for up to 26 weeks were harvested each week and found to provide functional neutrophils . Leukocytes harvested from the cultures were enriched for neutrophils using discontinuous Percoll density gradients . These cells mounted a chemiluminescence response to Proteus mirabilis in the presence of normal mouse serum (NMS) . They killed several NMS-opsonised bacterial species, an activity that was blocked by a monoclonal antibody to the C3 receptor of mouse neutrophils . Cultured bone marrow neutrophils expressed both Fc and C3 receptors . C3 receptor expression could be augmented by exposure to the chemotactic peptide f-Met-Leu-Phe . We conclude that murine bone marrow cell cultures provide a useful source of functional neutrophils, and that their productivity can be sustained in long-term culture . As their receptor expression can be augmented from the resting state by exogenous stimuli, they represent a useful cell source in studies of neutrophil activation.

J Clin Microbiol, 1987 Jun, 25(6), 1094 - 6
Hemolytic activity and invasiveness in strains of Proteus penneri; Rozalski A et al.; Twenty strains of Proteus penneri obtained from the Centers for Disease Control, Atlanta, Ga., were tested for their ability to hemolyze sheep and human erythrocytes, a property that is thought to be connected with the invasiveness and virulence of Proteus species . In the logarithmic phase of growth, P . penneri cultures are hemolytic for such erythrocytes . This ability is comparable to the hemolysis exhibited by nearly 100% of P . vulgaris and P . mirabilis strains, which is due to the production of a cell-bound hemolytic factor; is demonstrated only in broth cultures; and seems to facilitate the penetration of P . penneri and other Proteus species into the cells without cytotoxic effects . In contrast, a filterable alpha-hemolysin, which is produced transiently by a very few strains of P . mirabilis, was present in 4 of 20 P . penneri strains . This property, which is expressed at a high level over a long period, suggests a chromosomal origin . The penetration of an alpha-hemolytic P . penneri strain into Vero cells was accompanied by a drastic cytotoxic effect.

Helv Paediatr Acta, 1987 Jun, 42(5-6), 451 - 6
Nonsurgical management of neonatal multiple brain abscesses due to Proteus mirabilis; Hervas JA et al.; A newborn infant with Proteus mirabilis meningitis developed multiple brain abscesses with diameters ranging from 2 to 4 cm . Intravenous antibiotic therapy alone without surgical intervention led to the complete resolution of this complication . The case supports that this may be an acceptable treatment of multiple brain abscesses in neonates . However, the clinical outcome was relatively poor, since a porencephalic cyst, hypodense areas in CT scan, and psychomotor retardation were found at one year of age.

Pathol Biol (Paris), 1987 Jun, 35(5 Pt 2), 835 - 8
{Septicemia of urinary origin . Epidemiology and initial antibiotic treatment}; Massari P et al.; The SES group was formed by the "Ligue Francaise pour la Prevention des Maladies Infectieuses" to create a diagnostic and therapeutic expert system on septicemia . 461 cases of septicemia were thus collected from january 1 to december 31, 1985 . 83 out of these septicemias had an urinary tract portal of entry, 21 were contracted in hospital . The mean age was 65 +/- 21 years (57 +/- 20 years for the 461 cases NS) . There were 46 women and 37 men, i.e., a sex-ratio apposite to that of the overall population of septicemias (p less than 0.001) . Au urinary lesion was found in 27 patients (p less than 0.001), a neurological disease in 22 (p less than 0.05), a cardiac disease in 24 (NS) . 94 bacteria were isolated (11 polymicrobic septicemias) from the blood cultures: 56 E . coli, 7 Klebsiella, 6 Proteus, 7 Gram positive Cocci . 57 out of the 81 patients whose antibiotherapy was known received single-drug treatment (74%, vs 49% for the whole group, p less than 0.001) . The evolution was known in 75 patients, uncomplicated in 57 (fatality rate: 11%) . Prognosis did not appear to be influenced by the type of pathogen, or the existence of an urinary abnormality.

Pathol Biol (Paris), 1987 Jun, 35(5 Pt 2), 753 - 6
{Fosfomycin-trometamol (monuril): pharmacokinetics and food-drug interactions}; Muller-Serieys C et al.; A new water soluble monobasic salt of fosfomycin with trometamol has been recently developed for oral administration . The objective of this study was to evaluate the pharmacokinetics of trometamol-fosfomycin (monuril) in serum and urine in 10 healthy volunteers after oral administration of one single dose (50 mg/kg) . In the volunteers, the concentrations of fosfomycin were measured before and after food absorption in serum and urine samples taken at t = 0, 2, 4, 6, 8, 24 h after the dose (plus 0.5 hand 1 h for serum samples) . The measurement of fosfomycin levels was carried out by means of a microbiological procedure using Proteus mirabilis ATCC 21100 as test organism . The results indicated at 2 h after oral administration of the antibiotic, a mean serum peak level of 21.04 +/- 6.88 micrograms/ml . The urine concentrations reached 2,000 to 2,750 micrograms/ml at the 2nd hour, with high levels (mean: 1,876 +/- 709 micrograms/ml) till the 8th hour and persistence of noticeable concentrations at 24 h (334 +/- 210 micrograms/ml) . The influence of food absorption, even variable, decreased significantly the rate of absorption with lower serum and urine levels . Taking into account this factor influencing the bioavailability and the distribution of the drug, the results of the study confirm that a high proportion of the oral dose of trometamine salt of fosfomycin is well absorbed; the extremely high urinary recovery of the drug could certainly allow short course therapy in the treatment of uncomplicated urinary tract infection.

Antimicrob Agents Chemother, 1987 Jun, 31(6), 865 - 9
Paradoxical antibacterial activity of cefmenoxime against Proteus vulgaris; Ikeda Y et al.; The growth-inhibitory effect of cefmenoxime against Proteus vulgaris was studied by using the broth dilution and paper disk diffusion methods . Cefmenoxime showed growth-inhibitory activity against Proteus vulgaris at low concentrations but not at high concentrations up to a certain limit . This paradoxical antibacterial activity was not observed with cefoperazone and cefbuperazone . The induction of beta-lactamase by cefmenoxime and the rate of hydrolysis of cefmenoxime in the culture broth were proportional to the initial concentration of this antibiotic . At high initial concentrations, cefmenoxime was rapidly inactivated . On the other hand, neither cefoperazone nor cefbuperazone was inactivated irrespective of concentration . We conclude that cefmenoxime induces beta-lactamase in P . vulgaris, perhaps accounting for its paradoxical antibacterial effect.

Foot Ankle, 1987 Jun, 7(6), 350 - 4
Outbreak of wound infections following outpatient podiatric surgery due to contaminated bone drills; Rutala WA et al.; An outbreak of podiatric infections due to an uncommon strain of Proteus mirabilis occurred following outpatient podiatric surgery . An evaluation of the operating room environment failed to reveal the strain of P . mirabilis from any site other than three bone drills . Thus the drills served as the reservoir for the organism that was subsequently inoculated onto the hands of the surgeon or directly to a patient during bone drilling . The gas sterilization procedure that was used to sterilize the drills was found deficient . No additional cases of P . mirabilis infection have been observed since the elimination of the contaminated drills.

Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi, 1987 May, 20(2), 132 - 9
{Urinary tract infections and microbiological characteristics of Proteus penneri isolated in Taiwan}; Tsai WC et al.; Proteus penneri has been reported to be involved in urinary tract infections and calculi formation . We analyzed 2,265 positive urine cultures from patients hospitalized in Taipei Veterans General Hospital, Taiwan and found that 47 patients (2.1%) were infected by P . penneri . Most of the patients were male with age over sixty and had been treated with various kinds of antibiotics . Most of the patient's urine were collected by catheter . They were alkaline (pH 8.0) and contained amorphous phosphate, triple phosphate and protein . All the isolates of P . penneri in Taiwan showed beta-hemolysis and slight swarming on sheep blood agar plate, and exhibited a green color on upper layer of sulfide-indole-motility medium after addition of Kovacs indole reagent . Except for nitrate reduction and N2 production, the biochemical characteristics of the P . penneri isolated in Taiwan were similar to those of P . penneri isolated otherwise . The Taiwan isolates of this organism were highly susceptible to cefotaxime, cefotazidime, cefotizoxime, moxalactam, nalidixic acid; but were resistant to ampicillin, carbenicillin, cefonicid, cefoperazone, ceftriaxone, cephalexin, cephapirin, chloramphenicol, clindamycin, gentamicin, nitrofurantoin, oxacillin, piperacillin, tetracycline, tobramycin, trimethoprim-sulfamethoxazole, vancomycin, and cephalothin.

Am J Med Genet, 1987 May, 27(1), 99 - 117
Proteus syndrome: an expanded phenotype; Clark RD et al.; We report on 11 new cases of Proteus syndrome to illustrate the broad range of the phenotype in this hamartomatous dysplasia . The cardinal manifestations of this sporadic disorder are hemihypertrophy, macrodactyly, exostoses, scoliosis, cavernous hemangiomas, lipomas, linear sebaceous nevi, and deeply rugated soles of the feet . Intelligence is usually normal . The differential diagnosis includes Klippel-Trenaunay-Weber and partial lipodystrophy syndromes.

Am J Med Genet, 1987 May, 27(1), 87 - 97
Proteus syndrome in southern Africa: natural history and clinical manifestations in six individuals; Viljoen DL et al.; Six individuals with Proteus syndrome have been investigated; 2 were adults and the others ranged in age from 2 to 11 years . They had a wide spectrum of manifestations and severity together with the hitherto unreported anomalies of penile hypertrophy, macro-orchidism, goiter, and failure of breast development . These findings were associated with normal endocrine function . Bizarre digital overgrowth, hemihypertrophy, thickened palms and soles, exostoses of the skull, and multiple hamartomata were common anomalies . Early overgrowth of limbs and digits occurred in several instances but the ultimate stature of 2 adults was normal . Surgical intervention offers cosmetic and orthopedic benefits, but these must be assessed in the light of potential post-operative complications.

Am J Med Genet, 1987 May, 27(1), 119 - 25
Severe proteus syndrome in an 18-month-old boy; Malamitsi-Puchner A et al.; We describe an 18-month-old Greek boy with macrocephaly, partial gigantism of hands and feet, hemihypertrophy, pigmented nevi, and other anomalies compatible with the Proteus syndrome . Cerebral involvement in a most severe form and at an early age concurs with the suggestion that encephalocraniocutaneous lipomatosis may represent a more circumscriptive manifestation of Proteus syndrome . Localized triggering of several growth factors is a challenging pathogenetic consideration of the syndrome.

Urology, 1987 May, 29(5), 570 - 4
Clinical comparison of piperacillin and cefamandole in treatment of complicated urinary tract infections; Resnick MI et al.; The efficacy and safety of piperacillin were compared with those of cefamandole in 72 patients (mean age: 63 years) with complicated urinary tract infections . Efficacy was evaluable in 25/34 piperacillin-treated patients (12 Gm/day) and in 23/38 cefamandole-treated patients (6 Gm/day) . Clinical cure or improvement was noted in all patients who were given piperacillin and in 96 per cent (22/23) of those who received cefamandole . Seventy-one per cent (41/58) of the organisms cultured pretherapy were gram-negative aerobic bacteria . Escherichia coli was the most frequently isolated organism (15/58, or 26%), followed by Pseudomonas species (8/58, or 14%), and Proteus species (8/58, or 14%) . Adverse clinical experiences were few, and none was directly attributed to therapy with either antibiotic . The changes noted in the results of laboratory tests were considered to be unrelated to the antibiotics administered . Thus, both piperacillin and cefamandole were safe and effective in the treatment of patients with complicated urinary tract infections.

Am J Vet Res, 1987 May, 48(5), 794 - 8
Chronic urinary tract infection in dogs: induction by inoculation with bacteria via percutaneous nephropyelostomy; Ling GV et al.; Dogs were inoculated via percutaneous nephropyelostomy with bacteria isolated from canine patients with urinary tract infections (4 dogs were inoculated with Escherichia coli, 2 were inoculated with Proteus mirabilis, and 1 was inoculated with coagulase-positive staphylococci) . At approximately monthly intervals after bacterial inoculation, bladder urine specimens were collected via antepubic cystocentesis, and renal pelvic urine specimens were collected via percutaneous nephropyelocentesis . Dogs were euthanatized between 89 and 294 days after bacterial inoculation . Extensive microscopic examination was conducted on the urinary tract of each dog . The dogs did not develop any of the common clinical signs of urinary tract infections (ie, increased frequency of urination, fever, craniodorsal abdominal {renal} pain, or malaise) . Inflammation in the lower urinary tract of the dogs was more severe than that in the kidneys . Although pyelitis was present, extension into the outer medulla and renal cortex seemed to be confined to nephropyelostomy tracts . The most severe bladder lesion was found in the dog that developed cystic calculi after inoculation with coagulase-positive staphylococci.

J Immunol, 1987 May 1, 138(9), 3060 - 8
Somatic evolution of diversity among anti-phosphocholine antibodies induced with Proteus morganii; Claflin JL et al.; The variable region sequences of light and heavy chains (VL and VH) were determined for 11 hybridoma antibodies produced in response to the PC moiety on Proteus morganii . These hybridomas were derived from two separate fusions, one obtained from mice early in a secondary response and the other from late in a secondary response . All of these antibodies possessed a cross-reactive idiotype found on anti-PC antibodies in the M603 family, and exhibited preferential specificity for PC in the context of P . morganii . We found that all of the antibodies were derived from a single VH/VL pair . VH was encoded by V1, DFL16.1 and JH1, and VL was encoded by a consensus VK8 gene and JK5 . Antibodies differed from each other by somatic point mutations that occurred at a high rate . The mutations in VL were approximately one-third as abundant as those in VH and were randomly distributed throughout the molecule . Mutations in VH were concentrated in CDR 2 and 3 and had a replacement to silent ratio that was three to six times greater than predicted from random accumulation . Based on the sequence data, a single genealogic tree with multiple branches could accommodate all the hybrids from a fusion . We concluded that in both examples the anti-PC response arose by somatic mutation and stepwise selection from a single precursor . Antigen binding studies with these 11 hybridomas and a 12th that had no mutations revealed that the acquisition of preferential specificity for antigen was dependent on somatic mutation of germline genes . Additional binding studies demonstrated that continued selection during clonal expansion was probably antigen driven . An unexpected finding was five independently selected antibodies from one fusion that had identically mutated VH and VL sequences . We suggest that the hypermutation mechanism is not a continuously active process during clonal expansion and that it is regulated, probably during the mid to late phase of the primary response.

Bioorg Khim, 1987 May, 13(5), 660 - 9
{Antigenic polysaccharides of bacteria . 22 . Structure of the O-specific polysaccharide chain of Proteus hauseri lipopolysaccharide}; Vinogradov EV et al.; The following structure of the repeating unit of the Proteus hauseri O-specific polysaccharide was established on the basis of monosaccharide composition and 13C NMR data of the polysaccharide and products of its Smith degradation and partial cleavage with hydrogen fluoride: (Formula: see text).

