Eur J Cancer, 1991, 27(2), 174 - 8 Pefloxacin and vancomycin vs . gentamicin, colistin sulphate and vancomycin for prevention of infections in granulocytopenic patients: a randomised double-blind study; Archimbaud E et al.; To test the value of pefloxacin for the prevention of infections in patients with chemotherapy-induced neutropenia, oral pefloxacin plus vancomycin (PV) (n = 76) or gentamicin, colistin sulphate and vancomycin (GCV) (n = 74) were administered in a randomised double-blind study . Infections were significantly less severe in the PV than in the GCV group . Patients receiving PV had significantly fewer episodes of bacteraemia and central venous line infections than patients treated with GCV . Gram-positive and gram-negative infections were significantly less frequent in patients receiving PV, because of fewer infections with Staphylococcus species and enterobacteriaceae . Stool culture detected significantly more gram-positive organisms in the PV group and more gram-negative organisms in the GCV group . Thus, PV was more efficacious than GCV for the prevention of gram-positive and gram-negative infections in the neutropenic patients, despite lower efficacy in eradicating gram-positive organisms from the lower intestinal tract. Int J Clin Pharmacol Res, 1991, 11(6), 295 - 9 Species incidence and antimicrobial-agent resistance patterns of Enterobacteriaceae in Charles Nicolle Hospital, Tunis, from 1983 to 1987; Kechrid A et al.; Between July 1983 and December 1987, 13,108 strains of enterobacteriaceae were isolated at Charles Nicolle Hospital in Tunis . This study reports the prevalence of different species isolated, their resistance and the evolution of bacterial resistance during that period . There appeared to be a great stability in the distribution of bacterial groups . Among the commonly sensitive species, Proteus mirabilis showed a high proportion of strains resistant to ampicillin (79.3%), carbenicillin (75.9%), cefalotin (73.8%) and gentamicin (46%) . The proportions of resistant strains in P . mirabilis were much the same for each successive year from 1983 to 1987, and the percentages of resistant strains in the majority of the bacterial species were similarly stable . Amikacin and cefotaxime remained the most active antibiotics against enterobacteriaceae. Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove Suppl, 1991, 34(3), 349 - 403 {Colicinogeny in nonspecific intestinal inflammations and colorectal cancer}; Bures J et al.; Colicins are proteinaceous substances produced by Escherichia coli strains and related bacteria of Enterobacteriaceae family . They are considered to be an important factor in preserving the balance of the intestinal microflora . Their antibiotic action on susceptible bacteria is supplemented with cytotoxicity for several pro- and eukaryotic cells . The large bowel is a natural site of their action . Besides of enhancing oxidoreductive activity of leukocytes in vitro, colicins are also believed to influence inflammatory reaction in vivo . For these reasons, the first part of the present work was concerned with studying colicinogeny in nonspecific inflammatory bowel diseases (IBD) . No significant difference has been found out in colicinogeny between a total of 93 IBD-related and 160 healthy controls . In testing leukocyte migration inhibition, colicins of autologous E . coli were used as antigens . The migration index out of normal range showed 36% patients with ulcerative colitis (5/14), 80% patients with Crohn's disease (12/15), and only one clinically healthy control subject (1/16; 6%) . The obtained results are considered to be proof of cellular hypersensitivity of IBD patients to colicins of their own E . coli strains . In several colicins the antitumorous effect has been reported in both the in vitro and in vivo experimentation . The second part of this work was concerned with colicinogeny in colorectal cancer . Colicinogenic E . coli were evidenced in 42 subjects (40%) from 105 patients with colorectal carcinoma . Controls showed colicinogenic E . coli in 102/160 clinically healthy subjects (64%), and the difference was as significant as p less than 0.05 . In colorectal cancer group, the subjects with proved colicinogeny showed lesser amounts of colicinogenic E . coli strains in contrast with non-colicinogenic ones . In colorectal cancer patients with colicinogenic E . coli strains, B and M colicins were of most frequent occurrence in them no antitumorous effect has been experimentally stated . If changes of colicinogeny were only either the manifestation or consequence of tumor disease, so both the presence or absence of colicinogenic E . coli would have been dependent of clinical patients's condition, stage of disease (in accord with Dukes) or correlated with the tumor markers . For these accounts, a total of 28 colorectal cancer patients underwent a colicinogenic study . However, no colicinogeny dependence was evidenced of either clinical condition or Dukes stage, showing no correlation with any of cancer markers investigated (carcinoembryonic antigen, CA 19-9, alfa-1-fetoprotein, alfa-1-orosomucoid, Cancer serum index, sialic acid, lysozyme).(ABSTRACT TRUNCATED AT 400 WORDS) Bull Soc Pathol Exot, 1991, 84(5 Pt 5), 712 - 20 {Current orientation of antibiotic treatment in neonatal bacterial infection}; Begue P; The bacterial infection are responsive of severe sepsis and localizations in neonates, with a high mortality . The right choice of the first antibiotics is essential, and they must be well-fitted, early and bactericidal . The antibiotics of choice in the mother-linked infections are directed towards streptococcus group B and E . coli . Ampicillin must be replaced by a third generation cephalosporin because E . coli are resistant in more than 50% of cases . In tropical areas the first neonatal infections may be also the fact of multiresistant hospital acquired bacteria, which are transmitted during delivery by lack of hygiene . As in the nosocomial infections the causative pathogens are resistant Enterobacteriaceae, Pseudomonas and Staphylococcus . In all cases the neonatologist must use cephalosporin 3rd generation associated to aminoglycoside . The biological background and the cost of those antibiotics must be reevaluated in the high risk-areas (delivery rooms, nurseries, pediatrics departments). Wien Med Wochenschr, 1991, 141(23-24), 533 - 6 {Epidemiology and pathogen spectrum of urinary tract infections}; Breyer S et al.; Urinary tract infections still are a diagnostic as well as a therapeutical problem . The knowledge on the frequency of the causative organisms and their sensitivity to antibiotics and the different modes of urinary tract infections as well are very important, especially because of remaining organizational and medical-technical problems to identify the organisms . E . coli-bacteria are up to now the most frequent pathogens of urinary tract infections, with a resistance rate of 30% against aminopenicillins . An increase of resistant Enterobacter- and Pseudomonas-aeruginosa-strains against quinolones is known and could be observed also in our hospital . The demand for knowledge of sensitivity pattern of the causative organisms still remain for a successful antibiotic therapy. Int Arch Allergy Appl Immunol, 1991, 96(2), 149 - 55 Immunocytochemical determination of the role of alveolar macrophages in endotoxin processing in vitro and in vivo; Keller GE 3rd et al.; Endotoxin (lipopolysaccharide or LPS) inhalation has been implicated in increased pulmonary edema, most likely due to activation of an inflammatory response . The purpose of this study was to determine the cell types in the lung responsible for binding inhaled lipid A from Enterobacter agglomerans LPS . Five-hour exposures of aerosolized lipid A resulted in measurable pulmonary edema in hamsters, as determined by the accumulation of lung water . Immunocytochemistry was used to localize the inhaled lipid A in the cell types in the lung . Alveolar macrophages had decreased levels of lipid A as compared to unexposed controls, suggesting a possible metabolism by the macrophages . In vitro exposure of macrophages to lipid A resulted in a time-dependent clearance of lipid A which was inversely related to its concentration . Alveolar macrophages thus appear to be responsible for the removal of inhaled lipid A in this model and may initiate the physiological events which bring about pulmonary edema. Drugs Exp Clin Res, 1991, 17(6), 305 - 8 Cefixime shows good effects on group A and group B beta-haemolytic streptococci; Liberto MC et al.; There is continued interest in the development of oral beta-lactam compounds, which can be used clinically to treat various bacterial infections, particularly those caused by beta-haemolytic streptococci . Cefixime is a new orally active cephalosporin, with a broad spectrum of antibacterial activity, including Enterobacteriaceae, Haemophilus influenzae, Branhamella catarrhalis, Streptococcus pneumoniae and Streptococcus pyogenes . Cefixime is highly resistant to hydrolysis by most beta-lactamases . In this study the authors examined the effects of this molecule on Group A and Group B beta-haemolytic streptococci, recently isolated from clinical specimens in the authors' laboratory . MICs and the growth curves of 36 strains of Group A streptococci and the effects of sub-MICs on buccal cell adhesion were evaluated . The results show that concerning the sub-MIC cefixime effect on streptococci adherence, the treatment led to a decrease in adherence to the cells of the strains studied . Moreover cefixime showed good activity with 86.1% of the strains with MIC less than or equal to 0.5 microgram/ml, and the growth curves demonstrated that the molecule possesses a bactericidal effect after 3 h . Concerning Group B streptococci, 70.3% of the strains showed a MIC less than or equal to 2 micrograms/ml . In conclusion cefixime demonstrates good activity on beta-haemolytic streptococci, particularly those of Group A. Scand J Infect Dis, 1991, 23(5), 599 - 605 Resistant strains isolated from bacteremia patients in northern Norway; Scheel O et al.; Bacterial isolates from blood cultures in 1985 and 1989 (227 and 258 isolates, respectively), were compared as regards resistance to a series of antimicrobial agents including the more recent beta-lactams and quinolones . An increase in the number of coagulase-negative staphylococcal strains and a decrease in Staphylococcus aureus strains were detected, otherwise there were no significant differences in the bacterial patterns in 1985 compared to 1989 . Except for chloramphenicol, there was no major increase in antimicrobial resistance among Gram-negative species . An increase in the number of multiresistant enterobacteriaceae strains was due to an increased number of klebsiella strains and a decrease in Proteus mirabilis . S . aureus showed an increased resistance to sulfonamides . No methicillin-resistant strain was found . Coagulase-negative staphylococci were significantly more often multiresistant in 1989 than in 1985, and significant increase in resistance to gentamicin, sulfonamides and fusidic acid was found. Scand J Infect Dis, 1991, 23(5), 589 - 98 Septicemia in patients with hematological disorders and neutropenia . A retrospective study of causative agents and their resistance profile; Gunther G et al.; In order to identify the cause of septicemia and the resistance patterns of bacteria in Swedish patients with hematological disorders, all positive blood cultures collected at a hematological ward during 1980-1986 were evaluated retrospectively . 198 episodes of septicemia in 129 patients were recorded . 54% were males and 46% women with a median age of 67 years (range 16-88) . Patients with acute leukemia (46%), lymphoma (19%) and myeloma (19%) dominated . The absolute neutrophil count (ANC) was less than 0.5 x 10(9)/l in 76% of the bacteremic episodes . A total of 253 consecutive isolates were found with 53% Gram-negatives and 47% Gram-positives . The dominating pathogens were Escherichia coli (27%), klebsiella/enterobacter (15%), pseudomonas (7%), coagulase negative staphylococci (13%), alpha-streptococci (13%), Staphylococcus aureus (10%) and anaerobes (6%) . Coagulase negative staphylococci showed a significant increase in isolation rate during the study period . The majority of E . coli were resistant to ampicillin . The susceptibility of klebsiella/enterobacter to ceftazidime and cefuroxime was reduced, while no imipenem resistant strains occurred . Among coagulase negative staphylococci 61% were resistant to isoxazolylpenicillin, none to vancomycin . No dramatic changes in the etiology of septicemia or the susceptibility pattern during the study period were noticed . Coagulase negative staphylococci, S . epidermidis in particular, constitute an increasing problem among granulocytopenic patients. Scand J Infect Dis, 1991, 23(5), 577 - 82 Bacteriuria in patients treated with clean intermittent catheterization; Bakke A et al.; Bacteriuria has been studied in 407 patients treated with clean intermittent catheterization (CIC) during 1 year . Significant bacteriuria was found in 50.6% of 1413 analyzed urine samples . Escherichia coli was the dominating species (54.8%) . The relative distribution of species was different in males and females, but there were no differences between the CIC patients and a reference group of outpatients . On the other hand, a higher frequency of resistance among enterobacteria was found in samples from CIC patients compared to the reference group . The majority of CIC patients with bacteriuria had no symptoms, and bacteriuria per se does not seem to be an indication for treatment in most of these patients. Gynecol Obstet Invest, 1991, 32(1), 44 - 50 The role of beta-lactamase-producing bacteria in obstetrical and gynecological infections; Brook I; Pelvic inflammatory disease (PID) is a polymicrobial infection that evolves multiple aerobic and anaerobic bacteria . Several of the bacterial pathogens that participate in PID can produce the enzyme beta lactamase . These include Bacteroides species (including Bacteroides bivius, Bacteroides disiens, and Bacteroides