Microb Drug Resist, 1995 Winter, 1(4), 331 - 3 Prevalent mechanisms of resistance among common enterobacterial isolates in Greek hospitals; Legakis NJ et al.; The recent data concerning antibiotic resistance of the enterobacteria isolated in Greek hospitals are reviewed . A variety of mechanisms of resistance, clustered in most of the cases, was observed . Epidemics of plasmids were responsible for dissemination of third-generation cephalosporins, aminoglycosides, and trimethoprim resistance among Klebsiella pneumoniae and, to a lesser extent, Escherichia coli isolates . Stable depression of the expression of chromosomal cephalosporinase is the main cause of resistance to third-generation cephalosporins observed at high frequencies in Enterobacter spp . strains. Acta Pol Pharm, 1995 Jan-Feb, 52(1), 77 - 85 Susceptibility of bacteria isolated from non-parenteral preparations applied in paediatric hospitals to antibiotics; Zembrzuska-Sadkowska E et al.; No strains resistant to all tested antibiotics were found among the 33 Gram-positive and 17 Gram-negative bacteria isolated from non-parenteral drugs and purified water . Three strains: S . aureus, coagulase-negative staphylococcus and B . cereus have been found to be resistant to 6-8 antibiotics, whereas six Gram-negative strains belonging to Enterobacter agglomerans and Ps . aeruginsosa were resistant to 6-12 antibiotics . The most effective agent against all tested Gram-positive bacteria was cephaloridine, and erythromycin against the staphylococci . Tetracycline and ceftazidim were the least effective . Gentamycin was the only antibiotic effective to all Gram-negative strains, and ceftazidim to most of them . Cefsulodin was ineffective to Ps . aeruginosa. Rheumatol Int, 1995, 15(4), 167 - 70 Diagnostic value of synovial fluid analysis in children with reactive arthritis; Huppertz HI et al.; We report on three children with pauciarticular arthritis in whom the clinical picture and serology were compatible with both arthritis reactive to infection with Yersinia or Salmonella and with Lyme arthritis . Results of analysis of synovial fluid by polymerase chain reaction for enterobacterial or borrelial sequences were negative . Immunofluorescence with specific antibodies revealed the presence of amorphous enterobacterial antigens in synovial fluid cells . Since this staining did not reveal enterobacterial morphology, we infected synovial fluid cells of two children with juvenile rheumatoid arthritis in vitro with Yersinia or Salmonella . After 24 h typical rods were observed, but after about 1 week amorphous antigen similar to what had been found in the three patients was seen . In cases of reactive arthritis with ambiguous results of serological testing the diagnosis may be confirmed by demonstration of enterobacterial antigens in synovial fluid. Med Trop (Mars), 1995, 55(4), 354 - 6 {Nosocomial septicemias due to multiresistant enterobacteria: preliminary considerations in 32 cases observed in the African hospital environment}; N'Doye B et al.; In hospital settings in Africa the many other concerns of sanitary officials and the lack of available resources often make hospital hygiene and nosocomial infection secondary problems . To illustrate the importance of these issues in an African pediatric setting, this report describes a series of 32 cases of nosocomial septicemia that occurred within a 2-month period in the Pediatric Department of Principal Hospital in Dakar . There were 10 deaths . The infecting organisms were similar to those observed in industrial countries . Klebsiella Pneumoniae was identified in 16 cases, Escherichia coli in 5, and an association of both bacteria in 5 . A profile of beta-lactamase enzymes with a classic epidemiologic spectrum was observed in 15 of 21 strains of Klebsiella pneumoniae and in 3 of 10 strains of Escherichia coli . The authors discuss the conditions that may have encouraged the outbreak of septicemia, regret the lack of a service to monitor hospital hygiene, and propose prophylactic measures using laboratory tests that are feasible in a hospital setting in Africa. Ann Dermatol Venereol, 1995, 122(9), 580 - 4 {Balanitis and infectious agents . A prospective study of 100 cases}; Abdennader S et al.; INTRODUCTION: The aim of this study was: 1) to evaluate the rate of micro-organism isolation in 100 patients consulting for balanitis at the Centre of sexually transmitted diseases at the St . Louis Hospital in Paris in comparison with that of micro-organisms isolated in 60 men without balanitis; 2) to search for a possible correlation between the clinical aspect of the disease and the nature of the infectious agent identified . METHODS: One hundred consecutive patients were included in the study . All underwent a clinical examination and samples were taken for bacteriology, mycology and virology examinations . Sixty healthy volunteers served as controls . Two samples were taken from the balanopreputial groove in search for fungi and bacteria . RESULTS: Candida albicans (CA) was isolated in 33 p . 100 of the patients . A pathogenic bacteria (beta-haemolytic streptococci, Staphylococcus aureus, Klebsiella), or a potentially pathogenic germ (Haemophilus parainfluenzae, anaerobic bacteria, Gardnerella vaginalis, Streptococcus milleri, group HB5) was found without CA in 28 p . 100 of the cases, a commensal flora (enterobacteria, group D streptococci) was found without CA in 8 p . 100 and in 31 p . 100 of the cases non causal agent could be identified . DISCUSSION: This series confirms the non-pathogenic nature of commensal bacteria: the number of isolations was similar in the subjects with and without balanitis (p < 0.9) . The role played by the other bacteria in the development of balanitis is discussed: saprophytic association or direct pathogenesis? The significant difference in the rate of bacteria isolations in patients with balanitis compared with controls (p < 0.001) is in favour of a pathogenic role . The clinical presentation was not predictive of the presence of any particular micro-organism excepting the presence of pustules which were highly suggestive of candidiasis. Trop Geogr Med, 1995, 47(6), 244 - 7 Bacteriological profile and holding temperatures of ready-to-serve food items in an open market in Awassa, Ethiopia; Ashenafi M; Various types of ready-to-serve food items purchased at the Awassa open market were evaluated for their bacteriological profile and holding temperatures . The food items included roasted offals, fish soup, cooked and sauced macaroni and spaghetti, and shiro sauce . Spaghetti and macaroni were held at ambient temperatures (20-30 degrees C) and had high aerobic mesophilic count (> 10(6) cfu/g) and Enterobacteriaceae count (> 10(5) cfu/g) . They also yielded Shigella and Staphylococcus spp . Most of the other food items were held at higher temperatures (> 40 degrees C) and the aerobic mesophilic count in most cases was relatively lower (< 10(5) cfu/g) . Several bacterial genera were isolated and Micrococcus and Bacillus spp . dominated the aerobic microflora . The unhygienic conditions of the food service environment, possibilities of cross contamination from utensils and keeping food items at ambient temperatures for several hours were considered to be critical points. Med Pregl, 1995, 48(11-12), 437 - 40 {The role and importance of plasmid resistance in certain pathogenic enterobacteria}; Mandic A et al.; Conjugation, as a process of gene recombination where R-plasmids are transferred from resistant to sensitive genera of bacteria, is very important in the onset and development of infective multiple resistance to the bacterial division potential, whereas it enables fast spreading of resistant genera in the human population . Problems in regard to etiologic therapy of intestinal infections are most serious in shigellosis which is shown in our results of examining 450 genera of Shigella-sonnei isolated during the period January 1990-December 1994 . Thus, resistance to ampicillin occurs in 99.4%, while resistance to streptomycin and cotrimoxazole occurs in 94% . Results of gene resistance transmission from Shigella-sonnei genera, potential donors into recipients by conjugation in vitro, show high frequency of transfer to ampicillin which points to the fact that it is determined by plasmids and transposons-mobile extrachromosomal gene structure . Similar results are gained by multiple-resistant genera of Salmonella wien . However, the stereotype which is dominant in our region and which makes more than 70% of all isolated salmonellas, Salmonella enteritidis is still sensitive to all most commonly used antimicrobial drugs . On the basis of gathered results it may be concluded that the antibiotics of choice in the etiologic therapy of intestinal infections are quinolone-norfloxacin and ciprofloxacin because the resistance which may occur is chromosomally determined. Annu Rev Microbiol, 1995, 49, 747 - 75 Leucine-responsive regulatory protein: a global regulator of gene expression in E . coli; Newman EB et al.; The leucine-responsive regulatory protein (Lrp) regulates transcription of the many genes of the Lrp regulon, repressing some and activating others, some in response to L-leucine and some independent of it . The physiology and molecular biology of the regulon in Escherichia coli are summarized here . However, the high degree of conservation of the protein suggests that it has an important role in all enterobacteria . We suggest that this role is not only as a transcriptional regulator but also as a determinant of chromosome structure. Rev Mal Respir, 1995, 12(5), 415 - 27 {Mechanism of antibiotic resistance in bacteria responsible for respiratory infections}; Dye D et al.; Bacterial resistance is both a frequent phenomena and in perpetual evolution; currently it effects all antibiotics . The acquisition of resistance is a result of chromosomal mutations or is a contribution of genetic material either as plasmids or transposons . The principle mechanisms which can be isolated or associated can be grouped together under changes of bacterial permeability which alters the target of the anti-infectious agents; or the synthesis of enzymes which inhibit the activity of the antibiotic . Some micro-organisms such as Staphylococcal aureus, Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and certain enterobacteria have developed resistance to varying degrees against the antibiotics initially or more recently introduced which pose, in some cases, very real therapeutic problems . The prescribing doctor should recognise the principle bacterial phenotypes which are resistant, as well as the rules of association of the different antibiotics in order to institute an effective anti-infectious regime, which allows the cure of the patient and limits any introduction of resistance or the selection of resistant mutants. Drugs, 1995, 49 Suppl 2, 16 - 28 Classification and structure-activity relationships of fluoroquinolones; Bryskier A et al.; Fluoroquinolones are potent broad spectrum antibacterial agents . Two classifications have been described: chemical and biological . Quinolones can be classified into 4 groups according to their chemical structures: monocyclic, bicyclic, tricyclic and tetracyclic derivatives . Each group can be subdivided into subgroups if a fluorine atom is fixed at the 6-position . The biological classification recognised 4 groups . Groups 1 and 2 are composed of compounds showing limited spectra (Enterobacteriaceae) and groups 3 and 4 contain compounds displaying broad antibacterial spectra . Compounds that are highly metabolised fall into groups 1 and 3 and those poorly metabolised (< 5%) into groups 2 and 4 . The structure of fluoroquinolones may help to predict antibacterial activity, pharmacokinetics, physicochemical properties, toxicity and adverse events. Drugs, 1995, 49 Suppl 2, 100 - 11 Quinolones and osteomyelitis: state-of-the-art; Lew DP et al.; The present review provides a critical quantitative analysis of the use of quinolones in osteomyelitis . Only papers published in peer-reviewed journals and related to the following areas were selected: experimental osteomyelitis, penetration of quinolones into human bone and clinical use in comparative and non-comparative studies . Cumulated results show clinical success rates of more than 90% in osteomyelitis caused by Enterobacteriaceae, after prolonged oral use of ciprofloxacin . However, further comparative studies using oral quinolones as single agents or in combination (versus standard parenteral therapy) are required in osteomyelitis due to S . aureus or P . aeruginosa, or in more complicated situations such as diabetic osteomyelitis or foreign body infection. Scand J Infect Dis, 1995, 27(3), 245 - 51 Bacteremia at a Danish university hospital during a twenty-five-year period (1968-1992); Arpi M et al.; In the 25-year period 1968-92, 3,317 out of 477,420 patients admitted to Frederiksberg Hospital experienced 3,491 episodes of bacteremia . Enterobacteriaceae dominated as causative agents (57%), following by Gram-positive cocci (31%) and anaerobes (7%) . Polymicrobial bacteremia was found in 8% of the episodes . The incidence of Enterobacteriaceae bacteremia culminated in the middle (1978-82) of the period (4.7/1,000 admissions) and decreased during the last decade . Gram-positive bacteremia increased throughout the period (from 1.8 to 2.9; p < 0.001), due mainly to increasing incidences of bacteremia caused by non-hemolytic streptococci, Streptococcus pneumoniae and coagulase-negative staphylococci . Bacteroides fragilis accounted for a rising incidence of anaerobic bacteremia (from 0.3 to 0.7; p < 0.05) . Clinical data were available for the 2,599 bacteremic episodes in the 20-year period 1968-87 . 59% of these were hospital acquired . Of those, 38% were associated with indwelling catheters, mainly bladder catheters (28%) and i.v . lines (7%) . The urinary tract dominated as source of bacteremia (46%), followed by the respiratory (11%) and the gastrointestinal tract (9%) . Half of the patients had predisposing underlying diseases, most frequently malignancies (20%) and diabetes mellitus (7%) . The mortality rate related to bacteremia decreased from 25% to 11% (p < 0.001) . More than half (55%) of the fatal cases related to bacteremia occurred within the first 2 days after the first positive blood culture was obtained . Logistic regression analysis defined 7 variables that independently influenced the outcome related to bacteremia: age, source, culture verification of source, shock, body temperature, leukocyte count and empiric antibiotic treatment.