J Immunol Methods, 1985 May 10, 79(1), 149 - 57 Detection of an antigen (MY4) common to M . tuberculosis and M . leprae by 'tandem' immunoassay; Praputpittaya K et al.; A novel 'tandem' immunoassay for the detection of mycobacterial antigen was devised using a monoclonal antibody (ML 34) both as solid phase 'capture' and as the 125I- or enzyme-labelled 'tracer' antibody . This antibody binds to the repeating epitopes (MY4b) of a water-soluble protease-resistant antigen from M . tuberculosis, M . leprae and some other species of mycobacteria . Optimal binding results could be obtained within 4 h by the consecutive incubation of ML34-coated microtitre plates with antigen followed by the labelled ML34 antibody . The binding of intact bacilli was positive for M . tuberculosis but not for M . leprae . These results suggested that the MY4 antigen is expressed on the surface of M . tuberculosis and internally within M . leprae . Analysis of subcellular fractions suggested that this antigen is a constituent of cell walls. Pediatr Infect Dis, 1985 May-Jun, 4(3), 270 - 3 Hepatotoxic reactions in children with severe tuberculosis treated with isoniazid-rifampin; Tsagaropoulou-Stinga H et al.; The incidence and degree of liver injury was prospectively evaluated in 44 children, ages between 4 months and 14 years (mean age, 4.5 years) treated for tuberculosis with 15 to 20 mg isoniazid/kg/day and 15 mg rifampin/kg/day (INH-RIF) . None of the patients had hepatic dysfunction before initiation of treatment . Elevation of the serum alanine aminotransferase (ALT) concentration (greater than 100 units) occurred in 36 patients (82%) . One patient with an increase in the ALT value had coincidental infection with hepatitis B . The incidence of hepatotoxicity did not correlate with the patients' age or sex . Fifteen of the 36 patients developed clinical hepatitis with jaundice . In 7 patients liver enlargement and prolongation of the prothrombin time were also observed . In all but one patient liver dysfunction was recognized 6 to 30 days (mean, 14 days) after start of treatment . Biochemical signs of hepatic injury in the 35 surviving patients regressed completely without alteration of the INH-RIF regimen in 22 patients . These facts suggest the possibility that hepatocellular damage may be due to the effect of tubercle bacilli products liberated in the liver after their destruction by antituberculous drugs . However, the high rate of hepatotoxic reactions warns that the dose of 10 mg INH/kg/day should not be exceeded when that drug is combined with RIF. J Appl Bacteriol, 1985 May, 58(5), 461 - 3 Search for acid-fast bacilli in bottled mineral waters; Caroli G et al.; Samples of bottled mineral water sold in Italy in accordance with the law on microbiological standards were examined for the presence of acid-fast bacilli . Eighty-four samples were tested, 11 with added carbon dioxide and 73 without . Acid-fast bacilli were found in 1 of the former samples and in 8 of the latter, a total of 10.7% . The mycobacterial count was always very low (2-3 cfu/litre) except for one sample which showed large numbers of Mycobacterium sphagni . This finding was not confirmed in two following samplings of the same water . The other acid-fast bacilli isolated were: M . gordonae (four strains), M . flavescens (one strain), M . phlei (one strain) and Nocardia sp . (two strains) in two samples of different water . These bacilli are not thought to be a normal component of the waters but are the result of incidental contamination . The risk of infection from drinking such waters can be regarded as irrelevant in hospitalized or immunologically compromised subjects who fact a greater risk when using tap water for drinking or washing. Cell Immunol, 1985 May, 92(2), 404 - 13 Effects of the methanol extraction residue (MER) tubercle bacillus fraction on the production of antibodies in vitro . III . Consequence of prior sensitization to MER; Halperin D et al.; Mice repeatedly immunized with the methanol extraction residue fraction of tubercle bacilli (MER) in incomplete Freund's adjuvant produced high titers of circulating antibodies against MER, as assessed by the enzyme-linked immunosorbent assay (ELISA) method . Spleen cells derived from these animals failed to respond to the usual nonspecific immunopotentiating influence of MER on the primary production of antibodies (generation of specific plaque-forming cells) in vitro to sheep red blood cells . The defect was expressed by B lymphocytes and splenic macrophages, but not by splenic T lymphocytes or peritoneal exudate macrophagic cells . Impaired responsiveness by spleen cells from MER-immunized animals to nonspecific immunostimulation was also expressed with regard to another, unrelated biological response modifier, lipopolysaccharide . There was no impairment of responsiveness to polyclonal mitogenic stimulation . Possible mechanisms of the effects described are discussed. Rev Infect Dis, 1985 May-Jun, 7(3), 434 - 40 Two errors in enteric epidemiology: the stories of Austin Flint and Max von Pettenkofer; Evans AS; The misconceptions of two physicians, Austin Flint and Max von Pettenkofer, in interpreting epidemiologic data on the water transmission of enteric disease are reviewed . Austin Flint failed to recognize the transmission of typhoid fever from well water in an epidemic he investigated in North Boston, New York, in 1843 . He later discovered and freely admitted his error . Max von Pettenkofer, who had studied cholera in the 1854 outbreak and in many subsequent outbreaks, failed to confirm John Snow's observations in England on the water transmission of cholera . Pettenkofer eventually swallowed live cholera bacilli and did not develop cholera . He remained convinced to the end of his life that cholera is not directly transmitted by drinking water. J Clin Microbiol, 1985 May, 21(5), 861 - 4 Alternate radiolabeled markers for detecting metabolic activity of Mycobacterium leprae residing in murine macrophages; Prasad HK et al.; This study demonstrated the utility of using 4% NaOH as a murine macrophage cell-solubilizing agent to discriminate between host macrophage metabolism and that of intracellular Mycobacterium leprae . A 4% concentration of NaOH had no deleterious effect on labeled mycobacteria . Thereby, alternate radiolabeled indicators of the metabolic activity of intracellular M . leprae could be experimented with . Significant incorporation of 14C-amino acid mixture, {14C}leucine, {14C}uridine, and carrier-free 32P was observed in cultures containing freshly extracted ("live") strains of M . leprae as compared with control cultures containing autoclaved bacilli. J Clin Microbiol, 1985 May, 21(5), 808 - 14 Intracellular multiplication of leprosy-derived mycobacteria in Schwann cells of dorsal root ganglion cultures; Mukherjee R et al.; Organized nerve cultures of dorsal root ganglia from neonatal mice were infected with Mycobacterium leprae, the causative agent of leprosy . A significant multiplication of the acid-fast bacilli was observed within the Schwann cell component of the culture . The growth of these bacilli was sensitive to antileprosy drugs and was not observed directly in bacteriological media . These organisms were brightly stained with the monoclonal antibody to phenolic glycolipid-I, a M . leprae-specific marker . The antigenic, pathogenic, and biochemical characteristics of this mycobacterium are under investigation. Antimicrob Agents Chemother, 1985 May, 27(5), 817 - 20 In vitro activity of cefbuperazone compared with that of other new beta-lactam agents against anaerobic gram-negative bacilli and contribution of beta-lactamase to resistance; Del Bene VE et al.; Cefbuperazone was compared with other currently available and investigational antibiotics against 278 clinical isolates of anaerobic gram-negative bacilli by an agar dilution method . Cefbuperazone and cefotetan were equally active against Bacteroides fragilis, with 8% of the organisms tested found to be resistant to 32 micrograms of either drug per ml . Cefoperazone, cefotaxime, ceftriaxone, and cefmetazole were less active against these strains; cefoxitin, moxalactam, piperacillin, clindamycin, and metronidazole were more active . None of the agents were consistently active against any of the other anaerobic gram-negative bacilli except imipenem, for which the minimum concentration required to inhibit 90% of all strains tested was 4 micrograms/ml . A 10,000-fold increase in inoculum size caused an increase in the MIC of ceftriaxone, cefotaxime, and cefoperazone but not of cefbuperazone, cefotetan, or cefoxitin . Investigation of the mechanism of resistance to cephalosporin-like agents demonstrated a correlation between the level of resistance and beta-lactamase activity . Cefbuperazone, cefotetan, and cefoxitin were not hydrolyzed, had lower MICs, and were less affected by changes in inoculum size than were cefotaxime, ceftriaxone, and cefoperazone. Acta Cytol, 1985 May-Jun, 29(3), 457 - 60 Role of fine needle aspiration biopsy in the diagnosis and management of malacoplakia; Akhtar M et al.; A case of malacoplakia of the colon and retroperitoneum is presented . The diagnosis was made by both endoscopic biopsy and fine needle aspiration biopsy (FNAB) . The response to therapy was monitored by sequential FNAB . The initial biopsy revealed large numbers of bacilli within the histiocytes; these bacilli were markedly reduced in number during successful therapy but reappeared in large numbers when the disease relapsed . It is suggested that FNAB may play a role in both the diagnosis and management of patients with malacoplakia. Arch Pathol Lab Med, 1985 May, 109(5), 433 - 6 Bile pancreatitis; Suda K et al.; Bile pancreatitis was studied both macropathologically and histopathologically in cases with an abnormal pancreatic choledochoductal junction, in which free communication between the pancreatic duct and the common bile duct occurred . The intraductal pressure of the pancreatic duct is normally higher than that of the bile duct, therefore, the pancreatic juice flows into the bile duct . In this study, we found squamous carcinoma cells from an adeno-squamous cell carcinoma of the gall-bladder in the main pancreatic duct . Hence, the possibility of bile reflux into the pancreatic duct was also considered . Outstanding findings, such as degeneration and disappearance of the pancreatic ductal epithelium, intraluminal aggregation of bacilli, and diffuse interlobular fibrosis were found in four of 15 cases with an abnormal junction . Similar ductal alterations and diffuse fibrosis were found neither in the controls nor in the remaining 11 cases . Therefore, it appears that pancreatic disorders due to the reflux of bile occurs in the presence of bacteria. Antimicrob Agents Chemother, 1985 May, 27(5), 739 - 44 Development of two DNA probes for differentiating the structural genes of subclasses I and II of the aminoglycoside-modifying enzyme 3'-aminoglycoside phosphotransferase; Young SA et al.; Two DNA probes were developed to screen for the genes encoding 3'-aminoglycoside phosphotransferase activity in gram-negative bacilli . The 3'-I phosphotransferase {APH(3')I} probe was subcloned from Tn903; the APH(3')II probe was subcloned from Tn5 . Each probe proved to be specific for genes corresponding to its own APH(3') subclass and did not hybridize with DNA from other classes when tested at high stringency by either Southern hybridization or dot-blot hybridization methods . The APH(3')I probe hybridized to DNA obtained from organisms demonstrating APH(3')I activity as measured by the phosphocellulose paper binding assay (PPBA) as well as to DNA from organisms reported to have both APH(3')I and APH(3')II activity by PPBA . This probe did not hybridize to DNA from organisms showing only APH(3')II activity by PPBA . The APH(3')II probe demonstrated homology with DNA from organisms showing APH(3')II activity by PPBA but not with DNA from organisms showing APH(3')I activity or both APH(3')I and APH(3')II activity by PPBA . We conclude that organisms previously believed to contain both APH(3')I and APH(3')II genes based on PPBA contain in fact only the APH(3')I gene. J Gen Microbiol, 1985 May, 131 ( Pt 5), 1001 - 13 Ultrastructure of bacilli and the bacillary origin of the macrophagic inclusions in Whipple's disease; Silva MT et al.; An electron microscopic and cytochemical study of the Whipple bacillus in jejunal biopsies from three untreated patients was made using fixation procedures developed for the satisfactory preservation of bacterial ultrastructure . The envelopes of the normal-looking bacilli present free in the lamina propria consisted of the following layers . (i) A cytoplasmic membrane with a triple-layered profile and a mean thickness (peak-to-peak distance) of 6.08 nm . (ii) A thick (20 nm) cell wall containing peptidoglycan; the wall had a hitherto undescribed inner layer that contained polysaccharides, possibly teichoic acids . (iii) Surrounding the cell wall, a surface membrane with a symmetric profile and a mean peak-to-peak distance of 4.74 nm . The ultrastructural pattern of the Whipple bacillus wall corresponds to that of Gram-positive bacteria, but with an additional surface membrane . This membrane is different from the outer membrane of Gram-negative bacteria because it has a symmetric profile, is thinner and has no periodic acid-Schiff (PAS)-positive components . Normal-looking bacilli were seen very rarely inside jejunal macrophages, but degenerating bacteria were abundant in these phagocytes . Electron microscopy and ultrastructural cytochemistry of Whipple bacilli inside jejunal macrophages of the three untreated patients showed