Eur J Clin Microbiol Infect Dis, 2004 Nov, 23(11), 818 - 24 Epub 2004 Nov. Identification and immunoreactivity of proteins released from Streptococcus agalactiae; Fluegge K et al.; The aim of the present study was to identify released proteins of Streptococcus agalactiae and to investigate their immunoreactivity with human sera to determine whether such proteins might be viable as carrier proteins in conjugate vaccines . Infections with S . agalactiae are the leading cause of sepsis and meningitis in neonates . Vaccination of women of childbearing age would be a desirable alternative to intrapartum antibiotic prophylaxis, but factors that mediate S . agalactiae invasive disease and virulence are poorly defined . Capsule-based vaccines have shown only low immunogenicity to date, and interest has shifted towards S . agalactiae proteins, either as candidate vaccine antigens or as carrier proteins for serotype-specific S . agalactiae polysaccharides . In this study, some major released proteins of S . agalactiae could be identified, including molecules known to be present on the surface of bacterial cells but not previously described as released proteins, such as CAMP factor, a phosphocarrier protein, aldolase, enolase, PcsB, and heat-shock protein 70 . Serotype-specific differences in the protein patterns of extracellular products and immunoreactivity with human sera could be detected by SDS-PAGE and Western blot . The identification of unexpected released proteins may indicate secondary functions for these proteins . In addition, the widespread immunoreactivity of these proteins with human sera as shown by Western blot indicates that released proteins may be promising candidates as carrier proteins in conjugate vaccines. J Bacteriol, 2004 Nov, 186(21), 7100 - 11 Four proteins encoded in the gspB-secY2A2 operon of Streptococcus gordonii mediate the intracellular glycosylation of the platelet-binding protein GspB; Takamatsu D et al.; Platelet binding by Streptococcus gordonii strain M99 is mediated predominantly by the cell surface glycoprotein GspB . This adhesin consists of a putative N-terminal signal peptide, two serine-rich regions (SRR1 and SRR2), a basic region between SRR1 and SRR2, and a C-terminal cell wall anchoring domain . The glycosylation of GspB is mediated at least in part by Gly and Nss, which are encoded in the secY2A2 locus immediately downstream of gspB . This region also encodes two proteins (Gtf and Orf4) that are required for the expression of GspB but whose functions have not been delineated . In this study, we further characterized the roles of Gly, Nss, Gtf, and Orf4 by investigating the expression and glycosylation of a series of glutathione S-transferase-GspB fusion proteins in M99 and in gly, nss, gtf, and orf4 mutants . Compared with fusion proteins expressed in the wild-type background, fusion proteins expressed in the mutant strain backgrounds showed altered electrophoretic mobility . In addition, the fusion proteins formed insoluble aggregates in protoplasts of the gtf and orf4 mutants . Glycan detection and lectin blot analysis revealed that SRR1 and SRR2 were glycosylated but that the basic region was unmodified . When the fusion protein was expressed in Escherichia coli, glycosylation of this protein was observed only in the presence of both gtf and orf4 . These results demonstrate that Gly, Nss, Gtf, and Orf4 are all involved in the intracellular glycosylation of SRRs . Moreover, Gtf and Orf4 are essential for glycosylation, which in turn is important for the solubility of GspB. J Bacteriol, 2004 Nov, 186(21), 7091 - 9 Rgg regulates growth phase-dependent expression of proteins associated with secondary metabolism and stress in Streptococcus pyogenes; Chaussee MA et al.; The transcriptional regulatory protein Rgg coordinates amino acid catabolism and virulence factor expression in Streptococcus pyogenes . We used a proteomic approach to compare cytoplasmic proteins isolated from S . pyogenes wild-type strain NZ131 (serotype M49) to proteins isolated from an rgg mutant strain during the exponential and stationary phases of growth . Proteins were separated by two-dimensional gel electrophoresis, and 125 protein spots of interest were identified by tandem mass spectrometry . Comparative analysis of proteins isolated from the isogenic strains revealed that growth phase-associated regulation of enzymes involved in the metabolism of arginine (ArcABC), histidine (HutI), and serine (SdhA) was abrogated in the rgg mutant strain, which synthesized the proteins in the exponential phase of growth . In contrast, the enzymes were detected only among wild-type proteins isolated from organisms in the stationary phase of growth . The differences in protein composition were correlated with previously described metabolic changes . In addition, proteins associated with thermal and oxidative stress responses, including ClpE and ClpL, were present in samples isolated from the rgg mutant strain but not in samples isolated from the wild-type strain . The rgg mutant strain was more tolerant to elevated temperature and puromycin than the wild-type strain; however, the mutant was less tolerant to paraquat . We concluded that Rgg is a global regulatory factor that contributes to growth phase-dependent synthesis of proteins associated with secondary metabolism and oxidative and thermal stress responses. J Antimicrob Chemother, 2004 Dec, 54(6), 1148 - 51 Epub 2004 Oct 15. Bactericidal activity of amoxicillin against non-susceptible Streptococcus pneumoniae in an in vitro pharmacodynamic model simulating the concentrations obtained with the 2000/125 mg sustained-release co-amoxiclav formulation; Sevillano D et al.; OBJECTIVES: To investigate the bactericidal activity against Streptococcus pneumoniae of simulated amoxicillin serum concentrations obtained in humans after 2000/125 mg sustained-release (SR) and 875/125 mg co-amoxiclav administered twice and three times a day, respectively . METHODS: An in vitro computerized pharmacodynamic simulation was carried out and colony counts were determined over 24 h . Ten strains non-susceptible to amoxicillin (four of them exhibiting an MIC of 4 mg/L, five strains with an MIC of 8 mg/L and one strain with an MIC of 16 mg/L) were used . RESULTS: With amoxicillin 2000 mg, an initial inoculum reduction >99.99% was obtained for strains with an MIC of 4 mg/L, >/=99% for strains with an MIC of 8 mg/L and 70.6% for the strain with an MIC of 16 mg/L at 24 h sampling time . At this sampling time, no reduction of initial inocula was obtained with amoxicillin 875 mg/8 h for two of the four strains with an MIC of 4 mg/L, three of the five strains with an MIC of 8 mg/L or for the strain with an MIC of 16 mg/L . CONCLUSIONS: The new co-amoxiclav 2000/125 mg SR formulation appears to offer advantages versus previous formulations with respect to bactericidal activity against current amoxicillin non-susceptible strains. Int J Pediatr Otorhinolaryngol, 2004 Nov, 68(11), 1435 - 9 Acute mastoiditis in infancy: the Soroka experience: 1990-2000; Niv A et al.; Acute mastoiditis (AM) is an uncommon but serious complication of acute otitis media (AOM) . In the pre-antibiotic era, AM was seen more frequently than it is today, but it was rare in infants . However, in the last two decades an increase in the incidence of AM in infancy has been reported in the literature . During the years 1990-2002, we treated 113 patients with 128 episodes of AM; of them, 24 were infants (median age 6 months; 18 males) who suffered from 26 episodes of AM . Twenty developed AM as a complication of their first episode of AOM . One of the four infants with a prior history of AOM suffered from common variable immunodeficiency . A significant increase in the incidence of AM in infants was recorded during the study period (P = 0.01) . The most common presenting clinical signs were post-auricular swelling and fever >38 degrees C (77% and 77%, respectively, of all patients) . Seventeen episodes of AM were not treated with prior antibiotics . Tympanocentesis was performed in all episodes of AM . Middle ear fluid culture was positive in 17 (65%) of the 26 AM episodes . The most common pathogens cultured were Streptococcus pneumoniae (10 infants, 58% of all pathogens, 3/10 intermediately susceptible to penicillin) followed by Streptococcus pyogenes (4, 23%), non-typable H . influenzae (2, 12%) and S . aureus (1, 6%) . Temporal bone CT showed bone destruction in 14 patients; 3 infants had subperiosteal abscesses and 3 lateral sinus thrombosis . Ten infants underwent mastoid surgery due to non-resolution of symptoms and signs with antibiotic therapy . Eight underwent cortical mastoidectomy with two patients undergoing ventilation tube introduction only . The remainder of the infants healed with conservative treatment . Conclusions: (1) A significant increase in the incidence of AM in infants was recorded over the last decade, though a specific reason for this trend remains uncertain; (2) Most of the cases of AM followed the infant's initial AOM episode, and most of the infants had not received prior antibiotic therapy; (3) The clinical signs and symptoms of AM were more severe in infants than in older patients; (4) While S . pneumonia was the most common pathogen isolated in middle ear fluid cultures, the involvement of S . pyogenes in AM was higher than that reported in AOM. Microbes Infect, 2004 Nov, 6(13), 1156 - 62 The fibronectin-binding capacity and host cell adherence of Streptococcus pyogenes strains are discordant with each other; Edwards ML et al.; Surface exposed fibronectin-binding proteins (FBPs) play an important role in the adherence of Streptococcus pyogenes (group A streptococcus, GAS) to host cells . This pathogen expresses numerous FBPs, of which SfbI, SfbII and PrtF2 are major surface exposed FBPs . However, GAS strains differ in the genetic potential to express these proteins . To test whether this difference reflects in differences in fibronectin (Fn) binding, a set of circulating strains previously examined for adherence to host cells was used . The 68 distinct strains were isolated from throat, skin and blood . They were analyzed for (a) the presence of genes for SfbI, SfbII and PrtF2 and (b) the extent of Fn binding . The results suggest that strains possessing two or more of the genes for these FBPs bound Fn significantly more than strains possessing none or one of the genes . No correlation between the extent of Fn binding and the tissue site of isolation was found . Furthermore, together with our previous studies on adherence capacity of these GAS strains, we found no correlation between Fn binding ability and the avidity of the strains to adhere to epithelial cells . We suggest that while Fn binding is important for adhesion, for many GAS strains the extent of Fn binding is not the critical determinant of adherence. Clin Infect Dis, 2004 Oct 15, 39(8), 1148 - 54 Epub 2004 Sep 27. An outbreak of conjunctivitis due to a novel unencapsulated Streptococcus pneumoniae among military trainees; Crum NF et al.; BACKGROUND: Bacterial conjunctivitis usually occurs as sporadic cases; outbreaks are uncommon and usually are associated with school campuses . We report an outbreak of Streptococcus pneumoniae conjunctivitis at a military training facility . METHODS: An outbreak investigation was done . Each case of conjunctivitis was evaluated with an assessment tool including demographic and clinical data . Conjunctival swabs were obtained . Pneumococci underwent standard testing, including serotyping with the Quellung reaction, capsular staining, and multilocus sequence typing . Sequence types were compared with previous reported outbreak strains by construction of dendrograms . Carriage rates of S . pneumoniae were determined among previously undiagnosed case patients with conjunctivitis, and a case-control study was performed . Control measures included education to increase hand washing, distribution of alcohol-based hand gel, and prompt treatment of patients with conjunctivitis . RESULTS: During a 6-week period, 92 cases of conjunctivitis occurred among 3500 persons, with an attack rate of 1.75 cases per 100 person-months . Eighty cases (87%) were due to S . pneumoniae; 45 (49%) were confirmed, and 35 (38%) were probable . Ten percent of recruits surveyed carried the outbreak strain . Twenty-two percent self-reported symptoms consistent with conjunctivitis during the outbreak period; sharing washcloths was associated with conjunctivitis (odds ratio, 11.7; P=.03) . The causative organism was resistant to azithromycin but susceptible to telithromycin . The outbreak strain was an unencapsulated S . pneumoniae that has not been previously described; it was most closely related to the sequence type causing the Dartmouth College (Hanover, NH) outbreak of conjunctivitis in 2002 . CONCLUSIONS: We report a conjunctivitis outbreak among military trainees caused by a novel, unencapsulated strain of S . pneumoniae. Clin Infect Dis, 2004 Oct 15, 39(8), 1129 - 35 Epub 2004 Sep 14. Multicenter study of a rapid molecular-based assay for the diagnosis of group B Streptococcus colonization in pregnant women; Davies HD et al.; BACKGROUND: Current prevention of infection due to group B Streptococcus (GBS) involves giving intrapartum antibiotics to women on the basis of either antenatal culture colonization status or presence of risk factors . METHODS: We prospectively compared the performance characteristics of a rapid molecular diagnostic test (IDI-Strep B; Infectio Diagnostic) with culture for intrapartum GBS detection after 36 weeks' gestation in 5 North American centers during the period September 2001-May 2002 . Antenatal GBS screening was done according to the usual practice of participating hospitals . Two combined vaginal/anal specimens were obtained from participants during labor by use of standard techniques and processed by the same laboratories that processed the antenatal specimens . Each swab sample was processed simultaneously by culture and with IDI-Strep B . The collected specimens were randomized for order of testing of the swab samples by culture or the rapid test . RESULTS: Of enrolled women, 803 (91.1%) were eligible for analysis . The overall intrapartum GBS colonization rate by culture was 18.6% (range, 9.1%-28.7%) . Compared with intrapartum culture, the molecular test had a sensitivity of 94.0% (range, 90.1%-97.8%), specificity of 95.9% (range, 94.3%-97.4%), positive predictive value of 83.8% (range, 78.2%-89.4%), and negative predictive value of 98.6% (range, 97.7%-99.5%) . The molecular test was superior to antenatal cultures (sensitivity, 94% vs . 