Gram negative

Acta Ophthalmol (Copenh), 1978 Dec, 56(6), 977 - 83
Ampicillin penetration into the rabbit eye; Salminen L; Distribution of intravenously injected ampicillin of 50 mg/kg was studied in the rabbit eye using radioactive tracer method . Antibiotic concentration regarded as therapeutic in the treatment of gram-negative organisms was obtained in all vascularized ocular structures . Intermediate values were measured from the cornea and aqueous humour . In the vitreous body and lens, ampicillin was unable to approach a concentration that would be effective against the common gram-negative organisms . The low ampicillin concentration in the vitreous body and lens was unchanged by systemically administered probenecid, which in other parts of the eye caused significantly higher ampicillin levels.

J Bacteriol, 1978 Dec, 136(3), 1037 - 49
Cell envelope associations of Aquaspirillum serpens flagella; Coulton JW et al.; Specific regions of the cell envelope associated with the flagellar basal complex of the gram-negative bacterium Aquaspirillum (Spirillum) serpens were identified by studying each of the envelope layers: outer membrane, mucopeptide, and plasma membrane . The outer membrane around the flagella insertion site was differentiated by concentric membrane rings and central perforations surrounded by a closely set collar . The perforations in both the outer membrane and the isolated mucopeptide layer were of a size accomodating the central rod of the basal complex but smaller than either the L or the P disks . The P disk of the complex may lie between the mucopeptide and the outer membrane . Electron microscopy of intact, spheroplasted, or autolyzed preparations did not adequately resolve the location of the inner pair of disks of the basal complex . Freeze-etching, however, revealed differentiation within the plasma membrane that appeared to be related to the basal complex . The convex fracture face showed depressions which are interpreted as impressions of a disk surrounded by a set of evenly spaced macromolecular studs and containing a central "plug" interpreted as the central rod . In thin sections, blebs, which appear to be associated with the flagellar apparatus, were seen on the cytoplasmic side of the plasma membrane . Superimposing the dimensions of the flagellar basal complex and the spacings of the cell envelope layers and using the position of the L disk within the outer membrane for reference, showed that the S disk might be within and the M disk beneath the plasma membrane . A tentative model was developed for comparison with that based on the structure of the Escherichia coli basal complex.

Am J Clin Pathol, 1978 Dec, 70(6), 914 - 7
Laboratory evaluation of a multitest system for identification of gram-negative organisms; Rosenthal SL et al.; Seventy-two oxidase-positive or nonfermentative organisms, or both, all of which could be identified with reasonable certainty by alternative means, were used to challenge the OXI/FERM tube . There was 91% concurrence of identification between the two methods . Three observers, working independently, agreed upon the interpretation of each of the tests in the OXI/FERM system from 91% to 100% of the time . Duplicate OXI/FERM tubes inoculated with the same strain yielded identical interpretations 95% of the time for all tests except citrate utilization (89%) . The OXI/FERM tube thus appeared to be an accurate identification method and yielded test results that were easily interpreted and adequately reproducible.

Chest, 1978 Dec, 74(6), 671 - 2
Superior vena cava syndrome caused by invasive aspergillosis; Gartenberg G et al.; A 37-year-old man with blastic crisis of chronic myelogenous leukemia was admitted for chemotherapy . After treatment with an infusion of vincristine, he became leukopenic and febrile . Two episodes of gram-negative septicemia were treated with prolonged courses of antibiotics; however, fever persisted, and the patient developed the superior vena cava syndrome . Despite therapy with amphotericin B, the patient died . At autopsy a thrombus of Aspergillus was found completely occluding the superior vena cava.

Arch Microbiol, 1978 Nov 13, 119(2), 203 - 12
A novel method for the isolation and study of a magnetotactic bacterium; Moench TT et al.; The magnetococcus, a magnetotactic bacterium, has been grown in a complex simulated natural environment . Sufficiently pure samples of cells were obtained magnetically making axenic cultures unnecessary for many purposes . The magnetococcus is a Gram-negative coccus, 1.6 micron in diameter and readily distinguished by highly refractile inclusions and its magnetotactic behavior . This organism is actively motile by means of two bundles of flagella . Electron dense ferromagnetic inclusions were localized between the flagellar bundles . Collections of magnetococci were morphologically homogeneous and negligibly contaminated by extraneous bacteria . DNA extracted from pooled collections of cells was homogeneous by analytical CsC1 centrifugation . The guanine-cytosine content was 61.7% . Total iron by percent cellular dry weight was 3.8% . Comparisons with a previously described magnetotactic marine coccus were made.

Lancet, 1978 Nov 4, 2(8097), 968 - 9
Stomach as source of bacteria colonising respiratory tract during artificial ventilation; Atherton ST et al.; 10 adults had intermittent positive-pressure ventilation for 3--34 days . All 10 had paralytic ileus . Microbial overgrowth in the stomach was found in 9 patients (bacterial in 7 and fungal in 2); gram-negative bacteria predominated . The trachea invariably became colonised by bacteria, mainly gram-negative organisms . In 3 instances the gram-negative bacteria were found in the stomach before they appeared in the tracheal aspirate, and in 1 case the pathogen originated in the faeces.

Exp Hematol, 1978 Nov, 6(10), 767 - 76
Liquid preservation of canine granulocytes obtained by counterflow centrifugation-elutriation; Contreras TJ et al.; Granulocytes (PMN) were isolated from 120 ml of canine whole blood by a modification of the counterflow centrifugation-elutriation technique . Isolated cell suspensions of 96% granulocytes and 4% mononuclear leukocytes with a 21:1 PMN/RBC ratio were stored at 4 degrees C in 4:4:2 medium consisting of four parts HBSS minus Ca++ and Mg++, four parts MEM, twp parts autologous plasma, and 20 microgram/ml gentamicin for 15 days . Granulocytes were stored at concentrations of approximately 4 x 10(6) PMN/ml in polypropylene centrifuge tubes . The stored granulocyte suspensions were assayed in vitro 0, 1, 4, 8, and 15 days to monitor chemotaxis, bacterial growth inhibition, O2 consumption associated with phagocytosis, and enzyme activities . Cell volume analysis was used to evaluate cellular integrity of the liquid-stored granulocytes . Canine granulocytes isolated by the modified dilution technique of counterflow centrifugation-elutriation can be preserved for up to 15 days with 77 +/- 6% granulocyte survival with maintenance of morphological and organelle integrity, as well as retention of in vitro functions of recognition, migration, phagocytosis, and killing of gram-negative bacteria.

Clin Orthop, 1978 Nov-Dec, (137), 106 - 11
Excision arthroplasty with delayed wound closure for the infected total hip replacement; Mallory TH; Methods of management of infections in total hip replacement vary from the use of antibiotics with reimplantation to a complete removal of the prosthetic unit . This is a series of 10 consecutive patients having documented sepsis following total hip replacement characterized by gram-negative organisms which was managed with the method of excision (Girdlestone) arthroplasty with delayed wound closure . Parenteral antibiotics were used while the wound remained open . Once wound healing had been accomplished, the patients were placed on appropriate oral antibiotics and continued on same for approximately 6 months . The duration of follow-up was 3-5 years . All patients have continued to remain free of clinical sepsis . One patient has chronic pain . All patients are fully ambulatory and are fully satisfied with their functional capacities . Recognizing a serious infection following total hip replacement, especially characterized by the presence of gram-negative organisms, requires drastic treatment methods . Excision arthroplasty with delayed wound closure is a reasonable alternative, especially in view of the functional results obtained.

Acta Paediatr Scand, 1978 Nov, 67(6), 725 - 30
Bacterial meningitis in childhood in an African city . Factors influencing aetiology and outcome; Hailemeskel H et al.; In a retrospective study of 120 children aged 1 month and above with bacterial meningitis confirmed by positive CSF culture, 88.4% were found to be due to three common organisms: H . influenzae, Str . pneumoniae and N . meinigitidis . Gram-negative enteric organisms accounted for 10% of the infections . Despite intensive antibiotic and ancillary therapy, there has been no significant change in case fatality and sequelae over the past decade in this institution . The present study confirms that factors related to the organism and the host are important in determining the outcome of therapy . H . influenzae and Str . pneumoniae infections are associated with statistically significant rise in case fatality rate and neurologic sequelae at the end of therapy . The presence of neurological abnormality at the time of diagnosis significantly increases case fatality rate while delay in diagnosis appears to primarily influence the frequency of neurological sequelae . Protein-energy malnutrition increases the frequency of neurological sequelae and death from bacterial meningitis without significantly influencing the pattern of bacterial aetiology . The finding of enteric Gram-negative meningitis in association with diarrhoeal disease in the present study adds a new dimension to one of the most prevalent health problems in developing countries and needs to be confirmed.

Artif Organs, 1978 Nov, 2(4), 413 - 20
Partial artificial heart (ALVAD) use with subsequent cardiac and renal allografting in a patient with stone heart syndrome; Norman JC et al.; The abdominal left ventricular assist device (ALVAD) is an order of magnitude more effective than conventional intra-aortic balloon pumping (IABP) in unloading and providing circulatory support to the failing left ventricle . This is a report of a unique case which demonstrates that in the absence of pulmonary vascular obstruction or constriction, the ALVAD can substitute for both left and right heart function . A 21-year-old patient with a congenital bicuspid aortic valve developed acute valvular endocarditis which rapidly progressed to congestive heart failure . An operation was undertaken, the mitral and aortic valves were excised and replaced by porcine heterografts, and a fistula from the right sinus of Valsalva to the right ventricle was closed . When coronary circulation was restored, irreversible ischemic contracture of the left ventricle, or "stone heart" syndrome, developed and emergency ALVAD or partial artificial heart implantation was effected . This device functioned as a total artificial heart for nearly six days, while a donor heart was sought . The patient then underwent removal of the ALVAD and cardiac and renal allografting . The transplanted heart functioned well, but the patient expired fifteen days later from gram-negative sepsis.