that the degenerative process is a sequence that leads to the loss of bacillary forms and to the accumulation of bacterial remnants resistant to degradation by the macrophage . These remnants correspond to the innermost, polysaccharide-containing portion of the bacillus wall . The progressive accumulation of these PAS-positive wall remnants is the origin of the intramacrophagic inclusions that are important in the histological diagnosis of Whipple's disease . The reported results indicate that in the three patients studied, the Whipple bacillus multiplies extracellularly, the bacteria that are phagocytosed by macrophages being degraded. S Afr Med J, 1985 Apr 13, 67(15), 603 - 4 Intra-ocular tuberculosis associated with a penetrating injury . A case report; Murray RI et al.; A case of histologically proven intra-ocular tuberculosis is described . The condition was preceded by penetrating trauma, and no evidence of systemic tuberculosis other than a positive Mantoux test was found . Numerous acid-fast bacilli were seen in pathological sections of the eye . We suspect that a tuberculosis bacillaemia from an undetected healed focus coincided with the trauma and thereby produced intra-ocular tuberculosis. J Biol Chem, 1985 Apr 10, 260(7), 4055 - 8 Presence of a nonmetabolizable solute that is translocated with Na+ enhances Na+-dependent pH homeostasis in an alkalophilic Bacillus; Krulwich TA et al.; The presence of a nonmetabolizable solute whose uptake is coupled to the inward translocation of Na+ has been found to enhance Na+-dependent pH homeostasis and survival of an obligately alkalophilic bacterium . Upon shift of cells of Bacillus firmus RAB from growth medium to buffers at pH 10.5, viability and maintenance of a relatively acidified cytoplasm depended upon the presence of Na+ and was augmented by the inclusion of alpha-aminoisobutyric acid in the buffer . Similarly, when cells were first equilibrated at pH 8.5 and then shifted to buffer at pH 10.5, an extraordinary capacity to maintain a relatively low pHin was exhibited, but only in the presence of Na+ . In this protocol, the inclusion of alpha-aminoisobutyric acid actually resulted in an early overshoot of proton influx and also rendered a suboptimal concentration of Na+ efficacious in pH homeostasis . When a protonophoric uncoupler was added to the equilibration and shift buffers, Na+-dependent acidification of the interior was inhibited at early time points . The results support the conclusion drawn from earlier work that a Na+/H+ antiporter plays a critical role in pH homeostasis in the obligately alkalophilic bacilli . Moreover, the current findings indicate that the Na+/solute symporters are a physiologically functional pathway for completing the sodium cycle that controls pHin. Indian J Lepr, 1985 Apr-Jun, 57(2), 399 - 403 Chest infection due to M . fortuitum in a case of lepromatous leprosy--a case report; Katoch K et al.; Lepromatous leprosy cases may be immunocompromised due to the extensive disease and also because of steroid therapy for repeated reactions . Such patients are likely to be at higher risk for getting opportunistic infection due to various environmental microbes . This paper reports a case of lepromatous leprosy with repeated lepra reaction who was found to have chest infection due to M . fortuitum . It is suggested that mycobacterial culture and sensitivity should be recommended in cases who are immunocompromised and whose pathological specimens contain acid fast bacilli . Species identification and sensitivity can be very helpful in proper management of such cases who will otherwise pass off as tuberculosis. Br J Dermatol, 1985 Apr, 112(4), 405 - 13 Foot infection in coal miners: a reassessment; Hope YM et al.; Foot infection has been studied in 514 coal miners: 70% of men had some evidence of infection but dermatophyte fungi accounted for only one-third of those affected; Gram-negative bacilli accounted for much of the remaining pathology . Itching and cracking were more severe in those with dermatophytes than in those with Gram-negative bacilli . Duration of service in the industry correlated with increasing dermatophyte infection, but not with bacillary infection . Wetness of the feet predisposed to bacillary infection but not to dermatophyte infection . There was no evidence of an association of atopy with either form of infection. Am J Clin Pathol, 1985 Apr, 83(4), 463 - 8 The bone marrow in disseminated Mycobacterium avium-intracellulare infection; Farhi DC et al.; Thirteen cases of disseminated Mycobacterium avium-intracellulare (MAI), representing a total of 27 bone marrow specimens, were studied . The patients ranged from 25 to 46 years of age and included ten immunocompromised and three immunocompetent hosts . Peripheral blood findings included anemia in all patients, leukopenia in 73%, thrombocytopenia in 45%, and pancytopenia in 45% . Fourteen of the specimens (52%) showed granulomas ranging from small, subtle lymphohistiocytic aggregates to larger lymphohistiocytic lesions and clusters of epithelioid histiocytes; almost half of these lesions were missed initially . Rare acid-fast bacilli were seen in only one case, but 53% grew MAI on culture . In one case of the acquired immunodeficiency syndrome, culture was positive in the absence of inflammation or AFB on staining . These findings are not significantly different from those reported in disseminated Mycobacterium tuberculosis infection. J Bacteriol, 1985 Apr, 162(1), 434 - 7 Heat shock proteins in bacilli; Streips UN et al.; Five strains of bacilli, including a nonsporulating strain, when heat shocked, accelerated the synthesis of a specific subset of proteins . The major heat shock protein in all bacilli had a molecular weight of 66,000 . The response persisted for at least 40 min and could be eliminated upon a shift down to 37 degrees C. J Gen Microbiol, 1985 Apr, 131 ( Pt 4), 919 - 26 Genetic analysis of fusion recombinants and presence of noncomplementing diploids in Bacillus megaterium; Fleischer ER et al.; We have attempted to undertake genetic analysis in Bacillus megaterium using the technique of protoplast fusion that has been successfully applied in Staphylococcus and Streptomyces . Efficient production of protoplasts, fusion and regeneration techniques have been established . However, variability in numbers and types of recombinants using two-, three-, and four-factor crosses was observed throughout these studies . No linkages were detected, even between loci known to be linked by cotransduction with bacteriophage MP13 . These results were similar to those reported by Alfoldi and coworkers using B . megaterium strain 216, even though the experimental design was significantly changed . During initial subculturing, segregants were observed in a 1:2:2 ratio of noncomplementing diploids:parental-1:parental-2 . The ratio changed dramatically after seven subcultures . Double recombinants appeared after nine subcultures . These results corroborate those reported in B . subtilis and suggest that there is a locus-inactivation phenomenon present in Bacillus which is not evident in Streptomyces or Staphylococcus . Until the mechanism is elucidated, protoplast fusion should not be used for chromosomal mapping in B . megaterium . However, it can be used to transfer plasmids among the bacilli at a frequency of 10(-5)-10(-6) per regenerated protoplast. J Clin Microbiol, 1985 Apr, 21(4), 565 - 8 Radiometric selective inhibition tests for differentiation of Mycobacterium tuberculosis, Mycobacterium bovis, and other mycobacteria; Gross WM et al.; In the context of a busy reference laboratory, radiometric selective inhibition tests were evaluated for rapid differentiation of Mycobacterium tuberculosis and Mycobacterium bovis and of the M . tuberculosis complex from other mycobacteria . p-Nitro-alpha-acetylamino-beta-hydroxypropiophenone at 5 micrograms and hydroxylamine hydrochloride at 62.5 and 125 micrograms per ml of 7H12 medium were used to separate the M . tuberculosis complex from other mycobacteria (MOTT bacilli) . Since it is important epidemiologically to distinguish M . tuberculosis from M . bovis, susceptibility to 1 microgram of thiophene-2-carboxylic acid per ml was also determined radiometrically . By using these three agents as selective inhibitors, M . tuberculosis, M . bovis, and MOTT bacilli were differentiated with a high degree of specificity by a BACTEC radiometric procedure . Results of tests performed on clinical isolates submitted on solid medium to our reference laboratory were available within 5 days. Antimicrob Agents Chemother, 1985 Apr, 27(4), 672 - 3 Comparison of a beta-lactamase induction test with a test that detects low-frequency resistance to cefotaxime; Menzies RE et al.; A paper strip test that detects cefotaxime-resistant variants of gram-negative bacilli was described and compared with a beta-lactamase induction test . Both tests demonstrated a potential for resistance that is not indicated by standard agar dilution and agar diffusion tests. J Antimicrob Chemother, 1985 Mar, 15(3), 283 - 9 Evaluation of the resistance mechanisms of gentamicin-resistant Gram-negative bacilli and their susceptibility to tobramycin, netilmicin and amikacin; Maes P; Two hundred and fifty-three gentamicin-resistant Gram-negative bacilli, isolated from clinical material, were tested for sensitivity to tobramycin, netilmicin and amikacin . Amikacin was effective at 16 mg/l in 90% of cases, whereas there was no difference between netilmicin and tobramycin activity; 13.3% of strains were susceptible to 8 mg/l netilmicin, and 14.8% of strains to 4 mg/l tobramycin . The lack of difference in results between tobramycin and netilmicin is explained by local enzyme patterns . In our population, the AAC(3)II is predominant, and inactivates gentamicin, tobramycin and netilmicin, in contrast to the U.S.A . where ANT (2") seems to be the most common enzyme. Med Clin North Am, 1985 Mar, 69(2), 315 - 31 Tuberculous meningitis; Molavi A et al.; Tuberculous meningitis arises from the discharge of bacilli from a subjacent caseous focus into the subarachnoid space . Meningeal involvement is most marked at the base of the brain . The clinical spectrum is very broad and the outcome of therapy depends mainly on the stage of disease at the time treatment is instituted. Tubercle, 1985 Mar, 66(1), 1 - 7 Supervised intermittent chemotherapy for pulmonary tuberculosis in a rural area of China; Kan GQ et al.; In order to ensure regularity of ambulatory treatment of new cases of pulmonary tuberculosis, a fully supervised intermittent chemotherapy regimen was tried in two rural counties of Beijing . The bare-foot doctors of the village health co-operatives were designated to administer and supervise treatment . The regimen consisted of isoniazid and streptomycin daily for 1 month, then every 3 days for 5 months and then every 5 days for a total of 12 or 18 months . For smear-negative cases the daily phase was omitted . The compliance rate among 229 patients in 1 year was 99.4% . The sputum conversion rate among 104 cases harbouring sensitive bacilli was 95.2% . Discontinuation of the regimen due to side-effects as necessary in 3 cases (1.3%) . Since 1979, this treatment programme has been adopted in the whole rural area of Beijing, and the coverage rate among newly diagnosed smear-positive cases in 1983 reached 90% . A reserve regimen consisting of rifampicin and ethambutol for patients who do not convert their sputum after 6 months of treatment with isoniazid and streptomycin was added . The overall conversion rate achieved in 1981 was 97.8% . The average overall cost of drugs for each patient treated in this treatment programme was 49 yuan (RMB), about $24.00 U.S. Br J Ophthalmol, 1985 Mar, 69(3), 187 - 8 Capnocytophaga keratitis; Roussel TJ et al.; We report two cases of bacterial keratitis caused by Capnocytophaga, a genus of capnophilic Gram negative bacilli . Both responded to topical and subconjunctival clindamycin. Infect Immun, 1985 Mar, 47(3), 793 - 8 Increased translocation of bacteria from the gastrointestinal tracts of tumor-bearing mice; Penn RL et al.; Aerobic gram-negative bacilli and other indigenous gastrointestinal (GI) bacteria are important opportunistic pathogens in immunosuppressed cancer patients . These same bacteria frequently translocate from the GI tracts of mice immunosuppressed by single injections of certain anticancer drugs or by T-lymphocyte impairments . Since similar cellular and humoral immune deficiencies may be present in the tumor-bearing host, we sought to determine if progressive growth of a tumor alone would be sufficient to enhance the translocation of indigenous bacteria from the murine GI tract . Pathogen-free DBA/2 mice were injected intraperitoneally with 10(6) viable sarcoma 180 (S-180) cells or 0.5 ml of sterile buffer . Mesenteric lymph nodes, livers, spleens, and kidneys were tested for the presence of translocated aerobic GI bacteria on various days after tumor injection . Immunity was assessed by measuring footpad delayed-type hypersensitivity and serum hemagglutinins to sheep erythrocytes . Overall, translocated aerobic GI bacteria infected 33 of 92 S-180-bearing mice (36%) and only 9 of 99 control mice (9%) (P less than 10(-6)) . Cumulatively, 50 of 460 sites (10.9%) in S-180-bearing mice were infected with translocated GI bacteria as opposed to only 9 of 485 sites (1.9%) in control animals (P less than 10(-7)) . GI bacteria often translocated to infect more than one site in tumor-bearing mice, but not in controls . Aerobic gram-negative bacilli translocated 11 times in tumor-bearing mice, but only once in controls, even though the mean cecal population levels