Zh Mikrobiol Epidemiol Immunobiol, 1999 May-Jun, (3), 3 - 6 {The seroresistance of enterobacteria isolated from different sources}; Gritsenko VA et al.; 395 representatives of the family Enterobacteriaceae, isolated from household and drinking water, from healthy and sick persons, were used as an example to demonstrate that their seroresistance was greatly connected with the type of the source from which these bacteria had been isolated . Experiments showed the phenotypic conversion of Escherichia coli towards an increase in their seroresistance on contact with human blood serum . The study revealed the pleiotropic effect produced by the action of serum on a number of other properties, responsible for survival in a macroorganism (anticomplement and antilysozyme activities, adhesive capacity and hydrophobic properties of the outer surface). Antibiot Khimioter, 2000, 45(4), 28 - 9 {Enterobacterial sensitivity to beta-lactam antibiotics}; Chernen'kaia TV; The susceptibility to betalactams of 868 enteric bacteria isolated from the patients at the hospital was studied . The isolated pathogens included: E . coli (549), Klebsiella sp . (195), Serratia sp . (124) . Ampicillin and cefazoline demonstrated the lowest activity . Cefotaxime, ceftazidime and imipenem were active against 90 per cent of isolates . Among E . coli isolates the susceptibility to the above mentioned drugs was the following: 95.1, 96.9, 99.3 per cent, among Klebsiella sp.--89.7, 88.7, 97.9 per cent, among Proteus sp.--89.5, 90.3, 91.9 per cent respectively . Thus cefotaxime may be used in antibacterial empiric therapy if Pseudomonas aeruginosa infection is excluded. Am J Vet Res, 2000 Jun, 61(6), 699 - 705 Use of repetitive sequence-based polymerase chain reaction for molecular epidemiologic analysis of Streptococcus equi subspecies equi; Al-Ghamdi GM et al.; OBJECTIVE: To determine whether repetitive sequence-based polymerase chain reaction (rep-PCR) could be used to differentiate Streptococcus equi isolates, to examine S equi isolates from throughout the world, and to determine whether a horse had > 1 subtype of S equi during an outbreak of disease . SAMPLE POPULATION: An initial group of 32 S equi isolates, 63 S equi isolates from various geographic areas, and 17 S equi isolates obtained during outbreaks of disease . PROCEDURE: An aliquot of S equi genomic DNA was amplified, using enterobacterial repetitive intergenic consensus primers . Gel electrophoresis was performed on 1.5% agarose gels, and a computed-assisted program was used to compare rep-PCR results . RESULTS: Use of these primers to analyze 100 ng of S equi genomic DNA resulted in patterns of 6 to 14 bands . The 32 initial isolates were separated into 7 rep-PCR subtypes . There were 30 rep-PCR subtypes found among 29 S equi isolates obtained from Minnesota, Michigan, Canada, and Australia and 34 S equi isolates obtained from Kentucky and other sources . Furthermore, the same clone was identified in several horses during an outbreak of disease . Infected horses on the same farm all had a single clone of S equi . CONCLUSION AND CLINICAL RELEVANCE: Analysis of these results suggests that rep-PCR is useful for delineating S equi into rep-PCR subtypes . Results revealed that isolates with the same geographic source or similar date of collection did not always have the same rep-PCR subtype . A single clone of S equi usually predominated during an outbreak of disease. Helicobacter, 2000 Jun, 5(2), 69 - 78 Different Helicobacter pylori strains colonize the antral and duodenal mucosa of duodenal ulcer patients; Thoreson AC et al.; BACKGROUND: We have investigated the possibility that the same patients may be colonized by Helicobacter pylori strains of different genotypes or phenotypes in the antrum as compared to in the duodenum . The strains were typed for DNA fingerprints, different lipopolysaccharides (LPS), and Lewis antigen expression on the O-side chains of LPS . MATERIALS AND METHODS: Polymerase chain reaction (PCR) amplifications using primer sequences (i.e., the Enterobacterial Repetitive Intergenic Consensus {ERIC}) and randomly amplified polymorphic DNA (RAPD) elements were performed to asses chromosomal DNA diversity between H . pylori strains . The expression of different LPS types and Lewis antigens in the various H . pylori isolates were determined by whole bacterial enzyme-linked immunosorbent assays using monoclonal antibodies . RESULTS: Duodenal ulcer patients had different H . pylori genotypes in the duodenum as compared to in the antrum as shown by ERIC-PCR (44%) and by RAPD-PCR (75%) . Different DNA patterns were found among the strains that were isolated from various regions of the duodenum in 4 of 16 patients (25%) as shown by ERIC-PCR and in 8 of 16 patients (50%) as shown by RAPD-PCR . Sixty-three percent of the duodenal ulcer patients had H . pylori strains with a different Lewis antigen phenotype in the duodenum as compared to in the antrum, and 3 of 16 patients (19%) had strains with different Lewis antigens expressed by strains from different duodenal biopsies from the same patient . CONCLUSION: The results suggest that a mixed population of different H . pylori strains with marked variation, both genotypically and phenotypically, colonize the same patient. Eur J Biochem, 2000 Jun, 267(12), 3672 - 84 Analysis of the domain structure and the DNA binding site of the transcriptional activator FhlA; Leonhartsberger S et al.; FhlA is the transcriptional activator of the genes coding for the formate hydrogen lyase system in Escherichia coli . It is activated by the binding of formate and induces transcription by sigma54 RNA polymerase after binding to specific upstream activating sequences (UAS) . Sequence comparison had shown that FhlA exhibits a structure composed of three domains, which is typical for sigma54-dependent regulators . By analyzing the N-terminal domain of FhlA of E . coli (amino acids 1-378; FhlA-N) and the rest of the protein (amino acids 379-693; FhlA-C) as separate proteins in vivo and in vitro the functions of the different domains of FhlA were elucidated . The FhlA-C domain is active in ATP hydrolysis and activation of transcription and its activity is neither influenced by the presence of formate nor of the antiactivator HycA . However, it is stimulated in the presence of the FhlA-specific UAS, indicating that this region of FhlA is responsible for DNA binding . FhlA-N is not active itself but able to reduce the activity of full-length FhlA in trans, probably by formation of nonfunctional heterooligomers . The DNA binding site of FhlA was analyzed by hydroxyradical footprinting . Each UAS consists of two binding sites of 16 bp separated by a spacer region . A consensus sequence could be deduced and a model is presented and supported by in vivo data in which a FhlA tetramer binds to the UAS on one side of the DNA helix . Performing an extensive screening we could show that the FhlA regulatory system is conserved in different species of the family Enterobacteriaceae . The analysis of orthologs of FhlA revealed that they are able to functionally replace the E . coli enzyme. J Extra Corpor Technol, 1999 Sep, 31(3), 125 - 9 Investigations into the sterility of manually assembled extracorporeal circuits with vented reservoirs; Searles B et al.; This study was designed to investigate the ability of an extracorporeal circuit (ECC) with a vented hard shell reservoir to remain sterile for a period of 72 h under dry conditions . The study was conducted in three phases . In Phase One: Two previously published methods for detecting contamination of the ECC were compared . A group of positive controls was collected by contaminating identical circuits with a known level of Enterobacter cloacae (ATTC: 13047) before initiating a regimen of "sample-dilute-sample" culturing . Negative controls for this phase were conducted by randomly sampling 1 L per manufacturer's lot of lactated ringers with each detection method . Culture results suggest that large volume filtration, but not small aliquot sampling, is sensitive to extremely low levels of contamination . No growth was detected in any negative control samples . In Phase Two: 19 ECC consisting of a membrane oxygenator, vented hardshell reservoir, arterial filter, and PVC tubing were removed from their sterile packages, assembled, and left unprotected in the moderate traffic environment of a research laboratory . The circuits were then primed with Lactated Ringer's solution . The prime solution was sampled for aerobic contamination by large volume filtration . None of the 19 samples detected contamination . In Phase Three: 43 ECC identical to the Phase Two circuits were assembled and left unprotected in the substerile pump room . The circuits were then primed, circulated, and cultured as in Phase Two . One of the 43 samples was discarded because of a recognized break in aseptic technique during sample collection . None of the remaining samples detected contamination . Mathematical calculations of binomial probabilities suggest that the chance of an open ECC developing a detectable level of contamination within 72 h of its dry assembly is insignificant. Int J Syst Evol Microbiol, 2000 May, 50 Pt 3, 1087 - 93 Rapid identification of Staphylococcus epidermidis; Wieser M et al.; During the collection of airborne bacteria in a museum in England some bacterial strains were isolated which due to their fatty acid profiles were clearly identified as members of the genus Staphylococcus . As fatty acid compositions of coagulase-negative staphylococci are very similar, differing only in quantities but not in qualities, further identification at the species level without a fatty acid database was not achieved . Investigation of the isolates using the Staph ID 32 API system resulted in an identification of the isolates as Staphylococcus epidermidis (probabilities of 79.7-95.5%) . For further genotypic characterization of these isolates, some Staphylococcus epidermidis strains from different sources and the type strains of Staphylococcus aureus, Staphylococcus capitis, Staphylococcus epidermidis, Staphylococcus gallinarum, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri and Staphylococcus xylosus were subjected to repetitive-sequence PCR, including enterobacterial repetitive intergenic consensus (ERIC) PCR, BOX-PCR and repetitive extragenic palindromic unit sequence (REP) PCR . ERIC- and BOX-PCR yielded a species-specific banding pattern for all Staphylococcus epidermidis strains . Furthermore, all staphylococcal reference strains investigated exhibited distinct banding patterns, clearly distinguishable from that of Staphylococcus epidermidis . No species-specific banding patterns could be observed after REP-PCR . As species identification of coagulase-negative staphylococci by fatty acid analyses and biochemical tests is known to be difficult ERIC- and BOX-PCR seem to be excellent tools for the identification of Staphylococcus epidermidis isolates. Int J Syst Evol Microbiol, 2000 May, 50 Pt 3, 1043 - 53 Characterization of Nodularia strains, cyanobacteria from brackish waters, by genotypic and phenotypic methods; Lehtimaki J et al.; An investigation was undertaken of the genetic diversity of Nodularia strains from the Baltic Sea and from Australian waters, together with the proposed type strain of Nodularia spumigena . The Nodularia strains were characterized by using a polyphasic approach, including RFLP of PCR-amplified 16S rRNA genes, 16S rRNA gene sequencing, Southern blotting of total DNA, repetitive extragenic palindromic- and enterobacterial repetitive intergenic consensus-PCR, ribotyping and phenotypic tests . With genotypic methods, the Nodularia strains were grouped into two clusters . The genetic groupings were supported by one phenotypic property: the ability to produce nodularin . In contrast, the cell sizes of the strains were not different in the two genetic clusters . 16S rRNA gene sequences indicated that all the Nodularia strains were closely related, despite their different origins . According to this study, two genotypes of Nodularia exist in the Baltic Sea . On the basis of the taxonomic definitions of Komarek et al . (Algol Stud 68, 1-25, 1993), the non-toxic type without gas vesicles fits the description of Nodularia sphaerocarpa, whereas the toxic type with gas vesicles resembles the species N . spumigena and Nodularia baltica. Proteins, 2000 Aug 1, 40(2), 290 - 8 Comparative X-ray analysis of the un-liganded fosfomycin-target murA; Eschenburg S et al.; MurA, an essential enzyme for the synthesis of the bacterial cell wall, follows an induced-fit mechanism . Upon substrate binding, the active site forms in the interdomain cleft, involving movements of the two domains of the protein and a reorientation of the loop Pro112-Pro121 . We compare two structures of un-liganded MurA from Enterobacter cloacae: a new orthorhombic form, solved to 1.80 A resolution, and a monoclinic form, redetermined to 1.55 A resolution . In the monoclinic form, the loop Pro112-Pro121 stretches into solvent, while in the new form it adopts a winded conformation, thereby reducing solvent accessibility of the critical residue Cys115 . In the interdomain cleft a network of 27 common water molecules has been identified, which partially shields negative charges in the cleft and stabilizes the orientation of catalytically crucial residues . This could support substrate binding and ease domain movements . Near the hinge region an isoaspartyl residue has been recognized, which is the product of post-translational modification of the genetically encoded Asn67-Gly68 . The homogeneous population with L-isoaspartate in both structures suggests that the modification in Enterobacter cloacae MurA is not a mere aging defect but rather the result of a specific in vivo process . Am J Infect Control, 2000 Jun, 28(3), 258 - 61 Enterobacter cloacae sepsis outbreak in a newborn unit caused by contaminated total parenteral nutrition solution; Tresoldi AT et al.; OBJECTIVE: The study aimed to investigate an outbreak caused by Enterobacter cloacae in a neonate intensive care unit . DESIGN: A descriptive study of an outbreak of sepsis in high-risk neonates was used . SETTING: The study was set in a tertiary care university teaching hospital . PATIENTS: The patients were 11 neonates infected with Enterobacter cloacae whose symptoms and signs of sepsis developed during a 16-hour period . All but one neonate received parenteral nutrition . Isolates from blood cultures, in-use parenteral nutrition solutions, and control aliquots of parenteral nutrition solution were typed by pulsed-field gel electrophoresis . RESULTS: Enterobacter cloacae was found in the refrigerated aliquots of parenteral nutrition solution, in blood cultures from infected newborns, and from in-use parenteral nutrition solutions . All these strains of Enterobacter cloacae had the same antibiotic susceptibility pattern and the same genomic DNA profile . The strain isolated from the one patient who did not receive parenteral nutrition presented a different susceptibility profile and genotype . CONCLUSION: The source of the nosocomial sepsis was the parenteral nutrition solution in 10 neonates . This contamination apparently occurred during preparation of the parenteral solution. J Antimicrob Chemother, 2000 Jun, 45(6), 895 - 8 Antimicrobial resistance in Enterobacteriaceae in Brooklyn, NY: epidemiology and relation to antibiotic usage patterns; Saurina G et al.; In November 1997, all Enterobacteriaceae isolated at 15 hospitals in Brooklyn were collected . Extended-spectrum beta-lactamases (ESBLs) were present in 44% of 409 Klebsiella pneumoniae isolates . Six isolates had reduced susceptibility to carbapenems, including two that were not susceptible to any of the antibiotics tested . Pulsed field gel electrophoresis revealed a commonality of resistant isolates within and between hospitals . The occurrence of ESBLcontaining isolates was associated with cephalosporin usage (P = 0.055) . ESBLs were present in 4.7% of Escherichia coli and 9.5% of Proteus mirabilis isolates . It is concluded that ESBL-producing Enterobacteriaceae are endemic in Brooklyn, are spread between hospitals, and may be associated with cephalosporin usage. J Antimicrob Chemother, 2000 Jun, 45(6), 881 - 5 Detection of extended-spectrum beta-lactamases in members of the family enterobacteriaceae: comparison of the MAST DD test, the double disc and the Etest ESBL; M'Zali FH et al.; A technically simple method-the MAST double disc (MDD) test-for the detection of extended-spectrum beta-lactamase (ESBL) production by bacteria is described . A wide range of ESBL, non-ESBL and Class 1 beta-lactamase-producing isolates was examined . The MDD test, which uses discs containing ceftazidime and a complementary disc containing ceftazidime and clavulanate and a second pair containing cefotaxime and cefotaxime and clavulanate was compared with the standard double disc diffusion test and an Etest method . Both the Etest and the MDD correctly identified 93% of ESBL producers . The MDD is an inexpensive alternative to current methods for the detection of ESBL production. N Z Med J, 2000 Mar 24, 113(1106), 96 - 8 Nosocomial blood stream infection in Auckland Healthcare hospitals; Nicholls TM et al.; AIM: To report the epidemiology of nosocomial bloodstream infections in Auckland Healthcare Hospitals . METHODS: From January 1995 to December 1997 every positive blood culture result was followed up by an infection control nurse who recorded relevant clinical, laboratory and treatment information on a data collection sheet . The clinical significance of each isolate was determined and the most likely source recorded . RESULTS: During the three year study period, there were 1,046 nosocomial blood stream infections yielding 1,147 isolates . The most common isolates/groups were: coagulase negative staphylococci 19%, S . aureus 18%, E . coli 12%, streptococci 10%, other Enterobacteriaceae 10%, Enterobacter spp . 7%, Pseudomonas spp . 5%, anaerobes 2%, and yeasts 4% . The most common sources were: intravascular lines 40%, urinary tract 8%, skin/soft tissue 8%, gastrointestinal 7%, and unknown 25% . The overall results were strongly influenced by the neonatal intensive care unit at National Women's Hospital where 58% of blood stream infections had intravascular-lines as the source and 53% of the isolates were coagulase negative staphylococci . The overall blood stream infection rate was approximately 6/1,000 admissions . Rates per 1,000 inpatient days for haematology, intensive care, oncology, neonatal and all other patients were 13, 11, 3, 3 and 1 respectively . CONCLUSIONS: Surveillance data that are clinically relevant are useful in identifying areas where infection prevention strategies can be implemented . Because of the importance of lines as a source of nosocomial blood stream infections all aspects of line care are being reviewed with the aim of reducing these devices as a source of blood stream infection. J Clin Microbiol, 2000 Jun, 38(6), 2204 - 9 Evaluation of IS200-PCR and comparison with other molecular markers To trace Salmonella enterica subsp . enterica serotype typhimurium bovine isolates from farm to meat; Millemann Y et al.; A procedure that uses an original molecular marker (IS200-PCR) and that is based on the amplification of DNA with outward-facing primers complementary to each end of IS200 has been evaluated with a collection of 85 Salmonella enterica subsp . enterica serotype Typhimurium isolates . These strains were isolated from a group of 10 cows at different stages: during transportation between the farm and the slaughterhouse, on the slaughter line, from the environment, and from the final product (ground beef) . The 85 isolates were characterized by their antibiotic resistance patterns and were compared by IS200-PCR and by use of four other genotypic markers . Those markers included restriction profiles for 16S and 23S rRNA (ribotypes) and amplification profiles obtained by different approaches: random amplified polymorphic DNA analysis, enterobacterial repetitive intergenic consensus PCR, and PCR ribotyping . The results of the IS200-PCR were in accordance with those of other molecular typing methods for this collection of isolates . Five different genotypes were found, which made it possible to refine the hypotheses on transmission obtained from phenotypic results . The genotyping results indicated the massive contamination of the whole group of animals and of the environment by one clonal strain originally recovered from one cow that excreted the strain . On the other hand, a few animals and their environment appeared to be simultaneously contaminated with genetically different strains. J Hosp Infect, 2000 May, 45(1), 35 - 41 Molecular investigation of Stenotrophomonas maltophilia isolates exhibiting rapid emergence of ticarcillin-clavulanate resistance; Barbier-Frebour N et al.; The prevalence of Stenotrophomonas maltophilia resistance to ticarcillin-clavulanate has dramatically increased in our hospital over the past few years . Sixty-six clinical isolates, collected from 61 patients, were tested for antibiotic susceptibility and genotyped by two different enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR) systems . Although two small outbreaks were identified in the medical intensive care unit, the remaining 58 strains generated 48 different PCR patterns . The rapid emergence of resistance in S . maltophilia occured in absence of an epidemic and was probably influenced by increasing-b-lactam use in our hospital . J Hosp Infect, 2000 May, 45(1), 19 - 28 An evaluation of hospital cleaning regimes and standards; Griffith CJ et al.; A four-part study assessing cleanliness in up to 113 environmental surfaces in an operating theatre and a hospital ward is reported . Surfaces were assessed visually, using microbiological methods and ATP bioluminescence . Results from a preliminary random survey indicated variability in cleanliness . These results were then used to select sites for monitoring before and after routine cleaning, over a 14-day period . Using published microbiological and ATP specifications 70 and 76% of these sites were unacceptable after cleaning . Visual assessment was a poor indicator of cleaning efficacy with only 18% considered unacceptable . Sites most likely to fail in the ward were in the toilet and kitchen, areas which are frequently implicated in the spread of infectious intestinal disease . Operating theatre sites had lower ATP results but 61% of sites would be considered unacceptable . There was no significant difference in general microbiological or ATP results overall before and after routine cleaning . Although some important hand contact sites showed no significant difference, overall there was a significant decrease in staphylococcal and enterobacteria counts in the ward but not in the operating theatre after cleaning . The routine cleaning programmes used did not include a biocide and cleaning using a hypochlorite based sanitizer gave much lower values . The results are discussed in relation to infection control, cleaning audits and cleaning schedules: an integrated cleaning monitoring programme using ATP bioluminescence in conjunction with visual and microbiological assessments is recommended . Indian J Pediatr, 1996 Jul-Aug, 63(4), 517 - 21 Intravenous immunoglobulin for prophylaxis of nosocomial sepsis; Atici A et al.; A total of 76 premature newborn infants with gestational age of 34 weeks or less were enrolled in a randomized controlled study to determine whether intravenously administrated immunoglobulin (IVIG) is able to prevent nosocomial sepsis . Forty infants were given 0.5 g/kg IVIG on the first day of life and 36 infants with similar gestational age and birth weight were selected as controls and did not receive IVIG . The frequency of proven sepsis, with a positive blood and/or cerebrospinal fluid culture, was significantly lower in infants who received IVIG as compared to controls (42.5 vs 80.0%) (p < 0.01) . The mortality rate attributable to infection was not different in IVIG recipients and in controls (41 vs 48%) (p > 0.05) . The overall mortality rates in the two groups were not different either (35.0 vs 44.4%) (p > 0.05) . The majority of micro-organisms isolated from the blood culture of the patients were gram negative microorganisms (Klebsiella, Enterobacter) . IVIG therapy was believed to be effective for prophylaxis of nosocomial infection, but such therapy was not able to reduce overall mortality rate or mortality rate due to systemic infection in prematurely born infants in our intensive care unit where the causative pathogens are usually gram negative microorganisms. Appl Environ Microbiol, 2000 Jun, 66(6), 2536 - 40 Role of volatile fatty acids in development of the cecal microflora in broiler chickens during growth; van Der Wielen PW et al.; It is known that volatile fatty acids can inhibit growth of species of the family Enterobacteriaceae in vitro . However, whether these volatile fatty acids affect bacterial populations in the ceca of chickens is unknown . Therefore, a study was conducted to investigate if changes in volatile fatty acids in ceca of broiler chickens during growth affect bacterial populations . Results showed that members of the Enterobacteriaceae and enterococci are present in large numbers in 3-day-old broilers and start to decrease when broilers grow older . Lactobacilli are present in large numbers as well in 3-day-old broilers, but they remain stable during the growth of broilers . Acetate, butyrate, and propionate increase from undetectable levels in 1-day-old broilers to high concentrations in 15-day-old broilers, after which they stabilize . Significant negative correlations could be calculated between numbers of Enterobacteriaceae and concentrations of undissociated acetate, propionate, and butyrate . Furthermore, pure cultures of Enterobacteriaceae isolated from the ceca were grown in the presence of volatile fatty acids . Growth rates and maximal optical density decreased when these strains grew in the presence of increasing volatile fatty acid concentrations . It is concluded that volatile fatty acids are responsible for the reduction in numbers of Enterobacteriaceae in the ceca of broiler chickens during growth. Appl Environ Microbiol, 2000 Jun, 66(6), 2318 - 24 Molecular cloning, sequencing, and expression of omp-40, the gene coding for the major outer membrane protein from the acidophilic bacterium Thiobacillus ferrooxidans; Guiliani N et al.; Thiobacillus ferrooxidans is one of the chemolithoautotrophic bacteria important in industrial biomining operations . Some of the surface components of this microorganism are probably involved in adaptation to their acidic environment and in bacterium-mineral interactions . We have isolated and characterized omp40, the gene coding for the major outer membrane protein from T . ferrooxidans . The deduced amino acid sequence of the Omp40 protein has 382 amino acids and a calculated molecular weight of 40,095.7 . Omp40 forms an oligomeric structure of about 120 kDa that dissociates into the monomer (40 kDa) by heating in the presence of sodium dodecyl sulfate . The degree of identity of Omp40 amino acid sequence to porins from enterobacteria was only 22% . Nevertheless, multiple alignments of this sequence with those from several OmpC porins showed several important features conserved in the T . ferrooxidans surface protein, such as the approximate locations of 16 transmembrane beta strands, eight loops, including a large external L3 loop, and eight turns which allowed us to propose a putative 16-stranded beta-barrel porin structure for the protein . These results together with the previously known capacity of Omp40 to form ion channels in planar lipid bilayers strongly support its role as a porin in this chemolithoautotrophic acidophilic microorganism . Some characteristics of the Omp40 protein, such as the presence of a putative L3 loop with an estimated isoelectric point of 7.21 allow us to speculate that this can be the result of an adaptation of the acidophilic T . ferrooxidans to prevent free movement of protons across its outer membrane. Biometals, 2000 Mar, 13(1), 65 - 72 A gene of the major facilitator superfamily encodes a transporter for enterobactin (Enb1p) in Saccharomyces cerevisiae; Heymann P et al.; While in fungi iron transport via hydroxamate siderophores has been amply proven, iron transport via enterobactin is largely unknown . Enterobactin is a catecholate-type