Am J Med, 1987 Apr 27, 82(4A), 220 - 3
Comparative, double-blind study of oral ciprofloxacin and intravenous cefotaxime in skin and skin structure infections; Ramirez-Ronda CH et al.; The effectiveness and safety of orally administered ciprofloxacin and intravenously administered cefotaxime were compared in a double-blind study of 60 men with infections of skin and soft tissue, including cellulitis, ulcers, abscesses, cellulitis with ulcers or abscesses, wound infections, and post-traumatic infections . Patients in the ciprofloxacin group received 750 mg orally every 12 hours for a mean duration of 9.6 days (six to 18 days), and those in the cefotaxime group received 2.0 g intravenously every eight hours for a mean duration of 9.3 days (five to 14 days) . Infection was documented bacteriologically in 78 percent of the patients in the ciprofloxacin group and in 83 percent of the patients in the cefotaxime group . Pathogens included Staphylococcus aureus, enterococci, group B streptococci, Escherichia coli, Proteus mirabilis, and Klebsiella and Pseudomonas species . Half of the infections were mixed infections . Ninety percent (19 of 21) of the infections were bacteriologically eradicated with ciprofloxacin, and 82 percent (18 of 22) were eradicated with cefotaxime . Treatment was completely successful in 79 percent (22 of 28) of the patients in the ciprofloxacin group and in 68 percent (19 of 28) in the cefotaxime group (p greater than 0.1) . The side effects in both treatment groups were comparable . This study demonstrates that orally administered ciprofloxacin is comparable in effectiveness and safety to cefotaxime administered intravenously in the treatment of infections of skin and soft tissue, and that it can offer an alternative in the treatment of such infections.

Jpn J Antibiot, 1987 Apr, 40(4), 843 - 65
{Fundamental and clinical studies on cefuzoname in the pediatric field}; Toyonaga Y et al.; Cefuzoname (CZON) one of the aminothiazolyloxyiminoacetamido cephalosporins, was studied for its antibacterial activity, absorption and excretion, concentration in the cerebrospinal fluid (CSF) and the penetration, and clinical efficacy . The following are a summary of the results: 1 . Antibacterial activity; The antibacterial activity of CZON was studied on clinically isolated Staphylococcus aureus (cefazolin (CEZ)-susceptible and CEZ-tolerant strains), Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis . Compared with CZON were cefmenoxime (CMX), latamoxef (LMOX), cefoperazone, cefmetazol (CMZ), cefotiam and CEZ, but for S . aureus cefamandole (CMD) was replaced for CPZ . Activities of CZON against S . aureus, both CEZ-susceptible and CEZ-tolerant strains, were superior to those of 6 control drugs . The distribution of MICs for the CEZ-susceptible strains was 0.10-12.5 micrograms/ml, and for the CEZ-tolerant strains 0.20-greater than 100 micrograms/ml . MIC peaks were 0.39 micrograms/ml and 0.78-1.56 micrograms/ml for CEZ-susceptible and CEZ-tolerant strains, respectively . Against both susceptible and tolerant strains, CZON showed superiority to CMZ and CMD, which are used prevalently and used for Methicillin-resistant S . aureus also . Distributions of MICs of CZON (and the peak of MICs) on E . coli, K . pneumoniae, and P . mirabilis were less than or equal to 0.025-1.56 (less than or equal to 0.025), less than or equal to 0.025-25 (less than or equal to 0.025-0.05), less than or equal to 0.025-25 (less than or equal to 0.025) micrograms/ml, respectively, showing CZON's similar antibacterial activity to those of cephalosporins, CMX and LMOX, which are 5th group . 2 . Absorption and excretion: Eight patients, aged 10 months to 15 years, were administered with CZON 20 mg/kg, one shot intravenously . Serum concentrations somewhat varied from patient to patient, but the mean value was 48.7 micrograms/ml after 30 minutes of administration which decreased rapidly to 13.3 micrograms/ml after 1 hour, to 3.4 micrograms/ml after 2 hours, to 1.14 micrograms/ml after 4 hours, and to 0.15 microgram/ml after 6 hours . Half-lives were 0.67-1.47 hours, with the mean of 0.87 hour . Urinary recovery rates were 24.7-55.9%, with the mean of 45.1%, in 6 hours after administration . 3 . CSF concentration and penetration rate: To 4 pediatric patients with purulent meningitis, CZON 25 mg/kg or 50 mg/kg was administered and the concentration in CSF was measured.(ABSTRACT TRUNCATED AT 400 WORDS)

Arzneimittelforschung, 1987 Apr, 37(4), 441 - 4
Distribution of cefodizime to exudate in the croton oil-induced rat granuloma pouch and its therapeutic effects on experimental infections in the pouch; Arai S et al.; Cefodizime was compared with cefotaxime (CTX) in regard to its distribution to an inflammatory site (exudate in croton oil-induced granuloma pouch) of rats and its therapeutic effects on experimental infections in such pouches after intravenous injection . Cefodizime levels in rat serum and pouch exudate were higher than those of CTX, and the former compound disappeared from the serum and pouch exudate far more slowly than the latter . In the tests for therapeutic effects, cefodizime showed almost the same degree of inhibitory activity as CTX against growth in pouch exudate of Escherichia coli Ec-7, Proteus mirabilis Pm-428, and Serratia marcescens Sm-390 for which the minimum inhibitory concentrations (MICs) of cefodizime were equal to or greater than the CTX values, and such activity of cefodizime lasted for a longer period than that of CTX . These results suggest that the above pharmacokinetic features of cefodizime compensate for its MICs against organisms displaying lower values for CTX.

J Urol, 1987 Apr, 137(4), 793 - 7
Adherence of Escherichia coli and Proteus mirabilis to human transitional cells; Szabo RJ et al.; This study utilizes a light microscopy assay for bacterial adherence to human male transitional cells . Prior light microscopy studies have used voided squamous cells, periurethral cells or scraped vaginal cells, which are less representative of the cells lining the majority of the urinary tract . Using a modification of previous bacterial adherence assays, the mean adherence for 28 strains of E . coli in 92 bacteria-cell incubations was 10.2 +/- 11.5 (standard deviation) bacteria per cell . The mean adherence for 20 strains of P . mirabilis in 60 bacteria cell incubations was 8.1 +/- 11.4 . No statistically significant difference in adherence between E . coli and P . mirabilis was found (p greater than 0.05) . Studies comparing the adherence of E . coli isolated from the urine of patients with pyelonephritis (eight strains), cystitis (10 strains) and anal swabs of females without urinary tract infections (10 strains), showed no statistically significant differences in mean adherence (p greater than 0.05) . However, there was a trend toward higher adherence in the more virulent groups . Experiments comparing the adherence of P . mirabilis isolated from infected renal stones to P . mirabilis isolated from anal swabs of female patients without history of P . mirabilis UTI revealed no statistically significant differences in mean adherence between the two groups (p greater than 0.05) . These data do not support previous contentions that P . mirabilis adhere poorly to human transitional cells . The absence of a significant difference in adherence among strains of E . coli and P . mirabilis that differ in clinical pathogenicity suggests that factors other than adherence contribute to their virulence.

Jpn J Antibiot, 1987 Apr, 40(4), 823 - 42
{Nationwide study of the antimicrobial susceptibility of clinical isolates of Proteus group in Japan}; Igari J et al.; We discussed the antimicrobial susceptibilities of Proteus group isolated in 1983 and 1984 and also the annual changes of the susceptibilities from 1980 to 1984 . The tested strains were isolated in 103 hospitals in Japan . Antibiotics tested for this study were ampicillin (ABPC), cefazolin (CEZ), cefmetazole (CMZ), and gentamicin (GM) . The MIC's were determined by the standard method of the Japan Society of Chemotherapy . Susceptibilities of the bacterial strains to the 4 antibiotics were described below: 1 . Proteus mirabilis had good susceptibilities to all the antibiotics tested . 2 . Susceptibilities of Proteus vulgaris were low to ABPC and CEZ, but high to CMZ and GM . 3 . Proteus morganii showed low susceptibilities to ABPC and CEZ, and moderate to CMZ and GM . 4 . Susceptibilities of Proteus rettgeri were low to ABPC and CEZ, and 25-40% of the strains were resistant to CMZ and GM . 5 . Proteus inconstance had low susceptibilities to ABPC and CEZ, but fairly good to CMZ . About 55% of the strains showed resistance to GM . 6 . There were no significant annual changes in susceptibilities of P . mirabilis, P . vulgaris and P . morganii to ABPC, CEZ and CMZ during the period from 1980 to 1984, but decreased susceptibilities to GM were noted in 1982 . 7 . There was no evidence of changes in susceptibilities of strains of P . rettgeri to ABPC and CMZ, but a tendency of decreasing susceptibilities to CEZ was shown from 1981 . 8 . P . inconstance showed no major changes in susceptibilities to ABPC, CMZ and GM . 9 . Frequencies of resistant strains with MIC of 25 micrograms per ml or more in P . mirabilis, P . morganii and P . rettgeri were higher in 1982 and/or 1983 than the other years.

Mikrobiyol Bul, 1987 Apr, 21(2), 98 - 102
{Susceptibility of gram-negative bacilli to aminoglycosides}; Willke A et al.; In this study, the antibiotic sensitivity results of some gram-negative bacilli to aminoglycosides have been presented . 704 E . coli, 152 Klebsiella, 158 Proteus, 155 Pseudomonas strains were examined . These bacilli were isolated from the clinical samples at the bacteriology lab.in Ibni Sina Hospital, between January 1986-January 1987 . The percents of E . coli strains susceptible to gentamicin, tobramycin, netilmicin and amikacin were 74%, 84%, 90%, 85% respectively . The sensitivity pattern of Proteus strains to the same antibiotic at the same order was 45%, 57%, 68, 84% . On the other hand 52%, 61%, 87%, 92% of Klebsiella strains and 32%, 53%, 86%, 81% of Pseudomonas strains have been found to be susceptible to gentamicin, tobramycin, netilmicin and amikacin respectively . According to these results, the resistance of gram-negative bacilli to aminoglycosides (including amikacin) is relatively high in our hospital, but amikacin or netilmicin should be preferred to others in which cases aminoglycoside therapy is considered.

Zh Mikrobiol Epidemiol Immunobiol, 1987 Apr, (4), 9 - 11
{Effect of polyvinylpyrrolidone on microbial cells}; Mal'tsev VN et al.; The oral administration of polyvinylpyrrolidone to rats produces no effect on the intestinal microflora . At the same time, polyvinylpyrrolidone solutions decrease the toxicity of Escherichia coli and Proteus vulgaris, produce a bactericidal and agglutinating effect.

Can J Microbiol, 1987 Apr, 33(4), 300 - 3
Urease activity related to the growth and differentiation of swarmer cells of Proteus mirabilis; Jin T et al.; Urease activity was measured using whole cells of both long (swarming) and short (nonswarming) populations of Proteus mirabilis from casein hydrolysate agar (CHA) and broth (CHB) cultures, and from brain heart infusion broth (BHIB) cultures . Urease is a constitutive enzyme for both long and short cells, but its activity was tremendously increased when urea was incorporated into the media . Urease production was also affected by culture age and media used . Before exponential phase, urease activity was very low, and it increased to its highest point after about 4 h in BHIB and 8 h in both CHA and CHB cultures at 37 degrees C . Long cells had higher urease activity than did short cells when grown on CHA, and was also expressed by two different strains cultured in BHIB . Strain PM23, in BHIB, was able to form long cells (swarming cells) to a maximum proportion after about 4 h, but strain IM47 could not differentiate in any of the liquid media . The former had more urease when swarming differentiation was initiated . PM23 grew relatively faster than IM47 when the former began to differentiate, but this fast growth could not be observed when nutrient broth or minimal medium was used . These observations suggest that long or swarming cells are "faster growing" rather than "nongrowing bacteria".

J Am Acad Dermatol, 1987 Apr, 16(4), 899 - 906
Lethal genes surviving by mosaicism: a possible explanation for sporadic birth defects involving the skin; Happle R; A genetic concept is advanced to explain the origin of several sporadic syndromes characterized by a mosaic distribution of skin defects . It is postulated that these disorders are due to the action of a lethal gene surviving by mosaicism . The presence of the mutation in the zygote will lead to death of the embryo at an early stage of development . Cells bearing the mutation can survive only in a mosaic state, in close proximity with normal cells . The mosaic may arise either from a gametic half chromatid mutation or from an early somatic mutation . This concept of origin is proposed to apply to the Schimmelpenning-Feuerstein-Mims syndrome, the McCune-Albright syndrome, the Klippel-Trenaunay syndrome, the Sturge-Weber syndrome, and neurocutaneous melanosis . Moreover, this etiologic hypothesis may apply to two other birth defects that have recently been delineated, the Proteus syndrome (partial gigantism of hands or feet, hemihypertrophy, macrocephaly, linear papillomatous epidermal nevus, subcutaneous hemangiomas and lipomas, accelerated growth, and visceral anomalies), and the Delleman-Oorthuys syndrome (orbital cyst, porencephaly, periorbital appendages, and focal aplasia of the skin.

Eur J Biochem, 1987 Mar 2, 163(2), 389 - 95
Murein biosynthesis in synchronized cells of Proteus mirabilis . Quantitative analysis of O-acetylated murein subunits and of chain terminators incorporated into the sacculus during the cell cycle; Gmeiner J et al.; Cells of Proteus mirabilis, synchronized by sucrose density gradient centrifugation, were grown in complex medium containing radioactive N-acetylglucosamine . At various times, labelled murein sacculi were isolated and digested with endo-N,O-acetylmuramidase from Chalaropsis . The murein fragments thus obtained were separated into disaccharide peptides as the monomeric subunits and into peptide-cross-linked subunits by gel filtration . The subunits were further differentiated into O-acetylated and non-O-acetylated species, and into subunits containing anhydro-N-acetylmuramic acid which were glycan chain terminators in the native sacculi . Quantification of the subunit species gave the following results . At specific times during the cell cycle, murein subunits were lost from the polymer and a transient decrease in cross-linkage was observed . The overall degree of cross-linkage in mature murein, i.e . the ratio of peptide-cross-linked subunits versus uncross-linked subunits, was 1.15 as determined by regression analysis . Anhydro-N-acetylmuramic-acid-containing murein subunits representing glycan chain terminators were found either peptide-cross-linked or uncross-linked as monomers . Since these two subunit species were recovered in a defined ratio of 1.6, mature murein consisted of at least two different types of glycan chains . On average, each chain contained 15.4 murein subunits . About 60% of the murein subunits in mature murein were O-acetylated and showed a higher degree of cross-linkage than the non-O-acetylated portion . Finally, following the composition of the sacculus during the cell cycle revealed a complex precursor-product relationship between non-O-acetylated and O-acetylated subunits during murein maturation . The data allowed us to deduce several features of the assembly process of murein sacculi.

J Clin Microbiol, 1987 Mar, 25(3), 578 - 9
Expanded clinical spectrum of infections caused by Proteus penneri; Krajden S et al.; Strains of Proteus penneri from seven abdominal wounds (after bowel resection), five urine samples, and eight other sites were isolated in mixed cultures . Seven urine isolates were in pure cultures . All infections were nosocomially acquired, indicating that complete identification of P . penneri in the clinical laboratory is warranted.