of these bacteria were relatively low (range, 4.33 to 5.28 log10 bacteria per g) . The population levels of cecal aerobic bacteria were similar in S-180 and control mice throughout the period of observation . S-180 mice had significantly suppressed (P less than 0.04) delayed-type hypersensitivity and serum hemagglutinin responses when sensitized 4 or 8 days after S-180 injection . S-180 growth was associated with a neutrophilic leukocytosis and a slight drop in platelet counts; no bleeding was detected . Thus, the translocation of gram-negative bacilli and other indigenous aerobic bacteria from the GI tract to the mesenteric lymph nodes and other organs was increased in immunosuppressed S-180-bearing mice, and this increase was not caused by bacterial overgrowth in the intestines or by neutropenia. Jpn J Antibiot, 1985 Mar, 38(3), 595 - 614 {Clinical evaluation of TMS-19-Q, a new macrolide antibiotic, in otorhinolaryngological infections}; Baba S et al.; The clinical study for TMS-19-Q.O tablet was performed with multicenter trial . The results obtained were as follows; Final global improvement rating in 332 cases of otorhinolaryngological infections were excellent in 99, good in 142, fair in 40 and poor in 51 and the effective rate was 72.6% . Those of 266 cases with acute infection were excellent in 93 and good in 121 and the effective rate was 80.5% . Optimum daily doses would be 600 mg based on the analysis of 144 cases of the acute infection with sensitive bacteria (MIC: less than or equal to 3.13 micrograms/ml) . In acute infection, major causative bacteria were Gram-positive cocci (GPC) indicating the frequency of 72.0% in total isolates and 87.5% in singly isolated cases . In chronic infection, although GPC were also dominant, Gram-negative bacilli were observed in 31.9% . Clinical and bacteriological effective rates of 160 cases of acute infection with single species were 80.6% and 90.3%, and those of 43 cases in chronic infection were 44.2% and 72.7%, respectively . The resistant rates of isolates in acute infection to TMS-19-Q were 13.3% in S . aureus, 7.7% in S . epidermidis, 6.0% in S . pyogenes and 0% in S . pneumoniae . Those in chronic infection were 20.0% in S . aureus and 25.0% in S . epidermidis . Slight adverse reactions, such as skin eruption or gastrointestinal disorders were observed in 14 cases and no severe one was observed . Slight elevation of GOT, GPT, Al-P, BUN, S-Cr . or eosinophil were observed in 12 cases . These results suggest that TMS-19-Q would be useful antibiotic for otorhinolaryngological infections. Clin Lab Med, 1985 Mar, 5(1), 91 - 7 Instruments for microbial identification; Kelly MT; Microbiology instruments can provide rapid and accurate identification of gram-negative bacilli . The three instruments currently in widespread use vary in accuracy of identification, types of organisms identified, speed of identification, cost, and degree of automation . If matched to the needs of individual laboratories, microbiology instruments can enhance the quality and efficiency of bacterial identification. Rev Infect Dis, 1985 Mar-Apr, 7(2), 257 - 71 Intestinal perforation in typhoid fever: a historical and state-of-the-art review; Bitar R et al.; The appropriate therapy for intestinal perforation in typhoid fever has been controversial since the late 1880s . Around the turn of the century, surgery became the established mode of therapy, with a mortality of 69% based on 166 patients in the English-language medical literature, and continued to be the preferred treatment until the advent of chloramphenicol in 1948 . At this time the surgical mortality was approximately 50% . Following the recovery of a few patients with perforation treated only with antimicrobial agents (six initially, then eventually 22), nonsurgical therapy became the accepted mode of treatment . This change was never justified and this review demonstrates this . Appropriate therapy is virtually always surgical, usually consisting of simple closure and irrigation . Chloramphenicol alone is inadequate antimicrobial therapy in a patient with perforation and must be supplemented by other antimicrobials directed against enteric aerobic gram-negative bacilli and enteric anaerobes. Int J Lepr Other Mycobact Dis, 1985 Mar, 53(1), 75 - 8 Electron microscopic findings of the peripheral nerve lesions of nude mice inoculated with M . leprae; Fukunishi Y; Peripheral nerve lesions of nude mice inoculated with Mycobacterium leprae were examined from 1 year to 1 year and 8 months post-inoculation . Leprosy bacilli and intracytoplasmic foamy structures were found in the perineurial cells, endothelial cells of capillaries, Schwann cells, and axons of the myelinated nerve fibers inside the lepromas of foot pads . In the proximal portion of the sciatic nerve, bacilli were found chiefly in the macrophages of the endoneurial space . Bacilli were not found in the perineurial cells of the sciatic nerves . Marked fibrosis, hypertrophy or degeneration of Schwann cells, demyelination, axonal damage or irreversible destruction of nerve architecture were not observed clearly . Therefore, it is thought that nude mice inoculated with M . leprae are suitable models for the study of the early peripheral nerve lesions of lepromatous leprosy. Int J Lepr Other Mycobact Dis, 1985 Mar, 53(1), 52 - 5 Survival of Mycobacterium lepraemurium in vitro for thirty years by lyophilization; Nakamura M; It was demonstrated that the virulence of Mycobacterium lepraemurium could be maintained in vitro for 30 years when the bacilli from the infected subcutaneous mouse tissue were suspended in 10% bovine serum-water, frozen, dried, and stored in a refrigerator . However, it was noted that a complete loss of virulence occurred when the bacilli were suspended in saline . Thus, the selection of the suspending solution is of the utmost importance in maintaining bacterial virulence by lyophilization. Cell Immunol, 1985 Mar, 91(1), 1 - 11 Strain variation of lymphokine production and specific antibody secretion in mice infected with Mycobacterium lepraemurium; Hoffenbach A et al.; Mice from strains showing either phenotypical expression of Bcg gene (C57BL/6, BALB/c, DBA/1, and (C57BL/6 X DBA/2)/F1, CBA, A/J, DBA/2) were infected intravenously with 10(7) Mycobacterium lepraemurium (MLM) . The number of acid-fast bacilli (AFB) within the spleens, the ability of spleen cells to produce in vitro interleukin 1 and 2, and the serum levels of specific anti-MLM antibodies were assessed 3 months later . The number of AFB recovered from the spleens of various strains followed the strain distribution of genetically controlled innate resistance established for Mycobacterium bovis infection . A decrease of interleukin 2 production by spleen cells could be detected in C57BL/6, DBA/1, DBA/2 and (C57BL/6 X DBA/2)F1 mice only . The level of anti-MLM antibodies was found to be higher in C57BL/6, BALB/c and A/J mice than in the other strains tested . Thus no evidence appeared of a direct influence of the Bcg gene on lymphokine production and antibody secretion. Am Rev Respir Dis, 1985 Mar, 131(3), 352 - 6 Therapeutic effect of a new antibacterial substance ofloxacin (DL8280) on pulmonary tuberculosis; Tsukamura M et al.; A new antibacterial substance, ofloxacin (DL8280), was used in the treatment of pulmonary tuberculosis . The agent was given to 19 patients with chronic cavitary lung tuberculosis as single doses of 300 mg daily for 6 to 8 months . A decrease in the amount of tubercle bacilli in the sputum was observed in almost all patients, and negative conversion occurred in 5 . Resistance of tubercle bacilli to the agent appeared in patients who did not show negative conversion . No side effects were observed during the administration period . The agent was considered useful in lung tuberculosis therapy. Acta Cytol, 1985 Mar-Apr, 29(2), 101 - 7 Abrasive bronchial brushing cytology . A preliminary study of 200 specimens for the diagnosis of neoplastic and nonneoplastic bronchopulmonary lesions; Shroff CP; Two hundred subjects with chronic respiratory symptoms with a suspicion of malignancy were selected for bronchial brushing cytology . Prior sputum examination had shown malignant squamous cells in two cases only . The cytologic appearances of the brushing smears were divided into five categories: 41 (20.5%) smears with positively malignant cells; 20 (10%) smears predominantly showing chronic inflammatory features; 31 (15.5%) smears with mainly acute inflammatory changes; 60 (30%) smears with normal cytologic features; and 48 (24%) smears unsatisfactory for cytologic interpretation . Thirteen patients with a positive cytology had a positive tissue biopsy for malignancy . Among the group with chronic inflammatory changes, acid-fast bacilli were identified in nine cases, and one smear showed frank tuberculous granuloma . In the unsatisfactory group, two cases showed malignant cells in the postbrushing sputum . There was one false-negative report for malignancy in the entire study . This study confirms the sensitivity and accuracy of bronchial brushing cytology in the diagnosis of various bronchopulmonary lesions, especially malignancy and pulmonary tuberculosis, in India. J Infect Dis, 1985 Mar, 151(3), 399 - 406 Microbial resistance to newer generation beta-lactam antibiotics: clinical and laboratory implications; Sanders CC et al.; Certain nonfastidious, gram-negative bacilli possess the ability to rapidly develop resistance to many of the newer "enzyme stable" beta-lactam antibiotics . This finding poses many clinical problems including emergence of resistance during therapy with the drugs . Therapeutic alternatives for patients are severely limited when this problem occurs because multiple drug resistance may arise simultaneously . To date, two mechanisms have been found to be responsible for this resistance . The first, which produces multiple beta-lactam resistance, is the induction of chromosomal beta-lactamases that mediate resistance to nonsubstrate drugs by the creation of a nonhydrolytic barrier that blocks access to target proteins within the cell . The second mechanism, which produces beta-lactam/aminoglycoside resistance, involves a change in outer membrane permeability . Outbreaks of nosocomial infections with these multiple drug-resistant organisms and spread of the strains throughout the hospital are already being seen . Control of these problems can only be achieved through the judicious and restricted use of these new antibiotics. J Lab Clin Med, 1985 Mar, 105(3), 359 - 67 Testicular lesions in Whipple's disease; James TN et al.; In two patients with Whipple's disease a variety of abnormalities were found in the testis . In both there was a thickened tunica albuginea containing macrophages filled with Schiff-positive bacilli, and both exhibited Whipple bacilli alone or in small clumps within the tunica media of the testicular arteries . One patient had focal inflammatory lesions among the Leydig cells . The most prominent abnormality in each was the abundance of Whipple bacilli within the epithelium of the seminiferous tubules . Some of these bacilli (which were free rather than within macrophages) appeared to be being shed into the tubular lumen; there was no associated inflammation . In some areas macrophages filled with bacilli appeared to migrate from the arterial adventitia toward the seminiferous tubules . Potential significance of these findings is discussed relative to a variety of testicular and prostatic diseases, as well as the possible (and arguable) relationship to the acquired immune deficiency syndrome. Am J Med, 1985 Feb 8, 78(2A), 42 - 3 Efficacy and safety of aztreonam versus tobramycin for aerobic gram-negative bacilli lower respiratory tract infections; Rodriguez JR et al.; Aztreonam therapy was evaluated for the management of 80 patients with gram-negative bacilli lower respiratory tract infections . Study results confirmed its efficacy and safety for this indication. Am J Med, 1985 Feb 8, 78(2A), 65 - 76 Antimicrobial combinations in the therapy of infections due to gram-negative bacilli; Allan JD et al.; Antimicrobial combinations are used most frequently to provide broad-spectrum coverage; however, they are also frequently employed to enhance antimicrobial activity (synergism) . Although there is extensive in vitro documentation of synergism for many antibiotic combinations, a clear advantage for these combinations has been difficult to demonstrate in clinical studies . Several types of combinations have been useful in clinical medicine and frequently result in synergism . These include combinations of a cell wall-active agent with an aminoglycosidic aminocyclitol, combinations of a beta-lactamase inhibitor with a beta-lactam, and combinations of agents that inhibit sequential steps in a metabolic pathway . Given its spectrum of activity, aztreonam will often be used with clindamycin or a beta-lactam antibiotic . Combinations of beta-lactams may be synergistic via several mechanisms . However, these combinations also exhibit significant potential for antagonism when used against gram-negative bacilli and, therefore, require careful evaluation prior to clinical use. J Parasitol, 1985 Feb, 71(1), 89 - 95 Bacterial endosymbionts of Acanthamoeba sp; Hall J et al.; Gimenez staining of presumably axenic Acanthamoeba sp., strain HN-3, showed rod-shaped cytoplasmic inclusions . Electron microscopy of thin sections of the amebae showed these to be bacilli which measured 1.3 to 3.3 microns by 0.22 to 0.33 micron . Their cell envelopes were those typical of gram-negative bacteria, surrounded by an electron-translucent area that stains with ruthenium red, suggesting the presence