54%; P<.0001) and prediction of intrapartum status on the basis of risk factors (sensitivity, 94% vs . 42%; P<.0001) . CONCLUSION: Use of this test for determination of GBS colonization during labor is highly sensitive and specific and may lead to a further reduction in rates of neonatal GBS disease. Curr Microbiol, 2004 Nov, 49(5), 366 - 71 Molecular characterization and transcription of the luxS gene that encodes LuxS autoinducer 2 synthase in Streptococcus bovis; Asanuma N et al.; Presence of the luxS gene that encodes LuxS autoinducer 2 (AI-2) synthase in Streptococcus bovis was demonstrated, and the molecular properties and transcription of the gene were examined . The S . bovis luxS was transcribed in a monocistronic fashion . Intracellular luxS-mRNA increased sharply during the initial exponential growth, and decreased abruptly after the middle exponential phase . The large drop in luxS transcription began before the glucose supply to cells decreased or the growth rate declined . Transcription of luxS was not directly related to cell density, and continued at a maximal rate when cells were kept growing at a maximal rate . It is conceivable that AI-2 activity in S . bovis acts as a signal for adjusting cell physiology and metabolism in response to environmental conditions . However, the role of LuxS in S . bovis, including the regulation of AI-2 synthesis,, remains to be clarified. J Antimicrob Chemother, 2004 Dec, 54(6), 1067 - 71 Epub 2004 Oct 14. Pulsatile delivery of amoxicillin against Streptococcus pneumoniae; Cha R et al.; OBJECTIVE: beta-Lactam antimicrobials are dosed intermittently or continuously based on their short half-lives and concentration-independent activity . Based on the relationship between antimicrobial killing and bacterial growth cycle, the pharmacodynamics of a unique pulsatile strategy was investigated . METHODS: In vitro pharmacodynamic models with initial inocula of 6 log(10) cfu/mL were utilized to simulate amoxicillin regimens against two Streptococcus pneumoniae isolates: 16891 (MIC = 4 mg/L) and ATCC 49150 (MIC = 0.016 mg/L) . Time-kill profiles of pulsatile dosing of amoxicillin (total daily dose fractionated equally and given at 0, 2, 4 and 6 h for each 24 h cycle) were compared with regimens of every 8 h and every 12 h with the same 24 h drug exposure . Each regimen targeted cumulative peak concentrations of 30, 15 and 5 mg/L for each 24 h cycle . A t(1/2) of 1 h was simulated for all experiments . Bacterial density was quantified over 96 h . RESULTS: Against 16891, every 8 h and every 12 h regimens exhibited minimal bacterial kill at all dosing levels . In contrast, pulsatile dosing at 30 mg/L/24 h resulted in an initial modest approximately 1 log(10) cfu/mL kill with regrowth to growth control levels at 24 h but was immediately followed by a rapid approximately 2 log(10) cfu/mL kill by 32 h . This pattern of kill and regrowth repeated at the same magnitude for each 24 h cycle for the 96 h study duration . Against the susceptible strain (ATCC 49150), both pulse and traditional dosing of amoxicillin resulted in rapid and significant kill to our detection limits for the entire study duration . A pattern of kill and regrowth was only observed at the lowest dose (0.05 mg/L) against ATCC 49150 . At therapeutic levels, all regimens rapidly achieved undetectable limits against this strain for the study duration . No significant alterations in post-exposure MICs were noted . Overall bacterial density reduction was similar between the regimens for the susceptible isolate and greater with pulsatile regimens against the less susceptible strain . CONCLUSION: Pulsatile dosing, which involves administration of the total daily dose over the first 6 h of the day, may represent a unique and alternative strategy for dosing beta-lactam antimicrobials. J Biol Chem, 2004 Dec 17, 279(51), 53241 - 7 Epub 2004 Oct 13. Streptococcus pneumoniae-induced p38 MAPK-dependent phosphorylation of RelA at the interleukin-8 promotor; Schmeck B et al.; Streptococcus pneumoniae is the major cause of community-acquired pneumonia and one of the most common causes of death by infectious disease in industrialized countries . Little is known concerning the mechanisms of target cell activation in this disease . The present study shows that NF-kappaB and p38 MAPK signaling pathways contribute to chemokine synthesis by lung epithelial cells in response to pneumococci . In infected lungs of mice pneumococci stimulate expression of the interleukin (IL)-8 homolog keratinocyte-derived chemokine and granulocyte-macrophage colony-stimulating factor, as well as activate p38 MAPK . Human bronchial epithelium was chosen as a cellular model, because it establishes the first barrier against pathogens, and little is known about its function in innate immunity . Pneumococci infection induces expression of IL-8 and granulocyte-macrophage colony-stimulating factor as well as activation of p38 MAPK in human bronchial epithelial cells (BEAS-2B) . Inhibition of p38 MAPK activity by SB202190 and SB203580 blocks pneumococci-induced cytokine release . In mouse lungs in vivo as well as in cultured cells, pneumococci activate NF-kappaBinanIkappaB kinase-dependent manner . Inhibition of p38 MAPK by chemical inhibitors or by RNA interference targeting p38alpha reduces pneumococci-induced NF-kappaB-dependent gene transcription . Blockade of p38 activity did not affect inducible nuclear translocation and recruitment of NF-kappaB/RelA to the IL-8 promotor but did reduce the level of phosphorylated RelA (serine 536) at IL-8 promotor and inhibited pneumococci-mediated recruitment of RNA polymerase II to IL-8 promotor . Thus, p38 MAPK contributes to pneumococci-induced chemokine transcription by modulating p65 NF-kappaB-mediated transactivation. Infect Control Hosp Epidemiol, 2004 Sep, 25(9), 759 - 64 Pattern of culture-proven neonatal sepsis in a district general hospital in the United Kingdom; Haque KN et al.; OBJECTIVE: To determine the incidence, clinical characteristics, and risk factors associated with the first culture-proven episode of sepsis among neonates in a neonatal intensive care unit (NICU) . SETTING: Level-II NICU in the United Kingdom . PATIENTS: Neonates with their first culture-proven sepsis between January 1, 1996, and December 31, 2000 . METHODS: Demographic data were obtained from the NICU database and chart review . Sepsis was considered early (EOS; < 72 hours old) or late (LOS; > 72 hours old) . Data were also collected on potential risk factors . RESULTS: Among 14,767 live births, 1,612 (11%) neonates were admitted to the NICU during the study period . Nine hundred eight were screened for sepsis . One hundred twenty-four had at least one positive culture (overall sepsis rate of 8.4 per 1,000 live births {1%} or 77 per 1,000 NICU admissions) . Twenty-four neonates had EOS and 100 had LOS . Coagulase-negative staphylococci (CoNS) and group B Streptococcus were the most frequent organisms causing EOS, whereas CoNS and Escherichia coli most frequently caused LOS . Birth before 30 weeks' gestation and birth weight less than 1,500 g were risk factors for sepsis . Resuscitation at birth was the leading risk factor for EOS and respiratory support prior to sepsis, presence of a central or peripheral catheter, and total parenteral nutrition were leading risk factors for LOS . CONCLUSIONS: A strong inverse relationship existed between gestational age of 30 weeks or younger and birth weight of 1,500 g or less and LOS . Resuscitation and indwelling intravenous catheters were also risk factors. J Korean Med Sci, 2004 Oct, 19(5), 735 - 8 Detection rates of bacteria in chronic otitis media with effusion in children; Park CW et al.; This study was performed to investigate polymerase chain reaction-based detection of bacterial DNA in middle ear fluid and assess the correlation between the PCR-positive rate with several factors associated with middle ear effusion . The purpose was to gain a further understanding of bacterial infection as a major cause of otitis media with effusion . Of the 278 specimens of middle ear fluid, 39 (14%) tested positive by ordinary culture . The overall detection rate of bacterial DNA using the PCR method was 36.7% for middle ear effusion, and bacterial DNA detection rates of Hemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis in the middle ear effusion were 29.1%, 4.7% and 10.8%, respectively . The bacterial DNA detection rate was higher in ears with a history of acute otitis media than those without the history . High detection rates were observed in patients younger than 48 months who have had a higher tendency to present with acute otitis media . We concluded that PCR is a more sensitive method for the detection of bacteria in middle ear effusion than ordinary culture, and acute otitis media is a major contributor to the pathogenesis of otitis media with effusion. Zhonghua Er Ke Za Zhi, 2004 Sep, 42(9), 697 - 700 {In vitro antibacterial activity of cefdinir against isolates of respiratory tract pathogens in children}; Lu Q et al.; OBJECTIVE: To study the in vitro antibacterial activity of cefdinir against clinical isolates of respiratory tract pathogens in Children . METHODS: MIC values of cefdinir against 380 strains were determined with E-test method and compared with those of cefaclor . RESULTS: All penicillin-susceptible Streptococcus pneumoniae (PSSP) strains were also susceptible to cefdinir and cefaclor . Both cefdinir and cefaclor were not active against penicillin-resistant SP (PRSP) . Against penicillin-intermediate SP (PISP) the susceptibility rates of cefdinir and cefaclor were 70.1% and 57.4%, respectively . The activity of cefdinir and cefaclor against beta-lactamases negative Hemophilus influenzae (HI) was excellent, but the susceptibility rates of cefdinir and cefaclor against beta-lactamases positive HI were 85.0% and 70.0%, respectively with MIC(90) of 1.5 mg/L vs . 256.0 mg/L . Cefdinir presented higher activities and lower MIC values than cefaclor against Moraxella catarrhalis (MC), Group A streptococcus (GAS), methicillin susceptible staphylococcus aureus (MSSA), and extended spectrum beta-lactamases (ESBLs) negative Escherichia coli (E . coli) or Klebsiella pneumoniae (K . pn) . Both cefdinir and cefaclor were not susceptible to ESBLs positive E . coli and K . pn . CONCLUSIONS: Cefdinir exhibits excellent activity against PSSP, PISP, HI, as well as MC, GAS, MSSA and ESBLs negative E . coli or K . pn. Expert Rev Anti Infect Ther, 2004 Jun, 2(3), 427 - 37 Significance, management and prevention of Streptococcus agalactiae infection during the perinatal period; Berner R; The highest annual death rate during the first five decades of life occurs in the first year, particularly during the perinatal period between the onset of labor and 72 h after birth . Invasive bacterial disease evoking the severe inflammatory response syndrome is a leading cause of perinatal morbidity and mortality . Group B streptococcus (Streptococcus agalactiae) is the most important pathogen in this period of life, although the concept of intrapartum antimicrobial prophylaxis has impressively reduced the rate of culture-proven invasive infection in neonates . This strategy, however, has considerable limitations since group B streptococcus-related stillbirths or prematurity and late-onset sepsis cannot be prevented . Moreover, the use of intrapartum antimicrobial prophylaxis has significantly increased the use of antibiotics during labor and therefore may select for intrapartum infections caused by other bacteria, including those resistant to antibiotics . Several advances in the development of vaccines and research on virulence factors and pathways involved in the immune response to group B streptococcus have been accomplished within the last years, including complete sequencing of the group B streptococcus genome . Development of effective vaccines and implementation of vaccination strategies will be one of the key challenges in the future for prevention of neonatal group B Streptococcus infections. Expert Rev Anti Infect Ther, 2003 Oct, 1(3), 363 - 70 Moxifloxacin (Avelox): a novel fluoroquinolone with a broad spectrum of activity; Caeiro JP et al.; Moxifloxacin (Avelox) is a recently-developed fluoroquinolone that has a broad spectrum of antimicrobial activity, including typical respiratory pathogens, atypical and intracellular respiratory pathogens, Gram-negative pathogens and many anaerobes . This spectrum of activity makes moxifloxacin particularly suitable for the therapy of community-acquired respiratory tract infections . It also has enhanced activity against specific bacteria, such as Mycobacteria spp . and Legionella . Moxifloxacin has pharmacologic characteristics that support once-daily dosing regimens and dual routes of excretion that require little or no adjustment for renal or hepatic insufficiency . The drug has maintained an excellent safety profile based upon broad global usage, and no adverse events