Medicine (Baltimore), 1978 Nov, 57(6), 527 - 44
Overwhelming strongyloidiasis: an unappreciated opportunistic infection; Scowden EB et al.; Strongyloides stercoralis is an intestinal nematode which infects a large portion of the world's population . Individuals with infection confined to the intestinal tract are often asymptomatic but may have abdominal pain, weight loss, diarrhea, and other nonspecific complaints . Enhanced proliferation of the parasite in compromised hosts causes an augmentation of the normal life-cycle . Resultant massive invasion of the gastrointestinal tract and lungs is termed the hyperinfection syndrome . If the worm burden is excessive, parasitic invasion of other tissues occurs and is termed disseminated strongyloidiasis . A variety of underlying conditions appear to predispose to severe infections . These are primarily diseases characterized by immunodeficiency due to defective T-lymphocyte function (Table 1) . Individuals with less severe disorders become compromised hosts because of therapeutic regimens consisting of corticosteroids or other immunosuppressive medication . The debilitation of chronic illness or malnutrition also predisposes to systemic stronglyloidiasis . The diagnosis of strongyloidiasis can be readily made by microscopic examination of concentrates of upper small bowel fluid, stool, or sputum . Important clues suggesting this infection include unexplained gram-negative bacillary bacteremia in a compromised host who may have vague abdominal complaints, an ileus pattern on X-ray, and pulmonary infiltrates . Eosinophilia is helpful, if present, but should not be relied upon to exclude the diagnosis . The treatment of systemic infection due to Strongyloides stercoralis with either thiabensazole 25 mg/kg orally twice daily is satisfactory if the diagnosis is made early . Because of several unusual features of this illness in compromised hosts, the standard recommendation for 2 days of therapy should be abandoned in such patients . Immunodeficiency, corticosteroids, and bowel ileus reduce drug efficacy . Thus a longer treatment period of at leuch as blind loops or diverticula necessitate longer treatment . Stool specimens and upper small bowel aspirates should be monitored regularly and treatment continued several days beyond the last evidence of the parasite . In particularly difficult situations where either worm eradication is impossible or reinfection is probable, short monthly courses of antihelminthic therapy seem to be effective in averting recurrent systemic illness . Finally, prevention of hyperinfection or dissemination due to Strongyloides stercoralis can be accomplished by screening immunocompromised hosts with stool and upper small bowel aspirate examinations . These would be especially important prior to initiating chemotherapy, or before giving immunosuppressive medications or corticosteroids to patients with nonneoplastic conditions such as systemic lupus erythematosus, nephrotic syndrome, or renal allografts.

J Am Dent Assoc, 1978 Nov, 97(5), 843 - 6
Juvenile periodontitis (periodontosis): current concepts; Vogel RI et al.; The clinical signs and symptoms of periodontosis have been described . Although initially described as a degenerative, noninflammatory disease, recent evidence suggests that periodontosis is inflammatory, with virulent gram-negative microorganisms, selective immune deficiencies, dysfunction of polymorphonuclear leukocytes, genetic predisposition, or any combination of these as possible etiologic factors . Several authors have, therefore, advocated replacing the term periodontosis, which implies a degenerative disease, with destructive or idiopathic juvenile periodontitis . Although various treatments have been proposed, a definitive therapy for the disease depends on the future elucidation of the specific causative factors.

J Bacteriol, 1978 Nov, 136(2), 708 - 13
Restriction endonucleases: general survey procedure and survey of gliding bacteria; Mayer H et al.; Among 120 strains of gliding bacteria which were screened for restriction endonucleases, 27 were found positive . Additionally, three strains carried enzymes able to release the supercoiled state of closed circular DNA . By using a new rapid method, restriction endonuclease activity was released by stirring about 0.5 g of cells (fresh weight) in a motor-driven glass homogenizer in buffer containing Triton X-101, ethylenediaminetetraacetic acid, and mercaptoethanol . A yield from 60 to 80% of the total activity present in the cells was obtained with minimal destruction of the cells . The enzyme activity in the crude extract was measured semi-quantitatively by digestion of DNA and subsequent separation of the fragments on an agarose slab gel . The method appears to be generally applicable for the extraction of restriction endonucleases from gram-negative bacteria on an analytical scale and in a modified form for large-scale preparation of restriction enzymes.

Can J Microbiol, 1978 Oct, 24(10), 1253 - 61
Endotoxic activity of cell-free rumen fluid from cattle fed hay or grain; Nagaraja TG et al.; The cell-free rumen fluid from cattle fed hay or grain exhibited the following biological characteristics which strongly suggest the presence of endotoxin or a toxic principle similar to endotoxin of gram-negative bacteria: proved lethal to mice when injected with actinomycin D; proved extremely lethal to chick embryo; induced biphasic pyogenic response in rabbits; enhanced susceptibility to bacterial infection in mice; evoked positive epinephrine skin reaction in rabbits and phenol-water or aqueous ether proved lethal to mice and chick embryos . A quantitative difference in concentrations of endotoxin was observed on LD50 in mice and chick embryos and response to the epinephrine skin test in rabbits . Cell-free rumen fluid of grain-fed cattle contained at least twice as much endotoxin as that of hay-fed cattle . Endotoxin in cell-free rumen fluid and in higher concentration in cattle fed grain than in those fed hay support the hypothesis that rumen bacterial endotoxins may participate in the pathogenesis of diseases associated with high grain feeding such as lactic acidosis and the sudden-death syndrome.

Infect Immun, 1978 Oct, 22(1), 41 - 51
In vitro evaluation of opsonic and cellular granulocyte function by luminol-dependent chemiluminescence: utility in patients with severe neutropenia and cellular deficiency states; Stevens P et al.; Actively phagocytizing polymorphonuclear leukocytes (PMN) emit light or chemiluminescence (CL) which has been shown to be linked to the oxidative activity of the PMN . The measurement of CL has been demonstrated to be a useful tool for the in vitro assessment of intracellular and opsonophagocytic function of PMN . We have increased the sensitivity of the CL measurement by the addition of luminol to the in vitro reaction of PMN, bacteria, and serum . The presence of luminol, which can be oxidized to emit light, amplifies the detection of CL and PMN cellular activity . This amplification effectively reduces the number of PMN that are necessary for assessment of PMN function from 1 x 10(7) to as low as 2 x 10(4) PMN/assay and permits the evaluation of PMN function in severely neutropenic patients (100 PMN/mm3) in whom cellular PMN function has been heretofore extremely difficult to assess by other methodology . When this luminol-dependent CL method was used, three of eight neutropenic leukemic patients with gram-negative septicemia were found to have deficient opsonic activity and/or increased or depressed cellular oxidative activity . Because the initial slope of CL is dependent on the amount of serum and heat-labile factors, this method can also be used effectively as a simple technique for the analysis of specific rates of opsonophagocytosis of various microorganisms . Additionally, this method can detect the cellular PMN abnormalities of chronic granulomatous disease and myeloperoxidase deficiency . The luminol-dependent CL method is a simple, sensitive, reproducible technique that provides useful information about PMN metabolic activity, particularly in studies in which the number of PMN is limited.

Cancer Treat Rep, 1978 Oct, 62(10), 1581 - 3
Pancytopenia induced by aminoglutethimide in the treatment of breast cancer; Lawrence B et al.; Aminoglutethimide is an investigational agent of proven benefit in the treatment of metastatic breast carcinoma . We report herein a case of aminoglutethimide-induced pancytopenia complicated by bleeding and gram-negative septicemia . Severe pancytopenia is a rare but important side effect of this new drug and is rapidly reversible when the agent is withdrawn.

Clin Chim Acta, 1978 Sep 15, 88(3), 517 - 22
Reduced level of non-esterified fatty acids in sera from patients with infectious respiratory disease; Crum JW et al.; Sera from 103 fasting individuals 3 to 76 years of age and free of clinical infectious disease and sera from 183 patients with infectious disease were assayed for serum total non-esterfied fatty acids (tNEFA) and compared . Data were also separated into five groups according to age of donor: 3--7, 8--19, 20--35, 36--60, and 61--76 years . The mean group serum levels of tNEFA increased with age . Among patients with infectious diseases sixty-five were diagnosed as having hepatitis, 41 with infectious mononucleosis, 18 with cellulitis, 12 with pulmonary tuberculosis, 11 with non-pneumococcal pneumonia, 9 with pneumococcal pneumonia, 8 with pharyngitis, 6 with pyelonephritis, 6 with aseptic meningitis, 4 with Gram-negative sepsis, and 3 with encephalitis . The sera from 23 non-fasting patients with gonorrhea were also tested . The serum tNEFA levels were found to be altered, in fact depressed from normal group values, only in patients with pneumonia or tuberculosis . This depression may be related to aberrant pulmonary metabolism during pneumonia.

Appl Environ Microbiol, 1978 Sep, 36(3), 445 - 9
Endotoxins in commercial vaccines; Geier MR et al.; Twenty samples of commercial vaccines intended for administration to humans were assayed for the presence of bacterial endotoxins by using the Limulus amebocyte lysate test . Sixteen of the vaccines contained more than 0.1 ng of endotoxin per ml (which corresponds to 103 bacterial cell wall equivalents per ml in the undiluted vaccines) . These results suggest that at some stage of preparation, the vaccines have contained varying amounts of gram-negative bacteria and may indicate the presence of other bacterial products as well . It might be useful to list the level of endotoxins, phage, and other contaminants on each vaccine lot to facilitate studies on any side effects of these contaminants . Selection of vaccine lots with the least endotoxin might reduce some of the adverse effects of vaccinations.

Radiology . 1978 Sep;128(3):642.
Pneumoarthropathy: an unusual radiographic sign of gram-negative septic arthritis; Meredith HC et al.; Gas in the joint and periarticular tissues appeared as an early radiographic manifestation of gram-negative septic arthritis of the hip in a diabetic patient . The features of gram-negative septic arthritis are discussed and the value of an early diagnosis is emphasized.

Allergol Immunopathol (Madr), 1978 Sep-Oct, 6(5), 409 - 14
Protection against fatal endotoxin shock in mice by antihistamines; Wittig HJ et al.; Protection against endotoxin shock by antihistamines and similar pharmacologic agents has been reported in the literature . The authors tested the validity of this form of treatment by animal experiments which were conducted in three phases . During the first phase, 10 mice each were treated intravenously with various doses of gram negative endotoxin to determine the dose of endotoxin which would kill 80% of the animals (LD80) . This dose was determined to be 36 mg/kg bodyweight . During the second phase, 10 mice each were pretreated with various doses of either diphenhydramine (Benadryl) or of hydroxyzine HCI (Atarax) one hour prior to the administration of the LD80 of endotoxin . It appeared that high doses of diphenhydramine as well as of hydroxyzine were highly fatal to most animals by causing severe convulsions within 3 to 6 hours at doses of 40 or 50 mg/kg . Doses of less than 1 mg/kg appeared to have no protective effect, while doses of 2.5 and of 5 mg/kg, given one hour prior to the LD80 of endotoxin, had some protective value . In the case of diphenhydramine, 60% of the animals survived with 5 mg/kg pretreatment . Hydroxyzine hydrochloride protected 100% of the 10 animals so treated during the initial experiment and 90% during a subsequent experiment, if given 1 hour before the endotoxin . The third phase of this experiment was designed to determine the optimal time at which hydroxyzine needs to be given to protect against fatal endotoxin shock . Given 6 hours before endotoxin, hydroxyzine appeared to protect half of the animals, 1 hour prior to endotoxin, 5 mg/kg of hydroxyzine protected 90% of animals; if given simultaneously, it protected all animals . When hydroxyzine was given 1 hour after endotoxin there was a 70% survival and, if given 3 hours after endotoxin, a 40% survival.