J Urol, 1987 Mar, 137(3), 373 - 9
Considerations in the choice of sutures for wound closure of the genitourinary tract; Edlich RF et al.; The ideal suture for use within the urinary tract should maintain its tensile strength until wound repair is satisfactory and then it should undergo rapid total absorption without promoting stone formation . The bladder has a great potential for repair, attaining 100 per cent of the strength of the unwounded tissue in 14 to 21 days . Braided synthetic absorbable sutures appear to be suited ideally for closure of incised wounds of a urinary conduit . They maintain their tensile strength for approximately 21 days, during which time the healing tissues regain strength rapidly . Because sutures are foreign bodies and have access to urine, they may serve as a nidus for stone formation . Several factors that have been identified as important determinants of foreign body urolithiasis include the presence of urine, urine volume and pH, infection, physical and chemical configuration of the foreign body, and animal species . The incidence of suture urolithiasis is related directly to the duration in which the sutures are present in the urinary tract . Consequently, absorbable sutures are preferred over nonabsorbable sutures for closure of wounds of the urinary conduit . In the absence of infection braided synthetic absorbable sutures have distinct advantages over gut sutures for closure of urinary tract wounds . They are absorbed by nonenzymatic hydrolysis in a predictable manner with limited inflammatory response . In contrast, gut sutures have an unpredictable absorption rate by enzymatic degradation and elicit an exaggerated inflammatory response . Because infected urine, especially Proteus species, accelerates the degradation of absorbable synthetic sutures to a greater degree than gut sutures, wound closure in the presence of infection should be accomplished with the absorbable natural fiber suture . Nonabsorbable sutures or staples should not be used in the urinary tract because they predictably promote urolithiasis.

J Fam Pract, 1987 Mar, 24(3), 253 - 9
A two-center review of bacteremia in the community hospital; Haddy RI et al.; There are fewer studies on bacteremia coming from the community hospital, where the practicing family physician is likely to see this problem, than from the university hospital . The hypothesis of this study was that patterns of bacteremia would be different between the two types of hospitals . Two hundred four patient episodes of culture-proven bacteremia from two analogous community hospitals were reviewed . Bacteremia was discovered in 2.6 of 1,000 patients, which is lower than reports from university hospitals . Of the 213 organisms isolated, slightly more were gram-negative than gram-positive, whereas many tertiary care centers report a preponderance of gram-negative organisms . About 20 percent of the episodes of bacteremia ended in death, a rate lower than in many tertiary care centers, and slightly more patients died of gram-negative than gram-positive bacteremia . The most common organisms in descending order were the streptococci and Escherichia coli followed by Staphylococcus aureus, Klebsiella pneumoniae, Proteus species, and Streptococcus pneumoniae . The most common sources of bacteremia were, in decreasing order, urinary tract, source unknown, heart valve, and lung . The most common underlying disorders were, in decreasing order, malignancy, diabetes mellitus, complicated urinary tract infection, valvular heart disease, and postoperative infection . Correctness of treatment of bacteremia appeared to increase survival.

AJR Am J Roentgenol, 1987 Mar, 148(3), 491 - 5
Stones in the urinary bladder in children and young adults; Lebowitz RL et al.; Bladder stones were diagnosed in 22 children and young adults at The Children's Hospital, Boston, from 1969 to 1985 . One half of the patients were less than 12 years old (mean, 11.9 years) . One or more lithogenic factors were implicated in all but two . The most common causes were the presence of an intravesical foreign body, infection with Proteus (a urea-splitting organism), exstrophy of the bladder, and the presence of intestinal mucosa in the urinary tract . The radiologic features of the stones were not specific, and no special techniques were needed to identify them . Heightened awareness of patients at risk will lead to prompt diagnosis and treatment.

Jpn J Antibiot, 1987 Mar, 40(3), 476 - 92
{Comparative, controlled study on an ampicillin suppository (KS-R 1) with an oral form of ampicillin in urinary tract infections}; Fujii R et al.; Subjects were in-patients with bacterial urinary tract infections, ranging in age 4 months to 11 years 4 months . As a rule, daily dose was either four 125 mg (in potency) suppositories or four 125 mg (in potency) oral form given at 6-hour intervals over a period of 5 days . The number of children subjected to this study was 105 . These children were divided into 2 groups (suppository 54; oral form 51) with matched pretreatment background factors . Therapeutic effectiveness rates were 70.4% for the suppository and 66.7% for the oral form, and no significant difference was observed between the 2 groups . Rates of efficacy by severity, presence or absence of underlying and/or complication diseases, daily dose and causative microorganisms did not differ significantly between the 2 groups . There was no significant difference in time-courses of improvement of clinical signs and symptoms between the 2 groups . Eradication rates for causative microorganisms were 65.9% for the suppository and 62.5% for the oral form . Most frequently isolated causative microorganisms were Escherichia coli and Proteus mirabilis . No significant differences were recognized in the therapeutic effect and usefulness evaluated by physicians in charge . The frequency of side effects did not differ significantly between the suppository group (6 with diarrhea and 1 with anal pain: 12.1%) and the oral form group (5 with diarrhea, 1 with displeasure and 1 with vomiting: 12.7%) . Abnormal laboratory findings appeared in 6 cases (2 with eosinophilia, 2 with increased GOT and 2 with increased GPT) in the suppository group and 7 cases (2 with eosinophilia, 2 with thrombocytosis, 2 with increased GOT and 1 with increased GPT) in the oral form group.

Zh Mikrobiol Epidemiol Immunobiol, 1987 Mar, (3), 49 - 53
{Immunostimulant preparation made from the antigens of opportunistic microorganisms in the treatment of inflammatory lung diseases}; Egorova NB et al.; The results of the trial of an immunostimulating preparation, consisting of Klebsiella pneumoniae, Proteus, Escherichia coli and Staphylococcus antigenic complexes, on 20 patients with acute pulmonary abscess and bronchiectasis are presented . The preparation was introduced subcutaneously in 5 injections . The preparation was found to have low reactogenicity, and in the course of immunotherapy the manifestations of systemic and local reactions became considerably less pronounced . Immunotherapy produced a good curative effect, objectively manifested by a decrease in coughing and in the amount of sputum gradually changing its character . After the fourth and fifth injections the patients no longer ejected purulent sputum . Fluoroscopic examination revealed a considerable decrease in the size of the pathological focus . The preparation stimulated immunological reactions, and immunization resulted in a considerable increase in the titer of antibodies to all components of the combined preparation, as well as in an increase in the number of functionally active T-lymphocytes, in the blood of the patients.

Antimicrob Agents Chemother, 1987 Feb, 31(2), 226 - 9
In vivo evaluation of tigemonam, a novel oral monobactam; Clark JM et al.; Tigemonam, a new monobactam with excellent activity against gram-negative bacteria, was evaluated for in vivo efficacy and absorption after oral administration to laboratory animals . Tigemonam is absorbed when administered orally to mice and dogs . In a variety of gram-negative systemic infections in mice, orally administered tigemonam was efficacious in all infections studied . Comparison drugs such as amoxicillin, cephalexin, and cefaclor were less efficacious, especially in infections caused by beta-lactamase-producing organisms . In localized infections, tigemonam also demonstrated excellent in vivo activity . In acute pyelonephritis in mice caused by Escherichia coli or Proteus sp., tigemonam was very effective . In a rat lung model with Klebsiella pneumoniae, tigemonam was active with a median effective dose of 46 mg/kg compared with 160 mg/kg for cefaclor and over 200 mg/kg for amoxicillin . Tigemonam was well absorbed in laboratory animals and with its excellent gram-negative spectrum of activity should prove of value in oral antibiotic therapy in humans.

J Clin Microbiol, 1987 Feb, 25(2), 216 - 21
Diaper area skin microflora of normal children and children with atopic dermatitis; Keswick BH et al.; In vitro studies established that neither cloth nor disposable diapers demonstrably contributed to the growth of Escherichia coli, Proteus vulgaris, Staphylococcus aureus, or Candida albicans when urine was present as a growth medium . In a clinical study of 166 children, the microbial skin flora of children with atopic dermatitis was compared with the flora of children with normal skin to determine the influence of diaper type . No biologically significant differences were detected between groups wearing disposable or cloth diapers in terms of frequency of isolation or log mean recovery of selected skin flora . Repeated isolation of S . aureus correlated with atopic dermatitis . The log mean recovery of S . aureus was higher in the atopic groups . The effects of each diaper type on skin microflora were equivalent in the normal and atopic populations.

Br J Exp Pathol, 1987 Feb, 68(1), 89 - 100
Roles of antibody and complement in the bactericidal activity of mouse peritoneal exudate neutrophils; Hart PH et al.; The contributions of complement and antibody to phagocytosis and, as a separate process, intracellular killing of Proteus mirabilis, were investigated using mouse peritoneal exudate neutrophils . Phagocytosis of P . mirabilis was promoted by both immune mouse (IMS) and normal mouse (NMS) sera . Opsonization by IMS promoted significantly greater phagocytosis than did NMS, as did NMS compared with heated IMS (HIMS) . The ability of NMS to opsonize P . mirabilis for both phagocytosis and phagocytic killing was diminished by chelation with EGTA and abolished by chelation with EDTA . This suggested that fixation of complement by both alternative and classical pathways provided optimal opsonization of this organism in NMS . In order to study intracellular killing as a process separate from phagocytosis, peritoneal exudate cell suspensions were exposed to P . mirabilis, previously incubated with 1% NMS, 1% IMS, 10% HNMS (heated normal mouse serum) or 10% HIMS, followed by centrifugation of the phagocyte-bacteria mixtures on Percoll density gradients . Populations of neutrophils containing viable intracellular bacteria, and relatively free of extracellular bacteria (less than 7% of total) were recovered in washed suspensions of cells fractionated at densities greater than 1.069 g/ml . For P . mirabilis that had been opsonized with 1% NMS before phagocytosis, the continued presence of extracellular serum was necessary for intracellular killing . NMS stimulated significantly greater intracellular killing than did HNMS, which stimulated some intracellular killing compared with the absence of serum, in which no killing occurred . IMS was similar to NMS in its ability to stimulate intracellular killing . EGTA partially blocked the stimulation of intracellular killing by NMS, and EDTA abolished it . These findings suggested that (as for optimal opsonization) complement activated via both alternative and classical pathways was responsible for optimal stimulation of intracellular killing.

Vopr Onkol, 1987, 33(2), 58 - 63
{A complex vaccine in the prevention of staphylococcal, Pseudomonas aeruginosa and Proteus infections in esophageal cancer patients}; Kochetkova VA et al.; An analysis of clinico-immunological data has demonstrated a considerable decline in non-specific and specific defences against such major factors of hospital infection in esophageal cancer patients as staphylococcal, blue pus and Proteus bacilli . Immunization with a complex vaccine including concentrated staphylococcal anatoxin, blue pus and Proteus vaccines was shown to stimulate the said factors of anti-infectious immunity and to be followed by a 4.7-fold decrease in the incidence of postoperative pyo-inflammatory complications . The said vaccine may be recommended for prevention of infectious complications in cancer patients since its administration is followed by a low-level reaction matched by a marked increase in immunologic vigor.

Pediatr Radiol, 1987, 17(6), 486 - 8
The Proteus syndrome: the magnetic resonance and radiological features; Cremin BJ et al.; The Proteus syndrome is a recently delineated group of skeletal and mesodermal malformations . Its characteristics include hemihypertrophy and fatty/lymphangiomatous masses . This description outlines the imaging sequences available to the radiologist . It is mainly concerned with the use of magnetic resonance imaging . This shows the extent of the mesodermal malformation with particular reference to the extent of intra abdominal infiltration.

Pediatr Radiol, 1987, 17(6), 481 - 5
Radiologic findings in the Proteus syndrome; Azouz EM et al.; The radiological findings in two patients with the Proteus syndrome are described . Features in our two cases not previously mentioned or stressed include vertebral dysplasia and enlargement (megaspondylodysplasia), bilateral genu valgum, recurrent after surgery and intraabdominal and mesenteric lipomatosis . Emergency laparotomy was performed on the first patient who had a twisted necrotic portion of mesenteric fat . Macrodactyly, skeletal muscle atrophy and subcutaneous fat accumulation in the abdominal wall were present in both . In addition the second patient was mentally retarded and had frontal bony prominence of skull . Computed tomography was used for the specific diagnosis of the lipomatous tissues in both patients.

IARC Sci Publ, 1987, (84), 384 - 90
N-nitrosamine formation in urinary-tract infections; Ohshima H et al.; Urine samples from 31 patients with urinary-tract infections and from 31 controls were analysed for volatile nitrosamines, N-nitrosamino acids, total N-nitroso compounds as a group, and nitrite/nitrate . The concentration of N-nitrosodimethylamine was significantly elevated in urines infected with Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae . The levels of nitrite, N-nitrosoproline and total N-nitroso compounds, when expressed as the amount per mol creatinine, were also significantly increased in patients with bacteriuria . Several bacterial strains were capable of catalysing nitrosation of morpholine at neutral pH . These results suggest that N-nitroso compounds can be formed in vivo in the infected bladder, which could explain the association between urinary-tract infections and increased risk for bladder cancer.

Arkh Patol, 1987, 49(8), 35 - 41
{Electron microscopic-radioautographic study of bacterial invasion in severely burned patients}; Sarkisov DS et al.; Wound pieces taken from 3-6 sites at a time during surgical treatment of the wound in 10 patients with thermal burns involving 25-50% of the body surface area, were examined by electron-microscopic radioautography and bacteriologically . The burn wounds were found to contain not only live (RNA-synthesizing) bacteria but also replicating (DNA-synthesizing) bacteria, and to be heterogeneous in terms of bacterial seeding (the largest numbers being present in the scab and the smallest, in the granulation tissue), but not of bacterial species; these were represented in all layers by mixed populations (Pseudomonas aeruginosa, pathogenic Staphylococcus, Proteus), although the deep layers contained more pathogenic and more virulent subpopulations than the more superficial ones . Septic patients had considerably more organisms in all layers of their wounds than nonseptic patients, and contained proliferating organisms in the granulation tissue . The main steps in the penetration of individual microbial species into the circulation were traced out by means of electron-microscopic radioautography.

Vet Med Nauki, 1987, 24(7), 49 - 58
{Hygienic research on meat-dressing shops and enterprises}; Kaloianov I et al.; Observations were made on the hygiene state of the meat-conditioning departments and enterprises of 13 meat-dressing combines . Both qualitative and quantitative investigations were carried out with regard to 9 bacteriologic indexes . The result of studies on a total of 1,042 samples of washings taken from equipment, working tools, machines, working milieu, and hands and aprons of workers prior to beginning work showed that in case all regulations of cleaning, washing, and disinfection were observed the residual microflora, and, more specifically organisms that were of interest from a sanitary point of view were lowered to minimum counts . No pathogenic Staphylococcus and Salmonella organisms were isolated . It was found that during work the count of indicative organisms considerably rose . No pathogenic staphylococci were isolated . In one case only were there Salmonella typhimurium organisms on the surface of a circular saw for carcass cutting . The overall bacteriologic investigation of a total of 137 samples of minced meat and meat balls and other products prepared with such meat revealed that the average counts of various organisms ranged as follows: aerobic mesophiles--3,653 830/g, and coliforms--31,748/g; Escherichia coli organisms were demonstrated in 10.22 per cent of the cases, B . proteus--in 1.46 per cent, and pathogenic staphylococci--in 3.65 per cent of the samples . None of the samples, weighing 25 g each showed the presence of Salmonellae . No correlative dependence was found between the coli titer and the coli index of the products.