siderophore produced by several enterobacterial genera grown in severe iron deprivation . By using the KanMX disruption module in vector pUG6 in a fet3delta background of Saccharomyces cerevisiae we were able to disrupt the gene YOL158c Sce of the major facilitator super family (MFS) which has been previously described as a gene encoding a membrane transporter of unknown function . Contrary to the parental strain, the disruptant was unable to utilize ferric enterobactin in growth promotion tests and in transport assays using 55Fe-enterobactin . All other siderophore transport properties remained unaffected . The results are evidence that in S . cerevisiae the YOL158c Sce gene of the major facilitator super family, now designated ENB1, encodes a transporter protein (Enb1p), which specifically recognizes and transports enterobactin. Infect Dis Clin North Am, 2000 Jun, 14(2), 435 - 47, ix Cephalosporins, carbapenems, and monobactams; Asbel LE et al.; Nonpenicillin beta-lactams exhibit a variable spectrum of antimicrobial activity, have a wide range of clinical uses and a favorable safety profile . Cefepime's twice-daily dosage and increased activity against Enterobacteriaceae may offer some advantages over older cephalosporins . The carbapenems offer a broad antimicrobial spectrum, and meropenem has an improved safety profile compared with imipenem . Aztreonam is a useful alternative for patients with aerobic gram-negative infections who are allergic to penicillin . The emergence of resistant organisms, however, is an increasing problem with the frequent use of these antibiotics. Curr Microbiol, 2000 Jun, 40(6), 367 - 71 Transformation of internal extracellular bacteria isolated from Rhagoletis completa cresson gut with enhanced green fluorescent protein; Peloquin JJ et al.; We discovered Zeocintrade mark is an effective antibiotic against Enterobacter agglomerans and Klebsiella pneumoniae strains isolated from the walnut husk fly (Rhagoletis completa Cresson: Family Tephritidae) and that bleomycin resistance can be used as a selective marker in transforming plasmids . We transformed Ent . agglomerans and K . pneumoniae strains originally isolated from their close association with R . completa gut to produce enhanced green fluorescent protein, a variant of green fluorescent protein in the first demonstration of genetic transformation of internal extracellular bacteria isolated from a tephritid pest . We report methods for plasmid-mediated transformation of these bacteria, the expression of fluorescent marker protein from the transforming plasmids, and the stability of the transforming plasmid in the bacteria . We also discuss applications of this technology in the study of pest biology and control implementation. Scand J Infect Dis, 2000, 32(2), 189 - 96 Influence of breastmilk on the development of resistance to intestinal colonization in infants born at the Atma Jaya Hospital, Jakarta; Bonang G et al.; A study of intestinal colonization resistance (CR) in breastfed versus formula-fed newborns at 4 intervals after birth in Jakarta, Indonesia, is described . To measure the intestinal CR for gram-negative enterobacilli, mean values of Enterobacteriaceae concentrations and mean numbers of Enterobacteriaceae biotypes were determined . The CR values found in this study show, that in all 4 sampling periods, at < 1, 2, 4 and 6 months, the mean concentration of Enterobacteriaceae was somewhat lower in the breastfed group than in the formula-fed group (only significant at 6 months) . This means that the intestinal CR of the breastfed group may have been slightly higher than that in the formula-fed group . In both study groups, the CR was lower in the second and fourth month than soon after birth and at 6 months . For epidemiological reasons, comparison was performed of the Enterobacteriaceae biotypes found in samples from mother and child . The data show that, in the first sampling period, regardless of the theoretical possibility of a 'more intense (skin) contact' during breastfeeding (which might promote transfer of also microorganisms), the breastfed infants had a significantly lower percentage of identical Enterobacteriaceae biotypes than did the formula-fed group . This could possibly be ascribed to a higher CR in the breastfed group . Determination of the concentration of Enterococcus species was found applicable to reproducibly measure the CR in the newborns at 6 months and in the mother-group. J Food Prot, 2000 May, 63(5), 633 - 7 Effect of electron beam irradiation on color and microbial bioburden of red paprika; Nieto-Sandoval JM et al.; The effect of irradiation with electron beams on the microbiological quality and color properties of red paprika was examined . The irradiation doses ranged from 0 to 12.5 kGy . The counts performed were total mesophilic aerobic microorganisms, Enterobacteriaceae, coliforms, sulfite-reducing clostridia, molds, and yeasts . It was concluded that molds, yeasts, and sulfite-reducing clostridia were the most resistant species, although a 10-kGy dose of irradiation leads to optimum sanitation . Extractable color and apparent color were analyzed to appraise the incidence of the irradiation treatments in the color properties of red paprika . Extractable color was determined according to the American Spice Trade Association method, and apparent color was analyzed by reflectance using the CIELab color space . Data showed no significant differences between the color properties of irradiated and nonirradiated samples . Irradiation was a suitable procedure to minimize the bioburden of red paprika with small modifications of its color properties. Antimicrob Agents Chemother, 2000 Jun, 44(6), 1470 - 8 Biochemical-genetic characterization and regulation of expression of an ACC-1-like chromosome-borne cephalosporinase from Hafnia alvei; Girlich D et al.; A naturally occurring AmpC beta-lactamase (cephalosporinase) gene was cloned from the Hafnia alvei 1 clinical isolate and expressed in Escherichia coli . The deduced AmpC beta-lactamase (ACC-2) had a pI of 8 and a relative molecular mass of 37 kDa and showed 50 and 47% amino acid identity with the chromosome-encoded AmpCs from Serratia marcescens and Providentia stuartii, respectively . It had 94% amino acid identity with the recently described plasmid-borne cephalosporinase ACC-1 from Klebsiella pneumoniae, suggesting the chromosomal origin of ACC-1 . The hydrolysis constants (k(cat) and K(m)) showed that ACC-2 was a peculiar cephalosporinase, since it significantly hydrolyzed cefpirome . Once its gene was cloned and expressed in E . coli (pDEL-1), ACC-2 conferred resistance to ceftazidime and cefotaxime but also an uncommon reduced susceptibility to cefpirome . A divergently transcribed ampR gene with an overlapping promoter compared with ampC (bla(ACC-2)) was identified in H . alvei 1, encoding an AmpR protein that shared 64% amino acid identity with the closest AmpR protein from P . stuartii . beta-Lactamase induction experiments showed that the ampC gene was repressed in the absence of ampR and was activated when cefoxitin or imipenem was added as an inducer . From H . alvei 1 cultures that expressed an inducible-cephalosporinase phenotype, several ceftazidime- and cefpirome-cross-resistant H . alvei 1 mutants were obtained upon selection on cefpirome- or ceftazidime-containing plates, and H . alvei 1 DER, a ceftazidime-resistant mutant, stably overproduced cephalosporinase . Transformation of H . alvei 1 DER or E . coli JRG582 (ampDE mutant) harboring ampC and ampR from H . alvei 1 with a recombinant plasmid containing ampD from E . coli resulted in a decrease in the MIC of beta-lactam and recovery of an inducible phenotype for H . alvei 1 DER . Thus, AmpR and AmpD proteins may regulate biosynthesis of the H . alvei cephalosporinase similarly to other enterobacterial cephalosporinases. Int Surg, 2000 Jan-Mar, 85(1), 77 - 81 Fournier's gangrene in Nigeria: a review of 21 consecutive patients; Eke N et al.; A review of 21 consecutive cases of Fournier's gangrene seen at the University of Port Harcourt Teaching Hospital (UPTH) in the period 1994-1998 is presented . All the patients were males with an average age of 43.4 years . Most of the patients had a predisposing factor . There was a low incidence of pre-existing medical conditions . The commonest organisms isolated were of the enterobacteria group . All the patients were treated with antibiotics, surgical debridement and frequent wound dressings with hypertonic saline, hydrogen peroxide and Eusol . In 71.4% of the cases, the wounds healed by secondary intention . The mortality was 9.5% . The deaths occurred in the older age group . We recommend surgical debridement of necrotic tissues as they present and suggest that the surgical procedures be minimal as scrotal wounds heal satisfactorily. J Biotechnol, 2000 Apr 14, 79(1), 63 - 72 Use of a plasmid of a yersinia enterocolitica biogroup 1A strain for the construction of cloning vectors; Strauch E et al.; A plasmid with a size of 2,682 base pairs isolated from the Yersinia enterocolitica biogroup 1A strain # 29807 was characterized in respect to its suitability as a basic replicon for cloning vectors . The copy number of the plasmid was determined to be approximately 14 copies per cell and it was shown to be compatible with vectors with an origin of replication derived from ColE1 and p115A . The replication region of the plasmid encodes a primer RNAI and countertranscript RNAII . Two vectors, pIV1 and pIV2, containing a kanamycin resistance gene and the lacZalpha fragment with the multiple cloning site of pBluescriptSK + were constructed . A mobilizable derivative was successfully introduced into different bacteria belonging to the family Enterobacteriacea . To prove the applicability of the novel vectors for cloning purposes, a 13 kb hemolysin operon of Escherichia coli was inserted into pIV1, and the resulting recombinant plasmid was stably maintained and expressed in E . coli and Y . enterocolitica. Methods, 2000 Jun, 21(2), 125 - 32 Plasminogen activation in degradation and penetration of extracellular matrices and basement membranes by invasive bacteria; Lahteenmaki K et al.; Methods to assess in vitro the role of plasminogen activation in enterobacterial degradation of extracellular matrices and their protein components as well as in penetration through basement membrane are described . Development of these methods was initiated after the findings that enterobacterial surface structures (fimbriae and the Pla surface protease) function in plasminogen activation as well as in laminin- and/or fibronectin-specific adhesion . Enterobacteria with these properties degrade radiolabeled laminin as well as metabolically labeled extracellular matrix from cultured endothelial or epithelial cells . Plasmin-coated bacteria also penetrate through the reconstituted basement membrane preparation Matrigel . The processes are dependent on plasminogen activation by the invasive bacteria . The results suggest a pathogenic similarity between enterobacteria and tumor cells in cellular metastasis through tissue barriers . Clin Infect Dis, 2000 May, 30(5), 799 - 808 Epub 2000 Apr 28. Antimicrobial susceptibility testing: special needs for fastidious organisms and difficult-to-detect resistance mechanisms; Jorgensen JH et al.; Clinical microbiology laboratories are faced with the challenge of accurately detecting emerging antibiotic resistance among a number of bacterial pathogens . In recent years, vancomycin resistance among enterococci has become prevalent, as has penicillin resistance and multidrug resistance in pneumococci . More recently, strains of methicillin-resistant Staphylococcus aureus with reduced susceptibility to vancomycin have been encountered . In addition, molecular techniques have demonstrated that there are still problems detecting methicillin resistance in staphylococci, especially in coagulase-negative species . Among members of the family Enterobacteriaceae, mutated beta-lactamase enzymes may confer difficult-to-detect resistance to later-generation penicillins and cephalosporins . Anaerobic bacteria are no longer entirely predictable in their susceptibility to agents that might be selected for empiric therapy . Therefore, clinical microbiology laboratories may not be able to rely on a single susceptibility testing method or system to detect all those emerging resistant or fastidious organisms . For reliable detection, laboratories may need to employ conventional, quantitative susceptibility testing methods or use specially developed, single concentration agar screening tests for some resistant species . Certain of these screening tests are highly specific, while others may require additional confirmatory testing for definitive results . Therefore, laboratories must retain the versatility to apply several different approaches to detect resistance in both common and infrequently encountered bacterial pathogens. Transfus Clin Biol, 2000 Apr, 7(2), 171 - 6 {Prevalence of bacterial contamination of standard platelet units: prospective study}; Loukhmas L et al.; BACKGROUND: Platelet concentrates contaminated with bacteria are a main source of transfusion-associated sepsis . Several studies have reported a very wide incidence (0-10%) of contamination . The aim of this study is to assess the prevalence of bacterial contamination of standard platelet units at the regional blood transfusion center in Casablanca . STUDY DESIGN AND METHODS: During 15.5 months, 3,458 platelet concentrates (PCs) were analysed . The plasma from the bag and the tube was homogenised . One-fifth of the tube contents were inoculated every day for five days in two tubes containing 2.5 mL of Tryptic soy broth . One tube was incubated at room temperature and the other at 37 degrees C for 24 hours . The bacteria were identified by standard procedures . RESULTS: Twenty-five (0.72%) of 3,458 platelet bags were contaminated . Twenty-two bacteria (88%) were found in the platelet bags stored three days or more, of which 14 (56%) were Staphylococci coagulase negative, two Staphylococcus aureus, one alpha-haemolytic Streptococcus, four bacillus cereus, one Enterobacter cloacae, one Escherichia Coli and two Xanthomonas maltophilia . CONCLUSION: The incidence reported in this