fragilis group), Neisseria gonorrheae, Enterobacteriaceae and Staphylococcus aureus . A recent increase in numbers of beta-lactamase-producing strains of these organisms in PID has been associated with increased failure rates of penicillins in eradication of this infection . These organisms cannot only survive penicillin therapy but also protect penicillin-susceptible pathogens from the drug . These direct and indirect virulence characteristics of beta-lactamase-producing bacteria require the administration of appropriate antimicrobial therapy directed against all of these pathogens in the therapy of PID. Chemotherapy, 1991, 37(6), 413 - 9 Comparative antibacterial activity of the penem ALP 201; Bergan T et al.; The minimum inhibitory concentration (MIC) of the new penem ALP 201 was tested against 243 recent clinical isolates of which 95 were from the family Enterobacteriaceae, 50 were from the genus Streptococcus, 50 were Staphylococcus aureus and 48 were Staphylococcus epidermidis . An agar dilution technique was used to determine the MIC50 and MIC90 of ALP 201 in comparison with cefotaxime, cefuroxime, clindamycin, imipenem, piperacillin, tobramycin and vancomycin . Overnight cultures were suspended to produce inocula of 10(5) colonies from a replicator . ALP 201 was shown to have an activity similar to imipenem against most species; ALP 201 was less active than imipenem against Serratia spp . and was more active against S . epidermidis . beta-Lactamase production did not affect the activity of ALP 201 . All the other compounds tested were less active than ALP 201 and imipenem. Blood Purif, 1991, 9(2), 92 - 101 In vitro study of the transfer of cytokine-inducing substances across selected high-flux hemodialysis membranes; Evans RC et al.; The in vitro transfer of cytokine-inducing substances (CIS) across cellulose triacetate and polyacrylonitrile hollow-fiber high-flux hemodialyzers was studied using culture filtrates of gram-negative bacteria isolated from hemodialysis center environments . With Enterobacter cloacae, no transfer of CIS was seen despite the potent cytokine inducibility and endotoxin content of the challenge solution . In contrast, interleukins 1 and 6 and tumor necrosis factor inducing substances did penetrate both dialyzer types challenged with Pseudomonas aeruginosa culture filtrates containing a high endotoxin content . Transfer was not seen, however, upon dilution of the challenge solution to lower, yet clinically very high levels of endotoxin . These results show that, in vitro, the transfer of CIS across high-flux membranes is critically dependent upon the quality and the quantity of the challenge material employed. Pharmacotherapy, 1991, 11(5), 382 - 414 Ampicillin-sulbactam and ticarcillin-clavulanic acid: a comparison of their in vitro activity and review of their clinical efficacy; Itokazu GS et al.; Sulbactam (SB) and clavulanic acid (CA) are irreversible inhibitors of the beta-lactamases in the Richmond and Sykes classes II-VI . When combined with ampicillin and ticarcillin, SB and CA, respectively, extend the spectrum of activity of these penicillins to include some beta-lactamase-producing aerobes (Enterobacteriaceae, Hemophilus influenzae, staphylococci) and anaerobes (Bacteroides fragilis group) which would otherwise be resistant . Neither effectively inhibits the class I beta-lactamases frequently produced by Pseudomonas aeruginosa, Enterobacter, and Serratia, in part explaining the resistance observed with these organisms . Clinically, both agents were as effective as the comparative therapies in all but two of the trials reviewed . Given the current data, the decision to add these agents to the formulary should be based on hospital resistance patterns and on the cost of these antimicrobials in comparison to conventional therapies. Boll Ist Sieroter Milan, 1991-92, 70(1-2), 475 - 81 Epidemiological evaluation by rRNA-DNA hybridization of strains of Salmonella enterica subsp . enterica serovar Abortusovis isolated in southern Italy in the years 1981-1989; Nastasi A et al.; Salmonella enterica subsp . enterica serovar Abortusovis is a major agent of abortion of the sheep and is firmly established, although at low prevalence, in Sicily . This paper describes the application rDNA gene restriction pattern fingerprinting to investigate relatedness among 7 serovar Abortusovis strains isolated at the "Istituto Zooprofilattico Sperimentale" of Sicily and 29 isolates identified at the Southern Italy Centre of Enterobacteriaceae between 1981 and 1989 . Although Abortusovis serovar has exhibited a remarkable degree of homogeneity, genomic DNA polymorphisms, that have emerged, suggest possible importation of bacterial clones from different geographic areas. Zentralbl Bakteriol, 1991 Jan, 274(4), 446 - 55 A murine monoclonal antibody that recognizes a genus-specific epitope in the Salmonella lipopolysaccharide outer core; Tsang RS et al.; A murine monoclonal antibody 105 made from spleen cells of a mouse immunized with a mixture of common Salmonella serotypes reacted specifically with salmonellae from the most frequently encountered O serogroups of A (O:2) to E (O:3), and with strains from the less common O serogroups that represent the subspecies I, II, IIIb, IV, V and VI . Specificity for Salmonella was demonstrated by the lack of reactivity of monoclonal antibody 105 with any of the 30 other different species of Gram-positive and Gram-negative bacteria tested including 16 species in the family of Enterobacteriaceae . Studies to elucidate its binding epitope have shown that it reacts with the three distal sugar residues joined through specific anomeric linkages as present only in the Salmonella lipopolysaccharide outer core, which explains its specificity for the Salmonella . The failure of monoclonal antibody 105 to react with a subspecies IIIa Salmonella suggested a different outer core structure in this strain of Salmonella and also that monoclonal antibodies to the outer core of Salmonella lipopolysaccharide should be useful in the molecular analysis of their diversity. Arch Microbiol, 1991, 155(3), 221 - 8 Interspecies compatibility of selenoprotein biosynthesis in Enterobacteriaceae; Heider J et al.; Several species of Enterobacteriaceae were investigated for their ability to synthesize selenium-containing macromolecules . Seleniated tRNA species as well as seleniated polypeptides were formed by all organisms tested . Two selenopolypeptides could be identified in most of the organisms which correspond to the 80 kDa and 110 kDa subunits of the anaerobically induced formate dehydrogenase isoenzymes of E . coli . In those organisms possessing both isoenzymes, their synthesis was induced in a mutually exclusive manner dependent upon whether nitrate was present during anaerobic growth . The similarity of the 80 kDa selenopolypeptide among the different species was assessed by immunological and genetic analyses . Antibodies raised against the 80 kDa selenopolypeptide from E . coli cross-reacted with an 80 kDa polypeptide in those organisms which exhibited fermentative formate dehydrogenase activity . These organisms also contained genes which hybridised with the fdhF gene from E . coli . In an attempt to identify the signals responsible for incorporation of selenium into the selenopolypeptides in these organisms we cloned a portion of the fdhF gene homologue from Enterobacter aerogenes . The nucleotide sequence of the cloned 723 bp fragment was determined and it was shown to contain an in-frame TGA (stop) codon at the position corresponding to that present in the E . coli gene . This fragment was able to direct incorporation of selenocysteine when expressed in the heterologous host, E . coli . Moreover, the E . coli fdhF gene was expressed in Salmonella typhimurium, Serratia marcescens and Proteus mirabilis, indicating a high degree of conservation of the seleniating system throughout the enterobacteria. Lab Delo, 1991, (2), 57 - 9 {The use of stains for the detection of the pathogenetic factors of Escherichia and Salmonella}; Grigor'eva LV et al.; The authors have modified the technique for using three stains to detect enterobacterial pathogenicity factors . The methods have been tried with 306 Escherichia and Salmonella strains . The most accurate results were obtained when azure eosin was layered onto culture growth surface and when Congo red was added into solid medium . Crystal violet layering yielded less specific results . The techniques listed above helped detect pathogenicity factors of up to 25-30 percent of Escherichia and up to 17 percent of Salmonella strains . The methods are recommended to be used in complex with other tests in practical studies. J Bacteriol, 1991 Jan, 173(1), 161 - 7 Biological characterization of an Enterobacter cloacae outer membrane protein (OmpX); Stoorvogel J et al.; We have described a gene coding for an Enterobacter cloacae protein, provisionally called OmpX (J . Stoorvogel, M . J . A . W . M . van Bussel, J . Tommassen, and J . A . M . van de Klundert, J . Bacteriol . 173:156-160, 1991) . In the work reported here, OmpX was localized in the cell envelope by means of sucrose gradient fractionation of membrane vesicles . Overproduction of OmpX in Escherichia coli from a multicopy plasmid resulted in a reduction in the amount of OmpF . No accumulation of OmpF, of its uncleft precursor, or of its degradation products could be detected in various cell fractions by Western immunoblot analysis using monoclonal antibodies produced in response to OmpF . A decrease in the rate of synthesis of ompF mRNA was indicated by a beta-galactosidase assay in an ompF-lacZ fusion strain containing the cloned ompX gene and by Northern (RNA) blot analysis . These results indicate that the inhibition is at the level of transcription . Colony hybridization, using an internal ompX fragment as a probe, showed a widespread distribution of the ompX gene among clinical isolates of members of the family Enterobacteriaceae . To study the function of the OmpX protein and its role in the regulation of porin protein synthesis, the ompX gene was deleted from the Enterobacter cloacae chromosome and replaced by the aphA gene . The absence of the ompX gene had no apparent effect on cell growth or on the regulation of the porin proteins. Acta Biochim Pol, 1991, 38(4), 449 - 57 Phosphorylation of acyclonucleosides by nucleoside phosphotransferase from higher plants and bacteria; Rutkowski M et al.; New pyrimidine acyclonucleosides, prepared by us, were phosphorylated by nucleoside phosphotransferase from wheat shoots as well as from Enterobacter agglomerans . Conditions and parameters of enzymic phosphorylation were optimized and the results obtained with the two phosphotransferases were compared. Bull Soc Pathol Exot, 1991, 84(4), 317 - 22 {Is cytobacteriological examination of sputum necessary for the diagnosis of bronchopulmonary superinfections in Abidjan?}; Kacou A et al.; About 276 sputums analysed from 1984 to 1989, 61% of them have been positive . Beside the usual germs of the oropharynged flora, 115 bacteria susceptible of being pathogenic have been isolated . The kinds which are frequently found are Klebsiella = 31 (27%), Escherichia coli = 20 (17%), Enterobacter = 19 (17%), Staphylococcus aureus = 17 (15%) and Pseudomonas aeruginosa = 12 (10%). Roum Arch Microbiol Immunol, 1991 Jan-Mar, 50(1), 53 - 60 Studies of bacterial, rotaviral and Cryptosporidium etiology of acute diarrheal diseases in hospitalized children; Constantiniu S et al.; 657 hospitalized children with acute diarrheal disease were studied for bacterial and rotaviral etiology . Cryptosporidium presence was followed in 123 children . Intestinal pathogens were detected in 195 (29.6%) cases: 132 (20.3%) enterobacteria, 47 (7.1%) rotaviruses, 4 (3.2%) Cryptosporidium sp . and 12 (1.8%) combined infections . Among enterobacteria, E . coli was the most frequent (10% cases) with enteropathogenic (EPEC), enterotoxigenic (ETEC), enterohemorrhagic (EHEC) and enteroinvasive (EIEC) groups . Other isolated pathogens were Salmonella--21 (3.1%), C . jejuni/coli--13 (1.9%), Shigella--3 (0.9%), Y . enterocolitica O3--1 (0.1%) . Among opportunistic pathogenic enterobacteria, the following were isolated: Kl . pneumoniae--24 (3.7%), Enterobacter species--4 (0.6%), Providencia alcalifaciens--1 (0.1%) . Aeromonas hydrophila was isolated in 1 child . Combined infections were detected in 12 children: 10--enterobacteria + rotaviruses associations and 2--pathogenic enterobacteria associations. Chemotherapy, 1991, 37(4), 260 - 9 In vitro activity of a new quinolone, rufloxacin, against nosocomial isolates; Mattina R et al.; The in vitro activity of rufloxacin (MF 934), a new broad-spectrum fluoroquinolone, was tested against 1,032 gram-positive and gram-negative clinical isolates and compared to that of five other compounds of this class . All quinolones except for ciprofloxacin had limited activity against group A and B streptococci and pneumococci (MIC 90% of 4-64 mg/l) and no activity against enterococci . Most species of the enterobacteriaceae and staphylococci were found to be sensitive to rufloxacin (MIC 90% of 0.5-8 and 2-8 mg/l) . Like the other quinolones except for ciprofloxacin, rufloxacin was not active against Pseudomonas aeruginosa . The antibacterial activity of rufloxacin was affected only minimally by an increase in the bacterial inoculum or by alterations in the pH of the medium . In spite of the relatively higher MICs of rufloxacin compared to those of the other quinolones, its favorable pharmacokinetic properties may account for its good clinical efficacy. Biol Met, 1991, 4(4), 244 - 50 The specificity of bacterial siderophore receptors probed by bioassays; Rabsch W et al.; The ability to utilize siderophores of bacterial and fungal origin has been studied in wild-type and mutant strains of the enterobacterial genera Salmonella, Escherichia, Shigella, Moellerella, Klebsiella, Enterobacter, Hafnia, Pantoea, Ewingella, Tatumella, Yersinia, and in the non-enterics Aeromonas, Pseudomonas and Aureobacterium . Although only a few representative strains were tested, the results show characteristic genus-specific