Arch Microbiol, 1978 Aug 1, 118(2), 141 - 52
Chemical composition of the peptidoglycan-free cell walls of methanogenic bacteria; Kandler O et al.; Cell walls were prepared from freeze-dried samples of 7 strains of Methanobacterium by mechanical disintegration of the cells followed by incubation with trypsin . Electron microscopy revealed the presence of sacculi exhibiting the shape of the original cells, on which no surface structure could be detected . Ultrathin sections of the isolated sacculi showed a homogenously electron dense layer of about 10--15 nm in width . The ash content varied between 8 and 18% of dry weight . The sacculi of all the strains contained Lys: Ala:Glu:GlcNAc or GalNAc in a molar ratio of about 1:1.2:2:1 . In one strain (M . ruminantium M1) alanine is replaced by threonine, however, Neutral sugars and--in some strains--additional amounts of the amino sugars were present in variable amounts, and could be removed by formamide extraction or HF treatment without destroying the sacculi . No muramic acid or D-amino acids typical of peptidoglycan were found . Therefore, the sacculi of the methanobacteria consist of a different polymer containing a set of three L-amino acids and one N-acetylated amino sugar . From cells of Methanospirillum hungatii no sacculi, but tube-like sheaths could be isolated, which tend to fracture perpendicularly to the long axis of the sheath along the fibrills seen on the surface . The sheaths consist of protein containing 18 amino acids and small amounts of neutral sugars . They are resistent to the proteinases tested and are not disintegrated by boiling in 2% sodium dodecylsulfate for 30 min . The three Gram-negative strains Black Sea isolate JR-1, Cariaco isolate JR-1 and Methanobacterium mobile do not contain a rigid sacculus, but merely a SDS-sensitive surface layer composed of regularly arranged protein subunits . This evidence indicates that, within the methanogens, different cell wall polymers characteristic of particular groups of organisms may have evolved during evolution, and supports the hypothesis that the evolution of the methanogens was separated from that of the peptidoglycan-containing procaryotic organisms at a very early stage.

Can J Microbiol, 1978 Aug, 24(8), 1007 - 10
Acetic acid and hydrogen metabolism during coculture of an acetic acid producing bacterium with methanogenic bacteria; Patel GB et al.; Two microorganisms originally existing as a mixed culture obtained from an anaerobic digester fluid were separated for pure and coculture studies . One of these was motile, Gram-negative, and non-sporeforming, and it required yeast extract for growth and acetic acid production . This isolate produced H2 and did not need H2 and (or) CO2 for growth and acetate formation . The other isolate was a methanogen whick resembled Methanobacterium arbophilicum in morphology and substrate specificity . Coculture growth of the two isolates in yeast extract broth (80% N2--20% CO2 gas phase) indicated that the non-methanogen produced up to four to five times more H2 than when grown separately . Although the growth of the non-methanogen was not enhanced by the removal of H2 by the methanogen, the hydrogen produced was essential for the growth of methanogen . Similar results were obtained when the non-methanogen was cocultured with Methanospirillum hungatti GP1 . Cultivation of the non-methanogen in the presence of M . hungatti GP1 (under abundance of 80% H2--20% CO2) indicated that the acetate produced was consumed by M . hungatii, without inhibiting the growth of the other culture.

J Bacteriol, 1978 Aug, 135(2), 633 - 40
Morphological and cell association characteristics of Rochalimaea quintana: comparison of the Vole and Fuller strains; Merrell BR et al.; The vole and Fuller strains of Rochalimaea quintana were grown on monolayers of mouse L cells irradiated 7 days previously and examined by light microscopy and scanning and transmission electron microscopy . Most of the bacteria of both strains were shown to adhere to the L cells but remained in an extracellular location . Cell division was frequently seen among the extracellular bacteria . The few intracellular bacteria seemed to be within vacuoles and did not multiply . Attachment to the eucaryotic cell did not seem to involve pili or other bacterial surface structures . The dimensions of the bacteria were approximately 0.45 micron in width by 1.0 to 1.7 micron in length . The cell envelope consisted of the usual trilaminar cell wall and plasma membranes separated by a layer of low electron density, as found in other gram-negative bacteria . No significant differences between the vole and Fuller strains either in morphology or relationship to eucaryotic cells were encountered.

Arch Dermatol, 1978 Aug, 114(8), 1199 - 202
Mycetoma-like infection caused by previously undescribed bacterium; Hoffman TE et al.; A 56-year-old man had a verrucous plaque with draining abscesses on the dorsum of hir foot for four years . Examination of cultures revealed a Gram-negative bacterium that, to our knowledge, has not been described in the literature . The infection was cured by treatment with co-trimoxazole (trimethoprim and sulfamethoxazole) and topical 10% lactic acid in hydrophylic emulsion base.

J Exp Med, 1978 Aug 1, 148(2), 557 - 68
Macrophage stimulation by bacterial lipopolysaccharides . II . Evidence for differentiation signals delivered by lipid A and by a protein rich fraction of lipopolysaccharides; Doe WF et al.; Stimulation of macrophages to lyse tumor cells is a property common to lipopolysaccharide (LPS) extracted from a variety of smooth and rough bacterial strains by several different preparative procedures . The relationship between macrophage stimulation and the structural characteristics of LPS is defined . In protein-free LPS, lipid A bears the stimulatory signal which results in the differentiation of elicited macrophages into killer cells . The polysaccharide moiety is neither stimulatory itself nor does it block the activity of complete LPS on macrophages . Extraction of LPS by the butanol or Boivin procedures produces preparations in which LPS is complexed through its lipid A moiety to a protein rich component, LAP . Isolated LAP delivers a macrophage differentiation signal which is independent of lipid A . The presence of these two structurally distinct constituents in the cell walls of gram-negative bacteria broadens the biological environments in which they can stimulate macrophages in vivo.

Arch Otolaryngol, 1978 Aug, 104(8), 462 - 3
Sinus infection due to Eikenella corrodens; Dudley JP et al.; Eikenella corrodens is a gram-negative rod that has been identified as a cause of endocarditis, osteomyelitis, pneumonia, cellulitis, and other infections . Because it is difficult to grow unless it is incubated in 10% carbon dioxide and because it may be overgrown by other organisms, it can be overlooked as a sinus pathogen . This is a report of the isolation of E corrodens from the sinuses of three patients with sinusitis . Three important features of infection with E corrodens, which are illustrated by these cases, are as follows: (1) the indolence of E corrodens infections; (2) the unusual susceptibility pattern of E corrodens; and (3) the fact that E corrodens is often isolated in mixed culture . The purulent contents of sinus cavities should be cultured in aerobic, anaerobic, and 10% carbon dioxide atmospheres.

Can J Microbiol, 1978 Aug, 24(8), 922 - 31
A Zoogloea sp . associated with blooms of Anabaena flos-aquae; Caldwell DE et al.; Bacteria were found attached to the heterocysts of Aphanizomenon flos-aquae and embedded within the mucilage of both anabaena flos-aquae and Microcystis aeruginosa in freshwater plankton . Electron microscopy of thin sections preceding the peak of an Anabaena flos-aquae bloom showed that the density of bacterial cells was 7.4 X 10(5) cells/ml in the planktonic macroenvironment and 2.6 X 10(11) cells/ml within the microenvironment of cyanobacterial mucilage . The bacteria occurred in aggregates and isolation required that these be dispersed by homogenizing at 50 000 rpm with glass beads . This procedure yielded a single bacterial isolate from blooms of Anabaena flos-aquae during 2 consecutive years . The isolate was flagellated, catalase- and oxidase-positive . Gram-negative, and rod-shaped to pleomorphic . Observation that the isolate required a pH greater than 8 for consistent growth, could not grow alone on liquid media but could grow alone on the corresponding solid media, could grow in liquid media only in the presence of Anabaena, formed tough mucilagenous colonies on solid media only in the presence of Anabaena extract, and rapidly assimilated but did not respire extracellular 14C-labelled organic matter produced by Anabaena suggested that the occurrence of the bacterium in cyanobacterial mucilage was not coincidental but reflected an obligatory bacterial requirement for the biological or physicochemical microenvironment of the mucilage . The bacterial isolate occurred in three growth forms . Either as a planktonic swarmer cell (which showed a positive chemotactic response to the cyanobacterium) embedded in cyanobacterial mucilage, or embedded in its own mucilage derived, in part, from a low molecular weight (below 1300) carbohydrate secreted by the cyanobacterium . These cultural, biochemical, and ecological characteristics suggest that the isolate is a new species in the genus Zoogloea and of potential importance in phytoplankton ecology.

Arch Microbiol, 1978 Jul, 118(1), 35 - 43
Reisolation of the carbon monoxide utilizing hydrogen bacterium Pseudomonas carboxydovorans (Kistner) comb . nov; Meyer O et al.; From enrichment cultures four carbon monoxide utilizing bacteria were isolated; strain OM5 isolated from waste water was studied in detail . The cells are Gram-negative, slightly curved rods, motile by a single subpolarly inserted flagellum . The colonies are smooth, translucent and not slimy . The cells are able to grow autotrophically in mineral medium under an atmosphere of 40% CO, 5% O2 and 55% N2 at a doubling time of 20h (30 degrees C) or of 85% H2, 5% O2 and 10% CO2 at a doubling time of 7h . Heterotrophic growth occurred on organic acids such as acetate(td = 8h), pyruvate(td = 8h), lactate, crotonate, malate, succinate (td = 8h), formate (td = 35h) and glyoxylate as substrates . The enzyme system for carbon monoxide utilization is formed only during growth on CO; hydrogenase is present in cells grown on CO or on H2 + CO2 as well as grown on pyruvate . The rate of oxygen reduction by intact CO-grown cells is 3.7-fold higher in the presence of hydrogen than in the presence of carbon monoxide . During growth the stoichiometry of gas uptake was 6.1 CO + 2.8 O2 + H2O leads to CH2O +5.1 CO2 . For the new isolate the name Pseudomonas carboxydovorans (Kistner) comb . nov . has been proposed.

Arch Pathol Lab Med, 1978 Jul, 102(7), 344 - 50
The pathology of Legionnaires' disease . Fourteen fatal cases from the 1977 outbreak in Vermont; Winn WC Jr et al.; Fourteen fatal cases from the 1977 Vermont outbreak of Legionnaires' disease have been analyzed . Serious underlying diseases were present in all patients . The only consistent lesions were in the lungs . Bronchopneumonia was present in all cases and was confluent in most . No lobe of the lung was preferentially involved and consolidation was usually bilateral . Abscesses were evident macroscopically in only two cases . Microscopically, there was an extensive alveolar infiltrate of polymorphonuclear neutrophils and macrophages . Lysis of the inflammatory cells was frequently present and was associated with an increased number of bacteria . Coagulative necrosis of lung was present in a few cases, and the possibility of a bacterial toxin must be considered . Bacteria were well stained by the Dieterle stain and appeared Gram-negative in tissue imprints from the unfixed lung.

