Am J Med, 1982 Nov, 73(5), 658 - 62 Staphylococcus aureus bacteremia in diabetic patients . Endocarditis and mortality; Cooper G et al.; The presentation and course of Staphylococcus aureus bacteremia in 27 diabetic patients (18 insulin-dependent) were compared with those in 34 nondiabetic patients . The groups were comparable in age, proportion with pre-existing cardiac valvular disease, community-acquired bacteremia, fever, and leukocytosis . Endocarditis (vegetation or new regurgitant murmur) was present in eight (30 percent) diabetics and four (12 percent) nondiabetics (p = 0.16) . A primary focus of infection was present in 67 percent of diabetics and 65 percent of nondiabetics . Among those with a focus, six of 18 diabetics and none of 22 nondiabetics had endocarditis (p less than 0.005) . Fifteen of 54 (28 percent) patients who received appropriate antibiotic therapy died . After stratificaton for underlying illness, there was no mortality difference between those with and without endocarditis (three endocarditis deaths versus 1.78 expected), or between those with and without diabetes (four diabetic deaths versus 4.8 expected) . Diabetics with staphylococcal bacteremia were more likely than nondiabetics to have endocarditis in the presence of a primary focus . They had no increase in mortality. Clin Exp Immunol, 1982 Nov, 50(2), 355 - 9 Mitogenic stimulation of malignant B cells . Chronic lymphocytic leukaemia: relationship between stimulation and surface phenotype; Bloem AC et al.; Peripheral blood lymphocytes (PBL) from 14 patients with chronic lymphocytic leukaemia (CLL) were stimulated with pokeweed mitogen (PWM), formalinized Staphylococcus aureus (Sta) and a combination of both mitogens . The leukaemic B cells were characterized by rosetting techniques (using mouse erythrocytes and complement coated erythrocytes) and immunofluorescence for membrane bound immunoglobulin (mIg) . No clear correlation between phenotype and the reactivity with PWM could be found . Results of stimulation with Sta however, indicate that lymphocytes carrying membrane bound IgM (mIgM) and IgD (mIgD) and the receptor of the third complement component (C3R) can be induced to differentiate into immunoglobulin (Ig) containing cells . Addition of PWM to these cultures often enhanced this response . Some leukaemic B cells are able to differentiate after challenge with the appropriate stimulus. Acta Otolaryngol, 1982 Nov-Dec, 94(5-6), 421 - 9 Ototoxicity of netilmicin; Tjernstrom O et al.; Ototoxicity and efficacy of netilmicin was evaluated in 76 consecutive patients with moderate to severe infections with Gram-negative rods and Staphylococcus aureus . Netilmicin alone was efficacious in 47 patients and in another 23 patients cure or improvement was seen with netilmicin combined with another antibiotic, usually penicillin . Therapeutic failure was seen in 4 cases, 2 of which were regarded as netilmicin failures . Vestibular function and hearing acuity was thoroughly examined by electronystagmography and audiometry . In spite of the extensive examination of the audiovestibular function it was possible to detect only one probable case of ototoxicity related to netilmicin, a reversible vestibular dysfunction . The importance of pre-therapeutic audiovestibular examination is stressed. Immunology, 1982 Nov, 47(3), 557 - 67 Effect of Staphylococcus aureus Cowan i bacteria on the mitogenic response of human B-cell subsets; Harada H et al.; We have made a detailed investigation to determine which of the B-cell subsets could be stimulated by Staphylococcus aureus Cowan I bacterium (SpA CoI) . B-cell subsets were separated from peripheral blood and tonsil lymphocytes by means of rosette formation with E, EAIgG, anti-immunoglobulin (Ig) conjugated OE (OE-Pro A) or by separation on a bovine serum albumin (BSA) discontinuous density gradient . The cells responding to SpA CoI included E receptor negative (E-), C3 receptor positive (C3R+), and surface Ig positive (SIg+) B-cell subsets . Among these B-cell subsets, FcR-n cells were more responsive than FcR+ cells . These B-cell subsets responded alone to SpA CoI and significantly proliferated, although, they failed to respond alone to pokeweed mitogen (PWM) and Protein A of S . aureus (Protein A) . Among the SIg+ B-cell subsets stimulated with SpA CoI, IgM+ and IgG+ B cells showed much less response . Both Protein A receptor positive (Pro A . R+) and negative (Pro A . R-) cells responded well to SpA CoI . Fractionation of B cells on a BSA gradient revealed that comparatively small sized and denser B-cell subsets responded well to SpA CoI . From these criteria, it is suggested that B cells responding to SpA CoI are capable of stimulating not only mature B cells, but can also stimulate immature B cells. Antimicrob Agents Chemother, 1982 Nov, 22(5), 906 - 8 In vitro susceptibility of methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains to N-formimidoyl thienamycin; Witte JL et al.; A total of 82 clinical isolates of methicillin-resistant Staphylococcus aureus and 21 isolates of methicillin-susceptible S . aureus were studied for in vitro susceptibility to N-forminidoyl thienamycin at incubation temperatures of 30 and 35 degrees C . The disk diffusion test results were correlated with the macrobroth dilution test by means of the error rate-bounded method of analysis . Both methicillin-susceptible and (to a lesser degree) methicillin-resistant strains were generally susceptible to the antibiotic as judged from their minimum inhibitory concentrations . The discrepancy between in vitro results obtained at 30 and at 35 degrees C was not very remarkable . However, tolerance of N-formimidoyl thienamycin was observed in 37% of methicillin-resistant strains and 24% of methicillin-susceptible strains at an incubation temperature of 30 degrees C; at 35 degrees C, the values were 54% (methicillin-resistant strains) and 14% (methicillin-susceptible strains). Proc Natl Acad Sci U S A, 1982 Nov, 79(21), 6693 - 7 Membrane potential and gentamicin uptake in Staphylococcus aureus; Mates SM et al.; At pH 5.0, the electrical potential (delta psi, interior negative) across the plasma membrane of Staphylococcus aureus exhibits a minimum of -85 to -90 mV; the pH gradient (delta pH, interior alkaline) across the membrane approximates a maximum of about -100 mV . Under these conditions, uptake of the aminoglycoside gentamicin is negligible, and viability of the organism is not impaired by the antibiotic . In contrast, at pH 7.5, at which delta psi is about -130 mV and delta pH is 0, gentamicin uptake is observed and the drug markedly decreases viability . Dramatically, when the ionophore nigericin is added at pH 5.0, gentamicin uptake is induced, there is a striking decrease in viability, and the effect is associated with an increase in delta psi at the expense of delta pH . Consistently, valinomycin, which dissipates delta psi in the presence of potassium, abolishes gentamicin uptake and killing . In addition, from pH 5.0 to pH 7.5, there is a direct relationship between the magnitude of delta psi and both gentamicin uptake and its bactericidal effect . However, a threshold delta psi of -75 to -90 mV is apparently necessary to initiate uptake and killing . These observations provide a strong indication that delta psi plays a critical role in the uptake and antibacterial action of gentamicin and suggest that nigericin-like ionophores may be clinically useful in synergy with aminoglycosides. Pediatr Med Chir, 1982 Nov-Dec, 4(6), 675 - 8 {Incidence of osteomyelitis and septic arthritis in a neonatal pathology unit}; Scarcella A et al.; During a five years period 8 newborns on 2035 admissions developed septic arthritis representing a very low incidence of 4% . Umbilical catheters were used in 3 patients . Staphylococcus aureus was the most frequent etiologic agent and in 6/8 cases blood cultures were positive for the same pathogen agent . Because of the paucity of clinical signs in the first period in the sick neonate, detection of the disorder by the radiologist assumes great importance in the neonatal intensive care unit, as early recognition and therapy may prevent residual deformity. Antimicrob Agents Chemother, 1982 Nov, 22(5), 901 - 2 Evaluation of the Cathra inoculating device for susceptibility testing of methicillin-susceptible and methicillin-resistant Staphylococcus aureus strains; Boyce JM et al.; We compared the antimicrobial susceptibility results obtained with the Cathra replicator and reference methods when Staphylococcus aureus strains were tested by using agar dilution techniques . The Cathra replicator and the 0.001-ml calibrated loop gave results that fell within +/- 1 log2 dilution for greater than or equal to 95% of isolates when methicillin and cefamandole were tested. J Trauma, 1982 Nov, 22(11), 954 - 9 Control of methicillin-resistant Staphylococcus aureus in a burn unit: role of nurse staffing; Arnow P et al.; We investigated retrospectively the spread of methicillin-resistant Staphylococcus aureus (MRS) in a burn unit . During 8 months, 34% of the patients acquired MRS, and transmission continued despite barrier isolation precautions and treatment of colonized personnel with topical intranasal antibiotics . Several findings suggested MRS was spread primarily by contact transmission involving personnel: case-control comparison showed burn size to be the major host risk factor for colonization; correlation analysis of environmental factors revealed a significant (p = 0.001) association of new cases with increased patient load and with staffing by overtime or temporary nurses; and environmental sampling yielded few colonies of MRS . The outbreak halted following implementation of control measures, among which assignment of separate nurses to colonized patients appeared to be essential . The association of different nurse staffing variables with persistence then eradication of MRS suggests nurse staffing may have been an important factor in staphylococcal transmission. Coll Relat Res, 1982 Nov, 2(6), 481 - 94 "Embryonic" collagen (type I trimer) alpha 1-chains are genetically distinct from type I collagens alpha 1-chains; Shupp-Byrne DE et al.; Our laboratory has previously demonstrated that cell lines derived from early embryonic mouse sources produce procollagen and collagen and suggested that this material represents a new genetic type of collagen . Evidence was presented using carboxymethyl cellulose chromatography, analytical isoelectric focusing, cyanogen bromide peptide analysis, amino acid analysis, and carbohydrate analysis which demonstrated that this "embryonic" collagen consisted of three identical alpha-chains, distinctly different from types I, II and III and IV collagen and thus probably represented a new type of collagen . Further evidence is presented using Staphylococcus aureus V-8 protease generated peptide maps and immunological studies using antisera prepared against "embryonic" collagen and procollagen . These data clearly demonstrated that "embryonic" collagen is clearly distinct from type I alpha-chains and represents a unique genetic species of collagen. Infection, 1982 Nov-Dec, 10(6), 371 - 4 The importance of incubation temperature for detecting beta-lactam-resistant Staphylococcus aureus strains; El Hagarawy N et al.; Sixty-six isolates of methicillin-resistant Staphylococcus aureus strains originating from Austria, Egypt, the Federal Republic of Germany and Switzerland were tested for their sensitivity to 12 beta-lactam antibiotics at both 30 degrees and 37 degrees C using the agar disk diffusion test . The MICs for six of the beta-lactam antibiotics were determined by the microdilution technique . Resistance to methicillin was always accompanied by resistance to several beta-lactam antibiotics . Resistance to all semi-synthetic penicillins and cephalosporins, including cefotaxime, was higher at 30 degrees C than at 37 degrees C . Cephalothin and cefamandole proved to be the most effective cephalosporin antibiotics against methicillin-resistant S . aureus strains . Newer cephalosporins, i.e . cefotaxime, cefoxitin and cefuroxime, exhibited only a low rate of activity against these strains . The occurrence of phage-type "85" in S . aureus strains from Austria, Egypt and Germany indicates that certain lysotypes are widespread. Appl Environ Microbiol, 1982 Nov, 44(5), 1076 - 80 Microbiological quality of five potato products obtained at retail markets; Duran AP et al.; The microbiological quality of frozen hash brown potatoes, dried hash brown potatoes with onions, frozen french fried potatoes, dried instant mashed potatoes, and potato salad was determined by a national sampling at the retail level . A wide range of results was obtained, with most sampling units of each products having excellent microbiological quality . Geometric mean aerobic plate counts were as follows: dried hash brown potatoes, 270/g; frozen hash brown potatoes with onions, 580/g; frozen french fried potatoes 78/g; dried instant mashed potatoes, 1.1 x 10(3)/g; and potato salad, 3.6 x 10(3)/g . Mean values of coliforms, Escherichia coli, and Staphylococcus aureus were less than 10/g. Antimicrob Agents Chemother, 1982 Nov, 22(5), 852 - 8 Selection for mercurial resistance in hospital settings; Porter FD et al.; The frequency of resistance to Hg2+ in 1980 to 1981 collections from Barnes Hospital, St . Louis, Mo., was only 2% for Staphylococcus aureus and 9% for Escherichia coli . The frequency of Hg2+ resistance in E . coli isolates from Jikei University Hospital, Tokyo, Japan, was 57% during 1972 to 1977 and decreased to 29% in 1979 to 1982; for S . aureus the frequency of Hg2+ resistance dropped from 36% in 1972 to 1977 to 10% in 1979 to 1982 . Frequencies of resistances to cadmium (S . aureus) and arsenic (S . aureus and E . coli) remained approximately constant during this time . The decrease in frequency of mercurial resistance is attributed to