Ann Urol (Paris), 1987, 21(3), 168 - 72
{Obstruction of the upper excretory tract associated with primary urinary infection . Diagnosis, treatment and course . Apropos of 196 cases}; Charton M et al.; The association of upper urinary tract obstruction and urinary tract infection is a relatively common disease which requires early diagnosis and systematic treatment . The diagnosis of this disease can be difficult as many patients present with totally asymptomatic forms which may be revealed suddenly and totally unpredictably by an episode of severe infection . 196 (16%) of the 1,225 patients operated between January 1977 and June 1985 for upper urinary tract obstruction also presented with urinary tract infection at the time of admission . Suggestive urological signs were present in only 49% of the patients and infectious signs were present in 39% . 26 patients had acute renal failure and 9 presented at least 3 signs of severity . The bacteria most frequently isolated were E . coli (29% of M.S.U.s and 11% of blood cultures) and Proteus mirabilis (30% of M.S.U.s and 11% of blood cultures) . Treatment always consisted of a combination of surgery and antibiotic therapy . Surgery was conservative in only 71% of patients at the first operation . 23 patients required specific symptomatic treatment due to the presence of signs of severity . Renal function, evaluated on the basis of the serum creatinine, was considerably improved by treatment, particularly in patients with acute renal failure on admission . In terms of bacteriological results, 92% of patients were discharged from hospital with sterile urine . 20% of the patients reviewed as outpatients had persistent urinary tract infection, generally caused by Proteus mirabilis . Three patients (1.5%) died, including 2 from the initial infectious syndrome.

Nahrung, 1987, 31(5-6), 557 - 61
Proteus dysbioses in patients with ulcerative colitis; Kanareykina SK et al.; In patients with ulcerative colitis Proteus could be isolated from all the gastrointestinal portions studied: mouth cavity, stomach, small intestine, small intestinal mucous membrane, and mostly from faeces . In some patients with ulcerative colitis a decrease in membraneous hydrolysis of polysaccharides was noted . Severe Proteus dysbiosis was associated with a sharp decrease in absorption processes at the small intestinal mucous membrane . The Proteus strains obtained from the patients belonged mostly to 3 serogroups: OA, OB, OC . Studies in virulent properties of Proteus in experiments with white mice gave positive results in 96% cases . Enterotoxin could be found in no case . As the result of vaccinal therapy in most patients disappearance or decrease of signs of malabsorption, increase in weight, stool normalization, and better hematological indices was manifested.

Acta Microbiol Hung, 1987, 34(1), 39 - 44
A comparison of cefonicid with other beta-lactams regarding the effect of human and mouse sera on antibacterial activity; Uri JV; The effect of the addition of 50% human or mouse serum on the antibacterial activity of cefonicid, three first generation cephalosporins and ampicillin was studied . Human serum added to the test system considerably reduced the activity of cefonicid against Staphylococcus aureus and Staphylococcus epidermidis strains, and to a lesser degree against Proteus mirabilis, Escherichia coli and Klebsiella pneumoniae strains . Human serum also reduced, albeit to a lesser extent, the activities of cephalothin, cefazolin, and ampicillin, whereas it increased the activity of cephaloridine . In contrast, mouse serum did not or only insignificantly reduced the activity of cefonicid against some of the bacterial isolates; this is reflected in the excellent protective effect of cefonicid in experimental mouse infections.

Dev Comp Immunol, 1987 Spring, 11(2), 331 - 41
Comparative analysis of hemolytic and hemagglutinating activities in the coelomic fluid of Eisenia foetida and Lumbricus terrestris (Annelida, Lumbricidae); Kauschke E et al.; The CF of Lumbricus terrestris and Eisenia foetida was analyzed with regard to the protein patterns by isoelectric focusing . The CF of E . foetida results in a variety of protein bands; after separation: seven of these with isoelectric points at pH 5.1, 5.2, 5.4, 5.6, 5.8, 6.0 and 6.2 cause the hemolysis of red blood cells . The protein pattern of normal CF of L . terrestris is relatively poor . Most of the protein bands are located at the top of the separation (pH less than 5.1) near the anode . However, the number of protein bands is drastically enhanced within 24 hours after an intracoelomic injection of foreign material . Some of the induced proteins show a similar pattern at comparable pH ranges to the CF of E . foetida . The induced proteins with isoelectric points at pH 4.7, 5.0, 5.1, 5.2, 5.4, 5.8, 6.0 and 6.2 effect the hemolysis of vertebrate erythrocytes . After stimulation with rabbit erythrocytes an enhanced bactericidal and bacteriostatic activity against Proteus vulgaris can be proven and seems to be related to the induced hemolytic proteins . The antibacterial activity can be completely adsorbed by incubation of the CF with rabbit erythrocytes, which indicates its binding ability to marker molecules on the erythrocytes surface.

J Urol (Paris), 1987, 93(2), 65 - 71
{Postoperative outcome of residual pyelocaliceal stones}; Hiraishi K et al.; The purpose of this paper is to investigate the outcome of postoperative residual stones and their influence to the renal function . We followed up 65 patients (73 kidneys) with residual stones after conventional operation . The follow-up period was on an average 11 years and 9 months . 50 of 73 kidneys were infected before surgery . The most frequently cultured organisms was Proteus mirabilis . Urinary infection persisted in 34 of 50 kidneys after surgery . The residual stones smaller than 5 mm existed in 10 kidneys, of which 7 became sterile . The stones between 5 and 10 mm existed in 18 kidneys, of which 7 (38.9%) became sterile, but in 22 kidneys with stones larger than 10 mm, the infection was not eliminated but in 2 kidneys . Conversely, postoperative infection was never found in 23 kidneys being sterile before operation . Residual stones increased in size in 39 kidneys, did not change in 19 kidneys, diminished in 3 kidneys, fell to the ureter requiring surgery in 7 kidneys and the spontaneous passage of stones was observed in 4 kidneys . In comparing the stone increase group with that of stone stable, the former had a high frequency of stones larger than 5 mm, of postoperative urinary infection and of many stone forming factors . We studied the change of renal function only by IVP in 71 kidneys . Thirty-two kidneys with residual stones and infection showed moderate or severe deterioration of renal function in a large majority of cases . Conversely, in 24 of 34 kidneys without infection, the renal function was stable and only 6 kidneys showed moderate or severe deterioration of renal function.

J Am Paraplegia Soc, 1987 Jan-Apr, 10(1), 11 - 4
Bacteremia in the spinal cord injury population; Bhatt K et al.; Positive blood cultures were found in 41 patients on the Spinal Cord Injury Service at the Milwaukee VAMC during the period of July, 1980 to December, 1985 giving an incidence of bacteremia of 1.3% . Mortality rate was 17% . Most common pathogens were E . Coli, Proteus mirabilis, Serratia marcescens and Staphylococcus aureus . A review of 29 available charts revealed genitourinary and respiratory tracts as the most common sources of infection (72.4% and 10.3% respectively) . Other sources of infection were skin, postoperative, intravenous catheter site and cellulitis . Initial febrile response was seen in 93.1% of patients with 48.1% having temperature greater than 38.3 degrees C . Hypotension (blood pressure less than 90/50 mm Hg) was noted in five out of the 29 (17.1%) patients . Clinical diagnosis of disseminated intravascular coagulation was made in two out of the 29 (6.9%) patients . Underlying risk factors were poor nutrition, respirator dependency, indwelling Foley catheters and manipulative procedures . Incidence and mortality rates are similar to the non-SCI population as reported elsewhere . The risk factors are different; therefore preventive management is extremely important.

J Comp Physiol {B}, 1987, 157(1), 77 - 83
Cytotoxic activity in the coelomic fluid of the annelid Eisenia foetida Sav; Kauschke E et al.; The annelid Eisenia foetida not only causes hemolysis of red blood cells of several vertebrate species, but also has a toxic effect on a variety of cell types, such as chicken fibroblasts, guinea-pig polymorphonuclear leukocytes and insect hemocytes . However, it has no influence on the vitality of the coelomocytes of Lumbricus terrestris and other lumbricides, nor on the hemocytes of the snail Helix pomatia, the mussels Anodonta cygnea and Unio tumidus, free cells of the turbellarian Euplanaria sp . or whole Rhabditis oxycerca (nematode) and the protozoons Paramaecium caudatum and an amoeba of the Proteus-type . By electrofocussing the hemolytic activity of pooled coelomic fluid was separated into 7 hemolytic bands . Three of them are cytotoxic . The cytotoxic effect is a result of the destruction of the cell membrane, as shown by measuring the release of lactate dehydrogenase (LDH) . The bacteriostatic and bacteriocidal action of the coelomic fluid of E . foetida against a broad spectrum of gram positive and gram negative bacteria was tested . An antibacterial activity could be observed only against Proteus vulgaris and Bacillus megaterium . It was noted that the so-called Eisenia foetida-factor acts on an antigenic structure at the cell surface when anti-sheep-E-antibody was used under competitive conditions . The binding between the Eisenia foetida-factor and this membrane structure is relatively strong as it cannot be removed by subsequent treatment with anti-sheep-E-antibody or 2 M KCl.

Eur Urol, 1987, 13 Suppl 1, 64 - 8
Trometamol-fosfomycin (Monuril) bioavailability and food-drug interaction; Bergogne-Berezin E et al.; A new water-soluble monobasic salt of fosfomycin with trometamol has recently been developed for oral administration . The objective of this study was to evaluate the pharmacokinetics of trometamol-fosfomycin (Monuril) in serum and in urine in 10 healthy volunteers after oral administration of one single dose (50 mg/kg) . In the same volunteers the concentrations of fosfomycin were measured before and after food absorption, in serum and urine samples taken at t = 0, 2, 4, 6, 8 and 24 h after the dose (plus 0.5 and 1 h for serum samples) . The measurement of fosfomycin levels was carried out by means of a microbiological procedure using Proteus mirabilis ATCC 21100 as test organism . The results indicated at 2 or 4 h serum peak levels ranging from 9 to 28 micrograms/ml, with mean values of about 17-21 micrograms/ml . The urine concentrations reached 2,000-2,500 micrograms/ml at 2 h, with high levels maintained till the 8th hour (1,200-2,750 micrograms/ml) and persistence of noticeable concentrations at 24 h (100-700 micrograms/ml) . The influence of food absorption, even variable, decreased significantly the rate of absorption, with lower serum and urine levels, as measured in the same volunteers . Taking into account this factor influencing the bioavailability and the distribution of the drug, the results of the study confirm that a high proportion of the oral dose of trometamine salt of fosfomycin is absorbed; the extremely high urinary recovery of the drug even after food administration could certainly allow short-course therapy or even single-dose therapy in the treatment of uncomplicated urinary tract infection.

Antibiot Med Biotekhnol, 1987 Jan, 32(1), 39 - 42
{Antibiotic sensitivity of bacteria in the genus Proteus in relation to the source of isolation and specific classification}; Nekhorosheva AG et al.; One hundred and ninety-one Proteus strains isolated from patients with various pathological processes were studied with respect to their sensitivity to 14 antibiotics . It was shown that their resistance depended on the isolation source and microbial species . Amikacin proved to be the most active agent . It was efficient against all the Proteus species, irrespective of the isolation source . Among the drugs efficient against P . mirabilis and P . vulgaris there were gentamicin, tobramycin and sisomicin sulphates.

Antimicrob Agents Chemother, 1987 Jan, 31(1), 126 - 8
Five-year survey of changing patterns of susceptibility of bacterial uropathogens to trimethoprim-sulfamethoxazole and other antimicrobial agents; Alon U et al.; We analyzed the antibiotic susceptibility of 5,348 urinary isolates of Escherichia coli, "Klebsiella aerogenes," and Proteus mirabilis grown in three laboratories from 1980 to 1985 . A continuous rise in resistance to trimethoprim-sulfamethoxazole was observed; 63% of the strains from inpatients in 1984 and 51% of those from outpatients in 1985 were resistant to this drug . Isolates from outpatients in 1985 were mostly susceptible to nitrofurantoin (mean susceptibility, 92%) and to oral cephalosporins (mean susceptibility, 84%) . As for isolates from inpatients, none of the antimicrobial agents now used was satisfactory for initial chemotherapy, indicating a need for new antibacterial strategies.

Zh Mikrobiol Epidemiol Immunobiol, 1987 Jan, (1), 59 - 63
{Experimental study of the immunological activity of a preparation made from the antigenic complexes of opportunistic microorganisms administered by different routes}; Kuz'mina LA et al.; The data obtained in the experimental study of the humoral factors of local and systemic immunity, as well as the morphofunctional changes of internal organs, after multiple subcutaneous and aerosol immunization with the combined preparation of Proteus, Staphylococcus, Klebsiella pneumoniae and Escherichia coli antigens (preparation nC-4) are presented . The subcutaneous and aerosol administration of preparation nC-4 has been found to induce an increase in the levels of antibodies to all components of the preparation in the blood serum and in respiratory tract secretions . The introduction of the preparation through the respiratory tract resulted in an earlier intensive accumulation of specific antibodies and IgA in respiratory tract secretions . The results of the quantitative cytological study of respiratory tract secretions and the morphofunctional changes of the lymphoid tissue associated with the lungs are indicative of an important role played by cell-mediated immunity factors in the formation of local postvaccinal immunity.

Zh Mikrobiol Epidemiol Immunobiol, 1987 Jan, (1), 3 - 6
{Ultrastructural characteristics of Proteus vulgaris and Proteus mirabilis cells differing in the capacity for swarming}; Bondarenko VM et al.; Specific differences in the structure of colonies and the location of microbial cells in colonies, characteristic for aggregating and nonaggregating genetically related pairs of P . vulgaris and P . mirabilis strains, have been demonstrated by means of transmission and scanning electron microscopy . In calculating the number of flagellae per 100 outlines of microbial bodies revealed in negatively stained preparations, the fact that both aggregating and nonaggregating bacteria possess practically the same number of flagellae, on the average 4-8 flagellae per microbial cell outline, has been established . This fact indicates that the presence of flagellae in microbial cells is unrelated to their capacity for swarming.

Crit Rev Microbiol, 1987, 14(1), 73 - 97
Buoyant density variation during the cell cycle in microorganisms; Kubitschek HE; The behavior of cell buoyant density during the cell cycle has been determined for a number of different cell types, including bacteria, yeast, and mammalian cells . Mean buoyant density was extremely constant and independent of cell age during the cell cycle of the bacterium Escherichia coli, the fission yeast Schizosaccharomyces cerevisiae, the protozoan Amoebae proteus, cells from suspension cell cultures of mouse lymphoma and myeloma, and Chinese hamster ovary cells . In all of these cases, the buoyant densities of these cells were very narrowly distributed, with coefficients of variation of 0.1 to 0.3% . In contrast, buoyant density was variable in cells with thick cell walls and high buoyant densities . Density varied markedly during the cell cycle of the budding yeast Schizosaccharomyces cerevisiae and of the bacterium Streptococcus faecium . The average buoyant densities of cells in exponentially growing cultures of E . coli or Schizosaccharomyces pombe were also independent of growth rate of the cultures . Experiments with E . coli have established that cell buoyant density is controlled by the osmoregulatory system . Although the regulatory mechanisms for this control are unknown, the results suggest that the same or similar mechanisms regulate buoyant density in all of the cells that do not have unduly heavy cell walls and, therefore, these regulatory mechanisms were either conserved during evolution or reflect the convergent evolution found for organic osmolytes.