(ABSTRACT TRUNCATED AT 250 WORDS) Prog Clin Biol Res, 1995, 392, 113 - 39 The lipopolysaccharide of Legionella pneumophila serogroup 1 (strain Philadelphia 1): chemical structure and biological significance; Zahringer U et al.; The lipopolysaccharide (LPS, endotoxin) of Legionella pneumophila serogroup 1 (Philadelphia 1) exhibits peculiar chemical features which may account for its importance as a bacterial virulence factor . The O-chain of this LPS constitutes a homopolymer of an unusual sugar, 5-acetamidino-7-acetamido-8-O-acetyl-3,5,7, 9-tetradeoxy-D-glycero-L-galacto-nonulosonic acid (legionaminic acid) of which about 10-75 residues are present . Due to the lack of free hydroxyl groups, this homopolymer renders the cell surface highly hydrophobic and, therefore, supports adherence to the membrane of target cells including alveolar macrophages . Investigations of the serological specificity of the serogroup 1 LPS revealed a monoclonal antibody (mAb 3/1) which recognizes an epitope located in the environment of the 8-O-acetyl group of legionaminic acid . According to epidemiological studies, this determinant appears to be associated with L . pneumophila virulence . The outer core oligosaccharide of L . pneumophila LPS exhibits also hydrophobic properties due to the presence of N- and O-acetyl groups as well as 6-deoxy sugars . The inner core expresses both similarities and differences as compared to enterobacterial core oligosaccharides in containing Kdo but lacking heptose and phosphate groups . Lipid A possesses some unique structural features since its backbone consists of a bisphosphorylated beta-GlcpN3N-(1-->6)-GlcpN3N disaccharide with only amide-linked acyl groups having 14-22 carbon atoms . Long chain fatty acids {28:0(27-oxo) and 27:0-dioic} possessing the double length as enterobacterial acyl groups, may be responsible for the low endotoxicity of L . pneumophila lipid A. Med Dosw Mikrobiol, 1995, 47(1-2), 25 - 33 {Potential pathogenic throat bacterial flora in acute successive pharyngitis and tonsillitis in children}; Chylak J; The purpose of this work was to determine the frequency of occurrence of S . aureus, H . influenzae, H . parainfluenzae, beta-hemolytic streptococci, Enterobacteriaceae spp . and nonfermenting rods in a group of children suffering from acute successive pharyngitis and tonsillitis . Specimens were taken during three acute occurrences and twice after treatment from first and second acute occurrences . S . aureus was isolated from the throats of 55.1%-62% of the sick children . H . influenzae and H . parainfluenzae were isolated from about 22% to over 40% of the sick children, beta-haemolytic streptococci were isolated from 10.3%-16.2% of the sick children and Enterobacteriaceae spp . were isolated from the throats of 6.1%-16.25% of the sick children . Nonfermenting rods were isolated from only one sick child . Two or more possible bacterial pathogens were isolated from several sick children . Among them S . aureus with H . influenzae or with H . parainfluenzae or with beta-haemolytic streptococci were most often isolated . After treatment of these children, S . aureus, H . influenzae, H . parainfluenzae were more rarely isolated from the throat, and beta-haemolytic streptococci or Enterobacteriaceae spp . were isolated occasionally . Similarly, after treatment mixed potentially pathogenic bacterial flora were more rarely seen. Infect Control Hosp Epidemiol, 1995 Jan, 16(1), 25 - 9 Interrepeat fingerprinting of third-generation cephalosporin-resistant Enterobacter cloacae isolated during an outbreak in a neonatal intensive care unit; Verweij PE et al.; OBJECTIVE: To investigate an outbreak in neonates of Enterobacter cloacae infection resistant to third-generation cephalosporins . DESIGN: A retrospective study of an outbreak in the neonatal intensive care unit (NICU) and review of E cloacae isolates in pediatric wards and other intensive care units from June 1992 through March 1993 . SETTING: An academic tertiary care hospital . PATIENTS: Six patients admitted to the NICU were colonized or infected with E cloacae resistant to third-generation cephalosporins . In the period preceding the outbreak, four E cloacae isolates were available from four patients in the pediatric surgical ward . Nine isolates from four patients in two other intensive care units (ICUs) also were collected during the outbreak . Isolates were biotyped by the API 50CH system and genotyped by polymerase chain reaction (PCR) fingerprinting . RESULTS: Typing by interrepeat PCR showed that 21 isolates, which were obtained from five neonates, were identical . One neonate was colonized with a different strain . Some neonates were colonized with a single type of E cloacae for a relatively long period of time . Isolates of patients who were cared for in the pediatric surgical ward and the two other intensive care units (ICUs) showed different genotypes . One patient in an ICU was colonized with an E cloacae strain genetically identical to the outbreak strain . No predominant biotype could be established . CONCLUSIONS: E cloacae can colonize neonates for a long period of time and although colonization with E cloacae initially may arise endogenously, we were able to show further transmission by cross-contamination in a neonatal intensive care unit. Chemotherapy, 1995 Jan-Feb, 41(1), 5 - 13 In vitro and in vivo activity of DQ-2556, a new cephalosporin; Ishida Y et al.; The antibacterial activity of DQ-2556, a new cephalosporin, was compared with that of cefepime, cefpirome, and other antibiotics . DQ-2556 was more active than cefepime and less active than cefpirome against gram-positive bacteria . DQ-2556 was the most active compound against most members of the Enterobacteriaceae, such as Escherichia coli, Klebsiella, Proteus, Salmonella spp., and Shigella spp., and Haemophilus influenzae and Neisseria gonorrhoeae . In vivo, treatment with DQ-2556 was as or more efficacious than that with reference compounds in both systemic and respiratory tract infections in mice . DQ-2556 achieved higher concentrations than cefepime and cefpirome in lungs and kidney of mice. Chemotherapy, 1995 Jan-Feb, 41(1), 14 - 7 In vitro activity of isepamicin (Sch 21420), a new aminoglycoside; Qadri SM et al.; The narrow therapeutic/toxic ratio of existing aminoglycosides has led to a search for safer drugs of this class . Isepamicin is a semi-synthetic aminoglycoside with a significantly low nephro as well as ototoxicity in animals and which is expected to have a clinical efficacy comparable to that of amikacin . We therefore compared its antibacterial activity with amikacin against 817 recent clinical isolates of gram-positive and gram-negative bacteria . The in vitro activity of isepamicin was comparable or slightly greater than amikacin against Staphylococcus aureus and most Enterobacteriaceae . However, it was significantly more inhibitory towards Serratia marcescens, Enterobacter and Klebsiella pneumoniae. J Antibiot (Tokyo), 1995 Jan, 48(1), 73 - 82 Synthesis and biological activity of novel cephalosporins containing a (Z)-vinyl dimethylphosphonate group; Smith PW et al.; A series of cephalosporins containing a novel 7-{2-(Z)-(2-amino-thiazol-4- yl)-3-(dimethoxy-phosphoryl)-acryloylamino} group were prepared and their antibacterial activity measured against a range of pathogens . In general the compounds displayed a broad spectrum of activity against both Gram positive and Gram negative organisms, except Pseudomonas aeruginosa . Activity against the latter could be achieved by introducing a catechol moiety at the 3 position of the cephalosporin . The methyl phosphonates in general were stable to a wide range of beta-lactamases, including the TEM enzymes and the Enterobacter cloacae P99 chromosomal enzyme . In addition, they showed the advantage of being highly water soluble. Dev Biol Stand, 1995, 84, 255 - 62 OmpA fusion proteins for presentation of foreign antigens on the bacterial outer membrane; Hobom G et al.; The ompA genes of Escherichia coli and Shigella dysenteriae have been used to construct a group of enterobacterial surface expression vectors for foreign genes . Linker oligonucleotides were inserted into the sequence corresponding to the third or fourth outer domain to allow in-frame sandwich fusion of foreign genes or epitopes into ompA . Influenza haemagglutinin was inserted without its leader peptide and anchor sequences and shown to be transferred as an ompA fusion protein to the bacterial surface in large amounts . The stability of this system depends on the stem structure (i.e . the bottom part) of the haemagglutinin unit which apparently initiates the folding process that extends into the ompA segment . This fusion construct can be used as a vector system and has been used to transfer to the bacterial surface several other proteins inserted into it, including beta-galactosidase, foot-and-mouth disease virus (FMDV) and malaria antigens . All are exported from the cytoplasm across both the inner and outer membranes to become exposed on the bacterial surface . Very hydrophobic segments or inserts with distinct secondary structures, such as the capsid protein, VP1 of FMDV, will, however, block this process. Diagn Microbiol Infect Dis, 1995 Jan, 21(1), 1 - 8 Development, characterization, and initial evaluations of S1 . A new chromogenic cephalosporin for beta-lactamase detection; Sutton LD et al.; A novel, chromogenic cephalosporin reagent (S1) for beta-lactamase testing was produced that shares physicochemical characteristics with nitrocefin (formerly 87/312) . S1 and nitrocefin in a disk-testing format for beta-lactamase performed at 100% agreement for detecting enzyme-producing isolates of Bacteroides fragilis group, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae, Staphylococcus aureus, and selected Enterobacteriaceae . The time required to achieve an initial color change or a strong positive reaction was comparable for both chromogenic reagents for all organisms except the Gram-positive species . S1 reaction times were approximately 50% faster than nitrocefin for beta-lactamase-positive enterococci and S . aureus . These results from the developmental studies and a commercially prepared disk lot indicate that S1 is a promising beta-lactamase disk test reagent with the ability to detect all significant enzyme-producing species strains, some significantly earlier than the nitrocefin disk method. J Basic Microbiol, 1995, 35(2), 73 - 82 Microbiological survey of a South African poultry processing plant; Geornaras I et al.; Bacterial populations associated with poultry processing were determined on neck skin samples, equipment surfaces and environmental samples by replicate surveys . Aerobic plate counts, Enterobacteriaceae counts, Enterobacteriaceae counts and Pseudomonas counts were performed by standard procedures and the prevalence of Listeria, presumptive Salmonella and Staphylococcus aureus determined . Statistically significant (P < 0.05) increases in counts of all types of bacteria were obtained on product samples as a result of processing . Although bacterial counts on neck skin samples decreased by 0.3 to 0.4 log CFU g-1 after spray washing of carcasses, subsequent spinchilling and packaging of whole carcasses resulted in 0.7 to 1.2 log CFU g-1 increases . Bacterial numbers on equipment surfaces, however, decreased significantly from the "dirty" to the "clean" areas of the abattoir . Transport cages, "rubber fingers", defeathering curtains, shackles and conveyor belts repeatedly showed aerobic plate counts in excess of 5.0 log CFU 25 cm-2 . Aerobic plate counts of scald tank and spinchiller water were 2 log CFU ml-1 higher than those of potable water samples . Bacterial numbers of the air in the "dirty" area were higher than those of the "clean" area . Listeria, presumptive Salmonella and Staphylococcus aureus were isolated from 27.6, 51.7 and 24.1% of all product samples, respectively, and Listeria and Staphylococcus aureus were also isolated from selected equipment surfaces. Zh Mikrobiol Epidemiol Immunobiol, 1995 Jan-Feb, (1), 10 - 5 {The cellular fatty acid composition of bacteria in the family Vibrionaceae}; Vasiurenko ZP et al.; Vibrio cholerae strains, serovar O1, biovar eltor, subtype Ogawa, isolated from different sources, V . cholerae classica and NAG vibrios have identical cell fatty acid composition with the prevalence of hexadecenoic, hexadecanoic and octadecenoic acids . V . parahaemolyticus and V . alginolyticus fatty acid profiles, being identical, are similar to V . cholerae profile, differing from it mainly by a higher content of dodecanoic acid . The similarity of the fatty acid profiles of Aeromonas sp . and Vibrio strains is indicative of their phylogenetic relationship . The fatty acid composition of Plesiomonas shigelloides characterized by the presence of methylenehexadecanoic acid and at the same time by its similarity to that of Vibrio and Aeromonas in the content of the majority of fatty acids, confirms the position on the intermediate status of the genus Plesiomonas between the families Enterobacteriaceae and Vibrionaceae. Clin Exp Rheumatol, 1995 Jan-Feb, 13(1), 59 - 64 A longitudinal study of calprotectin as an inflammatory marker in patients with reactive arthritis; Hammer HB et al.; OBJECTIVE: To examine the value of calprotectin, a major granulocyte protein with bactericide properties, as an inflammatory marker in patients with reactive arthritis . METHODS: Twenty-five patients with Chlamydia-induced and 27 patients with enterobacteria-induced reactive arthritis were analysed . At the first visit and after 3, 12, 24, 52 and 104 weeks, calprotectin concentrations were measured in plasma and when possible, in synovial fluid . C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were analysed and clinical assessments of disease activity were performed . RESULTS: Of the inflammatory markers, the plasma calprotectin concentrations were the first to normalize during recovery . Calprotectin concentrations in the plasma were highly correlated with CRP and ESR, and calprotectin was found to have high correlation coefficients with the clinical assessments of disease activity . High calprotectin concentrations were found in the synovial fluid . CONCLUSION: The high correlations between calprotectin in plasma and clinical and laboratory markers of inflammation, as well as the rapid normalization following clinical improvement, demonstrate that calprotectin may be used as an inflammatory marker in patients with reactive arthritis. J Fr Ophtalmol, 1995, 18(4), 250 - 8 {Retrospective study of the prevalence and sensitivity to antibiotics of bacteria isolated from ocular samplings}; Schlegel L et al.; PURPOSE: This study evaluates the variability of the bacterial flora and the changes in their antibiotics sensitivity tests between 1988 and 1993 in 46090 specimens (conjunctival cultures, corneal scrapings, vitreous, aqueous humour, ocular foreign bodies) . METHODS: The specimens were cultured and antibiotics sensitivity test was carried out on the pathogens only (3309 strains) . RESULTS: Streptococci (36.1%) and Staphylococcus aureus (35.6%) are the most frequent species with Enterobacteriaceae (12.1%) and Haemophilus (7.8%) . S . aureus and Streptococcus pneumoniae are more prevalent with decreasing values for other bacteria (Khi-2 of trend, Mantel's extension, p < 0.05) . Antibiotics sensitivity yield expected results without any remarkable changes during the study . No multi-resistant strain was isolated . CONCLUSION: The increase of number of S . aureus and S . pneumoniae is the major change noted in pathogens found from our eye samples. Klin Lab Diagn, 1995 Jan-Feb, (1), 49 - 51 {Evaluation of a system of multimicrotests for biochemical identification of enterobacteria (MMT E2) in a controlled epidemiological trial . 