series is higher than that reported by most authors. Am J Gastroenterol, 2000 May, 95(5), 1231 - 8 Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome; Nobaek S et al.; OBJECTIVE: The influence of the gastrointestinal (GI) microflora in patients with irritable bowel syndrome (IBS) has not been clearly elucidated . This study was undertaken to see if patients with IBS have an imbalance in their normal colonic flora, as some bacterial taxa are more prone to gas production than others . We also wanted to study whether the flora could be altered by exogenous supplementation . In a previous study we have characterized the mucosa-associated lactobacilli in healthy individuals and found some strains with good colonizing ability . Upon colonization, they seemed to reduce gas formation . METHODS: The study comprised 60 patients with IBS and a normal colonoscopy or barium enema . Patients fulfilling the Rome criteria, without a history of malabsorption, and with normal blood tests underwent a sigmoidoscopy with biopsy . They were randomized into two groups, one receiving 400 ml per day of a rose-hip drink containing 5 x 10(7) cfu/ml of Lactobacillus plantarum (DSM 9843) and 0.009 g/ml oat flour, and the other group receiving a plain rose-hip drink, comparable in color, texture, and taste . The administration lasted for 4 wk . The patients recorded their own GI function, starting 2 wk before the study and continuing throughout the study period . Twelve months after the end of the study all patients were asked to complete the same questionnaire regarding their symptomatology as at the start of the study . RESULTS: All patients tolerated the products well . The patients receiving Lb . plantarum had these bacteria on rectal biopsies . There were no major changes of Enterobacteriaceae in either group, before or after the study, but the Enterococci increased in the placebo group and remained unchanged in the test group . Flatulence was rapidly and significantly reduced in the test group compared with the placebo group (number of days with abundant gas production, test group 6.5 before, 3.1 after vs 7.4 before and 5.6 after for the placebo group) . Abdominal pain was reduced in both groups . At the 12-month follow-up, patients in the test group maintained a better overall GI function than control patients . There was no difference between the groups regarding bloating . Fifty-nine percent of the test group patients had a continuous intake of fermented products, whereas the corresponding figure for the control patients was 73% . CONCLUSIONS: The results of the study indicate that the administration of Lb . plantarum with known probiotic properties decreased pain and flatulence in patients with IBS . The fiber content of the test solution was minimal and it is unlikely that the fiber content could have had any effect . This type of probiotic therapy warrants further studies in IBS patients. J Biol Chem, 2000 May 19, 275(20), 15526 - 34 ATP modulates subunit-subunit interactions in an ATP-binding cassette transporter (MalFGK2) determined by site-directed chemical cross-linking; Hunke S et al.; The binding protein-dependent maltose transport system of enterobacteria (MalFGK(2)), a member of the ATP-binding cassette (ABC) transporter superfamily, is composed of two integral membrane proteins, MalF and MalG, and of two copies of an ATPase subunit, MalK, which hydrolyze ATP, thus energizing the translocation process . In addition, an extracellular (periplasmic) substrate-binding protein (MalE) is required for activity . Ligand translocation and ATP hydrolysis are dependent on a signaling mechanism originating from the binding protein and traveling through MalF/MalG . Thus, subunit-subunit interactions in the complex are crucial to the transport process but the chemical nature of residues involved is poorly understood . We have investigated the proximity of residues in a conserved sequence ("EAA" loop) of MalF and MalG to residues in a helical segment of the MalK subunits by means of site-directed chemical cross-linking . To this end, single cysteine residues were introduced into each subunit at several positions and the respective malF and malG alleles were individually co-expressed with each of the malK alleles . Membrane vesicles were prepared from those double mutants that contained a functional transporter in vivo and treated with Cu(1,10-phenanthroline)(2)SO(4) or bifunctional cross-linkers . The results suggest that residues Ala-85, Lys-106, Val-114, and Val-117 in the helical segment of MalK, to different extents, participate in constitution of asymmetric interaction sites with the EAA loops of MalF and MalG . Furthermore, both MalK monomers in the complex are in close contact to each other through Ala-85 and Lys-106 . These interactions are strongly modulated by MgATP, indicating a structural rearrangement of the subunits during the transport cycle . These data are discussed with respect to current transport models. Chest, 2000 May, 117(5), 1434 - 42 A comparative analysis of patients with early-onset vs late-onset nosocomial pneumonia in the ICU setting; Ibrahim EH et al.; STUDY OBJECTIVE: To compare the clinical outcomes of critically ill patients developing early-onset nosocomial pneumonia (NP; ie, within 96 h of ICU admission) and late-onset NP (ie, occurring after 96 h of ICU admission) . DESIGN: Prospective cohort study . SETTING: A medical ICU and a surgical ICU from a university-affiliated urban teaching hospital . PATIENTS: Between July 1997 and November 1998, 3, 668 patients were prospectively evaluated . INTERVENTION: Prospective patient surveillance and data collection . RESULTS: Four hundred twenty patients (11.5%) developed NP . Early-onset NP was observed in 235 patients (56.0%), whereas 185 patients (44.0%) developed late-onset NP . Among patients with early onset NP, 114 patients (48 . 5%) spent at least 24 h in the hospital prior to ICU admission, compared to 57 patients (30.8%) with late-onset NP (p = 0.001) . One hundred eighty-three patients (77.9%) with early-onset NP received antibiotics prior to the development of NP, as compared to 162 patients (87.6%) with late-onset NP (p = 0.010) . The most common pathogens associated with early-onset NP were Pseudomonas aeruginosa (25.1%), oxacillin-sensitive Staphylococcus aureus (OSSA; 17.9%), oxacillin-resistant S aureus (ORSA; 17.9%), and Enterobacter species (10.2%) . P aeruginosa (38.4%), ORSA (21.1%), Stenotrophomonas maltophilia (11.4%), OSSA (10.8%), and Enterobacter species (10.3%) were the most common pathogens associated with late-onset NP . The ICU length of stay was significantly longer for patients with early-onset NP (10.3 +/- 8.3 days; p < 0.001) and late-onset NP (21 . 0 +/- 13.7 days; p < 0.001), as compared to patients without NP (3.5 +/- 3.2 days) . Hospital mortality was significantly greater for patients with early-onset NP (37.9%; p = 0.001) and late-onset NP (41.1%; p = 0.001) compared to patients without NP (13.1%) . CONCLUSIONS: Both early-onset and late-onset NP are associated with increased hospital mortality rates and prolonged lengths of stay . The pathogens associated with NP were similar for both groups . This may be due, in part, to the prior hospitalization and use of antibiotics in many patients developing early-onset NP . These data suggest that P aeruginosa and ORSA can be important pathogens associated with early-onset NP in the ICU setting . Additionally, clinicians should be aware of the common microorganisms associated with both early-onset NP and late-onset NP in their hospitals in order to avoid the administration of inadequate antimicrobial treatment. Spine, 2000 May 15, 25(10), 1287 - 9 Enterobacter agglomerans spondylodiscitis: a possible, unrecognized complication of tetracycline therapy; Porter P et al.; STUDY DESIGN: This case report describes infection in a lumbar disc in a healthy young man with an organism of low pathogenicity . The patient was taking a prolonged course of antibiotics at the time the infection occurred . OBJECTIVE: To describe this unique case of infective spondylodiscitis . SUMMARY OF BACKGROUND DATA: To the authors' knowledge, spinal infection with Enterobacter agglomeranshas never been reported . This organism is a transient gut colonizer, and may have established itself secondary to the patient's prolonged ingestion of tetracycline for acne . METHODS: This 22-year-old farmer had spontaneous lumbar back pain . Radiologic investigations showed an abnormality in the L4-L5 disc region, and together with other investigations, were suggestive of infection . The diagnosis was confirmed by surgical aspiration . RESULTS: Antibiotic therapy was administered, and the patient made a complete recovery . Follow-up radiographs showed a complete loss of the L4-L5 disc space with only minimal bone destruction . CONCLUSION: A unique cause of infective lumbar discitis is presented . Several features of this case are unusual . The magnetic resonance findings were not readily diagnostic . The cultured organism is usually nonpathogenic . The infection may have been secondary to prolonged tetracycline therapy. Rinsho Byori, 2000 Jan, Suppl 111, 9 - 16 {Drug-resistant bacteria in clinical situations}; Watanabe A; There are two major categories of drug-resistant bacteria that can cause severe and intractable infections . The first includes multi drug-resistant Mycobacterium tuberculosis(MDRMT), penicillin-resistant Streptococcus pneumoniae(PRSP), and beta-lactamase positive or negative ampicillin-resistant Haemophilus influenzae, which used to be isolated from the patients with community-acquired infection . However, these pathogens have been often isolated in recent years from patients with hospital/chronic care facilities/nursing-home mass infection . The second major category includes methicillin-resistant Staphylococcus aureus(MRSA), vancomycin-resistant Enterococcus species(VRE), Pseudomonas aeruginosa, and Enterobacteriaceae including extended-spectrum beta-lactamases(ESBLs) producing strain, which are mainly isolated from compromised patients with nosocomial infections . The pathogenicity of these pathogens, almost all of which are found in the normal flora of humans, is weak, but often cause nosocomial infections in compromised patients . We need, therefore, surveillance system for these pathogens, and carefully determine whether these pathogens, if isolated, are causative pathogens. Med Dosw Mikrobiol, 1999, 51(3-4), 357 - 62 {Peritonitis determined by the site of intra-abdominal surgery}; Chylak J et al.; The aim of this study was to determine bacterial flora infecting the peritoneal cavity during intraabdominal surgery by site of operation . Three groups of patients were examined . 29 patients who underwent surgery on the stomach, duodenum, biliary tract or pancreas, 15 patients operated on because of acute appendicitis and 63 patients operated on because of colon or rectum tumours . At the end of the operation but before closure cultures were obtained by swab from the completed anastomosis site . Samples were placed into transport medium and transported promptly to the laboratory . The results of the bacteriological examinations showed that the peritoneal cavity of all patients operated on were infected with bacteria characteristic for the digestive tract, especially by Enterobacteriaceae spp., Enterococcus spp . and Bacteroides spp . From patients operated on because of rectum or colon tumours 3 or 4 bacterial species were isolated most often and they were often infected with P . aeruginosa and C . albicans . This was in contrast to patients from the other groups . In patients infected with polymicrobial flora, B . fragilis and E . coli or enterococci and E . coli and enterococci were most often seen. Postepy Hig Med Dosw, 2000, 54(1), 3 - 15 {REP and ERIC repetitive DNA sequences in bacteria--diagnostic significance}; Ugorski M et al.; Main part of eukaryotic genomes is build of unique sequences coding proteins and RNAs, but they contain as well numerous repeats interspersed with single-copy fragments . Existence of repetitive sequences were also demonstrated in prokaryotic genomes . They are found in different species of Gram-negative and Gram-positive bacteria . Interspersed repetitive sequence elements called REP and ERIC sequences are present in different species of Enterobacteriaceae family, including Escherichia coli and Salmonella typhimurium . Their functions are not completely clear, probably they play important role in regulation of gene expression . Nevertheless, REP and ERIC elements are widely use in identification and genetic analysis of bacteria . For example, using rep-PCR technique it is possible to discriminate between closely related serovars of the same species, which enables to analyze phylogenetic and epidemiological relations among them. Alcohol Clin Exp Res, 2000 Apr, 24(4), 570 - 5 Metronidazole increases intracolonic but not peripheral blood acetaldehyde in chronic ethanol-treated rats; Tillonen J et al.; BACKGROUND: Metronidazole leads to the overgrowth of aerobic flora in the large intestine by reducing the number of anaerobes . According to our previous studies, this shift may increase intracolonic bacterial acetaldehyde formation if ethanol is present . Metronidazole is also reported to cause disulfiram-like effects after alcohol intake, although the mechanism behind this is obscure . Therefore, the aim was to study the effect of long-term metronidazole and alcohol treatment on intracolonic acetaldehyde levels and to explore the possible role of intestinal bacteria in the metronidazole related disulfiram-like reaction . METHODS: A total of 32 rats were divided into four groups: controls (n = 6), controls receiving metronidazole (n = 6), ethanol group (n = 10), and ethanol and metronidazole group (n = 10) . All rats were pair-fed with the liquid diet for 6-weeks, whereafter blood and intracolonic acetaldehyde levels and liver and colonic mucosal alcohol (ADH) and aldehyde dehydrogenase (ALDH) activities were analyzed . RESULTS: The rats receiving ethanol and metronidazole had five times higher intracolonic acetaldehyde levels than the rats receiving only ethanol (431.4 +/- 163.5 microM vs . 