the termination of the use of organomercurials (largely phenylmercury and thimerosal) in hospital liquid detergents and disinfectants . It is proposed that selection for mercurial resistance occurred within the hospital setting when there was widespread use of mercurials . The resistance patterns and phage types for each of four new mercurial-resistant S . aureus isolates from St . Louis were distinct, indicating that no single type of "hospital staph" predominates . Furthermore, resistance to thimerosal, merbromin, and methylmercury and the ability to volatilize 14C from {14C}methylmercury were found with the new isolates and never with previously known mercurial resistance plasmids in S . aureus. Eur J Biochem, 1982 Nov, 128(1), 71 - 5 Amino-acid sequence of the beta 1 isosubunit of taipoxin, an extremely potent presynaptic neurotoxin from the Australian snake taipan (Oxyuranus s . scutellatus); Lind P; The amino acid sequence of the beta 1 isosubunit of taipoxin, an extremely potent presynaptic neurotoxin from the Australian snake taipan, has been determined . The beta 1 isosubunit, which is neither toxic nor enzymatically active on its own, consists of a single polypeptide chain of 118 amino acids . The main fragmentation of the reduced and S-carboxymethylated derivative was accomplished by cleavage with Staphylococcus aureus V8 protease . Tryptic peptides were used to align and complete the sequence, which was determined by automated Edman degradation . The taipoxin beta 1 isosubunit is closely homologous to the taipoxin alpha and gamma subunits and to enzymatically active pancreatic and elapid snake venom phospholipases A2. Dig Dis Sci, 1982 Nov, 27(11), 1046 - 50 Jaundice associated with nonhepatic Staphylococcus aureus infection . Does teichoic acid have a role in pathogenesis? Rose HD, Lentino JR, Mavrelis PG, Rytel MW. A previously healthy young man developed jaundice early in the course of a febrile illness caused by an unrecognized deep-seated Staphylococcus aureus abscess . The serum bilirubin level peaked 11 days before the abscess was discovered and drained . During this time the bilirubin level returned to normal, circulating immune complexes were detected, and the serum free teichoic acid antibody titer was elevated . Indirect immunofluorescent staining of liver tissue for teichoic acid revealed 2+ nuclear fluorescence of the hepatocytes . These findings suggested that circulating free teichoic acid was deposited in the liver and may have had an endotoxin-like effect in the hepatocytes . With the appearance of specific antibody in the serum, circulating teichoic acid was neutralized and further hepatic injury ceased. Biokhimiia, 1982 Nov, 47(11), 1918 - 27 {Isolation, some properties and heterogeneous nature of DNA-topoisomerase (relaxing enzyme) from Ehrlich ascites carcinoma cells}; Naktinis VI et al.; DNA-topoisomerase catalyzing the conversion of a superhelical circular covalently closed DNA molecule into a super-helix free circular molecule, was isolated from mouse Ehrlich ascites carcinoma cells and purified 209-fold . The optimal conditions for the action and stability of the enzyme were elaborated . Using polyacrylamide gel electrophoresis under non-denaturating conditions as well as in the presence of Na-DS the heterogeneity of purified DNA-topoisomerase was established . This heterogeneity implies the presence of three active forms of the enzyme with Mr of 97 000, 81 000 and 69 000, respectively . Using one-dimensional fingerprint method and limited proteolysis with Staphylococcus aureus protease, it was demonstrated that the low molecular weight enzyme forms are products of limited proteolysis of the highest molecular weight form of DNA-topoisomerase. Vet Microbiol, 1982 Nov, 7(5), 471 - 83 Staphylococcus aureus isolated from poultry in Australia . I . Phage typing and cultural characteristics; Kibenge FS et al.; The phage typing and cultural characteristics of 574 strains of S . aureus of poultry origin in Australia were examined . With the avian phage set of Shimizu (1979) it was possible to type 74.2% of strains . A number of significant variations in the phage typing patterns of Australian strains compared to those reported from Japan and Europe were observed . A lower proportion of Australian strains were of avian phage group I and a higher proportion of group III . A high proportion of strains were of mixed lytic groups . No locally isolated phages were able to increase significantly the percentage of typeable strains, although four local phages appeared to be of greater value for phage typing poultry strains of S . aureus than some other phages of the avian phage set . The international (human) phage set was of limited value in typing Australian strains of poultry origin although four strains were identified which were indistinguishable from strains of human origin . Using cultural characteristics of the strains in conjunction with phage typing, the Australian strains of S . aureus were assigned to one of three major groups and nine subgroups . A list of typing phages considered to be valuable for use on Australian poultry strains of S . aureus is given. Immunol Lett, 1982 Nov, 5(5), 277 - 82 IFN-alpha-induced modulations of the events in human mixed lymphocyte cultures; Argov S et al.; Autologous mixed lymphocyte cultures (AMC) with T-enriched subset of human blood lymphocytes as responders and B-cells or plastic adherent cells as stimulators and allogeneic mixed lymphocyte cultures (MLC) were assayed for blastogenesis and generation of cytotoxic potential . The activated cells lyzed K562 and Daudi, autologous and allogeneic PHA-blasts . The AMC population affected the autologous and allogeneic blasts at a similar strength and there was no indication for selective effects . B-Blasts induced with Staphylococcus aureus were not lyzed . The MLC populations had a stimulation-specific cytotoxic component . This was revealed by the stronger effect against the stimulator PHA-blasts and by the lysis of the stimulator B-blasts . Short-time interferon (IFN) treatment prior to the lytic assay enhanced the anti-Daudi and anti-K562 lytic activity of the AMC and MLC populations . With AMC the lytic efficiency against the autologous and allogeneic PHA-blasts were not changed while with MLC they were also elevated . This increase was confined to the non-specific component of the cytoxicity . The proliferation of lymphocytes was suppressed when interferon was added at the initiation of the mixed cultures . On a per-cell basis the cytotoxic potential of these cultures were stronger . In the MLC the stimulation-specific component increased more substantially than the effect against the non-specific targets . It is possible that the IFN-induced modification of the culture conditions such as suppression of the initial proliferation favored the growth of the specific clone . Re-exposure of these cells to another dose of interferon prior to the lytic assay had no effect on the lytic potential. Postgrad Med, 1982 Nov, 72(5), 58 - 64, 69-73, 75 The spectrum of staphylococcal disease . From Job's boils to toxic shock; Bass JW; Strains of Staphylococcus aureus are known to differ in their ability to produce a number of toxins and digestive enzymes that may contribute to the organisms's virulence and invasive potential . Independent from these, however, certain strains produce a variety of specific toxins that cause specific clinical diseases, including staphylococcal food poisoning, staphylococcal enterocolitis, exfoliative skin disorders, and most recently, the toxic shock syndrome . This article reviews those diseases known to be mediated by specific staphylococcal toxins. J Immunol, 1982 Nov, 129(5), 2134 - 41 Effects of taxol on human neutrophils; Roberts RL et al.; Taxol, a plant alkaloid, promotes and stabilizes microtubule assembly in cells and cellfree systems . In the present study, the effects of taxol on various functional, morphologic, and biochemical phenomena in human peripheral blood PMN (Hypaque-Ficoll) were examined . Taxol (10(-7) M) inhibited PMN chemotaxis stimulated by N-formyl-methionyl-leucyl-phenylalanine (f-met-leu-phe) or endotoxin-activated serum by more than 60% . The inhibition was not readily reversed by washing, and taxol itself was not a chemoattractant, nor is it a secretagogue . Spontaneous nondirected migration, cell spreading on a glass surface, and orientation of cell organelles in response to a chemoattractant gradient were also inhibited by taxol . Taxol (10(-5) M) decreased killing of Staphylococcus aureus, but did not alter phagocytosis of heat-killed Candida or hexose monophosphate shunt activity in resting or stimulated PMN . Ultrastructural studies showed that PMN incubated in f-met-leu-phe, taxol, or both had increased (p less than 0.001) numbers of centrosome-associated microtubules, and the microtubules of cells incubated in taxol with or without f-met-leu-phe were organized into bundles . Taxol (10(-5) M) markedly inhibited post-translational tyrosinolation of alpha-chains of tubulin in both resting and f-met-leu-phe-stimulated PMN . The data indicate that taxol inhibits PMN locomotion and bacterial killing, supporting a role for microtubules in these processes . The ultrastructural and biochemical data also support the view that taxol mediates its effects on PMN by its effect on microtubules. J Immunol Methods, 1982 Oct 29, 54(2), 191 - 202 Autoradiographic detection of IgG and viral antigens; Gerdes JC et al.; Autoradiographic methods can be used as an alternative to indirect immunofluorescence to detect viral antigen expression or the presence of IgG in tissue sections . Iodinated protein A isolated from Staphylococcus aureus detects an influx of IgG into the central nervous system of mice inoculated with the coronavirus SD . Antispecies antibody that has been iodinated detects coronavirus antigen expression for 24 days post-inoculation while it is only detectable for 10 days by immunofluorescence . A direct comparison of indirect fluorescence and autoradiographic methods indicates that the autoradiographic techniques are considerably more sensitive . This increased sensitivity is sufficient to permit the detection of viral antigen in formalin fixed paraffin embedded tissue sections. FEBS Lett, 1982 Oct 18, 147(2), 201 - 6 The structure of the cell wall of Staphylococcus aureus studied with neutron scattering and magnetic birefringence; Torbet J et al.; The cell wall complex was extracted from Staphylococcus aureus and characterized in suspension by means of small-angle neutron scattering and magnetically induced birefringence . The neutron scattering measurements show that the complex has a thickness of approximately 420 A, a mass per unit area of 93 +/- 11 daltons/A2 and is approximately 75% water by volume . The neutron scattering density is higher near the surface than in the interior in accordance with a trilamellar structure . The magnetically induced birefringence measurements demonstrate that a high degree of magnetic orientation is possible due to the anisotropic nature of the wall complex structure. J Immunol Methods, 1982 Oct 15, 54(1), 73 - 80 Quantitative determination of in vitro immunoglobulin secretion with protein A from Staphylococcus aureus; Manciulea M; A micromethod for the quantitative determination of Ig secreted in vitro by mice lymphocytes isolated from the spleen of normal animals is described . The indicator system consists in sheep erythrocytes radiolabelled with sodium chromate (51Cr) and coated with protein A of Staphylococcus aureus (51Cr-labelled ES) . When splenocytes were incubated in fluid phase at 37 degrees C for 3 1/2 h with rabbit antisera to mouse Ig (IgM and IgG) and with guinea pig complement, the immune complexes formed between the secreted Ig and its specific IgG antibody are bound to protein A on the erythrocyte surface allowing the complement-mediated lysis of 51Cr-labelled ES . The degree of haemolysis produced in this experimental system, which reflects the amount of in vitro secreted Ig, was quantitatively measured by radioactive determination of 51Cr release . In combination with the ES plaque assay the method also gives information as immunoglobulin secretion per plaque forming cell. Biochem J, 1982 Oct 15, 208(1), 77 - 82 Purification of a protein having pore forming activity from the rat liver mitochondrial outer membrane; Linden M et al.; A protein with pore-forming activity has been isolated from the outer membrane of rat liver mitochondria . The purification involves sucrose gradient centrifugation, differential centrifugation in the presence of Triton X-100, and DEAE-Sepharose and CM-Sepharose chromatography . The yield of the purified protein was approx . 