Equine Vet J, 1978 Jul, 10(3), 148 - 52
Infection patterns in pony mares challenged with the agent of contagious equine metritis 1977; Timoney PJ et al.; Contagious equine metritis 1977 was reproduced in pony mares using cultures of the Gram-negative coccobacillus aetiologically associated with the disease . Variability in clinical response was observed in the first of 2 experiments, with the presence of semen, either alone or in an extender, appearing to potentiate the pathogenicity of the challenge strain of the organism . The experimental disease was characterised by a variable degree of vaginal discharge and concomitant inflammatory changes involving the vervix and vagina . Although all of the affected mares recovered spontaneously, a high percentage continued to harbour the Gram-negative coccobacillus in their genital tracts for variable periods after challenge . Shedding of the organism was either relatively constant or intermittent and was not solely related to the oestrous period . Cytological examination of smears of cervical and urethral swabs was of diagnostic value only during the clinical phase of the infection . There was evidence that reinfection of mares could occur after an interval of 2 weeks.

Clin Orthop, 1978 Jul-Aug, (134), 320 - 4
Eikenella corrodens in human bites; Bilos ZJ et al.; Eikenella corrodens, a gram negative rod, was cultured in about one third of 24 patients with human bite wounds . The organism was sensitive to penicillin but not to methicillin . Clinically the infections in which Eikenella corrodens were found were not different from other infections . Because of the variety of possible pathogens in human bite infections, we start the patients on a broad spectrum antibiotic while awaiting the results of the culture and sensitivity . However, antibiotics alone are not sufficient treatment in HBI; 20 of 24 patients in this series required surgical drainage . Surgical treatment consists of thorough exploration, exteriorization and excision of devitalized tissues . Complications were more frequent in sutured wounds, or when surgical drainage was delayed.

Clin Orthop, 1978 Jul-Aug, (134), 268 - 74
Gram negative bone and joint infection: sixty patients treated with amikacin; Schurman DJ et al.; Sixty patients with bone and joint infections secondary to gram negative infection were evaluated in relation to treatment with amikacin . Forty-seven of these patients had osteomyelitis, and 13 had joint infections, including 3 prosthetic replacements . The patients' average was 35 years and there was no predilection for any particular skeletal location . Only 6 patients had no associated predisposing medical problems . Of these problems fracture, diabetes and narcotic abuse were most common . Thirty patients had Psuedomonas infection, and 15 others had multiple pathogens including Pseudomonas . Aminoglycoside antibiotics had been previously used in 25 . Amikacin was given for an average of 22 days with a mean dose of 13.4 mg/kg . Bone and synovial fluid levels of amikacin were in therapeutic range . At least 48 patients had concurrent local wound treatment in addition to parenteral administration of amikacin . In 47 patients enough information was available to determine the efficacy of treatment . Twenty-seven (57%) of these patients were considered cured, both clinically and for bacteriologic response; and additional 9 (19%) were considered partially cured . Amikacin is effective against susceptible pathogens in bone and joint infections and is a reasonable choice when aminoglycoside antibiotic is indicated.

Proc Natl Acad Sci U S A, 1978 Jul, 75(7), 3216 - 9
Identification of the structural proteins of an ATP-driven potassium transport system in Escherichia coli; Laimins LA et al.; The three structural proteins of the ATP-driven Kdp potassium transport system of Escherichia coli {Rhoads, D . B., Waters, F . B . & Epstein, W . (1976) J . Gen . Physiol . 67, 325-341} have been identified and found to be located in the inner membrane . The high-affinity repressible Kdp system in one of four potassium transport systems in E . coli . The Kdp proteins were identified both in growing cells as well as in heavily UV-irradiated cells infected with transducing phages carrying the kdp operon . Although all previously identified ATP-driven transport systems of Gram-negative bacteria have been shown to contain a periplasmic protein component, no evidence was found for such a component or for an outer membrane component of the Kdp system . The molecular weights of the three inner membrane proteins, KdpA, KdpB, and KdpC, were determined to be 47,000, 90,000 and 22,000, respectively.

Am J Trop Med Hyg, 1978 Jul, 27(4), 822 - 6
Pathology of Bolivian Hemorrhagic fever in the African green monkey; McLeod CG Jr et al.; Gross and microscopic pathological findings are presented for an African green monkey model of fatal Bolivian hemorrhagic fever . Six animals were inoculated with 1,000 plaque-forming units of Machupo virus, the etiological agent of Bolivian hemorrhagic fever . Five of the monkeys died within 13 days with signs of fever, anorexia, shock, and hemorrhage . The sixth monkey survived until the 24th day and died with signs of central nervous system disease . Gross lesions in the five monkeys that die in the acute stage included hepatic necrosis, necrotic enteritis, bronchopneumonia, and hemorrhages in the subcutis, lungs, intestine, liver, and lymph nodes . Microscopically, necrosis was consistently seen in liver, intestine, skin, oral cavity, and adrenal cortex . Acute thrombosis was observed in four monkeys, in blood vessels of the intestine, lung and choroid of the brain . Gram-negative bacteria were seen in many tissues, suggesting terminal bacteremia . The sixth monkey was emaciated and had bronchopneumonia, but did not have the necrotic hepatic and enteric lesions observed in the other five monkeys . The significant microscopic lesions in this monkey included encephalomyelitis, ganglionitis, and bronchopneumonia.

MMW Munch Med Wochenschr, 1978 Jun 30, 120(26), 891 - 4
{Immune defects as a cause of septic complications in leukemias and malignant lymphomas (author's transl)}; Hennemann HH; Septicemias, especially those due to gram-negative pathogens, frequently occur in leukemias, malignant lymphomas and other malignant or metabolic diseases leading to inanition . The causes are disturbances of cellular defense and humoral immune defects . The immune reaction can be affected by disordered antibody function . In addition to a disturbance of leukocyte function due to reduction of granulocytes (granulocytopenia) disturbances of leukocyte function also occur with a normal cell count (granulocytopathy) especially under cytostatic therapy . Besides specific antibiotic therapy it is important to improve the defense position of the organism by treating the primary disease and to assess the disordered immune status correctly.

Biochim Biophys Acta, 1978 Jun 16, 510(1), 1 - 10
Intracellular location of flexirubins in Flexibacter elegans (Cytophagales); Irschik H et al.; The inner and outer membranes of 2 strains of Gram-negative Flexibacter elegans, Fx e1 and Fx 3/4, could be separated on sucrose density gradients after the cells had been converted into spheroplasts, and the spheroplasts had been lysed in presence of EDTA and the detergent Brij 58 . The light fraction (rho = 1.14 g . cm-3) contained the components of the respiratory chain in high concentrations, but only low amounts of the lipopolysaccharide component, 2-keto-3-deoxyoctonic acid, and was thus mainly material from the inner membrane . The heavy fraction (rho = 1.175 g . cm-3) contained only traces of respiratory chain enzymes, but the majority of the 2-keto-3-deoxyoctonic acid, and was thus mainly material from the outer membrane . The flexirubin pigments were found almost quantitatively in the latter fraction . Strain Fx 3/4 produced carotenoids in addition to flexirubins; in this case the flexirubins were located in the outer, and the carotenoids in the inner membrane.

South Med J, 1978 Jun, 71(6), 684 - 93
Saturday Conference: a clinician looks at the aminoglycoside antibiotics; Alford RH; Aminoglycoside antibiotics provide physicians with valuable drugs for coping with serious, often hospital-acquired gram-negative rod infections which are occurring with increasing frequency . Use of these agents may be advantageous and even lifesaving . There are potential hazards associated with their administration . Narrow therapeutic indices coupled with susceptibility to degradation by resistant bacteria should temper our enthusiasm for aminoglycosides.

Invest Ophthalmol Vis Sci, 1978 Jun, 17(6), 528 - 32
Rapid detection of experimental E . coli endophthalmitis by the Limulus lysate test; Avallone AN et al.; Experimental E . coli endophthalmitis was produced in rabbits . The Limulus lysate test was applied to aqueous and vitreous samples at various intervals after the intravitreal injection of E . coli organisms . Results indicated that this test is feasible using vitreous and aqueous samples . The Limulus test was positive for E . coli endotoxin within hours after infection, requiring only 1 hr to determine the presence of endotoxin after sampling . This test may have some value in the rapid diagnosis of gram-negative endophthalmitis.

Lancet, 1978 May 27, 1(8074), 1125 - 7
Total support of the circulation of a patient with post-cardiotomy stone-heart syndrome by a partial artificial heart (ALVAD) for 5 days followed by heart and kidney transplantation; Norman JC et al.; A patient with acute bacterial endocarditis in whom ischaemic contracture of the left ventricle (stone-heart syndrome) developed during aortic and mitral valve replacement had an emergency implantation of an intracorporeal partial artificial heart (an abdominal left-ventricular assist device of ALVAD) . This device functioned as a total artificial heart for nearly 6 days, while a donor heart for transplantation was sought . The ALVAD was then removed, and the patient received allografts of a heart and a kidney . The transplanted heart functioned well, but the patient died 15 days later from gram-negative sepsis . There was no evidence of cardiac or renal allograft rejection.

Biochim Biophys Acta, 1978 May 23, 518(3), 450 - 6
Heterologous transfection with bacteriophage phiX174 DNA: and improved system; Suzuki M et al.; A highly efficient and much more reproducible system for the heterologous transfection of several kinds of Gram-negative bacterial spheroplasts with bacteriophage phiX174 DNA was established . By mild washing of the speroplasts, the efficiency of transfection of all non-host heterologous bacterial species tested increased one or more orders of magnitude in producing the progeny phages and/or the infectious intermediates . Using the improved heterologous transfection systems, it has become clearer that a strong suppression system operates on the processes of phiX174 progeny phage production and not on those of phiX174 dougle-stranded replicative form DNA synthesis in the heterologous bacterial cells . Similar stimulatory effects of this washing procedure were observed in the homologous transfection . With this improved assay system, even less than 100 molecules of phage phiX174 DNA can be detected and the number of molecules can be determined with accuracy.

J Infect Dis, 1978 May, 137(5), 507 - 13
Lack of specificity of the limulus lysate test in the diagnosis of pyogenic arthritis; Elin RJ et al.; The diagnosis of pyogenic arthritis may be difficult to confirm since culture results are sometimes negative . This study attempted to evaluate the utility of the limulus lysate assay for the early detection of pyogenic arthritis due to gram-negative organisms . Seven-one specimens of synovial fluid from 46 patients were evaluated for reactivity in the limulus test, pyrogenic responses in rabbits, total white blood cell count, total neutrophil count, total red blood cell count, and protein and glucose concentrations . All patients with culture-proven septic arthritis or presumptive septic arthritis had joint fluid specimens that yielded a positive result in the limulus assay (12 patients) . However, 52.9% of patients (18 of 34) who had a nonseptic cause for their joint effusion also had a joint fluid specimen that was positive in the limulus test . A positive limulus test result showed a significant correlation with an elevated total white blood cell count (P less than 0.0005), an elevated absolute neutrophil count (P less than 0.0005), and a decreased concentration of glucose (P less than 0.005) in synovial fluid, and the production of fever in rabbits after injection of synovial fluid (P less than 0.05) . Thus, this study suggests that a positive result in the limulus test on joint fluid is nonspecific for a septic process, but a negative result would be evidence against it.