differences in the utilization of hydroxamate and catecholate siderophores . Moreover, the different response to structural alterations of certain siderophore classes by some wild-type and mutant strains points to variable interacting receptor domains. Scand J Infect Dis Suppl, 1991, 78, 17 - 21 Why are carbapenems active against Enterobacter cloacae resistant to third generation cephalosporins? Pechere JC. The broad antibacterial activity of carbapenems includes Gram-negative rods resistant to third generation cephalosporins . To increase the understanding of this improved activity, the factors involved in the efficacy of imipenem and ceftriaxone against Enterobacter cloacae have been examined . Resistance to ceftriaxone is primarily the result of a selection of resistant clones ("derepressed mutants"), pre-existing within the Enterobacter populations . Most of the resistant clones produce large amounts of beta-lactamases, and some of them show a decreased expression of porin F coupled with an increased expression of porin C . Determination of outer membrane permeability, as calculated in intact cells using a HPLC-based technique, showed that imipenem penetrated three times faster than ceftriaxone . Moreover, unlike ceftriaxone, imipenem penetration was not affected in a porin F deficient mutant . This suggests that imipenem has an additional pathway not available for ceftriaxone, possibly porin C . The rate of beta-lactamase hydrolysis in experimental conditions thought to be physiologically relevant, and the affinity for PBPs, estimated by calculation, were similar for the two antibiotics . Thus, the activity of imipenem against ceftriaxone resistant E . cloacae seems to result mainly from a selective permeability of the outer membrane. Biol Met, 1991, 4(3), 186 - 91 Chiral linear hydroxamates as biomimetic analogues of ferrioxamine and coprogen and their use in probing siderophore-receptor specificity in bacteria and fungi; Berner I et al.; Linear hydroxamate derivatives, possessing chiral alpha-amino acid moieties, were synthesized and their iron transport activities were studied in bacteria and fungi . No growth-promoting activity could be detected in the Gram-positive hydroxamate-auxotroph Aureobacterium flavescens JG9 . However, Gram-negative enterobacteria, such as Escherichia coli, Pantoea agglomerans and Hafnia alvei were able to utilize iron from these analogues . Uptake of 55Fe-labeled analogues was inhibited by sodium azide, suggesting an active transport process . The receptors involved during uptake in enterobacteria were identified by using appropriate indicator organisms which are defective in the transport of either ferrioxamines (P . agglomerans FM13), coprogens (H . alvei), or both of these siderophore classes (E . coli fhuE) . Our data suggest that the chiral hydroxamates are recognized by the ferrioxamine receptor (FoxA) and the coprogen receptor (FhuE) at a ratio which depends on the optical lambda/delta isomer fraction and the nature of side chains . Transport was also observed in the fungus Neurospora crassa, known to take up coprogen rather than ferrioxamines, suggesting that in this fungus the synthetic analogues behave like coprogen. Dev Genet, 1991, 12(1-2), 54 - 62 Cell-cell contact mediates cAMP secretion in Dictyostelium discoideum; Fontana DR et al.; Cyclic adenosine 3':5' monophosphate (cAMP) and cell-cell contact regulate developmental gene expression in Dictyostelium discoideum . Developing D . discoideum amoebae synthesize and secrete cAMP following the binding of cAMP to their surface cAMP receptor, a response called cAMP signaling . We have demonstrated two responses of developing D . discoideum amoebae to cell-cell contact . Cell-cell contact elicits cAMP secretion and alters the amount of cAMP secreted in a subsequent cAMP signaling response . Depending upon experimental conditions, bacterial-amoebal contact and amoebal-amoebal contact can enhance or diminish the amount of cAMP secreted during a subsequent cAMP signaling response . We have hypothesized that cell-cell contact regulates D . discoideum development by altering cellular and extracellular levels of cAMP . To begin testing this hypothesis, these responses were further characterized . The two responses to cell-cell contact are independent, i.e., they can each occur in the absence of the other . The responses to cell-cell contact also have unique temperature dependences when compared to each other, cAMP signaling, and phagocytosis . This suggests that these four responses have unique steps in their transduction mechanisms . The secretion of cAMP in response to cell-cell contact appears to be a non-specific response; contact between D . discoideum amoebae and Enterobacter aerogenes, latex beads, or other amoebae elicits cAMP secretion . Despite the apparent similarities of the effects of bacterial-amoebal and amoebal-amoebal contact on the cAMP signaling response, this contact-induced response appears to be specific . Latex beads addition does not alter the magnitude of a subsequent cAMP signaling response.(ABSTRACT TRUNCATED AT 250 WORDS) FEBS Lett, 1990 Dec 17, 277(1-2), 212 - 4 Use of electrospray mass spectrometry to directly observe an acyl enzyme intermediate in beta-lactamase catalysis; Aplin RT et al.; Electrospray mass spectrometry was used to directly observe intact acyl enzyme complexes formed between a class C beta-lactamase (from Enterobacter cloacae P99) and four poor substrates/inhibitors . In each case the molecular weight difference between the unreacted and the reacted beta-lactamase was consistent with the formation of an acyl enzyme. Biochem J, 1990 Dec 15, 272(3), 627 - 31 Cloning, sequencing and analysis of the structural gene and regulatory region of the Pseudomonas aeruginosa chromosomal ampC beta-lactamase; Lodge JM et al.; The chromosomal gene from Pseudomonas aeruginosa encoding beta-lactamase has been cloned, and the sequence determined and compared with corresponding sequences of beta-lactamases from members of the enterobacteriaceae . Upstream of the beta-lactamase gene is an open reading frame which we postulate encodes a regulatory protein, AmpR . We identified a helix-turn-helix region in AmpR and a putative AmpR-binding site. J Antimicrob Chemother, 1990 Dec, 26 Suppl F, 3 - 11 Changes in the antibiotic sensitivities of urinary pathogens, 1971-1989; Gruneberg RN; All urinary pathogens from general practice and hospital have been tested for sensitivity to a range of antimicrobial agents for the last 19 years . There have been marked changes during that time . In general practice there has been a considerable increase in the proportion of staphylococcal infections from 5.1% to a peak of 14.8% in 1982 and a more recent decline to 3.4% . There has also been a decrease in the proportion caused by Proteus mirabilis, from 9.2% to 5.0% . Similar, but smaller changes have been observed in the proportions of hospital urinary tract infections (UTI) caused by these organisms, while the proportion of hospital infections due to Klebsiella spp . and Enterobacter spp . has fallen from 16.8% to 9.2% . These and other changes have been reflected in changing patterns of sensitivity to antibiotics . In particular, sensitivity of urinary pathogens to ampicillin/amoxycillin has continued to fall both in general practice and in hospital . Nalidixic acid resistance is becoming more important as the proportion of Gram-positive urinary pathogens (especially enterococci) increases . More organisms were sensitive to ciprofloxacin than the other drugs tested, with no evidence of increasing resistance over a six-year period . Over the same time there has been a reduction of overall sensitivity of urinary pathogens to trimethoprim from 90.8% to 82.5% in general practice, with no significant change in isolates from hospital practice. Am Ind Hyg Assoc J, 1990 Dec, 51(12), 652 - 8 Stimulation and release of prostaglandins and thromboxane from macrophages by cotton dust associated lipopolysaccharides; Elissalde MH et al.; Decreases in the ventilation capacity of human lungs following the inspiration of cotton dust correlates more closely with the concentration of endotoxin in the dust than with any other parameter measured thus far . A lipopolysaccharide isolated from the endotoxin of Enterobacter agglomerans, a common bacterial contaminant of cotton fiber, stimulated isolated rat macrophages to produce and release prostaglandins 6 keto-PGF1 alpha, PGF2 alpha, PGE2, PGD2, PGA2, and PGB2 and thromboxane B2 . If in vivo human pulmonary macrophages respond in a similar fashion by releasing these arachidonic acid metabolites or their immediate precursors in response to stimulation by cotton dust associated lipopolysaccharides, some of the acute pulmonary changes observed in humans following inspiration of cotton dust could be caused by increased release of these biologically active compounds . Daily release of arachidonic acid metabolites at concentrations significantly above normal homeostatic levels could produce some of the pathophysiologic pulmonary changes observed in byssinotics . This paper reports the results of an experiment to quantitate arachidonic acid metabolite production following macrophage stimulation by E . agglomerans lipopolysaccharide . Procedures are described for the stimulation of macrophages by cotton dust associated lipopolysaccharide, for the separation and identification of arachidonic acid and its metabolites by high-performance liquid chromatography, and for the quantification of those products by radioisotope techniques. Wei Sheng Wu Xue Bao, 1990 Dec, 30(6), 408 - 16 {Analysis of cellular fatty acids of Enterobacteria species by gas chromatography-mass spectrometry}; Zhou F et al.; Cellular fatty acid compositions of 15 Enterobacteria were analyzed by gas chromatography-mass spectrometry(GC-MS) . About 30 fatty acids were detected in chromatograms, and 13 of them were chemically identified, e.i . C11:0, C12:0, C13:0, C14:0, C15:0, 2OH-C14:0, 3OH-C14:0, C16:1, C16:0, aC17:0, delta C17:0, C18:1 and C18:0 . The major cellular fatty acids in all fifteen species were C16:0, C18:1, C15:0, C14:0, C16:1, C13:0, 3OH-C14:0 and C18:0 . The cellular fatty acids of Enterobacteria species were characterized by normal straight-chain saturated acids and monounsaturated acids, of which the most abundant fatty acid was C16:0 . 3OH-C14:0 was found in all strains of Enterobacteria, whereas 2OH-C14:0 was only found in strains of Serratia species . Other unknown compositions also would have been certain characteristics for bacteria . The present paper would provide some of useful reference data for chemotaxonomy and molecular microbiology of Enterobacteria. Wei Sheng Wu Xue Bao, 1990 Dec, 30(6), 403 - 7 {A new serotype of Salmonella IIIb}; Pan R et al.; An enterobacterium culture, S3188, providing with Salmonella biological characteristics, except exhibiting indole positive reaction, was isolated from the intestinal content of reptile a snake . It utilized malonate, did not ferment dulcitol, it attacked lactose promptly, and ONPG positive . H antigens appeared diphasic . By cross agglutination and absorption tests, it was demonstrated that the antigenic formula of this strain is 53:1, Z13:e, n,(Z15).. . It was found to be a new serotype of Salmonella IIIb. Biochem J, 1990 Dec 1, 272(2), 505 - 10 Nucleotide sequences of genes encoding the type II chloramphenicol acetyltransferases of Escherichia coli and Haemophilus influenzae, which are sensitive to inhibition by thiol-reactive reagents; Murray IA et al.; Sensitivity of enzymes to inhibition by thiol-reactive reagents is often presented as evidence for the possible involvement of cysteine residues in substrate binding and catalysis or to highlight possible important differences in structure and mechanism between closely related enzymes . The primary phenotypic distinction between the enterobacterial type II chloramphenicol acetyltransferase (CATII; typified by the enzyme encoded by the incW transmissible plasmid pSa) and the CATI and CATIII variants is the greatly enhanced susceptibility of CATII to inactivation by thiol-specific modifying reagents . Determination of the nucleotide sequence of the gene, catII, present on pSa and that of a related determinant, catIIH, isolated from Haemophilus influenzae indicates that sensitivity to such reagents cannot be due to the presence of additional reactive cysteine residues in CATII . Comparative analysis of the inactivation of CATII and CATIII by 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB), 4,4'-dithiodipyridine (DTDP) and methyl methanethiosulphonate (MMTS) suggests that (i) inactivation occurs as a result of chemical modification of the same residue (Cys-31) in each enzyme, (ii) reagents that inactivate via a pseudo-first-order process (DTNB and DTDP) appear to bind with a greater affinity to CATII, and (iii) the intrinsic reactivity of Cys-31 in CATII greatly exceeds that of the corresponding residue in CATIII . The results lead to the conclusion that a striking difference in chemical reactivity of a unique and conserved thiol group between closely related enzyme variants may not be easily explained even when a high-resolution tertiary structure is available for one of them . Plausible explanations include more favourable access of reagents to Cys-31 in CATII or an enhanced reactivity of its thiol group imposed by the side chains of residues that are not in immediate contact with it. Oral Surg Oral Med Oral Pathol, 1990 Dec, 70(6), 715 - 9 In vitro effect of chlorhexidine and amikacin on oral gram-negative bacilli from bone marrow transplant recipients; Brown AT et al.; Prophylactic use of chlorhexidine (CHX) mouthrinses has been shown to benefit the oral health status of bone marrow transplant recipients and other immunosuppressed persons and to reduce systemic complications of oral origin . However, a problem that often emerges with these patients is oropharyngeal and lower respiratory tract colonization by opportunistic aerobic or facultative gram-negative bacilli (GNB) . Trends in four studies indicated that CHX rinses may predispose these persons to oral colonization by GNB such as