2% of the total outer membrane proteins . The protein, when inserted into soya bean phospholipid vesicles, increases the {3H}sucrose permeability of the vesicles but had no effect on the permeability of high-molecular-weight {14C}dextran (Mr 70 000) . The protein is very active, since as little as 3-4 micrograms of protein per mg of phospholipid is required for the complete release of {3H}sucrose from the vesicles . Sucrose diffusion channels could not be reconstituted with other membrane proteins such as rat liver cytochrome oxidase or cytochrome b5 . Purified pore protein revealed a single band of apparent Mr 30000 when resolved by sodium dodecyl sulphate/polyacrylamide-gel electrophoresis . This polypeptide could be further resolved by isoelectric focusing into a major (pI7.9) and two relatively minor (pI7.6 and 7.2) components . Proteolytic mapping with V8 proteinase from Staphylococcus aureus suggests that these probably represent a single component showing charge heterogeneity . The reason for the charge heterogeneity is not known . The amino acid composition of the protein revealed 47.8% polar amino acids with a relatively high lysine content. Int Surg, 1982 Oct-Dec, 67(4 Suppl), 414 - 6 Tropical pyomyositis; Ajao OG et al.; Tropical pyomyositis, a suppurative condition involving a group or groups of muscles, has only been described in the tropical areas of the world . An etiological factor in the genesis of this disease is closed muscle trauma causing bleeding, hematoma formation, muscle necrosis, and secondary blood borne infection; but this does not explain why the condition occurs or is contracted only in the tropical belt . The commonest organism present in the abscess is Staphylococcus aureus . Neglected or poorly treated tropical pyomyositis can give rise to chronic osteomyelitis or septic arthritis. Zh Mikrobiol Epidemiol Immunobiol, 1982 Oct, (10), 53 - 6 {Protective action of a combined preparation and staphylococcal anatoxin in reproducing a local staphylococcal infection in white mice}; Berlovskaia TI et al.; In experimental local staphylococcal infection in white mice, previously immunized with staphylococcal toxoid and the combined preparation (staphylococcal toxoid + protective somatic staphylococcal antigen), the advantage of the latter in protecting the animals against infection with Staphylococcus aureus belonging to different phage groups has been revealed . Immunization with the combined preparation, carried out in 2 injections, has been found to stimulate antimicrobial immunity, simultaneously with antitoxic one, which indicates the expediency of the further study of the combined preparation. Eur J Biochem, 1982 Oct, 127(3), 553 - 8 Synthesis of peptidoglycan in vivo in methicillin-resistant Staphylococcus aureus; Wyke AW et al.; The cell-wall composition and degree of cross-linking of peptidoglycan in a strain of Staphylococcus aureus (strain MR-1) which is highly resistant to methicillin were similar to those of other strains of S . aureus . When the organism was grown in the presence of very low concentrations of methicillin (equivalent to 3 x 10(-4) x minimum growth-inhibitory concentration {MGIC} there was a large decrease in the degree of cross-linking of the peptidoglycan . Increasing concentrations of methicillin (up to 1.25 x 10(-2) x MGIC) caused a further decrease in cross-linkage but thereafter a minimum value was reached . This remained unchanged even after growth of the organisms in much higher concentrations of the antibiotic up to 0.3 x minimum growth-inhibitory concentration . S . aureus MR-1 was able to grow normally for many generations under these conditions and reduction in cross-linkage of peptidoglycan was the only change detected in wall chemistry . Growth in the presence of methicillin (up to 0.3 x MGIC) (or other beta-lactam antibiotics) did not lead to an imbalance in the biosynthesis of peptidoglycan since no soluble polymers were secreted into the growth medium and nucleotide-linked precursors did not accumulate intracellularly . High concentrations of beta-lactam antibiotics (5 x MGIC) were bacteriostatic not bactericidal and this may be related to an apparent deficiency in the endogenous autolytic enzymes of strain MR-1 . Studies of the penicillin-binding proteins after growth in the presence of methicillin suggest that one of these proteins remains resistant to very high concentrations of the antibiotic . We propose that this protein acts as the primary transpeptidase responsible for the incorporation of newly synthesised peptidoglycan into the growing wall. Avian Dis, 1982 Oct-Dec, 26(4), 924 - 7 Infectious tenosynovitis in young turkeys; Page RK et al.; Two viruses serologically related to the tenosynovitis virus of chickens were isolated from two flocks of turkeys experiencing outbreaks of tenosynovitis . Both viruses produced a tenosynovitis when injected into the foot pad of young turkeys . Staphylococcus aureus was not isolated from either flock, nor was there any evidence of Mycoplasma synoviae antibody in either flock. Can J Microbiol, 1982 Oct, 28(10), 1127 - 32 Complement fixation by antibodies to the alpha toxin of Staphylococcus aureus; Lo CY et al.; When rabbits were injected with the heat-denatured alpha toxin (toxoid) of Staphylococcus aureus, the immune response was demonstrated by an increase in antitoxin that fixed complement . Such antitoxin was detected in 72% of normal human sera . After fractionation of the antitoxin into two types (the antibinding antibodies and the indirect hemagglutinating antibodies), both types of antibodies were found to fix complement in the standard serological complement fixation test . In addition, the indirect hemagglutinating antibodies were capable of fixing complement when the antigen (alpha toxin or toxoid) was covalently or noncovalently bound to erythrocyte membranes . The fixation of complement by membrane-bound immune complexes did not result in lysis of the carrier erythrocytes . The prevalence of complement-fixing antitoxin in normal humans and animals raised the concern that the outcome of in vivo experiments involving alpha toxin could be influenced by the immune status of the host. J Pharm Sci, 1982 Oct, 71(10), 1160 - 4 Improved high-pressure liquid chromatographic method for the analysis of erythromycin in solid dosage forms; Tsuji K et al.; A stability-indicating high-pressure liquid chromatographic (HPLC) method for the assay of erythromycin in enteric film-coated tablets was developed . The method used a reversed-phase column at 70 degrees with a mobile phase of acetonitrile-methanol-0.2 M ammonium acetate-water (45:10:10:35) at pH 7.0 . The column were evaluated for the analysis of erythromycin . The HPLC method was also applicable for the analysis of salts and esters of erythromycin . The linearity and precision of the HPLC assay method for erythromycin in the solid dosage form were examined by spiking erythromycin into a tablet placebo a 60-120% of the label . The recovery of erythromycin was 99.9% with a relative standard deviation of less than 1% . The correction factors to express the results of HPLC in terms of antimicrobial bioequivalency against Staphylococcus aureus TCC 6538P for erythromycins A, B, and C were determined to be 1.0, 0.92, and 0.48, respectively . Eight lots of tablets were assayed by the HPLC method, and the results, expressed in terms of erythromycin bioequivalency, showed no statistically significant difference from those of the microbiological assay method. J Thorac Cardiovasc Surg, 1982 Oct, 84(4), 497 - 504 Mini-thoracotomy and chest tube insertion for children with empyema; Raffensperger JG et al.; In contrast to the two prior decades, empyema in children has become a rare disease during the past 10 years . Thirty-two children with empyema from all causes were treated at The Children's Memorial Hospital in Chicago in the 11 years between 1970 and 1982 . Twenty cases followed postinfectious pneumonia, most commonly due to Staphylococcus aureus . The remaining patients had either an esophageal leak or a pleural infection following an intrathoracic operation . Fourteen of our patients were managed with a "mini-thoracotomy," which allowed accurate drainage of purulent material, debridement of fibrinous exudate, and rapid expansion of the lung with prompt relief from fever and toxicity . In our hands, this procedure provided results which were superior to those obtained with simple closed chest tube drainage . In addition, during this period of time, ultrasound examination of the chest has provided a rapid, accurate technique for the early detection and localization of fluid accumulations within the pleural cavity . Pre-drainage thoracentesis can be accurately guided by ultrasonic imaging. J Infect Dis, 1982 Oct, 146(4), 487 - 97 Pathogenesis of foreign body infection: description and characteristics of an animal model; Zimmerli W et al.; An animal model involving the subcutaneous implantation of tissue cages into guinea pigs and subsequent infection with Staphylococcus aureus was used for study factors pertinent to foreign body infection . Whereas 10(8) colony-forming units (cfu) of S . aureus strain Wood 46 did not produce any abscesses in the absence of foreign material, 10(2) cfu was sufficient to infect 95% of the tissue cages despite the presence of polymorphonuclear leukocytes (PMNLs) in sterile tissue cage fluid . Opsonization of S . aureus by tissue cage fluid was adequate during the first hour of infection, but opsonic coating of the organisms decreased at 20 hr after the induction of infection . PMNLs from sterile tissue cage fluid showed decreased phagocytic and bactericidal activities when compared with PMNLs from either blood or peritoneal exudate obtained after short- or long-term stimulation (P less than 0.001). Invest Ophthalmol Vis Sci, 1982 Oct, 23(4), 479 - 88 Intraocular granuloma: a Schistosoma mansoni model of ocular inflammation; Stein PC et al.; An experimental uveitis model was developed in New Zealand rabbits by an intraocular injection of Schistosoma mansoni eggs . An inflammatory response was clinically apparent after 5 days and histologically was characterized by an eosinophilic infiltrate into the vitreous and choroid . The chorioretinitis that developed resulted in the disruption of the photoreceptor layer . After 30 days, eggs were enveloped by a granulomatous host response similar to that observed in animals infected systemically with Schistosoma mansoni . Reduction (immunomodulation) of granuloma size and cellularity compared with controls was observed in paraffin sections of eyes challenged (100 eggs) 4 weeks after a priming injection (500 eggs) in the contralateral eye . The granulomatous response was not evident when heat-killed eggs were injected intraocularly . Extracts made from viable eggs also induced an intense vitreous infiltrate 12 hr after injection . Serum collected from rabbits injected with 500 or more eggs showed antibody (7s) reactivity for 125I-labeled bovine S antigen, as demonstrated by immunoprecipitation with Staphylococcus aureus (Pansorbin) . This model is useful for analyzing immunologic parameters involved in ocular granulomatous and parasitic diseases, humoral and cellular responses mediating autosensitization to retinal or other ocular antigens, and possible for screening chemotherapeutic agents for immunomodulation of potentially injurious host inflammatory responses. J Neurosurg Nurs, 1982 Oct, 14(5), 280 - 2 Osteomyelitis of the skull; Phillips K; Osteomyelitis of the skull is a direct infection of the bone . It can be an acute or chronic disease . It usually has an insidious initial onset . Complications can be life-threatening and even fatal . The most frequently associated organism responsible for the disease is Staphylococcus aureus . Tissue specimens must be obtained for definitive culture and sensitivity reports . It is also important that devitalized bone and sequestra be removed as part of adequate therapy . A typical presentation on skull series is a moth-eaten appearance; however, this may not be recognized radiographically for several months . The antibiotic chosen must be given in high enough doses to assure adequate serum levels to eradicate the organism responsible for causing the disease . Length of treatment depends on the clinical course and the extent of infection but may involve several months or longer . Good nursing care is essential in dealing with osteomyelitis and involves preventive as well as therapeutic management . Patient education and support are important aspects of nursing care in helping the patient cope with the disease. J Bacteriol, 1982 Oct, 152(1), 524 - 6 Expression in Escherichia coli of a staphylococcal gene for resistance to macrolide, lincosamide, and streptogramin type B antibiotics; Hardy K et al.; Plasmid pBD9, which comprises two plasmids from Staphylococcus aureus, pE194 and pUB110, was joined to plasmid pBR322 by in vitro recombination to form plasmid pKH80 . The ermC gene of plasmid pE194 confers inducible resistance to macrolide, lincosamide, and streptogramin type B antibiotics . When pKH80 was transferred to Escherichia coli K-12, the bacteria became resistant to several of these antibodies. Proc Natl Acad Sci U S A, 1982 Oct, 79(20), 6114 - 8 Energy-dependent arsenate efflux: the mechanism of plasmid-mediated resistance; Silver S et al.; Plasmid-mediated resistance to arsenate, arsenite, and antimony(III) is coordinately induced by arsenate, arsenite, antimony(III), and bismuth(III) . Resistance to arsenate was recently shown {Silver, S., Budd, K., Leahy, K.M., Shaw, W.V., Hammond, D., Novick, R.P., Willsky, G.R., Malamy, M.H . & Rosenberg, H . (1981) J . Bacteriol . 