Helv Chir Acta, 1978 May, 45(1-2), 143 - 5
{A new surgical lavage}; Buhler HU et al.; The application in purulent peritonitis of a novel surgical lavaging agent with unique properties is reported . Taurolin is a non-toxic formaldehyde-transmitter with a Thiadiazine structure exhibiting a twofold action in gram-negative sepsis owing to its bactericidal potency and its ability to denature endotoxins in vivo . The present study reports the surgical treatment of 62 patients with appendicitis and peritonitis of varying genesis, using 0.5% Taurolin as lavaging and 2% Taurolin as instillation agents . After 5 days 22 out of 25 patients with purulent peritonitis were void of intraperitoneal bacteria . To date no significant adverse drug reactions were observed.

Can J Microbiol, 1978 May, 24(5), 525 - 32
Pseudomonas maltophilia: identification of the hydrocarbons, glycerides, and glycolipoproteins of cellular lipids; Tornabene TG et al.; The nature of quantity of the free lipids of Pseudomonas maltophilia have been examined . Lipid components identified as phosphatidyl ethanolamine, phosphatidyl glycerol, diphosphatidyl glycerol, phosphatidylamino acid derivatives and phosphatidic acid accounted for about one-half of the total lipids and are generally typical of gram-negative bacteria . The remaining lipids were identified as a complex family of aliphatic hydrocarbon isomers (C22--C32) and a mixture of glycolipoproteins . These components are generally atypical lipids of bacteria . The glycolipoproteins were composed of a broad range of amino acids, ketodeoxyotulonic acid, mannose, glucose, 4-aminopentose, glucosamine, phosphates, and a relatively large quantity of fatty acids, principally OH-13:0 . The total esterified fatty acids consist of cyclopropane, iso- and anteiso-branched and normal saturated and unsaturated chains in the range from C14 to C20 . Amide bound fatty acids consist of OH 11:0, OH-12:0, OH-13:0, and methyl-branched OH-13 in addition to methyl-branched and normal saturated and unsaturated chains.

J Infect Dis, 1978 May, 137 Suppl, S144 - S149
Efficacy and safety of cefamandole plus either gentamicin or tobramycin in therapy of severe gram-negative bacterial infections; Gentry LO; Thirty-one patients with severe gram-negative bacterial infections were treated successfully with a combination of cefamandole nafate plus gentamicin or tobramycin . The patients were divided into two treatment groups: group 1 received low-dose therapy (80--100 mg of cefamandole nafate/kg per 24 hr plus 3 mg of either gentamicin or tobramycin/kg per 24 hr), and group 2 patients, who had suspected bacteremia, received high-dose therapy (170 mg of cefamandole nafate/kg per 24 hr plus 5 mg of either gentamicin or tobramycin/kg per 24 hr) . All of the patients were clinically and bacteriologically cured of their primary infections . All four episodes of bacteremia were cleared within 24 hr after therapy was initiated . There was a uniform decrease in the rate of creatinine clearance which was slightly greater in group 2 patients; however, all creatinine clearance values were within the normal range and actually improved during therapy . There was no difference between the clearance values of the tobramycin-treated patients and gentamicin-treated patients . A few transient abnormalities in results of liver function tests occurred during the study . In one patient whose serum was positive for hepatitis-associated antigen, the alkaline phosphatase, aspartate aminotransferase, and bilirubin values were elevated on admisssion of the patient to the hospital, increased fivefold during therapy, and decreased to the base-line admission values six days after therapy; however, it is difficult to establish that this reaction was antibiotic-induced hepatic toxicity.

Arch Dis Child, 1978 Apr, 53(4), 334 - 7
Dosage schedule of gentamicin for chronic renal insufficiency in children; Yoshioka H et al.; Gentamicin was given to paediatric patients with chronic renal disease complicated by infections by Gram-negative organisms, in which renal function varied from normal to severely insufficient . Peak serum levels after an intramuscular dose of 1 mg/kg body weight ranged from 3.1 to 9.4 microgram/ml, which appeared adequate for therapy . The peak value was not related to the renal function of the individual patients . The serum half-life of gentamicin correlated inversely with the value for endogenous creatinine clearance . A diagram for the estimation of the serum half-life of gentamicin using the creatinine clearance value is presented . As a practical guide, it is recommended that the dose of gentamicin in children with renal function impairment be 1 mg/kg given intramuscularly and that the interval between doses be almost three times as long as the serum half-life, which can be estimated by means of the diagram for individual patients . The accuracy and safety of this method were confirmed by treating children with this adjusted dosage schedule.

Arch Surg, 1978 Apr, 113(4), 397 - 401
'Lethal' burns . A progress report; Monafo WW et al.; Sixteen consecutive patients, nine of whom also had inhalation injury, had burns over 72% body surface area or more . The expected death rate was 94% . In fact, all of the eight patients still alive after 48 hours survived . The early deaths were primarily due to inhalation injury, the treatment of which remains an unsolved problem . A mixture of cerium nitrate and silver sulfadiazine was used for topical wound antisepsis . The wound flora was sparse: 447 of 814 wound-surface cultures were sterile; Gram-negative bacteria were recovered in 13% . This efficacious wound bacteriostasis appeared primarily responsible for the absence of late death.

Can J Microbiol, 1978 Apr, 24(4), 339 - 52
Chlamydiae, rickettsiae, and their cell wall defective variants; Kordova N; Inapparent chlamydial and rickettsial infections are an important source of the dissemination of the parasites and may cause explosive outbreaks of severe diseases in man and animal . However, it is engimatic how these obligate intracellular microbes induce latency and why or how inapparent infections convert into active disease . Currently, microbiologists believe that chlamydiae and rickettsiae are gram-negative bacteria unique in their intracellular habitat . This review presents evidence that these organisms have another peculiarity; namely, defective cell walls present throughout much of their life cycle . In this survey, the properties of the small and large forms of chlamydiae and rickettsiae are reexamined with regard to the current knowledge of cell wall defective variants of free-living bacteria . Data are presented in support of the concept that chlamydiae and rickettsiae are cell wall defective microbes whose small 'bacterial' forms have lost the ability to reproduce as bacteria during evolution; the large forms including ultrafilterable phases of the life cycle of these parasites are responsible for inapparent infections of healthy carriers, whereas conversion into small 'bacterial forms may cause, under appropriate conditions manifest diseases . This concept may provide challenging and profitable directions in the search to explain puzzling phenomena associated with chlamydiae and rickettsiae.

Am Fam Physician, 1978 Apr, 17(4), 134 - 40
Opportunistic ocular infections; Ostler HB et al.; Since corticosteroids were introduced, a steadily increasing number of opportunistic pathogens have been causing major disease in both systemically and locally compromised hosts . In ocular disease, the most common cause of compromise (and of infection with such opportunistic pathogens as the herpeviruses, many gram-negative bacteria, numerous fungi and Toxoplasma) is the topical use of corticosteroids and antibiotic-corticosteroid preparations . To avoid the damaging and sometimes blinding results of opportunistic infection, the use of these preparations should be carefully restricted.

Fortschr Med, 1978 Mar 30, 96(12), 653 - 60
{Drug therapy of shock}; Bartels O et al.; Shock is to define by clinical symptoms, measurable haemodynamic and metabolic changes, clotting failure and disorders of fluid, electrolyte and acid-base balance . It is essential to remove hypovolemia, acidosis, cardiovascular failure, pulmonary and renal insufficiency . Quite a lot of proved and controversial pharmacological substances are placed at physician's disposal . However, the mortality of cardiogenic shock and gram-negative septic shock is more than 80% respectively 30%, often caused by shock lung or irreversible injury to the kidneys . Shock due to depletion of extracellular fluid, poisoning and acute pancreatitis require specific treatment.

Can Med Assoc J, 1978 Mar 18, 118(6), 659 - 62
Evaluation of three antibiotic programs in newborn infants; Marks S et al.; Emergence of gram-negative bacteria resistnant to a number of antibiotics in intensive care nurseries for neonates emphasizes the need for alternatives in antibiotic combinations . One commonly used combination, gentamicin-ampicillin, and two newer combinations, tobramycin-cephalothin and amikacinampicillin, were evaluated prospectively in 60 newborns in such a nursery . Subjects were randomly assigned to one of the above therapy groups . Dosages in mg/kg.d were 100 for ampicillin and cephalothin, 6 for gentamicin and tobramycin and 15 for amikacin . Aminoglycoside serum concentrations, clinical tolerance and toxicity were monitored . Aminoglycoside concentrations after intravenous administration of the drugs were within the expected range (gentamicin and tobramycin 4 to 6 microgram/mL and amikacin 15 to 20 microgram/mL) . There was no hematologic, renal or hepatic toxicity attributable to antibiotic therapy and the combinations were tolerated equally; no bilirubin displacement was detected in vitro or in vivo.

S Afr Med J, 1978 Mar 11, 53(10), 358 - 60
Septicaemia in kwashiorkor; Scragg JN et al.; In blood and stool cultures from 90 Black children with kwashiorkor, the commonest organisms isolated were Gram-negative aerobic rods . The mortality rate was highest in the group who developed septicaemia . In patients with negative blood cultures, the outcome was much more favourable, although the majority of them showed evidence of respiratory and/or bowel infections . It is felt that routine antibiotic therapy is advisable in the management of kwashiorkor.

J Trauma, 1978 Mar, 18(3), 188 - 93
Prospective trials of dexamethasone and aerosolized gentamicin in the treatment of inhalation injury in the burned patient; Levine BA et al.; The addition of an inhalation injury to a cutaneous burn results in a significant increase in patient mortality rates, both from early pulmonary edema and, later, Gram-negative pneumonitis . Steroids have been shown to decrease mortality in an inhalation injury model . Aerosolization of gentamicin has been used successfully to treat severe bronchial infections . Therefore, a prospective, randomized trial was undertaken to evaluate both these drugs . Sixty burned patients, with inhalation injury confirmed by bronchoscopy and 133Xenon scan, were studied: 30 patients received either dexamethasone or saline placebo for 3 days; serial pulmonary functions were measured on those able to cooperate; another 30 patients received either aerosolized gentamicin or placebo for 10 days . Both drug-treated groups were comparable to their controls in age and mean burn size . Results of the steroid trial showed no major differences in mortality, pulmonary complications, or changes in pulmonary functions . Results of the gentamicin trial showed no major differences in mortality, time of death, or pulmonary and septic complications between treated and control groups.

Arch Intern Med, 1978 Mar, 138(3), 478 - 80
Hyperchloremia and negative anion gap associated with polymyxin B administration; O'Connor DT et al.; A patient receiving polymyxin B sulfate intravenously for Gram-negative "anion gap" . Both abnormalities resolved following discontinuation of the drug . In vitro investigation suggested that the electrolyte abnormalities resulted from the polycationic properties of polymyxin B.