the enterobacteria, Klebsiella pneumoniae and Enterobacter cloacae . Since GNB are generally susceptible to broad-spectrum aminoglycoside antibiotics such as amikacin, the in vitro sensitivities of K . pneumoniae, E . cloacae, Pseudomonas aeruginosa, and Escherichia coli ATCC reference strains and K . pneumoniae and E . cloacae oral clinical isolates to combinations of CHX and amikacin were determined by means of a disk diffusion sensitivity assay on Mueller-Hinton agar . The amikacin minimum inhibitory concentrations for all GNB tested were much lower (less than or equal to 4.69 to less than or equal to 9.37 micrograms/ml) than those for CHX (less than or equal to 18.75 to less than or equal to 300 micrograms/ml), and combinations of CHX and amikacin gave larger growth inhibition zones than CHX alone . No antibacterial antagonism between CHX and amikacin was found, and their solubilities were compatible . Therefore use of topical amikacin in conjunction with CHX rinses may reduce oral colonization by GNB in severely immunocompromised patient populations. Surg Clin North Am, 1990 Dec, 70(6), 1297 - 312 Acute cholangitis; Lipsett PA et al.; Cholangitis is an infection of the biliary ductal system that results from the combination of bactibilia and biliary obstruction . Choledocholithiasis has been the leading cause of cholangitis . However, in recent years, especially at tertiary referral centers, nonoperative biliary manipulations, often in patients with unresectable malignancies, have become the most common cause of cholangitis . As a result, the complete triad of fever and chills, jaundice, and abdominal pain, as originally described by Charcot, is now seen less frequently . Most patients still have leukocytosis and abnormal liver function tests, but many patients with indwelling tubes may develop cholangitis without significant jaundice . E . coli, Klebsiella species, and the enterococci remain the most frequently isolated organisms, and anaerobes including Bacteroides fragilis are recovered in 15% to 30% of patients . However, Enterobacter and Pseudomonas species, as well as yeasts, are now being isolated more frequently from patients with indwelling tubes, who often have been treated previously with antibiotics . Computed cholangiography usually is necessary to determine the cause and site of biliary obstruction . In the majority of patients with cholangitis, cholangiography can be delayed until the patient has been afebrile for a minimum of 24 to 48 hours . Initial therapy includes bowel rest, intravenous fluids, and antibiotics . Many antibiotic regimens are now available to cover the gram-negative aerobes, the enterococcus, and the anaerobes that are likely to be causing the biliary infection . The combination of a penicillin and an aminoglycoside has been the gold standard . However, recent studies suggest that the newer broad-spectrum penicillins provide adequate therapy for these patients . Only a small percentage (5%-10%) of patients with toxic cholangitis require emergency biliary decompression . The choice of percutaneous or endoscopic drainage should be made on the basis of the presumed site and cause of obstruction as well as local expertise . The nature of the biliary obstruction may be the most important determinant of outcome . At present, patients with end-stage malignant obstruction account for most of the deaths, whereas approximately 95% of patients survive an episode of cholangitis. Zentralbl Bakteriol, 1990 Dec, 274(3), 406 - 16 Suppression of blastogenic transformation of lymphocytes by Bacteroides fragilis in vitro and in vivo; Rodloff AC et al.; Bacteroides species and Enterobacteriaceae are known to cause synergistic infections . However, the mechanisms behind this synergy are not completely understood . Several authors have shown that Bacteroides species may inhibit the phagocytosis of Enterobacteriaceae by polymorphonuclear leukocytes as well as by macrophages . With the present study we have addressed the question of whether Bacteroides fragilis (BF) is also capable of suppressing specific immune functions . When incubated together with murine lymphocytes, BF significantly inhibited the blastogenic transformation of these cells stimulated by Escherichia coli-lipopolysaccharide (LPS) or concanavalin A . This effect was dose dependent and was not mediated by prostaglandins . Other bacteria such as E . coli or Listeria monocytogenes did not show such an extensive suppression, while Streptococcus pneumoniae was equally active . BF also inhibited the pokeweed mitogen induced blastogenic transformation of human lymphocytes . Moreover, lymphocytes from BF-injected animals obtained 3 to 12 hours after infection proved to be partly refractory for LPS-stimulation . Finally, BF injections also affected T-cell dependent immunity as judged from the aggravation of an experimental listeriosis in mice. J Antimicrob Chemother, 1990 Dec, 26(6), 769 - 81 In-vitro and in-vivo antibacterial activities of E1040, a new cephalosporin with potent antipseudomonal activity; Hiruma R et al.; E1040 is a new parenteral cephalosporin with a broad antibacterial spectrum and potent activity against Gram-negative bacteria including Pseudomonas aeruginosa . The in-vitro activities of E1040 against clinical isolates of Enterobacter cloacae, Ent . aerogenes, Providencia rettgeri, and Morganella morganii were superior to those of ceftazidime, cefoperazone, cefmenoxime, and cefuzonam . The activities of E1040 against Gram-positive cocci were comparable with those of ceftazidime, but it was less active than cefmenoxime, cefuzonam, and cefoperazone . Against Ps . aeruginosa, E1040 was more potent than the other compounds, with an MIC90 of 0.39 mg/l, 1/16 that of ceftazidime . The in-vitro activity of E1040 was well sustained in vivo as shown by results obtained in experimental infections in mice . In particular, E1040 was the most active drug against Ps . aeruginosa including gentamicin-resistant and beta-lactamase-overproducing strains . Morphological studies using a scanning electron microscope and a phase-contrast microscope showed that E1040 caused spheroplast and bulge formation in Ps . aeruginosa at low concentrations. J Antimicrob Chemother, 1990 Dec, 26 Suppl F, 145 - 56 Susceptibility to ciprofloxacin of nosocomial gram-negative bacteria and staphylococci isolated in the UK; George RC et al.; At the end of 1989 the Division of Hospital Infection of the Central Public Health Laboratory completed five years of continuous surveillance of ciprofloxacin susceptibility amongst strains of Staphylococcus aureus and Pseudomonas aeruginosa . The strains studied were referred from many different UK laboratories for epidemiological or other typing . Between 1987 and 1989, referred cultures of coagulase-negative staphylococci, Klebsiella spp . and Enterobacter spp . were also examined . In total, 25,728 cultures from 254 different laboratories were included in the study, and S . aureus was the most common species amongst the survey material . Resistance to non-quinolone antimicrobials was common amongst the isolates . Over the study period there has been a gradual decline in the percentage of cultures received that were fully susceptible to ciprofloxacin and an increase in the number of laboratories referring strains with resistance or reduced sensitivity . Full susceptibility of S . aureus to ciprofloxacin has declined from 99.6% of 8981 cultures isolated in the two years before launch to 92.8% of 1968 cultures isolated during 1989 . Amongst the coagulase-negative staphylococci there has been a similar decline in susceptibility from 99.4% of 658 cultures examined in 1987 to 92.6% of 433 cultures studied in 1989 . There was also a decrease in susceptibility of P . aeruginosa isolates to ciprofloxacin from 98.6% of 2579 cultures isolated in 1985 and 1986 to 86.3% of 1152 cultures examined during 1989 . Most of this decrease was attributable to the appearance of strains of intermediate susceptibility to ciprofloxacin (MICs 2 or 4 mg/l) . Virtually no resistance to ciprofloxacin was observed amongst isolates of Klebsiella spp . and Enterobacter spp . referred between 1987 and 1989 . The emergence of ciprofloxacin resistance, and by implication cross resistance to many of the other fluoroquinolones, is a worrying development and suggests that caution should be exerted in the use of these compounds for the treatment of infections due to staphylococci and P . aeruginosa. Eur J Epidemiol, 1990 Dec, 6(4), 407 - 11 rRNA probing of chromosomal DNA of epidemic and sporadic isolates of Salmonella enterica subsp . enterica serovar Kottbus from northern and southern Italy; Nastasi A et al.; Fifty-two strains of Salmonella enterica subsp . enterica serovar Kottbus, identified at the Centres of Enterobacteriaceae of Northern and Southern Italy, were investigated by molecular genetic methods . Thirteen isolates were recovered during two food-poisoning outbreaks that occurred in May 1987 in Lombardy . The rDNA gene restriction patterns, obtained by probing endonuclease cleaved chromosomal DNA with photobiotin labeled Escherichia coli rRNA, revealed some heterogeneity among strains isolated from Southern Italy, whereas Northern Italy isolates exhibited virtually identical banding patterns. Burns, 1990 Dec, 16(6), 445 - 8 Infection control in a Third World burn facility; Bowen-Jones JR et al.; A study of wound colonization by bacteria in 49 consecutive admissions was conducted over a 2-month period in patients with burns at King Edward VIII and Clairwood Hospitals, Durban, neither of which possess proper burn units . Specimens for culture were collected from patients, staff and the environment . Bacteria most frequently isolated were Staph . aureus, Klebsiella spp., Ps . aeruginosa and Enterobacter spp . Cross-infection occurred due to breakdown of aseptic techniques . Staff hands and contaminated baths and benches were also implicated . Recommendations to reduce cross-infection are presented. Biochem Biophys Res Commun, 1990 Nov 30, 173(1), 53 - 9 Primary structure and expression of the Ssc-protein of Salmonella typhimurium; Hirvas L et al.; A 1020-bp open reading frame (ORF) was found immediately downstream of the ompH gene of Salmonella typhimurium . This ORF (ORF-36) encodes a moderately hydrophobic protein with 341 amino acid residues (calculated molecular mass, 35,928 Da) . The ORF-36 product was detected in minicells . Downstream of ORF-36, another ORF was found . It is highly homologous to the E . coli ORF (ORF-17.4) which precedes the lpx-genes involved in lipid A biosynthesis . ORF-36 is probably analogous to the firA gene of E . coli, the sequence of which has not yet been published . Thus it appears that the enterobacterial ompH and lpx genes are separated only by the ORF-36 and ORF-17.4 genes . We also discuss the data on the function of the ORF-36 protein . On this basis, we suggest that the protein could be called the Ssc protein. Kansenshogaku Zasshi, 1990 Nov, 64(11), 1400 - 7 {Nosocomial infection by new quinolone resistant Enterobacter cloacae}; Nada T et al.; For the past two years, five strains of new quinolone resistant Enterobacter cloacae have been isolated from three patients in our hospital; strain A was isolated from patient A, strain B from patient B, and strains C1, C2, C3 from patient C . These five strains were resistant to new quinolones and other antimicrobial agents including ampicillin, piperacillin, methicillin, cefotaxime, cefoperazone, kanamycin, gentamicin, tetracycline, minocycline, and chloramphenicol . Plasmid DNA profiles on agarose gel indicated that strain B and C3 carried completely the same plasmid pattern, but strain A gave a different plasmid pattern . Furthermore chromosomal DNAs extracted from strains A, B and C3 were digested with restriction endonucleases EcoR I, BamH I and Sma I . They were separated by pulsefield gel electrophoresis . The banding profiles of strains B and C3 showed the same pattern . It is, therefore, highly suggested that strains B and C3 are the same E . cloacae strain, although isolated from different patients at different time . The possible route of nosocomial infection between these two patients who were hospitalized in the same room after an interval of 4 months was discussed. J Antimicrob Chemother, 1990 Nov, 26 Suppl D, 115 - 21 Efficacy of intravenous ofloxacin: a French multicentre trial in 185 patients; Mouton Y et al.; The efficacy of intravenous ofloxacin therapy (200 mg 12-hourly) followed, when appropriate, by oral administration of the same dose was evaluated in an open multicentre trial involving 185 patients in 31 French hospitals . Dosage adjustment was made for patients in renal failure . Infection was hospital-acquired in 35 cases, 53 patients required admission to an intensive care unit . The infections comprised septicaemia (n = 56), pneumonia (n = 18), bronchitis (n = 10), urinary tract (n = 78), female pelvis (n = 8), bone and joint (n = 5), skin and soft tissues (n = 10) . The causative pathogens were: Staphylococcus spp . (n = 23), Streptococcus spp . (n = 11), Escherichia coli (n = 85), Haemophilus influenzae (n = 9), Klebsiella, Enterobacter or Serratia spp . (n = 21), Salmonella spp . (n = 22), Chlamydia spp . (n = 3), Legionella spp . (n = 1), Mycoplasma pneumoniae (n = 1) and miscellaneous Gram-negative bacilli (n = 17) . All were ofloxacin-susceptible . Mean duration of therapy was 8.06 ( +/- 2.6) days for the i.v . and 14.8 ( +/- 14.39) days for the oral preparation . Clinical cure was achieved in 173 patients (93.5%) . It is concluded that iv ofloxacin is an effective treatment for a range of infections due to susceptible organisms. J Antimicrob Chemother, 1990 Nov, 26 Suppl D, 107 - 14 Severe infections treated with intravenous ofloxacin: a prospective clinical multicentre Swiss study; Regamey C et al.; In this open prospective clinical trial of iv ofloxacin, 87 patients were treated for severe bacterial infections . Overall results showed a clinical cure rate of 75% and 79/87 87 patients improved . 