of a capsule . The bacilli grew and reproduced in the cytoplasm of both trophozoites and cysts of Acanthamoeba sp . There was no evidence of a surrounding phagosomal or phagolysosomal membrane . They were retained by the ameba both during encystment and excystment . All attempts to isolate the endosymbionts in embryonated eggs and/or standard bacteriological media failed; and they persisted within the amebae for 1 to 6 mo despite temperature shocking or constant treatment of cultures with penicillin, streptomycin, chloramphenicol, tetracycline, erythromycin, polymyxin B, ampicillin, isoniazid, rifampicin, or gentamycin at concentrations of 10(-5) to 10(-3) M. Br J Exp Pathol, 1985 Feb, 66(1), 109 - 22 Lysozyme as a measure of cellular dynamics in the lesions of leprosy; Ridley MJ et al.; The levels and distribution of lysozyme-positive cells and exudate were studied in leprosy lesions through the spectrum, in untreated and treated patients, in relapse and in reactions . Altogether 124 skin biopsies were examined by the immunoperoxidase technique . Monocytes, neutrophil-polymorphs and mast cells were the most conspicuous cells seen . Lysozyme proved to be a useful means of indexing renewal of these cells in the lesions . Peak numbers of monocytes were seen in lesions of active lepromatous leprosy (LL) and of tuberculoid leprosy (TT), at poles of opposite immunological performance . In TT the stimulus for recruitment was delayed hypersensitivity (DH) . A decline in DH from TT towards the middle of the spectrum, mid-borderline, was accompanied by a fall in monocyte level . Furthermore, reacting lesions due to enhanced DH also had increased numbers of monocytes . On the other hand reactions associated with immunological deterioration were similar to active lepromatous leprosy (LL) and monocyte influx was raised in response to the stimulus of free multiplication of bacilli in both cases . In TT delayed hypersensitivity acted also to promote the rapid transformation of monocytes to epithelioid and giant cells all of which were strongly positive for lysozyme . This was in contrast to much lower levels in histologically similar macrophage-epithelioid cells of BT granulomas . Lysozyme synthesis was not seen in macrophages after ingestion of M . leprae . Early foamy change was made conspicuous by lysozyme deposited in phagocytic vacuoles, but old foam cells in regressing lepromas were negative . Lysozyme bound to dead extracellular M . leprae but not to viable or intracellular organisms . Dead bacilli or immune complexes appeared to be the stimulus for neutrophil-polymorph recruitment, mainly in reactions. J Hyg (Lond), 1985 Feb, 94(1), 9 - 21 Subdivision of Mycobacterium tuberculosis for epidemiological purposes: a seven year study of the "Classical' and 'Asian' types of the human tubercle bacillus in South-East England; Grange JM et al.; Human strains of Mycobacterium tuberculosis were divided into the 'Classical' and 'Asian' types according to their sensitivity to thiophen-2-carboxylic acid hydrazide . The isolation of these two types in South-East England was studied during a seven-year period (1977-1983) . The 'Asian' type was more prevalent among ethnic Asian patients than among ethnic Europeans . Among Europeans there was a decline in the isolation rate of 'Classical' strains and a small but significant increase in 'Asian' strains during the study period, so that the proportion of the latter type in this group is increasing . The type of bacillus was unrelated to the site of isolation except that the incidence of lymphadenitis due to the 'Asian' type among European females was significantly higher than expected . In general, European patients tended to be older than Asian patients, and the differences in age distribution according to site of isolation and type of bacillus in each ethnic group were small . A notable exception occurred with European females infected with the 'Asian' type, whose age distribution was similar to the Asians . In view of the differences in behaviour of the two types of human tubercle bacilli in this country there is a need to continue a bacteriological surveillance and also to determine whether the nature of the host-pathogen interaction varies according to the type of bacillus. Am J Pathol, 1985 Feb, 118(2), 238 - 47 Role of cord factor in the modulation of infection caused by mycobacteria; Silva CL et al.; The subcutaneous, intradermal, and pulmonary inflammatory lesions induced in mice by viable Mycobacterium bovis (BCG) with no glycolipid cord factor (CF) on the outer cell wall (delipidated BCG, dBCG) was drastically different from that induced by inoculation with intact bacteria . The reaction caused by dBCG was of an acute nature: the cells making up the inflammatory infiltrate exhibited polymorphonuclear-like (PMNs) morphologic characteristics, there was a decrease on delayed hypersensitivity response, and the lesion was resolved around the 16th day after inoculation . Complete disappearance of viable organisms from the lungs, liver, and spleen of these animals occurred in parallel with the dissipation of the dBCG-induced inflammatory infiltrate, showing that CF plays an important role in the host-parasite relationship that takes place in infections caused by mycobacteria . In addition, when deprived of this glycolipid component, bacilli lose their immunostimulant ability. Infect Immun, 1985 Feb, 47(2), 472 - 9 Isolation, propagation, and characterization of a newly recognized pathogen, cilia-associated respiratory bacillus of rats, an etiological agent of chronic respiratory disease; Ganaway JR et al.; A Gram-negative, filamentous, rod-shaped bacillus which failed to grow in cell-free media was isolated in apparently pure culture from the bronchial scraping and washing of a laboratory rat suffering from chronic respiratory disease by inoculating embryonated chicken eggs via the allantoic route . None of the embryos died during 20 serial passages at weekly intervals . The bacillus was reisolated in embryonated eggs from cesarean-derived barrier-maintained N:SD(SD) rats 8 and 12 weeks after intranasal inoculation with 10th-passage allantoic fluid . The inoculated rats were housed in Horsfall-type units and remained free from other known respiratory pathogens, including mycoplasmas and murine viruses, throughout the study . The bacillus colonized the ciliated epithelial cells of the respiratory tract and caused a marked peribronchial infiltration and hyperplasia of mononuclear cells which progressed with time . The bacillus, ca . 0.2 micron wide by 4 to 6 micron long, stained very poorly with basic aniline dyes but was readily demonstrated with the Warthin-Starry silver technique . It was heat labile (56 degrees C for 30 min); spore forms were not observed . It withstood freeze-thawing and was successfully stored at -70 degrees C . Although no visible means of locomotion was observed with the electron microscope, a slow gliding motility, sometimes with bending and flexing of bacilli apparently adherent to the glass surface, was observed with phase microscopy . As an etiological agent of chronic respiratory disease of rats, this cilia-associated respiratory bacillus (tentatively designated the CAR bacillus) may be the first recognized gliding bacterium known to cause disease in a warm-blooded vertebrate. S Afr Med J, 1985 Jan 26, 67(4), 126 - 9 Guinea-pig inoculation and culture for Mycobacterium tuberculosis in infertile women . A study of cost-effectiveness; Seaward PG et al.; Endometrial biopsy (EB) specimens obtained from infertile women at Natalspruit Hospital are routinely subjected to histological examination, culture for tubercle bacilli and guinea-pig inoculation (GPI) . A retrospective analysis of 103 EB specimens from Natalspruit Hospital and 255 specimens from private patients (in the Greater Johannesburg area) examined during January 1981 - August 1983 revealed a 1,96% overall incidence of endometrial tuberculosis (TB) . The incidence of endometrial TB in infertile Black women attending Natalspruit Hospital during this period was 4,85% . Confirmed cases of endometrial TB yielded positive cultures in 57% of cases; GPIs were positive in 71% of cases and histological findings were positive in 42% of cases . Statistical comparison of culture and GPI was difficult because of the small number of cases involved . Cost analysis of culture and GPI suggested that culture of EB specimens as a routine screening procedure for infertile patients is more cost-effective and that GPI tests should be reserved for cases in which TB is highly probable . The literature on symptoms, pathology and diagnostic investigation of pelvic TB is briefly reviewed. Prog Clin Biol Res, 1985, 189, 405 - 17 Validity of the endotoxin assay in post surgical patients; Buller HR et al.; In a prospective study 56 patients were studied after major surgery for 10 days to correlate endotoxemia with bacteremia and clinical septicemia . Endotoxemia was detected with a quantitative plasma endotoxin assay using limulus lysate and a chromogenic substrate . Clinical septicemia was defined using a set of predetermined criteria . In 29 patients both bacterial cultures and endotoxin assays were negative . One patient showed clinical signs of septicemia . In 14 patients, low grade endotoxemia (mean 47 +/- 15 pg/ml) was observed in the first three days after surgery . Only three of these patients also showed positive endotoxin tests after this period . Corresponding blood cultures were frequently negative (81%) most likely due to prior and concurrent antibiotic prophylaxis . Two endotoxin positive patients had clinical signs of septicemia . In a total of 16 patients, including two patients from the former group endotoxemia (mean 56 +/- 21 pg/ml) was noted beyond the third post-operative day . Samples for blood cultures collected simultaneously were positive for gram negative bacilli in six patients . Clinical septicemia was present in 12 of the 16 patients . The positive and negative predictive value of the endotoxin test for bacteremia and/or septicemia after the third day of surgery for all patients was found to be 75% and 98% respectively . The results of this small prospective study in surgical patients suggest that this rapid endotoxin test is a useful clinical adjunct for both the detection and exclusion of gram negative bacteremia/septicemia. Digestion, 1985, 32(2), 145 - 8 Tuberculous oesophagopulmonary communication: effectiveness of antituberculous chemotherapy . A case report and review of literature; Bashi SA et al.; A patient with tuberculous oesophagopulmonary communication diagnosed by oesophagography and confirmed by endoscopy was successfully treated by medical means: a tuberculous aetiology was suggested by the detection of tubercle bacilli in the gastric washings and on culture . On reviewing the medical literature, successful results were reported in 3 adults and 2 children. Folia Histochem Cytobiol, 1985, 23(1-2), 3 - 10 The role of the BCG dose and the mouse strain in the inhibition of development of neoplasms susceptible and nonsusceptible to the action of natural cytotoxic cells; Skorski T; The susceptibility of Ehrlich Ascites Carcinoma (EAC) cells to the action of natural cytotoxic cells of DBA/2 and Balb/c mice in vitro was established . Leukaemia L 1210 cells proved insensitive to the in vitro action of natural cytotoxic cells of DBA/2 mice, but not to those of Balb/c ones . BCG, one of the inductors of cytotoxic NK cells, when administered to DBA/2 or Balb/c mice before introduction of EAC cells inhibited the growth of this tumour but did not retard the development of leukaemia L 1210 in DBA/2 mice . The change in the number of peritoneal exsudate cells (PEC) in DBA/2 mice after intraperitoneal injection of BCG was demonstrated to be dependent on the dose and the time elapsed after bacilli introduction . The antitumour action of BCG does not depend on changes in the number of PEC caused by the bacilli . Both large (3.0 mg) and small (0.02 mg) doses of BCG inhibit the development of EAC in Balb/c mice ("sensitive" to BCG), notwithstanding the time of administration of the bacilli . In DBA/2 mice ("resistant" to BCG) development of EAC can be inhibited only by the large dose of BCG since small one is sometimes ineffective. Ann Rech Vet, 1985, 16(1), 7 - 16 {Experimental paratuberculosis: biological diagnosis in calves inoculated with strains of mycobactin-dependent mycobacteria}; Thorel MF et al.; During an experiment on the pathogenicity of mycobactin-dependent mycobacteria strains for calf, the kinetics of antibody formation during infection was studied . The progress of cellular immunity was followed by examining delayed hypersensitivity using four allergens (bovine tuberculin HCSM, avian tuberculin HCSM, avian tuberculin PPD, and johnin PPD), and that of humoral immunity using complement fixation test and ELISA . Simultaneously, the elimination of bacilli in the faeces was examined . The excretion of bacilli, although intermittent, appeared to be the most demonstrative proof of infection: it could be shown at any stage of the disease . On the contrary, the delayed hypersensitivity using the avian tuberculin, and the serologic tests (the complement fixation test and ELISA), were positive only at defined periods of the disease: hypersensitivity reactions developed earlier than humoral reactions . The results obtained during these experiments confirmed that the mycobactin-dependent strains of "wood-pigeon" mycobacteria caused a disease in calves similar to the disease caused by Mycobacterium paratuberculosis. Ann Rech Vet, 1985, 16(1), 69 - 79 Naturally-occurring Tyzzer's disease (Bacillus piliformis infection) in commercial