146, 983-996} to be due to decreased accumulation of arsenate by the induced resistant cells . We report here that decreased net uptake results from accelerated efflux of arsenate by induced plasmid-containing cells of Staphylococcus aureus and Escherichia coli . The efflux system in S . aureus was inhibited by nigericin, monensin, and proton-mobilizing uncouplers; efflux was unaffected by valinomycin . The mechanism of arsenate efflux in S . aureus was apparently not by chemiosmotic coupling to the membrane electrical potential or pH gradient . The intracellular efflux system was inhibited by low pH and mercurials (reversible by mercaptoethanol) . The efflux rate was relatively independent of external pH or phosphate level and showed a sigmoidal pattern of concentration dependence. Eur J Biochem, 1982 Oct, 127(2), 381 - 9 Primary structure of parvalbumin from rat skeletal muscle; Berchtold MW et al.; The primary structure of parvalbumin from rat skeletal muscle has been determined principally by automated sequencing of tryptic peptides using 4-N,N-dimethylaminoazobenzene 4'-isothiocyanate as the Edman reagent on a solid-phase sequencer . Remaining positions and most peptide overlaps were identified by analysis of peptides arising from CNBr, chymotryptic and Staphylococcus aureus protease cleavages and through digestions with carboxypeptidases A, B and Y . Reverse-phase high-performance liquid chromatography on C-18 supports was employed for all peptide separations . Structural homology between rat and rabbit parvalbumins helped to confirm the alignments of the tryptic peptides T4-T3, T2-T6 and to define the position of the Lys triplet (36-38) . A comparison of the two mammalian proteins revealed 14 amino acid differences, which are all located on the surface of the molecule . A prediction of the secondary structure has been made and found to be very similar for the rat and rabbit proteins with the exception of the sequence region 72-78, located between the Ca2+, Mg2+-binding CD and EF domains. Acta Orthop Scand, 1982 Oct, 53(5), 715 - 20 Treatment of chronic osteomyelitis; a prospective study of 55 cases treated with radical surgery and primary wound closure; Damholt VV; A prospective and consecutive series of 55 patients were treated for chronic osteomyelitis occurring mainly in the lower extremity and after fractures treated with internal fixation . The mean duration of osteomyelitis was 27 months . Sixty-five per cent had previously undergone operations and had been hospitalized for an average of 131 days . Staphylococcus aureus was cultured in 72 per cent of the cases as the solitary agent . In 6 cases no bacteria were found . The remaining cases had more than one species . The treatment consisted of radical operation, removal of all internal fixation, sequestrectomy, partial decortication and primary wound closure with suction drainage . External fixation was used for bone stabilization . In 13 cases plastic procedures were carried out . Antibiotics appropriate for the sensitivity patterns were given for a maximum of 3 months . Primary wound healing was obtained in 98 per cent of the cases . In practically all cases the sedimentation rate normalized within 4 weeks after the operation . The results in the available literature indicate that radical operation is effective in the treatment of osteomyelitis and this treatment seems economical as regards hospitalization time and quantity of antibiotics required. Ann Intern Med, 1982 Oct, 97(4), 496 - 503 Combination antimicrobial therapy for Staphylococcus aureus endocarditis in patients addicted to parenteral drugs and in nonaddicts: A prospective study; Korzeniowski O et al.; Single (nafcillin for 6 weeks) and combined (nafcillin for 6 weeks plus gentamicin for 2 weeks) drug regimens were compared in two separate multicenter prospective randomized trials . Forty-eight parenteral drug addicts and 30 nonaddicts with clinically and bacteriologically documented Staphylococcus aureus endocarditis were studied . In the addicts, combined therapy effected a more rapid mean clinical response (defervescence and normalization of leukocyte count) and a reduced duration of bacteremia in patients with right-sided endocarditis . In the nonaddicts, combined therapy effected more rapid clearance of bacteremia, but was associated with a higher incidence of azotemia . The addition of gentamicin did not alter morbidity or mortality in either group. Am J Med, 1982 Oct, 73(4), 552 - 63 Role of opsonins in clinical response to granulocyte transfusion in granulocytopenic patients; Keusch GT et al.; Fifty febrile severely granulocytopenic patients were given four daily transfusions of 2.2 X 10(10) normal donor granulocytes . Twenty-three (46 percent) responded clinically, although both responders and nonresponders were similar in clinical characteristics at the outset . This study examines the relation between serum opsonic activity before initiation of granulocyte administration and clinical response . Opsonic activity to three test organisms (Escherichia coli 286 and ON 2, and Staphylococcus aureus) and to 15 blood stream isolates from 14 patients was measured as serum-dependent uptake of heat-killed 14C-labeled bacteria by normal donor leukopheresis granulocytes in an in vitro assay and compared with results obtained with a standard normal serum in each assay . At a concentration of 8 percent serum, all patient groups were equivalent to standard (90 to 102 percent) for the three test organisms . When rate-limiting concentrations of serum (1 to 2 percent) were employed, opsonic activity remained similar to standard for S . aureus in all patient groups and for the two E . coli strains in responders (82 to 98 percent) . In contrast, opsonins for E . coli decreased to 41 to 50 percent of standard in nonresponders (p less than 0.01) . When patients with proved infection were separately analyzed, opsonin activity for E . coli 286 and ON 2 was significantly greater in responders than nonresponders (73.6 versus 34.9 percent and 124.8 versus 58.1 percent, respectively for the two strains) (p less than 0.01) . Patients with opsonin activity of 50 percent or greater of standard had a greater response rate (73 versus 19 percent and 45 versus 0 percent for the two E . coli strains) (p less than 0.005 and p = 0.08, respectively) . Eight of 10 patients with 75 percent or greater of standard for opsonic activity against their own blood stream isolates also responded, whereas zero of four with opsonins less than 75 percent of standard had a favorable outcome . These results indicate that serum opsonic activity may be a determinant of clinical response to granulocyte transfusion in infected granulocytopenic patients and may be predictive of outcome . We conclude that opsonic activity should be assessed in such patients before granulocyte administration and suggest a trial of plasma infusion in opsonin-deficient patients. Proc Natl Acad Sci U S A, 1982 Oct, 79(19), 5788 - 92 Complete amino acid sequence and glycosylation sites of glycoprotein gp71A of Friend murine leukemia virus; Chen R; The complete amino acid sequence of glycoprotein gp71A of Friend murine leukemia virus (F-MuLV) is presented . The protein moiety of gp71A was digested with Staphylococcus aureus (SV8) protease, trypsin, and thermolysin . The sequences of the peptides were determined by the micro dansyl Edman procedure . gp71A is composed of 445 amino acid residues and contains eight oligosaccharide side chains, which are attached exclusively to asparagine by N-glycosyl bonds primarily in the COOH-terminal half of the polypeptide . gp71A is rich in proline (49 residues), tryptophan (16 residues), and cysteine (19 residues) . Proline has the highest molar content (11%) of all amino acids . The prolines cluster in two segments . The most interesting one stretches between residue 233 and residue 283 and contains 18 prolines within 51 amino acids . This proline-rich domain most likely forms a flexible polyproline helix . The comparison of gp70 of Moloney murine leukemia virus (Mo-MuLV gp70) with F-MuLV gp71A revealed that 70 amino acids have been exchanged and 9 residues have been deleted from Mo-MuLV gp70 . The most striking alterations have taken place within the large polyproline segment (residues 247 to 281) . In this part of the molecule 7 amino acids have been deleted in Mo-MuLV and 18 residues have been replaced . This evidence supports the proposal of Shinnick et al . {Shinnick, T . M., Lerner, R . A . & Sutcliffe, J . G . (1981) Nature (London) 293, 543-548} that this area is a "hot spot" for recombination. Acta Pathol Microbiol Immunol Scand {C}, 1982 Oct, 90(5), 251 - 5 Induction and abrogation of suppressor cell function in humans: effect on B cell activation by different polyclonal activators; Lilic D et al.; In a reverse plaque forming cell (PFC) assay, the effect of concanavalin A (Con-A)-induced suppressor cells on polyclonally activated B lymphocytes was studied . Differentiation to PFC, as induced by pokeweed mitogen (PWM), Staphylococcus aureus or Epstein-Barr virus (EBV) was in all cases suppressed by the addition of ConA-pretreated cells . The EBV-stimulated cells showed the smallest PFC response and appeared least amenable to suppression . IgA-secreting cells were less suppressible than IgM- and IgG-secreting cells regardless of the polyclonal B lymphocyte activator used . The suppressor cells were radiosensitive. J Gen Virol, 1982 Oct, 62 (Pt 2), 385 - 92 Monoclonal antibody specific for avian sarcoma virus structural protein p27; Richert ND; A hybridoma cell line which secretes antibody to the Rous sarcoma virus (RSV) structural protein p27 has been established . The hybrid resulted from the fusion of NS-1 myeloma cells with spleen cells from a Balb/c mouse which was immunized with RSV-transformed mouse cells . Antibodies produced by the hybrid clone immunoprecipitated p27 and gag precursor proteins (Pr180gag,pol, Pr76gag and Pr66gag) from {35S}methionine-labelled chicken embryo fibroblasts transformed by the Schmidt-Ruppin strain of RSV . When Schmidt-Ruppin virus was radioactively labelled with {35S}methionine, p27 was the only virus structural protein immunoprecipitated . Antibody production by the hybrid clone (designated 7-29-D6) has remained stable for longer than 12 months at a level of 50 micrograms IgG/ml medium . A highly sensitive method to determine the subclass specificity of monoclonal antibodies is described . In this procedure, the clone is incubated with {35S}-methionine, and radiolabelled antibody is precipitated with affinity-purified, subclass-specific rabbit anti-mouse serum and Staphylococcus aureus . The advantages of this procedure are discussed. J Gen Virol, 1982 Oct, 62 (Pt 2), 297 - 311 Identification of a neutralization-specific antigen of a calf rotavirus; Killen HM et al.; Monospecific polyclonal antisera were raised in guinea-pigs against the calf rotavirus polypeptides VP1, VP2, VP3 + 4, VP4.2, VP6, VP7.1, VP7.2 and VP10 . All of the antisera gave a similar pattern of cytoplasmic immunofluorescence in rotavirus-infected cells, but spots of fluorescence of varying intensity with different sera were seen over the nucleus . Immune precipitation, using Staphylococcus aureus to collect immune complexes, showed that VP2 was precipitated by antiserum to VP2 (alpha-VP2) and VP6 by alpha-VP6, alpha-VP7.1 and alpha-VP7.2 both precipitated the same range of proteins from infected cells (VP7, VP7.1 and VP7.2) or from virions (VP7.1 and VP7.2) . VP10, either from virions or infected cells, was not precipitated by alpha-VP10 . The only antiserum which efficiently neutralized infectivity was alpha-VP7.2 . There were low levels of neutralization with alpha-VP10 (but the results varied from experiment to experiment) and traces with alpha-VP6 . alpha-VP7.1 and the other antisera did not neutralize even though alpha-VP7.1 agglutinated double-shelled particles as seen in immune electron microscopy to a greater extent than alpha-VP7.2 . Both VP7.1 and VP7.2 were shown to be glycoproteins by tunicamycin treatment of infected cells . Core particles only were agglutinated by alpha-VP10 . All the evidence leads us to conclude that there were major neutralizing antigenic determinants present on VP7.2, a minor component of the outer shell of the virion. Hoppe Seylers Z Physiol Chem, 1982 Oct, 363(10), 1141 - 53 Studies on cytochrome c oxidase, IX . The primary structure of polypeptide VIa; Biewald R et al.; The complete amino acid sequence of the cytoplasmic polypeptide VIa of cytochrome c oxidase from beef heart is described . The primary structure of this component of complex IV of the respiratory chain is elucidated by isolation and sequencing of overlapping glutamic acid, arginine, tryptophan and methionine fragments obtained by cleavage with Staphylococcus aureus protease, protease from submaxillaris glands of mice, 2-iodosylbenzoic acid and cyanogen bromide . The chain length of polypeptide VIa is 98 amino acids, the resulting molecular mass of 10670 Da . The hydrophilic protein does not contain a hydrophobic membrane penetrating sequence domain . Its function in the respiratory complex IV is unknown. J Infect Dis, 1982 Oct, 146(4), 518 - 23 Improved test for IgM antibody to Epstein-Barr virus using an absorption step with Staphylococcus aureus; Sumaya CV et al.; The determination of levels of IgM antibody to Epstein-Barr virus (EBV) capsid antigen was improved by absorbing unfractionated test serum with Staphylococcus aureus cells containing protein A . Nonspecific background fluorescence was significantly decreased, thus facilitating the reading of slides and the detection of specific fluorescent reactions in serum with low levels of this IgM antibody . Moreover, the inclusion of the absorption step eliminated false-positive reactions caused by the presence of rheumatoid factor in serum and shortened the time needed for the incubation of test serum with the EBV-infected cell smear . This improved antibody test should facilitate the laboratory diagnosis of acute EBV infections, including unaccompanied by a heterophil antibody response. Proc Natl Acad Sci U S A, 1982 Oct, 79(19), 6008 - 12 Three distinct stages of B-cell defects in common varied immunodeficiency; Saiki O et al.; B-lymphocyte function of 15 patients with primary common varied immunodeficiency or related disease were examined . All patients had low serum levels of IgM, IgG, and IgA, but 12 of 15 patients had nearly normal numbers of peripheral blood B lymphocytes . Mononuclear cells and B cells from peripheral blood were assayed for B-cell mitogenic responses to anti-Ig mu chain antibodies or to Staphylococcus aureus strain Cowan I (referred to as Cowan I), and for differentiation to Ig-secreting cells of IgM, IgG, and IgA classes in the presence of Cowan I and pokeweed mitogen or T-cell factor . The patients all showed profound B-cell defects in one or more of the assays and could be divided into three approximately equal groups based on their responses . The first group showed normal proliferation in response to the two B-cell mitogens and near normal numbers of IgM-secreting cells but no IgG- or IgA-secreting cells . B cells in the second group showed proliferative responses to Cowan I or anti-mu, but no differentiation to Ig-secreting cells . The third group had no B-cell proliferative responses