2}; Ugrimov SA et al.; Commercial system of multimicrotests for biochemical identification of enterobacteria MMT E2 and routine tube tests were compared in a controlled epidemiologic experiment with 205 enterobacterial strains . The system has been developed at the Allergen Research and Production Amalgamation . System MMT E2 fairly well met the requirements to diagnostic preparations of this kind; its results were compatible and well reproducible . This system in complex with commercial MMT E1 system may be used for species identification of enterobacteria . Practical application of both the systems will considerably simplify the process of identification of these microorganisms. Pharmacotherapy, 1995 Jan-Feb, 15(1 Pt 2), 3S - 8S Trends in antimicrobial resistance among today's bacterial pathogens; Thornsberry C; Resistance of nosocomial and community-acquired pathogens to antimicrobial agents is a serious problem with significant clinical consequences . Microbiologic surveillance data, such as those provided by the National Nosocomial Infections Surveillance System, supply information on current nosocomial pathogens in the United States . Many species show resistance to commonly used antimicrobials and, in many cases, it is emerging resistance . Resistance in many gram-negative bacteria is caused by beta-lactamase production . Escherichia coli, the leading nosocomial pathogen, is capable of hyperproducing TEM-1 beta-lactamase . A novel form of resistance in Klebsiella pneumoniae and E . coli is caused by extended-spectrum cephalosporinases . Many Enterobacteriaceae can be induced to produce group 1 beta-lactamase by exposure to broad-spectrum cephalosporins and other beta-lactams . Thirty percent of Haemophilus influenzae isolates are resistant to ampicillin because of beta-lactamase production . Issues of concern in gram-positive species include multiple antimicrobial resistance in methicillin-resistant Staphylococcus aureus, enterococci, and coagulase-negative staphylococci, and increasing beta-lactam resistance in Streptococcus pneumoniae . To minimize the development of resistance, antimicrobials must be administered judiciously, and infection-control practices must be instituted and followed. Mol Microbiol, 1995 Jan, 15(1), 87 - 95 A histidine decarboxylase gene encoded by the Vibrio anguillarum plasmid pJM1 is essential for virulence: histamine is a precursor in the biosynthesis of anguibactin; Tolmasky ME et al.; We have identified and sequenced an hdc gene in the Vibrio anguillarum plasmid pJM1 which encodes a histidine decarboxylase enzyme and is an essential component for the biosynthesis of anguibactin . The open reading frame corresponds to a protein of 386 amino acids with a calculated molecular mass of 44,259.69 Da . The amino acid sequence has extensive homology with the pyridoxal-P-dependent histidine decarboxylases of Morganella morganii, Klebsiella planticola, and Enterobacter aerogenes . Tn3-HoHo1 transposition mutagenesis of the hdc gene present in a recombinant clone carrying the entire pJM1 iron uptake region produced two derivatives, one with the lacZ gene in the same orientation as the direction of hdc transcription and the other with the lacZ gene in the opposite orientation . A . V . anguillarum strain harbouring one of the mutated derivatives was unable to grow under iron-limiting conditions and did not produce anguibactin . Therefore, the hdc gene must play a role in the biosynthetic pathway of this siderophore and consequently in conferring the high virulence phenotype to this bacterium . The role of histidine decarboxylase in biosynthesis of anguibactin was confirmed by the fact that growth under iron starvation was restored by addition of histamine to the medium . The presence of anguibactin was also demonstrated in supernatants from cultures of the hdc mutant strains grown under iron starvation with the addition of histamine, further confirming that histamine is a precursor in the biosynthesis of the siderophore.(ABSTRACT TRUNCATED AT 250 WORDS) J Hosp Infect, 1995 Jan, 29(1), 19 - 33 Evolution of bacterial susceptibility to antibiotics during a six-year period in a haematology unit; Durand-Gasselin B et al.; A knowledge of the bacterial ecology of a haematology unit should help in the management of the febrile patient with or without neutropenia . We studied the prevalence and the susceptibility profiles of bacteria isolated during a six-year period among patients hospitalized in a 44-bed haematology unit . Antibiotic use over this period was also studied . The most prevalent bacteria were coagulase-negative staphylococci (CNS) (35.1%), Escherichia coli (11.4%), Staphylococcus aureus (9.9%), Enterococcus spp . (8.2%), and Pseudomonas aeruginosa (7.5%) . The susceptibility of CNS to oxacillin decreased from 67-44% over six years, while that of enterobacteriaceae to amoxycillin and piperacillin was reduced by about 50% . P . aeruginosa susceptibility to ceftazidime remained remarkably stable at around 90%, despite extensive empirical use . Imipenem and ciprofloxacin were used restrictively and ceftazidime-resistant P . aeruginosa remained susceptible to these two agents in most cases . Our antibiotic policy was found to be compatible with the frequency of the bacterial strains isolated in our department and with their susceptibility profiles. J Invest Surg, 1995 Jan-Feb, 8(1), 65 - 84 Effects of a water-soluble ethylhydroxyethyl cellulose on gut physiology, bacteriology, and bacterial translocation in acute liver failure; Wang X et al.; Bacterial infection and bacteremia are common complications in patients with acute liver failure . Bacterial translocation from the gut has been suggested to be a major cause of bacterial infections in experimental acute liver failure . In the present study, a water-soluble ethylhydroxyethyl cellulose (EHEC) was administered orally 1 and 24 hours prior to 90% hepatectomy in the rat in order to prevent bacterial translocation in experimental acute liver failure induced by subtotal liver resection in the rat . Ninety percent hepatectomy alone resulted in 80 to 100% translocation to mesenteric lymph nodes or blood 2 and 4 hours after operation . There was no translocation in rats undergoing sham operation or 90% hepatectomy with EHEC administration prior to operation (p < .01) . Bacterial overgrowth, increased bacterial adherence onto the intestinal surface, and diminished intestinal and mucosal mass were also observed in animals with subtotal liver resection, but not in those administered EHEC . A delayed 2-hour intestinal transit time occurred in both groups receiving subtotal liver resection, with or without oral EHEC . EHEC inhibited bacterial growth and DNA synthesis and altered bacterial surface properties after 1-hour incubation with bacteria in vitro, an interaction that was not further influenced by time . These results imply that EHEC may alter enterobacterial capacities of metabolism, proliferation, and invasion by effects on the bacterial surface . Furthermore, EHEC seems to possess a trophic action on the intestine, though without enhancing the intestinal motility. Clin Infect Dis, 1995 Jan, 20(1), 84 - 94 Molecular epidemiology of infections due to Enterobacter aerogenes: identification of hospital outbreak-associated strains by molecular techniques; Georghiou PR et al.; Molecular techniques were used to study the epidemiology of infections due to Enterobacter aerogenes in a tertiary-care hospital . Sixty-two clinical isolates were collected from 43 patients over 3 months . Restriction endonuclease analysis (REA) of chromosomal DNA and repetitive-element polymerase chain reaction (rep-PCR) with primers based on repetitive extragenic palindromic (REP) and enterobacterial repetitive intergenic consensus (ERIC) bacterial DNA sequences were used for genomic fingerprinting . REA with HindIII or EcoRI yielded complex banding patterns that differentiated community-acquired from some hospital-acquired organisms . Less complex fingerprints were obtained with rep-PCR, which also distinguished between epidemiologically unrelated strains . More discriminatory DNA fingerprints were provided by rep-PCR when REP primers rather than ERIC primers were used . Two clusters of genomically distinct isolates from patients with recent or current exposure to the hospital environment were identified by REA and rep-PCR . Most isolates within each cluster contained characteristic plasmids, and some isolates contained additional plasmids . These results suggest colonization and infection with genotypically related strains of E . aerogenes in a nosocomial setting . Although REA and plasmid profiling are useful techniques for the epidemiological typing of E . aerogenes, genomic fingerprinting with rep-PCR may offer the advantages of ease, speed, and broad species applicability over existing molecular-typing techniques. Lab Anim, 1995 Jan, 29(1), 37 - 44 Antibiotic treatment of nude rats and its impact on the aerobic bacterial flora; Hansen AK; A colony of nude rats were treated with the antibiotics ampicillin, spiramycin, sulfadoxine/trimethoprim, tetracycline, lincomycin and spectinomycin over a period of 30 weeks . The rats were monitored bacteriologically during the whole treatment period and for a period of 24 weeks after the treatment . Antibiograms of each isolated microorganism were made in vitro . The primary target, Pasteurella pneumotropica, was suppressed by the treatment, but reappeared after ending the medication . Klebsiella pneumoniae subsp . pneumoniae, never observed before the use of antibiotics in the colony, became one of the most common organisms in the colony . Furthermore, this bacterium was resistant to all antibiotics tested in vitro . Also other Enterobacteriaceae and some Streptococcaceae were propagated . Only Staphylococcus aureus seemed to have been eradicated by the treatment . It is concluded, that such antibiotic treatment does not necessarily improve the microbiological quality of the rats, and that it imposes a high risk of propagating resistant bacteria. Jpn J Antibiot, 1995 Jan, 48(1), 71 - 91 {Bacteriological, pharmacokinetic and clinical studies of SY5555 dry syrup in the pediatric field}; Toyonaga Y et al.; Bacteriological, pharmacokinetic and clinical studies on SY5555 dry syrup (powder which is dissolved before use), a new penem antibiotic for oral use, were performed . The following results were obtained . 1 . Antibacterial activities . MICs of SY5555, clavulanic acid/amoxicillin (CVA/AMPC), cefotiam (CTM), cefpodoxime (CPDX), cefaclor (CCL) and cefdinir (CFDN) were determined against clinically isolated Staphylococcus aureus, coagulase negative staphylococci, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Moraxella catarrhalis, Escherichia coli and Enterobacter cloacae at a dose of 10(6) CFU/ml . MICs of SY5555 against S . aureus, CNS, S . pneumoniae, S . pyogenes, H . influenzae, M . catarrhalis, E . coli and E . cloacae were 0.2, 0.2, 0.2, < or = 0.025, 0.78, 0.2, 0.78 and 3.13 micrograms/ml, respectively, showing excellent antibacterial effects on these pathogens . Although the effects of SY 5555 against H . influenzae and E . coli were slightly inferior to those of CPDX and CFDN, the drug showed the most excellent antibacterial effect on other strains as compared with the control drugs . 2 . Absorption and excretion In this study, plasma concentrations and urinary recovery rates were examined after administration of SY5555 at doses of 5 and 10 mg/kg (potency) after meals . With both 5 and 10 mg/kg doses, peak plasma concentrations were reached 1 hour after administration, at 0.25-2.61 micrograms/ml (mean 1.47 micrograms/ml) and 1.08-2.17 micrograms/ml (mean 1.74 micrograms/ml), respectively . The plasma levels rapidly decreased to 0.06-0.19 micrograms/ml (0.12 micrograms/ml) and 0.0503-0.0637 micrograms/ml) after 6 hours . The half-lives 1.12 hours in the 5 mg/kg group and 1.0 hour in the 10 mg/kg group . The urinary recovery rates were determined in the first 8 hours after administration in the 5 mg/kg and 6 hours in the 10 mg/kg group, and the values were as low as 1.05-12.3% and 1.6-4.33%, respectively . 