have occurred that were unanticipated . Streptococcus pneumoniae, which are resistant to earlier fluoroquinolones, are less likely to be resistant to moxifloxacin. Ann Trop Paediatr, 2004 Sep, 24(3), 259 - 65 Experience with NTBC therapy in hereditary tyrosinaemia type I: an alternative to liver transplantation; Joshi SN et al.; We present the clinical data of five infants with type I (hepato-renal) tyrosinaemia on NTBC therapy . All presented initially at the local hospital in the 1st year of life with progressive abdominal distension owing to hepato-splenomegaly and with radiological evidence of liver cirrhosis, except for one child who was diagnosed during screening because of an affected sibling . Age at commencement of NTBC therapy ranged from 6 to 30 months . All infants showed remarkable improvement within 2-6 months of starting NTBC treatment, except one who died 2 months after commencement of therapy from uncontrolled liver failure, severe coagulopathy and Streptococcus pneumoniae septicaemia . NTBC treatment along with a phenylalanine- and tyrosine-restricted diet has effectively reversed most clinical manifestations of this disease . To date, none of our patients has developed hepatic carcinoma and NTBC was well tolerated without side-effects . NTBC is costly but life-saving and is an obvious alternative to more hazardous liver transplantation . Clin Exp Allergy, 2004 Oct, 34(10), 1649 - 54 Desloratadine partially inhibits the augmented bacterial responses in the sinuses of allergic and infected mice; Kirtsreesakul V et al.; BACKGROUND: Allergic rhinitis (AR) is considered a major predisposing factor for the development of acute bacterial rhinosinusitis . How AR augments a bacterial infection is unknown . OBJECTIVE: Our purpose in this study was to test whether an H1 receptor antagonist, desloratadine, could reduce the augmented effect of an ongoing allergic reaction on acute bacterial rhinosinusitis . METHODS: Three groups of infected and ovalbumin (OVA)-sensitized mice were studied: (1) infected and allergic mice treated with desloratadine, (2) infected and allergic mice treated with placebo, and (3) infected mice . A fourth group of uninfected, non-sensitized mice served as a control for the cellular changes . BALB/c mice were sensitized by two intraperitoneal injections of OVA given 8 days apart . One day after the second injection, the mice were nasally exposed daily to 6% OVA (the groups treated with desloratadine or placebo) or phosphate-buffered saline (PBS) (the infection-only group) for 5 days . After the second OVA exposure, the mice were intranasally inoculated with Streptococcus pneumoniae . Desloratadine or placebo was given daily throughout the OVA exposure period . Nasal allergic symptoms were observed by counting of nasal rubbing and sneezing for 10 min after OVA or PBS nasal challenge . On day 5 post-infection, nasal lavage culture was done, and the inflammatory cells in the sinuses were evaluated by flow cytometry . RESULTS: Mice that were made allergic, infected, and treated with placebo showed more organisms and phagocytes than did only infect mice . They also manifested allergic nasal symptoms and eosinophil influx into the sinuses . Desloratadine treatment during allergen exposure reduced allergic symptoms and reduced sinonasal infection (P<0.05) . There tended to be less myeloid cell and neutrophil influx (P=0.09 both), but not eosinophil influx (P=0.85) compared with that in the placebo-treated group . CONCLUSION: Desloratadine treatment during nasal challenge inhibited allergic symptoms and reduced sinonasal infection, suggesting that histamine via an H1 receptor plays a role in the augmented infection in mice with an ongoing allergic reaction. Eur J Biochem, 2004 Oct, 271(20), 4075 - 83 Cloning, expression and interaction of human T-cell receptors with the bacterial superantigen SSA; De Marzi MC et al.; Superantigens (SAgs) are a class of disease-causing and immunostimulatory proteins of bacterial or viral origin that activate a large number of T-cells through interaction with the Vbeta domain of T-cell receptors (TCRs) . In this study, recombinant TCR beta chains were constructed with human variable domains Vbeta5.2, Vbeta1 and Vbeta2.1, expressed as inclusion bodies, refolded and purified . The Streptococcus pyogenes SAg SSA-1 was cloned and expressed as a soluble periplasmic protein . SSA-1 was obtained both as a monomer and a dimer that has an intermolecular disulfide bond . We analyzed the biological activity of the recombinant SAgs by proliferation assays . The results suggest that SSA dimerization occludes the TCR interaction site . Naturally occurring SSA dimerization was also observed in supernatants of S . pyogenes isolates . An SSA mutant {SSA(C26S)} was produced to eliminate the Cys responsible for dimerization . Affinity assays using a resonant biosensor showed that both the mutant and monomeric wild type SSA have affinity for human Vbeta5.2 and Vbeta1 with Kd of 9-11 microm with a fast kass and a moderately fast kdiss . In spite of the reported stimulation of Vbeta2.1 bearing T-cells by SSA, we observed no measurable interaction. Am J Dent, 2004 Aug, 17(4), 233 - 6 Relationship between S . mutans and the autofluorescence of carious dentin; Banerjee A et al.; PURPOSE: To investigate the relationship between the presence of S . mutans and the autofluorescent signal detected in carious dentin, using confocal laser-scanning microscopy . METHODS: Experiment 1:15 visually caries-free freshly extracted premolars were coated with varnish except for two 2 mm x 2 mm windows; five were subjected to a 15-day bacterial artificial caries system using Streptococcus mutans while 10 underwent a 7-day controlled, lactic acid (0.5 M, pH 2.7) demineralization protocol . At the end of both periods, all teeth were longitudinally sectioned and the 20 bacterial and 40 acid-induced artificial lesions were examined by confocal laser-scanning microscopy . The media containing the S . mutans was also examined for autofluorescence . Experiment 2: 20 750 microm-thick caries-free coronal dentin disks were prepared from 10 healthy premolars . Ten underwent a demineralization protocol using 0.1 M EDTA (pH 4.8) for 21 days . All 20 were finally subjected to the same artificial bacterial caries system as above for 15 days and then examined for autofluorescence using confocal laser-scanning microscopy . RESULTS: Experiment 1 results showed that acid-demineralized lesions did not generate any autofluorescence . Lesions created by the bacterial system did exhibit autofluorescence . The media with or without S . mutans did not exhibit autofluorescence . Experiment 2: bacteria-induced lesions on dentin that had previously been acid-demineralized generated a visibly stronger autofluorescence signal than those lesions grown on sound dentin . It is hypothesized that dentin demineralization during the carious process exposes more matrix to a bacteria-matrix interaction, thus generating or refining the matrix chromophore responsible for the autofluorescence signal detected in carious dentin. J Infect Dis, 2004 Nov 1, 190(9), 1661 - 9 Epub 2004 Sep 21. Tissue-specific contributions of pneumococcal virulence factors to pathogenesis; Orihuela CJ et al.; We assessed the ability of Streptococcus pneumoniae mutants deficient in either choline binding protein A (CbpA), pneumolysin (Pln), pyruvate oxidase (SpxB), autolysin (LytA), pneumococcal surface protein A, or neuraminidase A (NanA) to replicate in distinct anatomical sites and translocate from one site to the next . Intranasal, intratracheal, and intravenous models of disease were assessed in 4-week-old BALB/cJ mice by quantitation of bacterial titers in the relevant organs . Mice were also observed by use of real-time bioluminescent imaging (BLI) . BLI allowed visualization of the bacteria in sites not tested by sampling . All mutants were created in D39 Xen7, a fully virulent derivative of capsular type 2 strain D39 that contains an optimized luxABCDE cassette . NanA, SpxB, and, to a lesser extent, CbpA contributed to prolonged nasopharyngeal colonization, whereas CbpA and NanA contributed to the transition to the lower respiratory tract . Once lung infection was established, Pln, SpxB, and LytA contributed to bacterial replication in the lungs and translocation to the bloodstream . In the bloodstream, only Pln and LytA were required for high-titer replication, whereas CbpA was required for invasion of the cerebrospinal fluid . We conclude that transitions between body sites require virulence determinants distinct from those involved in organ-specific replication. Mol Biotechnol, 2004 Oct, 28(2), 105 - 12 Expression of a functional single-chain Fv antibody on the surface of Streptococcus gordonii; Giomarelli B et al.; Gram-positive bacterium Streptococcus gordonii, a human oral commensal, was engineered to display a single-chain Fv (scFv) antibody fragment at the cell surface . The previously developed host-vector system allowed expression of the Guy's 13 scFv as a fusion with the streptococcal surface protein M6 . Surface expression of the 515-amino acid M6/scFv fusion protein was confirmed by Western blot analysis on cellular fractions and flow cytometric analysis . Guy's 13 scFv was derived from the Guy's 13 monoclonal antibody, which was raised against streptococcal antigen I/II (SA I/II), the major adhesin of the caries-producing bacterium Streptococcus mutans . Surface plasmon resonance was used to test binding of scFv-expressing S . gordonii to SA I/II . Whole cells of recombinant S . gordonii were found to specifically bind to immobilised SA I/II and binding was inhibited by fluid-phase SA I/II in a dose-dependent manner . Production of a functional scFv in S . gordonii is the first step towards the development of genetically engineered commensal bacteria that, by colonizing mucosal surfaces, may provide the host with sustained delivery of recombinant antibodies. J Mol Biol, 2004 Oct 29, 343(4), 997 - 1005 Plasmin(ogen)-binding alpha-enolase from Streptococcus pneumoniae: crystal structure and evaluation of plasmin(ogen)-binding sites; Ehinger S et al.; Alpha-enolases are ubiquitous cytoplasmic, glycolytic enzymes . In pathogenic bacteria, alpha-enolase doubles as a surface-displayed plasmin(ogen)-binder supporting virulence . The plasmin(ogen)-binding site was initially traced to the two C-terminal lysine residues . More recently, an internal nine-amino acid motif comprising residues 248 to 256 was identified with this function . We report the crystal structure of alpha-enolase from Streptococcus pneumoniae at 2.0A resolution, the first structure both of a plasminogen-binding and of an octameric alpha-enolase . While the dimer is structurally similar to other alpha-enolases, the octamer places the C-terminal lysine residues in an inaccessible, inter-dimer groove restricting the C-terminal lysine residues to a role in folding and oligomerization . The nine residue plasminogen-binding motif, by contrast, is exposed on the octamer surface revealing this as the primary site of interaction between alpha-enolase and plasminogen. Carbohydr Res, 2004 Oct 20, 339(15), 2541 - 7 Complementary exploration of the action pattern of hyaluronate lyase from Streptococcus agalactiae using capillary electrophoresis, gel-permeation chromatography and viscosimetric measurements; Kuhn AV et al.; Hyaluronic acid (HA) was treated with hyaluronate lyase (GBS HA lyase, E.C . 4.2.2.1, from Streptococcus agalactiae strain 4755), and the products have been analyzed by capillary electrophoresis (CE-UV and online CE-ESIMS), gel-permeation chromatography (GPC) and viscosimetric measurements . The resulting electropherograms showed that the enzyme produced a mixture of oligosaccharides with a 4,5-unsaturated uronic acid nonreducing terminus . More exhaustive degradation of HA led to increasing amounts of di-, tetra-, hexa-, octa- and decasaccharides . Using CE, linear relationships were found between peak area of the observed oligosaccharides and reaction time . Determination of viscosity at different stages of reaction yielded an initial rapid decrease following Michaelis-Menten theory . A reaction time-dependent change in the elution position of the HA peak due to partial digestion of HA with GBS hyaluronate lyase has been observed by GPC . These results indicated that the HA lyase under investigation is an eliminase that acts in a nonprocessive endolytic manner, as at all stages of digestion a mixture of oligosaccharides of different size were found . For GBS HA lyase from Streptococcus agalactiae strain 3502, previously published findings reported an action pattern that involves an initial random endolytic cleavage followed by rapid exolytic and processive release of unsaturated disaccharides . Our results suggest that differences between the two enzymes from distinct S . agalactiae strains (GBS strains 4755 and 3502) have to be considered. Am J Perinatol, 2004 Oct, 21(7), 403 - 7 Low colony counts of asymptomatic group B streptococcus bacteriuria: a survey of practice patterns; Aungst M et al.; The purpose of this study was to survey expert opinion on the management of low colony counts (< 100,000 colony forming units/mL) of asymptomatic group B streptococcus (GBS) bacteriuria discovered in the first trimester . A survey was sent to the 241 senior obstetricians affiliated with each of the Obstetrics and Gynecology training programs in the United States on July 10, 2002 . Surveys received by the deadline (September 1, 2002) were included in the dataset . Eighty-five completed surveys were returned for a response rate of 35% . Seventy-seven percent reported treating low colony counts of asymptomatic GBS bacteriuria in the first trimester at the time of diagnosis, whereas 23% stated they did not treat prior to labor (margin of error 7.5% with 95% confidence) . Nine percent stated that their institution had a written protocol for the treatment of low colony counts of asymptomatic GBS bacteriuria . Two physicians indicated that they screened for asymptomatic GBS bacteriuria at 28 weeks . Currently, no generally accepted protocol for the management of low colony counts of asymptomatic GBS bacteriuria exists . This survey indicates that most of the responding senior obstetricians at United States training programs treat low colony counts of asymptomatic GBS bacteriuria in the first trimester. N Z Med J . 