or differentiation in our assays . In several patients from each group, (i) helper T cells were functional in Ig-secreting-cell responses with purified normal B cells, (ii) patient T cells did not significantly suppress formation of Ig-secreting cells by normal cells in coculture, and (iii) removal of T cells with addition of T-cell-replacing factor, or partial removal of monocytes, did not alleviate any of the defects . These studies show that primary B-cell defects in common varied immunodeficiency occur at several levels, probably representing blocks at different stages of differentiation. Proc Natl Acad Sci U S A, 1982 Oct, 79(19), 5768 - 72 Escherichia coli host factor required specifically for the phi X174 stage III reaction: in vitro identification and partial purification; Wolfson R et al.; A cell-free extract prepared from phi X174-infected Escherichia coli cells sustained in vitro synthesis of viral DNA (stage III reaction) when supplemented with fraction II from uninfected cells . The reaction was dependent upon deoxyribonucleoside triphosphate, ATP, added phi X174 replicative form I DNA template, and the fraction II from uninfected cells . This reaction differed from the stage II reaction (semiconservative replication of duplex replicative form DNA) by the production of stable viral protein-DNA complexes sensitive to anti-phi X174 antiserum . Three types of protein-DNA complexes were identified, 50S, 92S, and a 114S complex that cobanded in CsCl and cosedimented in neutral sucrose gradients with a phi X174 phage marker . The sensitivity of these complexes to anti-phi X174 antiserum and Staphylococcus aureus provided a relatively rapid biochemical assay for direct measurement of the amount of DNA synthesized by the stage III reaction . With this assay, an E . coli factor (SIII) required specifically for the synthesis of viral protein-DNA complexes was identified and purified 200-fold from uninfected E . coli cells . The partially purified SIII factor was required for the synthesis of DNA and viral protein-DNA complexes in the phi X174-infected cell extracts and could not be replaced by rep protein, single-strand binding protein, or DNA polymerase III holoenzyme. Ophthalmology, 1982 Oct, 89(10), 1173 - 80 Classification of chronic blepharitis; McCulley JP et al.; Since last thoroughly evaluated over three decades ago, the clinical spectrum of chronic blepharitis has changed . The relative prevalence of Staphylococcus aureus alone or in combination with seborrheic blepharitis has decreased . The relative prevalence has increased of seborrheic blepharitis with or without associated excess meibomian secretions (meibomian seborrhea) or inflammation (meibomitis) . Primary meibomitis appears not to be a primarily infectious entity but to represent a facet of generalized sebaceous gland dysfunction and to be found in association with seborrheic dermatitis or acne rosacea . The keratoconjunctivitis found in association with primary meibomitis may be contributed to by the production of bacterial lypolytic exoenzymes that split neutral lipids, resulting in an increased level of free fatty acids in the tears . A frequent finding of keratoconjunctivitis sicca in this patient population, especially the S . aureus group (50%), is of note . Of particular importance is that these entities be recognized as chronic diseases requiring control and ones for which there is no "cure." J Clin Microbiol, 1982 Oct, 16(4), 700 - 3 Quantitation of pathogenic potential of Staphylococcus aureus; Zierdt CH et al.; Numerical estimates of the pathogenicity of Staphylococcus aureus strains were made for phage-typed strains from a relative incidence of significant to nonsignificant isolates from hospital patients . For a specific phage-patterned strain, the number of isolates from significant (wounds, abscesses, blood, etc.) sites was divided by the number of isolates from nonsignificant (respiratory tract, body surfaces, etc.) sites . This value, multiplied by 100, was the index of infection potential (IIP) . IIP values for the S . aureus strains studied ranged from a low of 8 to a high of 50 . The average IIP for all phage-patterned strains that occurred 50 or more times was 20 . There was an inverse relationship between length of the phage pattern (number of the 26 typing phages that lysed the strain) and pathogenicity . Those strains with shorter phage patterns had higher IIP values and were more pathogenic . Strains lysed by one phage had an average IIP of 27, whereas those lysed by 18 phages had an average IIP of 14. J Invest Dermatol, 1982 Oct, 79(4), 250 - 3 Importance of the keratinized epithelial cell in bacterial adherence; Bibel DJ et al.; The effect of cellular pathology and keratinization of skin and nasal cells upon binding of Staphylococcus aureus were examined . Adherence with epithelial cells obtained from either the skin or nasal mucosa of patients with atopic dermatitis was greater than that observed with normal cells (p less than 0.001); the difference in adherence between psoriatic and normal cells was not statistically significant . Tested nasal cells were microscopically differentiated into 4 general types based on stage or layer of keratinization: spinous, low granular, high granular, and keratin . The degree of adherence was related to the progress of keratinization . Data indicated the existence of 2 types of receptors for S . aureus on nasal cells: One, present upon both granular and fully keratinized cells, is not blocked by teichoic acid and appears responsible for the higher bacterial counts on atopic cells; the second is found on keratinized cells only and is susceptible to teichoic acid. J Neurochem, 1982 Oct, 39(4), 1090 - 100 Limited digestion of guinea pig myelin basic protein and its carboxy-terminal fragment (residues 89-169) with Staphylococcus aureus V8 protease; Diebler GE et al.; Staphylococcus aureus V8 protease has been reported to have a strict specificity for cleavage of the Glu-X bond in ammonium bicarbonate (pH 7.9) . With myelin basic protein and one of its major peptic fragments (residues 89-169) as substrates, selective cleavage of Asp(32)-Thr(33), Asp(37)-Ser(38), and Glu(118-Gly(119) bonds was observed, as well as the unusual cleavage of the Gly(127)-Gly(128) bond . The Asp-Glu and Glu-Asn bonds in the sequence of Gln-Asp-Glu-Asn-Pro(81-84) were resistant to V8 protease attack . The following peptides were identified as products of limited cleavage of basic protein by V8 protease: (1-32), (1-37), (33-169), (38-169), (33-118), (38-118), (33-127), (38-127), (119-169), and (128-169) . Cleavage of the peptic peptide (89-169) yielded fragments (89-118), (89-127), (119-169), and (128-169) . All peptides were identified by amino acid analysis, as well as NH2- and COOH-terminal analyses . Time course studies with basic protein showed that V8 protease initially attacked the bonds between Asp(32) and Thr(33) and Asp(37) and Ser(38) . With peptide (89-169) the initial cleavage was between Glu(118) and Gly(119) . Peptides (89-118) and (89-127) were encephalitogenic in the Lewis rat . The activity of these peptides in the rat confirms the presence of a minor encephalitogenic site in guinea pig basic protein . Peptide (89-127) was encephalitogenic in the guinea pig, as expected, because it contains the intact encephalitogenic site . V8 protease digestion of basic protein yields some interesting new fragments, not previously available for biologic studies. Biochemistry, 1982 Sep 28, 21(20), 5089 - 96 Largomycin: preparation, properties, and structure; Vandre DD et al.; Largomycin has been purified to homogeneity by chromatography on hydroxylapatite whereby carbohydrate and protease impurities were removed . Largomycin is an acidic protein (pI 4.13, molecular weight 29300) which forms a dimer in phosphate buffer . An N-terminal amino acid sequence analysis from the amino-terminal residue gave, for the first 32 residues, Asp-Ile-Leu-Ile-Ala-Gly-Ala-Thr-Gly-Asn-Val-Gly-Lys-Pro-Leu-Val-Glu-Gly-Leu-Leu - Ala-Ala-Gly-Lys-Pro-Val-Arg-Ala-Leu-Thr-Arg-Asn.. . The sequence from the carboxyl terminus was -Ala-Ala-Leu-Phe-OH with threonine, valine, and glutamic acid being released upon prolonged digestion . The same amino acid sequences were found for largomycin prepared from either the culture broth or the mycelium of Streptomyces pluricolorescens . The similarities extended to the other physical properties, the antimicrobial activity against Staphylococcus aureus and Sarcina lutea, and the antitumor activity against KB cells . Largomycin inhibits the biosynthesis of DNA and RNA . An iodinated derivative did not bind to KB cells . The antimicrobial activity was lost following ultraviolet irradiation, protection against which was not afforded by p-aminobenzoic acid. Biochemistry, 1982 Sep 28, 21(20), 4867 - 73 Phosphoenolpyruvate-dependent phosphotransferase system of Staphylococcus aureus: factor IIIlac, a trimeric phospho-carrier protein that also acts as a phase transfer catalyst; Deutscher J et al.; Factor IIIlac (FIII) consists of three identical subunits . It could be shown that each of the subunits carries a phosphoryl group upon phosphorylation (P-FIII) with phosphoenolpyruvate (PEP), enzyme I, and histidine-containing phospho-carrier protein (HPr) . The phosphoryl group is bound to a histidyl residue in P-FIII . Each subunit of FIII contains four histidyl residues . After tryptic cleavage a peptide was isolated that contained one other histidyl residue besides the active center histidine . By further cleavage of the peptide T-2 with V-8 Staphylococcus aureus protease it could be shown that His-19 in the sequence of the peptide T-2 is the active center histidine . Another peptide (1-38), caused by incomplete tryptic cleavage, could be isolated . It inhibited the phospho-transfer reaction from PEP to the sugar molecule at the step of factor III-enzyme II recognition . It competes with factor III for the binding site of enzyme II, the membrane component . It is a very hydrophobic peptide . This hydrophobic region is buried in factor III . But upon phosphorylation of factor III it is turned out . Thus P-FIII binds to Triton X-100 micelles whereas factor III does not . This conformational change caused by phosphorylation could be shown by proton nuclear magnetic resonance methods {Kalbitzer, H.R., Deutscher, J., Hengstenberg, W., & Rosch, P . (1981) Biochemistry 20, 6178-6185}, by circular dichroism spectroscopy, and by the Ouchterlony double-diffusion method . Antibodies against FIII do not precipitate P-FIII. JAMA, 1982 Sep 24, 248(12), 1493 - 5 Staphylococcal nasal carriage and subsequent infection in peritoneal dialysis patients; Sewell CM et al.; Thirty patients undergoing long-term home-based peritoneal dialysis were monitored for 13 months for carriage of Staphylococcus aureus in the nares and for the development of infectious complications . The patients could be divided into three groups with regard to S aureus carriage: chronic, intermittent, and noncarriers . Twenty-five episodes of peritonitis and 20 episodes of catheter exit-site infections occurred during 268 patient-months of observation . Staphylococcus aureus accounted for eight episodes of peritonitis and 12 episodes of exit-site infection . Chronic and intermittent carriers of S aureus were found to be at higher risk of development of infection than noncarriers. Am J Obstet Gynecol, 1982 Sep 15, 144(2), 186 - 9 The effect of menses and use of catamenial products on cervical carriage of Staphylococcus aureus; Noble VS et al.; Cervical specimens for culturing for Staphylococcus aureus were obtained during menstruation and at midcycle from 40 users of tampons and twelve users of pads . Nine women (two users of pads and seven users of tampons) were colonized by S . aureus . Colonization rates of the cervix were similar for users of tampons and users of pads (18% and 17%, respectively) . S . aureus was isolated more frequently during menstruation (17%) than at midcycle (5.8%) . Six women had positive menstrual cultures without a positive midcycle culture, whereas no women had positive midcycle cultures and negative menstrual cultures . These observations indicate a significant (p less than 0.05) association of menses with staphylococcal colonization of the cervix. Ann Ophthalmol, 1982 Sep, 14(9), 881 - 5 Focal giant papillary conjunctivitis from retained contact lenses; Stenson S; Three cases of retained contact lenses leading to focal papillary conjunctivitis of the upper lids reminiscent of the more diffuse changes of lens or suture-induced giant papillary conjunctivitis are reported . One silicone and two cabufocon lenses were responsible . Corneal changes occurred in two of the three cases . Secondary infection with Staphylococcus aureus was found in one patient . In two, conjunctival cytology suggested a hypersensitivity mechanism . In all three patients the simple removal of the retained lens was sufficient to reverse pathology . The focal nature of the papillary changes observed in these patients as well as in those cases occurring post-operatively from exposed suture edges would point towards an important direct mechanical etiologic factor in addition to the proposed hypersensitivity basis for the similar diffuse upper lid papillary hypertrophy characteristic of giant papillary conjunctivitis. Acta Paediatr Scand, 1982 Sep, 71(5), 821 - 6 Antibiotic treatment of Staphylococcus aureus infection in cystic fibrosis; Szaff M et al.; During the period 1965-79 191 cystic fibrosis patients have been treated with 2349 course of anti-staphylococcal chemotherapy in the Danish Cystic Fibrosis Centre . The standard treatment was orally administered Fusidic acid in combination with Oxacillin or Dicloxacillin given for 14 days . In cases of penicillin allergy Fusidic acid in combination with Rifampicin was given . The overall results showed that S . aureus was eradicated from sputum by a single