3 . Clinical results The clinical responses were examined in a total of 73 cases including 4 acute pneumonia, 13 acute bronchitis, 11 tonsillitis, 3 pharyngitis, 12 scarlet fever, 2 pertussis, 6 urinary tract infection, 6 otitis media, 7 lymphadenitis, 2 staphylococcal scalded skin syndrome, 2 phlegmon, 4 impetigo and 1 purulent parotitis . The treatment was effective or better in 66 of 70 cases with an efficacy rate of 94.3% (3 undeterminable cases were excluded) . Bacteriological effects were examined during the clinical course for detected or suspected pathogens found before administration of SY5555 . The effects were determined in 50 cases including 7 cases of polymicrobacterial infections, 57 strains in total . Eight strains, however, persisted, hence the overall eradication rate was 86.0%.(ABSTRACT TRUNCATED AT 400 WORDS) J Clin Microbiol, 1995 Jan, 33(1), 199 - 201 Evaluation of new medium with chromogenic substrates for members of the family Enterobacteriaceae in urine samples; Kodaka H et al.; A new medium containing 5-bromo-4-chloro-3-indolyl-beta-D-glucuronide cyclohexylammonium salt (Glu agar) for Escherichia coli and a new medium containing 5-bromo-3-indolyl-beta-D-galactoside (Gal agar) for beta-galactosidase-positive members of the family Enterobacteriaceae were compared with MacConkey agar in a diagnostic trial with 3,562 urine specimens . The isolation rates of E . coli and beta-galactosidase-positive Enterobacteriaceae were increased 8.4 and 19.5%, respectively . The sensitivities and specificities of Glu agar and Gal agar were 98.5 and 100% and 99.2 and 99.5%, respectively. J Clin Microbiol, 1995 Jan, 33(1), 161 - 5 Clinical impact of bacteria and fungi recovered only from broth cultures; Morris AJ et al.; We prospectively evaluated 356 bacteria and fungi recovered from broth enrichment tubes from cultures with sterile direct plates to determine the clinical impact of isolates recovered only from broth cultures . These "broth only" isolates (BOI) were classified as contaminants or true on the basis of review of patient charts . True isolates were considered clinically relevant only if they altered or should have altered patient management . Of 356 BOI, 259 (73%) were considered contaminants (mostly coagulase-negative staphylococci and Propionibacterium spp.) and 97 (27%) were considered true . For individual microorganisms, 9 of 9 (100%) Staphylococcus aureus isolates, 13 of 13 (100%) members of the family Enterobacteriaceae, 10 of 12 (83%) fungi, 7 of 10 (70%) enterococci, 7 of 11 (64%) other gram-negative bacilli, 13 of 31 (45%) anaerobic bacteria, 10 of 24 (42%) streptococci, 22 of 140 (16%) coagulase-negative staphylococci, 6 of 92 (7%) Propionibacterium spp., and 0 of 14 (0%) diphtheroids and Bacillus spp . were classified as true . Eleven of 97 (11%) patients with true BOI had clinically relevant isolates . Fifty-nine of the 97 (61%) patients with true isolates already were on therapy, and no change was made because of the BOI . Six (6%) patients with contaminants received therapy for their BOI . We conclude that broth inoculated as an adjunct to direct plating seldom yields results that favorably alter patient management and could be omitted for most specimens without compromising patient care. Sci China B, 1995 Jan, 38(1), 60 - 6 Structure and oxygen sensitivity of nifLA promoter of Enterobacter cloacae; Deng X et al.; The nucleotide sequence of the nifLA promoter of Enterobacter cloacae E26 was determined, and the transcription start site of nifLA was mapped by the primer extension . Studies on the oxygen regulation of E . cloacae nifLA promoter with the nifL'-lacZ fusion showed that the nifLA promoter was sensitive to oxygen as Klebsiella pneumoniae nifLA promoter reported previously . Comparison between the nifLA promoter sequences of E . cloacae and K . pneumoniae revealed the presence of an 11-bp conserved sequence between the -24/-12 consensus of sigma 54-dependent promoter and NtrC binding motif . The 11-bp sequence is speculated to be involved in the oxygen regulation of the nifLA promoter of both enteric bacteria. Antimicrob Agents Chemother, 1995 Jan, 39(1), 87 - 93 Frequency and mechanism of resistance to antibacterial action of ZM 240401, (6S)-6-fluoro-shikimic acid; Ewart CD et al.; Spontaneous resistance to (6S)-6-fluoro-shikimic acid arose in Escherichia coli and other enterobacteria at high frequencies, between 10(-5) and 10(-4) . Two resistant variants of E . coli were tested for their susceptibilities to the diastereomeric compound, (6R)-6-fluoro-shikimate, and both of them had become resistant to this compound as well . (6S)-6-Fluoro-shikimate-resistant variants of E . coli generally failed to transport {14C}shikimate . In E . coli K-12, (6S)-6-fluoro-shikimate resistance cotransduced with his at the same frequency as shiA, a gene locus that governs shikimate transport phenotypes . We propose that the loss of susceptibility to (6S)-6-fluoro-shikimic acid in spontaneous resistant variants is due to the loss of activity of the transport system by which it enters the bacterial cytoplasm. Mycopathologia, 1995, 129(2), 117 - 25 Enterobacter cloacae is an endophytic symbiont of corn; Hinton DM et al.; The bacterium Enterobacter cloacae is presently used for biocontrol of postharvest diseases of fruits and vegetables and as a preplant seed treatment for suppression of damping-off . This bacterium has apparent affinities for several grass species, but it is not considered to be an endophyte . While screening corn for fungi and bacteria with potential for biocontrol of various corn diseases, the surface-sterilized kernels of one unknown Italian corn cultivar produced fungus-free corn seedlings with roots endophytically infected by E . cloacae . This paper describes the microscopic nature of E . cloacae RRC 101 with corn, and the in vitro control of Fusarium moniliforme and other fungi with this bacterium . Light and electron microscopy determined that this isolate of E . cloacae was biologically associated with corn seedling roots, where it was distributed intercellularly within the cortex and stele . This is a first report of a strain of this bacterium as an endophytic symbiont of roots . Following a topical application of E . cloacae to kernels, and upon germination this bacterium readily infected roots of two other corn cultivars . The bacterium was observed within the endosperm of germinating corn seedling, but germination was not affected . Further, the bacterium was isolated from leaves and stems of 3- to 6-week-old seedlings indicating that the above ground portions of corn were also colonized . There was no evidence of damage to cells of the root during a three to four week observation period . This bacterium was antagonistic to several isolates of the corn pathogen Fusarium moniliforme, and to two other species of fungi, all of which produce mycotoxins on corn. Eur J Cancer B Oral Oncol, 1995 Jan, 31B(1), 58 - 62 Surveillance of oral cultures for Enterobacteriaceae during bone marrow transplantation; Galili D et al.; Bone marrow-transplanted patients can suffer from severe life-threatening infections . Oral bacterial cultures were collected from a group of 40 patients prior to and following bone marrow transplantation every 3 days, following initial preparation and eradication of oral infections . The samples were grown on the Titertek-Enterobac kit specific for Enterobacteriaceae . In 426 oral cultures 30.5% grew gram-negative bacteria, 76.6% of them were Enterobacteriaceae . young male patients had 8.3% positive cultures at the study start, a percentage which constantly increased during later periods . Older patients did not follow the same pattern . Also, the allogeneic transplantation group had a higher percentage of Enterobacteriaceae than the autologous group (49.0 versus 19.5%) . In blood cultures 18 out of the 94 positive ones showed the presence of Enterobacteriaceae . The most commonly found microorganisms in oral cultures were Klebsiella oxytoca (23%), Enterobacter cloacae (18%) and Klebsiella pneumoniae (15%) . The decrease in the positive oral cultures from 35.0% during the pretransplantation period to 5.4% close to the transplantation, demonstrates that the preparatory protocol used for the prevention of oral infections was highly effective. Antibiot Khimioter, 1995 Jan, 40(1), 45 - 9 {A system of processing data of clinical microbiology laboratories}; Aleksandrova IA et al.; The COBAS BACT automized system (Hoffman la Roche, Switzerland) was used in the practical work of the laboratory of clinical microbiology . The analyzer performed two functions i.e . the identification of gram-negative pathogens of the family Enterobacteriaceae and the rapid assay of their susceptibility to antibacterial drugs . The primary computer processing was embedded in the COBAS BACT machine . An information system providing the automatization of the secondary processing of the results of microbiological tests was developed . It included not only a system of the data bases for storage of the information and accumulation of the statistical data on the assays and their results but also the automized position of the microbiologist providing the possibility of the statistical information accumulation and reading . The CLIPPER program was used as a basis for the system development . The results of the secondary computer processing are illustrated by the actualities of the determination of the etiological factor of postoperative meningitis and septicemia carried out in 1993. Microbiol Immunol, 1995, 39(4), 255 - 9 Chromatographic study of spirosin by use of monoclonal antibodies to spirosin of Yersinia enterocolitica; Yamato M et al.; Two monoclonal antibodies (MAbs) reacting with spirosins from Enterobacteriaceae were obtained in a course of screening MAbs to spirosin from Yersinia enterocolitica SYT-11-72 (YE72) . The antibodies were designated MAbs-S44 and S50 . They were IgG2b and IgG2a, respectively, both with kappa light chains . On Western blotting after limited proteolysis of YE72 spirosin with Staphylococcus aureus V8 protease, they reacted markedly with peptide fragments of 27 and 35 kDa, suggesting the presence of an antigenic determinant on the fragments . When supernatant cell lysate from Escherichia coli K12 was chromatographed on DEAE-cellulose and Sepharose CL-6B columns successively, a 96-kDa protein with alcohol dehydrogenase (ADH) activity was always associated with reactivity to MAb-S50 . These findings combined with N-terminal amino acid sequences clearly indicate the identity of spirosin to ADH in E . coli. J Infect Dis, 1995 Jan, 171(1), 204 - 8 A universal approach to bacterial molecular epidemiology by polymerase chain reaction ribotyping; Kostman JR et al.; Oligonucleotide primers complementary to conserved regions of the 16S and 23S ribosomal RNA genes were used to amplify the 16S-23S intergenic spacer region of bacterial pathogens . The amplification patterns produced were compared for their potential use in molecular epidemiologic analysis . This method, polymerase chain reaction (PCR) ribotyping, was applied to isolates of Staphylococcus aureus, Enterococcus faecium, Escherichia coli, and Enterobacter species . Length polymorphisms in the amplified DNA distinguished unrelated strains of all bacteria . The banding patterns of 3 S . aureus isolates from the blood of 1 patient on 3 consecutive days were identical . Plasmid analysis, biotyping, and antibiograms were also obtained on the Enterobacter isolates . All three of these methods showed considerable variability after in vitro passage of bacteria, but PCR ribotypes remained stable . Results demonstrate the utility of the conserved primers for PCR ribotyping, a widely applicable method for the molecular epidemiology of genetically diverse bacteria. Dent Mater, 1995 Jan, 11(1), 19 - 23 Disinfection of dental stone casts: antimicrobial effects and physical property alterations; Ivanovski S et al.; OBJECTIVES . The purpose of this study was to evaluate the effectiveness of disinfecting solutions incorporated into dental stone casts against a standard and representative group of microorganisms and to note changes in the physical properties of the casts . METHODS . Irreversible hydrocolloid impressions were contaminated individually with Escherichia coli, Staphylococcus aureus, Enterobacter cloacae, Pseudomonas aeruginosa, Klebsiella pneumoniae, Actinobacter calcoaceticus, Bacillus subtilis, Mycobacterium phlei and Candida albicans . Four readily available disinfecting solutions (glutaraldehyde, povidone-iodine, chlorhexidine and sodium hypochlorite) were added to the die stone mix used to pour up the impressions . The set cast surfaces were swabbed at 1 h and 24 h, the samples plated on agar and incubated at 37 degrees C for 24 h and 3 d for M . phlei . Subsequently, colony forming units were counted . The physical properties assessed were setting time, setting expansion, compressive strength, detail reproduction and delayed expansion of the stone . RESULTS . Only glutaraldehyde and povidone-iodine killed all contaminating microorganisms within 1 h, while the 1:5 dilution of sodium hypochlorite solution was equally effective after 24 h . Two percent glutaraldehyde was the most effective disinfectant with the least adverse effects on the physical properties of the set cast . Although povidone-iodine caused a decrease in the compressive strength of the set cast, it can be considered to be a sound alternative . SIGNIFICANCE . This study supports the concept of incorporating disinfectants into model stone as a standard operating procedure for impressions of unknown history and, most sensibly, all dental impressions. Int J Clin Pharmacol Res, 1995, 15(1), 17 - 22 Resistance patterns to beta-lactams and quinolones in clinical isolates of bacteria from Cuban hospitals; Gonzales I et al.; The resistance patterns to 26 beta-lactams and 8 quinolones of clinical isolates from Cuban hospitals were evaluated using the disk susceptibility test, according to the NCCLS guidelines (1992) . The genera studied were Escherichia sp (320), Enterobacter sp (10), Klebsiella sp (90), Proteus sp (10), Pseudomonas sp (90), Serratia sp (20), and Staphylococcus sp (80) . Higher resistance to beta-lactams was observed in the genera Pseudomonas, Escherichia and Klebsiella . For fluoroquinolones we found no significant resistance, with the exception of the genus Klebsiella . The most effective antibiotics were cephalosporins of the second and third generations, fluoroquinolones, and non-classical beta-lactams (cephamycins, moxalactam and monobactams) . On the contrary, a pronounced resistance was found to penicillin, oxacillin, ticarcillin, ampicillin, methicillin, nalidixic acid and cinoxacin . These resistance patterns correspond to the high consumption of these antibiotics throughout the country. Biochemistry, 1994 Dec 20, 33(50), 15071 - 9 Detection of the covalent intermediate of UDP-N-acetylglucosamine enolpyruvyl transferase by solution-state and time-resolved solid-state NMR spectroscopy; Ramilo C et al.; Uridine diphosphate-N-acetylglucosamine (UDP-NAG) enolpyruvyl transferase from Enterobacter cloacae catalyzes the transfer of an enolpyruvyl moiety from phosphoenolpyruvate (PEP) to the 3-hydroxyl of UDP-NAG to form enolpyruvyl UDP-NAG and inorganic phosphate . Indirect evidence for the involvement of a covalent intermediate, in which the C-2 of O-phosphothioketal moiety is attached to Cys-115, in the reaction catalyzed by UDP-NAG enolpyruvyl transferase has been reported by Wanke and Amrhein {Wanke, C., & Amrhein, N . (1993) Eur . J . Biochem . 