2004 Aug 20;117(1200):U1023. The prevention of early-onset neonatal group B streptococcus infection: technical report from the New Zealand GBS Consensus Working Party; Campbell N et al.; AIMS: Early-onset neonatal group B streptococcus (GBS) is the leading infectious cause of disease in newborn babies . Since intrapartum antibiotics interrupt vertical GBS transmission, this is now a largely preventable public health problem . An important first step is to develop (then implement) nationally, agreed prevention policies . METHODS: Representatives from the New Zealand College of Midwives, the Paediatric Society of New Zealand, the New Zealand Committee of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the Royal New Zealand College of General Practitioners, and the Homebirth Association met to review evidence that will assist in the formulation of GBS prevention policies that are most suitable for New Zealand . RESULTS: The Technical Working Group noted that (i) no strategy will prevent all cases of early-onset GBS infection, (ii) intrapartum antibiotics are associated with rare, but serious, adverse effects, (iii) concerns remain over developing antibiotic resistance, (iv) an economic analysis is required to help inform policy, (iv) reliable bedside diagnostic tests for GBS in early labour are not yet available and (iv) the most important determinant of effectiveness will be compliance with a single national prevention policy . CONCLUSIONS: As an interim measure a GBS risk-based prevention strategy is recommended . This exposes the least numbers of women and their babies to antibiotics, while virtually preventing all deaths from GBS sepsis . Continuing education of health professionals and pregnant women, auditing protocol compliance, tracking adverse events amongst pregnant women, and national surveillance of neonatal sepsis and mortality rates and antibiotic resistance are necessary for the strategy's success. Arch Pediatr, 2004 Oct, 11(10), 1277 - 81 {Antibiotic therapy for lower tract infections in children}; Ovetchkine P; Lower respiratory tract infections in children encompass mainly bronchiolitis and community acquired pneumonia.Severity of bronchiolitis is linked to the intensity of the respiratory distress and young age . This syndrome is caused by viral infection, thus, initial antibiotherapy is not justified . In community acquired pneumonia, prognostic is dependent on the nature of the infective agent . Eventhough viruses are mainly responsible for the illness, bacterial (and particularly pneumococcal) agent cannot be ignored . Initial antibiotics must be efficient on Streptococcus pneumoniae. Rev Argent Microbiol, 2004 Apr-Jun, 36(2), 63 - 7 {Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina}; Perez J et al.; Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients . The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes . This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium . The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina . In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes . All the isolates were found to be sensitive to penicillin . A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected . In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected . These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine . The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment. Clin Infect Dis, 2004 Oct 1, 39(7), 930 - 8 Epub 2004 Sep 13. Effect of the 7-valent pneumococcal conjugate vaccine on nasopharyngeal colonization by Streptococcus pneumoniae in the first 2 years of life; Ghaffar F et al.; BACKGROUND: Studies suggest that the 7-valent pneumococcal conjugate vaccine (PCV7) reduces carriage of vaccine-type (VT) Streptococcus pneumoniae (SP) . We studied the effect of PCV7 on carriage of VT- and non-VT (NVT) SP, by studying the effect of PCV7 on nasopharyngeal (NP) colonization by VT and NVT SP during early childhood . METHODS: At 2 months of age, 278 infants were enrolled in this study . To determine carriage of SP, NP samples were obtained before each PCV7 dose, at 9 months of age, and 2-3 months after the booster dose of vaccine . RESULTS: The carriage of SP increased slightly, from 12% (95% confidence interval {CI}, 8%-16%) of subjects at 2 months of age to 18% (95% CI, 13%-23%) at 4 months of age (P<.05) . Carriage of SP remained in 24%-30% of subjects during subsequent months . Between the 12- and 18-month visits, the carriage rate of VT SP decreased significantly, from 18% (95% CI, 13%-23%) to 9% (95% CI, 5%-13%) of subjects (P=.001) . The trend of a decrease in carriage of penicillin-nonsusceptible SP, from 16% of subjects (95% CI, 11%-21%) at the 12-15-month visit to 9% (95% CI, 5%-13%) at the 15-18-month visit, was found after the booster dose of vaccine . CONCLUSION: The reduction of VT-SP colonization and replacement by NVT SP after the booster dose of vaccine suggests the possibility that widespread vaccination will result in replacement of pneumococci mainly by antibiotic-susceptible NVT SP. J Clin Microbiol, 2004 Oct, 42(10), 4889 - 90 Culture-negative neonatal meningitis and endocarditis caused by Streptococcus agalactiae; Negre VL et al.; We describe a case of culture-negative meningitis and endocarditis caused by Streptococcus agalactiae in a 27-day-old boy . S . agalactiae was detected in cerebrospinal fluid and serum by broad-spectrum PCR amplification. J Clin Microbiol, 2004 Oct, 42(10), 4620 - 6 Longitudinal study of transmission, diversity, and stability of Streptococcus mutans and Streptococcus sobrinus genotypes in Brazilian nursery children; Klein MI et al.; The aim of this study was to perform a follow-up evaluation of the Streptococcus mutans and Streptococcus sobrinus colonization profile of children's oral cavities, which included the pattern of vertical transmission from mother to child, genotypic diversity, and stability of the strains . The subjects were 16 mother-child pairs, who were monitored for 20 months . Samples of saliva, tongue dorsum, alveolar ridge mucosa, and dental plaque from the children were collected bimonthly . Saliva samples from the mothers were also collected . After isolation and identification, the arbitrarily primed PCR method was performed for the genotypic characterization of S . mutans (968 isolates) and S . sobrinus (111 isolates) . At the time the strains were acquired, the children harbored one to four distinct genotypes of S . mutans and only one genotype of S . sobrinus . Although S . mutans prevalence and genotypic diversity were greater than those of S . sobrinus, the presence of matching genotypes of S . mutans and S . sobrinus was similar (in 81.25 and 83.33% of mother-child pairs, respectively), suggesting vertical transmission for both species . This longitudinal study showed an increase in genotypic diversity of S . mutans in the oral cavity during the follow-up period: most of the initially acquired genotypes persisted, normally those genotypes transmitted by the mother, and some were lost during follow-up; new strains were also acquired . In conclusion, S . mutans and S . sobrinus genotypes acquired from maternal or alternative sources may show effective persistence in the oral cavity and/or transitory detection in the children's mouths, reflecting the continuous development of oral microbiota in children. Eur J Paediatr Dent, 2004 Sep, 5(3), 131 - 5 Zinc oxide-eugenol and calcium hydroxide pulpectomies in baboon primary molars: histological responses; Cleaton-Jones P et al.; AIM: To compare histological responses to zinc oxide-eugenol (ZOE) and calcium hydroxide (CH) pulpectomies in primary molar teeth with inflamed pulps . STUDY DESIGN: This was an experimental study in 17 juvenile baboons (Papio ursinus) . METHODS: Pulpitis was induced with fresh human carious dentine or Streptococcus mutans placed into occlusal cavities in 78 primary molars; after 14 days a pulpectomy was performed on the same primary molars with the two root fillings randomly allocated . The root canal openings were then covered with IRM and the cavity filled with amalgam . After 90 days specimens were harvested and examined under the light microscope with the examiner blind to the treatment . RESULTS: Reaction frequencies in the ZOE-treated versus CH-treated teeth were: no recognisable pulp 89% and 82%, internal root resorption 0% and 1%, external root resorption 11% and 24%, presence of bacteria 5% and 18%, periapical abscesses 24% and 52% . STATISTICS: Fisher's exact probability test showed a statistically significant higher prevalence of periapical abscesses in the CH-treated group (P=0.03, relative risk 2.2) . CONCLUSIONS: ZOE pulpectomy is preferred to CH for the treatment of infected pulps in primary molars. Rev Argent Microbiol, 2004 Apr-Jun, 36(2), 85 - 7 {Evaluation of 61 episodes of infective endocarditis in intravenous drug abusers and human immunodeficiency type-1 virus infection}; Corti ME et al.; We conducted a retrospective evaluation to determine the clinical and microbiological characteristics of 61 episodes of infective endocarditis (IE) in intravenous drug abusers (IDA), HIV seropositive patients . Forty-nine males and 6 females between 15 and 42 years of age were included in the study . All the included patients presented 61 episodes of IE . Fever and cardiac murmur were present in all episodes; 43 (70.4%) had hepatomegaly; 29 (47.5%) had splenomegaly . Thirty-eight (62.3%) presented cough (9 with hemoptysis); 25 (41%) had dyspnea, and 5 (8.2%) had jugular ingurgitation . Fundoscopy showed alterations in 3 patients (4.9%) . Bacteriological confirmation was obtained in 41 episodes (67.2%); blood cultures revealed Staphylococcus aureus in 30 cases (73.1%), Streptococcus viridans in 8 (19.5%) patients, Staphylococcus epidermidis in 1 (2.4%), Staphylococcus hominis in 1 (2.4%) and Streptococcus pneumoniae in one case (2.4%) . The tricuspid valve was involved in 51 episodes (83.6%), the aorta in 6 (9.8%), the mitral valve in 3 (4.9%) and the pulmonary valve in one (1.6%) . There was evidence of right bivalvular involvement in 2 patients (3.2%) and tricuspid and mitral involvement in another (1.6%) . Pericardial effusion was detected in 19 episodes (31.1%) . Six patients (10.9%) died during the acute episode of IE. Rev Esp Quimioter, 2004 Jun, 17(2), 155 - 60 {Coverage of the 23-valent pneumococcal vaccine in those older than 64 years of age in the region of Castellon and Valencia, Spain}; Montaner M et al.; The different serotypes of Streptococcus pneumoniae isolated from adults aged over 64 years in the Valencia and Castellon health region of Spain from June 1999 to December 2003 were analyzed . A total of 163 strains were evaluated; 58.3% were invasive, 47.24% were from respiratory source, and 4.9% were from exudates . The greatest percentage of samples was obtained from the group of patients aged 65 to 75 years (60.7%), while the lowest percentage was obtained from the group of patients aged over 85 years (10.4%) . In the latter group, 53% of the strains were invasive and 29.4% were isolated from sputum . A total of 21 serotypes were identified, with the most common (> 3%) being: serotype 3 (22.1%); serotype 19 (12.9%); serotype 6 (12.3%); serotype 9 (8.6%); serotype 14 (10.4%); serotype 23 (8%); serotype 29 (3.7%); and serotype 18 (3.1%) . Serotype 3 was the most common serotype found in all samples, with the exception of exudate, while serotype 23 was not isolated in blood . In this population group, the coverage of the 23-valent vaccine was 88.4% . Serotypes not included in this vaccine but isolated from invasive samples were serotypes 16, 24, 29 and 35 . No changes were observed in serotype distribution over the 4-year period of the study . However, it is necessary to continue epidemiological monitoring to determine whether serotype substitution occurs. Cell Microbiol, 2004 Nov, 6(11), 1085 - 96 Candida albicans and Streptococcus salivarius modulate IL-6, IL-8, and TNF-alpha expression and secretion by engineered human oral mucosa cells; Mostefaoui Y et al.; We investigated the involvement of oral epithelial cells via two cytokines (IL-6 and TNF-alpha) and one chemokine (IL-8) in local defences against live yeast (Candida albicans) and bacteria (Streptococcus salivarius) using an engineered human oral mucosa model . We report that the yeast changed from the blastospore to the hyphal form and induced significant tissue disorganization at later contact periods (24 and 48 h) compared to the bacteria . However, this effect did not reduce the viability or total number of epithelial cells . Gene activation analyses revealed that IL-6, IL-8 and TNF-alpha mRNA levels rose in tissues in contact with live C . albicans or S . salivarius . Gene activation was followed by an upregulation of protein secretion . IL-6 levels were higher after contact with C . albicans than with S . salivarius . IL-8 levels after contact with S . salivarius were higher than with C . albicans . Our study suggests that S . salivarius is more efficient at inducing proinflammatory mediator release than C . albicans . These results provide additional evidence for the contribution of oral epithelial cells to the inflammatory response against fungi and