rabbits: a clinical and pathological study; Peeters JE et al.; Tyzzer's disease has been detected in nine unrelated, commercial rabbitries . During the acute stage of the disease, recently weaned rabbits showed profuse watery diarrhoea . Mortality was between 14.2 and 41.2% during the first three weeks of the outbreaks . In surviving animals, there was a chronic evolution with depression, anorexia, loss of weight and sometimes extreme cachexia . Reproduction animals were less badly affected . Multifocal hepatic necrosis, focal myocardial necrosis, patches of mucosal necrosis in ileum, caecum and colon and marked caecal oedema were most prominent at autopsy . In histological sections of the liver, bundles of slightly Gram-negative and Giemsa-, PAS- and silver-positive rod-shaped bacilli were established in apparently viable hepatocytes bordering foci of necrosis . They were also present in myocytes around necrotic foci in the heart and in enterocytes and smooth muscle cells of the muscularis mucosae of the intestinal mucosa . Transmission electron microscopy showed that these organisms had a similar ultrastructure as Bacillus piliformis . Most antibiotics used failed to combat the disease . Only oxytetracycline was active. Jpn J Antibiot, 1985 Jan, 38(1), 128 - 32 {Clinical studies with cefoperazone in the biliary disease}; Morinaga T et al.; The concentration of cefoperazone (CPZ) in serum and bile was estimated after intravenous drip infusion of 1 g of the drug in 11 patients, who have performed cholecystectomy, choledocholithotomy and T-tube drainage for gallstone diseases . Administration of cefazolin (CEZ) 1 g was compared by the cross over method . After 1 g intravenous drip infusion of CPZ, the mean serum concentration was 88.3 +/- 24 micrograms/ml at 1 hour, 52 +/- 11.7 micrograms/ml at 2 hours and 36.5 +/- 10 micrograms/ml at 4 hours . The maintenance period of serum concentration was inclined to be longer in CPZ than in CEZ . After 1 g intravenous drip infusion of CPZ, the mean bile concentration reached to 810 +/- 459 micrograms/ml in 2 hours and it was maintained as high as 562 +/- 319 micrograms/ml even after 4 hours . On the other hand, after 1 g intravenous drip infusion of CEZ, the mean bile concentration was only 28.7 +/- 26 micrograms/ml in 1 hour and was low level in the progress . As compared with the highest concentration of CPZ and CEZ in same patient, the mean bile concentration of CPZ (942 +/- 525 micrograms/ml) was about 30 times higher than that of CEZ (28.6 +/- 26.3 micrograms/ml) . There was no difference in the group of Gram-positive cocci between minimum inhibitory concentration (MIC) of CPZ and that of CEZ . While MIC of CEZ in the group of Gram-negative bacilli was from 0.78 to over 400 micrograms/ml, MIC of CPZ in that group was from 0.10 to 50 micrograms/ml . The value in CPZ was lower than that in CEZ at all strains . No side effects was seen in all patients. J Gen Microbiol, 1985 Jan, 131 ( Pt 1), 175 - 9 Fatty acid composition of oral isolates of Selenomonas; Jantzen E et al.; Fatty acids of 16 strains of Selenomonas isolated from the human oral cavity were examined by gas-liquid chromatography . The strains showed similar patterns, characterized by the presence of straight-chain fatty acids in the range C11 to C18 . Fatty acids of odd-numbered carbon atoms dominated and the major acids were n-pentadecanoate and 3-hydroxytridecanoate . The general fatty acid pattern of Selenomonas differed distinctly from those of other previously analysed anaerobic or microaerophilic Gram-negative bacilli. J Infect Dis, 1985 Jan, 151(1), 140 - 7 Capnocytophaga species: infections in nonimmunocompromised and immunocompromised hosts; Parenti DM et al.; Retrospective review of isolates of Capnocytophaga, a genus of capnophilic gram-negative bacilli, referred to the Massachusetts State Laboratory Institute in Boston revealed 31 patients with infection due to Capnocytophaga, 16 in nonimmunocompromised hosts . These infections included empyema (three patients), lung abscess (one), sinusitis (one), conjunctivitis (three), subphrenic abscess (one), wound (three), osteomyelitis (one), and bacteremia (three) . Two of the wound infections were closed-fist injuries involving bone or soft tissue . Capnocytophaga was frequently isolated as part of a polymicrobial infection with other oral flora . There was only one death in the nonimmunocompromised group . In contrast, of 15 immunocompromised patients with 16 episodes of bacteremia due to Capnocytophaga, 87% had leukopenia and 73% had significant oral pathology such as gingivitis, mucositis, or ulceration . Five immunocompromised patients died . Thus, Capnocytophaga species may cause disease in both nonimmunocompromised and immunocompromised hosts . Isolation of this organism should suggest an oral source for infection. Rev Mal Respir, 1985, 2(4), 209 - 14 {Controlled study comparing 3 daily chemotherapy regimens for six months in pulmonary tuberculosis in routine practice in Algiers . Results at 30 months}; Mazouni L et al.; Three anti-tuberculous regimens were compared in Algiers . The three regimens use Isoniazid and Rifampicin every day for six months; two of them used a third drug, Ethambutol or Pyrazinamide for the first three months . The results at 12 months after cessation of chemotherapy have already been reported . At 30 months (or 24 months after the end of treatment) the results were analysed for 513 cases: in 27 cases (5%) there was a relapse or therapy failed . Of 21 relapses 13 occurred in the first six months of follow up, four during the next six months, three during the third and one in the final six months . No further relapse was seen between the thirtieth and forty second months . All the cases of failure or relapse had received an additive chemotherapy . Two patients were on chemotherapy again for a relapse noted in under six months; the other 25 patients had a satisfactory outcome after receiving a regime of six to 12 months containing Rifampicin in 21 cases or a regime 12 months without Rifampicin in four cases . There was no statistically significant difference between the three therapeutic series for those cases with tubercle bacilli initially sensitive to the antituberculous drugs . On the other hand, for primary Isoniazid resistance a third drug is essential during the initial treatment . In the overall analysis pyrazinamide was as effective as Ethambutol in avoiding failure due to primary drug resistance and relapses up to 30 months. Rev Pneumol Clin, 1985, 41(3), 177 - 80 {Resistance of Mycobacterium tuberculosis . An 8-year survey in the Poitiers area}; Ranger S et al.; We have studied in Poitiers area from 1977 to 1984 the resistance of 853 Mycobacterium tuberculosis strains to the main anti-tuberculosis drugs . The overall rate of drug resistance was showed to be steady over the years while the primary resistance rate has decreased . The only one drug resistance has concerned para-aminosalicylic acid, streptomycin and isoniazid . Foreigners, most of them Asian people or North-African people, often bear resistant tubercle bacilli (29,03%) compared with French people (9,29%) . We encountered drug resistance phenomena essentially among less than 60 years old patients . Drug susceptibility tests remain indispensable for a good epidemiologic supervision at the time of relapses and among patients possibly infected with multiresistant germs. Rev Neurol (Paris), 1985, 141(5), 420 - 2 {61 years' survival of Koch's bacillus in a closed focus . Disclosure in a case of spinal cord compression caused by sequelae of Pott's disease}; Bouchez B et al.; A 68 year-old woman presented with a spinal cord compression from an angular kyphosis due to Pott's disease at age 7 . Clinical, radiological and pathological studies of the vertebral lesions did not demonstrate an evolutive lesion . However, culture yielded some viable Koch's bacilli . This bacteriologic confirmation 61 years later exemplifies the importance of host immunity reactions, that may prevent the development of KB, and the remarkable capacity of survival of the bacillus. Microbios, 1985, 43(172), 7 - 15 Temperature-induced changes in viability, diphenoloxidase and permeability of Mycobacterium leprae; Prabhakaran K et al.; Among mycobacteria secretion of the enzyme diphenoloxidase has been established as a property of Mycobacterium leprae . The antileprosy drug dapsone (DDS), which completely inhibits the enzyme from plant and mammalian sources, does not readily penetrate intact M . leprae . When the drug is complexed with polylysine, it easily permeates the bacteria and produces 100% inhibition of its diphenoloxidase, suggesting a permeability barrier of the cytoplasmic membrane of M . leprae to dapsone . In this study: (1) when the organisms, purified from fresh tissues of experimentally infected armadillos, were treated with dilute alkali or exposed to warmer temperatures, DDS penetrated the bacteria and inhibited the diphenoloxidase . Washing with trypsin had no effect . Dapsone easily permeated the bacilli, purified from tissues stored at 0 degrees C or at -80 degrees C . (2) Diphenoloxidase of freshly-prepared M . leprae was stimulated when the bacteria were exposed to 50 degrees C for 10 min; at 60 degrees C the activity decreased, and at 100 degrees C the enzyme was completely inactivated . When the enzyme was assayed at temperatures below 37 degrees C, the activity was considerably lower, indicating that M . leprae may not be a psychrophilic organism in this respect . (3) The bacteria exposed to 50 degrees C failed to multiply in mouse footpads . M . leprae remained viable in tissues stored at 0 degrees C or -80 degrees C; but when the bacteria purified from these tissues were frozen, they lost their viability . On the other hand, the organisms separated from fresh tissues remained viable when frozen at -80 degrees C . The inhibition of diphenoloxidase of M . leprae by dapsone could serve as an indirect method to assess the integrity of the bacterial cell membrane and to predict whether the bacteria would retain their viability on freezing. Chemotherapy, 1985, 31(4), 324 - 8 Rifampicin for non-tuberculous infections? Gruneberg RN, Emmerson AM, Cremer AW. Large populations of rifampicin-sensitive strains of Mycobacterium tuberculosis have been exposed in vitro to changing concentrations of rifampicin (RIF) in line with changes in the blood level of the drug observed during treatment, and to much lower concentrations . Experiments in which the organism was exposed to either 7 or 14 days of cyclically-changing rifampicin concentrations have resulted in the elimination of the M . tuberculosis test strains without the emergence of RIF resistance . The significance of these laboratory findings is discussed in relation to the debate as to whether rifampicin should be used in short courses for the treatment of non-tuberculous infections or whether it should be withheld for fear of inadvertently generating rifampicin-resistant strains of tubercle bacilli . It is argued that the evidence for withholding rifampicin from use in short courses against non-tuberculous infections is slight. Reprod Nutr Dev, 1985, 25(1A), 127 - 39 {Attachment of horse cecum Ciliata to plant fragments . Degradation of chloroplasts . Attachment of bacteria to cecal Ciliata}; Bonhomme-Florentin A; Cecum microfauna association with different plant tissues was examined by scanning and transmission electron microscopy . The ciliates were attached to the damaged areas of the leaves and their highest concentrations were found on the epidermis and mesophyll tissues . The degradation of plant tissue was due to protozoal ingestion of the plant fragments . The morphology of ingested envacuolized chloroplasts changed rapidly, showing different stages of digestion inside the ciliate endoplasm . Intact chloroplasts were rarely observed but the grana of fragmented thylakoid membranes was often seen . The chloroplasts then appeared in concentric rings resembling pseudomyelinic figures . Plastoglobuli indicated the chloroplastic origin of these figures . Cecum microflora association with the microfauna showed that the different morphological types of cecal bacteria had three ways of attaching: some appeared to be attached via small amounts of extracellular material and some by capsule - like material; others (bacilli), due to an electron-dense outer layer, were observed to adhere so closely that they conformed to the shape of the ciliate. Can Med Assoc J, 1985 Jan 1, 132(1), 45 - 7 Tuberculous pseudotumour of the liver developing during antituberculous chemotherapy; Forward KR et al.; A 29-year-old Chinese woman presented with a liver mass 2 months after initiation of chemotherapy for disseminated tuberculosis . A percutaneous liver biopsy revealed tuberculous pseudotumour . Although acid-fast bacilli were seen in the biopsy specimen, no organism could be cultured . No changes were made in the antituberculous chemotherapy, and the mass subsequently resolved . The patient was still well 18 months after presentation . To the authors' knowledge, the features of tuberculous pseudotumour seen with ultrasonography and computerized tomography have not previously been described, nor has this condition previously been reported in patients already receiving antituberculous chemotherapy. Surv Immunol Res, 1985, 4 Suppl 1, 63 - 9 Thymopentin treatment in patients with chemotherapy-resistant lepromatous leprosy; Castells A et al.; Leprosy is a chronic infectious disease caused by Mycobacterium leprae; it is chiefly involving the skin and peripheral nerves . In lepromatous leprosy there are widespread loose infiltrates with M . leprae multiplying extensively in the skin macrophages and Schwann cells of peripheral nerves . Such patients reveal a decrease of circulating T helper cells, which is still more pronounced in the cutaneous lesions . Due to the ever increasing bacterial resistance to classical dapsone and combined chemotherapy as well, an immunomodulatory approach seemed reasonable: Eight patients with long-lasting (5-40 years) disease who had become resistant to combined chemotherapy were treated with thymopentin, 50 mg s.c., 3 times weekly for 5 weeks and thereafter combined with dapsone and clofazimine for 5 months . During the trial a statistically significant increase in E-rosette-forming cells (p less than 0.05) was observed, along with a steady improvement of the bacterial status of the nasal mucus . Although the skin lesions did not disappear within the observation period of the study, it is important to realize that long-term improvement of such lesions is always initiated by clearance of bacilli from the nasal mucus, hence, thymopentin treatment appears to be a promising approach to chemotherapy-resistant lepromatous lepra. Acta Leprol, 1985 Jan-Mar, 3(1), 29 - 35 {Are there subpolar tuberculoid cases?