J Orthop Res, 1987, 5(1), 23 - 8
Role of internal fixation in infection of open fractures: studies with Staphylococcus aureus and Proteus mirabilis; Merritt K et al.; Studies of infections in open fractures are described . The hamster was chosen as the experimental model . Osteotomies of the femur were created with an osteotomy saw . Some osteotomies were left to heal and others were fixed with an 0.9 mm K-wire . The infection rates in fixed and unfixed fractures were compared . The first group of hamsters with fixed and unfixed osteotomies was returned to cages with open wounds . There was no difference in the infection rate at 2 weeks . The second group was deliberately contaminated with Staphylococcus aureus and then returned to cages with open wounds . In this group, the infection rate at 2 weeks was lower in the internally-fixed fractures than in the unfixed fractures . The third group was deliberately contaminated with the gram negative organism Proteus mirabilis . In these animals, the infection rate was increased in the presence of the internal fixation device . The fourth group was deliberately contaminated with both Staphylococcus aureus and Proteus mirabilis . The infection rate in these animals was very high; Proteus was recovered from those animals with internal fixation and Staphylococcus was recovered from those animals without internal fixation . These studies in the hamster document the usefulness of this animal as an inexpensive and reproducible model for studying infection of open fractures . The hamsters tolerated the procedure well, and wound and fracture healing progressed satisfactorily.

Metab Pediatr Syst Ophthalmol, 1987, 10(2), 45 - 7
Lectins for the identification of ocular bacterial pathogens; Avni I et al.; In a preliminary in vitro investigation, fluorescein-conjugated lectins were used in the identification of bacteria commonly involved in ocular infections . Clinical isolates of Staphylococcus aureus, Staph . epidermidis, Streptococcus pneumoniae, Strep . pyogenes, Pseudomonas aeruginosa, Hemophilus influenzae, and Proteus mirabilis were incubated with each of eleven lectins using a slide technique . Bacterial fluorescence was readily observed with a fluorescence microscope . All clinical isolates bound wheat germ agglutinin . The Gram-positive isolates bound Concanavalin A, while the Gram-negative isolates did not, with rare exceptions . Streptococcal species isolates reacted with Dolichos biflorus agglutinin, while staphylococcal species isolates did not . Lectins may be useful in furthering the initial identification of causative organisms in bacterial ocular infections.

Scand J Urol Nephrol Suppl, 1987, 104, 47 - 57
Urinary pathogens and bacterial sensitivity in hospitalized urological patients based upon clinical aspects; Naber KG et al.; For a total of 396 hospitalized urological patients with complicated and/or hospital-acquired urinary tract infections (UTI) urinary pathogens with colony counts of 10(5)/ml or more were determined, several species were then subclassified by epidemiological markers . The minimal inhibitory concentrations (MIC) were measured using the agar dilution method for seven penicillins and for four penicillin combinations, for six oral and 14 parenteral cefalosporins, for three older and five newer quinolones, for two aminoglycosides, for two monobactams, for trimethoprim alone and in combination with sulfamethoxazole, for fosfomycin and for imipenem . Sensitivity and resistance of the strains were defined using breakpoints according to DIN 58.940 or analogous concentrations . The bacterial spectrum and the rate of resistant strains were correlated to clinical aspects pertaining to sexual status, age and underlying abnormalities within the urinary tract . There was a statistical difference in the frequency of E . coli and enterococci between patients with (complicated UTI) and without (uncomplicated UTI) abnormalities . Within the group of complicated UTI Proteus spp . were found significantly more often in patients with urolithiasis, Klebsiella spp . and staphylococci in patients with prostatic tumours (benign and malignant), enterococci in patients with prostatic and other tumours and E . coli in patients with abnormalities other than urolithiasis or tumours . Almost all antibiotics tested could be used in patients with uncomplicated UTI for empiric or calculated therapy if a rate of resistance of up to 10% is acceptable . In patients with urolithiasis only the newer acylaminopenicillins, the newer (fluoro-)quinolones, trimethoprim in combination with sulfamethoxazole, fosfomycin and imipenem fulfill this criterion . In order to treat complicated UTI with underlying tumours within the urinary tract empirically only piperacillin, apalcillin, imipenem and some of the newer quinolones (ofloxacin, ciprofloxacin and pefloxacin) could be recommended . The same was true for patients with indwelling catheters still present or recently removed.

Arch Immunol Ther Exp (Warsz), 1987, 35(5), 553 - 61
Immunogenic effect of bacteriophage in patients subjected to phage therapy; Kucharewicz-Krukowska A et al.; Fifty seven cases of bacterial infections subjected to phage therapy were tested for a production of antibodies against the applied bacteriophages . Monoinfections confirmed in 40 patients were caused in majority of cases by pyogenic Staphylococci (29 cases) and rarely by Gram-negative bacteria: Klebsiella, Escherichia, Proteus and Pseudomonas (11 cases) . Polyinfections caused by the above types of bacteria were recorded in 17 cases . The titer of neutralizing and hemagglutinating antibodies was determined before phage therapy, in the 10th day and in some cases in the 21st day of its course . The effect of natural and immune antibodies on the final result of therapy was analyzed.

Arch Immunol Ther Exp (Warsz), 1987, 35(2), 175 - 83
Bacteriophage treatment of suppurative skin infections; Cislo M et al.; The study material comprised 31 patients with chronic suppurative infections of the skin caused by Pseudomonas, Staphylococcus, Klebsiella, Proteus and Escherichia . Within 2-16 weeks of the treatment, an improvement of the general state was observed as well as suppression of the local inflammation, purification of a wound from the suppurative and necrotic content, faster healing of the ulcers and fully negative results of the bacteriologic tests . In 16 cases, an outstanding therapeutic effect was obtained, in 7 cases marked improvement was reported and in 2 a transitory improvement was reported . In 7 patients the treatment was abandoned due to the lack of improvement (1 case) or development of side effects (6 cases) . The results obtained provide evidence for the high effectiveness of phage therapy in the treatment of suppurative skin infections.

Ophthalmic Res, 1987, 19(6), 309 - 17
Persistence of retinal dopamine cells in the degenerated eye of the cave salamander, Proteus anguinus L; Nguyen-Legros J et al.; The Proteus anguinus L . is a blind cave perennibranch amphibian whose visual system undergoes an important morphogenetic degeneration in adulthood . The eyeball becomes atrophied and disappears under the fat tissue of the head . However, a retina can still be identified and a photophobic behavior of the animal indicates a remaining photosensitivity . In the oldest animal observed, some photoreceptor cells are still present as well as other types of retinal neurons . Characteristic synapses are observed in both the inner and outer plexiform layers . Dopaminergic amacrine cells, with processes in the inner plexiform layer, can be identified by their tyrosine-hydroxylase immunoreactivity . Taken together, these results indicate a possible functional role of the remaining retina . Since dopamine is especially involved in light adaptation from darkness, the residual retina could act in triggering the turning behavior of Proteus in response to lightening.

Scand J Infect Dis Suppl, 1987, 52, 56 - 64
Imipenem/cilastatin for pediatric infections in hospitalized patients; Nalin DR et al.; One hundred and four children who were hospitalized for documented or suspected non-CNS bacterial infections (56 males/48 females, 22 days to 15 years old) were treated with intravenous imipenem/cilastatin for 9.4 days (range 3 to 28 days) . Children up to three years of age received 100 mg/kg/day and older children 60 mg/kg/day, administered in four divided doses . Bacterial pathogens were isolated before therapy in 85% . Diagnoses in the 74 evaluable patients included bronchopneumonia with or without empyema (20%), peritonitis complicating appendicitis (16%), skin/soft tissue abscesses (14%), septicemia (11%) and miscellaneous other infections (39%) . Among evaluable patients, 95% were clinically cured or improved . One patients, a marasmic child with pneumonitis due to pseudomonas, died during therapy . One evaluable patient each with shigellosis, Klebsiella pneumoniae empyema and streptococcal pneumonia had bacteriologic eradication or suppression but, due partly to noninfectious complications, had no overall clinical improvement . Most bacterial isolates (101/108) were eradicated, including many gram-negative and gram-positive aerobes and anaerobes; three pathogens persisted (one Proteus mirabilis and one Salmonella typhi, one Staphylococcus aureus); and one Escherichia coli pyelonephritis recurred after therapy ended too early . Imipenem/cilastatin was well tolerated by 91% of children . Clinical adverse experiences (AEs), none serious except for the one death, occurred in 19%; 12% were judged possibly related to imipenem/cilastatin, but none probably or definitely related . No serious laboratory AEs occurred; the most common AEs were eosinophilia (11%), urine discoloration, and infusion site pain . Imipenem/cilastatin is well tolerated and has excellent clinical efficacy in a wide variety of pediatric infections.

Arch Immunol Ther Exp (Warsz), 1987, 35(4), 431 - 7
Structure of the 0-specific polysaccharide of Proteus mirabilis S 1959; Kaca W et al.; The complete structure of the 0-specific polysaccharide of the strain Proteus mirabilis S 1959, as analyzed by 13C NMR, is presented . Some data demonstrating the significant heterogeneity of the 0-specific chain in the investigated lipopolysaccharide are also described.

Scand J Urol Nephrol, 1987, 21(3), 219 - 23
Infection-induced urinary calculi and renal failure; Holmgren K et al.; During 1974-1984 altogether 481 patients were treated for end-stage renal disease (ESRD) . Eight patients, five women and three men, with chronic pyelonephritis as the primary cause of ESRD, had staghorn urinary calculi as a predisposing factor for renal failure . These eight patients were studied retrospectively concerning epidemiological and bacteriological aspects, the treatment of the stone disease, and the development of uraemia . Anatomical and metabolic abnormalities such as bladder outlet disturbances, primary hyperparathyroidism, phenacetin abuse or metabolic stone disease were found in six patients . The women had all been infected with Proteus mirabilis, whereas the men had been infected with various microorganisms . The average time taken for the development of ESRD, estimated from the first sign of renal impairment, was 7.4 +/- 2.9 (SD) years . Five patients had died before this study commenced . One of the patients still alive was on dialysis treatment . Two patients who were doing well without dialysis were stone free and had sterile urine after successful pyelolithotomy . It is concluded that the prevalence of infectious urinary calculi as a cause of uraemia in patients with ESRD is low . The time taken for uraemia to develop is short in these patients and they often have anatomical abnormalities . Proteus is commonly found in this group of patients . Patients with staghorn calculi, urinary tract infection and impairment of renal function are at risk of developing uraemia.

Microbios, 1987, 51(208-209), 191 - 201
Dimethyl sulphoxide respiration in Proteus mirabilis; Meganathan R et al.; Dimethyl sulphoxide (DMSO) was found to serve as an electron acceptor for the anaerobic growth of Proteus mirabilis on fermentable substrates such as glucose and pyruvate, as well as on oxidizable substrates such as glycerol and lactate . In a complex medium, formate greatly stimulated growth in the presence of DMSO . Cell extracts were found to reduce DMSO to dimethyl sulphide (DMS) in the presence of an electron donor . It was found that NADH, formate, lactate, reduced benzyl viologen, and dithionite can serve as electron donors . Chlorate resistant (chl) mutants were found to be unable to grow using DMSO as an electron acceptor . However, in one chl mutant, growth and DMSO reduction could be partially restored by growth in the presence of high concentrations of molybdate.

Microbiol Sci, 1987 Jan, 4(1), 29 - 31
Copper resistance in bacteria; Trevors JT; Copper is a required trace element for many organisms, yet it can exert an inhibitory effect on bacterial growth at relatively low concentrations . However, there are some bacterial species that can tolerate high levels of copper . It also has been reported that copper resistance is plasmid-encoded in Escherichia coli, Proteus vulgaris and a Pseudomonas syringae isolate . It is not known if copper is effluxed from the cell, detoxified by binding to copper-binding proteins, or binds to cell-surface components . Actual data on copper transport in bacteria is also lacking, indicating that this area of research deserves serious attention.

Microbiol Immunol, 1987, 31(8), 737 - 44
Overproduction of gene products by the super-high-copy-number plasmid pNR333; Mochizuki A et al.; The plasmid pNR333 is a kanamycin-resistant, deletion derivative of pNR113 with an extremely high copy number in Escherichia coli and in Proteus mirabilis . In order to determine the usefulness of pNR333 as a replication gene of vector, the genes encoding chloramphenicol acetyl-transferase (CAT) and beta-galactosidase (beta-gal) were cloned individually into both pNR333 and other low-copy-number plasmids . The expression of the cloned genes was compared by measuring the specific activity of each enzyme and the amounts of the proteins produced . A hybrid plasmid pNR333-cat expressed 53 times as much activity of CAT as the low-copy plasmid S-a which had a copy number of four . The lacZ gene cloned in pNR333 produced 17 times as much beta-gal as in the low-copy-number plasmid pNR1150 . These results suggest that pNR333 is a useful vector plasmid for producing a large amount of polypeptides in E . coli hosts.

Dev Comp Immunol, 1987 Winter, 11(1), 47 - 55
Reactions of hemocytes of immune and non-immune Galleria mellonella larvae to Proteus mirabilis; Morton DB et al.; Immune larval Galleria mellonella removed live Proteus mirabilis from the hemolymph less effectively than did non-immune larvae . This was attributed to a decline in total hemocyte counts, levels of plasmatocytes and granulocytes and hemocyte adhesion capacity . Immune serum possessed factors which reduced bacterial adhesion to the hemocytes . This was not due to altering bacterial surfaces but rather to irreversible suppression of hemocyte activity.

Folia Parasitol (Praha), 1987, 34(1), 69 - 74
Bacterial isolation from and transmission by Boophilus decoloratus and Boophilus geigyi; Amoo AO et al.; Bacteria were isolated from the haemolymph of Boophilus decoloratus and Boophilus geigyi which had engorged on trade cattle in Nigeria . All the genera of the bacteria were also isolated from the eggs which they laid although some of them were missing from the larvae which eventually hatched . When clean rabbits were inoculated with some genera of bacteria and clean, laboratory bred larvae of B . decoloratus and B . geigyi fed on them, the same genera of bacteria were subsequently isolated from the haemolymph of the engorged adults, the eggs they produced and the larvae which hatched from them . Staphylococcus pyogenes and Pseudomonas aeruginosa were consistently encountered in the haemolymph, eggs and larvae of both Boophilus species while Proteus mirabilis was additionally consistent in B . geigyi.

Rev Mal Respir, 1987, 4(6), 301 - 9
{Prognostic factors in operated non-small cell cancer of the lung . Study from a randomized therapeutic trial}; Benichou J et al.; This article presents the results of a prognostic study of primary resected lung cancer (non-small cell) . The data result from a randomised clinical trial of immunotherapy with a non-specific adjuvant; the follow-up was between four to seven years . Thirty-five clinical, biological and anatomo-pathological parameters were gathered at the time of inclusion in the trial . The response criteria used were survival without recurrence and total survival . A multivariate analysis using the Cox's model was carried out for each criterion . At the reference date of the 1st April 1985, 125 relapses and 132 deaths were counted amongst 219 patients; there was only one patient lost to follow-up and only 39 missing data were observed . The negative therapeutic results of the immunotherapy used were confirmed by this new intermediate analysis . The rate of survival without recurrence at 5 years was 43% and the overall survival at five years was 42% . The use of Cox's model to show the prognostic information at the 5% level for survival without recurrence could be summarised by five factors: main staging (the prognostic factor), leucocytosis, the cutaneous reaction to proteus, Karnofsky index and presence of physical signs . For stages I and II the outcome was identical and no factor was predictive at the 5% level . For stage III the cutaneous reaction to proteus and leucocytosis were prognostic . For overall survival, the prognostic information at the 5% level could be summarised by five factors: staging (main prognostic factor), leucocytosis, Karnofsky index, presence of physical signs and lymphocytosis . For stages I and II whose outcome was identical only Karnofsky index and lymphocytosis were predictive at the 5% level.(ABSTRACT TRUNCATED AT 250 WORDS)

Gene, 1987, 59(1), 107 - 13
IS431, a staphylococcal insertion sequence-like element related to IS26 from Proteus vulgaris; Barberis-Maino L et al.; We present the nucleotide sequence of IS431, a new staphylococcal insertion sequence-like element flanking the mercury-resistance determinant of pI524 and associated with the methicillin-resistance determinant . IS431 left is 800 bp long and has a perfect terminal inverted repeat (IR) of 22 bp; IS431 right is 786 bp long and has a terminal IR homologous to the IR of IS431 left except that the terminal 8 bp are absent . Both IRs share a 10-bp homology with the IR of IS26 from Proteus vulgaris . No directly repeated sequences were detected immediately adjacent to the IRs . An open reading frame (ORF) of 675 bp spans most of the IS431 sequence . Its deduced amino acid (aa) sequence shows 40% homology to the 234-aa-long putative transposase coded by ORFI of IS26.