course of chemotherapy in 74% of the cases, although in 8% the original strains (phage-type) was replaced by a new strain . Repeated or extended treatment was successful in most of the remaining cases and, as a result, only 9% of our patients harboured S . aureus continuously for 6 months or more . On the average each patient received 2 anti-staphylococcal treatment per year, but no decrease in efficacy of repeated treatment was seen . Likewise, no significant increase of S . aureus precipitins and no development of resistant strains was seen in our patients . Due to the efficacy of chemotherapy and the principles of early treatment whether there are clinical symptoms of infection or not, S . aureus infection is now considered a minor problem without relation to poor prognosis in our cystic fibrosis patients. Biken J, 1982 Sep, 25(3), 111 - 9 Isolation of recombinants doubly and triply drug-resistant to streptomycin, tetracycline and chloramphenicol by PEG-induced cell fusion of singly resistant staphylococcus aureus L-forms; Hirachi Y et al.; Various combinations of four substrains of Staphylococcus aureus L-form (strain STA-EMT-1), each of which was resistant to one of the following four drugs, streptomycin (SM), tetracycline (TC), chloramphenicol (CP) and erythromycin (EM), were submitted to polyethylene glycol (PEG)-induced cell fusion . PEG-induced cell fusion followed by enrichment culture in the liquid basal medium supplemented with penicillin G resulted in development of recombinants that were doubly drug-resistant to SM and TC, SM and CP, and TC and CP, but no recombinant doubly resistant to EM and TC, was obtained by treatment of a EM-resistant and TC-resistant substrains with PEG . No recombinants resistant to SM, CP and TC could be obtained by treatment of substrains resistant to SM, CP and TC, respectively, with PEG . But recombinants triply resistant to these three drugs were produced by two-step cell fusion; that is by fusion of a recombinant doubly resistant to two of the three drugs with a substrain resistant to the third drug. Southeast Asian J Trop Med Public Health, 1982 Sep, 13(3), 366 - 72 Diarrhoea among Vietnamese refugees in the Philippines; Rodriguez SV et al.; A 6-month survey of diarrhoeas in Vietnamese refugee camp children was carried out and was responsible for 32.5% of pediatric consultations . One hundred twenty cases were studied and underwent laboratory work-up . Peak incidence was in the 4-6 years . Diarrhoea was observed to be at its peak in April and June which coincides with the increase in the number of transients and with the rainy season . Diarrhoea with fever and abdominal pain were the most prominent clinical symptoms . Only 8.3% grew bacterial pathogens' enteropathogenic E . coli being the most common followed by Staphylococcus aureus . It is apparent that a causative agent other than a bacterial pathogen such as a virus may play a major role in diarrhoeas in Vietnamese refugee infants and children . The lack of environmental sanitation and health education play a major role in the causation of diarrhoea in these refugee children. Pharmazie, 1982 Sep, 37(9), 658 - 60 Multivariate response surface optimization; Mager PP; A search strategy is proposed to find the best compromise among several extremes obtained from structure-activity relationships . The global optimum is established by evaluating the functions at the relative optimum points and selecting the most extreme of all solutions obtained . The example deals with the activity of rifamycin derivatives against a rifamycin-MS-resistant mutant of Staphylococcus aureus. Jpn J Antibiot, 1982 Sep, 35(9), 2249 - 51 {Antibacterial activity of netilmicin on cefazolin resistant Staphylococcus aureus}; Sasatsu M et al.; Many strains of cefazolin (CEZ)-resistant Staphylococcus aureus of recent clinical isolates were also resistant to gentamicin (GM) . In addition, the antibacterial activity of NTL was found to be stronger than that of GM and stronger than that of CEZ for those resistant strains and especially for those moderately resistant to GM. Appl Environ Microbiol, 1982 Sep, 44(3), 540 - 3 Microbiological quality of macaroni and noodle products obtained at retail markets; Swartzentruber A et al.; The microbiological quality of macaroni and noodle products was determined by a statistically based national survey at the retail level . Geometric means of aerobic plate counts for macaroni and noodle products were 520 and 1,400 per g, respectively . Means for yeast and mold counts were 72 per g for macaroni and 100 per g for noodles . Means for counts of coliforms and Staphylococcus aureus were less than 3 per g for both products . Escherichia coli was not found in macaroni but was present in 0.5% of the noodle samples and ranged from 3 to 93 per g. Antimicrob Agents Chemother, 1982 Sep, 22(3), 369 - 75 Distribution of amoxicillin and clavulanic acid in infected animals and efficacy against experimental infections; Boon RJ et al.; The therapeutic effects produced by formulations of amoxicillin plus clavulanic acid (BRL 25 000A and BRL 25 000G) were compared with those of amoxicillin and clavulanic acid separately against a variety of infections produced by amoxicillin-susceptible and beta-lactamase-producing (amoxicillin-resistant) bacteria . The infection models studied included intraperitoneal infections, a mouse pneumonia, experimental pyelonephritis, and local lesions caused by Staphylococcus aureus and Bacteroides fragilis . The distribution of amoxicillin and clavulanic acid in infected animals after the administration of amoxicillin-clavulanic acid was evaluated by measurement of the concentrations of the substances present in specimens collected at the sites of infection . The results showed that both amoxicillin and clavulanic acid were well distributed in the animal body after the administration of amoxicillin-clavulanic acid formulations, being present in significant concentrations at various sites of infection, e.g., peritoneal washings, pleural fluid, pus, and infected tissue homogenates . In a number of cases, the amoxicillin concentrations measured after the administration of BRL 25000 were higher than those found after treatment with amoxicillin alone, presumably as a result of inhibition of bacterial beta-lactamases by clavulanic acid at the site of infection . The ability of clavulanic acid to protect amoxicillin in vivo was confirmed by the efficacy of amoxicillin-clavulanic acid formulations in the treatment of the infections studied, most of which were refractory to therapy with amoxicillin. J Clin Microbiol, 1982 Sep, 16(3), 549 - 51 Sensitivity of passive bacterial agglutination for detection of hepatitis B surface antigen; Rajagopalan MS et al.; The sensitivity of passive bacterial agglutination (PBA), i.e., the agglutination of Staphylococcus aureus coated with antibodies to hepatitis B surface antigen by hepatitis B surface antigen, was assessed by testing reference panel no . 3A sera (Bureau of Biologics, U.S . Food and Drug Administration) . Of the 23 samples containing hepatitis B surface antigen, 18 were positive by PBA . Sera from 100 healthy adults were tested by PBA and reversed passive hemagglutination . Four sera were positive by both methods . One additional sample was positive only by PBA; if one assumes that it was a false-positive result, the rate of false-positive reactions was only 1%. Infect Immun, 1982 Sep, 37(3), 1112 - 8 Evidence for the secretion of soluble peptidoglycans by clinical isolates of Staphylococcus aureus; Zeiger AR et al.; Four isolates of Staphylococcus aureus from patients with endocarditis and bacteremia were capable of secreting high-molecular-weight soluble peptidoglycans when grown in a minimal cell wall medium containing penicillin G . Vancomycin was not able to substitute for penicillin G in triggering this secretion . Secretion reflected de novo synthesis of soluble peptidoglycan and was strongly dependent on time of incubation (30 to 60 min), and number of bacteria (2 X 10(8) to 5 X 10(8) colony-forming units per ml), but not on penicillin G concentration (10 to 250 micrograms/ml) . The incorporation of alanine into the peptidoglycans secreted in vitro by these isolates incubated in the presence of penicillin G under optimal conditions was variable . The least incorporation of alanine into peptidoglycan occurred with an isolate from a patient treated with nafcillin who had no detectable antipeptidoglycan titer. Arch Intern Med, 1982 Sep, 142(9), 1655 - 8 Complications of Staphylococcus aureus bacteremia . Occurrence in patients undergoing long-term hemodialysis; Francioli P et al.; Since staphylococcus aureus bacteremia continues to be a common occurrence in patients with arteriovenous fistulas who are undergoing long-term hemodialysis, the complications and outcome of 37 episodes of bacteremia were examined . Systemic complications included pulmonary emboli, empyema, persistent bacteremia, and endocarditis . Such events were rarely life threatening--three of the 34 episodes involving patients without severe concurrent medical problems resulted in death . Local complications at the fistula site were common; however, thrombosis, hemorrhage, impending rupture, and persistent bacteremia caused loss of fistula in 13 of the 22 episodes seen with fistula inflammation . Results of this study demonstrate that, although loss of vascular access was an important problem, particularly in patients with prosthetic grafts, patients with S aureus bacteremia who were undergoing long-term hemodialysis had a favorable prognosis for survival, particularly when they were compared with other patients not undergoing hemodialysis. Ann Intern Med, 1982 Sep, 97(3), 376 - 8 Treatment of infections due to methicillin-resistant Staphylococcus aureus; Watanakunakorn C; Strains of methicillin-resistant Staphylococcus aureus are resistant to other penicillins . The in-vitro susceptibility to the cephalosporins differs among strains . Some strains, susceptible to cephalosporins by the standard disk susceptibility test, are proved resistant by the quantitative dilution test; they may show pop-up colonies within the zone of inhibition when incubated further at room temperature . The clinical efficacy of the cephalosporins with or without an aminoglycoside in treating infections due to methicillin-resistant S . aureus is in doubt . To date, susceptible to vancomycin . In-vitro antagonism of vancomycin and rifampin against S . aureus has been shown . Thus, vancomycin alone appears to be the treatment of choice; if this treatment fails, aminoglycoside or rifampin should be added . Serum bactericidal titers should be carefully monitored before and after the addition of the new agent and in-vitro time-kill studies of combination of antibiotics done if feasible. Ann Intern Med, 1982 Sep, 97(3), 344 - 50 Vancomycin therapy for methicillin-resistant Staphylococcus aureus; Sorrell TC et al.; Ten patients with bacteremia due to methicillin-resistant Staphylococcus aureus were treated with vancomycin . These patients were compared with matched controls, nine bacteremic patients with methicillin-sensitive S . aureus, and one patient with penicillin-sensitive S . aureus . Controls were treated with a penicillin . There were no significant differences in time to defervescence, metastatic infections, relapse, mortality, need for surgical drainage, or duration of therapy . Fifteen of 19 episodes of serious methicillin-resistant S . aureus infection responded to vancomycin . Severe toxic effects included tinnitus, neutropenia, rash, and possible nephrotoxicity . Tolerance (a minimal bactericidal concentration to minimal inhibitory concentration ratio of at least 32), but not a minimal bactericidal concentration of at least 32 mg/L, correlated with therapeutic failure (respectively, p = 0.04 and p = 0.11, Fisher's exact test) . Bacteremic infections due to methicillin-resistant and methicillin-sensitive S . aureus cause similar morbidity and mortality . Vancomycin is effective but potentially toxic therapy for most serious infections due to methicillin-resistant S . aureus . In-vitro tests may not predict therapeutic efficacy. Ann Intern Med, 1982 Sep, 97(3), 325 - 9 Community-acquired methicillin-resistant Staphylococcus aureus infections: a new source for nosocomial outbreaks; Saravolatz LD et al.; Over a 19-month period, 165 patients with 183 infections caused by community-acquired, methicillin-resistant Staphylococcus aureus were seen at Henry Ford Hospital in Detroit, Michigan . The proportion of community-acquired staphylococcal infections resistant to methicillin rose from 3 % in March 1980 to 38% in September 1981 . Drug abuse, serious underlying illness, previous antimicrobial therapy, and previous hospitalization were all associated with the development of this infection . Concurrent with the community epidemic was a nosocomial epidemic of methicillin-resistant S . aureus infection, which accounted for 30.6% of all nosocomial staphylococcal infections in January 1981 . Control measures that included isolation, discharge precautions for carriers, and eradication of employee carriage were effective in preventing nosocomial transmission . The prevalence of methicillin-resistant S . aureus carriage among employees was 0.7% . Methicillin-resistant S . aureus may originate in the community as well as in the hospital, and presents a threat to patients in both settings. Ann Intern Med, 1982 Sep, 97(3), 317 - 24 Multiply antibiotic-resistant Staphylococcus aureus: introduction, transmission, and evolution of nosocomial infection; Locksley RM et al.; A burn patient with a multiply antibiotic-resistant Staphylococcus aureus infection was transferred to Harborview Medical Center from a burn unit in another state . Despite standard wound precautions, transmission to 34 patients occurred during the subsequent 15 months . Twenty-seven of the patients were infected . Disease included pneumonia, empyema, bacteremia, endocarditis, osteomyelitis, and burn and wound infections . Seventeen of the 34 patients died . Phage typing and plasmid analysis showed the spread of multiply resistant S . aureus from the burn unit to the surgical intensive care unit where a study evaluating the use of chloramphenicol in cases of bowel sepsis was in progress . During this period the organism became resistant to chloramphenicol by acquiring either of two chloramphenicol R-plasmids . Using plasmid profiles and antibiograms, four epidemic strains were identified that assisted in identifying patient and personnel reservoirs . The outbreak was controlled only after rifampin was added to vancomycin treatment of infected patients, which correlated with eradication of the carrier state. Ann Intern Med, 1982 Sep, 97(3), 309 - 17 Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus; Thompson RL et al.; Outbreaks of hospital-acquired infections caused by methicillin-resistant Staphylococcus aureus are being recognized with increasing frequency in the United States . Two thirds of outbreaks have been centered in critical care units . Infected and colonized inpatients appear to be the major institutional reservoir, and transient carriage on the hands of hospital personnel appears to be the most important mechanism of serial patient-to-patient transmission . In over 85% of hospitals into which they have been introduced, methicillin-resistant strains of S . aureus have become established as endemic nosocomial pathogens . A program designed to control a widespread outbreak in a university hospital used three surveillance methods to identify the major institutional reservoir of colonized and infected inpatients . Daily clinical laboratory surveillance, monthly prospective microbiology surveys of high-risk inpatients, and the recognition of previously infected 38%, 31%, and 31% of new cases, respectively . After control measures were instituted, the prevalence (p less than 0.001) and the number of acquisitions (p less than 0.002) of methicillin-resistant S . aureus declined over a 12-month period. Ann Intern Med, 1982 Sep, 97(3), 297 - 308 The emergence of methicillin-resistant Staphylococcus aureus infections in United States hospitals . Possible role of the house staff-patient transfer circuit; Haley RW et al.; Infections with methicillin-resistant strains of Staphylococcus aureus appear to be occurring with increasing frequency in some U.S . hospitals about a decade after a similar increase in Britain and other countries . In the United States, clustered methicillin-resistant S . aureus infections reported in scientific journals and in three hospital surveys have been almost entirely in large, tertiary referral hospitals affiliated with medical schools . Among 63 hospitals regularly reporting infections from 1974 to 1981 in the National Nosocomial Infections Study, the increase in methicillin-resistant S . aureus infections was entirely due to substantial increases in only four hospitals, all of which were large, tertiary referral centers affiliated with medical schools . The predominance of methicillin-resistant S . aureus infections in these large hospitals may be due to the large numbers of patients at high risk of infection and to the interhospital spread of the organism by the transfer of infected patients and house staff from similar hospitals or from nursing homes. Am J Clin Pathol, 1982 Sep, 78(3), 372 - 6 Tampon-related toxic-shock syndrome . Histopathologic and clinical findings in a fatal case; Blair JD et al.; Toxic-shock syndrome (TSS) is consistently associated with penicillin-resistant Staphylococcus aureus in the vagina of menstruating women who use tampons . Increasing evidence implicates Staphylococcal toxin(s) in the pathogenesis of the condition, but the nature and biological effects of such toxin(s) are not established . Comprehensive postmortem studies and histopathologic data are few and largely unknown . The autopsy of a 15-year-old girl with this syndrome showed extensive superficial ulcerations and thrombophlebitis of the vagina, with bacteria on the mucosal surface only . Systemic phlebitis and capillaritis, visceral interstitial edema and acute inflammation involving various organs suggest a toxic effect, which is primarily manifested by widespread vascular damage . The histogenesis of the vaginal ulcerations remains unclarified, although they probably contribute to the absorption of toxin(s). Surgery, 1982 Sep, 92(3), 513 - 9 Fibrin in peritonitis . III . The mechanism of bacterial trapping by polymerizing fibrin; Dunn DL et al.; We have previously shown that fibrin can act to contain microorganisms and prevent early septic death in experimental peritonitis . However, this trapping eventuates in abscess formation . Fibrinogen, the precursor molecule of fibrin, is known to possess binding structures for some pathogenic organisms . We compared the extent of incorporation of various aerobic and anaerobic bacteria as well as polystyrene latex microspheres into fibrin clots . Similar numbers of organisms and microspheres were incorporated into either noncontracted or contracted fibrin clots . Detailed comparisons of the binding of Escherichia coli or Staphylococcus aureus to human fibrinogen were then made . The addition of 111:B4 lipopolysaccharide did not inhibit incorporation of E . coli 0111:B4 into either type of fibrin clot . With initial inoculum sizes of 10(6) to 10(8) colony-forming units (CFU)/ml, S . aureus was better incorporated into contracted fibrin clots (P less than 0.01) than was E . coli, possible evidence for an easily saturable receptor mechanism . We concluded that microorganisms are incorporated into the polymerizing fibrin matrix in the same fashion as are inert particles of similar size, irrespective of external chemical structure . Adherence of bacteria to fibrinogen or polymerizing fibrin did not appear to represent a specific bacterial virulence factor, more likely representing an effective host defense mechanism of broad specificity. Cancer Res, 1982 Sep, 42(9), 3663 - 8 Regression of canine mammary carcinoma after immunoadsorption therapy; Holohan TV et al.; The plasma of dogs afflicted with mammary carcinoma was perfused through chambers bearing Staphylococcus aureus Cowan strain I in an attempt to remove tumor-promoting, immunosuppressive immune complexes from the peripheral blood of these animals . In this canine model of spontaneous mammary carcinoma, reduction of breast and/or soft-tissue tumor (posttreatment size equal to 0 to 50% of pretreatment tumor size) was observed in five of the ten animals so treated . Immune complexes capable of blocking lymphocytotoxicity were measured pre- and postimmunoadsorption; removal was more efficient in the five responders (four of six complexes) than in nonresponders (one of ten complexes), although statistical significance was not attained . The reduction of tumor size seen in soft-tissue sites was not always accompanied by a similar reduction of tumor size in visceral sites, and surgical resection of residual soft-tissue tumor nodules remaining after immunoadsorption treatment was required to achieve a complete response in two responding animals . No significant decrease in tumor size was observed in the control group, perfused without immunoadsorbent, nor in five additional tumor-bearing animals infused with normal dog plasma which had been passed through S . aureus Cowan strain I-containing chambers . These data indicate that immunoadsorption of tumor-bearing host plasma can result in reduction in size of canine mammary adenocarcinoma but that the response is dependent on the site of the tumor (s.c . versus visceral) and may require utilization of other modalities to achieve a complete disappearance of the tumor. Infect Immun, 1982 Sep, 37(3), 1270 - 7 Comparative role of complement in pneumococcal and staphylococcal pneumonia; Coonrod JD et al.; To evaluate the role of complement in pneumococcal and staphylococcal pneumonia, we decomplemented rats with cobra venom factor and inoculated them intratracheally with Staphylococcus aureus or type 25 pneumococci . S . aureus produced a patchy bronchopneumonia in normal Sprague-Dawley or Lewis rats, and decomplementation did not increase the severity of staphylococcal infection in either rat strain as judged by quantitative cultures of the lungs and blood at 6, 24, and 48 h after inoculation . In contrast, decomplementation markedly increased the severity of pneumonia caused by type 25 pneumococci in Sprague-Dawley and Lewis rats . In Sprague-Dawley rats, decomplementation significantly increased the number of bacteria in the lungs at 3, 6, and 24 h of infection . Bacteremia developed early in decomplemented Sprague-Dawley rats, but the higher pulmonary bacterial counts did not appear to be caused by bacteremic seeding of the lungs . Decomplemented Sprague-Dawley rats inoculated intravenously with pneumococci failed to develop the very high levels of bacteria in the lungs that were observed when the rats were inoculated intratracheally . Moreover, decomplemented Lewis rats inoculated intratracheally with pneumococci developed significantly increased numbers of pneumococci in the lungs early in infection (3 and 6 h) when they had no detectable bacteremia . These data indicate that in murine models complement plays a major protective role against type 25 pneumococci in the lung, whereas complement is not important to host defense in staphylococcal pneumonia. Am J Ophthalmol, 1982 Sep, 94(3), 402 - 7 Intraocular lenses and experimental bacterial endophthalmitis; Hopen G et al.; To determine if an intraocular lens renders bacterial endophthalmitis more resistant to therapy, an animal model was developed . Nine rabbits underwent bilateral extracapsular lens extraction with placement of a Simcoe posterior chamber IOL in one eye . Approximately 170 organisms of Staphylococcus aureus were inoculated into both eyes . The eyes of seen animals were treated with intravitreal and subconjunctival gentamicin after 24 and 48 hours . Vitreous cultures remained sterile in all treated eyes for one week after antibiotic therapy . Two animals that did not receive antibiotics showed persistent infection . There was no difference between aphakic and pseudophakic eyes in terms of clinical response or onset of negative cultures. Ann Intern Med, 1982 Sep, 97(3), 339 - 44 Mechanisms of resistance to beta-lactam antibiotics in strains of Staphylococcus aureus; Sabath LD; There are three major mechanisms of resistance of Staphylococcus aureus to beta-lactam antibiotics: enzyme mediated (penicillinase or beta-lactamase) by which the antibiotic is inactivated; intrinsic, which is not due to drug inactivation, and accounts for methicillin-resistance; and tolerance, in which there is a dissociation of the inhibitory and killing actions of beta-lactam antibiotics . In enzyme-mediated resistance, there are at least three different staphylococcal beta-lactamases, which probably account for differences in the inoculum effect with different cephalosporins . The intrinsic resistance is associated with differences in the affinity of beta-lactams for penicillin-binding proteins, but intrinsic resistance is probably more complex, because the pH of the medium, chelating agents, visible light, and temperature also effect its expression . Tolerance is clearly due to decreased autolytic enzyme activity (reflecting persistence of an enzyme inhibitor) of those tolerant organisms that need 32 (or more) times as much antibiotic for a bactericidal effect as for simple inhibition. Am J Dis Child, 1982 Sep, 136(9), 774 - 6 Osteogenesis imperfecta tarda in a child with hyper-IgE syndrome; Brestel EP et al.; A patient had recurrent pyogenic infections, chronic mucocutaneous candidiasis, and repeated long-bone fractures . Her disorder was diagnosed as hyper-IgE syndrome on the basis of clinical data, elevated levels of serum IgE, increased levels of IgE specific for Staphylococcus aureus, and impaired T-lymphocyte function . Roentgenograms confirmed the diagnosis of osteogenesis imperfecta tarda . The estimated likelihood of both conditions occurring in the same person is approximately one in 10 billion . The coincident finding of bone dysplasia in a patient with impaired T-lymphocyte function suggests a common mechanism for birth defects. Antimicrob Agents Chemother, 1982 Sep, 22(3), 364 - 8 Factors influencing detection of tolerance in Staphylococcus aureus; Goessens WH et al.; The phenomenon of tolerance to cloxacillin and methicillin was studied in Staphylococcus aureus . It was demonstrated that the minimal bactericidal concentrations showed marked differences, depending on the method of detection used . These differences resulted from carry-over of the antibiotic to the subculture plates . When carry-over of the antibiotic was prevented by the addition of beta-lactamase to the nutrient medium, the antibiotics were no longer bactericidal . At a certain antibiotic concentration and at higher concentrations, however, each strain showed a certain survival percentage after 24 h . The tolerance percentage was determined for 15 strains . The values found for the individual strains ranged from less than 0.1 to 11% for cloxacillin and methicillin . since these percentages were reproducible within narrow limits, they could be regarded as a characteristic of the strains . The tolerance percentage was independent of the growth phase of the initial cultures. Res Vet Sci, 1982 Sep, 33(2), 146 - 51 Effect of immunisation on the early influx of neutrophils during staphylococcal mastitis in ewes; Colditz IG et al.; The neutrophil influx into mammary secretions was studied in unimmunised, and in systemically and locally immunised, lactating and non-lactating ewes experimentally infected with Staphylococcus aureus . Systemic immunisation was effected by subcutaneous injection of