}; Saul A et al.; The idea of the existence of subpolar tuberculoid cases is supported on the spectral conception of Ridley and Jopling who included the subpolar lepromatous patients between LL and BL cases . According with Languillon, we have studied 40 tuberculoid cases to find out clinical, bacteriological, immunological and histopathological parameters of subpolar T cases . The subpolar T cases do exist, they are unstable cases which can slide through the immunological spectrum towards the L pole . These cases are characterized by numerous, symmetrical, dysesthetic tuberculoid lesions with an important neural involvement . Bacilli can be found in a small number in the smears of nasal mucosae in some cases . Mitsuda reaction is always positive and histopathologically the granulomas, lymphocytes and epithelioid cells are in less number without the epidermotropism which is very often seen in polar T cases. Ann Med Interne (Paris), 1985, 136(1), 59 - 68 {Treatment of pleuropulmonary tuberculosis in 1985}; Sandron D et al.; The treatment of pulmonary TB due to bacilli sensitive to antituberculous treatment should lead to 100 p . 100 therapeutic success . However, this result implies a good bacteriological knowledge of the Koch bacillus, of antituberculous drugs, of therapeutic strategy, of the duration of treatment and, finally, of the reasons for failure . The association of isoniazide (5 mg/kg/day), rifampicin (10 mg/kg/day) and ethambutol (20 mg/kg/day for the first two months) sterilizes tuberculous lesions in 9 months . The introduction of a fourth antituberculous drug, pyrazinamide (35 mg/kg/day for the first two months) enables the duration of treatment to be reduced to 6 months without any loss of efficiency . Tuberculous relapses, sometimes due to polyresistant bacilli, pose difficult problems requiring detailed bacteriological studies of antibiotic sensitivity . Specific measures have to be taken (adaptation of dosage, contra-indications of certain drugs) with respect to the individual patient (elderly patients, pregnant or lactating women) . Surgery has a role to play, especially in the treatment of sequellae . Admission to a sanatorium is reserved for infectious cases at the beginning of treatment and for patients living in poor conditions . The cover of social security is essential for successful treatment . Tuberculous is a compulsory notifiable disease. Microbios, 1985, 42(168), 97 - 102 Intrinsic energy potential of Mycobacterium lepraemurium essential for growth in NC-5 medium; Nakamura M et al.; The intrinsic energy potential of the fastidious mycobacterium, Mycobacterium lepraemurium, essential for growth in axenic liquid medium was determined by ultraviolet irradiation of the inoculum . The growth potential in NC-5 medium of irradiated inocula was measured by an ultrasensitive method of adenosine triphosphate (ATP) using a luciferin-luciferase acceptor system . The results indicate that growth of bacilli ceased when more than one third of the ATP pool in 7 X 10(6) cells was lost . The residual level of ATP is roughly equivalent to that found in 10(5) non-irradiated cells. Biochem Int, 1985 Jan, 10(1), 105 - 13 Systemic changes in hydrolytic enzyme activities in mice affected with murine leprosy; Aoyagi T et al.; In order to investigate the behavior of hydrolytic enzymes in chronic infections, the activities of 17 hydrolytic enzymes were tested in limb muscles, heart muscle, spleen, liver, and kidney of lepromatous mice infected with Mycobacterium lepraemurium (M . lepraemurium) and their controls . Typical increases in those enzymatic activities were seen in spleen and liver, where pathological changes were the most pronounced, especially at the 11th week after the inoculation of the bacilli . At the 16th week, the enzymatic changes became less remarkable probably because of the decreased viability of tissues in these organs . The enzymatic changes observed could not be explained as due to bacterial enzymes . These findings are compatible with the notion that the increases in hydrolytic enzyme activities are related to tissue damage caused by murine leprosy. Am J Trop Med Hyg, 1985 Jan, 34(1), 151 - 61 Manifestations of experimental leprosy in the armadillo; Job CK et al.; Three experiments, using different routes and doses of infection, were conducted using 42 armadillos . Thirty-six of them developed generalized disease . There is no significant sex or age difference in susceptibility . Route and dose of infection make very little difference in the disease prevalence except that the intravenous administration of a large dose reduces the period of development of generalized disease . It is quite possible that in armadillos the resistance to the disease is partly genetic . Although a majority of the armadillos developed lepromatous disease, borderline leproma is fairly common . In skin nodules large colonies of extracellular bacilli are demonstrated . Bacilli are also demonstrated in liver parenchymal cells. Medicine (Baltimore), 1985 Jan, 64(1), 36 - 48 Disseminated infection with Mycobacterium avium-intracellulare . A report of 13 cases and a review of the literature; Horsburgh CR Jr et al.; Thirteen cases of disseminated infection with Mycobacterium avium-intracellulare (MAI) seen at the National Jewish Hospital and Research Center and 24 cases from the literature were analyzed to define clinical and therapeutic features of the disease . Disseminated MAI infection was a disease of immunocompromised and apparently normal hosts . It was acquired from the environment by unknown mechanisms, usually entering the body through the lungs and spreading to include the reticuloendothelial system, bones, and less commonly, the skin . Diagnosis was often delayed and required culture of tissue or secretions . Medical personnel must maintain a high index of suspicion for MAI disease, especially in immunocompromised hosts . These patients should be monitored carefully for evidence of MAI with frequent cultures of blood and bone marrow . Blood culture systems able to recover MAI promptly and reliably should be employed (52, 64) . New diagnostic aids, such as the standardized preparation of PPD-B currently being prepared or tests for antibody to MAI, will help in differentiating MAI from other processes . If MAI is recovered, broad-spectrum therapy should be instituted . Response to combination antimicrobial chemotherapy in the patients surveyed in this report was gratifying . Over two-thirds of treated patients responded to therapy . New antimycobacterial agents such as ansamycin and thienamycin have been shown to have activity against MAI in vitro (40, 81, 92) and may further improve therapeutic efficacy . Studies of in vitro synergy, currently in progress in our laboratory, will also help define the optimal therapeutic regimen for each individual patient . While the patients presented in this report had a reassuring response to therapy, those who had many bacilli in the tissues had a poorer outcome . Patients with AIDS often have this lepromatous histology (37) and thus may respond more poorly than the patients in this report even when optimal therapy is employed . Careful monitoring of AIDS patients for MAI infection may permit earlier institution of therapy and improve the chances for control of the infection . Studies to assess the relationship of in vitro sensitivity to therapeutic response in these patients are currently underway in our laboratory . It is hoped that early institution of therapy and optimization of regimens according to in vitro sensitivity data will lead to decreased morbidity and mortality in all patients with MAI infection. Hansenol Int, 1985, 10(1-2), 1 - 4 Mast cells in histoid lepromatous lesions; Kumar R; Ten patients with histoid lesions among the lepromatous leprosy cases, of both sexes in the age group of 35-65 years, were included in this study . Skin biopsy from the nodule with surrounding healthy skin of histoid lesion was taken . The biopsies were fixed in Susa solution and processed for light microscopy . 5-7 mu thick sections were cut and stained with haematoxylin and eosin, Toluidine blue and Fite Faraco . Observations were made on the dermis to locate the mast cells and bacilli . Proliferation of mast cells and their degranulation were seen in the histoid nodule as compared to surrounding normal healthy skin where the cells were mainly intact . The study further investigates the role of mast cells in the histopathogenesis of the disease. Indian J Lepr, 1985 Jan-Mar, 57(1), 22 - 6 Immuno-stimulatory effect of levamisole in borderline leprosy cases; Arora SK et al.; Eleven cases of borderline-borderline leprosy were subjected to levamisole therapy for 3 months . Levamisole was given 150 mg/day on three consecutive days every fortnight along with dapsone (DDS) . Immuno-stimulation was assessed by lepromin test using Lepromin-A supplied by W.H.O . containing 4.0 X 10(7) bacilli per milli litre . It was found that there was statistically significant change in lepromin reaction after levamisole therapy. Indian J Lepr, 1985 Jan-Mar, 57(1), 115 - 23 L.D.H . isoenzymes sub-unit ratio in leprosy and the effect of clofazimine treatment on L.D.H . isoenzymes sub-unit; Bulakh PM et al.; The clinical material for our studies of serum total LDH activity and LDH isoenzymes in leprosy included 255 patients consisting of Tuberculoid (74), Lepromatous leprosy (116), and Lepromatous leprosy with lepra reaction (65) . 20 patients with suspected DDS resistance and repeated attacks of lepra reactions were selected for Clofazimine studies . All leprosy patients exhibited higher total LDH activity as compared to normals . M/H ratio was significantly increased in patients of Lepromatous leprosy and correlated closely with the clinical severity and advancement of disease . Tuberculoid leprosy patients showed values close to normals . Hence M/H ratio could demarcate two polar types of leprosy i.e . Tuberculoid and Lepromatous leprosy . Clofazimine treatment over a period of one year in patients with suspected DDS resistance and repeated attacks of lepra reaction decreased total LDH activity and M/H ratio considerably . Fall in M/H ratio during Clofazimine treatment could be attributed to the clearance of 'M' subunits by the drug due to removal of blockade of R.E.S . system produced by lepra bacilli. Prog Clin Biol Res, 1985, 181, 259 - 62 Norfloxacin for selective decontamination: a study in human volunteers; De Vries-Hospers HG et al.; During five consecutive days three different dosages of 200, 400 and 800 mg norfloxacin were administered to ten healthy males . Cultures of feces and oral washings revealed that even the lowest dose was effective in eliminating gram-negative bacilli from the gi-tract within a reasonable period of time . At this dose signs of a decreased CR due to norfloxacin and measured by both overgrowth by resistant ppmo or the appearance of beta-asp-gly in feces were not seen . Treatment with 100 mg norfloxacin twice daily seems therefore suitable for SDD, at least in volunteers . However, further studies in patients should be performed. Prog Clin Biol Res, 1985, 181, 245 - 50 Spread of multiresistant gram-negative bacilli among severely immuno-compromised mice during prophylactic treatment with different oral antimicrobial drugs; van der Waaij D et al.; Gram-negative infections are generally regarded as a major cause of severe infections in granulocytopenic patients . To prevent such infections, selective decontamination (SD) of the digestive tract has been introduced . It is assumed that if SD is applied on all patients in an oncologic station it may not only provide protection to patients thus treated, but it may have also epidemiologic consequences . SD may considerably reduce the number of circulating (antibiotic-resistant) strains in the ward and therewith significantly further reduce the chance of severe infection during periods of granulocytopenia . Because the effect which different kinds of antibiotics may have on the accumulation and spread of resistant bacteria cannot be studied in patients, it was investigated experimentally . Groups of 15 conventional mice were lethally irradiated and each group was treated with one antibiotic . On the day of irradiation one mouse per cage was orally contaminated with a multi-resistant strain either of E . coli or Ps . aeruginosa . The spread of these strains among cage mates as well as their effect on mortality was investigated . It appeared that ampicillin promoted spread and enhanced