84.7 +/- 14.4 microM,p = 0.0035) . In contrast, blood acetaldehyde levels were equal . Cecal cultures showed the increased growth of Enterobacteriaceae in the metronidazole groups . Metronidazole had no inhibitory effect on hepatic or colonic mucosal ADH and ALDH activities . CONCLUSIONS: The increase in intracolonic acetaldehyde after metronidazole treatment is probably due to the replacement of intestinal anaerobes by ADH-containing aerobes . Unlike disulfiram, metronidazole neither inhibits liver ALDH nor increases blood acetaldehyde . Thus, our findings suggested that the mechanism behind metronidazole related disulfiram-like reaction might be located in the gut flora instead of the liver. Dakar Med, 1999, 44(1), 69 - 75 {Micromethod for identification of enterobacteria}; Gassama A et al.; The aim of this study was to set accurate and reliable methods in the identification of Enterobacteriaceae . In Micro CSB Entero each of a strip with 20 cupules containing dehydrated substrates for biochemical identification of bacterial species . Strips were inoculated with 100 microliters per cupule and incubated . After 18 hours, reagents were added . Baye's theorem was used to validate tests . Reactions from Micro CSB were cleared and easily read . 102 strains of Enterobacteriaceae were identified by MicroCSB--89.3% were correctly identified . 0.9% were identified with other tests 9.8% were incorrectly identified MicroCSB gives many advantages: This method save time, space and is less expensive than the other methods and it gives security for identifying species belonging to the different genera. Dakar Med, 1999, 44(1), 20 - 4 {Sensitivity to cotrimoxazole of bacteria isolated at the Central University Hospital of Fann, Dakar}; Sow AI et al.; This study concern a survey of bacterial resistance to cotrimoxazole; 510 strains of Enterobacteria (167), Vibrio cholerae(206) and Staphylococcus aureus(137) were tested by disc diffusion and agar dilution methods . An interview was conducted with 86 health personals to appreciate the influence of prescription . Staphylococcus aureus were the most susceptible bacteria (13% of resistance), and Vibrio cholerae the most resistant (95%) . Related to the gender, Enterobacteria present 43 to 72% of resistance . The data of interview show a very frequent use of cotrimoxazole, related to the disponibility and the accessibility of this drug. Diagn Microbiol Infect Dis, 2000 May, 37(1), 41 - 4 Comparative in vitro bactericidal activity between cefepime and ceftazidime, alone and associated with amikacin, against carbapenem-resistant Pseudomonas aeruginosa strains; Bantar C et al.; Fifteen unique isolates of carbapenem-resistant Pseudomonas aeruginosa were selected for time-kill studies to assess the bactericidal activity of cefepime (CFP) and ceftazidime (CZD) (at 4 and 16 microg/mL), alone and associated with amikacin (AMK) (4 microg/mL) . CFP proved more active than CZD (p < 0.05, Student's t test) . Bactericidal activity after 24-h incubation was only achieved by the combination of CFP (16 microg/mL) plus AMK . The higher in vitro activity of cefepime over that of ceftazidime against imipenem-resistant P . aeruginosa strains highlights the differences of these drugs beyond Enterobacterspp . and Staphylococcus aureus. Biochem J, 2000 May 15, 348 Pt 1, 223 - 7 Comparative aspects of the diffusion of norfloxacin, cefepime and spermine through the F porin channel of Enterobacter cloacae; Chevalier J et al.; In Enterobacteriaceae, the permeability of the outer membrane to hydrophilic antibiotics is associated with the presence of pore-forming proteins . We tested the diffusion of the fluoroquinolone norfloxacin in four Enterobacter cloacae strains: a clinical isolate and three derivatives variously producing or lacking the D and F porins . We analysed the entry of norfloxacin into E . cloacae cells in the presence of either the polyamine spermine or the recently developed cefepime, which are known to penetrate through the Escherichia coli OmpF porin . Uptake of the fluoroquinolone was decreased in both cases; the initial rate of penetration decreased as more spermine blocked the channel . Our results indicate that, like beta-lactam molecules, fluoroquinolones translocate through the outer membrane via the F porin and that cefepime and norfloxacin entries are polyamine-sensitive . This suggests that the closure of the F porin channel by polyamines might modulate the susceptibility of E . cloacae to both fluoroquinolone and cephalosporin antibiotics. Food Addit Contam, 2000 Jan, 17(1), 17 - 25 Shelf-life extension of cod fillets with an acetate buffer spray prior to packaging under modified atmospheres; Boskou G et al.; Fresh cod fillets (Gadus morhua) were sprayed with a 10% acetate buffer (pH 5.6), packed with an industrial gas-flushing packaging machine under modified atmospheres (50% CO2--45% O2--5% N2, 2 cm3/1 g gas/product ratio) and stored at 7 degrees C for 12 days . Control cod fillets were directly packed and stored under the same conditions . A reduction of the aerobic plate counts was observed immediately after the cod fillets had been sprayed . During storage under modified atmospheres, there was complete inhibition of H2S-producing bacteria and Enterobacteriaceae in the treated cod fillets . Production of total volatile bases and trimethylamine (TMA) was inhibited in treated fillets for 10 days' storage under modified atmospheres . Inhibition of TMA production can be attributed to growth inhibition of H2S-producing bacteria, inhibition of the trimethylamine oxide (TMAO)-dependent metabolism of TMAO-reducing bacteria and the stable pH during storage . The shelf-life, at 7 degrees C, of treated cod fillets, based on cooked flavour score, was almost 12 days, ca 8 days more than shelf-life of the control fillets. Am J Vet Res, 1999 Oct, 60(10), 1322 - 7 Characterization of swimming motility and identification of flagellar proteins in Salmonella pullorum isolates; Chaubal LH et al.; OBJECTIVE: To identify swimming motility in Salmonella pullorum isolates and to characterize the flagellar proteins produced by motile isolates . SAMPLE POPULATION: 30 S pullorum isolates and isolates of 7 other Salmonella sp . PROCEDURE: Salmonella pullorum isolates were inoculated into high motility medium to evaluate swimming motility . Putative flagellar proteins were purified from the organisms and analyzed by means of gel electrophoresis and western blotting procedures, using various antisera specific for flagellar proteins . Antisera shown to be reactive with putative flagellar proteins were incorporated into the growth medium to examine their effects on motility of the isolates . RESULTS: All S pullorum isolates had evidence of swimming motility . Two putative flagellar proteins were purified from 2 of the S pullorum isolates: a 60 to 62 kd protein shown to react with antiserum specific for type y flagellar protein, and a 58 to 59 kd protein shown to react with antiserum specific for type d flagellar protein and with antibody reactive to a highly conserved flagellar epitope found on various Enterobacteriaceae . Antiserum specific for type d flagellar protein inhibited swimming motility of S pullorum isolates, but antiserum specific for type y flagellar protein did not . CONCLUSIONS: Results suggest that S pullorum isolates can be induced to manifest swimming motility when grown on medium with a low agar concentration and possess a 58 to 59 kd protein of d serotype and a second protein of 60 to 62 kd that also may be a flagellar protein. Urology . 2000 May 1;55(5):774. Complications of intrauterine intervention for treatment of fetal obstructive uropathy; Irwin BH et al.; The intrauterine surgical placement of vesicoamniotic shunts in the treatment of fetal obstructive uropathy associated with prune-belly syndrome to avoid such complications as renal damage and oligohydramnios remains controversial . We present a case of an infant born with prune-belly syndrome at 33 weeks and 5 days of estimated gestational age to a mother of two by vaginal delivery after a pregnancy complicated by fetal obstructive uropathy with attempted intrauterine intervention . After sonographic and laboratory diagnostic and prognostic evaluations, an intrauterine procedure was performed in which a vesicoamniotic shunt was placed under ultrasound guidance . Complications included dislodgment of the initial shunt, with a failed subsequent attempt at placement, oligohydramnios, preterm labor and delivery, and traumatic gastroschisis through the surgical abdominal wall defect . His hospital stay was further complicated by chronic renal insufficiency, prematurity, respiratory distress, bowel malrotation, an episode of gram-negative sepsis with Enterobacter cloacae, signs of liver failure, an exploratory laparotomy for severe enterocolitis, and orchiopexy for bilateral undescended testes . At present, it is unclear whether vesicoamniotic shunt placement can provide any significant improvement in the morbidity or mortality for patients with prune-belly syndrome . A large, prospective, randomized trial is needed to determine its efficacy. J Chemother, 2000 Apr, 12(2), 115 - 23 Antibiotic prophylaxis in children with relapsing urinary tract infections: review; Mangiarotti P et al.; Recurrent urinary tract infections (UTIs) are observed in 30-50% of children after the first UTI . Of these, approximately 90% occur within 3 months of the initial episode . The basic aim of antibiotic prophylaxis in children with malformative uropathy and/or recurrent UTIs, is to reduce the frequency of UTIs . The bacteria most frequently responsible for UTI are gram-negative organisms, with Escherichia coli accounting for 80% of urinary tract pathogens . In children with recurrent UTIs and in those treated with antibiotic prophylaxis there is a greater incidence of UTI due to Proteus spp., Klebsiella spp . and Enterobacter spp., whereas Pseudomonas spp., Serratia spp . and Candida spp . are more frequent in children with urogenital abnormalities and/or undergoing invasive instrumental investigations . Several factors are involved in the pathogenesis of UTI, the main ones being circumcision, periurethral flora, micturition disorders, bowel disorders, local factors and hygienic measures . Several factors facilitate UTI relapse: malformative uropathies, particularly of the obstructive type; vesico-ureteric reflux (VUR); previous repeated episodes of cystitis and/or pyelonephritis (3 or more episodes a year), even in the absence of urinary tract abnormalities; a frequently catheterized neurogenic bladder; kidney transplant . The precise mechanism of action of low-dose antibiotics is not yet fully known . The characteristics of the ideal prophylactic agent are presented in this review, as well as indications, dosages, side effects, clinical data of all molecules . While inappropriate use of antibiotic prophylaxis encourages the emergence of microbial resistance, its proper use may be of great value in clinical practice, by reducing the frequency and clinical expression of UTIs and, in some cases such as VUR, significantly helping to resolve the underlying pathology. Przegl Lek, 1999, 56(12), 755 - 9 {Participation of multiresistant gram-negative rods in systemic infections of newborns treated in the Neonatal Clinics of the University Hospital in Krakow in 1993-1997}; Kedzierska J et al.; Results of blood cultures in 1187 newborns hospitalized in the Department of Neonatology, University Hospital in Krakow in furing the last five years were analysed . A trial of monitoring the presence of multi-resistant strains of Enterobacteriaceae with new mechanisms of resistance to antibiotics as well as analysed of their antibiotics susceptibility patterns were undertaken . Surprisingly high percentage of Gram-negative rods E . cloacae and K . pneumoniae strains resistant to the 3rd generation of cephalosporins and participating in septic complications in the investigated hospital environment was demonstrated . There were identified 53 strains of Enterobacter sp., 35 strains of Klebsiella sp . and 3 strains of E . coli extremely resistant to ceftazidine, accounting for 72%, 56% and 5% of all isolated of the given kind, respectively . Dynamic increase in a number of multiresistant strains of K . pneumoniae from 11.1% of isolates in 1993 to 83% in 1997 was shown as well as remaining on a very high level frequency of isolation of Enterobacter sp . rods capable of producing chromosomal cephalosporinases was demonstrated . Full efficacy of carbapenems and high usefulness of ciprofloxacine in the treatment of infections were confirmed . The authors emphasize necessity for constant monitoring of susceptibility to antibiotics in resistant strains as well as for liquidating their sources and ways of their transmission. Appl Environ Microbiol, 2000 May, 66(5), 1862 - 5 Increased killing of Bacillus subtilis on the hair roots of transgenic T4 lysozyme-producing potatoes; Ahrenholtz I et al.; Transgenic potato plants expressing the phage T4 lysozyme gene which are resistant to the plant-pathogenic enterobacterium Erwinia carotovora subsp . carotovora have been constructed . The agricultural growth of these potatoes might have harmful effects on soil microbiota as a result of T4 lysozyme release into the rhizosphere . To assess the bactericidal effect of roots, we have developed a novel method to associate the cells of Bacillus subtilis with hair roots of plants and to quantify the survival of cells directly on the root surface by appropriate staining and fluorescence microscopy . With this technique, we found that the roots of potato plants (Desiree and transgenic control lines) without T4 lysozyme gene display measurable killing activity on root-adsorbed B . subtilis cells . Killing was largely independent of the plant age and growth of plants in greenhouse or field plots . Roots from potato lines expressing the T4 lysozyme gene always showed significantly (1.5- to 3.5-fold) higher killing . It is concluded that T4 lysozyme is released from the root epidermis cells and is active in the fluid film on the root surface . We discuss why strong negative effects of T4 lysozyme-producing potatoes on soil bacteria in field trials may not be observed . We propose that the novel method presented here to study interactions of bacteria with roots can be applied