218, 861-870} . In the enzyme from Escherichia coli, a noncovalent tetrahedral intermediate in which the C-2 of PEP is attached to the 3-OH of UDP-NAG via an ether linkage has been isolated by Marquardt et al . {Marquardt, J.L., Brown, E.D., Walsh, C.T., & Anderson, K.S . (1993) J . Am . Chem . Soc . 115, 10398-10399} . In this study, we provide direct evidence for the formation of a covalent O-phosphothioketal enzyme intermediate from UDP-NAG enolpyruvyl transferase of E . cloacae overexpressed in E . coli . The intermediate was obtained by incubation of the enzyme with {2,3-13C2}PEP and UDP-NAG and was characterized by solution-state 1D 13C and 31P NMR, 13C DEPT NMR, and 1H{13C}2D HMQC NMR spectroscopy . The 13C NMR spectra showed two coupled resonances at 29.3 and 88.7 ppm which were assigned to the C-3 and C-2 of the covalent intermediate, and the 13C DEPT confirmed that C-3 was a methyl group and C-2 was quaternary.(ABSTRACT TRUNCATED AT 250 WORDS) Proc Natl Acad Sci U S A, 1994 Dec 20, 91(26), 12892 - 6 A second class I ribonucleotide reductase in Enterobacteriaceae: characterization of the Salmonella typhimurium enzyme; Jordan A et al.; The nrdA and nrdB genes of Escherichia coli and Salmonella typhimurium encode the R1 and R2 proteins that together form an active class I ribonucleotide reductase . Both organisms contain two additional chromosomal genes, nrdE and nrdF, whose corresponding protein sequences show some homology to the products of the genes nrdA and nrdB . When present on a plasmid, nrdE and nrdF together complement mutations in nrdA or nrdB . We have now obtained in nearly homogeneous form the two proteins encoded by the S . typhimurium nrdE and nrdF genes (R1E and R2F) . They correspond to the R1 and R2 proteins . Each protein is a homodimer . Together they catalyze the reduction of CDP to dCDP, using dithiothreitol or reduced glutaredoxin, but not thioredoxin, as an electron donor . CDP reduction is strongly stimulated by low concentrations of dATP, presumably acting as an allosteric effector . Protein R2F contains an antiferromagnetically coupled dinuclear iron center and a tyrosyl free radical . The E . coli and S . typhimurium chromosome thus have maintained the information for a potentially active additional class I ribonucleotide reductase, whose role in vivo is as yet unknown . The allosteric regulation of this enzyme differs from that of the normally expressed reductase. Biochim Biophys Acta, 1994 Dec 14, 1209(2), 241 - 7 Involvement of L-tryptophan aminotransferase in indole-3-acetic acid biosynthesis in Enterobacter cloacae; Koga J et al.; L-Tryptophan aminotransferase (L-tryptophan:2-oxoglutarate aminotransferase; EC 2.6.1.27) from Enterobacter cloacae was purified 62-fold and characterized to determine its role in indole-3-acetic acid biosynthesis . The enzyme reversibly catalyzed the transamination of L-tryptophan with 2-oxoglutarate as the amino acceptor to yield indole-3-pyruvic acid and L-glutamate, and the Km values for L-tryptophan and indole-3-pyruvic acid were 3.3 mM and 24 microM, respectively . In the indole-3-acetaldehyde synthesis experiments in vitro, 94% of L-tryptophan was efficiently converted to indole-3-acetaldehyde by the purified L-tryptophan aminotransferase plus indolepyruvate decarboxylase . Furthermore, the amounts of L-tryptophan decreased with increases in the indolepyruvate decarboxylase activity, while the amounts of indole-3-acetaldehyde increased with increases in this activity . In genetic experiments, the amounts of L-tryptophan produced by Enterobacter and Pseudomonas strains harboring the gene for indolepyruvate decarboxylase were lower than those produced by these same strains without the gene, while the amounts of indole-3-acetic acid produced by Enterobacter and Pseudomonas strains harboring the gene for indolepyruvate decarboxylase were higher than those produced by these same strains without the gene . These results clearly show that L-tryptophan aminotransferase is involved in the indole-3-acetic acid biosynthesis and that indolepyruvate decarboxylase is the rate-limiting step in this pathway. J Infect Dis, 1994 Dec, 170(6), 1622 - 5 Ceftazidime resistance among selected nosocomial gram-negative bacilli in the United States . National Nosocomial Infections Surveillance System; Burwen DR et al.; To examine temporal trends in ceftazidime resistance, susceptibility data reported to the National Nosocomial Infections Surveillance system during 1987-1991 were analyzed among nosocomial Enterobacter species, Klebsiella pneumoniae, and Pseudomonas aeruginosa . Linear increases in resistance were observed for Enterobacter species and K . pneumoniae . One hospital experienced a dramatic rise from 1.0% in 1987-1989 to 40% in 1990-1991 (P < .001) in ceftazidime resistance among K . pneumoniae isolates . No increase was observed during this period for P . aeruginosa . Logistic regression analysis confirmed these trends (or the lack thereof) for Enterobacter species and P . aeruginosa; for K . pneumoniae, ceftazidime resistance was found to be increasing among isolates from teaching hospitals and intensive care units . Ceftazidime resistance is an emerging problem that has the potential for dramatic increases . Selective pressures for the development of ceftazidime resistance need to be identified and addressed. Infect Immun, 1994 Dec, 62(12), 5384 - 96 Nucleotide sequence analysis of genes essential for capsular polysaccharide biosynthesis in Streptococcus pneumoniae type 19F; Guidolin A et al.; Previous studies have shown that the capsular polysaccharide synthesis (cps) locus of the type 19F Streptococcus pneumoniae strain SSZ was closely linked to a copy of the insertion sequence IS1202 (J.K . Morona, A . Guidolin, R . Morona, D . Hansman, and J.C . Paton, J . Bacteriol . 176:4437-4443, 1994) . In the present study, we used plasmid insertion and rescue and inverse PCR to clone 6,322 bp of flanking DNA upstream of IS1202 . Sequence analysis indicated that this region contains six complete open reading frames (ORFs) and one partial ORF that are arranged as a single transcriptional unit . Chromosomal disruption of any of these ORFs in a smooth-type 19F strain leads to a rough (unencapsulated) phenotype, indicating that this operon is essential for capsule production . The ORFs have therefore been designated cps19fA to cps19fG, where cps19fA is the first gene of the type 19F cps locus . Furthermore, many of the gene products from this incomplete operon exhibit strong similarities to proteins known to be involved in the production of capsular polysaccharide, exopolysaccharide, teichoic acid, enterobacterial common antigen, and lipopolysaccharide from numerous other bacterial species . This has allowed us to propose functions for many of the type 19F cps gene products . Southern hybridization studies reveal that cps19fA and cps19fB are conserved among all 12 pneumococcal serotypes tested, whereas genes downstream of cps19fB are conserved among some, but not all, of the serotypes tested. Infect Immun, 1994 Dec, 62(12), 5376 - 83 A Salmonella enteritidis 11RX pilin induces strong T-lymphocyte responses; Ogunniyi AD et al.; Our previous work, using proteins fractionated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis to define antigens of Salmonella enteritidis 11RX able to stimulate T cells from S . enteritidis 11RX-primed (BALB/c x C57BL/6)F1 mice, had indicated the presence of a major antigenic determinant of 14 to 18 kDa (H.-M . Vordermeier and I . Kotlarski, Immunol . Cell . Biol . 68:299-305, 1990) . The 14-kDa size is similar to that of the monomeric units of one of the fimbrial structures, SEF14, produced by a human enteropathogen, S . enteritidis 27655 (J . Feutrier, W . W . Kay, and T . J . Trust, J . Bacteriol . 168:221-227, 1986) . Here we present data which indicate that S . enteritidis 11RX also produces this protein and that it is able to elicit delayed-type hypersensitivity reactions in S . enteritidis 11RX-primed animals and to stimulate in vitro proliferation of, and cytokine release from, T cells obtained from these animals, implying that this fimbrial protein is likely to be an important immunogen of S . enteritidis . The protein was purified to homogeneity and is free from contamination with lipopolysaccharide . Standard immunoblot analysis with unabsorbed S . enteritidis 11RX antiserum and antiserum absorbed with Salmonella typhimurium C5 and various strains of Escherichia coli, as well as a panel of anti-14-kDa-protein monoclonal antibodies, suggests that this fimbrial protein is not the common antigen expressed by a number of organisms belonging to the family Enterobacteriaceae . Immunogold electron microscopy with one of these monoclonal antibodies confirms that the 14-kDa protein and SEF14 are identical. J Hosp Infect, 1994 Dec, 28(4), 273 - 86 Enterobacter cloacae in a neonatal intensive care unit: account of an outbreak and its relationship to use of third generation cephalosporins; Acolet D et al.; After uneventful use of cefotaxime and ceftazidime as first line therapy for three years in our neonatal intensive care unit we isolated cephalosporin-resistant Enterobacter cloacae (CREC) strains which caused clusters of cases or colonization and/or serious neonatal infection . By using two or more typing methods, at least five different strains with similar patterns of antimicrobial sensitivities were identified . The results of a case-control study did not support the notion that the use of third generation cephalosporins was associated with colonization and infection by CREC . The outbreak was brought under control by interrupting the transmission of the epidemic strain D, by measures such as cohort nursing, diligent handwashing before and after procedures, and thorough environmental cleaning as well as by decontamination with glutaraldehyde after dismantling of the blood gas analyser believed to have acted as a persistent reservoir . Our experience highlights the danger of inadequate supervision and maintenance of equipment used for near-patient testing and the need to monitor such equipment not only in terms of its calibration and analytical performance but also microbiologically. Genetika, 1994 Dec, 30(12), 1582 - 6 {The ard gene, coding for a type I restriction inhibitor, is present in plasmids of FII, B/O, and K-groups of incompatibility}; Zavil'gel'skii GB et al.; The effect of conjugative plasmids of various incompatibility groups of the enterobacteria family on the activity of the cell restriction-modification system of type I (EcoK) was studied . Twenty-two conjugative plasmids of 15 incompatibility groups were tested . In addition to plasmids of the incI1 and incN groups studied earlier, conjugative plasmids of the incFII, incB/O, and incK groups were also shown to be able to weaken the action of type I restriction enzymes upon nonmodified DNA (Ard phenotype) . A hybridization analysis of all the plasmid DNAs studied, using ard gene DNA sequences from the ColIb-P9 (incI1) plasmid as a probe, was performed . The ard locus of the R100 (incFII) plasmid was cloned in the pBR322 and pACYC184 vectors . The ard gene was located 2.5 kb from the oriT site in the leading region on the R100 conjugative plasmid. Eur J Clin Microbiol Infect Dis, 1994 Dec, 13(12), 1046 - 52 Antibacterial activity of sucralfate versus aluminum chloride in simulated gastric fluid; Welage L et al.; Studies have previously demonstrated that sucralfate possesses intrinsic antibacterial activity . This study was designed to indirectly assess whether aluminum is the active antibacterial component of sucralfate and to further evaluate factors that may influence this agent's antibacterial activity . Utilizing an in vitro model, the antibacterial activity of sucralfate, an equivalent quantity of aluminum in the form of aluminum chloride, and a control were compared . In addition, the influences of bacterial species (Enterobacter cloacae and Pseudomonas aeruginosa), time (0-24 h) and environmental pH (3,5,7) on the agents' antibacterial activities were evaluated . Equivalent quantities of aluminum, as either sucralfate or aluminum chloride, were added to two of three flasks containing approximately 10(5) cfu/ml of bacteria in pH-adjusted simulated gastric fluid . The third flask served as a control . Samples were obtained over 24 h, diluted and subcultured onto agar plates . The experiments demonstrated that bacterial growth was influenced by pH, time and treatment (aluminum chloride or sucralfate) . Regardless of pH or bacterial species, bacterial death occurred within 20 min following the addition of aluminum chloride . In contrast, bacterial death following the addition of sucralfate was more variable and appeared to be pH dependent . In conclusion, sucralfate and aluminum chloride both possess antibacterial activity, even at pH values that normally support bacterial growth in gastric fluid . Although differences in the antibacterial activity of the two agents may in part be related to drug-induced changes in pH, these differences also support data suggesting that aluminum release from sucralfate is incomplete and is dependent on pH. Mol Biotechnol, 1994 Dec, 2(3), 209 - 17 Potential of genes and gene products from Trichoderma sp . and Gliocladium sp . for the development of biological pesticides; Lorito M et al.; Fungal cell wall degrading enzymes produced by the biocontrol fungi Trichoderma harzianum and Gliocladium virens are strong inhibitors of spore germination and hyphal elongation of a number of phytopathogenic fungi . The purified enzymes include chitinolytic enzymes with different modes of action or different substrate specificity and glucanolytic enzymes with exo-activity . A variety of synergistic interactions were found when different enzymes were combined or associated with biotic or abiotic antifungal agents . The levels of inhibition obtained by using enzyme combinations were, in some cases, comparable with commercial fungicides . Moreover, the antifungal interaction between enzymes and common fungicides allowed the reduction of the chemical doses up to 200-fold . Chitinolytic and glucanolytic enzymes from T . harzianum were able to improve substantially the antifungal ability of a biocontrol strain of Enterobacter cloacae . DNA fragments containing genes encoding for different chitinolytic enzymes were isolated from a cDNA library of T . harzianum and cloned for mechanistic studies and biocontrol purposes . Our results provide additional information on the role of lytic enzymes in processes of biocontrol and strongly suggest the use of lytic enzymes and their genes for biological control of plant diseases. Immun Infekt, 1994 Dec, 22(6), 214 - 7 {Fingerprinting with the polymerase chain reaction: confirmation of a Enterobacter cloacae epidemic in a neonatal intensive care unit.