J Membr Biol, 1978 Feb 6, 39(1), 49 - 56
Effect of polymyxin B on the structure and the stability of lipid layers; Miller IR et al.; Polymyxin B (PX) does not penetrate phospholipid monolayers and bilayers at low field strength across the lipid layers . The degree of penetration of PX is evaluated from its effect on the capacitance of the monolayers and on the conductance of the bilayers . PX added to one side of a bilayer causes its destabilization, it also enhances destabilization of lipid monolayers at positive electric fields across the surface layer in the direction of the adsorbed PX . PX lowers very little the fluorescence polarization of 1,6-diphenyl 1,3,5 hexatriene embedded in phospholipid vesicles . It is suggested that the penetration mechanism of PX into gram-negative bacteria is based on transient local breakdown of the plasma membrane.

Can J Microbiol, 1978 Feb, 24(2), 191 - 5
Cleavage planes in the envelope of Aquaspirillum bengal; Beveridge TJ et al.; The cell surface of Aquaspirillum bengal was devoid of superficial wall structure . When cells were freeze-cleaved and etched, multiple fracture planes through the cell envelope were exposed, which was unusual for an aquaspirillum . These included both convex and concave surfaces and they are compared with those of other gram-negative bacteria.

Br J Exp Pathol, 1978 Feb, 59(1), 48 - 51
The significance of secondary gram-negative coliform infection of the lungs of mice with influenzal pneumonitis; Yealland SJ et al.; Influenza-virus-induced pneumonia of mice was consistently shown to be associated with secondary infection with coliform organisms . Treatment with gentamicin effectively sterilized the lungs of these mice but had no effect on either mortality or extent of the pneumonic process . The significance of these findings is discussed.

J Gen Microbiol, 1978 Feb, 104(2), 269 - 76
Taxonomy and epidemiology of gram-negative bacterial plasmids studied by DNA-DNA filter hybridization in formamide; Roussel AF et al.; Phylogenetic and epidemiological relatedness among transferable plasmids belonging to the IncC, IncM and IncH incompatibility groups has been studied by DNA-DNA filter hydridization . Hybridization was carried out on nitrocellulose microfilters, at low temperature, in formamide and under paraffin oil . The degree of hybridization among plasmids belonging to the IncC and IncM groups supported the conclusions drawn from genetic classification . Studies on relatedness among plasmids belonging to the IncH group allowed their classification into three phylogenetic sub-groups . Comparison of DNA sequences of three plasmids sharing the same genetic properties and isolated from different bacterial species suggested an epidemiological spread of the same plasmid.

Br J Dermatol, 1978 Feb, 98(2), 229 - 31
Opportunistic infection of chronic skin ulcers with Pseudomonas putrefaciens; Appelbaum PC et al.; Heavy growth of Pseudomonas putrefaciens was isolated repeatedly in mixed culture with other Gram-negative rods from chronic ulcers on the extremities of an elderly patient with burnt-out leprosy . Treatment was with systemic cotrimoxazole, topical framycetin and general supportive therapy, and the ulcers gradually healed over a period of 4 weeks.

J Bacteriol, 1978 Feb, 133(2), 987 - 94
Caulobacter crescentus cell envelope: effect of growth conditions on murein and outer membrane protein composition; Agabian N et al.; The murein and membrane protein compositions of Caulobacter crescentus strains CB13B1a and CB15 have been characterized, and the influence on cell envelope constituents of culture conditions which affect morphogenesis have been studied . Amino acid and sugar analysis of murein sacculi revealed a simple A1gamma murein configuration typical of gram-negative bacteria . The membranes of C . crescentus had low levels of 2-keto-3-deoxyoctonate relative to enteric bacteria, in addition to the absence of lipid A components (Shapiro et al., Science 173:884-892, 1971; Chow and Schmidt, J . Gen . Microbiol, 83:369-373, 1974) . Nevertheless, C . crescentus membranes could be fractionated into inner and outer membrane components by sucrose density gradient centrifugation procedures developed for Escherichia coli . The proteins of the outer membrane were distributed between three major (I, II, and III) and two minor (IV and V) protein classes . Class I proteins were greater than or equal to 74,000 daltons and constituted the primary proteins of the outer membrane . Class I proteins were separated into approximately 50 polypeptides by two dimensional gel electrophoresis; the protein composition of thi s class was affected by culture conditions in both CB13B1a and CB15 . Class II (47,000 to 39,000 daltons) and III (20,000 to 11,500 daltons) proteins differed in each strain in composition and response to culture conditions.

Arch Pathol Lab Med, 1978 Feb, 102(2), 53 - 6
Leukapheresis and granulocyte transfusion; McCullough J; Granulocytes for transfusion can now be obtained from normal donors by one of four techniques that involve either centrifugation or reversible adhesion of granulocytes to nylon fibers . The leukapheresis process appears to be safe for donors and standards for the selection and care of donors are being formulated . It appears desirable to transfuse granulocytes that are compatible in a leukoagglutination crossmatching, however, better methods for histocompatibility testing must be developed . Granulocyte transfusions clearly are of benefit to patients with Gram-negative sepsis and granulocyte counts of less than 500/cu mm for at least ten days . They may be valuable for granulocytopenic patients with other severe infections; however, there is no indication that granulocyte transfusions are indicated prophylactically or for febrile granulocytopenic patients without evidence of infection.

Infect Immun, 1978 Feb, 19(2), 515 - 22
Humoral bactericidal systems: nonspecific and specific mechanisms; Skarnes RC; Bactericidal systems in normal serum from month-old rabbits and guinea pigs were characterized in terms of activity against rough- and smooth-phase species of gram-negative bacteria . Killing of the rough strains in the absence of natural antibody required complement and at least one additional nonspecific component exhibiting lability to freezer storage and to heating at 52 degrees C . Bactericidal action against the smooth-phase organisms, on the other hand, appeared to require natural antibody in addition to complement and the labile component . Both nonspecific and specific bactericidal systems were also functional in normal serum from adult animals . In immune systems, the labile nonspecific component was not essential for bactericidal activity . Whereas immune systems were subject to inhibition by homologous endotoxins, the normal serum bactericidal systems were not, indicating that the natural antibodies in normal serum were specific for surface antigens other than the O-somatic polysaccharides . The significance of these observations is discussed in relation to probable complement pathways that mediate killing in each of the systems described.

Am J Clin Pathol, 1978 Feb, 69(2), 161 - 4
Comparison of a commercial identification kit and conventional biochemical tests used for the identification of enteric gram-negative rods; McCarthy LR et al.; A comparison between 11 Minitek biochemical tests and corresponding conventional tubed media was undertaken with 1,089 isolates of enteric gram-negative rods . Overall correlation between Minitek and conventional biochemicals was 97.4% . Minitek proved to be a time- and space-saving miniaturized biochemical system that can be used effectively for the identification of enteric gram-negative rods.

J Supramol Struct, 1978, 9(2), 231 - 42
Lipopolysaccharide effects on sensitive and resistant variant Chinese hamster ovary cell lines; Brunson KW et al.; Chinese hamster ovary (CHO . K1 . PRO) cell growth was inhibited by addition of a gram-negative bacterial lipopolysaccharide (LPS) to the cell culture medium . Growth inhibition began after three or four days of incubation, was dose-dependent up to a maximum at an LPS concentration of 500 microgram/ml and was accompanied by cell shape changes and enhanced cytoplasmic vacuolization . Formation of bizarre CHO . K1 . PRO cell shapes and vacuole formation were most pronounced after seven days of incubation with LPS and could be observed by light and electron microscopy . An LPS-resistant cell population was obtained by intermittent in vitro exposure to high levels of LPS; these variant cells or clones derived from them failed to display growth inhibition in the presence of LPS . A clone from the LPS-resistant variant population showed altered cell properties compared to the parental cell line which included changes in cell morphology, adhesion, and endocytosis . Parental cells was markedly density-inhibited, whereas the cariant clone exhibited considerable growth after confluency . The LPS-resistant variant cells showed a more elongated morphology than the parental line . No significant differences were observed between rates of detachment of parental and variant cells when sparse cultures of either line were removed from tissue culture dishes by ethylenediaminetetracetate (EDTA) . However, at confluency approximately 100% of the variant cells versus 35% of the parental cells were removed by EDTA in one hour . Measurements of 125I-ferritin uptake by parental and variant cells showed approximately twenty-fold and twofold increases, respectively, in uptake induced by LPS when compared to untreated control cultures.

Zentralbl Chir, 1978, 103(24), 1623 - 31
{Intraoperative bacterial contamination and posttraumatic wound infection (author's transl)}; Kaufner HK et al.; In a consecutive series of 150 fractures treated surgically 16 wound infections were observed . Evaluating the intraoperative wound swabs, type and localisation of the fractures, duration of operation and tourniquet time it was tried retrospectively to find a relationship to these posttraumatic wound infections . The highest rate of infection was found in fractures of the tibia . Open fractures had a higher risk than closed ones . Furthermore, a prolonged duration of operation was related to a rising risk of infection . The intraoperative wound swabs themselves did not allow any conclusion concerning the risk of postoperative infection . Postoperative wound infections appeared nearly as frequent after negative as after positive intraoperative swab . Only the species of bacterias found intraoperatively allowed a conclusion concerning subsequent wound infection so far that after an intraoperative finding of gram-negative bacterias and - surprisingly - apathogenic sporogenic bacterias postoperative wound infections were observed more frequently than after finding other bacterias . In summary, however, the routine intraoperative wound swab does not seem to be suitable as a sreening-test for early recognation of impending postoperative wound infections.

Zentralbl Neurochir, 1978, 39(1), 103 - 7
{Bacteriostatic behavior of the tissue adhesive Fimomed (n-butyl-alpha-cyanoacrylate}; Willenberg E et al.; The tissue adhesive Fimomed (made in GDR), which is supplied in a non-sterilised form, was tested for its bacteriostatic behaviour . No such behaviour was found for Gram-negative bacteria, so that in view of the typical microorganisme occurring in hospitals sterilisation of the adhesive by means of gamma rays or an aseptic filling by the manufacturers is suggested.

Chemotherapy, 1978, 24(3), 179 - 86
Clinical experience with bacteraemia in patients with leukaemia and allied neoplastic diseases; Mortensen BT et al.; 134 bacteraemic episodes in 112 patients with leukaemia and allied disorders over a 5-year period were reviewed . The patients were divided, with respect to neoplastic disease, into 3 prognostic groups according to estimated periods of survival of years (group 1), months (group II) or weeks (group III) . High mortality was correlated to group III, gram-negative rod bacteraemia and septic shock . Low leucocyte levels and intensive antineoplastic treatment did not adversely influence the prognosis of the bacteraemic patients . Appropriate antibiotic therapy was correlated with a significantly lower mortality, and it is concluded that aggressive antibiotic therapy is indicated when bacteraemia is suspected from clinical judgement.

Chemotherapy, 1978, 24(3), 172 - 8
Amikacin therapy of serious gram-negative bacillary infections in chronic hemodialysis patients; Meyer RD et al.; Amikacin was used to treat 7 serious gram-negative bacillary infections in patients undergoing chronic hemodialysis . 4 were caused by pathogens resistant to gentamicin . 5 infections were cured; 1 was improved and another failed to respond . Mean 1-hour peak serum levels of amikacin ranged from 25.8 to 44.3 microgram/ml . Mean serum levels of amikacin after 6 h of hemodialysis were 61.5% of predialysis levels . Amikacin is highly effective but doses must be reduced in patients requiring hemodialysis and serum levels monitored to avoid ototoxicity.