bacteria. Med J Malaysia, 2004 May, 59 Suppl B, 59 - 60 Amplifying the manganese scavenging potential of Streptococcus zooepidemicus to reactive oxygen species during production of hyaluronic acid; Mashitah MD et al.; Streptococcus zooepidemicus (SZ) is an aerotolerant bacteria and its ability to survive under reactive oxidant challenge raises the question of the existence of a defense system . Thus growth, hyaluronic acid (HA) and hydrogen peroxide (H2O2) production by SZ in the presence of increasing concentration of Mn2+ were studied . The results suggested that the tested strain supported growth and HA production in cultures treated with 1 and 10 mM of Mn2+ regardless of H2O2 presence in the medium . This showed that SZ have acquired elaborate defense mechanisms to scavenge oxygen toxicity and thus protect cells from direct and indirect effect of this radical . In contrast, cells treated with 25 mM Mn2+ were sensitive, in which, the HA production was reduced considerably . Thus showing that the oxygen scavenger systems of the cells may be fully saturated at this concentration. Nippon Yakurigaku Zasshi, 2004 Oct, 124(4), 271 - 83 {Anti-allergic action effect of Pseudolarix amabilis Rehd . extract and its efficacy on atopic dermatitis}; Hirasawa Y et al.; Pseudolarix amabilis Rehd . extract was examined in vitro for antibacterial effects, anti-inflammatory effects, and inhibitory effects on histamine release . Pseudolarix amabilis Rehd . extract was also examined for efficacy on dermatitis in atopic dermatitis model mice (NC mice) and effects on keratinous moisture level and transepidermal water loss in miniature pigs . Pseudolarix amabilis Rehd . extract had antibacterial effects on Staphylococcus aureus, Candida albicans, and Streptococcus pyogenes; however this antibacterial effect varied with the temperature at which and conditions under which Pseudolarix amabilis Rehd . was extracted . Pseudolarix amabilis Rehd . extract at the final concentration of 2 mg/mL significantly inhibited the hyaluronidase activity; and at 0.005, 0.05, and 0.5 mg/mL, it also significantly inhibited the histamine release . In the mice in which atopic dermatitis had been induced, 28-day administration of Pseudolarix amabilis Rehd . extract at 4 and 400 mg/mL significantly inhibited aggravation of dermatitis without having effects on body weight . In the dorsal skin of miniature pigs, Pseudolarix amabilis Rehd . extract at 4 and 400 mg/mL significantly increased keratinous moisture level with the increase in the number of dosing days, and caused no changes in transepidermal water loss . From the above results, it is clear that Pseudolarix amabilis Rehd . extract inhibits both proliferation of bacteria and inflammation caused by antigens . Furthermore, it is suggested that Pseudolarix amabilis Rehd . extract will serve as a medicinal drug which effectively moistens the skin and prevents and heals dermatitis. Appl Environ Microbiol, 2004 Oct, 70(10), 6047 - 52 Galactose metabolism by Streptococcus mutans; Abranches J et al.; The galK gene, encoding galactokinase of the Leloir pathway, was insertionally inactivated in Streptococcus mutans UA159 . The galK knockout strain displayed only marginal growth on galactose, but growth on glucose or lactose was not affected . In strain UA159, the sugar phosphotransferase system (PTS) for lactose and the PTS for galactose were induced by growth in lactose and galactose, although galactose PTS activity was very low, suggesting that S . mutans does not have a galactose-specific PTS and that the lactose PTS may transport galactose, albeit poorly . To determine if the galactose growth defect of the galK mutant could be overcome by enhancing lactose PTS activity, the gene encoding a putative repressor of the operon for lactose PTS and phospho-beta-galactosidase, lacR, was insertionally inactivated . A galK and lacR mutant still could not grow on galactose, although the strain had constitutively elevated lactose PTS activity . The glucose PTS activity of lacR mutants grown in glucose was lower than in the wild-type strain, revealing an influence of LacR or the lactose PTS on the regulation of the glucose PTS . Mutation of the lacA gene of the tagatose pathway caused impaired growth in lactose and galactose, suggesting that galactose can only be efficiently utilized when both the Leloir and tagatose pathways are functional . A mutation of the permease in the multiple sugar metabolism operon did not affect growth on galactose . Thus, the galactose permease of S . mutans is not present in the gal, lac, or msm operons. J Biol Chem, 2004 Dec 10, 279(50), 52789 - 96 Epub 2004 Dec 10. Insight of host immune evasion mediated by two variants of group a Streptococcus Mac protein; Agniswamy J et al.; Group A Streptococcus has evolved numerous mechanisms to evade the host immune system to survive, disseminate, and cause disease . Recently a secreted protein named Mac-1 was identified and shown to enhance survival of the pathogen . A new variant of Mac-1 (designated Mac-2) also was recently described and shown to differ from Mac-1 by approximately 50% amino acid sequence divergence in the middle one-third of the molecule . To gain new information about the role of Mac-1 and Mac-2 in host-pathogen interactions, solution binding experiments were performed using surface plasmon resonance and purified Mac proteins . Mac-1 bound the same lower hinge region of human IgG as Fc receptors with 2.5 microM affinity, which lead to proteolytic cleavage of the antibody . Similar Km (6.8-18.9 microM) and kcat (0.02-0.13 s(-1)) values of the Mac-1 endopeptidase activity were obtained for IgG1, IgG2, IgG3, and IgG4 . Mac-2 variant, in contrast, bound human IgG poorly (KD = 16 mM) and had weak endopeptidase activity against IgG . Instead, Mac-2 bound FcgammaRII and FcgammaRIII with 5 and 75 microM affinity, respectively . This binding competitively blocked IgG from recognition by Fc receptors . Taken together, Mac proteins block immunoglobulin recognition by Fc receptors and degrade immunoglobulins, thereby enhancing survival of the pathogen through the inhibition of phagocytosis, endocytosis of IgG-opsonized particles, and antibody-dependent cell-mediated cytotoxicity . Consequently, these proteins may be potential therapeutic targets. Pathol Biol (Paris), 2004 Oct, 52(8), 489 - 92 {Emergence of macrolide resistant Streptococcus pyogenes strains in pediatric patients in France}; Mariani-Kurkdjian P et al.; A total of 206 recent throat isolates of Streptococcus pyogenes collected between 2002 and 2004 from children were tested for their susceptibility to penicillin, amoxycillin, erythromycin, clarythromycin and clindamycin . The erythromycin resistant isolates were further studied for their genetic mechanism of resistance by means of PCR . In all, 14.5% of the strains were erythromycin resistant and 13.5 and 1% expressed the constitutive MLS(B) and M resistance phenotypes and harbored the ermB and mef A genes respectively. Pathol Biol (Paris), 2004 Oct, 52(8), 438 - 43 {Rapid antigen detection tests for diagnosis of group A streptococcal pharyngitis: comparative evaluation of sensitivity and practicability of 16 in vitro diagnostics medical devices performed in July 2002 by the French health products safety agency (Afssaps) as part of its market control mission}; Charlier-Bret N et al.; Within the scope of its health products control mission, the French Health Products Safety Agency (Afssaps) collaborating with two expert's sites, has assessed the 16 tests available on the French market in 2002 for rapid diagnosis of the Streptococcus A tonsillitis . The purpose of this study was to verify the reliability and rapidity of these tests and to give some information to the users about their analytical criteria and practicability characteristics . The analytical study has been performed on a same panel of four reference strains of Streptococcus pyogenes dilutions to determine the limit of detection of all the reagents in the same condition of methodology . The limit of detection has been calculated with the results expressed in colony forming unit by ml (CFU/ml) . The practicability study has permitted to analyze the quality of the presentation, the easiness of the final reading and of performing tests . A score has been established for each rapid test . A classification of the analytical sensitivity (limit of detection) and practicability (score) of these 16 devices has been established . The limit of detection of the reagents giving the best results allows the detection of the lowest bacterial concentration of the panel which is 10(5) CFU/ml . Regarding practicability, the results suggest that, the immunochromatographic strip methods have the best score in a view with the use by a non medical laboratory. Nutr J . 2004 Oct 05;3(1):18. Effect of smoking on vitamin A, vitamin E, and other trace elements in patients with cardiovascular disease in Bangladesh: a cross-sectional study; Bashar SK et al.; BACKGROUND: Data regarding the impact of cigarette smoking on trace elements are scarce and inconsistent . In this study, we evaluated the effect of smoking on serum concentrations of trace elements among adult males with heart disease . METHODS: This cross-sectional study included 100 adults hospitalized with heart disease in Bangladesh . The major variables of interest included mean serum concentrations of trace elements and proportion of subjects with bacterial growth on throat swab culture . RESULTS: Smokers had significantly lower serum concentrations of retinol, alpha-tocopherol, selenium, and zinc and increased concentrations of copper . Throat swab cultures were more often positive for Streptococcus beta-hemolyticus in smokers than controls . CONCLUSIONS: Smoking decreases serum concentrations of trace elements . Smoking control programs are needed in Bangladesh to improve health and nutrition of the people who are already nutritionally deficient. Gastroenterol Hepatol, 2004 Aug-Sep, 27(7), 393 - 6 {Evaluation of Helicobacter pylori susceptibility to rifaximin}; Quesada M et al.; INTRODUCTION: Helicobacter pylori infection affects more than half the world's population . It is a major cause of chronic gastritis and there is a strong association with peptic ulceration and gastric adenocarcinoma . Rifaximin is a new nonabsorbable broad-spectrum antimicrobial agent that reaches high concentrations in the gastrointestinal tract . AIM: To evaluate the in vitro activity of rifaximin against H . pylori isolates . METHODS: Thirty-one H . pylori strains were analyzed by the agar dilution method . Clarithromycin was used as the control antibiotic . Staphylococcus aureus and Streptococcus pneumoniae were used as quality control strains . Plates were read at days 4 and 7 of incubation . The MIC50 and MIC90 of each antibiotic were calculated . Strains with a clarithromycin MIC of > 1 microg/ml were considered resistant . RESULTS: The MIC50 of clarithromycin at days 4 and 7 was 0.125 microg/ml and the MIC90 at days 4 and 7 ranged from 8 to 16 microg/ml, respectively . The MIC50 of rifaximin at days 4 and 7 ranged from 1 to 2 microg/ml, respectively, and the MIC90 was 4 microg/ml at both days 4 and 7 . Twenty percent of H . pylori strains were resistant to clarithromycin . All clarithromycin-resistant strains were inhibited at a maximal rifaximin concentration of 4 microg/ml . CONCLUSION: These results indicate that this new antibiotic may be useful for eradication of H . pylori infection . Because rifaximin is active against H . pylori strains resistant to clarithromycin, it could be useful in combination with this drug or in the treatment of therapeutic failure. Sichuan Da Xue Xue Bao Yi Xue Ban, 2004 Sep, 35(5), 687 - 9 {The effects of natural medicine on adherence of Streptococcus mutans to salivary acquired pellicle}; Xiao Y et al.; OBJECTIVE: To investigate the effects of 5 kinds of natural medicine such as Radix et Rhizoma Rhei on the adherence of Streptococcus mutans to salivary acquired pellicle, and to screen effective natural medicines for the prevention of caries . METHODS: The in vitro model of experimental pellicle was saliva-coated hydroxyapatites (S-HA) . Streptococcus mutans and S-HA were treated with natural medicines respectively, and then the adherence of bacteria to S-HA was tested . RESULTS: Radix et Rhizoma Rhei, Semen Arecae and Rhizoma Liguistici Chuanxiong could decrease the attachment of Streptococcus mutans to S-HA, and Semen Arecae was the most effective one . Radix Angelicae Dahuricae had no remarkable effect, and Catechu inhibited the adherence only after the bacteria being under treatment . CONCLUSION: Radix et Rhizoma Rhei, Semen Arecae, Rhizoma Liquistici Chuanxiong and Catechu could effectively inhibit the adherence of Streptococcus mutans to salivary acquired pellicle, but the effect of Radix Angelicae Dahuricae on the adherence is un-noticeable. Infect Dis Obstet Gynecol, 2004, 12(1), 27 - 30 Perimenopausal pneumococcal tubo-ovarian abscess--a case report and review; Seshadri S et al.; BACKGROUND: Genital tract infections in females secondary to Streptococcus pneumoniae (pneumococcus) are unusual . Tubo-ovarian abscess resulting from such an infection is a rare occurrence and diagnosis is not always easy . This report demonstrates the problems of recognizing this condition and summarizes the pathomechanism, investigations leading to a diagnosis and the subsequent management . CASE: A rare case of a tubo-ovarian abscess caused by pneumococcus, occurring in a previously healthy 48-year-old woman, is presented . The tubo-ovarian abscess may have developed insidiously and probably had an acute exacerbation prior to presentation . CONCLUSION: This case is unusual in that there were no identifiable initiating events for the source of the pneumococcal