mortality in comparison with a control group, whereas antibiotics currently used for SD did prevent spread of the multi-resistant strain and reduced mortality. Exp Clin Immunogenet, 1985, 2(1), 24 - 35 Low responsiveness to MLM bacilli associated with an impaired macrophage function in CBA/J mice; Saito N et al.; It has previously been reported that susceptibility to Mycobacterium lepraemurium (MLM) infection (subcutaneous inoculation) differs markedly between CBA/J and C57BL/6 mice . The high susceptibility of CBA/J mice was shown to be due to the generation of cyclophosphamide-sensitive, I-Jk-positive suppressor T cells . In the present study, we attempt to show functional differences between splenic macrophages of both strains of mice in terms of their phagocytic and antigen-presenting activities against MLM bacilli . The results show that (a) the secondary MLM-induced T-cell proliferative response is dependent on Ia-positive antigen-presenting cells (APC), (b) macrophages of CBA/J mice are able to present antigens to F1 T cells, and yet (c) they show an extremely low phagocytic activity, (d) antigen presentation by APC of CBA/J mice lasted for a longer period than that of C57BL/6 mice after MLM infection . These results suggest that there is a functional difference in CBA/J and C57BL/6 APC, which could account for the phenotypic difference in immune responsiveness to MLM bacilli. Antimicrob Agents Chemother, 1984 Dec, 26(6), 941 - 3 Effect of aztreonam on throat and stool flora of cancer patients; Jones PG et al.; Eighteen patients with hematological malignancies received aztreonam in one of two dosing regimens, 1 or 2 g every 8 h for a total of 7 to 9 days . Throat and stool cultures were obtained before and during treatment with aztreonam . Aztreonam had little effect on the predominant throat flora . In contrast, facultatively anaerobic gram-negative bacilli were markedly decreased in stools during the administration of aztreonam . Strict anaerobes in the stool were variably affected by aztreonam. Gastroenterol Jpn, 1984 Dec, 19(6), 556 - 62 Hepatic granuloma . Report of a case successfully treated by hepatectomy and antituberculous therapy; Sagara K et al.; A 62 year-old male presented with high fever, weight loss and painful hepatomegaly . The clinical presentation, results of laboratory studies, angiography and laparotomy suggested hepatic abscess or cholangiocarcinoma . He underwent left lobe hepatectomy, and pathological examinations revealed granuloma . Acid-fast bacilli, fungi and parasites were not identified by special stainings . Hepatic tuberculosis was considered most likely because, after operation, an intermediate-strength purified protein derivative (PPD) skin test gave strongly positive results and his subsequent response to antituberculous treatment was excellent . His complex clinical features and the diagnostic difficulties were outlined. J Clin Microbiol, 1984 Dec, 20(6), 1192 - 3 Detection of Cryptosporidium oocysts in sputum during screening for mycobacteria; Miller RA et al.; We report a case in which Cryptosporidium oocysts were detected during routine auramine screening of a sputum specimen for acid-fast bacilli . The patient was a 28-year-old male with acquired immune deficiency syndrome and intestinal cryptosporidiosis . Microbiology laboratory workers should be alert to the possibility that these oocysts may be present in sputum specimens from patients with acquired immune deficiency syndrome. Tubercle, 1984 Dec, 65(4), 237 - 51 The yield of active case-finding in persons with inactive pulmonary tuberculosis or fibrotic lesions . A 5-year study in tuberculosis clinics in Amsterdam, Rotterdam and Utrecht; Styblo K et al.; The aim of the study was to elucidate the yield of annual chest X-ray and bacteriological examination in subjects with inactive tuberculosis or fibrotic lesions . Nearly 15 000 such persons registered at the Tuberculosis Clinics (C.B.s.) in Amsterdam, Rotterdam and Utrecht were allocated at random to either the Check-up group or the Discharge group: every person had an initial chest X-ray and examination of sputum or tracheal lavage for tubercle bacilli . Those in the Check-up group were re-examined annually for 3 years, while those in the Discharge group were not, but were encouraged to come to the C.B . if they developed symptoms suggestive of tuberculosis . Every patient was invited, after 3 years, to attend for a final follow-up examination . Nearly 90% of patients in the Check-up group attended for annual examination . Twenty-eight reactivations were reported during the 3 years, 23 pulmonary and 5 non-respiratory . They occurred in 12 patients previously treated by chemotherapy (1.2 per 1000 per year), in 15 with inactive tuberculosis (1.5 per 1000 per year) and in one with a fibrotic lesion (0.3 per 1000) . Tubercle bacilli were found by smear and culture in only 2 cases and by culture only in 24 . In the majority of reactivations only a small number of colonies were isolated on culture and no deterioration on the X-ray was seen . In the discharge group, 917 persons reported to the C.B.s because of pulmonary symptoms; 12 reactivations were found during the 3 years: 10 of the patients had received previous chemotherapy . Only 2 patients were positive at microscopy and in the majority of culture-positive cases a small number of colonies were isolated; 5 of the 9 patients with pulmonary tuberculosis showed deterioration in the X-ray appearance . At the final re-examination in the fourth year, similar numbers of cases were found in the Check-up group (14) and Discharge group (15) . However, there were less smear-positive cases in the Check-up group and less cases with X-ray deterioration . There were 69 confirmed reactivations in all . The annual rate of reactivation was 1.6 per 1000 in the Check-up group and 1.1 per 1000 in the Discharge group . It is suggested that routine annual check-ups of patients with inactive tuberculosis or fibrotic lesions should be discontinued. Am Rev Respir Dis, 1984 Dec, 130(6), 1184 - 7 Pulmonary leukostasis in fatal human pneumococcal bacteremia without pneumonia; Reed WP et al.; An asplenic man developed fulminant pneumococcal bacteremia without pneumonia . He died of irreversible shock within 24 h . Autopsy revealed extensive pulmonary vascular leukostasis . This condition has been described in laboratory animals after intravascular challenge with endotoxin, gram-negative bacilli, and gram-positive organisms including pneumococci . This case illustrates that death in pneumococcal disease can occur in the absence of pneumonia and may be attributable to cardiovascular collapse . We present a proposed mechanism based on activation of complement and release of vasoactive mediators. Infect Immun, 1984 Dec, 46(3), 873 - 5 Histological and immunopathological studies of delayed hypersensitivity reaction to tuberculin in mice; Pelletier M et al.; At 4 to 6 weeks after intravenous infection with 2 X 10(4) CFU of dispersed Mycobacterium bovis bacilli (BCG), C3H/HeNCrIBR and C57BL/6NCrIBR mice exhibited a strong reaction to purified protein derivatives, as evaluated by the increase in footpad swelling at both 24 and 48 h after local antigenic challenge . However, histological studies of the footpad skin demonstrated a prominent perivascular infiltration with polymorphonuclear cells at 6 and 24 h after purified protein derivative challenge, whereas mononuclear cells represented the majority of infiltrating cells only at 48 h . An immunopathological study of the footpad skin showed granular deposits of immunoglobulins and complement in vascular walls and perivascular tissues at 6 and 24 h . These results demonstrate that the footpad swelling observed 24 h after the antigenic challenge is caused by an Arthus-type reaction, whereas that caused by cell-mediated immunity appears at 48 h . Hence, delayed hypersensitivity must be evaluated at 48 and not 24 h after challenge. Dig Dis Sci, 1984 Dec, 29(12), 1073 - 9 Possible role of mycobacteria in inflammatory bowel disease . I . An unclassified Mycobacterium species isolated from patients with Crohn's disease; Chiodini RJ et al.; A previously unrecognized Mycobacterium species was isolated from two patients with Crohn's disease . The organism is an acid-fast, mycobactin-dependent Mycobacterium that has characteristics which do not conform to any of the presently recognized species . It belongs to the Runyon group III mycobacteria and is most closely related to Mycobacterium paratuberculosis . Animal inoculation revealed pathogenicity for mice when injected intravenously or intraperitoneally, but not for rats, guinea pigs, rabbits, or chickens . The mice developed hepatic and splenic granulomas which contained numerous acid-fast mycobacteria . A 7-day-old goat which was inoculated orally with 50 mg of the organism developed both humoral and cell-mediated immunologic responses in two to three weeks and granulomatous disease of the distal small intestine, with noncaseating tuberculoid granulomas in five months . Acid-fast bacilli were not demonstrable in sections of the intestine, but a single organism was seen in each of two microgranulomas of the mesenteric lymph node . The Mycobacterium species was reisolated from the lymph node but not from intestine . Our findings raise the possibility that a Mycobacterium plays an etiologic role in at least some cases of Crohn's disease. Eur J Clin Microbiol, 1984 Dec, 3(6), 575 - 8 Pharmacokinetic and experimental data on beta-lactam antibiotics in the treatment of patients; Craig W; The in vitro and animal model studies on optimal dosage of the newer beta-lactams are summarized and put into historical perspective . They provide a rationale for dosage schedules that continuously maintain inhibitory serum and tissue concentrations throughout the dosage interval . In vitro studies on the post-antibiotic effect (PAE) with beta-lactams revealed only short time periods of post-antibiotic growth suppression with gram-positive cocci and no post-antibiotic effect with gram-negative bacilli . A similar lack of persistent growth suppression was observed with beta-lactams in a neutropenic mouse thigh infection model for both gram-positive and gram-negative bacteria . In the same animal model, dosing regimens of beta-lactams which continuously provided serum concentrations above the MIC were more efficacious than those that did not . The newer third-generation cephalosporins have prolonged half-lives and can maintain serum levels above the MIC for most pathogens, even when dosed at widely spaced intervals. Antimicrob Agents Chemother, 1984 Dec, 26(6), 833 - 6 Effect of hyperbaric oxyhelium gas on response of bacteria to antimicrobial agents in vitro; Kenward MA et al.; Modern diving techniques can require the treatment of infection in an atmosphere of pressurized oxyhelium gas . The antibiotic susceptibility of 16 species and strains (eight genera) of gram-negative bacilli and 3 species and strains (two genera) of gram-positive cocci to each of 21 antimicrobial agents was assessed in air at atmospheric pressure and in oxyhelium gas at an absolute pressure of 7 bar (ca . 709 kPa) . A disk diffusion technique was employed, and significantly different results were obtained in the two atmospheres . The effect of oxyhelium on diameters of growth inhibition varied significantly with the bacterium and with the antibiotic and was particularly marked with certain bacterium-antibiotic combinations . The gram-negative bacilli generally gave reduced zone diameters in oxyhelium, whereas the gram-positive cocci showed a mixture of effects. Tubercle, 1984 Dec, 65(4), 285 - 93 Skin-test sensitisation by tubercle bacilli and by other mycobacteria in Ethiopian school-children; Lema E et al.; Quadruple skin-testing with a range of 22 new tuberculins and PPD-RT23 was carried out on 665 school-children without BCG scars and 666 with BCG scars, in and around the towns of Butajira and Hosana in Shoa district of Ethiopia . Marked differences in patterns of sensitisation were distinguished between the 5 schools visited . In general, Mycobacterium chitae, M . diernhoferi, M . kansasii and M . vaccae were common sensitising agents in all schools, M . avium subspecies brunense, M . gilvum, M . rhodesiae and M . xenopi were absent, and the remaining species investigated were variably present between the schools . Contact with M . tuberculosis and M . leprae appeared greatest in Hosana and the possibility of sensitisation by M . ulcerans around the village of Enseno was discovered . The data also provided indirect evidence of the value of BCG in Shoa district . An interesting observation was the very variable enhancing effect that BCG vaccination had on sensitisation to individual fast growing species. Clin Exp Immunol, 1984 Dec, 58(3), 511 - 21 Production and characterization of monoclonal antibodies to Mycobacterium tuberculosis, M . bovis (BCG) and M . leprae; Kolk AH et al.; Thirty-two monoclonal antibodies (MoAb) to Mycobacterium tuberculosis H37Rv, M . bovis BCG and M . leprae were produced . The spleen cells of BALB/c mice immunized with sonicated or intact bacilli were fused with Sp2/0-Ag-14 myeloma cells . Many more antibody producing hybridomas were found when M . tuberculosis, rather than M . leprae, was used as the immunogen . The MoAb were characterized by an enzyme immunoassay and immunofluorescence on 16 mycobacterial species . The sodium dodecylsulphate polyacrylamide gel electrophoresis immunoperoxidase assay was used to determine the molecular weight of the antigens detected by the MoAb . Antigens of high, low and intermediate molecular weight were found . Some of the antigens were proteinaceous, others