}; Voss A et al.; Between end December 1993 and end January 1994 a cluster of children infected/colonized with Enterobacter cloacae was seen in the neonatal intensive care unit of the University Hospital Nijmegen . The results of the epidemiological investigation are reported, which was aimed to differentiate between a random cluster of endogenously acquired Enterobacter strains and those possibly acquired exogenously via cross-infection . 5 isolates of the 7 patients were available for fingerprinting using interrepeat PCR . According to the fingerprint pattern, 4 of these isolates were identical, thereby suggesting cross-infection among the children . 3 neonates were colonized/infected with genotypically different isolates, suggesting that the infection/colonization developed endogenously . A control strain isolated from a patient at another ward showed the same genotype as the outbreak isolates . The transmission took probably place through one of the surgeons who, among all possible health care workers, were the only professional group treating patients in both units. FEMS Microbiol Lett, 1994 Dec 1, 124(2), 195 - 202 Physical characterisation of the Escherichia coli B gene encoding nitroreductase and its over-expression in Escherichia coli K12; Michael NP et al.; The Escherichia coli B gene (nfnB) encoding nitroreductase has been cloned in Escherichia coli K-12 and its nucleotide sequence determined . The translated amino acid sequence was found to share substantial identity (88.5%) with the equivalent proteins of Enterobacter cloacae and Salmonella typhimurium . When the structural gene was placed under the transcriptional control of either the trp or lac promoter, recombinant nitroreductase was accumulated to 33% and 25% of the cell's soluble protein, respectively . Substitution of the nfrB ribosome binding site with that of the E . coli lacZ gene reduced production levels of nitroreductase . The sequenced region also contained two incomplete open reading frames of unknown function. Singapore Med J, 1994 Dec, 35(6), 602 - 4 Multiple antibiotic resistance in Klebsiella spp . and other Enterobacteriaceae isolated in Singapore; Inglis TJ et al.; A common pattern of multiple antibiotic resistance has been noted in bacteria isolated from Singaporean patients . The resistance pattern includes: ampicillin, cefuroxime, ceftazidime and other third generation cephalosporins, aztreonam, gentamicin and other aminoglycosides . The bacterial species implicated are Klebsiellas and other members of the Enterobacteriaceae . Preliminary laboratory investigation with a disk-diffusion augmentation test suggests the presence of extended-spectrum beta-lactamases . A retrospective study of laboratory blood culture records shows a rising incidence of resistance in Klebsiella spp . since 1985 . Antimicrobial susceptibility results suggest a high degree of co-transfer of aminoglycoside resistance . The high frequency of this type of multiple antibiotic resistance should result in greater caution in the selection of presumptive antibiotic therapy for septicaemia, in order to avoid treatment failure and further selection of resistant strains. Clin Investig, 1994 Dec, 72(12), 1015 - 9 Development of resistance by Enterobacter cloacae during therapy of pulmonary infections in intensive care patients; Fussle R et al.; The emergence of resistance during therapy and the efficacy of different antibiotic therapy regimens were studied in 38 intensive care patients suffering from pulmonary infections caused by Enterobacter cloacae . Every three days a fresh isolate was obtained from each patient and tested in vitro for susceptibility to 16 antibiotics by determination of the minimal inhibitory concentrations . During therapy with cefotaxime and tobramycin the E . cloacae strains from 47% of the patients became resistant to cefotaxime within 6 days . In all cases resistance encompassed all other broad-spectrum penicillins and cephalosporins tested, as well as aztreonam . Development of resistance regularly led to persistence of bacteria . Resistance to tobramycin, ciprofloxacin or imipenem was not observed . Treatment of 25 patients with persisting E . cloacae infections was successful in 17 out of 18 patients treated with imipenem and in 6 out of 7 patients receiving ciprofloxacin. Diagn Microbiol Infect Dis, 1994 Dec, 20(4), 203 - 8 Prevalence of important pathogens and the antimicrobial activity of parenteral drugs at numerous medical centers in the United States . II . Study of the intra- and interlaboratory dissemination of extended-spectrum beta-lactamase-producing Enterobacteriaceae; Sader HS et al.; The incidence of extended-spectrum beta-lactamases (ESBL)-producing Klebsiella pneumoniae and Escherichia coli has been increasing rapidly, and they are probably even more prevalent than is currently recognized because of difficulties in their detection by the clinical microbiology laboratory . In addition, several outbreaks associated with these multiresistant strains have been reported . In the present study we evaluated 30 clinical isolates (27 K . pneumoniae from 11 hospitals and three E . coli from three hospitals) that were resistant or intermediately susceptible to ceftazidime and/or cefuroxime . The main objective of the study was to evaluate the intra- and interhospital dissemination of ESBL-producing strains . The isolates were tested for susceptibility to ceftazidime, cefuroxime, gentamicin, and ofloxacin, and the ability of various susceptibility testing methods to detect resistance to these beta-lactams was evaluated . The production of ESBL was assessed by the disk approximation synergy test, and typing was performed by pulsed-field gel electrophoresis (PFGE) of chromosomal DNA . ESBL production was demonstrated in 15 K . pneumoniae (from seven hospitals) and in one E . coli strain . Most ESBL-producing isolates demonstrated cross resistance with gentamicin and ofloxacin . Chromosomal DNA analysis by PFGE exhibited a great genomic variability among ESBL-producing isolates . Our results also indicated the occurrence of both intra- and interhospital dissemination of these multiresistant strains. Can J Microbiol, 1994 Dec, 40(12), 1072 - 6 Demonstration of the indolepyruvate decarboxylase gene homologue in different auxin-producing species of the Enterobacteriaceae; Zimmer W et al.; Different Enterobacteriaceae were assayed for their ability to produce the plant hormone indole-3-acetate with the aim to study the distribution of the indole-3-pyruvate pathway, which is known to be involved in the production of indole-3-acetate in a root-associated Enterobacter cloacae strain . Other E . cloacae strains, and also Enterobacter agglomerans strains, Pantoea agglomerans, Klebsiella aerogenes, and Klebsiella oxytoca were found to convert tryptophan into indole-3-acetate . As it was also intended to identify the conserved regions of the indole-3-pyruvate decarboxylase, which is involved in producing indole-3-acetate in the E . cloacae strain, oligonucleotide primers were synthesized for different regions of the corresponding gene . One pair of these primers allowed us to amplify a segment of the predicted size by the polymerase chain reaction with DNA of the seven different Enterobacteriaceae that produce indole-3-acetate . Segments of five strains were cloned and sequenced . All sequences showed significant homology to the indole-3-pyruvate decarboxylase gene . As in addition a positive DNA-DNA hybridization signal was detected in the seven strains using the E . cloacae or E . agglomerans segments as a probe, indole-3-acetate biosynthesis is suggested to be catalyzed via the indole-3-pyruvate pathway not only in E . cloacae but also in the other soil-living Enterobacteriaceae . Conserved regions were detected in the indole-3-decarboxylase by alignment of the now-available five different partial sequences . These regions should enable identification of the gene in other bacterial families or even in plants. J Rheumatol, 1994 Dec, 21(12), 2274 - 80 Reactive arthritis: a favorable 2 year course and outcome, independent of triggering agent and HLA-B27; Glennas A et al.; OBJECTIVE . To study the 2 year course and clinical and radiological outcome of reactive arthritis and to identify possible outcome predictors . METHODS . Patients with chlamydia induced arthritis (n = 25) and arthritis induced by enterobacteria (n = 27), all derived from a 2-year epidemiological study on reactive arthritis (ReA) and possible ReA, were followed prospectively with clinical, laboratory and radiographic examinations . RESULTS . After one year, 40% of patients with chlamydia induced arthritis and 20% of those with enteroarthritis still had clinical signs of arthritis . After 2 years, 100 and 95%, respectively, had recovered . At that time, one patient with enteroarthritis had developed radiographic abnormalities exceeding grade I in peripheral joints . None developed bilateral sacroiliitis during the course . The duration of ReA was found to be independent of the triggering agent, sex, age, duration of arthritis prior to entry, pain, index of active joints, CRP and the presence of HLA-B27 . CONCLUSION . Early recognition and elimination of the triggering microbe seems important for the arthritis outcome in ReA . The results do not support the hypothesis that the presence of HLA-B27 heralds a more serious disease course or less favorable outcome, nor that the type of triggering agent predicts the outcome. J Chemother, 1994 Dec, 6(6), 392 - 8 In vitro antibacterial activity of the new quinolone Bay y3118 against clinical isolates; Ravizzola G et al.; The in vitro antibacterial activity of the new fluoroquinolone Bay y3118 against 609 clinical isolates was evaluated . Bay y3118 exhibited activity against a broad spectrum of organisms, including Gram-negative bacilli, Gram-positive cocci, mycobacteria . The activity of Bay y3118 was often superior to that of other quinolones . Against Gram-negative bacilli its activity was similar to that of ceftriaxone, cefotaxime, ceftazidime and imipenem except for Serratia marcescens, Klebsiella pneumoniae, Enterobacter spp . and Xanthomonas maltophilia, where its activity was superior . Gentamicin and piperacillin sometimes were less active . Bay y3118 was active against a large number of Gram-positive cocci . The fluoroquinolones tested were active against all the strains of Mycobacterium tuberculosis, but only Bay y3118 was effective against Mycobacterium avium. Antimicrob Agents Chemother, 1994 Dec, 38(12), 2838 - 42 Extended-spectrum beta-lactamases in clinical isolates of Enterobacter gergoviae and Escherichia coli in China; Cheng Y et al.; Resistance to ceftazidime, detected in isolates of Escherichia coli 5518 and Enterobacter gergoviae 3773 from our hospital, was transferred, together with resistance to aminoglycosides, trimethoprim, sulfonamide, and other beta-lactam antibiotics, by conjugation to E . coli JP559 . Both E . coli transconjugants were resistant to ampicillin, all cephalosporins, and aztreonam but remained susceptible to cefoxitin and imipenem . The enzymes of the two transconjugant strains readily hydrolyzed cephalosporins in a spectrophotometric assay . Hybridization results suggested that the extended-spectrum beta-lactamase produced by E . coli 5518 was a non-TEM, non-SHV enzyme, the origin of which is currently unknown . The beta-lactamase produced by E . gergoviae 3773 was of the SHV type and was further proved to be SHV-2 by DNA sequencing . Thus, extended-spectrum beta-lactamases are occurring in China as well as in other parts of the world. Int J Urol, 1994 Dec, 1(4), 332 - 6 Urinary bacteriology of continent urinary reservoirs and calculus formation; Terai A et al.; In order to investigate urinary bacteriology in relation to calculus formation in continent urinary reservoirs, a retrospective study was conducted of 19 patients with the Kock pouch and 23 patients with the Indiana pouch . Analysis of a total of 151 urine cultures showed that asymptomatic bacteria (any bacterial count) were present in 92% of urines from the Kock pouch and 74% from the Indiana pouch . The