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 circulatio