infection . Early recognition of a tubo-ovarian abscess is important in order to prevent the associated morbidity and mortality . This condition has the propensity to mimic a neoplasm. Infect Dis Obstet Gynecol, 2004, 12(1), 1 - 8 Antibiotic resistance patterns of group B streptococcal clinical isolates; Simoes JA et al.; OBJECTIVES: To determine the in vitro resistance of group B streptococcus (GBS) to 12 antibiotics . To determine if there has been any decrease in sensitivity to the penicillins or other antibiotics currently used for GBS chemoprophylaxis in pregnant women . Find suitable alternative antibiotics to penicillin . Find an antibiotic that will have minimal selective pressure for resistance among the endogenous resident vaginal microflora . METHODS: The antibiotic susceptibility profiles of 52 clinical isolates of GBS were evaluated to 12 antibiotics: ampicillin, azithromycin, cefamandole, cefazolin, ceftriaxone, ciprofloxacin, clindamycin, erythromycin, nitrofurantoin, ofloxacin, penicillin and vancomycin . Antibiotic sensitivities were determined using disk diffusion and microdilution methods according to the guidelines of the National Committee for Clinical Laboratory Standards (NCCLS) . RESULTS: All isolates were sensitive to vancomycin, ofloxacin, ampicillin, ciprofloxacin, nitrofurantoin and penicillin . However, the following number of clinical isolates exhibited intermediate or decreased sensitivity, nine (17%) to ampicillin, eight (15%) to penicillin, 14 (32%) to ciprofloxacin and one (2%) to nitrofurantoin . Thirty-one percent of the isolates were resistant to azithromycin and ceftriaxone, 19% to clindamycin, 15% to cefazolin and 13% to cefamandole . Eighteen (35%) of the clinical isolates tested were resistant to 6 of the 12 antibiotics tested . CONCLUSIONS: The relatively high rates of resistance for 6 of the 12 antibiotics tested suggest that for women allergic to penicillin and colonized with GBS, antibiotic sensitivities to their isolates should be determined . The antibiotic selected for intrapartum chemoprophylaxis should be guided by the organism's antibiotic sensitivity pattern . Patients with GBS bacteriuria should be treated with nitrofurantoin. Reprod Nutr Dev, 2004 May-Jun, 44(3), 195 - 206 Protozoa involved in butyric rather than lactic fermentative pattern during latent acidosis in sheep; Brossard L et al.; We used six ruminally cannulated Texel wethers to study the relative role of protozoa and lactate-metabolizing bacteria in ruminal fermentative patterns during an induced latent acidosis . The sheep were fed an alfalfa hay diet (H) and latent acidosis was induced, following a short transition period of one week, with a grain-rich acidotic diet (W, 60% wheat + 40% alfalfa hay) . Ruminal pH, ruminal volatile fatty acids (VFA), lactate and NH3 concentrations, protozoa and lactate-utilizing bacterial counts, the relative proportions of three main bacteria implicated in lactate metabolism (a lactate-producing species, Streptococcus bovis, and two lactate-utilizing species, Selenomonas ruminantium, and Megasphaera elsdenii) using specific 16S-rRNA-targeting oligonucleotide probes, and lactate dehydrogenase (LDH) activity were determined for both diets . The pH parameters (mean, minimum, maximum, time and area under pH 6.0 and 5.5) measured with the W diet were indicative of a latent (i.e., subacute and maintained) acidosis . However, a butyric rather than lactic latent acidosis was observed in this study . Total ruminal lactate concentration remained at low levels with the acidotic diet (< 4 mmol x L(-1)), but changes were observed in VFA composition, which was oriented towards butyrate at the expense of acetate (P < 0.05), while propionate remained constant . In agreement with the low ruminal lactate concentration, no changes in the proportion of S . bovis 16S-rRNA were observed . The lactate-metabolizing bacterial population also remained fairly constant in number, proportion and activity . The increase in butyrate concentration was accompanied by a proliferation of entodiniomorphs (P < 0.01) . These results suggest that the protozoa limited lactate accumulation and possibly also the decrease in pH during latent acidosis . Experiments with defaunated and faunated sheep could provide further evidence of the role of protozoa in the development of rumen latent acidosis. Ann Emerg Med, 2004 Oct, 44(4), 386 - 92 Pneumococcal vaccination in the emergency department: an assessment of need; Rudis MI et al.; STUDY OBJECTIVES: Immunization against Streptococcus pneumoniae with the 23-valent pneumococcal polysaccharide vaccine has been shown to be cost-effective for prevention of invasive pneumococcal disease . Yet 23-valent pneumococcal polysaccharide vaccine is widely underused, particularly among ethnic minorities . The objectives of this survey are to determine the rate of 23-valent pneumococcal polysaccharide vaccine vaccination among all adult patients presenting to the emergency department (ED) of a county-based, urban, tertiary care medical center; the willingness of patients to receive 23-valent pneumococcal polysaccharide vaccine; and reasons for nonvaccination . METHODS: A quality assurance survey was performed in the ED during 3 days in September 2002 . A survey was developed to determine 23-valent pneumococcal polysaccharide vaccine vaccination rates and eligibility according to indications and contraindications established by the Centers for Disease Control and Prevention (CDC) . Descriptive statistics were performed to quantify the proportion of patients who were immunized, eligible, and willing to receive 23-valent pneumococcal polysaccharide vaccine and reasons for nonvaccination . RESULTS: A total of 250 patients of 1,535 registered in the ED were surveyed during the 3-day period . Only 48 (19%) had a primary care provider . The majority of patients were Hispanic (73%) . Only 22 (9%) patients had received the vaccine . A total of 66 (26%) patients fit the CDC eligibility criteria for 23-valent pneumococcal polysaccharide vaccine, and 59 (89%) of these patients were willing to receive the vaccine during their ED visit . Most patients (79%) were eligible to receive 23-valent pneumococcal polysaccharide vaccine due to their comorbid illnesses . CONCLUSION: In the ED of our county-based urban medical center, 26% of patients were eligible for 23-valent pneumococcal polysaccharide vaccine; the majority of patients were Hispanic, unaware of the vaccine's existence, and willing to receive it during their ED visit . These data underscore a large unmet public health need among ethnic minorities in the ED. Microb Pathog, 2004 Oct, 37(4), 193 - 204 Alteration of gene expression in human middle ear epithelial cells induced by influenza A virus and its implication for the pathogenesis of otitis media; Tong HH et al.; Influenza A virus infection plays a significant role in the pathogenesis of Streptococcus pneumoniae-induced acute otitis media in children . An understanding of how influenza A virus modulates host cellular responses is critically important in efforts to explore the molecular mechanisms of this synergism . We used microarray technology to characterize the mRNA expression profile in human middle ear epithelial cells induced by influenza A virus . Alterations of mRNA expression in 142 out of approximately 12,600 genes were observed at 24h after virus infection . Of these 142 genes with altered expression, interferon inducible genes, chemokine and cytokine genes, pro- and antiapoptotic genes, signal transduction and transcription factors, cellular immune response, cell cycle and metabolism genes were the most prominent . Our results reveal several previously unknown alterations of host gene expression induced by influenza A virus which may provide new targets for further analysis of its role in this particular host-pathogen interaction. J Vet Med B Infect Dis Vet Public Health, 2004 Aug, 51(6), 272 - 7 Immunogenicity of murein-associated proteins from temperature-stressed Streptococcus suis cultures; Benga L et al.; We compared immunogenicity in pigs of whole cell lysate proteins (WCP) with murein-associated proteins (MAP) obtained from a virulent serotype 2 strain of Streptococcus (S.) suis grown at 32 or 42 degrees C . Protein fractions were tested for their ability to induce antibodies in 3-week-old piglets by enzyme-linked immunosorbent assay and Western blot analysis . We found a significant increase in the antibody levels in all sera irrespective of the preparation used for immunization . However, alpha-WCP sera showed higher reactivities than alpha-MAP sera, and piglets immunized with 32 degrees C preparations (alpha-32 sera) showed higher responses than those immunized with 42 degrees C preparations (alpha-42 sera) . Western blot analysis revealed that alpha-WCP sera in part reacted with different proteins when compared with alpha-MAP sera . Furthermore, some proteins were only detected by alpha-32 but not by alpha-42 sera . In conclusion, the results demonstrate the immunogenicity of cell wall MAP of S . suis, and highlight the importance of considering growth conditions in the preparation of subunit vaccines. Mol Microbiol, 2004 Oct, 54(1), 172 - 83 Identification of ComW as a new component in the regulation of genetic transformation in Streptococcus pneumoniae; Luo P et al.; Regulation of competence for genetic transformation in Streptococcus pneumoniae depends on a quorum-sensing system, genes involved in DNA uptake and recombination and a link between these two gene sets . The alternative sigma factor ComX provides this link . ComE, the response regulator of the quorum-sensing system, is required for expression of ComX and other early genes . However, an unknown ComE-dependent regulator is also required for competence when comX is expressed under control of the raffinose-responsive promoter of the aga operon . The gene comW (SP0018) is required for a high level of competence and is regulated by the quorum-sensing system, but its function is unknown . To explore its role further, comW was cloned into the multicopy plasmid pMSP3535, under the control of a nisin-inducible promoter (P(N)), and transformed into pneumococcal strains containing a raffinose-inducible comX gene (P(R)::comX) . Further introduction of a comE deletion blocked the endogenous CSP signal transduction pathway . In the resulting strain, competence was independent of CSP but depended on treatment with both nisin and raffinose, showing that coexpression of comW and comX complemented the comE deficiency . ComX protein accumulation and expression of a late competence gene in the above strain support the conclusion that ComW is a new positive factor involved in competence regulation. Mol Microbiol, 2004 Oct, 54(1), 159 - 71 Phase variable desialylation of host proteins that bind to Streptococcus pneumoniae in vivo and protect the airway; King SJ et al.; Most clinical isolates of Streptococcus pneumoniae consist of heterogeneous populations of at least two colony phenotypes, opaque and transparent, selected for in the bloodstream and nasopharynx, respectively . Microarray analysis revealed 24 orfs that demonstrated differences in expression greater than twofold between variants of independent strains . Twenty-one of these showed increased expression in the transparent variants, including 11 predicted to be involved in sugar metabolism . A single genomic region contains seven of these loci including the gene that encodes the neuraminidase, NanA . In contrast to previous studies, there was no contribution of NanA to adherence of S . pneumoniae to epithelial cells or colonization in an animal model . However, we observed NanA-dependent desialylation of human airway components that bind to the organism and may mediate bacterial clearance . Targets of desialylation included human lactoferrin, secretory component, and IgA2 that were shown to be present on the surface of the pneumococcus in vivo during pneumococcal pneumonia . The efficiency of desialylation was increased in the transparent variants and enhanced for host proteins binding to the surface of S . pneumoniae . Because deglycosylation affects the function of many host proteins, NanA may contribute to a protease-independent mechanism to modify bound targets and facilitate enhanced survival of the bacterium. Mol Microbiol, 2004 Oct, 54(1), 23 - 31 Molecular pathogenesis of neonatal group B streptococcal infection: no longer in its infancy; Doran KS et al.; The process of human infection by group B Streptococcus (GBS) is complex and multifactorial . While this bacterium has adapted well to asymptomatic colonization of adult humans, it remains a potentially devastating pathogen to susceptible infants . Advances in molecular techniques and refinement of in vitro and in vivo model systems have elucidated key elements of the pathogenic process, from initial attachment to the maternal vaginal epithelium to penetration of the newborn blood-brain barrier . Sequencing of two complete GBS genomes has provided additional context for interpretation of experimental data and comparison to other well-studied pathogens . Here we review recent discoveries regarding GBS virulence mechanisms, many of which are revealed or magnified by the unique circumstances of the birthing process and the deficiencies of neonatal immune defence . Appreciation of the formidable array of GBS virulence factors underscores why this bacterium remains at the forefront of neonatal pathogens. Lakartidningen, 2004 Aug 26, 101(35), 2642 - 4 {High-dose immunoglobulin--life-saving in invasive group A streptococcal infection . Report of eleven cases with only one fatality}; Arnholm B et al.; Invasive group A streptococcal infection is an uncommon but severe disease . Bloodcultures usually yield growth of Streptococcus