Mikrobiologiia, 1978 Jan-Feb, 47(1), 131 - 7
{Photosynthesizing bacteria from the Wanda Lake (Antarctica)}; Osnitskaia LK et al.; Photoautotrophic bacteria growing under anaerobic conditions in the light at 28 degrees C with carbon dioxide as a sole source of carbon were isolated from the ooze of the Vanda Lake at a depth of 68 m . The cells are rounded gram-negative rods, and form a dark-red pigment . The morphology and physiology of the cells were studied as well as absorption spectra of the cells and isolated pigments . The main maxima of absorption were found to be shifted to a short-wavelength region of the spectrum . This fact and peculiar conditions of their habitat as well as some other characteristics are the reasons why these bacteria are classed as a new species Chomatium vanda . As far as we know, this is the first description of photosynthetic bacteria inhabiting the Vanda Lake in the Antarctic.

Circ Shock, 1978, 5(1), 43 - 50
Effect of endotoxin on glucose uptake by the isolated forelimb of the dog; Furr PA et al.; Recent research has demonstrated that an increase in glucose utilization by skeletal muscle occurs in hemorrhagic shock . It is conceivable that the hypoglycemia of gram-negative septic shock is, in part, due to increased glucose utilization by peripheral tissues . The hypothesis tested in this study was that there is an increase in glucose uptake by the isolated innervated and/or denervated forelimb of the dog subjected to endotoxin shock . Results indicate that endotoxin does not affect a net increase of glucose uptake by the isolated forelimb . No increase in uptake occurred when blood glucose concentration was normal . However, when endotoxin hypotension induced a significant hyperglycemia or when arterial glucose concentration was elevated by glucose administration an apparent increase in forelimb glucose uptake occurred . It is concluded that endotoxin does not increase the uptake of glucose by skin and muscle except that it causes hyperglycemia secondary to increased sympathoadrenal discharge in the shock state . Thus, if the dog becomes sufficiently hyperglycemic, an apparent increase in glucose uptake occurs, probably because of accumulation of glucose in the interstititial space of skin and muscle.

Equine Vet J, 1978 Jan, 10(1), 1 - 4
Contagious equine metritis; Powell DG; An outbreak of contagious equine metritis that occurred on stud farms in the Newmarket area during 1977 is described . A Gram-negative coccobacillus was isolated from field cases and the disease was reproduced experimentally by inoculating a pure culture of the organism through the cervix of clean pony mares . Natural spread of the disease occurred by venereal transmission and following the handling, examination or teasing of infected mares . Bacteriological screening of the genital tract of mares and stallions before covering plus stricter standards of hygiene on the stud farms have been recommended as the methods to control the disease . A great deal more information about the disease is required before it can be confidently stated that it can be adequately controlled.

Acta Chir Acad Sci Hung, 1978, 19(4), 399 - 404
{Role of bacterial endotoxins in the tourniquet shock in rats}; Orban I et al.; By means of the lead acetate endotoxin sensitising method it was possible to demonstrate the development of endotoxaemia in tourniquet ischaemia of rats . The lethality of shock was greatly reduced by retreatment with radio-detoxified endotoxin (Tolerin) . Prelinary liquidation of the Gram-negative enceroflora caused a similar reduction of lethality . On the basis of the results endotoxaemia of intestinal origin triggered by the vasoactive substances liberated during ischaemia and reaching the circulation are considered of importance in the pathogenesis of tourniquet shock.

Infection, 1978, 6(5), 236 - 40
Therapy of serious infections with cefamandole; Parry MF et al.; Forty-four patients with serious bacterial infections were treated with cefamandole in a dose 1--2 g every four to six hours . Thirty-two patients were cured and six were markedly improved . Three of six failures were due to superinfection with cephalothin-resistant microorganisms . The over-all bacteriologic response was 80% . In 12 of 13 patients with bacteremia the blood was sterilized . Ten of 14 patients with gram-negative bacillary infections responded to treatment . Six of these were due to cephalothin-resistant microorganisms, three of which responded . Fifteen patients who were treated had a history of penicillin allergy . There were no serious reactions although skin rash did develop . Phlebitis was uncommon.

Scand J Infect Dis, 1978, 10(3), 229 - 34
Tobramycin in patients with various infections: a clinical evaluation; Atterholm I et al.; 22 patients with various gram-negative infections were treated with tobramycin at a dose of approximately 3 mh/kg body weight/24 h for 7 to 53 (mean 16) days . Therapy was monitored with determinations of drug serum concentrations and renal and audio-vestibular function tests . In 16 patients either cure of clinical improvement were achieved . Two patients did not improve . In another 4 patients the effect of tobramycin therapy could nto be evaluated . One patient exhibited a subclinical vestibular dysfunction and one patient experienced transient tinnitus . In one patient, slight but clinically significant renal impairment occurred.

Zentralbl Chir, 1978, 103(14), 935 - 7
{The problem of endotoxin shock after antibiotic therapy in surgery (author's transl)}; Margreiter R et al.; 2 fatal cases of endotoxin shock after antibiotic therapy due to massive Escherichia coli infection after surgery are described to emphasize this rare possibility of complication . In cases of major infections with Gram-negative bacterais antibiotics should therefore prophylactically be given initially in low doses and only after observation in increasing amounts.

Scand J Infect Dis Suppl, 1978, (13), 11 - 5
beta-lactamase insensitive or inhibitory beta-lactams: two approaches to the challenge of ampicillin-resistant E . coli; Richmond MH; The rising incidence of Gram-negative bacteria resistant to ampicillin in hospitals has brought about a need to develop novel beta-lactam antibiotics . This challenge is being met in two ways . First, attempts have been made to develop compounds insensitive to beta-lactamase hydrolysis . This has proved difficult in the penicillin series, but cefuroxime and cefoxitin are cephalosporin derivatives with the necessary properties . The second approach has been to discover novel beta-lactam nuclei capable of inhibiting beta-lactamases . So far this had led to the production of the clavulins and the olivacins, the latter class of molecules being closely related chemically to thienamycin.

Microbios, 1978, 18(73-74), 195 - 212
Development and standardization of a cytotoxic micro-assay for detection of enterotoxins: survey of enterotoxins from Escherichia coli of infant origin; Farkas-Himsley H et al.; The development of a practical cytotoxic micro-assay for detection of enterotoxins in crude bacterial lysates of E . coli and other Gram-negative bacteria, is described . This quantitative assay is based on growth inhibition of mouse-fibroblasts, maintained in suspension or by inhibition of uptake of DNA precursors . Guidelines for performing the assay and evaluating the results by statistical considerations, are described . The choice of a relatively cheap medium and a suitable number of target cells to achieve cell doubling in 24 h is given . The concentrations of proteins in the crude lysates from strains of different origin, are not of equal potency; a predetermined but different protein concentration for strains from infants, adults or porcine origin, are recommended for detection of the toxins and for achieving reproducible results . Production of toxic proteins is enhanced by mitomycin C in toxigenic strains and not in non-toxigenic strains . Screening of a limited number of lysates from E . coli strains originating from infants and a comparison of the cytotoxicity of several known toxigenic and non-toxigenic strains from human adults and porcine origin, are presented.

Health Lab Sci, 1978 Jan, 15(1), 9 - 14
Micromethod for rapid identification of gram-negative, nonfermentative bacteria; Gibson JB et al.; Because of the contemporary significance of gram-negative, nonfermentative bacteria as etiological agents, a simple, rapid determinative system is essential . Therefore, an accurate, reproducible, and an inexpensive micromethod for the identification of these organisms has been developed . Included in this system are twenty-five biochemical tests . Carbohydrate utilization is demonstrated by modification of Otto and Pickett's formula for oxidative attack and assimilation of carbon sources, while the other substrates are modifications of commercially available products . Inoculation is a two-fold procedure into a plastic multicompartmented tray with wells containing 100 micro liters of each substrate . Initial inoculation yields 10(5) colony forming units per well . The carbohydrates are supplemented with an additional 50 micro liters of a 1 X 10(11) saline suspension of organisms . Reactions are read after a maximum incubation of 48 hr at 35 C . The results obtained with the identification of 124 strains of nonfermentative bacteria utilizing a conventional media schema as suggested by the Center for Disease Control and the micromethod system demonstrated the high reproducibility and correlation achievable with this rapid and economical microtechnique.

Trans Ophthalmol Soc U K, 1978, 98(4), 506 - 7
Disseminated intravascular coagulopathy; Martin VA; Disseminated intravascular coagulation (DIC) is not a disease but a pathological process with widespread thrombus formation in small vessels; it occurs in many systemic conditions that stimulate the intravascular clotting mechanism . There may be widespread tissue involvement, and any tissue in the body may be affected, especially in the kidney, brain, liver, heart, and lungs . This abnormal coagulation is now commonly referred to as disseminated intravascular coagulopathy . It is prone to occur in obstetrical complications, in cancer, after transplantations, and where there has been tissue damage, such as burning, crushing, and surgery, all of which release thromboplastin into the circulation . It may also occur in Gram negative bacterial systemic infections, in antigen-antibody reactions, and in thrombotic thrombocytopenic purpura . When the eye is involved, the thrombi occur in the choriocapillaris, and are usually limited to the submacular and peripapillary choroid . The anterior parts of the eye generally escape involvement . Visual symptoms may be early, and may be due to central choroidopathy or to secondary retinal detachment.

Z Allg Mikrobiol, 1978, 18(5), 345 - 54
Site of ATPase activity in Myxococcus xanthus: lipid requirement for enzyme activity . Dedicated to Professor Dr . W . Schwartz on his 80th birthday; Voelz H; Treatment of cells with lysophosphatidylcholine, lysozyme, and phospholipase D removed most of their phospholipids and reduced ATPase activity to near zero . Addition of a microdispersion of phospholipids restored enzyme activity to various degrees . Phosphatidylcholine was most effective in reconstitution experiments, less effective were phosphatidylethanolamine and phosphatidylserine . Lipid analyses of cell fractions were possible through separation of cell wall and cell membrane in a sucrose gradient after differentiated treatment of glutaraldehyde fixed cells with lysophosphatidylcholine, lysozyme, and pronase . Phosphatidylcholine was almost exclusively a component of the cell membrane, whereas phosphatidylethanolamine was that of the wall . It is concluded that lipids are necessary for in vivo function of a Mg-dependent ATPase, and that membrane-associated phosphatidylcholine may serve as a matrix for the enzyme . Lipid extracts made from cells or cell fractions contained plasmologens, not previously reported to occur in Gram-negative, aerobic bacteria.