Br Poult Sci, 1986 Dec, 27(4), 593 - 9
Effects of times of collection and different storage methods on the microflora and nitrogen content of poultry waste; Kese AG et al.; An experiment was conducted to determine the effects of times of collection and storage methods on the kinds and numbers of microflora and nitrogen content of poultry excreta (waste) . Fresh waste collected in the morning had a higher mean count of viable bacteria than the evening collection in both strains of hen studied . Fresh waste samples had higher mean counts than dried ones . Escherichia coli and Proteus spp . were the predominant microflora identified in waste collected at both times from both strains . Collection time had no effect on the type of micro-organisms isolated . Bacillus spp . was least frequently isolated in fresh waste but most often in dried waste . Samples of waste collected in the morning from Babcock layers contained more nitrogen than those collected in the evening . Samples collected in the morning from Warren layers and stored under aerobic conditions had the highest nitrogen content . However, there were no significant differences in the nitrogen content of waste from Babcock layers attributable to storage method.

Eur J Epidemiol, 1986 Dec, 2(4), 312 - 5
Epidemiological study of surgical wound infections; Saenz Gonzalez MC et al.; The present report describes the results obtained in an epidemiological study of surgical wound infections through a continuous and active epidemiological surveillance program lasting one year and which covered all the Surgical Services of the University Clinical Hospital . The number of infections studied was 217, with an overall infection rate of 3% . The majority of the infections (46.5%) were detected in the General Surgery Service . Regarding the infection rate by Services, the highest corresponded to the Urology Service, with a rate of 10% . In 26% of the cases, other hospital-acquired infections occurred in patients who underwent a surgical operation . The microorganisms responsible for the infections observed were mainly Gram-negative (67%), and within these the most commonly isolated were E . coli and Proteus spp..

J Antimicrob Chemother, 1986 Dec, 18 Suppl E, 145 - 51
Imipenem as monotherapy in the treatment of intensive care patients with severe infections; Dirksen MS et al.; In an open study, 24 intensive care patients were treated with imipenem/cilastatin as monotherapy for serious bacterial infections . Twenty-one patients were treated for bronchopulmonary infection, two patients for septicaemia, and one patient for an empyema . Initially all strains were susceptible to imipenem . Gram-negative bacilli accounted for 80% of these isolates . The most frequently isolated species were Proteus mirabilis, Escherichia coli and Pseudomonas aeruginosa . All 24 patients were considered clinically cured . Sixteen of these patients (67%) were both clinically and microbiologically cured . In eight of the 24 patients (33%), the strains isolated initially persisted . In eight of the 24 patients (33%), colonization of the respiratory tract developed . Two of the five Ps . aeruginosa isolates developed resistance during therapy but in none of these patients was therapy considered to have failed . In 12 patients (50%), transient elevations in hepatic function tests were observed and these were probably drug-related . The present study supports the view that imipenem/cilastatin may be useful as monotherapy in the treatment of severe infections in intensive care patients.

Chemioterapia, 1986 Dec, 5(6), 375 - 8
Ofloxacin: therapeutic activity in experimental infections; Guerra L et al.; The therapeutic activity of ofloxacin, a new oral fluoroquinolone antibacterial agent, was tested in experimental infections in rodents . Its activity was compared with that of nalidixic acid, norfloxacin, amoxicillin and cotrimoxazole in Pseudomonas aeruginosa pyelonephritis in the rat, and with that of amikacin and cefotaxime in Proteus morganii thigh infections in mice . Ofloxacin proved to be more effective than reference drugs, even if parenterally administered, in reducing the bacterial count in muscle, kidney and urine.

J Gen Microbiol, 1986 Dec, 132 ( Pt 12), 3303 - 7
Effect of R-plasmid RP1 on surface hydrophobicity of Proteus mirabilis; Onaolapo JA et al.; The presence of R-plasmid RP1, as well as the conditions of growth, affected the surface hydrophobicity of a clinical isolate of Proteus mirabilis . However, results depended upon the method of assessment . Stationary phase plasmid-containing cells appeared to be less hydrophobic than plasmid-free cells when hydrophobicity was measured by the contact angle method, but more hydrophobic when measured by bacterial adherence to hydrocarbons or hydrophobic interaction chromatography . Cells growing in a chemostat differed in hydrophobicity from stationary phase cells and results varied with the growth rate . Plasmid-mediated effects were greatest in iron-depleted cells, and differences between plasmid-containing and plasmid-free cells were virtually eliminated by pre-treatment with antiserum.

J Antimicrob Chemother, 1986 Dec, 18(6), 703 - 8
Interactions of antimicrobial agents and antineoplastic agents; Yamashiro Y et al.; The in-vitro interactions of four antimicrobial agents (piperacillin, dibekacin, minocycline, norfloxacin) and four antineoplastic agents (mitomycin C, bleomycin, doxorubicin, 5-fluorouracil) were examined by the chequerboard dilution method using 108 clinical isolates of four species of Gram-negative bacilli . Among the antimicrobial agents, piperacillin showed the greatest degree of synergism and norfloxacin the least . The frequency of synergism was essentially similar among the antineoplastic agents, although 5-fluorouracil was more frequently synergistic than other antineoplastic agents against Pseudomonas aeruginosa . Among the four species, synergism was most frequently shown against Proteus vulgaris and least against Escherichia coli . Antagonism was rarely seen.

J Biol Chem, 1986 Nov 5, 261(31), 14837 - 43
Phosphorylation of Amoeba G-actin and its effect on actin polymerization; Sonobe S et al.; Mass culture of Amoeba proteus enabled us to do biochemical studies on this organism . Actin and profilin were purified from Amoeba to examine actin phosphorylation and polymerization . The apparent molecular weight of Amoeba actin was 44,000, and its isoelectric point was 5.8 . The apparent molecular weight of Amoeba profilin was 12,000, and its isoelectric point was 4.9 . It reduced the rate of actin polymerization as reported in the cases of profilins from other organisms . A protein of Mr = 44,000 (44 K protein) was phosphorylated in a Ca2+-dependent manner in cell homogenate of Amoeba without being inhibited by calmodulin antagonists . Using the homogenate as a kinase, purified Amoeba G-actin could be phosphorylated in proportion to the amount of actin . However, neither Amoeba F-actin nor rabbit skeletal muscle G-actin was phosphorylated . The phosphorylation of Amoeba actin with a kinase partially purified from A . proteus increased with dilution of the actin concentration . When Amoeba profilin was added, more than 80% of the actin was phosphorylated . By viscometry, electron microscopy, and ultracentrifugation analysis it was demonstrated that Amoeba G-actin phosphorylated in the presence of profilin and kinase did not polymerize in this solution . High-performance liquid chromatography analysis showed that phosphorylated Amoeba actin remained in a monomeric state even under conditions favorable for actin polymerization.

Jpn J Antibiot, 1986 Nov, 39(11), 2863 - 8
{Transfer of fosfomycin into human burn blister fluid and its pharmacokinetic analysis}; Koh B et al.; Fosfomycin (FOM) (50 mg/kg) was administered to burned patients by intravenous bolus injection . Burn blister fluid and serum were taken during 8 hours after injection, and concentrations of FOM in burn blister fluid and serum were determined by bioassay using Proteus sp . (MB-838) as the test organism . The serum concentrations of FOM were 257 +/- 34.6 micrograms/ml at 15 minutes, 222 +/- 34.8 micrograms/ml at 30 minutes, 166 +/- 34.6 micrograms/ml at 1 hour, 114 +/- 43.9 micrograms/ml at 2 hours, 79.5 +/- 34.9 micrograms/ml at 3 hours, 63 +/- 36.4 micrograms/ml at 4 hours, 44.3 +/- 27.6 micrograms/ml at 5 hours, 29.6 +/- 20.9 micrograms/ml at 6 hours and 17.9 +/- 12.8 micrograms/ml at 8 hours after the injection . FOM concentrations in burn blister fluid were 64.4 +/- 18.1 micrograms/ml at 30 minutes, 77 +/- 26.0 micrograms/ml at 1 hour, 71.6 +/- 24.7 micrograms/ml at 2 hours, 64.8 +/- 23.6 micrograms/ml at 3 hours, 43.2 +/- 8.8 micrograms/ml at 4 hours, 24.8 +/- 7.9 micrograms/ml at 6 hours and 17.9 +/- 10.5 micrograms/ml at 8 hours after the injection . The obtained data were analysed pharmacokinetically . The serum levels were analysed by a two-compartment model, and the transfer of FOM into burn blister was analysed by a modified deconvolution method . In results, Tmax and Cmax of FOM levels in burn blister fluid were calculated as 1.3 hours and 80.9 micrograms/ml, respectively . The transfer rate constant of FOM from serum to burn blister fluid (K1) and that from burn blister fluid to serum (K2) were calculated as 0.612 hr-1 and 1.10 hr-1, respectively.

Urol Clin North Am, 1986 Nov, 13(4), 591 - 604
Antimicrobial prophylaxis in urologic surgery; Larsen EH et al.; Nosocomial urinary tract infections represent approximately 40 per cent of all nosocomial infections, thereby contributing considerably to secondary bacteremia and sepsis and possibly increased mortality . Urethral catheterization is the single most important predisposing factor in the development of urinary tract infection . Patients at increased risk of nosocomial infectious complications are the elderly, malnourished and debilitated, those with diabetes or prosthetic devices, and those on immunosuppressive therapy . About 75 per cent of nosocomial urinary tract infections are attributable to gram-negative bacteria, a disproportionate number of which when compared with community-acquired infections are caused by Proteus, Klebsiella, and Pseudomonas . There is enough evidence in the literature to support the use of prophylaxis in urologic surgery . Antimicrobial prophylaxis reduces the incidence of postoperative urinary tract infection . It does not seem to reduce the incidence of transient perioperative bacteremia but probably prevents the development of sepsis, thereby reducing the number of serious infective complications, the average hospital stay, and the associated total cost of treatment . To achieve adequate urine, blood, and tissue levels of the antimicrobial agent at the time of surgery, the drug should be given preoperatively . A short perioperative course represents sufficient prophylaxis . Regimens with combinations of beta-lactam and aminoglycoside antibiotics or single use of an extended spectrum beta-lactam antibiotic are acceptable for this purpose.

N Z Med J, 1986 Oct 22, 99(812), 812 - 5
Chronic suppurative otitis media in the Solomon Islands: a prospective, microbiological, audiometric and therapeutic survey; Eason RJ et al.; Chronic suppurative otitis media affected 3.8% of 3500 Solomon Island children under 15 years (and 6.1% under 5 years) and was the sole cause of conductive hearing loss recorded in 265 children tested audiometrically . It was characterised by early onset (65% under 18 months) male preponderance and large central tubotympanic perforations . Measles, respiratory infections, swimming and malnutrition were identified as aetiological factors amenable to intervention . Proteus and pseudomonas were the principle aerobes isolated from ear pus and gentamicin the only antibiotic tested to be effective against them . However although a prospective therapeutic trial demonstrated a significantly improved outcome after aural toilet, no additional benefit was imparted by concurrent ototopical boric acid or aminoglycoside solution or oral antianaerobic clindamycin . Parental tuition in aural cleaning, avoidance of ear water entry, nose blowing and breathing will yield a good result in up to 60% of children in half of whom tympanic healing occurred.

S Afr Med J, 1986 Oct 11, 70(8), 455 - 60
Comparison of cefixime and co-trimoxazole in acute uncomplicated urinary tract infection . A double-blind general practice study; Levenstein J et al.; Five hundred and twenty-eight patients with presumptive acute uncomplicated urinary tract infection (UTI) were randomly assigned to receive cefixime 400 mg once daily, cefixime 200 mg twice daily or co-trimoxazole 2 tablets twice a day for 10 days; 477 completed at least 5 days of therapy . Of the patients 342 (65%) had positive baseline urine cultures, yielding 353 pathogens . A microbiological response was determined for 280 pathogens (79%), eradication being observed in over 94% of isolates; 153 pathogens (43%) were sensitive to both cefixime and co-trimoxazole and eradication was observed in over 96% of cases . Clinical response correlated well with microbiological response . The incidence of diarrhoea and stool changes was higher (P less than 0.005) in the patients who received cefixime once daily than in the other groups . There was a significantly higher incidence of stool changes with cefixime twice daily than with co-trimoxazole (P less than 0.05), but these did not necessitate discontinuation of therapy . Nausea was commoner with co-trimoxazole (P less than 0.05) . The majority of pathogens isolated were Escherichia coli, Proteus mirabilis and staphylococci . Approximately 24% of E . coli were resistant in vitro to co-trimoxazole (P less than 0.005) . Cefixime 200 mg twice daily is an effective and safe alternative to co-trimoxazole in the management of acute uncomplicated UTI.

Biochemistry, 1986 Oct 7, 25(20), 5987 - 91
Computer-aided model-building strategies for protein design; Pabo CO et al.; Model-building strategies for protein modification and design are developed . These strategies emphasize simple geometric aspects of protein structure, use local coordinate systems defined at particular residues, and systematically consider a large number of alternative sequences and conformations . We have written a computer program, PROTEUS, to implement these search methods . PROTEUS has been used to find positions where disulfide bonds could be added to the N-terminal domain of the lambda repressor and to predict how a loop on the surface of repressor could be shortened.

J Clin Lab Immunol, 1986 Oct, 21(2), 93 - 6
Response of bacterial antigen in palmoplantar pustulosis; Ishibashi A et al.; Motilities of leukocytes in response to bacterial antigens or sera were examined in tissues from patients with palmoplantar pustulosis (PPP) . Accelerated migration towards bacterial antigens was detected in the case of Staphylococcus epidermidis in 9 of 19 patients, to Propionibacterium acnes in 5 of 19, to Proteus mirabilis and Staphylococcus aureus in 3 of 19, while no acceleration was found in neutrophils from the controls . A significantly accelerated migration of normal lymphocytes in response to both patients' and control sera was nil . Inhibition of migration of guinea pig peritoneal exudate cells mixed with lymphocytes from PPP patients was detected in 12 out of 14 patients with the addition of S . epidermidis antigen and 8 of 14 with the addition of P . acnes antigen, while no such inhibition was detected in all 7 controls . The accelerated migration of neutrophils and inhibition of macrophages may participate in the development of PPP.