pyogenes and the bacteria may also be isolated from sterile sites e.g . muscle or pleura . The most serious manifestation is Streptococcal Toxic Shock Syndrome (STSS) with or without necrotizing fasciitis (NF) . This condition may occur in about a fifth of the cases with a very high case-fatality rate . Preclinical data and case reports suggest that the fatality rate can be reduced by treatment of high-dose intravenous immunoglobulin . A European placebo-controlled clinical trial with immunoglobulin has been conducted but was prematurely terminated due to difficulties in patient recruitment . In our clinic we have during the last 3.5 years seen 41 patients with invasive group A streptococcal infection and 11 of these have received high-dose immunoglobulin . The indication for that treatment has been hypotension and multiorgan failure . All 11 patients but one fullfilled the criteria for STSS and 5 had NF . Most of the patients were treated with a single dose intravenous infusion of 50 g immunoglobulin . All patients were treated with both benzylpenicillin and clindamycin . Ten patients were fully recovered--case-fatality rate 9 percent . We suggest that patients with invasive group A streptococcal infections who develop STSS with or without NF should be treated with high-dose intravenous immunoglobulin. Drugs, 2004, 64(20), 2347 - 77 Moxifloxacin: a review of its use in the management of bacterial infections; Keating GM et al.; Moxifloxacin (Avelox) is a fluoroquinolone antibacterial with a methoxy group in the C-8 position and a bulky C-7 side chain . Moxifloxacin is approved for use in the treatment of acute exacerbations of chronic bronchitis (AECB), community-acquired pneumonia (CAP), acute bacterial sinusitis and uncomplicated skin and skin structure infections (approved indications may differ between countries) . Moxifloxacin has a broad spectrum of antibacterial activity, including activity against penicillin-resistant Streptococcus pneumoniae . It achieves good tissue penetration and has a convenient once-daily administration schedule, as well as being available in both intravenous and oral formulations in some markets . Moxifloxacin has good efficacy in the treatment of patients with AECB, CAP, acute bacterial sinusitis and uncomplicated skin and skin structure infections, and is generally well tolerated . Thus, moxifloxacin is an important option in the treatment of bacterial infections . J Dairy Sci, 2004 Jun, 87(6), 1727 - 31 Influence of prepartum pirlimycin hydrochloride or penicillin-novobiocin therapy on mastitis in heifers during early lactation; Oliver SP et al.; A study was conducted in 2 dairy research herds to determine whether prepartum therapy of heifer mammary glands with penicillin-novobiocin or pirlimycin hydrochloride was effective for reducing the percentage of heifers and mammary quarters infected with mastitis pathogens during early lactation . Almost 96% of Jersey heifers (67 of 70) and 71.3% of quarters (199 of 279) were infected 14 d before expected calving . Of the quarters infected at 14 d before expected parturition, 75% (54 of 72) were uninfected following treatment with penicillin-novobiocin; 87% (61 of 70) were uninfected following treatment with pirlimycin, and 56% (32 of 57) were uninfected in the untreated negative control group . The majority of intramammary infections in Jersey heifers were due to coagulase-negative staphylococci (61%), Streptococcus species, primarily Streptococcus uberis (19%), and Staphylococcus aureus (8%) . Almost 73% of Holstein heifers (40 of 55) and 34.3% of mammary quarters (73 of 213) were infected 14 d before expected calving . Of the quarters infected at 14 d before expected parturition, 76% (19 of 25) were uninfected following treatment with penicillin-novobiocin; 59% (17 of 29) were uninfected following treatment with pirlimycin, and 26% (5 of 19) were uninfected in the untreated negative control group . The majority of intramammary infections in Holstein heifers were due to coagulase-negative staphylococci (44%) and Staph . aureus (30%) . In both herds, the bacteriological cure rate was significantly higher in heifer mammary glands treated with penicillin-novobiocin or pirlimycin hydrochloride than in untreated controls . Prepartum therapy of heifer mammary glands with penicillin-novobiocin or pirlimycin hydrochloride significantly reduced the percentage of heifers and quarters infected with mastitis pathogens during early lactation. Chemotherapy, 2004 Oct, 50(4), 196 - 201 Epub 2004 Sep 23. Activity of nadifloxacin (OPC-7251) and seven other antimicrobial agents against aerobic and anaerobic Gram-positive bacteria isolated from bacterial skin infections; Nenoff P et al.; BACKGROUND AND METHODS: The in vitro activity of nadifloxacin (OPC-7251), a novel topical fluoroquinolone, was assessed and compared with those of ofloxacin, oxacillin, flucloxacillin, cefotiam, erythromycin, clindamycin, and gentamicin against 144 Gram-positive bacteria: 28 Staphylococcus aureus, 10 Streptococcus spp., 68 coagulase-negative staphylococci (CNS), 36 Propionibacterium acnes, and 2 Propionibacterium granulosum strains . All strains originated from bacterial-infected skin disease and were isolated from patients with impetigo, secondary infected wounds, folliculitis and sycosis vulgaris, and impetiginized dermatitis . In vitro susceptibility of all clinical isolates was tested by agar dilution procedure and minimum inhibitory concentrations (MICs) were determined . RESULTS: Nadifloxacin was active against all aerobic and anaerobic isolates . MIC(90) (MIC at which 90% of the isolates are inhibited) was 0.1 microg/ml for S . aureus, 0.78 microg/ml for both Streptococcus spp . and CNS, and 0.39 microg/ml for Propionibacterium spp . On the other hand, resistant strains with MICs exceeding 12.5 mug/ml were found in tests with the other antibiotics . For both CNS and Propionibacterium acnes, MIC(90) values > or =100 microg/ml were demonstrated for erythromycin . Ofloxacin, cefotiam, erythromycin, clindamycin and gentamicin exhibited MIC(90) values < or =1 microg/ml for some bacterial species tested . Both oxacillin and flucloxacillin were active against all investigated bacterial species with MIC(90) values < or =1 microg/ml . CONCLUSION: In summary, nadifloxacin, a topical fluoroquinolone, was found to be highly active against aerobic and anaerobic bacteria isolated from patients with infected skin disease, and seems to be a new alternative for topical antibiotic treatment in bacterial skin infections. Int Immunol, 2004 Nov, 16(11), 1605 - 11 Epub 2004 Sep 27. LPS-binding protein-deficient mice have an impaired defense against Gram-negative but not Gram-positive pneumonia; Branger J et al.; LPS-binding protein (LBP) can facilitate the transfer of cell wall components of both Gram-negative bacteria (LPS) and Gram-positive bacteria (lipoteichoic acid) to inflammatory cells . Although LBP is predominantly produced in the liver, recent studies have indicated that this protein is also synthesized locally in the lung by epithelial cells . To determine the role of LBP in the immune response to pneumonia, LBP gene-deficient (-/-) and normal wild-type (WT) mice were intra-nasally infected with either Streptococcus pneumoniae or Klebsiella pneumoniae, common Gram-positive and Gram-negative pathogens, respectively . Pneumococcal pneumonia was associated with a 7-fold rise in LBP concentrations in bronchoalveolar lavage fluid of WT mice; LBP-/- mice infected with S . pneumoniae showed a similar survival and a similar bacterial burden in their lungs 48 h post-infection . In Klebsiella pneumonia, however, LBP-/- mice demonstrated a diminished survival together with an enhanced bacterial outgrowth in their lungs . These data suggest that LBP is important for a protective immune response in Klebsiella pneumonia, but does not contribute to an effective host response in pneumococcal pneumonia. Anal Biochem, 2004 Oct 15, 333(2), 296 - 302 Detection of cariogenic bacteria genes by a combination of allele-specific polymerase chain reactions and a novel bioluminescent pyrophosphate assay; Arakawa H et al.; We developed a novel bioluminescent assay for detection of pyrophosphate in polymerase chain reaction (PCR) product . The principle of this method is as follows: pyrophosphate released by PCR is converted to adenosine 5'-triphosphate (ATP) by pyruvate phosphate dikinase in the presence of the substrate pyruvate phosphate and the coenzyme adenosine 5'-monophosphate; subsequently, ATP concentration is determined by firefly luciferase reaction . The detection limit of pyrophosphate is 1.56 x 10(-15)mol/assay . Additionally, luminescent intensity reached a maximum at approximately 100 s and remained elevated beyond 10 min . This approach is applicable to the detection of cariogenic bacteria in dental plaque . Thus, the allele-specific PCR products of Streptococcus mutans and Streptococcus sobrinus developed in this study were measured via the proposed bioluminescent assay . This protocol, which does not require expensive equipment, can be utilized to rapidly monitor cariogenic bacteria in dental plaque. Colloids Surf B Biointerfaces, 2004 Aug 15, 37(1-2), 53 - 60 Path-dependency of the interaction between coaggregating and between non-coaggregating oral bacterial pairs--a thermodynamic approach; Postollec F et al.; Coaggregation, i.e . specific recognition between bacteria from different species, is a well-described phenomenon in the human oral cavity but remains physically poorly understood . With our study we aimed at elucidating some aspects of the mechanism of the coaggregation between the oral bacteria Streptococcus oralis J22 and Actinomyces naeslundii 147, in particular with respect to the driving force for coaggregation and its pathway-dependency . To that end, the macroscopic turbidity of the bacterial suspension, the morphology of the coaggregates, binding isotherms and heats of interaction were compared between the above-mentioned coaggregating bacterial pair and a non-coaggregating pair, Streptococcus sanguis PK1889 and A . naeslundii 147 . The coaggregating pair forms large aggregates, which rapidly sediment from the suspension while the non-coaggregating pair forms only very small coaggregates that remain homogeneously suspended . Coaggregation is further characterized by a high affinity between the partner cells that bind to each other in a strong cooperative mode . The interactions between both pairs occur under the release of heat and are thus enthalpically favorable . More heat is released for the coaggregating than for the non-coaggregating pair . Adding the coaggregating bacteria in steps to each other leads to saturation of enthalpically favorable binding sites . This is observed when the streptococcus is added to the actinomyces as well as when the addition is done the other way around . It is concluded that the cooperativity of the coaggregation process is based on an increase of entropy . It is furthermore shown that the density of the coaggregates as well as the heat effect of formation of these coaggregates depend on the number of steps in which the partner cells are added to each other . Adding S . oralis J22 in three steps to A . naeslundii 147 results in the formation of denser coaggregates under the release of less heat, as compared to that of addition in one step . These differences point to a larger entropy increase when in a step-wise mixing the coaggregating bacteria are allowed to form more densely-packed coaggregates. Rev Med Chil, 2004 Feb, 132(2), 219 - 22 {Acute suppurative thyroiditis . Report of a pediatric case}; Giadrosich V et al.; Acute suppurative thyroiditis (AST) is an uncommon condition because thyroid gland is remarkably resistant to infections . In children, anatomic defects such as a left pyriform sinus fistula or a thyroglossal duct remnant predispose to this infection . Once the diagnosis is confirmed by ultrasound or computed tomography, antimicrobial therapy based on the culture and Gram staining must be started . After two or three weeks of treatment, predisposing anatomic defects must be sought cautiously . We report a 13 year old girl presenting with cervical pain and fever . A cervical ultrasound showed an enlarged thyroid lobule with hypoecogenic zones that suggested a supurative collection . Cefotaxime and cloxacillin were started . A needle aspiration of the collection obtained a purulent material . The culture of this material yielded a Streptococcus Pneumoniae . The clinical condition of the patient improved and she was discharged in good conditions . Two months later a contrast esophagus X ray did not show predisposing anatomic defects. Head Neck, 2004 Oct, 26(10), 854 - 60 Deep neck infection: analysis of 185 cases; Huang TT et al.; PURPOSE: This study reviews our experience with deep neck infections and tries to identify the predisposing factors of life-threatening complications . METHODS: A retrospective review was conducted of patients who were diagnosed as having deep neck infections in the Department of Otolaryngology at National Taiwan University Hospital from 1997 to 2002 . Their demographics etiology, associated systemic diseases, bacteriology, radiology, treatment, duration of hospitalization, complications, and outcomes were reviewed . The attributing factors to deep neck infections, such as the age and systemic diseases of patients, were also analyzed . RESULTS: One hundred eighty-five charts were recorded; 109 (58.9%) were men, and 76 (41.1%) were women, with a mean age of 49.5 +/- 20.5 years . Ninety-seven (52.4%) of the patients were older than 50 years old . There were 63 patients (34.1%) who had associated systemic diseases, with 88.9% (56/63) of those having diabetes mellitus (DM) . The parapharyngeal space (38.4%) was the most commonly involved space . Odontogenic infections and upper airway infections were the two most common causes of deep neck infections (53.2% and 30.5% of the known causes) . Streptococcus viridans and Klebsiella pneumoniae were the most common organisms (33.9%, 33.9%) identified through pus cultures . K . pneumoniae was also the most common infective organism (56.1%) in patients with DM . Of the abscess group (142 patients), 103 patients (72.5%) underwent surgical drainages . Thirty patients (16.2%) had major complications during admission, and among them, 18 patients received tracheostomies . Those patients with underlying systemic diseases or complications or who received tracheostomy tended to have a longer hospital stay and were older . There were three deaths (mortality rate, 1.6%) . All had an underlying systemic disease and were older than 72 years of age . CONCLUSIONS: When dealing with deep neck infections in a high-risk group (older patients with DM or other underlying systemic diseases) in the clinic, more attention should be paid to the prevention of complications and even the possibility of death . Early surgical drainage remains the main method of treating deep neck abscesses . Therapeutic needle aspiration and conservative medical treatment are effective in selective cases such as those with minimal abscess formation . (c) 2004 Wiley Periodicals, Inc. Eye . 