86% of causative organisms (all sensitive to ofloxacin) were eliminated . The best results were obtained in urinary tract infections where all 30 patients were clinically cured and 27 organisms (Escherichia coli, group D streptococcus, Proteus mirabilis and Klebsiella pneumoniae) were eliminated . Rapid clinical cure was observed in five patients with prostatitis . Good results were seen in arthritis and osteomyelitis . Less than three days of parenteral therapy were required before improvement was seen in patients presenting with severe enterocolitis . Ofloxacin treatment was used for the treatment of lower respiratory tract infections in 35 patients . Clinical improvement was noted in 28 patients . Five patients had unsatisfactory responses, mainly due to underlying diseases . There were two failures, both in pneumococcal pneumonia . Three minor side effects were recorded . Ofloxacin can be given for severe bacterial infections due to Enterobacteriaceae, other Gram-negative rods and other sensitive organisms . It can be given in penicillin allergic patients but it should not be used in pneumococcal pneumonia. Bol Med Hosp Infant Mex, 1990 Nov, 47(11), 772 - 6 {Neonatal meningitis: observations on its etiology, mortality and sequelae}; Sanchez-Saucedo LU et al.; A retrospective study was carried out on all cases diagnosed with neonatal meningitis at the Hospital Infantil de Mexico Federico Gomez . A rate of 9.6 cases per 1,000 discharged patients was found as well as 6.7% association with sepsis . In 50 of the cases analyzed, an etiologic agent was identified in 23 children; the main bacteria identified were Escherichia coli (24%), Klebsiella pneumoniae (14%), Enterobacter (4%), Proteus mirabilis and Pseudomonas sp (2%), respectively . The mortality rate was 60% and sequelae were seen in 13 of the surviving 20 patients . The unfavorable prognosis of neonates with meningitis forces us to establish an early diagnosis, make every effort to identify the causing agent and try new medications as well as co-adjuvant treatments. Diagn Microbiol Infect Dis, 1990 Nov-Dec, 13(6), 467 - 72 Epidemiologic typing of Enterobacter sakazakii in two neonatal nosocomial outbreaks; Clark NC et al.; Two unrelated hospital outbreaks of Enterobacter sakazakii, involving meningitis, bacteremia, and colonization of neonates, were investigated . In each of these outbreaks, E . sakazakii was isolated from both patients and dried infant formula . In previous outbreaks, the source and mode of transmission of E . sakazakii in neonatal infections was not determined . In this study, we used a combination of typing methods (plasmid analysis, antibiograms, chromosomal restriction endonuclease analysis, ribotyping, and multilocus enzyme electrophoresis) to evaluate the isolates from each outbreak as to their relatedness . The typing results differed among outbreaks, but in each one, patient and formula isolates shared the same typing pattern . The only exceptions were disk antibiograms, which often varied among colonies selected from each of the isolates . Plasmid analysis, chromosomal restriction endonuclease analysis, ribotyping, and multilocus enzyme electrophoresis all were effective as epidemiological typing methods for E . sakazakii, especially when used in combination . By using this typing scheme, we have confirmed that E . sakazakii from intrinsically contaminated dried infant formula was the source of neonatal infection. J Reprod Med, 1990 Nov, 35(11 Suppl), 1070 - 7 Role of new cephamycins in the management of obstetric and gynecologic infections; Jones RN; The results of in vitro and in vivo studies of cefmetazole, a second-generation cephamycin, were reviewed . Cefmetazole's spectrum of activity includes clinical coverage of many Enterobacteriaceae, staphylococci, streptococci, Haemophilus species, pathogenic Neisseria organisms, Moraxella (Branhamella) catarrhalis and anaerobic bacteria . Cefmetazole is generally two to eight times more potent than cefoxitin against organisms within their spectra and is most active against staphylococci (minimal inhibitory concentration90 = 2.0 micrograms/mL) . Methicillin-resistant Staphylococcus aureus strains are more susceptible to cefmetazole, alone or in combination with fosfomycin, than to any other cephamycins, and cefmetazole is remarkably resistant to the beta-lactamases produced by aerobic and anaerobic bacteria . The incidence of adverse drug reactions is low (8.8% in the United States, 2.2% in Japan), and the drug has been demonstrated to have cost-containment potential. J Reprod Med, 1990 Nov, 35(11 Suppl), 1064 - 9 Role of cephamycins in obstetrics and gynecology; Sweet RL; Infections of the female upper genital tract are usually polymicrobic, often involving mixed aerobic (facultative) and anaerobic bacteria . Optimal therapy provides coverage against aerobes (both gram positive and gram negative and especially the Enterobacteriaceae) and anaerobes (especially the beta-lactamase-producing gram-negative species, such as Bacteroides) . A variety of antibiotics provide the broad spectrum of activity needed for these infections, including clindamycin plus an aminoglycoside, cephalosporins and cephamycins, imipenem, extended-spectrum penicillins and the beta-lactam agents combined with a beta-lactamase inhibitor . The cephamycins--cefoxitin, cefotetan and cefmetazole--have been shown to have a high rate of clinical efficacy and bacteriologic response . The cephalosporins are usually used for prophylaxis at the time of obstetric and gynecologic surgery . The cephamycins have recently undergone extensive evaluation for prophylaxis and have demonstrated comparable microbiologic and clinical efficacy . A pharmacokinetic comparison of cefoxitin, cefotetan and cefmetazole points to cefmetazole as a cost-effective alternative to cefoxitin and cefotetan for both prophylaxis and treatment of pelvic infections. Appl Environ Microbiol, 1990 Nov, 56(11), 3463 - 7 Survival of bacteria during aerosolization; Marthi B et al.; One form of commercial application of microorganisms, including genetically engineered microorganisms is as an aerosol . To study the effect of aerosol-induced stress on bacterial survival, nonrecombinant spontaneous antibiotic-resistant mutants of four organisms, Enterobacter cloacae, Erwinia herbicola, Klebsiella planticola, and Pseudomonas syringae, were sprayed in separate experiments in a greenhouse . Samples were collected over a distance of 15 m from the spray site for enumeration . Spores of Bacillus subtilis were used as tracers to estimate the effects of dilution on changes in population over distance . Viable counts of P . syringae, Enterobacter cloacae, and K . planticola decreased significantly over a distance of 15 m . Erwinia herbicola showed no significant decline in counts over the same distance . The degree of survival of P . syringae during aerosolization was dependent on ambient environmental conditions (i.e., temperature, relative humidity), droplet size of the aerosol, and prior preparative conditions . Survival was greatest at high relative humidities (70 to 80%) and low temperatures (12 degrees C) . Survival was reduced when small droplet sizes were used . The process of washing the cells prior to aerosolization also caused a reduction in their survival . Results from these experiments will be useful in developing sound methodologies to optimize enumeration and for predicting the downwind dispersal of airborne microorganisms, including genetically engineered microorganisms. J Med Microbiol, 1990 Nov, 33(3), 153 - 63 Interactions of Escherichia coli and Proteus mirabilis with mouse mononuclear phagocytes; Wells CL et al.; Five strains of enterobacteria (three of Escherichia coli and two of Proteus mirabilis) were studied to assess and compare their phagocytic uptake and intracellular killing by mouse macrophages . Each strain was injected intraperitoneally into separate groups of mice and peritoneal exudate cells were harvested after 3 min for phagocytosis to occur in vivo . Acridine orange staining showed that there were approximately 10-fold fewer intracellular P . mirabilis than E . coli cells . The average numbers of viable intracellular bacteria per leucocyte were 0.03 and 0.02 for P . mirabilis strains M13 and H1, respectively, and 0.48, 0.45, and 0.28 for E . coli strains M14, A-D M5 and H40 . Thus, both P . mirabilis strains were ingested less readily than any of the three E . coli strains (p less than 0.01) . The rates of in-vitro intracellular killing were similar for all five strains of bacteria . The intracellular killing constants (Kk) for the three mouse isolates were 0.017, 0.016 and 0.020 min for E . coli M14 and A-D M5, and P . mirabilis M13, respectively; the Kks for the two human isolates were 0.026 and 0.029/min for E . coli H40 and P . mirabilis H1, respectively . The Kks for all five strains were not significantly different . Assuming that the numbers of viable intracellular bacteria at the beginning of the assay represented 100% viability, 6-17% of the intracellular bacteria remained viable after 2 h, reflecting log10 3.9-5.6 bacteria (6-8) x 10(6) peritoneal exudate cells . Intravenous injection of these five strains into separate groups of mice demonstrated that the P . mirabilis strains were more virulent than the E . coli strains . Injection of each P . mirabilis strain was associated with ruffled fur and death, whereas mice given any of the three E . coli strains remained visibly healthy and none died . Consistent with these observations, quantitation of viable bacteria in the liver and spleen showed that greater numbers of P . mirabilis M13 than of E . coli M14 or A-D M5 persisted in these organs; similarly greater numbers of P . mirabilis H1 than of E . coli H40 persisted in the liver and spleen . Because the rates of intracellular killing of these five strains were similar, the relative virulence of both strains of P . mirabilis appeared to be associated with decreased phagocytic uptake rather than differences in intracellular survival. J Bacteriol, 1990 Nov, 172(11), 6261 - 7 Analysis of the Erwinia chrysanthemi arb genes, which mediate metabolism of aromatic beta-glucosides; el Hassouni M et al.; Erwinia chrysanthemi is one of the few members of the family Enterobacteriaceae that is capable of metabolizing most of the naturally occurring beta-glucosides . We previously isolated the clb genes, which allow the use of the disaccharide cellobiose as well as the aromatic beta-glucosides arbutin and salicin . We report here the isolation of the arb genes, which permit fermentation of the aromatic beta-glucosides only . Establishment of a functional Arb system in Escherichia coli depended on the presence of the phosphotransferase system and on the activation by the cyclic AMP-cyclic AMP receptor protein complex . Strains carrying mini-Mu-induced LacZ fusions to the arb genes were used to analyze arb genes organization and function . Three arb genes (arbG, arbF, and arbB) were identified and organized in this order . Genetic and structural evidence allowed us to assign a phospho-beta-glucosidase and a permease activity to the ArbB and ArbF proteins, respectively . Several Lac+ arb-lacZ insertions were introduced into the E . chrysanthemi chromosome . Both ArbG- and ArbF- strains were unable to ferment the aromatic beta-glucosides, whereas ArbB- strains were impaired only in salicin fermentation . None of the mutations in the arb genes affected cellobiose metabolism . The expression of the arb genes was substrate inducible and required the ArbF permease and, possibly, the ArbG protein . Collectively, our results underline the resemblance between the naturally expressed E . chrysanthemi arbGFB and the cryptic E . coli bglGFB operons, yet the arbG gene product seemed unable to activate E . coli bgl operon expression. Mol Plant Microbe Interact, 1990 Nov-Dec, 3(6), 429 - 37 The rcsA gene from Erwinia amylovora: identification, nucleotide sequence, and regulation of exopolysaccharide biosynthesis; Bernhard F et al.; RcsA is a positive activator of extracellular polysaccharide synthesis in the Enterobacteriaceae . A cosmid clone containing the rcsA gene from Erwinia amylovora was identified by its ability to restore mucoidy to an E . stewartii rcsA mutant . The rcsA gene was subcloned on a 2.2-kilobase HindIII-PstI fragment that hybridized with an E . stewartii rcsA probe and complemented E . stewartii and Escherichia coli rcsA mutants . In addition, the cloned E . amylovora rcsA gene stimulated expression of cps::lac fusions in E . coli and E . stewartii . The rcsA region was sequenced, and one open reading frame of 211 amino acids was found . The predicted protein sequence specified by this open reading frame was 55% homologous with that of the Klebsiella pneumoniae RcsA protein . Highly conserved regions in the 3' and 5' ends of the two proteins were observed . An E . amylovora rcsA mutant was constructed by Tn5 mutagenesis of the cloned gene followed by recombination of the mutation into the chromosome of wild-type strain Ea1/79 . The synthesis of both amylovorin and levan was reduced by more than 90% in this mutant, indicating common regulation of the two polysaccharides by rcsA . Virulence of the rcsA mutant on immature pear fruit was diminished but not completely abolished. Antimicrob Agents Chemother, 1990 Nov, 34(11), 2234 - 9 Effect of serum on the in vitro activities of 11 broad-spectrum antibiotics; Perl TM et al.; We evaluated the effect of serum on the in vitro activities of 11 antimicrobial agents against gram-negative isolates obtained from 100 patients with nosocomial bacteremia . The test organisms included 25 stains of Pseudomonas aeruginosa and 75 strains of the family Enterobacteriaceae . MICs were determined by broth microdilution with Mueller-Hinton broth alone or supplemented with 25 or 50% pooled, heat-inactivated human serum (25S or 50S, respectively) . Among the antibiotics evaluated, the protein binding ranged from 9 to 95% . The antibiotics tested and their MICs for 90% of the strains tested in 50S included ciprofloxacin (0.12 micrograms/ml), ceftazidime (1 micrograms/ml), imipenem (1 micrograms/ml), aztreonam (4 micrograms/ml), cefpirome (4 micrograms/ml), cefotaxime (16 micrograms/ml), cefoperazone (16 micrograms/ml), desacetylcefotaxime