J Antimicrob Chemother, 1986 Oct, 18 Suppl C, 243 - 53
Resistance to antibiotics at medical centres in different parts of the world; O'Brien TF; The diameters of the zones of inhibition of consecutive clinical isolates around antibiotic susceptibility test discs at medical centres in different parts of the world were computer filed and analysed by a series of programs that evaluate test quality and compare results . Percentages of isolates resistant to ampicillin at 18 centres ranged from 16 to 73 for Escherichia coli and from 3 to 56 for Proteus mirabilis . Percentages resistant to chloramphenicol ranged from 2 to 48 for E . coli, from 5 to 52 for Klebsiella pneumoniae, and from 8 to 67 for Serratia marcescens . Gentamicin resistance did not exceed 4% at any of 18 centres and was less than 1 at 14 of them for isolates of E . coli, while K . pneumoniae showed less than 2% resistance at six centres but averaged 22% at another eight . Multi-resistant isolates were ten-fold more frequent at eight centres than at the remaining six . Too few centres were sampled to characterize individual countries except in the United States where resistance seemed generally less prevalent.

Lab Anim Sci, 1986 Oct, 36(5), 486 - 91
A model for experimental bacterial cystitis in the dog; Senior DF et al.; To induce an experimental model of bacterial cystitis, ten preconditioned dogs underwent bladder irritation with a 0.1% alcoholic solution of salicylic acid followed in 24 hours by an intravesicular infusion of Proteus mirabilis . The dogs were observed for the following 14 days (five dogs) and 17 days (five dogs) and then euthanatized and necropsied . Tenesmus, dysuria, hematuria, and pollakiuria occurred in all dogs, but the severity of these signs diminished with time . The total white cell, neutrophil, and monocyte counts in the peripheral blood increased and urinalysis results were consistent with infection and severe inflammation . The infection persisted for the duration of the study, although the average quantitative bacterial count in urine progressively declined . No changes occurred in the measured clinical chemistry values . Severe inflammation was present on gross examination of the bladder and microscopic examination of the bladder, prostate, and renal pelvis . Less severe inflammation was present on microscopic examination of the urethra and ureter.

Can J Microbiol, 1986 Oct, 32(10), 772 - 8
Histochemical and biochemical urease localization in the periplasm and outer membrane of two Proteus mirabilis strains; McLean RJ et al.; Proteus mirabilis, a gram-negative bacillus, is often implicated in the formation of infectious kidney stones . As ureolytic activity of this organism is thought to play a major role in its pathogenesis, we adapted our recently described urease localization technique to visualize urease activity in vivo . Urease activity was ultrastructurally localized in two clinically isolated P . mirabilis strains by precipitating the enzymatic reaction product (ammonia) with sodium tetraphenylboron . Subsequent silver staining of the cells revealed urease activity to be predominantly associated with the periplasm and outer membranes of each strain . Biochemical measurements of urease activity in P . mirabilis cell fractions correlated well with histochemical observations in that the majority of urease activity was associated with the periplasm . Membrane-bound urease activity of these strains was associated mainly with the peptidoglycan in the detergent-insoluble (outer membrane) fraction.

J Bacteriol, 1986 Oct, 168(1), 431 - 3
Expression and regulation of the penicillin G acylase gene from Proteus rettgeri cloned in Escherichia coli; Daumy GO et al.; The penicillin G acylase genes from the Proteus rettgeri wild type and from a hyperproducing mutant which is resistant to succinate repression were cloned in Escherichia coli K-12 . Expression of both wild-type and mutant P . rettgeri acylase genes in E . coli K-12 was independent of orientation in the cloning vehicle and apparently resulted from recognition in E . coli of the P . rettgeri promoter sequences . The P . rettgeri acylase was secreted into the E . coli periplasmic space and was composed of subunits electrophoretically identical to those made in P . rettgeri . Expression of these genes in E . coli K-12 was not repressed by succinate as it is in P . rettgeri . Instead, expression of the enzymes was regulated by glucose catabolite repression.

J Wildl Dis, 1986 Oct, 22(4), 547 - 56
Renal function and fractional clearances of American river otters (Lutra canadensis); Hoover JP et al.; The finely lobulated kidneys of American river otters (Lutra canadensis) are not visualized on plain abdominal radiographs . Similar values for blood urea nitrogen (BUN), creatinine, and uric acid were obtained on different analytical systems used in 1984 and 1985 . The mean +/- SD for measured plasma osmolalities (309.80 +/- 8.86 mOsmol/kg) of otters in 1985 was significantly (P less than 0.01) less than that of calculated serum osmolalities in the same 1985 specimens (321.61 +/- 5.64 mOsmol/kg) and in 1984 specimens (322.20 +/- 7.16 mOsmol/kg) . Urine specific gravities and osmolalities were highly correlated (r = 0.92) . On routine urinalysis, protein and bilirubin were frequent chemical findings, and urobilinogen was present in all urine samples . White and red blood cells and epithelial cells were frequent findings on urine microscopic examinations . Proteus mirabilis was cultured from four of four female otters with genitourinary infections . The mean +/- SD creatinine values for paired serum and urine samples (n = 13) were serum creatinine (Scr) 0.66 +/- 0.09 mg/dl and urine creatinine (Ucr) 186.9 +/- 55.6 mg/dl . Corresponding values for serum electrolytes (Se) and urine electrolytes (Ue) yielded mean +/- SD calculated renal fractional clearances (FC = Ue/Se x Scr/Ucr) of sodium 9.65 +/- 5.81 x 10(-4), potassium 4.15 +/- 2.01 x 10(-2), chloride 10.81 +/- 5.33 x 10(-4), calcium 4.52 +/- 4.46 x 10(-3), and phosphate 6.58 +/- 3.44 x 10(-3).

Isr J Med Sci, 1986 Oct, 22(10), 745 - 52
Serological cross-reactions between Rickettsia typhi, Proteus vulgaris OX19, and Legionella bozemanii in a series of febrile patients; Sompolinsky D et al.; The sera of 19 patients with a febrile disease of undetermined etiology were positive in the indirect immunofluorescence assay (IFA) to Legionella bozemanii serogroup 1 (Lb) and Rickettsia typhi (Rt) . To both antigens, high titers of IgG-class and IgM-class antibodies were demonstrated . Several of the patients also had positive IFA and Weil-Felix reactions to Proteus vulgaris OX19 (PX 19) . A sharp reduction of the serotiters to all three antigens was achieved by absorption of the sera with any one of the organisms . We demonstrated, by crossed immunoelectrophoresis with an Lb extract and a rabbit reference anti-Lb serum, that a heat-stable and trypsin-resistant antigen (antigen no . 1) reacted consistently with patients' sera that had been incorporated into an intermediate gel . Sera from five patients with high-titer IFA reactions to Rt, but no reaction to Lb, showed no interaction with antigen no . 1.

Infect Immun, 1986 Oct, 54(1), 142 - 8
Characterization of a protein from normal human polymorphonuclear leukocytes with bactericidal activity against Pseudomonas aeruginosa; Hovde CJ et al.; Purification of a bactericidal protein (BP) from the cytoplasmic granules of normal human polymorphonuclear leukocytes (PMN) with activity against Pseudomonas aeruginosa is described . Bactericidal activity from acid extracts of a mixed granule population was purified 175-fold by a two-step chromatographic procedure . The first step, dye-ligand affinity chromatography with Matrex-Gel Orange A, was followed by cation-exchange chromatography with Bio-Rex 70 resin, and this combination routinely gave a yield near 80% . Only one peak of bactericidal activity against P . aeruginosa type I was found after each chromatographic step . Characterization of BP showed a single band with an apparent molecular weight of 55,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . Purified BP was most active against the six strains of P . aeruginosa tested and against Escherichia coli B (a deep rough mutant) . Purified BP killed 5 X 10(6) CFU of P . aeruginosa type I per ml at a concentration of 60 to 80 ng/ml . Proteus mirabilis and Staphylococcus aureus were both resistant to the bactericidal activity of BP . BP was shown to be glycosylated by periodic acid staining after gel electrophoresis and to have an isoelectric point near 7.5 by chromatofocusing . The amino acid composition of BP is presented.

Am J Med, 1986 Oct, 81(4), 607 - 11
Delayed cutaneous hypersensitivity reactions in hemophiliac subjects treated with factor concentrate; Brettler DB et al.; Cutaneous delayed-type hypersensitivity was measured using the Multitest CMI in a group of 97 patients with hemophilia who were enrolled in the New England Area Comprehensive Clinic . The Multitest CMI is a multipuncture system that dispenses seven test antigens including tetanus, diphtheria, Streptococcus, Proteus, tuberculin, Candida, and Trichophyton, and a glycerine-saline control solution . A reaction was considered positive if there was induration of at least 2 mm . If the results of one or more skin tests were positive, the patient was considered to have a positive reaction . Of the 83 patients with severe or moderate hemophilia A, 51 percent had negative reactions . No study control subject and only one patient with hemophilia B had a negative reaction . The 42 patients with hemophilia A who showed no reaction used a significantly greater amount of factor VIII concentrate than did those with hemophilia A who responded positively (1,960 units/kg per year versus 1,360 units/kg per year; p less than 0.025) and included a higher percent of patients who had seropositive results for human T lymphotropic virus type III (HTLV-III) antibody (89 percent versus 69 percent, p less than 0.025).

Infect Immun, 1986 Oct, 54(1), 43 - 9
Identification and characterization of a uroepithelial cell adhesin from a uropathogenic isolate of Proteus mirabilis; Wray SK et al.; Proteus mirabilis is a frequent cause of urinary tract infections in rehabilitation hospitals and among persons with structural abnormalities of the urinary tract . Adherence to uroepithelial tissues may be an important virulence determinant in these infections because most Proteus strains adhere to desquamated uroepithelial cells . To identify the adherence factor responsible for this phenomenon, we sheared outer membrane material from 35SO4-radiolabeled bacteria and allowed it to bind to uroepithelial cells . Following sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the major adherence element was a protein with an apparent molecular weight of 17,500 and was provisionally designated as the uroepithelial cell adhesin . This adhesin was purified by heat shock and gel filtration on Sepharose CL-4B . After purification, the adhesin was seen assembled as long, flexible rods by electron microscopy . The N-terminal amino acid sequence of the subunit had limited homology with that of the K99 fimbriae of Escherichia coli.

Br Med J (Clin Res Ed), 1986 Sep 13, 293(6548), 683 - 5
The Proteus syndrome: the Elephant Man diagnosed; Tibbles JA et al.; Sir Frederick Treves first showed Joseph Merrick, the famous Elephant Man, to the Pathological Society of London in 1884 . A diagnosis of neurofibromatosis was suggested in 1909 and was widely accepted . There is no evidence, however, of cafe au lait spots or histological proof of neurofibromas . It is also clear that Joseph Merrick's manifestations were much more bizarre than those commonly seen in neurofibromatosis . Evidence indicates that Merrick suffered from the Proteus syndrome and had the following features compatible with this diagnosis: macrocephaly; hyperostosis of the skull; hypertrophy of long bones; and thickened skin and subcutaneous tissues, particularly of the hands and feet, including plantar hyperplasia, lipomas, and other unspecified subcutaneous masses.

Can J Microbiol, 1986 Sep, 32(9), 719 - 22
Effect of radiation dose on the recovery of aerobic and anaerobic bacteria from mice; Brook I et al.; The presence of aerobic and anaerobic bacteria in the blood, spleen, and liver was investigated in mice that were exposed to 7, 8, 9, or 10 Gy 60Co radiation . Microorganisms were detected more often in animals exposed to higher doses of radiation . The number of mice that were culture positive and the number of isolates in one site increased with increasing dose . Bacteria were recovered in mice killed at various times after radiation, in 3 of 100 mice exposed to 7 Gy, in 13 of 100 irradiated with 8 Gy, in 23 of 90 exposed to 9 Gy, and in 34 of 87 irradiated with 10 Gy . The predominant organisms recovered were Escherichia coli, anaerobic Gram-positive cocci, Proteus mirabilis, Staphylococcus aureus, and Bacteroides spp . Escherichia coli and anaerobes were more often isolated in animals exposed to 10 Gy, while S . aureus was more often recovered in those irradiated with 9 Gy . These data demonstrate a relationship between the dose of radiation and the rate of infection due to enteric aerobic and anaerobic bacteria.

J Antimicrob Chemother, 1986 Sep, 18(3), 365 - 73
Antibacterial interaction of cefuroxime and serum from uraemic patients; Minelli Bertazzoni E et al.; A strain of Proteus rettgeri was exposed to combinations of subinhibitory concentrations of cefuroxime and serum from normal subjects and from uraemic patients (on conservative and on haemodialysis treatment) and the antibacterial activity of these was determined . Cefuroxime and normal serum gave a synergistic effect . Compared with controls, the combination of cefuroxime and uraemic serum from patients on conservative treatment showed a reduced inhibitory effect . The antibacterial activity of the combination including serum from dialysis patients was similar to that with normal serum; however, this was due to the greater activity of serum from these patients than of serum from normal subjects, and no synergistic interaction with cefuroxime was demonstrated . An alteration of bacterial growth was observed in the presence of uraemic serum . No clearcut correlation was found between the serum concentrations of uraemic metabolites and the antibacterial activity of the combination.

Int J Zoonoses, 1986 Sep, 13(3), 153 - 7
Urinary tract pathogens common amongst the inhabitants of a state capital, south west Nigeria; Adeyeba OA et al.; In the course of a survey of urine samples collected over a period of 12 months from male and female patients of different socio-economic backgrounds in Ibadan, Esch . coli, Klebsiella spp . Pseudomonas aeruginosa, Proteus spp., Staphylococcus aureus and Candida albicans were the most common pathogens isolated . The bacteria were commonly sensitive to the cephalosporins, kanamycin, ampicillin and cotrimoxazole in decreasing order of sensitivity.

Jpn J Antibiot, 1986 Sep, 39(9), 2407 - 20
{Basic and clinical studies of cefotiam in neonates and premature infants}; Iwata S et al.; The effect of cefotiam (CTM) on neonates and premature infants was examined in basic and clinical studies . Minimum inhibitory concentrations of CTM against 190 clinically isolated strains kept by this department were investigated . This drug was found to have a strong antibacterial effect against Escherichia coli, Klebsiella spp., Proteus mirabilis and Streptococcus agalactiae, Staphylococcus aureus and Staphylococcus epidermidis, although some strains were resistant . The CTM was given to 0-3, 4-7, and greater than or equal to 8 day-old premature infants and neonates by intravenous injection at the dose of 20 mg/kg, and we studied changes in serum CTM levels over time . Mean serum CTM levels were 62.3 micrograms/ml at 15 minutes and 16.4 micrograms/ml at 6 hours after the injection, with the half-life of 3.6 hours, for the 0-3 day-old premature infants . They were 38.5 micrograms/ml at 15 minutes and 10.1 micrograms/ml at 6 hours, with the half-life of 2.9 hours, for the 0-3 day-old neonates . Those levels were 22.5 micrograms/ml at 15 minutes and 2.9 micrograms/ml at 6 hours, with the half-life of 1.9 hours, for the 4-7 day-old neonates, and 51.8 micrograms/ml at 15 minutes and 1.0 micrograms/ml at 6 hours, with the half-life of 1.1 hours, for the greater than or equal to 8 day-old neonates . The CTM was given to 0-3 and greater than or equal to 8 day-old premature infants and neonates by 1-hour intravenous drip infusion at the dose of 20 mg/kg, and changes in serum CTM levels after the infusion were followed . The 0-3 day-old premature infant (there was only one subject) had a peak serum CTM level of 21.0 micrograms/ml 1 hour after the start of the infusion (that is, at the time of its completion), with the level decreased to 8.6 micrograms/ml at 7 hours and the half-life was 5.4 hours . The mean peak serum CTM level in 0-3 day-old neonates were 36.7 micrograms/ml at 1 hour, which decreased to a mean of 7.0 micrograms/ml at 7 hours; the half-life was 2.3 hours.(ABSTRACT TRUNCATED AT 400 WORDS)

Immun Infekt, 1986 Sep, 14(5), 188 - 90
{A simple enzyme assay for the simultaneous determination of penicillin derivatives and clavulanic acid in biological fluids}; Cullmann W et al.; A simple enzymatic assay for simultaneous determinations of amino-/ureidopenicillins and clavulanic acid concentrations in various body fluids is described; no pretreatment of the samples is required . The assay is based on the competitive inhibition of the chromogenic compound Padac by clavulanic acid in the presence of Proteus vulgaris beta-lactamase . Detection limit for clavulanic acid amounts 0.02 mg/l . Interferences with other antibiotics such as aminoglycosides, macrolides, quinolones etc . can be ruled out.