2004 Sep 24; {Epub ahead of print} A model for the management of an atypical endophthalmitis outbreak; Anderson OA et al.; PURPOSE OF STUDY: To present a model for the assessment, investigation, and management of an atypical outbreak of infectious endophthalmitis of indeterminate aetiology . METHODS: A published statistical model was used to determine when the case-load constituted an outbreak . Intraocular surgery was discontinued and a multidisciplinary infection control team was formed aimed at identifying potential causative factors among the following categories: environment around theatre, preoperative preparation, intraoperative theatre practices, intraoperative surgical practices, postoperative practices, equipment maintenance guidelines, cleaning/sterilization practices, and microbiological screening . RESULTS: Five cases of postoperative endophthalmitis developed following uncomplicated phacoemulsification cataract surgery by different surgeons over a 7-month period . Despite full investigation no single focus of infection could be determined . Four out of five cases were culture positive . Three grew Streptococcus viridans of different strains . The fourth culture grew Staphylococcus aureus . In the absence of a single causative factor, it was postulated the combined effect of multiple potential factors may have led to an increased bacterial load and subsequent infection rate . Improved practices were initiated including new cleaning protocols to combat the build-up of debris on phacoemulsification instruments . Cataract surgery was resumed with 3-monthly microbiological monitoring . There have been no further cases in the 12 months following the changes . CONCLUSION: Outbreaks of endophthalmitis typically present over a short time period and could often be attributed to a single infective cause . We present our experience of detecting and managing this cluster and recommend a 'ground-up' multidisciplinary model to manage future outbreaks of this devastating condition.Eye advance online publication, 24 September 2004; doi:10.1038/sj.eye.6701695 Acta Crystallogr D Biol Crystallogr, 2004 Oct, 60(Pt 10), 1910 - 1 Epub 2004 Sep 23. Crystallization of GcnA, an N-acetyl-beta-D-glucosaminidase, from Streptococcus gordonii; Langley DB et al.; Streptococcus gordonii is a primary colonizer of the surface of human teeth . The gcnA gene is one of a number of genes involved in glycoside metabolism . GcnA has N-acetyl-beta-D-glucosaminidase (EC 3.2.1.52) activity; it has been overexpressed, purified and crystallized . Diffraction has been observed to beyond 1.5 A resolution and synchrotron data have been recorded to 1.55 A resolution . The crystals belong to the orthorhombic space group P2(1)2(1)2, with unit-cell parameters a = 112.5, b = 104.0, c = 110.0 A . The crystals contain either a monomer or a dimer in the asymmetric unit. Int J Syst Evol Microbiol, 2004 Sep, 54(Pt 5), 1753 - 6 Streptococcus halichoeri sp . nov., isolated from grey seals (Halichoerus grypus); Lawson PA et al.; Phenotypic and phylogenetic studies were performed on six unidentified, Gram-positive, catalase-negative, chain-forming Streptococcus-like organisms recovered from grey seals . Biochemically the six strains were highly related to each other, but they did not appear to correspond to any recognized species of the genus Streptococcus . Comparative 16S rRNA gene sequencing studies confirmed that phylogenetically the strains were members of the genus Streptococcus, but sequence divergence values of greater than 3 % compared with reference streptococcal species demonstrated that the organisms from seals represent a novel species . SDS-PAGE analysis of whole-cell proteins confirmed the phenotypic distinctiveness of the seal organisms . Based on biochemical criteria and molecular chemical and genetic evidence, it is proposed that the unknown organism from seals be classified as a novel species, Streptococcus halichoeri sp . nov., the type strain of which is CCUG 48324T (= CIP 108195T). Int J Syst Evol Microbiol, 2004 Sep, 54(Pt 5), 1505 - 10 Vagococcus carniphilus sp . nov., isolated from ground beef; Shewmaker PL et al.; Nine enterococcus-like strains were referred to the Streptococcus Laboratory at the Centers for Disease Control and Prevention (CDC) for further identification from the National Antimicrobial Resistance Monitoring System Laboratory at the CDC . The cultures were isolated from ground beef purchased from retail in Oregon in 2000 . Conventional biochemical testing and analysis of whole-cell protein electrophoretic profiles distinguished these strains from known species of enterococci and vagococci . Comparative 16S rRNA gene sequencing studies revealed that these strains were most closely related to the species Vagococcus fluvialis . DNA-DNA reassociation studies confirmed that these nine strains represented a new taxon . The relative binding ratio was 87 % or greater at the optimal temperature, and the divergence was less than 1 % for strains hybridized against the isolate designated the type strain . DNA-DNA relatedness was 25 % to V . fluvialis and 9 % or less to the other three species of Vagococcus . DNA-DNA relatedness was 33 % or less to the 25 currently described species of Enterococcus . On the basis of this evidence, it is proposed that these strains be classified as Vagococcus carniphilus sp . nov . The type strain of V . carniphilus is 1843-02T (= ATCC BAA-640T = CCUG 46823T) . The clinical significance (if any) of these strains is yet to be determined. Antimicrob Agents Chemother, 2004 Oct, 48(10), 4040 - 1 Resistance phenotypes and genotypes of erythromycin-resistant Streptococcus pneumoniae isolates in Beijing and Shenyang, China; Tiemei Z et al.; Of a total of 192 Streptococcus pneumoniae isolates, 149 (77.6%) were not susceptible to erythromycin . Of these 149 isolates, 117 (79.1%) contained the erm(B) gene, 16 (10.8%) contained the mef(A) gene, and 15 (10.1%) harbored both the erm(B) and mef(A) genes. Antimicrob Agents Chemother, 2004 Oct, 48(10), 4020 - 2 Alterations of penicillin-binding proteins 1A, 2X, and 2B in Streptococcus pneumoniae isolates for which amoxicillin MICs are higher than penicillin MICs; Kosowska K et al.; Penicillin-binding proteins (PBPs) of 15 selected penicillin- and amoxicillin-resistant Streptococcus pneumoniae isolates (MICs of 2 to 8 and 8 to 16 microg/ml, respectively) were studied . In addition to typical changes in PBPs 1A and 2X, these strains had 10 unique changes in PBP 2B, including a (618)A-G substitution, which may be the key alteration associated with amoxicillin resistance. Antimicrob Agents Chemother, 2004 Oct, 48(10), 3954 - 8 Mutant prevention concentrations for single-step fluoroquinolone-resistant mutants of wild-type, efflux-positive, or ParC or GyrA mutation-containing Streptococcus pneumoniae isolates; Smith HJ et al.; Three fluoroquinolone-susceptible and five fluoroquinolone-resistant (two with ParC Ser79Phe mutations, one with a GyrA Ser81Phe mutation, and two that were efflux positive) Streptococcus pneumoniae isolates were exposed to one, two, four, eight, and sixteen times the MICs of ciprofloxacin, gatifloxacin, gemifloxacin, levofloxacin, and moxifloxacin . Mutational frequencies were calculated at each multiple of the MIC for which growth was observed . Mutant prevention concentrations (MPCs) and the multiple of the MIC at the MPC (MP(MIC)) were evaluated . All resulting mutants were sequenced for quinolone resistance-determining region changes in GyrA and ParC and were evaluated for reserpine-sensitive efflux . The MPC order was generally ciprofloxacin > levofloxacin > gatifloxacin > moxifloxacin > gemifloxacin . The MP(MIC) order varied depending on the genetic constitution of the original isolates from which the mutants were generated . For those mutants created from fluoroquinolone-susceptible isolates (those that had wild-type ParC and GyrA and were efflux negative), the MP(MIC) order was ciprofloxacin = moxifloxacin > gemifloxacin > levofloxacin > gatifloxacin . The MP(MIC)s of each fluoroquinolone for mutants created from isolates with a ParC mutation (with wild-type GyrA and efflux negative) were similar . A similar occurrence was observed with the mutants created from the efflux-positive isolates (with wild-type ParC and GyrA) . The MP(MIC) order for the mutants created from the isolate with a GyrA mutation (with wild-type ParC and efflux negative) was ciprofloxacin = gemifloxacin > levofloxacin = moxifloxacin > gatifloxacin . Gatifloxacin, levofloxacin, and moxifloxacin may be intrinsically more able to prevent the development of resistance by fluoroquinolone-susceptible isolates, isolates that are efflux positive, or isolates that carry a GyrA mutation . However, once a ParC mutation is present, the MPC increases dramatically for all fluoroquinolones. Antimicrob Agents Chemother, 2004 Oct, 48(10), 3928 - 33 Daptomycin is highly efficacious against penicillin-resistant and penicillin- and quinolone-resistant pneumococci in experimental meningitis; Cottagnoud P et al.; The penetration of daptomycin, a new lipopeptide antibiotic, into inflamed meninges ranged between 4.37 and 7.53% (mean, 5.97%) . Daptomycin was very efficacious in the treatment of experimental pneumococcal meningitis, producing a decrease of -1.20 +/- 0.32 Deltalog(10) CFU/ml . h in the bacterial titer of Streptococcus pneumoniae against a penicillin-resistant strain and of -0.97 +/- 0.32 Deltalog(10) CFU/ml . h against a penicillin- and quinolone-resistant strain found in cerebrospinal fluid (CSF) . For both strains, daptomycin was significantly superior to the standard regimen of a combination of ceftriaxone with vancomycin, sterilizing 9 of 10 CSF samples after 4 h . In vitro, daptomycin produced highly bactericidal activity in concentrations above the MIC. Antimicrob Agents Chemother, 2004 Oct, 48(10), 3697 - 701 Antimicrobial evaluation of nocathiacins, a thiazole peptide class of antibiotics; Pucci MJ et al.; Nocathiacins are cyclic thiazolyl peptides with inhibitory activity against gram-positive bacteria . BMS-249524 (nocathiacin I), identified from screening a library of compounds against a multiply antibiotic-resistant Enterococcus faecium strain, was used as a lead chemotype to obtain additional structurally related compounds . The MIC assay results of BMS-249524 and two more water-soluble derivatives, BMS-411886 and BMS-461996, revealed potent in vitro activities against a variety of gram-positive pathogens including methicillin-resistant Staphylococcus aureus, penicillin-resistant Streptococcus pneumoniae, vancomycin intermediate-resistant S . aureus, vancomycin-resistant enterococci, Mycobacterium tuberculosis and Mycobacterium avium . Analysis of killing kinetics revealed that these compounds are bactericidal for S . aureus with at least a 3-log(10) reduction of bacterial growth within 6 h of exposure to four times the MICs . Nocathiacin-resistant mutants were characterized by DNA sequence analyses . The mutations mapped to the rplK gene encoding the L11 ribosomal protein in the 50S subunit in a region previously shown to be involved in the binding of related thiazolyl peptide antibiotics . These compounds demonstrated potential for further development as a new class of antibacterial agents with activity against key antibiotic-resistant gram-positive bacterial pathogens. J Mater Sci Mater Med, 2004 Jul, 15(7), 831 - 7 Antibacterial and bioactive silver-containing Na2O x CaO x 2SiO2 glass prepared by sol-gel method; Catauro M et al.; The antibacterial effect of addition of silver oxide to Na2O x CaO x 2SiO2 glass have been studied . Silver containing and silver free Na2O x CaO x 2SiO2 glasses have been prepared by sol-gel synthesis using tetramethil orthosilicate, sodium ethoxide, calcium nitrate tetrahydrate and silver nitrate as starting materials and methyl ethyl ketone as solvent . The gel was examined by differential thermal analysis, thermo gravimetric analysis, FTIR spectroscopy and X-ray diffraction analysis . Antibacterial and bioactive tests on gel glass powders, obtained after a heat treatment of 2 h at 600 degrees C of the dried gel, were carried out . High antimicrobial effects of samples against Escherichia coli and Streptococcus mutans were found . FTIR measurements and SEM micrographs have ascertained the formation of a hydroxyapatite layer on the surface of samples soaked in a simulated body fluid for different times