incidence of organisms and total bacterial counts were similar for both pouches . The most prevalent organisms were Escherichia coli, Pseudomonas sp., Klebsiella sp., Proteus sp., Enterobacter sp., and Enterococcus sp . Urinary calculi developed in 42% of the Kock pouch patients and 13% of the Indiana pouch patients . More than half of the patients had multiple stone recurrence . Infectious stones developed in 32% of the Kock pouch patients, usually on the foreign materials, and 9% of the Indiana pouch patients . In general, no clear relationship was established between urinary bacteriology and calculus formation although Proteus sp . or Providencia sp . was determined to be the causative organism in some infectious stones . Furthermore, metabolic stones developed in 32% of the Kock pouch patients and 9% of the Indiana pouch patients . Because calcium phosphate was a constituent of 80% of the metabolic stones, the presence of urinary factors promoting calculus formation was suspected. Eur J Biochem, 1994 Nov 15, 226(1), 149 - 57 A common system controls the induction of very different genes . The class-A beta-lactamase of Proteus vulgaris and the enterobacterial class-C beta-lactamase; Datz M et al.; Among the Enterobacteriaceae, Proteus vulgaris is exceptional in the inducible production of a 29-kDa beta-lactamase (cefuroximase) with an unusually high activity towards the beta-lactamase-stable oximino-cephalosporins (e.g . cefuroxime and cefotaxime) . Sequencing of the corresponding gene, cumA, showed that the derived CumA beta-lactamase belonged to the molecular class A . The structural gene was under the direct control of gene cumR, which was transcribed backwards and whose initiation codon was 165 bp away from that of the beta-lactamase gene . This resembled the arrangement of structural and regulator genes ampC and ampR of the 39-kDa molecular-class-C beta-lactamase AmpC present in many enterobacteria . Moreover, cloned genes ampD and ampG for negative modulation and signal transduction of AmpC beta-lactamase induction, respectively, were also able to restore constitutively CumA overproducing and non-inducible P . vulgaris mutants to the inducible, wild-type phenotype . The results indicate that controls of the induction phenomena are equivalent for the CumA and AmpC beta-lactamase . Very different structural genes can thus be under the control of identical systems. Ned Tijdschr Geneeskd, 1994 Nov 5, 138(45), 2244 - 7 {Dutch results of the European study of prevalence of infection during intensive care (EPIIC) . II . Nature of the infections}; Ibelings MS et al.; OBJECTIVE . Evaluation of the point prevalence of ICU-acquired infections, the type of infection, the bacteriological cultures and the antibiotics used . DESIGN . Point prevalence study . SETTING . 78 Dutch ICUs, as part of ICUs in 17 West-European countries . METHOD . Collecting data by detailed questionnaires for each patient admitted to one of the participating ICUs, on one specified day: April 29th, 1992 . Follow-up lasted 6 weeks . RESULTS . The most frequently diagnosed ICU-acquired infections were pneumonia and infections of the lower respiratory tract (together 63%), followed by urinary tract infections (16%), sepsis (16%) and wound infections (11%) . The most frequently cultured pathogens were Gram-negative bacteria (92%), especially Enterobacteriaceae (34%) and Pseudomonas aeruginosa (30%), followed by Staphylococcus (37%), Enterococcus (20%) and surprisingly: 10% fungi . The most-prescribed antibiotics were the cephalosporins (30%), followed by broad-spectrum penicillins (17%), metronidazole (17%) and aminoglycosides (13%) . On the day of this survey there was in the Netherlands no infection with MRSA (Methicillin Resistant Staphylococcus aureus), although gentamicin resistant coagulase-negative Staphylococcus and ciprofloxacin-resistant P . aeruginosa were present . In most of the hospitals in the Netherlands, microbiologists, infectious disease specialists (84%) and infection control nurses (51%) take part in the ICU team . Half of the hospitals use selective decontamination . CONCLUSION . ICU-acquired infections are a real threat to the ICU patient . Despite a cautious antibiotics management in the Netherlands, resistance remains a serious problem. J Appl Bacteriol, 1994 Nov, 77(5), 574 - 82 Random amplification of polymorphic bacterial DNA: evaluation of 11 oligonucleotides and application to food contaminated with Listeria monocytogenes; Niederhauser C et al.; The polymerase chain reaction was used to obtain randomly-amplified polymorphic DNA (RAPD) profiles from Listeria spp . and enterobacteria . Eleven different oligonucleotides were evaluated . Only one, HR4 (19mer), generated reproducible and specific profiles for Listeria spp., while results for enterobacteria were controversial . A total of 57 different Listeria strains were subjected to the RAPD analysis and 27 different profiles were recognized . RAPD typing allowed strains of the same serotype to be distinguished but the same profile was obtained from different serotypes of L . monocytogenes in three cases and in one case two different serotypes of L . innocua yielded the same profile . RAPD-typing with HR4 allowed L . monocytogenes contamination in several food outlets to be traced back to a food processing plant . In additional experiments, the general utility of this RAPD system in typing Yersinia enterocolitica, verotoxigenic Escherichia coli and Salmonella enteritidis was evaluated. Tex Med, 1994 Nov, 90(11), 59 - 62 Antimicrobial resistance of bacterial pathogens at two tertiary-care centers, in Riyadh and Texas; Qadri SM et al.; Antimicrobial resistance of bacterial pathogens usually varies from one geographic location to another . During the last 20 years, outbreaks of disease caused by multiresistant bacteria have occurred with higher frequency in developing countries . We investigated the antimicrobial resistance patterns of bacteria isolated in 1992 from two tertiary-care centers, in Riyadh and Texas . Of the 8841 strains used, 5318 were isolated from clinical specimens of patients at King Faisal Specialist Hospital and Research Centre, Riyadh, and 3523 were from Olin E . Teague Veterans Medical Center, Temple, Tex . Members of Enterobacteriaceae at the King Faisal hospital were significantly more resistant to frequently prescribed antimicrobials than were those at the Olin Teague center . Susceptibility to less frequently used agents like ciprofloxacin and ceftazidime was similar at both hospitals . Resistance patterns of Pseudomonas aeruginosa, Haemophilus influenzae, and coagulase-negative staphylococci were similar at both medical centers . The Olin Teague center encountered significantly more methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. Biochem J, 1994 Nov 1, 303 ( Pt 3), 825 - 30 Kinetic and physical studies of beta-lactamase inhibition by a novel penem, BRL 42715; Farmer TH et al.; The interactions of Staphylococcus aureus, Bacillus cereus I, TEM, Klebsiella pneumoniae K1 and Enterobacter cloacae P99 beta-lactamases with the novel penem inhibitor BRL 42715 were investigated kinetically and, in some cases, by electrospray mass spectrometry (e.s.m.s.) . All the beta-lactamases were rapidly inactivated by BRL 42715, with second-order rate constants ranging from 0.17 to 6.4 microM-1.s-1 . The initial stoichiometry of beta-lactamase inhibition was essentially 1:1, with the exception of the K1 enzyme . In this instance about 20 molecules of BRL 42715 were hydrolysed before the enzyme was completely inhibited . Inhibited beta-lactamases did not readily regain activity in the absence of BRL 42715, the half-lives for regeneration of free enzyme ranging from 5 min for the K1 beta-lactamase to over 2 days for the staphylococcal enzyme . Recovery of activity was incomplete for TEM-1, K1 and P99 beta-lactamases, suggesting partitioning of the inhibited enzymes to give a permanently (or at least very stable) inactivated species . Examination of the interactions of the penem with TEM, B . cereus I and P99 beta-lactamases by e.s.m.s . also showed rapid and stoichiometric binding of the inhibitor . In all cases a mass increase of 264 Da over the native enzyme was observed, corresponding to the molecular mass of BRL 42715, showing that no fragmentation of the penem occurred on reaction with the beta-lactamases. J Med Microbiol, 1994 Nov, 41(5), 343 - 8 Trimethoprim resistance in urinary pathogens in northern Scotland: epidemic spread of a resistance plasmid encoding the type Ib trimethoprim-resistant dihydrofolate reductase; Young HK et al.; The prevalence of trimethoprim resistance in enterobacterial urinary pathogens from hospitalised patients in the Angus district of northern Scotland (22.8%) was twice that found in similar isolates from patients attending general practitioners (11.2%) . Thirty-three of the 143 trimethoprim-resistant strains were shown to harbour transferable plasmids conferring high-level trimethoprim resistance . In total, 17 different plasmid types were distinguished . Two plasmids, pUK1184 and pUK1185, accounted for 36% of the trimethoprim resistance plasmids and were shown by restriction endonuclease digestion fingerprints to be closely related to plasmid pUK28, previously demonstrated to be endemic in urinary pathogens in the Edinburgh area . Only 21% of the plasmids were shown to encode the type Ia trimethoprim-resistant dihydrofolate reductase, whereas 70% of the trimethoprim resistance plasmids were found to encode the type Ib dihydrofolate reductase . Hybridisation of the trimethoprim resistance plasmids identified in this study with gene probes specific for the integrase genes of transposons Tn7 and Tn21 indicates that the dhfrIa is rarely present within Tn7 or related transposons in these plasmids and may be more prevalent within Tn21-like transposons . In contrast, with the exception of the two endemic plasmids that harboured the dhfrIb gene within a Tn7-like transposon, the majority of dhfrIb genes were not found to be associated with either Tn7- or Tn21-like structures. J Bacteriol, 1994 Nov, 176(22), 6915 - 20 The identification of cryptic rhamnose biosynthesis genes in Neisseria gonorrhoeae and their relationship to lipopolysaccharide biosynthesis; Robertson BD et al.; Neisseria gonorrhoeae synthesizes a rough lipopolysaccharide that does not contain any of the repetitive units characteristic of the smooth lipopolysaccharide of members of the family Enterobacteriaceae . Three gonococcal homologs of Salmonella serovar typhimurium genes involved in the synthesis of the rhamnose component of the repetitive subunits have been isolated . Gonococcal homologs for rfbB, rfbA, and rfbD were found downstream of the galE gene in a region of the chromosome which shows overall homology with the meningococcal capsule gene complex region D . Sequence alignment demonstrated that the gonococcal gene products have 69, 65, and 54% amino acid identity with the Salmonella proteins RfbB, RfbA, and RfbD . The gonococcal RfbB and RfbA amino acid sequences share even more identical residues (73 and 65%, respectively) with the amino acid sequences derived from Escherichia coli genes o355 and o292, respectively . These genes are clustered with the genes involved in the biosynthesis of enterobacterial common antigen, and o355 is listed in the GenBank and Swiss Protein data banks as rffE (encoding UDP-GlcNAc-2-epimerase) . However, complementation studies demonstrated that o355 does not encode the enzyme UDP-GlcNAc-2-epimerase . Gonococcal strains constructed with null mutations in the rfbBAD genes were unchanged in lipopolysaccharide phenotype and in the synthesis of gonococcal carbohydrate-containing C antigen . We were unable to detect any changes in gonococcal phenotype with respect to lipopolysaccharide sialylation, monoclonal-antibody binding, serum sensitivity, or interaction with eukaryotic cells in vitro . We conclude that the absence of a homolog for rfbC precludes the existence of a functional dTDP-rhamnose biosynthesis pathway in the gonococcal strains examined and that these genes are only maintained in N . gonorrhoeae either because of the presence of the galE gene or because of another as yet unrecognized function. Infect Immun, 1994 Nov, 62(11), 5183 - 6 Specificity of the complement resistance and cell association phenotypes encoded by the outer membrane protein genes rck from Salmonella typhimurium and ail from Yersinia enterocolitica; Heffernan EJ et al.; Virulence-associated phenotypes of an outer membrane protein gene family of members of the family Enterobacteriaceae were compared by means of pBR322 constructs transformed into Escherichia coli HB101.rck (Salmonella typhimurium) and ail (Yersinia enterocolitica) promote serum resistance and eukaryotic cell invasion, properties not shared by other members of the gene family, pagC, ompX, and lom. Infect Immun, 1994 Nov, 62(11), 4722 - 6 Invasion of rabbit ileal tissue by Enterobacter cloacae varies with the concentration of OmpX in the outer membrane; de Kort G et al.; The outer membrane protein OmpX of Enterobacter cloacae shows high amino acid homology with virulence proteins PagC and Rck from Salmonella typhimurium and with Ail from Yersinia enterocolitica . Here we demonstrate a role for OmpX in the invasion of rabbit ileal tissue by E . cloacae . An organ culture system was used for maintenance of rabbit gut tissue during the experiments . The invasiveness of three E . cloacae strains, which differed in OmpX content, were compared with each other and with that of Salmonella typhimurium TML (a highly invasive strain) and S . typhimurium LT7 (a noninvasive strain) . There was no significant difference between the invasiveness of the wild type and that of an ompX deletion mutant strain of E . cloacae; they were equally as invasive or less invasive than S . typhimurium LT7 . The invasiveness of an OmpX overproducer strain of E . cloacae was 10-fold higher than that of its immediate parent carrying only the multicopy plasmid, higher than that of S . typhimurium LT7, but lower than that of S . typhimurium TML . The invasiveness of E . cloacae thus varied directly with the level of OmpX in the