J Clin Lab Immunol, 1986 Sep, 21(1), 17 - 22
Antigen specific stimulation of immune responses during long-term repeated skin testing with multiple antigens; Lesourd BM et al.; Delayed-type hypersensitivity (DTH) skin testing as an assay of immune competence is a widely used technique . Accordingly, clinical situations frequently occur which require that skin tests be performed many times on the same patient . In the present investigation, in vivo and in vitro immune responses were studied over a 7-month period in 22 normal human volunteers, each of whom were skin tested 6 times at monthly intervals with multiple antigens . Patterns of responses to the 7 specific skin test antigens observed during repeated skin testing in vivo indicated non-significant, but detectable, declines in skin test reactivity to tetanus, diphtheria and streptococcus antigens and increases in reactivity to trichophyton, tuberculin, candida and proteus antigens . In vitro lymphocyte transformation assays (LTAs) of cell-mediated immune (CMI) activities revealed that repeated skin testing, e.g., 3-5 serial skin tests, induced significantly increased levels of CMI reactions with 3 of the 4 skin test antigens used as challenge antigens . Since no significant changes in in vitro CMI responses were detected using 3 control "non-skin test" antigens, the effects observed were confirmed to be antigen specific . Increased IgG antibody responses were detected for only the toxoid antigens during the skin testing period . For the group of 22 normal volunteers, positive statistical correlations were not observed between any individual skin test antigen and the immune reactions assayed specifically for that antigen, including DTH responses and levels of circulating antigen-specific antibodies . Short term differences were detected between tetanus, diphtheria and streptococcus antigens in their LTA response patterns.(ABSTRACT TRUNCATED AT 250 WORDS)

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1986 Aug, 262(2), 208 - 19
Properties of an inducible beta-lactamase from Proteus vulgaris; Cullmann W et al.; The inducible beta-lactamase of the clinical Proteus vulgaris isolate 4917/81 was highly purified by column chromatography and by FPLC (cation ion exchange column) . Molecular weight of the enzyme amounted 33,000 daltons, as revealed by SDS-electrophoresis . The enzyme was not inhibited by p-chloromercuribenzoate, but by low concentrations of oxacillin and clavulanic acid . The enzyme inactivated not only penicillin derivatives (including ureidopenicillins), but also first-generation cephalosporins and above all oxime-cephalosporins such as cefuroxime, cefotaxime and related derivatives . Turnover rates of these agents were mainly influenced by the nature of substitution in 3' position of the cephalosporin nucleus . Breakdown was not detectable in compounds which were substituted in 6 alpha or 7 alpha position, respectively . The enzyme proved to be very sensitive to the nature of 6 alpha or 7 alpha substituent, as revealed by the study of enzyme kinetics; no turnover could be detected for the penem Sch29 482, imipenem, latamoxef, and aztreonam.

Antibiot Med Biotekhnol, 1986 Aug, 31(8), 606 - 10
{Effect of prodigiozan, levamisole and methyluracil on the course of an experimental infection and primary immune response}; Riabchinskaia LA et al.; The effect of prodigiosan, levamisol and methyluracil on the process of experimental sepsis caused by Proteus was studied comparatively on mice, and the primary immune response was studied on intact animals treated with prednisolone, cyclophosphan or azathioprin . It was shown that prodigiosan was a more active stimulator of antiinfectious resistance of the intact animals than levamisol or methyluracil . Its effect was evident with administration before the infection, while the effect of levamisol or methyluracil was evident in administration after the infection . When used prophylactically, prodigiosan increased the average life-span of the mice given prednisolone, had no effect on the infection process in the presence of cyclophosphan and increased the antibiotic therapy efficiency at the background of either prednisolone or cyclophosphan . Administration of prodigiosan after the infection without the use of antibiotics was not efficient in immunosuppression, whereas in combination with levamisol it increased the tolerance to the infection at the background of cyclophosphan . When used for the treatment purposes, levamisol had no effect on survival of the animals . However, it increased the average life-span of the intact mice also at the background of prednisolone . Prodigiosan stimulate the primary immune response in the intact animals at the background of azathioprin or cyclophosphan but not prednisolone . Levamisol increased the number of the antibody-producing cells (APC) in the intact animals in some experiments . At the background of azathioprin it had no effect on the number of the APC and at background of prednisolone or cyclophosphan it even lowered their number.(ABSTRACT TRUNCATED AT 250 WORDS)

Am J Med Sci, 1986 Aug, 292(2), 87 - 91
Relationships between human blood groups, bacterial pathogens, and urinary tract infections; Ratner JJ et al.; Blood groups of 137 patients with acute pyelonephritis and chronic upper tract infection, cystitis, and asymptomatic bacteriuria were compared with those of a normal uninfected control population . In addition, the identified uropathogens were categorized according to the patient's blood group . There was a significant association between the diagnosis of chronic upper tract infection and blood group B as compared with controls (p = less than 0.05, chi 2) . Analysis of the bacterial isolates showed that more patients with blood group B had infections with Pseudomonas sp., Klebsiella pneumoniae, and Proteus sp . than was expected; and fewer patients with blood group A had infections with Pseudomonas than predicted (p = less than 0.05, chi 2) . There was an increased number of patients in blood group AB with infections caused by Escherichia coli and Klebsiella pneumoniae . These results suggest that an individual's blood group may be a significant factor in the host-response to bacterial invasion and influence the development of infection with certain gram-negative bacilli.

Am J Physiol, 1986 Aug, 251(2 Pt 1), C153 - 8
Calcium and initial surface binding phase of pinocytosis in Amoeba proteus; Prusch RD; The uptake of membrane-bound solute and external medium by bulk-phase pinocytosis in Amoeba proteus is influenced by the level of Ca2+ in the external medium . Increasing external Ca2+ to approximately 10(-4) M increases pinocytotic intensity, while increases in Ca2+ above this level decrease the intensity of pinocytosis . The initial interaction of pinocytotic inducers and Ca2+ at the surface of Amoeba proteus was therefore examined . Alcian blue and Na+, both inducers of pinocytosis, differ in the manner with which they associate with the amoeba surface, suggesting the possibility of different pinocytosis-inducing sites on the amoeba surface . Low levels of external Ca2+ in the range of 3 X 10(-5) to 1.5 X 10(-4) M increase the amount of cationic inducer associated with the cell surface while, at the same time, decreasing anion association with the cell surface . It is suggested that Ca2+ influences ion association with the cell surface by controlling the availability of negative surface sites, which in turn influences pinocytotic intensity.

J Cell Sci, 1986 Jul, 83, 23 - 35
Two-directional pattern of movements on the cell surface of Amoeba proteus; Grebecki A; Particles of latex, glass and precipitated Alcian Blue were studied cinematographically on the surface of migrating Amoeba proteus and in the surrounding medium . The majority of the attached and all unattached particles flow steadily forward in the direction of the endoplasmic streaming and cell locomotion . Flow on the surface is faster than in suspension . Some particles stuck on the membrane move backwards from the frontal region . This retrograde transport is slower than the anterograde flow, and the rate decreases further when the particles approach cell regions adhering to the substratum, accurately following the pattern of the withdrawal of ectoplasm in the same zone . Both movements coexist in the same region and retrograde particles may pass anterograde ones at a distance less than their diameter . Transition from forward flow to backward transport occurs just behind the frontal cap, where the new ectoplasm is formed . The anterograde movement is interpreted as reflecting the general forward flow of the laterally mobile fluid membrane components, which become added to the frontal surface of the locomoting cell; the retrograde movement as retraction of membrane components that, externally, are linked to the transported material and, on the cytoplasmic side, to the contractile microfilamentous layer, as is postulated for cap formation in tissue cells.

Postgrad Med J, 1986 Jul, 62(729), 657 - 9
Cushing's syndrome--transitory immune deficiency state?
Wurzburger MI, Prelevic GM, Brkic SD, Vuckovic S, Pendic B.
A 28 year old female patient with Cushing's syndrome due to an adrenal adenoma also suffered from recurrent urinary infections (proteus), tonsillitis (streptococcus), permanent candidiasis and perimandibular abscess (Staphylococcus pyogenes) . Suppression of cellular and humoral immunity was confirmed by in vitro tests . After successful right adrenalectomy the clinical signs of Cushing's syndrome disappeared and no evidence of either bacterial or fungal infection were noted one year postoperatively . Immunological tests showed the restitution of both cellular and humoral immunity . The course of the disease in the patient supports the idea that Cushing's syndrome might be considered as a transitory immune deficiency state.

J Antibiot (Tokyo), 1986 Jul, 39(7), 956 - 65
Therapeutic effect of SF-2103A, a novel carbapenem antibiotic, in combination with cefotaxime, cefoperazone and other cephalosporins; Yoshida T et al.; Combinations of SF-2103A with cefotaxime, cefoperazone or cefazolin showed synergistic efficacy at a wide range of combination ratios against experimental infection in mice due to Proteus vulgaris GN76/C-1, producing type Ic cephalosporinase, Escherichia coli No . 29/36 RGN823, producing type IIIa (TEM-2) penicillinase and E . coli GN206, producing type Ib cephalosporinase . These effects by SF-2103A were greater than those seen with sulbactam . The in vitro and in vivo synergistic activities were roughly correlated . Potent in vivo activity of SF-2103A was related to good pharmacokinetic properties, with blood half-life of 30 minutes and urinary recovery of 55.2% after parenteral administration to rats . Furthermore, SF-2103A was stable to rat kidney homogenate . The high stability of SF-2103A in aqueous and biological media was correlated with the sulfonate group at C-3.

J Antibiot (Tokyo), 1986 Jul, 39(7), 938 - 42
Purification and properties of a beta-lactamase from Proteus penneri; Grace ME et al.; A cephalosporin-hydrolyzing enzyme from strains of Proteus penneri resistant to beta-lactam antibiotics was purified and characterized . The enzyme gave a single protein band on SDS-polyacrylamide gel electrophoresis with a molecular weight of 30,000 . This cephalosporinase has an isoelectric point of 6.8, a pH optimum of 6.5 and a temperature optimum of 45 degrees C . The enzyme hydrolyzed cephaloridine, cephalothin, cefuroxime, and cefotaxime more rapidly than penicillins . The relative rate, with cephaloridine as 100, were: cephalothin, 50; cefuroxime, 93; cefotaxime, 48; ceftriaxone, 23; cefoperazone, 11; benzylpenicillin, 3; ampicillin, 9; and carbenicillin, less than 1 . Cephamycins had low affinities for the enzyme . However, clavulanic acid and sulbactam, with high affinities for the enzyme, were inhibitors of this enzyme.

Mikrobiyol Bul, 1986 Jul, 20(3), 176 - 83
{Escherichia coli, coliform bacteria, Pseudomonas aeruginosa, Proteus and Staphylococcus aureus carriers among children 5-15 years old}; Yumul C et al.; The throat swap cultures of 250 children between 5-15 years ages examined for the microorganisms, E . coli, Coliform, Protus, Ps . aeruginosa and S . aureus . 66 (26.4%) E . coli, 64 (25.6%) S . aureus, 9 (3.6%) Coliform, 3 (1.2%) Ps . aeruginosa, 2 (0.2%) Proteus organisms were isolated from throat swaps cultures of 144 (57.6%) children . 106 (42.4%) children had contained normal oral flora . S . aureus and E . coli strains were tested using disk method for the sensitivity of some antibiotics . S . aureus strains were resistant 12.5% to gentamycin, 9.4% to cefoperazone and (1% to cefazolin, 48.4% to lincomycin and 87.5% to ampicillin . E . coli strains were resistant 42% to gentamycin, 37% to cefoperazone and 74% to cefazolin.

Am J Trop Med Hyg, 1986 Jul, 35(4), 840 - 4
The sensitivity of various serologic tests in the diagnosis of Rocky Mountain spotted fever; Kaplan JE et al.; Sensitivity indices for various serologic tests in the diagnosis of Rocky Mountain spotted fever (RMSF) were determined from RMSF surveillance data collected at the Centers for Disease Control (CDC) during 1981-1984 . During these 4 years, a total of 4,141 cases of RMSF in the U.S . were reported to CDC . Case report forms, which include information on dates and results of serologic testing, were received for 3,567 of these cases; 1,774 were laboratory-confirmed according to criteria published previously by CDC . Sensitivity indices for the Weil-Felix (Proteus OX-19, OX-2), indirect fluorescent antibody (IFA), latex agglutination (LA), complement fixation (CF) and indirect hemagglutination (IHA) tests were examined by analyzing cases confirmed by other means, in which data concerning the test in question were available . Analysis of serum pairs for a 4-fold or greater increase in antibody titer or a minimum diagnostic titer indicated high sensitivity indices for IHA (96%) and IFA (94%), but lower sensitivity indices for OX-19 (70%), OX-2 (47%), CF (63%) and LA (71%) . IFA and IHA appear to be the most sensitive serologic tests currently in use for the diagnosis of RMSF.

Arch Biochem Biophys, 1986 Jul, 248(1), 71 - 9
Interaction between pyridine adenine dinucleotides and bovine liver catalase: a chromatographic and spectral study; Jouve HM et al.; Two different fractions were present in crystalline bovine liver catalase, and could be resolved using dye-ligand affinity chromatography with Red-A Matrex gel containing Procion HE 3B . The major part (alpha) was not adsorbed on this gel . The second fraction (beta) was firmly adsorbed to the gel, and could be eluted either by high salt or by NADPH in the micromolar range . Elution of catalase beta was also obtained with NADH, NADP+, and ADP at higher concentration . Fractions alpha and beta displayed no detectable difference in specific activity, stability to heat, and light absorption data . It is suggested that the difference in behavior between alpha and beta is related to the binding of NADPH to the mammalian catalase {H . N . Kirkman and G . F . Gaetani (1984) Proc . Natl . Acad . Sci . USA 81, 4343-4347}, and that the beta fraction corresponds to the enzyme molecules that have at least one free site for NADPH binding . Modifications of catalase molecules in the presence of dithioerythritol (DTE) were examined using light absorption and EPR data . Thiol induced changes that corresponded to the formation of catalase complex II . They were partially reversed by NADPH at very low level, and the dinucleotide appeared to be oxidized in this process . DTE-treated bovine catalase was totally adsorbed on the Red-A Matrex columns, and could be eluted as fraction beta . Similar spectral changes in the presence of DTE and NADPH were displayed by a bacterial catalase from Proteus mirabilis . This enzyme was also able to oxidize NADPH, but was not adsorbed by Red-A Matrex . This work suggests that dye-affinity chromatography provides a very convenient tool for isolating dinucleotide-depleted catalase from bovine liver, facilitating further study of the physiological function of this cofactor within the enzyme.

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