not only to bacterial killing but also to interactions leading to growth-sustaining effects of plants on bacteria. Acta Clin Belg, 2000 Jan-Feb, 55(1), 16 - 21 Comparative in vitro activity of cefepime against strains isolated from intensive care and haematology patients; Vanpoucke H et al.; The aim of the study was to evaluate cefepime, a "fourth generation" cephalosporin, for its in vitro activity in comparison with 5 other broad spectrum antibiotics against clinical isolates from ICU and haematology patients . The strains were isolated from blood (8%), lower respiratory tract (41%), upper respiratory tract (14%), urine (20%) and other sites (17%) . They were divided into: 28 non-inducible Enterobacteriaceae, 35 inducible Enterobacteriaceae, 20 non-fermenters, 10 S . aureus and 10 Streptococcus spp . The MIC-values were determined by E-test . Overall, the rank order of susceptibility was cefepime (93%), imipenem (90%), piperacillin-tazobactam (81%), ciprofloxacin (79%), ceftriaxone (75%) and ceftazidime (74%) . Only cefepime was able to inhibit all inducible Enterobacteriaceae . Against Pseudomonas aeruginosa, cefepime had the same activity as ceftazidime . With the exception of ceftazidime (65%), all beta lactams demonstrated good activity against Gram positive cocci . The excellent activity against most Gram negative and Gram positive pathogens suggests that cefepime may be useful in the treatment of serious infections in the described patient population. Poult Sci, 2000 Apr, 79(4), 483 - 8 Physical, chemical, and microbiological changes in the ceca of broiler chickens subjected to incremental feed withdrawal; Hinton A Jr et al.; Trials were conducted to determine the effect of feed withdrawal on the weight, pH, native bacterial flora, and the persistence of Salmonella typhimurium in the ceca of market-age broilers . Broilers were provided medicated or unmedicated feed and then were subjected to feed withdrawal for 0 to 24 h in transportation crates or on litter . After feed withdrawal, broilers were stunned, bled, scalded, and picked . One cecum from each bird was aseptically removed and weighed . The cecum was then blended in 20 mL of distilled water, and the pH of the blended suspension was measured . The number of total aerobes, Enterobacteriaceae, S . typhimurium, and lactic acid bacteria in the suspension were enumerated on the appropriate bacteriological media . Results indicated that up to 24 h of feed withdrawal produced no significant change in cecal weight and that cecal pH varied by up to 0.3 units during feed withdrawal . There were significant increases in the population of Enterobacteriaceae during feed withdrawal in Trials 2 and 3, and there was a significant increase in the population of cecal aerobes in Trial 3 . Feed withdrawal produced significant decreases in the population of lactic acid bacteria in all trials, but no significant change in the population of S . typhimurium occurred during feed withdrawal . There were no significant differences in cecal weight, pH, native bacteria populations, or S . typhimurium populations between broilers that were subjected to feed withdrawal on litter or in crates . Findings indicate that feed withdrawal does not always effectively evacuate the contents of the ceca and that the ceca of broilers subjected to feed withdrawal can remain a source of foodborne bacterial pathogens. Genetika, 2000 Mar, 36(3), 322 - 30 {Cloning and expression of the lux-operon of Photorhabdus luminescens, strain Zm1: nucleotide sequence of luxAB genes and basic properties of luciferase}; Manukhov IV et al.; A chromosomal fragment of bacteria Photorhabdus luminescence Zm1, which contains the lux operon, was cloned into the vector pUC18 . The hybrid clone containing plasmid pXen7 with the EcoRI fragment approximately 7-kb was shown to manifest a high level of bioluminescence . By subcloning and restriction analysis of the EcoRI fragment, the location of luxCDABE genes relative to restriction sites was determined . The nucleotide sequence of the DNA fragment containing the luxA and luxB genes encoding alpha- and beta-subunits of luciferase was determined . A comparison with the nucleotide sequences of luxAB genes in Hm and Hw strains of Ph . luminescence revealed 94.5 and 89.7% homology, respectively . The enterobacterial repetitive intergenic sequence (ERIC) of 126 bp typical for Hw strains was identified in the spacer between the luxD and luxA genes . The lux operon of Zm1 is assumed to emerge through recombination between Hm and Hw strains . Luciferase of Ph . luminescence was shown to possess a high thermal stability: its activity decreased by a factor of 10 at 44 degrees C for 30 min, whereas luciferases of marine bacteria Vibrio fischeri and Vibrio harveyi were inactivated by one order of magnitude at 44 degrees C for 1 and 6 min, respectively . The lux genes of Ph . luminescence are suggested for use in gene engineering and biotechnology. Southeast Asian J Trop Med Public Health, 1999 Sep, 30(3), 546 - 8 Analysis of blood culture isolates from hospitalized neonates in Nepal; Karki BM et al.; Clinically suspected 77 cases of neonatal septicemia admitted to the pediatric ward of BP Koirala Institute of Health Sciences, Dharan, Nepal, were evaluated by blood culture . The blood culture was positive for bacterial growth in 46 (59.7%) cases . Gram-negative bacteria were isolated in 33 (71.7%) cases, the most common being Escherichia coli, followed by Klebsiella spp, Enterobacter spp . Staphylococcus aureus was the most common gram-positive bacteria . The bacterial isolates were most sensitive to gentamicin (74.5%) and ciprofloxacin (74.5%) followed by chloramphenicol (59.9%) . They were most resistant (78.8%) to ampicillin . This study for the first time underlines the pattern of bacterial isolates and their sensitivity pattern to antibiotics in this part of Nepal. Digestion, 2000, 61(3), 181 - 8 Structure and composition of common bile duct stones in relation to duodenal diverticula, gastric resection, cholecystectomy and infection; Sandstad O et al.; BACKGROUND: Common bile duct stones represent a clinical problem often involving severe infection, cholangitis and cholestasis . Stasis and infection are thought to play a part in the pathogenesis of choledocholithiasis . Investigations on the etiology of common bile duct stones are, however, scarce because of the difficult access to common bile duct stones and bile . In a clinical series of common bile duct stones, we studied the gross appearance of stones extracted endoscopically from the common bile duct and measured the cholesterol and bilirubinate content in order to elucidate factors of importance to etiology . METHODS: In 135 patients treated endoscopically for bile duct stones, the stones or parts of the stones were collected . Appearances of the cut surface of the stones were studied and described . Cholesterol and bilirubinate content were analyzed enzymatically and with infrared spectroscopy . The growth in bile of gas-producing bacteria previously shown to be correlated with enterobacteriacea was investigated . RESULTS: Seventy-five percent of the stones were pigment stones, the majority with concentric pigmented layering . There was good agreement between cholesterol measurements . With a cutoff at 50% for the infrared measurements and 25% for the enzymatic assay only 3 stones were discordant between cholesterol measurements and visual inspection . Twenty-one of 23 patients with a previous Billroth-II gastric resection had pigment stones (p < 0.05) . Gas-producing bacteria were significantly more prevalent in the bile from patients with layered pigment stones . CONCLUSION: Pigment stones with concentric layering highly suggestive of a cyclic process of crystallization were recovered from the common bile duct in 70% of the patients in our series . J Hosp Infect, 2000 Apr, 44(4), 245 - 53 Preventing pancreatic infection in acute pancreatitis; Qamruddin AO et al.; In acute pancreatitis, pancreatic inflammation may be complicated by the development of pancreatic infection with a high associated mortality . Pancreatic infection is related to the extent of pancreatic inflammation and necrosis and typically occurs in the second or third week of severe disease . It may be associated with a wide range of Gram-positive and Gram-negative bacteria, notably enterobacteria and also with Candida spp . Current surgical practice in the UK is to use prophylactic antimicrobial therapy in patients with severe disease, with the aim of preventing secondary pancreatic infection . Experimental evidence demonstrates that prophylactic antibacterial therapy prevents pancreatic infection and reduces mortality . Furthermore, studies of antibacterial prophylaxis in patients with acute pancreatitis suggest that prophylactic antibacterial therapy is associated with a reduction in mortality, particularly in those with severe disease . In general, broad-spectrum antibiotics have been used in animal and human studies . However, current evidence does not allow comparisons to be made between different antimicrobial agents . Nutritional strategies may also be important in the prevention of pancreatic infection . Enteral, rather than parenteral, nutrition has been associated with an improved clinical outcome in severe pancreatitis . JPEN J Parenter Enteral Nutr, 2000 Mar-Apr, 24(2), 56 - 60 Effect of oral genistein and isoflavone-free diet on cecal flora and bacterial translocation in antibiotic-treated mice; Wells CL et al.; BACKGROUND: There are several reports indicating that the isoflavone genistein may augment the integrity of the intestinal epithelial barrier as well inhibit bacterial internalization by cultured enterocytes . We speculated that oral genistein might enhance the integrity of the intestinal epithelial barrier as monitored by the extraintestinal dissemination of intestinal bacteria . METHODS: Mice were treated with oral antibiotics to induce cecal bacterial overgrowth accompanied by bacterial translocation of antibiotic-resistant enterobacteria, especially Escherichia coli . These mice were divided into separate groups that included chow-fed mice orally inoculated either with saline, vehicle, or genistein, and mice fed isoflavone-free diet and orally inoculated with either saline, vehicle, or genistein . Intestinal bacterial overgrowth was monitored by quantitative culture of excised ceca and bacterial translocation was monitored by quantitative culture of draining mesenteric lymph nodes . RESULTS: Mice fed the isoflavone-free diet had decreased populations of cecal bacteria compared with chow-fed mice, and bacterial translocation was reduced in chow-fed mice compared with mice fed isoflavone-free diet . However, bacterial translocation was similar in mice given oral genistein compared with appropriate control mice . CONCLUSIONS: Oral genistein had no noticeable effect on bacterial translocation in this model . However, the isoflavone-free diet had an antibacterial effect on cecal flora, and the isoflavone-free diet was associated with decreased numbers of cecal bacteria and decreased incidence of bacterial translocation. Turk J Pediatr, 1999 Jan-Mar, 41(1), 37 - 42 Epidemiology and antibiotic resistance of gram-negative urinary pathogens in pediatric patients; Gur D et al.; In order to determine the etiological agents and the rate of resistance to various antibiotics, 209 consecutive gram-negative bacteria isolated from children admitted to Hacettepe University Children's Hospital with urinary tract infections were investigated over a three-month period . Of these, 46 (22%) were nosocomial isolates . The most frequently isolated organism was E.coli (n: 141) followed by Klebsiella spp . (39), Proteus spp . (19), Pseudomonas spp . (8) and Enterobacter spp . (2) . In vitro susceptibilities were evaluated by microbroth dilution method, following NCCLS guidelines . Overall, 75 percent of the isolates were resistant to ampicillin, 52 percent were resistant to TMP/SMX and 25 percent to cefuroxime . Amikacin was the most active aminoglycoside; 93 percent of the isolates were susceptible to this agent, while resistance to gentamicin was 21 percent . Resistance to ceftazidime and ceftriaxone was 12 percent and 19 percent, respectively . Overall, resistance to imipenem was one percent and to ciprofloxacin three percent . These in vitro results should be taken into account before initiating empirical therapy; broad spectrum antibiotics should not be used if the isolate is susceptible to the older drugs in order to prevent the increase in resistance. Infect Immun, 2000 May, 68(5), 2457 - 63 The sigA gene which is borne on the she pathogenicity island of Shigella flexneri 2a encodes an exported cytopathic protease involved in intestinal fluid accumulation; Al-Hasani K et al.; In this study, the sigA gene situated on the she pathogenicity island of Shigella flexneri 2a was cloned and characterized . Sequence analysis showed that sigA encodes a 139.6-kDa protein which belongs to the SPATE (serine protease autotransporters of Enterobacteriaceae) subfamily of autotransporter proteins . The demonstration that SigA is autonomously secreted from the cell to yield a 103-kDa processed form and possesses a conserved C-terminal domain for export from the cell were consistent with the autotransporter pathway of secretion . Functional analysis showed that SigA is a secreted temperature-regulated serine protease capable of degrading casein . SigA was cytopathic for HEp-2 cells, suggesting that it may be a cell-altering toxin with a role in the pathogenesis of Shigella infections . SigA was at least partly responsible for the ability of S . flexneri to stimulate fluid accumulation in ligated rabbit ileal loops. J Chemother, 2000 Feb, 12(1), 30 - 9 Natural antibiotic susceptibility of Rahnella aquatilis and R . aquatilis-related strains; Stock I et al.; A database is described of the natural susceptibilities of 70 Rahnella strains to 71 antibiotics . MIC values were determined by a microdilution procedure and evaluated by a table calculation program . Rahnella aquatilis and R . aquatilis-related strains were naturally resistant to amoxycillin, ticarcillin, fosfomycin and to antibiotics to which other species of Enterobacteriaceae are also intrinsically