live bacteria or by intramuscular injection of killed bacteria in Freund's incomplete adjuvant . The initial inflammatory response to infection of the mammary glands of systemically immunised lactating ewes was at first comparable with that for unimmunised, lactating ewes . However by eight hours after challenge the leucocyte concentrations were lower in systemically immunised ewes . In non-lactating ewes immunised with live vaccine, higher leucocyte concentrations and higher proportions of neutrophils were recorded four hours after infection (hpi) than for unimmunised ewes or ewes immunised with killed vaccine . Prior local immunisation, by unilateral infusion of killed bacteria into mammary glands, enhanced the initial neutrophil influx in comparison to infection of unimmunised contralateral glands of non-lactating ewes by four hpi . For these animals the proportion of neutrophils in washings from immunised glands were significantly greater than for unimmunised glands four and six hpi . In two of three locally immunised lactating ewes there was a larger neutrophil influx into secretions of locally immunised glands than unimmunised glands six hpi . Neutrophils comprised more than 93 per cent of leucocytes from all infected glands by eight hpi . The results suggest that differences in the rate of influx of neutrophils into infected mammary glands of immunised and unimmunised ewes could be attributed to immunological enhancement of neutrophil recruitment or to limitation of toxic damage to tissues with consequently diminished neutrophil invasion. J Clin Microbiol, 1982 Sep, 16(3), 517 - 20 Long-term Staphylococcus aureus carrier state in hospital patients; Zierdt CH; Staphylococcus aureus colonization of 326 predominantly chronic-care (long-term) patients was studied for 24 years . There were 5,827 upper respiratory cultures positive for S . aureus, ranging from 10 to 88 per patient, determined by the number of years (1 to 21; average, 4.6) that the patient was studied . Patients on the average carried 2.8 S . aureus strains . One patient carried eight strains . Each patient had a predominant strain . Predominant strains tended to be permanent, with 87% persistence over the studied years . Lytic group III strains were more than twice as frequent as group I strains and eight times as frequent as group II strains . Patient carriage of multiple S . aureus strains was usual . A collection of large numbers of cultures over an extended period was necessary for this statistical study, since cultures positive for predominant strains were interspersed with negative cultures and cultures positive for minor strains . Thus, persistence of carriage of a predominant S . aureus strain in a patient continues despite frequent negative cultures and cultures positive for minor strains. Infect Control, 1982 Sep-Oct, 3(5), 377 - 83 Increasing occurrence of methicillin-resistant Staphylococcus aureus in the United States; Boyce JM et al.; Although several outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infections have been reported in recent years, the geographic distribution and frequency of MRSA infections in American hospitals is unknown . We conducted a questionnaire survey to determine the magnitude of the problem . Data from 261 hospitals were included in the survey . MRSA were reported by 145 hospitals located in 36 states . Large hospitals reported these organisms significantly more often than small hospitals (p less than .001) . University hospitals reported MRSA more often than community or community-teaching hospitals (p less than .001 and p less than .005, respectively) . The number of hospitals reporting MRSA increased from 24 in 1975 to 112 in 1980 (p less than .001 . Our data suggest that MRSA are widely distributed geographically and that the number of hospitals with these organisms has increased dramatically since 1975. Antimicrob Agents Chemother, 1982 Sep, 22(3), 470 - 4 Action of antifungal imidazoles on Staphylococcus aureus; Sud IJ et al.; In Staphylococcus aureus, using the imidazoles miconazole and ketoconazole, detailed studies of minimal inhibitory concentrations, kinetics of growth, viability, and release of intracellular K+ confirm that the two imidazoles work differently in this bacterium . Miconazole is bactericidal at low concentrations and causes release of cellular K+ . Ketoconazole has no bactericidal effect at any tested concentration and has little effect on K+ permeability of S . aureus; it slows growth at high concentration . This is reflected in a low minimal inhibitory concentration for miconazole and a high one for ketoconazole . The probable mechanisms of the bacteriostatic and bactericidal effects of the imidazoles are discussed in light of these results and the previously described antifungal mechanisms of the drugs . alpha-Tocopherol blocks the action of both imidazoles. Proc Natl Acad Sci U S A, 1982 Sep, 79(18), 5527 - 31 Affinity labeling of the plasma membrane 3,3',5-triiodo-L-thyronine receptor in GH3 cells; Horiuchi R et al.; The binding of 3,3',5-triiodo-L-thyronine (T3) to GH3 rat pituitary tumor cells was studied at 15 degrees C and was shown to be saturable, reversible, and stereospecific . Least-squares analysis of the binding data showed two classes of binding sites with dissociation constants of 1.8 +/- 0.2 nM and 260 +/- 30 nM and binding capacities of (5.2 +/- 0.2) X 10(4) and (1.6 +/- 0.2) X 10(6) sites per cell, respectively . Affinity labeling of intact cells was carried out by incubation of cells with 0.3 nM N-bromoacetyl-{125I}T3 at 15 degrees C for 1 hr . Analysis of the cellular extracts by sodium dodecyl sulfate gel electrophoresis showed three labeled protein bands with apparent molecular masses of 55, 47, and 33 kilodaltons (kDal) in a ratio of 86:7:7 . The labeling of only the 55-kDal protein band was selectively reduced to 50% by 20 microM unlabeled T3 . Highly purified plasma membranes of GH3 cells were prepared and shown to be free of nuclei . Affinity labeling of the purified plasma membranes gave the same labeling pattern as with intact cells . Peptide mapping by Staphylococcus aureus V8 digestion of the 55-kDal protein from cells or plasma membranes gave the identical peptide fragments . Thus the 55-kDal protein labeled from intact cells is the same protein as that from purified plasma membranes . These results together with our earlier findings {Horiuchi, R., Cheng, S.-y., Willingham, M . & Pastan, I . (1982) J . Biol . Chem . 257, 3139-3144} suggest that the 55-kDal protein may be involved in mediating the uptake of T3 in GH3 cells. J Gerontol, 1982 Sep, 37(5), 529 - 34 Oxidative metabolism and bactericidal capacity of polymorphonuclear leukocytes from normal young and aged adults; Nagel JE et al.; The ability of polymorphonuclear leukocytes (PMNs) from young and old individuals to reduce nitroblue tetrazolium, to kill Staphylococcus aureus in vitro, and to generate superoxide was determined . Investigation of PMNs from 202 humans, aged 26 to 95 years, failed to demonstrate an age relationship in their ability to reduce nitroblue tetrazolium . The ability of PMNs from 20 young (M age 34 years) individuals to kill S . aureus in vitro did not differ from cells from 18 elderly (M age 68 years) persons . Mean production of superoxide in response to stimulation with latex particles was, however, significantly lower (P less than .001) in cells from elderly adults . These results suggest a heterogeneity in any age-associated defect in PMN function . Several aspects of PMN function need to be evaluated in order to describe overall PMN function in the elderly. Arch Surg, 1982 Sep, 117(9), 1189 - 93 Primary and secondary healing in infected wounds . An experimental study; Johnson BW et al.; The beneficial effects of delayed closure of contaminated wounds are recognized, but not well defined . Rats with abdominal incisions were infected with Staphylococcus aureus or Escherichia coli and then subgrouped for primary or secondary healing . Noninfected rats served as controls . Between seven and 119 days later, the wounds were subjected to breaking-strength determination, hydroxyproline analysis, and light and scanning electron microscopy . In the controls, secondary closure gave stronger wounds than primary closure . In those infected with S aureus the wounds were stronger than in the primary-closure control group, regardless of the closure method . Of the E coli-infected wounds those primarily closed were weaker than those secondarily closed . Secondary closure gave infected wounds fewer complications . Biochemical and microscopic examination did not explain these findings. J Allergy Clin Immunol, 1982 Sep, 70(3), 191 - 8 A quantitative enzyme-linked immunosorbent assay for honeybee venom-specific immunoglobulin G; Reid MJ et al.; A quantitative enzyme-linked immunosorbent assay (ELISA) for honeybee venom-specific IgG is reported . This ELISA surmounts the problem of poor reproducibility due to nonparallelism of dilution curves in previously reported ELISAs . The assay is performed in polyvinyl "U" microtiter plates in which HBV is physically adsorbed to the wells . The antigen is sequentially overlaid with human serum albumin, unknown serum diluted in 10% normal goat serum (NGS), and peroxidase-labeled anti-human IgG in NGS . o-Phenylenediamine is used a substrate . The addition of stabilizing protein (NGS) is shown to be crucial in producing parallel dilution curves in this heterogeneous antigen-antibody system . Sensitivity is at or below 1 ng/ml . Coefficient of variation (using a midrange serum) is 12.1% for triplicate wells, 15.5% for sequential dilution, and 15.0% for six entirely separate assays . The assay correlates well with other methods, notably with the Staphylococcus aureus protein A solid-phase radioimmunoassay (r = 0.976). Acta Trop, 1982 Sep, 39(3), 225 - 36 Mechanism of destruction of Brugia malayi microfilariae in vitro: the role of antibody and leucocytes; Aiyar S et al.; Human and monkey leucocytes in serum from previously patent Brugia malayi infected monkeys adhered to and caused cytotoxicity to microfilariae of B . malayi in vitro . The phenomenon also occurred in human serum from confirmed cases of bancroftian and malayan elephantiasis . Adherence of leucocytes was not seen in serum from uninfected monkeys, monkeys with patent B . malayi infection and serum from rats infected with Breinlia booliati but now amicrofilaraemic . Immune serum failed to promote adherence of leucocytes to L3 of B . malayi . The activity was lost when the serum was either incubated with Protein A-bearing Staphylococcus aureus or heat inactivated at 56 degrees C for 30 min . Light and electron microscopic observations regarding the type of adhering cells and sequence of events following adherence are described. Biochim Biophys Acta, 1982 Aug 27, 717(3), 405 - 13 The purification and characterization of multiple forms of mouse submaxillary gland renin; Ho SC et al.; Five forms of renin, A0, A, C, D and E, from mouse submaxillary gland were purified by a two-step procedure including chromatography on the immunoaffinity column and CM-cellulose column . Four renin fractions, A0, A, C and E were purified to homogeneity by the criteria of polyacrylamide gel electrophoresis, analytical isoelectric focusing and Ouchterlony double immunodiffusion . All these forms of renin have molecular weights of 40 000 as determined by gel filtration on Sephadex G-100 column . No high molecular weight renin could be demonstrated . Individual renin fractions showed similar angiotensin I formation activity, 52-158 ng angiotensin I/ng protein per h . No other protease activity could be detected with hemoglobin or casein as substrate . These purified proteins showed a discrete pattern of migration under polyacrylamide gel electrophoresis . Under denaturing condition in SDS-gel electrophoresis, all but fraction D showed a protein band with a molecular weight of 30 000 . Fraction D showed a major component with molecular weight of 33 000 . The isoelectric points of these renin forms varied from 5.46 to 5.76 . They all reacted with antibody raised against renin A and showed similar pressor response activity with 20 ng quantities of the purified proteins . The closely related characteristics of these five forms of renin were further demonstrated by their similarity in peptide mapping patterns after limited digestion with Staphylococcus aureus V8 protease . The data suggest that these proteins are homologous proteins. J Immunol Methods, 1982 Aug 13, 52(3), 353 - 67 Immunospecific ferromagnetic iron-dextran reagents for the labeling and magnetic separation of cells; Molday RS et al.; Ferromagnetic iron dextran particles were prepared by reacting a mixture of ferrous chloride and ferric chloride with dextran polymers under alkaline conditions . Particles purified by gel filtration chromatography were in the size range of 30-40 nm, had an electron dense core of about 15 nm, were stable against aggregation in physiological buffer, showed little non-specific binding to cells and had a magnetic moment . Protein A from Staphylococcus aureus was covalently coupled to periodate-oxidized ferromagnetic iron-dextran particles . These conjugates were used to indirectly label antigen sites on human red blood cells and thymocytes for visualization by scanning and transmission electron microscopy . Cells labeled with these immunospecific ferromagnetic particles are were quantitatively retained by a simple permanent magnet and could be separated from unlabeled cells . Applications of these novel reagents in the separation of cells, cell membranes and receptors in drug targeting studies are discussed. Clin Chim Acta, 1982 Aug 4, 123(1-2), 127 - 38 A radioimmunoassay for total human cathepsin B; Recklies AD et al.; A radioimmunoassay for human cathepsin B is described, which demonstrates the usefulness of protein A-bearing Staphylococcus aureus as an immunosorb