plus cefotaxime (32 micrograms/ml), ceftriaxone (greater than 32 micrograms/ml), ticarcillin (128 micrograms/ml), and desacetylcefotaxime (greater than 128 micrograms/ml) . MICs for 90% of the strains tested were calculated with 95% confidence intervals to show the precision of the MICs for these strains . With the exceptions of ceftriaxone (greater than 95% protein bound) and cefoperazone (90% protein bound), serum had no significant effect on the in vitro activities of various agents . A fourfold-or-greater increase in the MIC of ceftriaxone was observed in 45 of 100 isolates with 50S and in 30 of 100 isolates with 25S . With cefoperazone, 17 of 100 isolates demonstrated more than 2 twofold dilution increases in 50S . Testing of antibiotics which were less protein bound illustrated minor effects primarily with members of the Enterobacteriaceae . The presence of serum did not adversely affect the in vitro activities of broad-spectrum agents against these nosocomial isolates. J Bacteriol, 1990 Nov, 172(11), 6512 - 7 Nucleotide sequence of the Pseudomonas fluorescens signal peptidase II gene (lsp) and flanking genes; Isaki L et al.; The lsp gene encoding prolipoprotein signal peptidase (signal peptidase II) is organized into an operon consisting of ileS and three open reading frames, designated genes x, orf149, and orf316 in both Escherichia coli and Enterobacter aerogenes . A plasmid, pBROC128, containing a 5.8-kb fragment of Pseudomonas fluorescens DNA was found to confer pseudomonic acid resistance on E . coli host cells and to contain the structural gene of ileS from P . fluorescens . In addition, E . coli strains carrying pBROC128 exhibited increased globomycin resistance . This indicated that the P . fluorescens lsp gene was present on the plasmid . The nucleotide sequences of the P . fluorescens lsp gene and of its flanking regions were determined . Comparison of the nucleotide sequences of the lsp genes in E . coli and P . fluorescens revealed two highly conserved domains in this enzyme . Furthermore, the five genes which constitute an operon in E . coli and Enterobacter aerogenes were found in P . fluorescens in the same order as in the first two species. Enferm Infecc Microbiol Clin, 1990 Nov, 8(9), 565 - 7 {Bacteriological study of bile from the gallbladder and bile ducts of patients surgically treated for biliary pathology}; Tejero A et al.; We have evaluated the results of a bacteriological study of bile in 115 patients undergoing biliary surgery in the Valdivia Hospital (Chile) . 35.6% of the positive bile cultures corresponded to patients with acute cholecystitis and only 22.5% to chronic disease . The culture was positive in 56.3% of cases of common bile duct stones and in 86.7% of cholangitis . Most positive bile cultures were monomicrobial, corresponding to patients with chronic cholecystitis . Most isolates were from Enterobacteriaceae, 49% of which corresponding to Escherichia coli . The in vitro sensitivity study showed that, as a rule, the strains were sensitive to the used antimicrobials. Zh Mikrobiol Epidemiol Immunobiol, 1990 Nov, (11), 26 - 9 {The characteristics of the biological properties of Shigella dysenteriae 1 circulating in the USSR and India: its biochemical activity and agglutinability}; Rubinov GE et al.; The properties of 71 S . dysenteriae 1 strains isolated from patients in the USSR and India in 1986-1988 were studied . The cultures possessed typical biochemical and serological properties . As revealed in this investigation, high fastidiousness of this infective agent to the quality of synthetic nutrient could become the cause of false negative reactions in different substrates used for the identification of enterobacteria, thus leading to diagnostic mistakes . The variability of the biochemical activity of different strains with respect to arginine, glycerol, maltose and trehalose (as well as the stability of these signs) was regarded as the theoretical substantiation of the possibility, in principle, to work out the scheme for the subdivision of S . dysenteriae 1 into independent biochemical variants. Ortop Travmatol Protez, 1990 Nov, (11), 59 - 62 {Antibiotic-resistant cultures and the possibility of developing hospital infection in trauma centers}; Gnetnev AM et al.; Antibiotic sensitivity and relation to typical staphylococcus bacteriophages of 1500 cultures of Staphylococcus and 100 cultures of Gram-negative bacteria, isolated from patients and carriers in clinics and subdivisions of the institute of traumatology and orthopaedics, have been studied . R-plasmids have been isolated from Gram-negative microorganisms, possessing plural resistance to antibiotics and relating to Enterobacteriaceae family . Failed to determine dependence between Staphylococcus cultures, isolated from patients and carriers in order to call them hospital-acquired ones . It has been noted predominance of the 11 phagocyte cultures in orthopaedic clinical picture of children and high percentage (55.1) of Staphylococcus carriage state in the clinical picture of acute traumata . Failed to detect hospital infection under the conditions of traumatologic hospital with application of common methods of bacteriologic investigations. Eur J Clin Microbiol Infect Dis, 1990 Nov, 9(11), 827 - 30 Isolation of Enterobacter aerogenes susceptible to beta-lactam antibiotics despite high level beta-lactamase production; Mellencamp MA et al.; This report describes a patient with nosocomial meningitis from whom four distinct isolates of Enterobacter aerogenes were recovered over a complicated course of chemotherapy . The initial isolate was susceptible to expanded spectrum beta-lactams despite constitutive production of high levels of beta-lactamase . Resistant isolates recovered during antibiotic therapy had lost a 42,000 outer membrane protein . These data suggest that b-lactam susceptibility in the original isolate was due to "hyperpermeability" mediated by the 42,000 Dalton protein. Z Gesamte Hyg, 1990 Nov, 36(11), 620 - 2 {Rapid glutamic acid decarboxylase test for identification of Escherichia coli}; Fiedler J et al.; A rapid, one-step glutamic acid decarboxylase test for the identification of Escherichia coli is described . The test gives a positive reaction (definite blue color) after 2 h to 3 h . Disturbing factors were explained . Microorganisms were cultured to Endo agar (SIFIN) supplemented with 1% meat peptone (Berlin-Chemie) . For rapid liberation of the enzyme a combination of lytic agents NaCl and Triton X-100 were necessary . A total of 6,867 strains of Enterobacteriaceae of clinically isolates were parallely tested to activity of lactose, indole, citrate respectively biochemical tests with 15 reactions on the one side and activity of lactose and glutamic acid decarboxylase on the other side . 99.2% of the E . coli strains gave a positive reaction with glutamic acid decarboxylase . The rapid test selected E . coli with more reliability than the combination of the lactose, indole and citrate reactions . Expenditure of time and materials was fewer. Z Gesamte Hyg, 1990 Nov, 36(11), 615 - 7 {Experience and problems with biochemical differentiation of Enterobacteriaceae with microtiter plates}; Schartmann B et al.; A self-made miniaturized test system for the biochemical identification of enterobacteriaceae in microtitre plates has been examined . Special emphasis was laid on easy and unequivocal interpretation of the reactions . This was achieved among other things by including further sugar fermentations . Applying a corresponding reaction matrix it is possible to get clear identifications, even in the case of missing test results . The performed tests show the usefulness of our test system. Therapie, 1990 Nov-Dec, 45(6), 461 - 5 {Clinical and pharmacokinetic study of pefloxacin in spontaneous ascitic fluid infections}; Ducroix JP et al.; Ten patients with spontaneous ascitic fluid infections received intravenously 400 mg of pefloxacin for pharmacokinetic evaluation of the drug and its diffusion into peritoneal space . The patients were then treated with oral pefloxacin (400 mg every 36 h except for icteric patients: 48 h) during 21 days . Total body clearance was decreased (0.66 +/- 0.16 ml/min/kg) and elimination half life was increased as compared to that observed in normal subject (28.2 +/- 7.6 h), the longest half-lives being observed in the cases with the most severe alteration of hepatic function . Peritoneal concentrations were higher than 1 microgram/ml (i.e . exceeding the minimal inhibitory concentrations for most of the bacterial species involved in ascitic fluid infections) from the first half-hour after infusion to at least 36 hours . 9 of the 10 cases were cured . Pefloxacin provided a well spaced rythm of administration is a suitable antibacterial drug for ascitic fluid infections in cirrhotic patients with two advantages: its effectiveness against Enterobacteriaceae and an oral administration. J Antimicrob Chemother, 1990 Nov, 26(5), 635 - 48 Prevalence of a transferable SHV-5 type beta-lactamase in clinical isolates of Klebsiella pneumoniae and Escherichia coli in Greece; Vatopoulos AC et al.; Analysis with a double-disc synergy test (DDST) of clinical isolates of Klebsiella pneumoniae and Escherichia coli during the period October 1988-September 1989 revealed that 24% of the former and 4% of the latter, mainly isolated from urine, possessed an extended-spectrum beta-lactamase . During this period no DDST was positive for isolates of other enterobacterial species . Transfer of ceftazidime resistance was demonstrated from six K . pneumoniae and two E . coli isolates resistant to third generation cephalosporins and aztreonam . Apart from one strain of K . pneumoniae, these strains harboured self-transferable multiresistance plasmids (c . 91 kb) with closely related EcoRI, HindIII, AvaII and PstI restriction patterns . These plasmids encoded an extended-spectrum beta-lactamase that conferred an unusually high level of resistance to ceftazidime and aztreonam (MIC greater than or equal to 64 mg/l) . This enzyme had a pI of 8.2 and a substrate profile similar to that of the SHV-5 enzyme isolated initially in Chile, and later in France (CAZ-4) . The remaining K . pneumoniae isolate harboured a transmissible multiresistance plasmid (c . 182 kb) that encoded the widely distributed SHV-2 enzyme . The resistance to cefoxitin that was observed in some of these strains was associated with outer membrane protein alterations. J Antimicrob Chemother, 1990 Nov, 26 Suppl C, 37 - 47 Cefodizime as a biological response modifier: a review of its in-vivo, ex-vivo and in-vitro immunomodulatory properties; Labro MT; Immunomodulation by antibacterial agents shows promise as a novel strategy in the treatment of infectious diseases . Cefodizime, a new oxi-imino-amino-2-thiazolyl cephalosporin, is a particularly good candidate in this context . In-vivo models of experimental infections show that prophylactic administration of cefodizime increases the survival of some strains of mice after challenge with Toxoplasma gondii or Candida albicans; its curative effect in infections due to members of the Enterobacteriaceae is better than that expected from in-vitro MIC determinations relative to other third-generation cephalosporins; this effect is even more marked in immunocompromised animals . Data obtained both in vivo and ex vivo show that cefodizime enhances various immune parameters such as phagocyte function, B lymphocyte responsiveness and delayed hypersensitivity; it may restore natural killer (NK) and phagocyte activity, as well as interleukin 1 (IL-1) and interferon production, in immunocompromised patients and animals . The in-vitro effects of this drug include enhancement of phagocyte bactericidal activity and alteration of bacterial virulence factors . The chemical basis for these various immunomodulatory properties is related to the thio-thiazolyl side-chain at position 3 of the cephem nucleus . To date, the mechanisms underlying the immunomodulatory properties of cefodizime have not been identified clearly, but it is likely that it interferes at different levels of specific and non-specific immune defences. Antimicrob Agents Chemother, 1990 Nov, 34(11), 2210 - 6 Development of "oligotyping" for characterization and molecular epidemiology of TEM beta-lactamases in members of the family Enterobacteriaceae; Mabilat C et al.; Based on the DNA sequences of blaTEM-1 and blaTEM-2, which encode parental penicillinases TEM-1 and TEM-2, respectively, and blaTEM-3, blaTEM-4, blaTEM-5, blaTEM-6, and blaTEM-7, which encode extended-spectrum beta-lactamases, we designed heptadecanucleotides to discriminate point mutations in five loci . Determination of the hybridization profiles by colony hybridization with this selection of probes, termed "oligotyping," allowed characterization of the TEM variants present in 265 clinical isolates of the family Enterobacteriaceae that exhibit synergism between a penicillinase inhibitor and broad-spectrum cephaslosporins . Among the 222 strains harboring TEM enzymes, Klebsiella pneumoniae (48%) and Escherichia coli (21%) were predominant, and TEM-3 was the most common enzyme (60%) . Penicillinases TEM-1 and TEM-2 were detected alone (15 and 1%, respectively), combined (1%), or associated with another TEM beta-lactamase (17 and 6%, respectively) . Fourteen variants, including seven new enzymes, were detected . One, TEM-13, was a new penicillinase with the same isoelectric point and substrate range as TEM-2 but differed by a single amino acid substitution, whereas the others, TEM-14 to TEM-19, were extended-spectrum beta-lactamases that consisted of novel combinations of known amino acid substitutions . Different TEM variants were found to coexist within the same cells . A patient could harbor two or three different strains that encoded the same enzyme or two indistinguishable isolates that produced distinct TEM beta-lactamases. Antimicrob Agents Chemother, 1990 Nov, 34(11), 2193 - 9 Outbreak of ceftazidime resistance caused by extended-spectrum beta-lactamases at a Massachusetts chronic-care facility; Rice LB et al.; During a 4-month period in late 1988, we