of a glycolipid nature . The immunofluorescence assay proved to be essential for the selection of MoAb since some MoAb reacted only in this assay and not in the enzyme immunoassay . The most specific clones were found in the fusions with spleen cells of mice immunized with intact rather than sonicated bacteria . One MoAb (F29-29) reacted only with M . tuberculosis H37Rv; one (F41-3) only with M . leprae and another (F29-45) reacted with M . tuberculosis and M . gastrii . Several MoAb only reacted with three mycobacterial species: M . tuberculosis, M . kansasii and M . gastrii . Others showed unique patterns of reactivity by enzyme immuno- and immunofluorescence assay . The potential use of the MoAb for the identification of mycobacteria and mycobacterial antigens is discussed. Cell Immunol, 1984 Dec, 89(2), 445 - 57 Potentiation of the rat delayed-type hypersensitivity reaction by the Fc portion of human IgG1; Ernst DN et al.; Fc fragments derived from a human IgG1 myeloma protein potentiate the rat delayed-type hypersensitivity (DTH) reaction to antigen challenge . Lewis rats immunized with heat-killed tubercle bacilli give augmented DTH reactions to the purified protein derivative of tuberculin when Fc fragments are included in the challenge dose . Similar potentiation of DTH by pFc' fragments indicates that the active site is located in the CH3 domain of IgG1 . Histologic evaluation of the augmented reaction sites revealed predominantly mononuclear cell infiltrates characteristic of DTH reactions . Skin tests of tubercle bacilli-sensitized rats with an unrelated antigen and/or Fc fragments fail to elicit significant reactions . Augmentation of the DTH reaction to purified protein derivative is restricted to the Fc or pFc' region fragments since intact monomeric IgG1, Fab fragments, and bovine serum albumin were all shown not to be active potentiators . The DTH reaction of ovalbumin-sensitized rats was similarly augmented when Fc fragments were included with a challenge dose of ovalbumin, thus supporting the general nature of the phenomenon . These results support the concept of Ig molecules as multifunctional proteins that can not only serve effector functions but also participate in the regulation of immune responses. J Med Microbiol, 1984 Dec, 18(3), 327 - 33 Occurrence and experimental infection of toads (Bufo marinus and B . granulosus) with Mycobacterium chelonei subsp . abscessus; Mok WY et al.; In a survey of 234 Amazonian toads and frogs, six strains of Mycobacterium chelonei subsp . abscessus were isolated from the liver or spleen of four of 66 Bufo marinus (6.1%) and from the kidney or peritoneal fluid of two of 86 B . granulosus (2.3%) . There were no histopathological lesions in the viscera of the infected animals . Experimental infection of 29 captive B . marinus and B . granulosus, by the intraperitoneal route, with a pooled inoculum of M . chelonei subsp . abscessus caused five deaths near the end of a 2-month observation period . M . chelonei subsp . abscessus was isolated from the liver, spleen, kidney, gonad, heart and lung of toads killed at various intervals after inoculation, and intracellular acid-fast bacilli were seen in these organs . Histological evidence of invasion of tissues by mycobacteria became apparent from the 45th day after infection . The susceptibility to infection of B . marinus and B . granulosus suggests that these toads may serve as a fortuitous animal host for M . chelonei subsp . abscessus. Int J Lepr Other Mycobact Dis, 1984 Dec, 52(4), 471 - 4 Primary dapsone-resistant leprosy in San Francisco; Gelber RH; The dapsone sensitivity of strains of Mycobacterium leprae from 54 multibacilliferous untreated leprosy patients presenting to the United States Public Health Service Hospital in San Francisco, California, U.S.A., from 1978 to 1981 was studied by mouse foot pad inoculation . M . leprae from 53 patients were found fully sensitive to dapsone . M . leprae from one patient were resistant to only the lowest dietary level of dapsone, 0.0001%, since growth of the bacilli was inhibited by higher and clinically easily achievable levels . Mouse plasma dapsone levels confirmed the reliability of the drug-containing diets. Eur J Clin Microbiol, 1984 Dec, 3(6), 579 - 91 Rationale for optimal dosing of beta-lactam antibiotics in therapy for bacterial meningitis; Scheld WM; This review considers the five major principles governing optimal dosing of beta-lactam antibiotics in therapy for bacterial meningitis: off the entry of passage of antibiotics into CSF, (2) the antimicrobial activity of beta-lactams within the purulent CSF in vivo, (3) the bactericidal activity within the CSF, (4) the route and mode of drug administration together with the postantibiotic effect, and (5) the duration of therapy . Special attention is paid to the third principle, bactericidal activity within the CSF, employing the model of the newer, third-generation cephalosporins used in the treatment of meningitis caused by gram-negative aerobic bacilli. Am J Phys Anthropol, 1984 Dec, 65(4), 381 - 6 Rib lesions in chronic pulmonary tuberculosis; Kelley MA et al.; The diagnosis of skeletal tuberculosis in human remains has traditionally been based upon the detection of secondary skeletal lesions which result from hemotogenous dissemination of tubercle bacilli (e.g., Pott's disease) . Since such lesions develop in less than 7% of cases of human tuberculosis, the paleodemography and paleoepidemiology of this disease have been difficult to assess from skeletal remains . This study presents a new diagnostic approach to tuberculosis, focusing on the skeletal manifestations of chronic pulmonary disease (which comprises approximately 90% of human-form tuberculosis) . Four hundred forty-five skeletal remains from persons dying of tuberculosis during the first half of the 20th century were examined . A total of 70/445 (16%) exhibited skeletal lesions in one or more locations as a response to infection . Of these 70, 39 (56%) were found to display a specific set of lesions restricted to the internal aspect of the ribs . These lesions take one of two forms: (1) diffuse periostitis or (2) localized abscess, and appear to correspond to areas of chronic pulmonary infection . The diffuse type of rib lesion is more commonly observed than the localized type . In our observations (and according to the natural history of tuberculosis) the occurrence of chronic pulmonary tuberculosis is usually mutually exclusive with hematogenous dissemination to secondary bone locations . Thus, the detection of rib lesions in cases of chronic pulmonary disease increases the absolute sample size of skeletal tuberculosis by a factor of two in this study. J Clin Microbiol, 1984 Dec, 20(6), 1196 - 7 Evaluation of the Quantum II Microbiology System for bacterial identification; Sylvester MK et al.; The Quantum II Microbiology System correctly identified 250 (89.6%) of 279 gram-negative bacilli from clinical specimens . There were 13 (4.7%) errors in genus identification and 7 (2.5%) errors in species identification; another nine (3.2%) isolates yielded biochemical reaction patterns which were not in the file of the system . Total test time per isolate, excluding inoculum preparation and incubation, was ca . 1.5 min. Int J Lepr Other Mycobact Dis, 1984 Dec, 52(4), 496 - 500 Effect of treatment on the cellular composition of cutaneous lesions in leprosy patients; Sarno EN et al.; We report on the cellular composition of the cutaneous lesions of 38 leprosy patients prior to and after 12-18 months of chemotherapy . All of the patients with tuberculoid (TT) disease had OKT4/OKT8 ratios that exceeded 1.0 . In the indeterminate patients, the ratio varied depending upon the immune status of the individual . A low ratio of OKT4/OKT8 cells (0.25) was found in the LL patients as previously reported . The low ratio of OKT4/OKT8 in the lesions of lepromatous patients did not undergo significant changes after treatment in spite of a marked reduction in the number of intracellular bacilli. Pediatrie, 1984 Dec, 39(8), 645 - 51 {Value of cefotaxime in gram-negative bacterial meningitis . Apropos of 3 developmental forms in neonates and infants}; Sarlangue J et al.; Three cases of meningitis with E . coli and H . influenzae are reported . They illustrate the recrudescence and relapse in bacterial meningitis . After the failure of initial antibiotic therapy, the treatment by Cefotaxime allowed a good outcome in all the cases . On account of the bacteriological, pharmacological and clinical data the authors advise using Cefotaxime in first purpose in meningitis with common gram negative bacilli. Jpn J Antibiot, 1984 Dec, 37(12), 2506 - 18 {Clinical evaluation of cefmenoxime in internal medicine, with special reference to infections associated with hematological disorders}; Uchida T et al.; Clinical evaluation of cefmenoxime (CMX, Bestcall) was examined in the infection associated with hematological disorders, respiratory tract and other disorders . Clinical effectiveness for severe infection of hematological disorders was 47.4% in good and 84.2% in fair response, however, in the respiratory tract infections, 89.7% in good response was obtained . Opportunistic infection due to Gram-negative bacilli are often experienced in patients with hematological disorders . It was discussed that CMX would be a good therapeutic agent against infectious diseases associated with hematological disorders because it's antibacterial spectrum would be parallel to pathogens of such disorders. Rev Med Interne, 1984 Nov, 5(4), 357 - 61 {Gas gangrene disclosing colonic cancer . Role of synergistic gangrene}; Guerin JM et al.; After reporting a case of synergistic gas gangrene of the retroperitoneum spreading to the thigh, revealing a carcinoma of the descending colon, the authors review the symptomatology and management of synergistic gas gangrene defined as a gas gangrene due to anaerobic non clostridial bacilli, and aerobic flora and emphasize the exceptional nature of its association with a carcinoma of the colon. J Clin Microbiol, 1984 Nov, 20(5), 933 - 5 Prevalence of gram-negative bacilli in nares and on hands of pharmacy personnel: lack of effect of occupational exposure to antibiotics; Weil DC et al.; Exposure to antibiotics alters host flora and facilitates colonization by gram-negative bacilli (GNB) . This may be important among pharmacy personnel, who have frequent contact with antibiotics and who have sometimes been suspected of inadvertently introducing GNB into parenteral solutions during admixture . We evaluated the risk of colonization by GNB, especially by tribe Klebsielleae (TK) which can proliferate in intravenous fluids, by culturing the hands and nares of 98 pharmacy personnel and 56 control subjects . Four culture surveys of pharmacy personnel yielded mean isolation rates of 79 and 52% for GNB and TK, respectively, from hands and 12 and 6.7% for GNB and TK, respectively, from nares; these rates did not differ significantly from those for control subjects (P greater than 0.1) . The frequency with which pharmacy personnel performed antibiotic admixture did not significantly affect the rate of isolation of GNB or TK (P greater than 0.2) . No multiresistant strains were isolated, and susceptibility patterns were similar for GNB species from pharmacy personnel and controls . These data indicate that occupational exposure of pharmacy personnel to antibiotics is not of sufficient magnitude to increase rates of nasal colonization or hand contamination with GNB. Am J Med, 1984 Nov, 77(5), 834 - 8 Contaminated medication nebulizers in mechanical ventilator circuits . Source of bacterial aerosols; Craven DE et al.; The contamination rates of medication nebulizers inserted into mechanical ventilator circuits were studied . Semiquantitative techniques were used to sample the reservoir fluid from in-line nebulizers during the first 24 hours after a circuit change . In the initial survey, high levels of contamination (organism concentrations above 10(3)/ml) were present in 13 (68 percent) of the 19 nebulizer reservoirs, and bacterial aerosols were produced by 10 (71 percent) of 14 nebulizers . Gram-negative bacilli were the predominant organisms isolated . Nebulizer contamination originated primarily from reflux of contaminated condensate in the ventilator circuit . When nebulizers were cleaned after each treatment, a reduced rate of contamination was found . Small bacterial aerosols (less than 3 microns in size) were produced in vitro after inoculation of nebulizers with gram-negative bacilli in concentrations isolated from in-use nebulizers . Contaminated in-line medication nebulizers generate small-particle bacterial aerosols that may increase the risk of ventilator-associated pneumonia and therefore should be cleaned or disinfected after each treatment rather than every 24 hours. Am Rev Respir Dis, 1984 Nov, 130(5), 839 - 44 Inhibition by streptomycin of tubercle bacilli within cultured human macrophages; Crowle AJ et al.; The strategy for using streptomycin against tuberculosis assumes that it is not effective intracellularly . But according to animal cell experiments, this is probably incorrect . We retested this assumption with a new experimental model using cultured human macrophages infected with tubercle bacilli so that the results would be directly relevant to human disease . At 5 and 50 micrograms/ml, streptomycin inhibited the bacilli strongly and killed some; at the lowest tested concentration of 0.5 micrograms/ml, it inhibited them weakly . It was acting intracellularly, because it could inhibit even when added 2 days after the macrophages had been infected and washed free of extracellular b