resistant, i.e . macrolides (except azithromycin), benzylpenicillin, oxacillin, rifampicin, fusidic acid, lincosamides and glycopeptides . Rahnella strains were also naturally resistant or intermediate to cefazolin, cefuroxime and loracarbef . All rahnellae were naturally sensitive or intermediate to doxycycline, minocycline, aminoglycosides, some penicillins and cephalosporins, carbapenems, aztreonam, quinolones, sulfamethoxazole, trimethoprim, cotrimoxazole, chloramphenicol and nitrofurantoin . Bimodal or broad MIC distributions were seen for several antibiotics, e.g . quinolones and cephalosporins . With the exception of quinolones no differences in natural antibiotic susceptibility were seen between reference strains of Rahnella genomovar 1 (n=6) and 2 (n=7) . Reference strains of genomovar 1 were pyrase-positive and more susceptible to quinolones than reference strains of genomovar 2, which were pyrase-negative . By discrimination of all rahnellae in the pyrase-positive and pyrase-negative strains the MIC distributions for quinolones became smaller and unimodal . Under the conditions described pyrase might be a parameter to differentiate strains of Rahnella genomovars 1 and 2. J Chemother, 2000 Feb, 12(1), 5 - 16 Microbial ecology and treatment of Helicobacter pylori infections: review; Adamsson I et al.; The aims of the present study were to investigate the ecological disturbances caused by four different anti-H . pylori regimens, to compare different methods for diagnosing H . pylori, and to study the genetic variability of H . pylori . The patients included in the study were all treated at the Center of Gastroenterology, Huddinge University Hospital, Karolinska Institute . All patients were H . pylori-positive before entering the study, confirmed by rapid urease test, histology, culture and urea breath test or PCR . Treatment regimens included in the study were omeprazole alone (OP), in combination with amoxicillin (OA), in combination with amoxicillin and metronidazole (OAM) and in combination with clarithromycin and metronidazole (OCM) . Samples from the mouth (saliva and dental plaque), stomach (biopsies from the gastric mucosa in the corpus and in the antrum) and the intestine (feces) were collected before, during and after treatment . The oral microflora was challenged by the three treatment regimens including antimicrobial agents, with the emergence of resistant streptococci and staphylococci in the OCM group . Bacterial strains in the gastric mucosa increased in numbers during treatment in all treatment groups, probably due to the pH rise, which provides a better environment for the commensal microflora . This overgrowth was especially pronounced during treatment with omeprazole alone (OP), possibly due to the fact that a concomitant suppression exerted by the antimicrobial agents occurred in the other treatment groups . H . pylori was, on the other hand, suppressed during treatment in all treatment groups, possibly due to a direct effect of omeprazole and to the colonization resistance expressed by the normal microflora . An emergence of resistant commensal strains in the gastric mucosa was seen in the OCM and the OAM groups . The intestinal microflora was most altered in the OAM and the OCM groups, with persistent disturbances in the OCM group 4 weeks after treatment . The frequency of resistant Enterococcus spp . (OCM), Enterobacteriaceae spp . (OA and OAM) and Bacteroides spp . (OCM) was increased during and after treatment . Different detection methods for H . pylori were compared and PCR was shown to have higher sensitivity than other routine diagnostic tests . The patients in the present study seemed to be colonized with a single strain of H . pylori . Treatment failures in patients treated with OAM were caused by recrudescence . These four patients with relapsing H . pylori infection, were shown to be reinfected with the original H . pylori strain, indicating that H . pylori escapes treatment by a thus far unknown mechanism. Antonie Van Leeuwenhoek, 2000 Feb, 77(2), 147 - 52 Antimicrobial resistance among urinary tract infection (UTI) isolates in Europe: results from the SENTRY Antimicrobial Surveillance Program 1997; Fluit AC et al.; The SENTRY Antimicrobial Surveillance Program was established to monitor the occurrence and antimicrobial susceptibility of bacterial pathogens via an international network of sentinel hospitals . Twenty European hospitals referred a total of 887 urinary tract infection (UTI) isolates to the European SENTRY reference laboratory during the period October-December 1997 . Ninety percent of the referred species were represented by Escherichia coli (52%), Enterococcus spp . (12%), Klebsiella spp . (7%), Proteus spp . (7%), Pseudomonas aeruginosa (7%), and Enterobacter spp . (5%) . The susceptibility of E . coli isolates to penicillins was less than 60%, while almost all of the isolates were susceptible to piperacillin/tazobactam (98% susceptibility), cephalosporins (98%), and carbapenems (100%) . Amikacin was the best aminoglycoside (99.8% susceptibility) . The susceptibility to quinolones was only 88-89%, with highest levels of resistance observed for isolates from Portugal, Italy, England, The Netherlands, and some centers in France, Spain, and Poland . The susceptibility of Klebsiella spp . to the newer generations of cephalosporins was 82-95% and to the carbapenems 100% . Amikacin was again the best aminoglycoside (94% susceptibility) . The susceptibility of Enterobacter spp . to any beta-lactam antibiotic was poor, except for the carbapenems (100% susceptibility) and cefepime (90% susceptibility), while the susceptibility to aminoglycosides was 80-89% . Proteus spp . showed complete susceptibility to cefepime, ceftriaxone, the carbapenems, and piperacillin/tazobactam, while the susceptibility of P . aeruginosa isolates was poor, with best results for the carbapenems (susceptibility 89%), piperacillin/tazobactam (susceptibility 84%), and amikacin and ticarcillin (susceptibility to both 80%) . Enterococcus spp . showed the highest susceptibility to vancomycin (98%), teicoplanin (98%), and ampicillin (94%). Lancet, 2000 Mar 18, 355(9208), 973 - 8 An antibiotic policy to prevent emergence of resistant bacilli; de Man P et al.; BACKGROUND: Fear of infection in neonatal intensive care units (NICUs) often leads to early use of empiric broad-spectrum antibiotics, a strategy that selects for resistant bacteria . We investigated whether the emergence of resistant strains could be halted by modifying the empiric antibiotic regimens to remove the selective pressure that favours resistant bacteria . METHODS: Two identical NICUs were assigned to different empiric antibiotic regimens . On unit A, penicillin G and tobramycin were used for early-onset septicaemia, flucloxacillin and tobramycin were used for late-onset septicaemia, and no broad-spectrum beta-lactam antibiotics, such as amoxicillin and cefotaxime were used . In unit B, intravenous amoxicillin with cefotaxime was the empiric therapy . After 6 months of the study the units exchanged regimens . Rectal and respiratory cultures were taken on a weekly basis . FINDINGS: There were 436 admissions, divided equally between the two regimens (218 in each) . Three neonates treated with the penicillin-tobramycin regimen became colonised with bacilli resistant to the empirical therapy used versus 41 neonates on the amoxicillin-cefotaxime regimen (p<.0001) . The relative risk for colonisation with strains resistant to the empirical therapy per 1000 patient days at risk was 18 times higher for the amoxicillin-cefotaxime regimen compared with the penicillin-tobramycin regimen (95% CI 5.6-58.0) . Enterobacter cloacae was the predominant bacillus in neonates on the amoxicillin-cefotaxime regimen, whereas Escherichia coli predominated in neonates on the penicillin-tobramycin regimen . These colonisation patterns were also seen when the units exchanged regimens . INTERPRETATION: Policies regarding the empiric use of antibiotics do matter in the control of antimicrobial resistance . A regimen avoiding amoxicillin and cefotaxime restricts the resistance problem. J Mass Spectrom, 2000 Mar, 35(3), 361 - 8 Confirmation of the structure of lipid A from Enterobacter agglomerans by electrospray ionization tandem mass spectrometry Boue SM, Cole RB. Electrospray ionization (ESI) combined with tandem mass spectrometry (MS/MS) was utilized for the structural confirmation of lipid A derived from Enterobacter agglomerans, a Gram-negative bacterium commonly found in field cotton . Previous ESI-MS studies conducted in our laboratory found that similarities exist between the fatty acid side-chains in the lipid A of E . agglomerans and that of Salmonella minnesota . It was noted that heterogeneity at the fatty acyl chain at position 3' of the diglucosamine backbone of E . agglomerans can take the form of either a myristyloxymyristyl group or, less commonly, a hydroxymyristyloxymyristyl moiety . In this work, tandem mass spectra obtained from heptaacyl and hexaacyl lipid A precursors derived from E . agglomerans and a known standard S . minnesota were compared to assist in structural elucidation . These ESI-MS/MS experiments confirmed the previously reported structure for lipid A derived from E . agglomerans . Moreover, MS/MS data indicated that the additional hydroxyl group of the 3'-position hydroxymyristyloxymyristyl moiety is present as the alpha-isomer. Am J Infect Control, 2000 Apr, 28(2), 123 - 9 Enterobacterial repetitive intergenic consensus polymerase chain reaction typing of isolates of Enterobacter cloacae from an outbreak of infection in a neonatal intensive care unit; Peters SM et al.; BACKGROUND: Enterobacter cloacae has become a common cause of nosocomial infections . This study was designed to investigate the pattern of spread of E cloacae during an outbreak in a neonatal intensive care unit . METHODS: Enterobacterial repetitive intergenic consensus polymerase chain reaction was used to examine 111 E cloacae isolates from 17 patients, including 81 from surveillance cultures, 23 from endotracheal tubes, 3 from eyes, and 1 each from blood, urine, skin, and throat . Antibiotic susceptibility profiles were also obtained . RESULTS: Infection with E cloacae resulted from endogenous bacteria and from horizontal transmission . One group of 61 isolates, a third of which were obtained from clinical specimens, was uniformly susceptible to imipenem and ciprofloxacin only . A second group of 50 isolates, only 18% of which were obtained from clinical specimens, was susceptible to all antibiotics tested except for aminopenicillins and first-generation cephalosporins . CONCLUSION: These data indicate that (1) patient-to-patient spread is an important cause of E cloacae infection in the neonatal intensive care unit and (2) highly antibiotic-resistant E cloacae may emerge during an outbreak. Int J Radiat Oncol Biol Phys, 2000 Apr 1, 47(1), 171 - 8 Neonatal neoplasms; Halperin EC; PURPOSE: To describe neoplasms diagnosed in children </= 28 days of age along with their treatment, associated congenital anomalies, and the long-term consequences of the diagnoses and treatments . METHODS AND MATERIALS: Utilizing autopsy records, a computerized tumor registry, and medical records, we identified patients and stillborns at Duke University Medical Center (DUMC) diagnosed with neoplasms at </= 28 days of age between 1930 and 1998 . RESULTS: Twenty-three neonates with neoplasms were identified . There were 7 males (30%) and 16 females (70%) . Follow-up of survivors ranged from 4 months to 27 years (mean 9 years) . The 20 patients identified via the computerized registry system for 1980-1998 constitute 2% (20/925) of all neoplasms seen in patients </= 16 years of age over this same time period at DUMC . The histologic diagnoses were teratoma/germ cell tumor (n = 8, 35%), neuroblastoma (n = 5, 22%), retinoblastoma (n = 4, 17%), primary central nervous system (CNS) tumor (n = 3, 13%), and one case each of rhabdomyosarcoma, glossal glial choristoma, and hemangioma in the setting of Kasabach-Merritt Syndrome . Of the eight teratoma/germ cell tumor patients, 6 were female (75%) and 2 male (25%) . There was one malignant germ cell tumor, 2 immature teratomas, and 5 teratomas . Two of the seven patients with immature teratomas or teratoma were long-term survivors following surgery . The one patient with malignant germ cell tumor, treated with surgery and chemotherapy, died . Associated anomalies were imperforate anus, congenital absence of a limb, left ventricular hypertrophy, fusion or absence of toes, coarctation of the aorta, and pulmonary valve dysplasia . Of the five children with neuroblastoma, 4 were female . INSS Stages were 1 (n = 1), 2A (n = 1), 3 (n = 1), and 4S (n = 2) . Two were treated with surgery + chemotherapy + radiotherapy; two with surgery + chemotherapy; and one with surgery alone . Four children are long-term survivors . Associated congenital anomalies and medical problems were ventricular septal defect, seizure disorder, and Fanconi's anemia . A child with a dumbbell neuroblastoma, treated with surgery and chemotherapy, is paraplegic . Of the four children with retinoblastoma, two were female . Two had trilateral disease and two bilateral . Three of the four had a family history of retinoblastoma . The two children with trilateral retinoblastoma died after therapy with surgery, craniospinal and orbital irradiation, and chemotherapy . Two children with bilateral disease are long-term survivors: one treated with radiotherapy + chemotherapy and one with radiotherapy alone . They have marked orbital bone growth abnormalities . The three patients with CNS tumors were female . The histologies were glioblastoma multiforme, anaplastic astrocytoma, and malignant mixed oligodendroglioma . Two of the patients are long-term survivors after surgery + chemotherapy . Six children received eight courses of radiation therapy: 2 for Stage 4S neuroblastoma with respiratory compromise from an enlarging liver and 4 for retinoblastoma . The two infants with trilateral retinoblastoma received two courses of irradiation each: one of the treatment of intraocular tumor and a second, at an older age, for the pineal tumor . The most serious complication of anesthesia was