isolated ceftazidime-resistant strains of Klebsiella pneumoniae and other members of the family Enterobacteriaceae from 29 patients at a chronic-care facility in Massachusetts . Ceftazidime resistance resulted from two distinct extended-spectrum beta-lactamases of the TEM type which efficiently hydrolyzed the cephalosporin: YOU-1 with a pI of 5.57 and YOU-2 with a pI of 5.2 . Genes encoding these enzymes were present on different but closely related high-molecular-weight, multiple antibiotic resistance plasmids of the H12 incompatibility group and were transferable by conjugation in vitro . Agarose gel electrophoresis of extracts from clinical isolates indicated that this outbreak arose from plasmid transmission among different strains of the family Enterobacteriaceae rather than from dissemination of a single resistant isolate . Isolation rates of ceftazidime-resistant organisms transiently decreased after use of this drug was restricted, but resistant isolates continued to be recovered 7 months after empiric use of ceftazidime ceased. Antimicrob Agents Chemother, 1990 Nov, 34(11), 2200 - 9 Novel plasmid-mediated beta-lactamase (MIR-1) conferring resistance to oxyimino- and alpha-methoxy beta-lactams in clinical isolates of Klebsiella pneumoniae; Papanicolaou GA et al.; Klebsiella pneumoniae isolates from 11 patients at the Miriam Hospital were identified as resistant to cefoxitin and ceftibuten as well as to aztreonam, cefotaxime, and ceftazidime . Resistance could be transferred by conjugation or transformation with plasmid DNA into Escherichia coli and was due to the production of a beta-lactamase with an isoelectric point of 8.4 named MIR-1 . In E . coli, MIR-1 conferred resistance to aztreonam, cefotaxime, ceftazidime, ceftibuten, ceftriaxone, and such alpha-methoxy beta-lactams as cefmetazole, cefotetan, cefoxitin, and moxalactam . In vitro, MIR-1 hydrolyzed cephalothin and cephaloridine much more rapidly than it did penicillin G, ampicillin, or carbenicillin . Cefotaxime was hydrolyzed at 10% the rate of cephaloridine . Cefoxitin inactivation could only be detected by a microbiological test . The inhibition profile of MIR-1 was similar to that of chromosomally mediated class I beta-lactamases . Potassium clavulanate had little effect on cefoxitin or cefibuten resistance and was a poor inhibitor of MIR-1 activity . Cefoxitin or imipenem did not induce MIR-1 . The gene determining MIR-1 was cloned on a 1.4-kb AccI-PstI fragment . Under stringent conditions, probes for TEM-1 and SHV-1 genes and the E . coli ampC gene failed to hybridize with the MIR-1 gene . However, a provisional sequence of 150 bp of the MIR-1 gene proved to be 90% identical to the sequence of ampC from Enterobacter cloacae but only 71% identical to that of E . coli, thus explaining the lack of hybridization to the E . coli ampC probe . Plasmid profiles of the 11 K . pneumoniae clinical isolates were not identical, but each contained a plasmid from 40 to 60 kb that hybridized with the cloned MIR-1 gene . Both transfer-proficient and transfer-deficient MIR-1 plasmids belonged to the N incompatibility group . Thus, the resistance of these K . pneumoniae strains was the result of plasmid acquisition of a class I beta-lactamase, a new resistance determinant that expands the kinds of beta-lactam resistance capable of spread by plasmid dissemination among clinical isolates. Diagn Microbiol Infect Dis, 1990 Nov-Dec, 13(6), 453 - 60 Production and characterization of murine monoclonal antibodies specific for serogroups E1 and E4 Salmonella; Tsang RS et al.; Two anti-Salmonella serogroup E-specific monoclonal antibodies (MAbs) are described . Neither antibody reacted with any of the 58 strains of serogroups A-D Salmonella tested by enzyme immunoassays nor did they react with any of the 21 other species of enterobacteria, 15 species of other Gram-negative bacteria, and 6 species of Gram-positive bacteria . In contrast, all 14 strains of serogroups E1 and E4 Salmonella reacted with both antibodies . Ascitic fluids of these two antibodies agglutinated all 42 strains of serogroups E1 and E4 Salmonella tested by slide agglutination method but did not agglutinate any of the 107 strains of other serogroups of Salmonella . Lysogenic conversion of serogroup E1 Salmonella strains by phages epsilon 15 and epsilon 34 resulted in loss of reactivities of these strains with the MAbs. Tidsskr Nor Laegeforen, 1990 Oct 20, 110(25), 3233 - 9 {Bacterial resistance against beta-lactam antibiotics}; Andersen BM; Beta-lactam antibiotics include the penicillins, cephalosporins, oxacephems (moxalactam), carbapenems (imipenem) and monobactams (azthreonam)--all with a common beta-lactam ring . Beta-lactam antibiotics block the synthesis and growth of the bacterial cell wall by binding to penicillin-binding proteins on the cytoplasma membrane . The bacteria may escape the effect of beta-lactam antibiotics by reducing the permeability of the cell wall (gramnegative bacteria), by producing beta-lactamases, by reducing the affinity for beta-lactams in their penicillin-binding proteins, or by developing tolerance to beta-lactam antibiotics . A combination of these resistance mechanisms may be found in the most resistant bacteria, such as Pseudomonas, Serratia and Enterobacter; bacteria often involved in nosocomial infections . Increased antibiotic pressure may select for beta-lactam resistance among other bacteria as well, such as staphylococci, streptococci, Haemophilus influenzae, meningococci and gonococci . Prudent use of antibiotics is mandatory essential to ensure a bactericidal effect of this most important and valuable group of antibiotics in the future. Presse Med, 1990 Oct 13, 19(33), 1538 - 40 {Listeria monocytogenes liver abscess . In a diabetic patient}; Ribiere O et al.; Most liver abscesses are caused by Enterobacteriaceae, sometimes associated with anaerobes . Listeriosis is an exceptional cause of liver abscess, usually in a context of disseminated infections . We report the case of a diabetic woman who had liver abscess due to Listeria monocytogenes . The organism was isolated after guided needle aspiration, and there was no other site of infection . The course of the disease gradually moved towards recovery under an antibiotic therapy that was based on sensitivity tests . A search for immunodeficiency proved negative . A review of the literature showed that the rare cases of listerial liver abscess share a common factor, diabetes mellitus, the importance of which has not yet been noticed. Mol Cell Biol, 1990 Oct, 10(10), 5359 - 64 Transformation of mouse BALB 3T3 cells by enterobacterial plasmid misrepair gene mucAB; Tosu M et al.; The enterobacterial plasmid misrepair gene mucAB, ligated to the metal-inducible mammalian MT-1 promoter, was introduced into the genome of mouse BALB 3T3 cells . In the presence of zinc ions, MucA but not MucB protein was produced, and the whole-cell population of each mucAB+ clone started to show the transformation phenotype in a few days . Foci appeared in the transformed cell population after 4 weeks, and cells from the foci produced tumors in nude mice, indicating malignant transformation by the mucA product . Growth of mucAB+ cells was stimulated by zinc-induced expression of mucA . The transformation phenotype was reversed by removing zinc ions from the culture, indicating that the transformation was due not to MucA-mediated mutation in the mouse genome but to the direct transforming activity of MucA protein. Antibiot Khimioter, 1990 Oct, 35(10), 41 - 3 {Use of the automated system for bacteriological diagnosis of suppurative complications}; Imshenetskaia VF; The use of the microbiological analyzer Cobas-Bact made it possible to markedly widen the possibilities of identifying pathogenic enterobacteria at the account of the species usually not detected with the routine methods . Rapid assay of antibiotic sensitivity with the Cobas-Bact system provided earlier and adequate antibacterial therapy of severe purulent complications. Int J Syst Bacteriol, 1990 Oct, 40(4), 379 - 83 Erwinia persicinus, a new species isolated from plants; Hao MV et al.; Five strains of a gram-negative, oxidase-negative, facultatively anaerobic, fermentative, motile, rod-shaped bacterium with the general characteristics of the family Enterobacteriaceae were isolated from tomatoes (three strains), a banana, and a cucumber . All of the strains produced a water-soluble pink pigment . As determined by DNA hybridization (hydroxyapatite method) these five strains were 85 to 100% related in 60 and 75 degrees C reactions, and related sequences exhibited 1% or less base sequence divergence, indicating that the organisms are members of a single species . These bacteria were most closely related to Erwinia rhapontici (68 to 72% at 60 degrees C, 42 to 44% at 75 degrees C, 10.5% divergence) and to hybridization group VIII in the Enterobacter agglomerans (Pantoea agglomerans, Erwinia herbicola) complex (64% at 60 degrees C, 32% at 75 degrees C, 14.5% divergence) . Phenotypic differentiation from Erwinia rhapontici, which also produces a water-soluble pink pigment, is based on negative reactions by the new species in tests for methyl red, N-acetylglucosamine, DL-tartrate assimilation, and acid production from amygdalin, dulcitol, D-fucose, beta-gentiobiose, alpha-methyl-D-glucoside, glycerol, D-lyxose, melezitose, D-turanose, xylitol, and D-xylose and a positive reaction for acetoin (Voges-Proskauer test) . On the basis of these data, the name Erwinia persicinus is proposed for the new organism . The type strain is strain HK 204 (= AJ 2716 = CDC 9108-82 = IAM 12843 = JCM 3704 = ATCC 35998). Int J Food Microbiol, 1990 Oct, 11(2), 143 - 50 Influence of freezing-thawing and refrigeration on R-plasmid (pRPJ24) stability in Enterobacter cloacae 94R; Jayaratne AH et al.; The effect of twenty freezing (-20 degrees C) and thawing cycles of Enterobacter cloacae 94R cells containing the R-plasmid pRPJ24 inoculated into broth and ground beef meat samples revealed no loss of resistance due to plasmid instability . In addition, low temperature storage at 4 degrees C did not produce any significant loss of the tetracycline and kanamycin resistances encoded on the pRPJ24 plasmid . The results of this study indicated that indigenous R-plasmids like pRPJ24 are stable in resident recipients like E . cloacae 94R in ground beef . However, the proportion of viable cells containing the pRPJ24 plasmid decreased significantly after 20 freezing-thawing cycles over 14 days incubation at 4 degrees C. Zentralbl Bakteriol, 1990 Oct, 274(1), 109 - 17 Biological activities and endotoxic activities of protective antigens (PAgs) of Leptospira interrogans; Masuzawa T et al.; The biological and endotoxic activities of protective antigens (PAgs) prepared by the chloroform-methanol-water method from Leptospira interrogans serovars lai, copenhageni and canicola were examined . The PAg preparations did not show a local Shwartzman reaction in the rabbits at doses of 100 micrograms and 50 micrograms/site and lethal toxicity to galactosamine-sensitized mice at the dose of 12.5 micrograms to 50 micrograms/mouse . PAgs exhibited a weak cytotoxic action on peritoneal exudate macrophages of C3H/HeJ and C3H/HeN mice at the dose of 500 micrograms/ml in vitro, but did not show cytotoxicity for BHK-21 cells kidney cells of the Syrian hamster, CHO-K1, ovary cells of the Chinese hamster, and CHL, lung cells of the Chinese hamster, at doses of 5 and 500 micrograms/ml . Gelation activity in the Limulus test was only observed at PAg concentrations over 100 ng/ml, which dose was 10,000 times that of lipopolysaccharide (LPS) of Escherichia coli O55:B5 . Furthermore, an adjuvant activity of PAgs was not observed in the production of anti-sheep red blood cell antibody in mice . Mitotic conversion of spleen cells from C3H/HeJ and C3H/HeN mice was observed by the addition of PAgs in vitro . These results indicated that the biological properties of PAgs were different from those of LPS prepared from gram-negative enterobacteria, that PAgs had no endotoxic activity and that the biological safety of PAgs as vaccine was proved. J Antimicrob Chemother, 1990 Oct, 26 Suppl B, 75 - 82 Double-blind comparison of pefloxacin and cefazolin as prophylaxis in elective cardiovascular surgery; Auger P et al.; A total of 162 patients (134 males and 28 females) scheduled for coronary artery bypass grafting (144) or valve surgery (18) were randomly assigned to receive, under double-blind conditions, either pefloxacin 400 mg iv or cefazolin 1.0 g 30 min before the surgical incision and then post-operatively 12-hourly x 4 or 6-hourly x 8, respectively . Positive per- and post-operative cultures were seen in 27 patients (11 pefloxacin, 16 cefazolin) and 47 micro-organisms were isolated: 34 per-operatively (21 pefloxacin, 13 cefazolin) and 13 post-operatively (4 pefloxacin, 9 cefazolin) . There were five failures of prophylaxis (2 pefloxacin, 3 cefazolin): two early (less than 5 days: 1 pefloxacin, 1 cefazolin) and three late (greater than or equal to 5 days, 1 pefloxacin, 2 cefazolin) divided into (i) one major primary failure in the cefazolin group (1 cefazolin resistant Staphylococcus epidermidis mediastinitis); (ii) two minor primary failures, one in each group (Gram-positive sternal incision abscesses) and (iii) two secondary failures (1 cefazolin resistant Enterobacter cloacae and Pseudomonas aeruginosa UTI in the cefazolin group and one culture negative pneumonia in the pefloxacin group) . Tolerance to both antibiotics was excellent . In our sample of patients, the efficacy and safety of pefloxacin was not different from those of cefazolin in prophylaxis in cardiovascular surgery. J Antimicrob Chemother, 1990 Oct, 26 Suppl B, 161 - 6 A clinical trial of pefloxacin in prostatitis; Guibert J et al.; Thirty-one patients with initial, recurrent or chronic prostatitis mainly caused by Enterobacteriaceae were treated with pefloxacin 400 mg bd for three to 105 days (median, 28 days) . The clinical and bacteriological results four weeks after the end of the treatment, were: 23 patients (74%) cured, 21 without reinfection and two with reinfection, failure in two and relapse in six patients . Side-effects, which were definitely related to pefloxacin, occurred in seven patients (22.5%) and were of a photosensitization-, muscular- and neuropsychic-type . A high eosinophil count was observed in another patient . In one patient, treatment was withdrawn because of side-effects. J Antimicrob Chemother, 1990 Oct, 26 Suppl B, 1 - 6 Quinolones in perspective; Neu HC; Fluoroquinolones have been in use for the past five years . The agents inhibit Enterobacteriaceae, Pseudomonas aeruginosa, and staphylococci, but some agents lack activity against streptococci and none of the commercially available agents inhibits anaerobic species . The fluoroquinolones possess many pharmacological advantages which have made them excellent therapy for urinary, selected respiratory, gastrointestinal, skin, soft tissue, bone, and sexually transmitted infections . They have also proved useful as prophylaxis in neutropenic patients . A major problem for the future is that inappropriate and indiscriminate use of quinolones will cause rapid development of resistance, particularly among staphylococci and P . aeruginosa. Tijdschr Kindergeneeskd, 1990 Oct, 58(5), 151 - 5 {Neonatal meningitis caused by Enterobacter sakazakii: milk powder is not sterile and bacteria like milk too!