outer membrane in rabbit ileal enterocytes challenged in situ. Plasmid, 1994 Nov, 32(3), 306 - 11 Incidence of tellurite resistance determinants among plasmids of different incompatibility groups; Hou Y et al.; Twenty tellurite resistance (TeR) plasmids of IncH12, IncH13, and IncHII groups isolated from Enterobacteriaceae hybridized with the pMJ606 (IncHI2) TeR probe, whereas the promiscuous Pseudomonas IncP alpha plasmids hybridized with only the IncP alpha TeR probe (pDT1555) . Neither of the TeR probes hybridized with the IncP2 Pseudomonas plasmids, which also specify TeR . None of the plasmids hybridized with pUM3, a plasmid carrying the arsABC genes that encodes resistance to arsenite, arsenate, antimony, and moderate levels of tellurite . These results show that the IncH12 TeR determinant is widespread in the Enterobacteriaceae and support the hypothesis that there are at least five distinct TeR determinants: (1) the telAB genes from the Escherichia coli chromosome; (2) IncHI2; (3) IncP2; (4) arsABC; and (5) the TeR determinants of IncP alpha plasmids. Klin Lab Diagn, 1994 Nov-Dec, (6), 44 - 5 {Use of serum to thermostable toxin for identification of Yersinia pseudotuberculosis}; Venediktov VS et al.; Serum to thermostable Y . pseudotuberculosis toxin is shown to induce agglutination of bacteria belonging to all 8 serologic variants of this species . No cross reactions with other enterobacterial species, including four Yersinia species, were detected . The results permit us recommend the antitoxic serum for identification of Y . pseudotuberculosis. Mol Microbiol, 1994 Nov, 14(4), 691 - 703 Non-motile mutants of Helicobacter pylori and Helicobacter mustelae defective in flagellar hook production; O'Toole PW et al.; Flagellar hooks were purified from Helicobacter pylori and Helicobacter mustelae . The 70 x 16 nm H . pylori hook was composed of FlgE subunits of 78kDa, while the 72 x 16 nm H . mustelae hook was composed of 87 kDa subunits . N-terminal sequence was obtained for the FlgE proteins of both species, and for an internal H . mustelae FlgE peptide . Degenerate oligonucleotide primers allowed amplification of a 1.2 kb fragment from the H . mustelae chromosome, which carried part of the flgE gene . The corresponding H . pylori gene was cloned by immunoscreening of a genomic library constructed in lambda ZAP Express . The translated H . pylori flgE sequence indicated a protein with limited homology with the hook proteins from Salmonella typhimurium and Treponema phagedenis . Mutants of H . pylori and H . mustelae defective in hook production generated by allele replacement were non-motile and devoid of flagellar filaments but produced both flagellin subunits, which were localized in the soluble fraction of the cell . The level of flagellin production was unchanged in the mutants, indicating that the regulation of flagellin expression in Helicobacter differs from that in the Enterobacteriaceae. Diagn Microbiol Infect Dis, 1994 Nov, 20(3), 143 - 9 Prediction of piperacillin-tazobactam susceptibility among Enterobacteriaceae, Pseudomonas aeruginosa, and other bacteria using ticarcillin-clavulanic acid, ceftazidime, and other broad-spectrum antimicrobial in vitro test results; Jones RN et al.; The ability of various in vitro beta-lactam susceptibility test results to predict the susceptibility of piperacillin-tazobactam (a new beta-lactam-beta-lactamase inhibitor combination) was assessed using more than 46,000 recent clinical isolates . The organisms were tested by reference-quality National Committee for Clinical Laboratory Standards (NCCLS) broth microdilution procedures and interpreted by the currently published NCCLS criteria . The recommended antimicrobial tests that would accurately predict the piperacillin-tazobactam in vitro efficacy had an overall very major, false-susceptible rate of only 0.6% (< or = 1.5% is acceptable) . The following drug tests can be used to judge piperacillin-tazobactam activity and spectrum (low patient risk) conservatively: for Enterobacteriaceae use ticarcillin-clavulanic acid results (0.6% very major error); for Pseudomonas aeruginosa use piperacillin (0.1%) results; for enterococci use ampicillin or ampicillin-sulbactam (1.8%) results; for Haemophilus influenzae and Moraxella catarrhalis use cefotaxime or cefuroxime or ceftriaxone (1.5%); and for staphylococci use oxacillin by NCCLS recommendations . When the piperacillin-tazobactam testing reagents become available, the direct testing of this combination should be applied to relevant clinical isolates . The piperacillin-tazobactam break points should be reassessed as indicated by the cited minimum inhibitory concentration population analysis to improve predictive accuracy; H . influenzae susceptibility modified to < or = 2/4 micrograms/ml and Enterococcus species susceptibility tested at < or = 16/4 micrograms. Bioconjug Chem, 1994 Nov-Dec, 5(6), 636 - 46 High yield, site-specific coupling of N-terminally modified beta-lactamase to a proteolytically derived single-sulfhydryl murine Fab'; Mikolajczyk SD et al.; The preparation of bispecific protein conjugates capable of performing diverse biological functions is an area of active investigation . Such conjugates are routinely prepared using techniques which employ random derivatization of lysine residues, but the overall utility of these methods is limited due to poor yields and heterogeneous conjugates . In this report we describe the development of site-specific linkage methodology for the chemical synthesis of a homogeneous enzyme-antibody Fab' conjugate with coupling efficiencies of at least 72% . The N-terminal threonine residue of beta-lactamase from the P99 strain of Enterobacter cloacae was oxidized to an aldehyde functional group under mild conditions with a 5-fold molar excess of sodium periodate . The murine Fab' with a single sulfhydryl at the hinge region was generated by further digestion of the peptic Fab' fragment with lysyl endopeptidase to remove a decapeptide containing two of the three cysteine residues . Coupling of the two modified proteins was accomplished through a bifunctional coupling reagent containing meleimide and aminooxy functional groups . Synthesis of the linker is described . Yields of 1:1 enzyme-Fab' were at least three times higher than for comparable random derivatization methods . Immunoreactivity and enzymatic activity were unaffected . Biodistribution studies showed a more favorable tumor to blood ratio with the site-specifically linked conjugate. Antimicrob Agents Chemother, 1994 Nov, 38(11), 2615 - 22 In vitro activity of the new fluoroquinolone CP-99,219; Neu HC et al.; The in vitro activity of the new fluoroquinolone CP-99,219 {7-(3-azabicyclo{3.1.0}hexyl)naphthyridone} was compared with those of four other quinolones against 541 gram-negative, 283 gram-positive, and 70 anaerobic bacterial isolates . CP-99,219 inhibited 90% of many isolates in the family Enterobacteriaceae at a concentration of < or = 0.25 micrograms/ml (range, < 0.008 to 1 microgram/ml), an activity comparable to those of tosufloxacin and sparfloxacin and two times greater than that of temafloxacin . Ninety percent of the Proteus vulgaris, Providencia rettgeri, Providencia stuartii, and Serratia marcescens isolates were inhibited by 0.5 to 2 micrograms of CP-99,219 per ml . CP-99,219 inhibited 90% of the Pseudomonas aeruginosa and Haemophilus influenzae isolates at 1 and 0.015 micrograms/ml, respectively . The compound inhibited methicillin-susceptible Staphylococcus aureus at 0.06 micrograms/ml, whereas a ciprofloxacin concentration of 1 microgram/ml was required to inhibit these organisms . CP-99,219 inhibited 90% of methicillin-resistant S . aureus isolates at a concentration of < or = 4 micrograms/ml, while ciprofloxacin and temafloxacin had MICs against these isolates of > 16 micrograms/ml . Streptococci were inhibited by < or = 0.25 micrograms/ml, an activity comparable to that of tosufloxacin . CP-99,219 was eight times more active than ciprofloxacin against Streptococcus pneumoniae . Bacteroides species were inhibited by CP-99,219 at a concentration of 2 micrograms/ml, whereas inhibition of these species required 4- and 16-microgram/ml concentrations of tosufloxacin and ciprofloxacin, respectively . The MBCs of CP-99,219 ranged from two to four times the MICs, and inoculum size had a minimal effect on MIC . CP-99,219 was active against P . aeruginosa at pH 5.5, with only a fourfold increase in MIC compared with values obtained at pH 7.5 . The addition of up to 9 mM Mg(2+) increased the MIC range from 0.03 to 0.06 microgram/ml to 0.12 to 0.5 microgram/ml . In view of its excellent in vitro activity against both gram-positive and gram-negative bacteria, CP-99,219 merits further study to determine it's clinical pharmacologic properties and potential for therapeutic use. Gastrointest Endosc, 1994 Nov-Dec, 40(6), 716 - 21 Antibiotics, biliary sepsis, and bile duct stones; Leung JW et al.; Bacteriologic studies of bile and blood cultures of 579 patients with ductal stones and infected bile revealed that 121 patients (21%) had associated bacteremia . Analysis of bile and stone cultures showed that Escherichia coli, Klebsiella sp, Enterobacter sp, Enterococcus sp, and Streptococcus sp were the most commonly isolated bacteria . Two-thirds of the patients with bacteremia had similar organisms isolated from blood and bile . Pharmacokinetic studies of the hepatic/biliary excretion profiles of ceftazidime, cefoperazone, imipenem, netilmicin, and ciprofloxacin were performed by ERCP and nasobiliary catheter drainage . The bile samples obtained immediately after cannulation from patients with complete biliary obstruction contained low or undetectable levels of the antibiotics administered--the exception being ciprofloxacin, which was present at a concentration of 20% of the serum level . In vitro determination of minimum inhibitory concentration of the aforementioned antibiotics against 199 isolates of biliary pathogens revealed imipenem and ciprofloxacin to have the highest antimicrobial activity . Based on pharmacokinetic studies and in vitro susceptibility findings, we conclude that ciprofloxacin is superior to the other tested antibiotics in prophylaxis and treatment of biliary sepsis. J Hosp Infect, 1994 Nov, 28(3), 219 - 29 Clinical and bacteriological survey after change in aminoglycoside treatment to control an epidemic of Enterobacter cloacae; de Champs C et al.; The effect of a change in the first line antibiotic treatment in a neonatal unit was studied . A total of 238 neonates (G1), admitted between 1 January and 31 July 1989, and treated with gentamicin, were compared with 398 (G2) admitted between 1 August 1989 and 31 July 1990 who received amikacin, in the combination of ampicillin plus an aminoglycoside . This change was implemented in an attempt to prevent the spread of an epidemic strain of Enterobacter cloacae resistant to third generation cephalosporins and all aminoglycosides, except amikacin . The change in treatment had no effect on the incidence of nosocomial infections {19.7% (G1) vs . 16.3% (G2) RR = 1.21 (0.86-1.70)}, but the proportion of patients with nosocomial infections caused by the E . cloacae decreased (6.3% vs . 2.0% RR 3.14 CI 1.35-7.28) . Certain trends in the bacterial ecology emerged: E . aerogenes and Enterococci increased in G2 . The proportion of gentamicin-resistant strains such as E . cloacae or Staphylococci decreased and there was no increase in aminoglycoside-resistant strains, except in Escherichia coli, in which resistance to amikacin rose from 0 to 3% . This study illustrates the influence of antimicrobial therapy on the species and the resistance of strains isolated in nosocomial infections . It also highlights the need for epidemiologic surveillance, and poses the question of how best to modify antibiotic policy. J Clin Microbiol, 1994 Nov, 32(11), 2706 - 8 Surgical wound infection caused by Rahnella aquatilis; Maraki S et al.; Rahnella aquatilis is a water-residing gram-negative rod, a member of the family Enterobacteriaceae, isolated rarely from clinical specimens of immunocompromised patients . A case of a surgical wound infection caused by R . aquatilis in a patient who underwent a prosthetic surgical intervention is reported . The presence of inducible beta-lactamase was suggested by the disk induction test and the conventional agar dilution assay . Literature on R . aquatilis infections in humans is reviewed. Z Orthop Ihre Grenzgeb, 1994 Nov-Dec, 132(6), 472 - 5 {Joint destruction and infection in advanced age}; Bettin D et al.; Because of degenerative joint diseases and the reduced resistance in older patients the correct diagnoses of joint-empyema is difficult . In 29 pat (> 60 y) the mean delay of diagnoses was 5.1 months . First location of the infection have been: urinary tract 12, pneumonia 6, skin infection 10, and decubitus 3 . Risk factors have been diabetes 4, polyarthritis 3, gout 3 and tuberculosis 3 . The species were: s . aureus 12, s . albus 2, streptococcus 2, diphtheroid 2, e.coli 2, pseudomonas 2, proteus 4, enterobacter 3 and salmonella 1 . 8 patients demonstrated mixed infections . The high mortality (3 pat.) and the frequent general sepsis (5 pat.) underline the importance of a missed joint-empyema in the elderly. J Mol Evol, 1994 Nov, 39(5), 448 - 51 Synonymous substitutions are clustered in enterobacterial genes; Eyre-Walker A; The spatial distribution of synonymous substitutions in enterobacterial genes is investigated . It is shown that synonymous substitutions are significantly clustered in such a way that a synonymous substitution in one codon elevates the rate of synonymous substitution in an adjacent codon by about 10% . The level of clustering does not appear to be related to the level of gene expression, and it is restricted to a range of two or three codons . There are at least three possible explanations: (1) sequence-directed mutagenesis, (2) recombination, and (3) selection. J Antimicrob Chemother, 1994 Nov, 34(5), 639 - 48 A multicentre study of the in-vitro activity of cefotaxime, cefuroxime, ceftazidime, ofloxacin and ciprofloxacin against blood and urinary pathogens; Amyes SG et al.; Th