a case of enterobacter cloacae sepsis in the central venous access line used for repetitively administering the anesthetic . CONCLUSION: The most common neonatal neoplasm histologic diagnoses are teratoma/germ cell tumor, neuroblastoma, and retinoblastoma . Neonatal neoplasms may be associated with congenital anomalies . Radiation therapy is administered infrequently in a population highly susceptible to late ill effects . When radiotherapy is required, anesthesia may be repetitively administered to aid in reproducible treatment. J Am Vet Med Assoc, 2000 Apr 1, 216(7), 1096 - 9, 1074-5 Subcutaneous emphysema, pneumoperitoneum, and pneumoretroperitoneum after gastrostomy tube placement in a cat; Mason NJ et al.; A 17-year-old spayed female domestic shorthair cat developed subcutaneous emphysema, pneumoperitoneum, and pneumoretroperitoneum during endoscopic placement of a gastrostomy feeding tube after gastric insufflation and cannula insertion . The cat underwent exploratory laparotomy to investigate the possibility of gastric rupture but only a 2- to 3-mm defect was found in the gastric fundus at the site of cannula insertion . Pasteurella multocida and Enterobacter spp were cultured aerobically from the peritoneal cavity . The cat recovered without complications. Can J Microbiol, 2000 Mar, 46(3), 278 - 82 Type I nitroreductases in soil enterobacteria reduce TNT (2,4,6,-trinitrotoluene) and RDX (hexahydro-1,3,5-trinitro-1,3,5-triazine); Kitts CL et al.; Many enteric bacteria express a type I oxygen-insensitive nitroreductase, which reduces nitro groups on many different nitroaromatic compounds under aerobic conditions . Enzymatic reduction of nitramines was also documented in enteric bacteria under anaerobic conditions . This study indicates that nitramine reduction in enteric bacteria is carried out by the type I, or oxygen-insensitive nitroreductase, rather than a type II enzyme . The enteric bacterium Morganella morganii strain B2 with documented hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) nitroreductase activity, and Enterobacter cloacae strain 96-3 with documented 2,4,6-trinitrotoluene (TNT) nitroreductase activity, were used here to show that the explosives TNT and RDX were both reduced by a type I nitroreductase . Morganella morganii and E . cloacae exhibited RDX and TNT nitroreductase activities in whole cell assays . Type I nitroreductase, purified from E . cloacae, oxidized NADPH with TNT or RDX as substrate . When expression of the E . cloacae type I nitroreductase gene was induced in an Escherichia coli strain carrying a plasmid, a simultaneous increase in TNT and RDX nitroreductase activities was observed . In addition, neither TNT nor RDX nitroreductase activity was detected in nitrofurazone-resistant mutants of M . morganii . We conclude that a type I nitroreductase present in these two enteric bacteria was responsible for the nitroreduction of both types of explosive. Clin Pharmacokinet, 2000 Mar, 38(3), 205 - 23 Clinical pharmacokinetics and pharmacodynamics of isepamicin; Tod M et al.; Isepamicin is an aminoglycoside antibacterial with properties similar to those of amikacin, but with better activity against strains producing type I 6'-acetyltransferase . The antibacterial spectrum includes Enterobacteriaceae and staphylococci . Anaerobes, Neisseriaceae and streptococci are resistant . The lower and upper break-points are 8 and 16 mg/L . Like other aminoglycosides, isepamicin exhibits a strong concentration-dependent bactericidal effect, a long post-antibiotic effect (several hours) and induces adaptive resistance . Isepamicin is administered intravenously or intramuscularly at a dosage of 15 mg/kg once daily or 7.5 mg/kg twice daily . Isepamicin is not bound to plasma proteins, and it distributes in extracellular fluids and into some cells (outer hair cells, kidney cortex) by active transport . Isepamicin is not metabolised and is eliminated solely via the renal route with an elimination half-life (t 1/2 beta) of 2 to 3 hours in adults with normal renal function . The clearance of isepamicin is reduced in neonates, and 7.5 mg/kg once daily is recommended in children <16 days old . Clearance is also reduced in the elderly, but no dosage adjustment is required . In patients with chronic renal impairment, isepamicin clearance is proportional to creatinine clearance (CLCR); the recommended regimen is 8 mg/kg with an administration interval of 24 hours in moderate impairment, 48 hours in severe impairment, 72 hours for CL(CR) 0.6 to 1.14 L/h (10 to 19 ml/min) and 96 hours for CL(CR) 0.36 to 0.54 L/h (6 to 9 ml/min) . In end-stage renal failure, isepamicin is eliminated by haemodialysis, but the administration interval should be determined by monitoring the plasma concentration . Compared with healthy volunteers, patients in the intensive care unit or with neutropenic cancer have an increased volume of distribution and a lower clearance, but the 15 mg/kg once daily regimen remains adequate . Isepamicin kinetics are linear in the range 7.5 to 25 mg/kg, so that dosage adjustments, if necessary, are straightforward . Isepamicin can induce nephro-, vestibulo- and oto-toxicity . However, animal and clinical studies show that isepamicin is one of the less toxic aminoglycosides . The usefulness of maintaining serum aminoglycoside concentrations within a therapeutic range remains controversial . With isepamicin, it is proposed to achieve a 1-hour concentration (30 minutes after a 30-minute infusion) >40 mg/L to maximise bactericidal efficacy, and a 'trough' concentration (at the end of the administration interval) <5 mg/L to minimise toxicity . These thresholds should be modified on an individual basis, considering covariates such as concomitant treatment, underlying disease, nature of bacterial strain and site of infection. J Biol Chem, 2000 Jun 2, 275(22), 16851 - 6 New beta -lactamase inhibitory protein (BLIP-I) from Streptomyces exfoliatus SMF19 and its roles on the morphological differentiation; Kang SG et al.; A new beta-lactamase inhibitory protein (BLIP-I) from Streptomyces exfoliatus SMF19 was purified and characterized . The molecular mass of BLIP-I was estimated to be 17.5 kDa by gel filtration fast protein liquid chromatography . The N-terminal sequence was NH(2)-Asn-Ser-Gly-Phe-Ser-Ala-Glu-Lys-Tyr-Glu-Gln-Ile-Gln-Phe-Gly . BLIP-I inhibited Bacto(R) Penase (Difco), and plasmid encoded TEM-1 beta-lactamase, whereas it did not inhibit Enterobacter cloacae beta-lactamases . The K(i) value of BLIP-I against TEM-1 beta-lactamase was determined to be 0.047 nm . The gene (bliA) encoding BLIP-I protein was identified by screening a genomic library using an oligonucleotide probe with a sequence based on the N-terminal sequence of BLIP-I . Analysis of the nucleotide sequence revealed that the gene was 558 base pairs in length and encoded a mature protein of 157 amino acid residues preceded by a 29-amino acid signal sequence . Pairwise comparison of the deduced amino acid sequence showed 38% identity with BLIP of Streptomyces clavuligerus . Furthermore, the 49th amino acid residue of BLIP-I was identical to Asp-49 of BLIP that was characterized to be an important residue for the inhibitory activity of BLIP . A modified BLIP-I in which Asp-49 was replaced by alanine (D49A) was obtained by site-directed mutagenesis . The inhibitory activities of recombinant (r) BLIP-I and its D49A mutant derivative, expressed in Escherichia coli, were compared . The K(i) value of rBLIP-I against TEM-1 beta-lactamase was similar to that of wild-type BLIP-I, but the D49A mutation increased the K(i) of rBLIP-I inhibition approximately 200-fold . A disruption mutant of the bliA gene in S . exfoliatus SMF19 was obtained by replacing the wild-type bliA gene with a copy inactivated by inserting a hygromycin resistance gene . The disruption mutant showed a bald phenotype, indicating that the bliA gene plays a role in morphological differentiation. J Antimicrob Chemother, 2000 Apr, 45(4), 537 - 9 Clinical relevance of Proteus mirabilis in hospital patients: a two year survey; de Champs C et al.; A retrospective study was performed on 1072 non-duplicate isolates of Proteus mirabilis, taken in the period April 1996 to March 1998, and on 100 patient charts randomly selected during the same period . P . mirabilis isolates accounted for 7.7% of Enterobacteriaceae . The isolates were predominantly from urine (70.2%); of the total, 38.0% were penicillinase-producing isolates, 6.9% were extended-spectrum beta-lactamase (ESBL)-producing isolates and 3.6% produced inhibitor-resistant beta-lactamase (IRB) . ESBL-producing isolates were observed in long-stay and intensive care and IRB-producing isolates in paediatric units . Of the 95 patients whose charts were examined, 69 had a confirmed infection, which in 42 cases was nosocomial. J Clin Microbiol, 2000 Apr, 38(4), 1339 - 46 Evaluation of the Wider system, a new computer-assisted image-processing device for bacterial identification and susceptibility testing; Canton R et al.; The Wider system is a newly developed computer-assisted image-processing device for both bacterial identification and antimicrobial susceptibility testing . It has been adapted to be able to read and interpret commercial MicroScan panels . Two hundred forty-four fresh consecutive clinical isolates (138 isolates of the family Enterobacteriaceae, 25 nonfermentative gram-negative rods {NFGNRs}, and 81 gram-positive cocci) were tested . In addition, 100 enterobacterial strains with known beta-lactam resistance mechanisms (22 strains with chromosomal AmpC beta-lactamase, 8 strains with chromosomal class A beta-lactamase, 21 broad-spectrum and IRT beta-lactamase-producing strains, 41 extended-spectrum beta-lactamase-producing strains, and 8 permeability mutants) were tested . API galleries and National Committee for Clinical Laboratory Standards (NCCLS) microdilution methods were used as reference methods . The Wider system correctly identified 97.5% of the clinical isolates at the species level . Overall essential agreement (+/-1 log(2) dilution for 3,719 organism-antimicrobial drug combinations) was 95.6% (isolates of the family Enterobacteriaceae, 96.6%; NFGNRs, 88.0%; gram-positive cocci, 95.6%) . The lowest essential agreement was observed with Enterobacteriaceae versus imipenem (84.0%), NFGNR versus piperacillin (88.0%) and cefepime (88.0%), and gram-positive isolates versus penicillin (80.4%) . The category error rate (NCCLS criteria) was 4.2% (2.0% very major errors, 0.6% major errors, and 1 . 5% minor errors) . Essential agreement and interpretive error rates for eight beta-lactam antibiotics against isolates of the family Enterobacteriaceae with known beta-lactam resistance mechanisms were 94.8 and 5.4%, respectively . Interestingly, the very major error rate was only 0.8% . Minor errors (3.6%) were mainly observed with amoxicillin-clavulanate and cefepime against extended-spectrum beta-lactamase-producing isolates . The Wider system is a new reliable tool which applies the image-processing technology to the reading of commercial trays for both bacterial identification and susceptibility testing. Eur J Clin Microbiol Infect Dis, 2000 Feb, 19(2), 112 - 7 Antibiotic susceptibility of bacterial strains isolated from patients with community-acquired urinary tract infections in France . Multicentre Study Group; Goldstein FW; The aim of this study was to determine the distribution and antibiotic susceptibility patterns of bacterial strains isolated from adults with community-acquired urinary tract infections (UTI) in France . From December 1996 to March 1997, each of 15 private laboratories in France consecutively collected about 80 non-duplicate strains isolated from adult outpatients with UTI, including patients receiving care at home, and tested their susceptibility by the disk diffusion test . A total of 1160 strains were collected: 1031 gram-negative bacilli, including Escherichia coli (n = 865), Proteus mirabilis (n = 68) and Klebsiella spp . (n = 40), and 129 gram-positive cocci, including Staphylococcus aureus (n = 16), other staphylococci (n = 25), group B streptococci (n = 25) and enterococci (n = 63) . In the case of 430 bacterial isolates, the patients had either been hospitalised in the last 6 months or received antibiotic treatment in the last 3 months . The antibiotic susceptibility rates for Escherichia coli were: amoxicillin (58.7%), amoxicillin-clavulanic acid (63.3%), ticarcillin (61.4%), cephalothin (66.8%) cefuroxime (77.6%), cefixime (83.6%), cefotaxime (99.8%), ceftazidime (99%), nalidixic acid (91.9%), norfloxacin (96.6%), ofloxacin (96.3%), ciprofloxacin (98.3%), cotrimoxazole (78.2%), fosfomycin (99.1%) and gentamicin (98.4%) . Of the Enterobacteriaceae, five strains produced an extended-spectrum beta-lactamase . Methicillin resistance was detected in nine Staphylococcus aureus isolates . The most important findings were two extended-spectrum, beta-lactamase-producing and three methicillin-resistant Staphylococcus aureus strains isolated from patients who had not been hospitalised in the last 6 months or taken antibiotics in the last 3 months . The findings indicate that these strains can spread within the community; therefore, monitoring antibiotic susceptibility of bacteria isolated in the community appears to be mandatory. Wiad Lek, 1999, 52(11-12), 554 - 8 {The occurrence of the Enterobacter genus rods in the clinical materials and materials taken from hospital environment}; Janicka G et al.; Due to continuously existing essential meaning of strains of Enterobacter spp . in human infections we investigated the occurrence of Enterobacter spp . in different clinical materials and in materials taken from hospital environment . Amongst 26,025 materials taken from patients there were 249 (1.0%) Enterobacter strains and respectively amongst 954 environmental materials--there were 11 (1.2%) Enterobacter spp . In isolated Enterobacter strains the percentage occurrence was: hospital materials: E . cloacae--65.6%, E . agglomerans--12.1%, E . aerogenes--6.25%, E . sakazakii--5.4%, E . gergoviae--1.3%, E . amnigenus--0.9%, E . intermedius--0.9% and Enterobacter spp.--7.6%; outpatient materials: E . cloacae--72.0%, E . sakazakii--12.0%, E . agglomerans--8.0%, E . aerogenes--4.0% and E .