}; Jaspar AH et al.; Powdered milk for infants can contain very low numbers of Enterobacter sakazakii . Larger amounts of this organism can result in non-infective colonization . In infants, particularly the premature newborn, such colonization has been associated with abdominal distention and bloody diarrhoea or bacteriuria, but cases of sepsis and meningitis have also been reported . Infection has been associated with the use of contaminated spoons or blenders as well as the habit of keeping the ready-made milk hot in bottle-heaters . The risk of contamination of the milk can be eliminated by boiling bottles, teats and spoons as well as disinfecting the blender before use . The possibility of bacterial replication can be significantly reduced by keeping the ready-made milk in a refrigerator and warming it up immediately before use eg by using a microwave oven. Br J Ind Med, 1990 Oct, 47(10), 688 - 91 Toxic risks from inhalation of bacterial endotoxin; Burrell R et al.; A potential risk for workers exposed to inhalation of endotoxin, as well as the primary tissue changes, is the possibility of subsequent development of adult respiratory distress syndrome . Accordingly, hamsters were administered one hour aerosols of Enterobacter agglomerans and allowed to rest for six hours to produce maximum microlesions in the lung . One hour before this peak, the animals were injected intravascularly with the same suspension used in the aerosol . After one hour the animals were killed and bronchopulmonary lavages were made for analysis of free lung cells . As anaesthesia alone has been reported to be one of the operative procedures that enhance the effect of previous exposure to endotoxin, controls had to include sham anaesthesia with no intravascular injection . Endotoxin inhalation induced significant increases in total number of pulmonary leucocytes, mostly neutrophils, but with a concomitant relative decrease in number of alveolar macrophages . These polymorphonuclear neutrophils are not seen in morphometric analysis of the alveoli . Of greater interest was the large increase in erythrocytes suggesting pulmonary haemorrhages . Such changes were not due to intravenous bacterial alone, and were only significant when the bacteria were inhaled . Taken together with the other known inflammatory effects of inhaled bacteria or bacteria containing endotoxin, such inhalation in an occupational setting constitutes an increasingly recognised risk for workers. J Infect Dis, 1990 Oct, 162(4), 981 - 3 Beta-lactam-resistant Enterobacter bacteremia in febrile neutropenic patients receiving monotherapy; Johnson MP et al.; Bacteremia with resistant Enterobacter species has been reported in febrile, neutropenic cancer patients receiving beta-lactam antibiotics . To assess the relationship between enterobacter bacteremia and ceftazidime monotherapy, medical records were reviewed and isolates were tested from 16 neutropenic and 35 nonneutropenic patients with Enterobacter bacteremia . Fifteen isolates from the neutropenic patients were resistant to extended spectrum cephalosporins; only 12 of 35 isolates from the nonneutropenic patients were resistant to Enterobacter species . The neutropenic patients also had more beta-lactam therapy, both immediately before bacteremia and in the preceding year, than did nonneutropenic patients . Prior beta-lactam antibiotic exposure may predispose neutropenic patients to develop resistant Enterobacter bacteremia. Jpn J Antibiot, 1990 Oct, 43(10), 1674 - 84 {Antimicrobial activities of gentamicin against fresh clinical isolates}; Deguchi K et al.; Antimicrobial activities of gentamicin (GM), compared with activities of other aminoglycosides (AGs) and beta-lactam antibiotics, were studied against clinical isolates obtained during a period of July-December 1989 . 1 . GM-resistant strains were noted in 24% of Staphylococcus aureus, 12% of Enterobacter spp., 24% of Serratia marcescens, 7% of Morganella morganii and 26% of Pseudomonas aeruginosa, but no GM-resistant strains were observed among isolates of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Proteus vulgaris . 2 . A majority of GM-resistant strains of S . aureus were methicillin-resistant S . aureus (MRSA) and a large number of GM-resistant strains of Enterobacter spp . was also resistant to new quinolones . GM showed, however, strong antimicrobial activities against new quinolones-resistant strains of S . marcescens, M . morganii and P . aeruginosa . 3 . Among all the isolates tested of S . marcescens, 24% were GM-resistant, 72% were tobramycin (TOB)-resistant, 86% were dibekacin (DKB)-resistant and 64% were amikacin (AMK)-resistant, hence the incidence of GM-resistant strains was the lowest . This tendency was also observed with P . vulgaris . However, among P . aeruginosa, 26% were GM-resistant, 14% TOB-resistant, 18% DKB-resistant and 22% AMK-resistant, thus the incidence rate for GM-resistance was somewhat higher . These results suggest that different AGs-modification enzymes were produced by various clinical isolates under the present condition . 4 . Comparing the ratio of GM-resistant strains in the present study with those in 1980 and 1983, the ratio increased among S . aureus, while decreases were observed among Enterobacter spp., S . marcescens, P . vulgaris and P . aeruginosa, indicating that a unilateral tendency of increases in GM-resistant strains did not exist among clinical isolates over the years. Int J Food Microbiol, 1990 Oct, 11(2), 151 - 7 The storage life of chicken carcasses packaged under carbon dioxide; Gill CO et al.; Broiler chicken carcasses were packaged under vacuum in film of low oxygen transmission rate, or under CO2 in gas-impermeable aluminum foil laminate . The packaged carcasses were stored at +3 or -1.5 degrees C . The initial flora was dominated by enterobacteria . Vacuum-packaged carcasses developed microbial populations in which enterobacteria continued to predominate, and were spoiled by persistent putrid odours after 2 weeks storage at 3 degrees C or 3 weeks storage at -1.5 degrees C . Growth of enterobacteria was inhibited on carcasses packaged under CO2, the microflora that developed being dominated by lactobacilli . However, slow growth of the enterobacteria eventually resumed, and putrid spoilage was apparent after 7 weeks storage at 3 degrees C or 14 weeks storage at -1.5 degrees C. J Med Microbiol, 1990 Oct, 33(2), 127 - 31 Antibacterial activity of fluoroquinolones in combination with zidovudine; Lewin CS et al.; Since patients with AIDS may receive fluoroquinolones concurrently with zidovudine, the antibacterial interaction of these drugs was investigated . No evidence was found of antagonism between zidovudine and ciprofloxacin, DR-3355, enoxacin, lomefloxacin or ofloxacin against enterobacteria, staphylococci or Pseudomonas aeruginosa . Furthermore, the bactericidal activity of the fluoroquinolones against selected enterobacteria in nutrient broth was not affected by a clinically achievable concentration of zidovudine . It seems unlikely that zidovudine will have an adverse effect on the antibacterial activity of the fluoroquinolones in patients with AIDS. J Nutr Sci Vitaminol (Tokyo), 1990 Oct, 36(5), 447 - 56 Biosynthesis of biotin-vitamers by family Enterobacteriaceae; Ohsugi M et al.; The biosynthesis of biotin-vitamers from various carbon sources by the members of the Enterobacteriaceae as one of the groups of intestinal bacteria was investigated . The biotin-vitamers synthesized in each case included one or more of dethiobiotin (main product), 7-keto-8-aminopelargonic acid, and biotin . True biotin was shown to be synthesized under aerobic conditions but not under anaerobic conditions by each of several strains belonging to one of the genera, Erwinia, Escherichia, Proteus, and Serratia, and using culture media containing one of galactose, peptone, Polypepton, or casamino acid . In addition, a biotin precursor, pimelic acid, was also synthesized by several bacteria utilizing carbon sources such as maltose, mannose, galactose, peptone, or casamino acid. Immunol Cell Biol, 1990 Oct, 68 ( Pt 5), 307 - 16 Partial purification and characterization of low molecular weight antigens of Salmonella enteritidis 11RX; Vordermeier HM et al.; Sephadex G100 chromatography and preparative sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE) using 16% polyacrylamide gels were used for the partial purification of 16-18 kDa proteins able to stimulate Salmonella enteritidis 11RX-primed T cells of (BALB/c x C57BL/6J)F1 mice . A soluble antigen (Ag) extract of S . enteritidis 11RX (s11RX) was used as the starting material for purification for two reasons . First, s11RX had been previously shown to induce in vitro proliferation of Salmonella-primed T cells; second, initial analysis of SDS-PAGE fractionated s11RX Ag using the 'T cell western blot' technique indicated that T cell stimulatory activity was located only in the 16-18 kDa region . The partially purified antigens were able to elicit delayed-type hypersensitivity reactions in vivo, and stimulated in vitro proliferation and interleukin-2 release from 11RX-primed T cells and T cell lines and clones derived from these cells, indicating that they are major antigenic determinants of S . enteritidis 11RX . Testing of 16-18 kDa proteins of several other bacteria indicated that these antigens may be 'common' and expressed by a number of organisms belonging to the Enterobacteriaceae. Drugs, 1990 Oct, 40(4), 608 - 51 Cefotaxime . An update of its pharmacology and therapeutic use; Todd PA et al.; Cefotaxime was the first 'third generation' cephalosporin to be marketed and is administered intramuscularly or intravenously . Similar to other agents of this class, it has a broad spectrum of in vitro activity, particularly against Enterobacteriaceae, including beta-lactamase-producing strains . Cefotaxime forms a metabolite, desacetylcefotaxime, which is antibacterially effective against many bacteria per se and acts additively or synergistically with cefotaxime against many strains . Since the first review of cefotaxime in the Journal, further studies have confirmed its value in the treatment of various infections: complicated urinary tract infections, lower respiratory tract infections, bacteraemia, meningitis, uncomplicated gonorrhoea, infections of skin and soft tissue and of bone and joints, and obstetric and gynaecological infections . Cefotaxime is effective as an empirical treatment of suspected infection due to susceptible organisms in immunocompromised patients and is of proven efficacy in serious, life-threatening infections in general . Cefotaxime reduces the incidence of postsurgical infection but the role of third generation cephalosporins in prophylaxis remains to be determined . The indications for which cefotaxime and other 'third generation' cephalosporins would be considered the most appropriate therapy remain largely dependent upon such factors as varied as cost, local medical custom, decisions of regulatory agencies and geographical patterns of bacterial resistance . Cefotaxime nevertheless represents a valuable 'third generation' cephalosporin of great clinical value in certain infectious conditions, in particular those which are serious and life-threatening and where resistance to therapies is creating a clinical problem. J Dent Que, 1990 Oct, 27, 491 - 4 {Case of recurrent intra-oral herpes}; Shapiro A; A case of severe Secondary Herpes Simplex infection is presented and the possibility of a secondary infection by Enterobacter cloacae is discussed. J Formos Med Assoc, 1990 Oct, 89(10), 926 - 9, 914 {Fournier's gangrene: report of 3 cases}; Cheng YL et al.; Fournier's gangrene is defined classically as a fulminant, rapidly spreading infection of the scrotum that also involves the perineum, penis and abdominal wall . The pathologic findings are described as synergistic gangrene secondary to a polymicrobial flora with a poorly defined portal of entry . We report 3 cases of Fournier's gangrene . Case 1 was a 67 years old who was admitted with the chief complaint of scrotal swelling and necrosis . Case 2 was a 59 years old who was admitted with the problem of scrotal swelling and pain, he had sought other medical help without success, and was then transferred to our hospital . Case 3 was a 62 years old who was admitted with the chief complaint of scrotal swelling and pain for 2 days . These 3 patients were all found to have diabetes mellitus . All 3 patients required aggressive surgical debridement, broad-spectrum antibiotics and adjunctive measures . Blood cultures were usually negative and pus cultures were typically aerobic gram-negative rods and gram-positive cocci and anaerobic bacteria of various types, especially Bacteroids fragilis . Our pus cultures revealed Escherichia coli and Staphylococcus aureus in Case 1, Enterobacter cloaca