Microbiol Immunol, 1978, 22(5), 235 - 47
R plasmids among Gram-negative bacteria with multiple drug resistance isolated in a general hospital; Suzuki S et al.; The incidence of conjugative R plasmids in multiple drug-resistant strains of gram-negative bacteria isolated in 1973 from patients in a 700-bed general hospital in Tokyo and some properties of the R plasmids isolated are described . Conjugative R plasmids were found in 52 of the 96 strains (54%), from which 74 R plasmids were demonstrated . It is remarkable that the isolation frequency of R plasmids mediating quadruple- or five-drug resistance was rather low, and the complete pattern of multiple resistance of the original isolates was only rarely transferred by conjugation . These results revealed the existing state of the distribution of R plasmids among hospital strains with multiple drug-resistance.

J Bacteriol, 1977 Dec, 132(3), 950 - 66
Novel bacterium infecting an African snail; Cole RM et al.; Nodules found in the superficial tissues of laboratory-maintained snails (Bulinus jousseaumei) contained a bacterium of two forms . This nonmotile microorganism occurred in intracellular packets as a simple gram-negative rod that appeared to undergo intrapacket transition to a cephalotrichous form . The latter is characterized by a "head" from which emerge long, thick, rigid, flagella-like, helically constituted filamentous organelles with a core and an outer component that is not an extension of the bacterial envelope . Neither form was successfully cultured, but clean snails derived from eggs removed before hatching developed nodules within 1 to 3 months of exposure to infected snails . The infectivity was specific for the host snail, and no transmission occurred to snails of 5 other genera tested . The presence of nodules did not interfere with longevity or reproduction of infected snails . Details of infectivity, transition, and taxonomic position of the bacterium remain to be explored, but it is reported because of unique morphological and ultrastructural features not previously known.

Pediatrics, 1977 Dec, 60(6), 908 - 12
Increased incidence of gram-negative neonatal sepsis with intramuscula iron administration; Barry DM et al.; During a five-year period the incidence of neonatal sepsis was 20 times higher in Polynesian newborns compared with European newborns (11 per 1,000 vs . 0.6 per 1,000 total births) . This high incidence in Polynesians was confined to a period when the infants were being given intramuscular iron dextran . When the iron administration was stopped the incidence of disease in Polynesians decreased from 17 per 1,000 to 2.7 per 1,000 total births . An analysis of the Polynesian iron-treated and non-iron-treated groups showed a statistically significant difference in the incidence of sepsis, the type of causative organism, and mortality . The data suggest that the iron dextran injections have impaired the immunity of the treated infants, making them more susceptible to Escherichia coli sepsis.

Can J Microbiol, 1977 Dec, 23(12), 1733 - 6
Microscopic examination of natural sessile bacterial populations from an alpine stream; Geesey GG et al.; Natural populations of bacteria assoiciated with the slime on submerged surfaces in a mountain stream were examined by phase-contrast and electron microscopy . The slime contained large numbers of bacteria which were predominantly gram-negative as determined by their cell wall structure . Examination of the in situ distribution of cells revealed that they were enmeshed in an extensive fibrous matrix whose component fibrils were stained with ruthenium red . The arrangement of slime fibrils immediately around individual bacterial cells suggested that this material was produced by these bacteria . This slime facilitated microcolony development and also anchored the bacteria to a particular surface . It is proposed that these slime-enmeshed microcolonies constitute functional communities within which most sessile bacteria live.

J Clin Microbiol, 1977 Dec, 6(6), 605 - 9
Evaluation of two rapid methods for identification of commonly encountered nonfermenting or oxidase-positive, Gram-negative rods; Dowda H; The ability of the expanded API-20E and the Oxi-Ferm System to identify 176 isolates of nonfermenting or oxidase-positive, gram-negative rods from 17 species or groups was studied . The expanded API-20E, without referral to a computer reference center, was able to identify 61.4% of the isolates to the species level . If reference to the computer center was utilized, an additional 25% could be identified . Of the isolates examined, 13.6% were misidentified, partially identified, or assigned no identification . Those assigned to the incorrect genus constituted 0.5% of the isolates tested; those assigned to the correct genus, but the wrong species, constituted 0.5%; 4.5% were placed in the correct genus with no species given; and 7.9% were assigned no identification . The Oxi-Ferm System was able to assign 75% of the isolates to the correct species without further testing, and an additional 19.3% required additional testing for correct identification . Those assigned to the incorrect genus represented 3.4% of the isolates tested; 1.1% were assinged to the correct genus, but the wrong species; and 1.1% were assigned to the correct genus, with no species indicated.

J Bacteriol, 1977 Dec, 132(3), 1045 - 7
Outer membranes of gram-negative bacteria . XV . Transmembrane diffusion rates in lipoprotein-deficient mutants of Escherichia coli; Nikaido H et al.; Permeability of the outer membrane to 6-aminopenicillanic acid was unaltered in an lpo mutant, lacking the Braun lipoprotein, a result suggesting that the lipoproteins by themselves form no or few diffusion pores.

Biochim Biophys Acta, 1977 Nov 15, 471(1), 92 - 104
Structural heterogeneity of the cytoplasmic and outer membranes of Escherichia coli; De Leij L et al.; The cytoplasmic and outer membranes of gram-negative bacteria can be isolated from spheroplasts, and separated on sucrose density gradients . Lysis of spheroplasts causes extensive membrane fragmentation and since the characteristics of the fragments obtained by different lysis procedures need not be identical, the influence of the disruption method on membrane composition has been examined . Spheroplasts of Escherichia coli J5 were lysed by osmotic shock, which did not significantly separate the cytoplasmic and outer membranes, but resulted in mixed membrane vesicles . Lysis in the French press and by sonication caused extensive membrane fragmentation and separation . Sonication, however, also caused some fusion between fragments of the outer and the cytoplasmic membranes; this intermembrane fusion increased with sonication time . When the cytoplasmic and outer membranes were well separated and intermembrane fusion was minimal or absent, the cytoplasmic and outer membrane fragments were heterogeneous with respect to density and ovarll phospholipid, protein and lipopolysaccharide composition . In addition, cytoplasmic, but not outer, membrane fragments were also heterogeneous with respect to protein composition . It is concluded, therefore, that membrane fragments obtained from the cytoplasmic and outer membranes are heterogeneous independently of the lysis procedures used to obtain these fragments . Possible reasons for this heterogeneity are discussed.

Am J Med, 1977 Nov, 63(5), 719 - 22
Effects of corticosteroids in the treatment of patients with gastric aspiration; Wolfe JE et al.; Forty-three of 88 patients suspected of having aspirated gastric contents met stringent criteria for the diagnosis of aspiration of gastric contents . One group of 25 patients was treated with corticosteroids and a second group of 18 patients was treated without corticosteroids . The two groups were clinically well matched according to all variables except that the patients who did not receive corticosteroids had greater hypoxemia and a higher incidence of infiltration on chest roentgenogram which would indicate that these patients had received greater pulmonary injury from aspiration of gastric contents . Thirty-two per cent of the patients who received steroids died compared to 28 per cent of those who did not receive steroids . Although the mortality rate difference was not statistically significant, the occurrence of gram-negative pneumonia five days after aspiration was more frequent in the patients treated with steroids.

HNO, 1977 Nov, 25(11), 373 - 8
{Special problems in the chemotherapy of bacterial infections in otolaryngology (author's transl)}; Wagner WH; The different occurrences of pathogens in acute and chronic otitis media, sinusitis, tonsillitis and infections of the respiratory tract are described, with consideration given to the development of gram-negative flora . Therapeutic plans are presented with regard to each of the possible organism patterns . Specific emphasis is given to the aminoglycoside antibiotics which can affect the auditory and vestibular systems.

Arch Intern Med, 1977 Nov, 137(11), 1547 - 50
Dopamine-related polyuria in patients with gram-negative infection; Flis RS et al.; Two patients developed polyuria with natriuresis while receiving intravenous dopamine hydrochloride for the treatment of hypotension . Both patients had Gram-negative pneumonia and both had evidence of extracellular volume depletion that was considered to be a result of the dopamine-induced polyuria . Following restoration of extracellular volume and withdrawal of dopamine therapy, both patients became normotensive and required no vasopressors . The diuretic action of dopamine, which persisted despite the severe intravascular volume contraction and perpetuated the hypotensive state in these two patients, is not well understood . The Gram-negative infection could play an important role possibly by enhancing the effect of dopamine on the renal vasculature.

Urologe A, 1977 Nov, 16(6), 346 - 50
{Septic shock in the urologic patient . III . Microbiological problems (author's transl)}; Hofstetter A et al.; From a microbiological point of view, the onset of septicemia in urology is related mainly to nosocomial germs; germs acquired outside of the hospital play a lesser role . The special problems caused by this kind of germ are analyzed in terms of our own cases . The limulus test as a possible method for the early diagnosis of gram negative septicemia is discussed critically . Chemotherapy as well as prophylactic measures is discussed.

An Esp Pediatr, 1977 Nov, 10(11), 835 - 42
{Limulus test in diagnosis of acute meningitis (author's transl)}; Aristegui J et al.; We tried to evaluate the utility of the Limulus Test in the diagnosis of acute meningitis . The study was made in 60 patients divided in three groups: Group A, formed by 37 children affected by purulent meningitis of known etiology; Group B, formed by 10 children affected by purulent meningitis of unknown etiology; Group C, formed by 13 children with viral meningitis . The results were compared with a control group (Group D), of 10 healthy children . The results correlated with the etiology, the cuantitative count of germs/ml . in C.S.F . and the clinical evolution . The results indicated that the Test is a rapid, simple and useful tool for the detection of endotoxin in the C.S.F . of purulent meningitis caused by Gram negative germs.

Z Gastroenterol, 1977 Nov, 15(11), 663 - 9
{Renal failure during liver disease--The significance of endotoxins (author's transl)}; Wilkinson SP; In cirrhosis and fulminant hepatic failure acute renal failure may occur both without ("functional renal failure") and with tubular necrosis, the two probably being the ends of a spectrum . The underlying pathophysiological change is an intense renal and intra-renal vasoconstriction . Evidence is presented that this is due to systemic endotoxaemia resulting from failure of the liver to filter endotoxins absorbed from the gastrointestinal tract . Acute renal failure complicating obstructive jaundic has also been related to endotoxaemia, but in contrast to cirrhosis and fulminant hepatic failure this is usually due to an associated gram-negative infection and the renal failure almost invariably has the features of acute tubular necrosis . Endotoxins have two major effects on the kidney: (i) renal vasoconstriction, and (ii) glomerular and peritubular fibrin deposition . The nature of the renal failure depends on the balance between these variables which may be profoundly altered by the underlying liver disease.

Gastroenterology, 1977 Nov, 73(5), 1005 - 7
Detection of bacterial infection of the pancreatic ducts in patients with pancreatitis and pancreatic cancer during endoscopic cannulation of the pancreatic duct; Gregg JA; Bacterial infections of the pancreas and bacteremia may occur during episodes of pancreatitis . Detection of bacterial infections of the pancreas in the past has required laparotomy . The present study was undertaken to determine whether bacterial infection of the pancreas occurred during nonsuppurative pancreatitis . During endoscopic cannulation of the main pancreatic duct, secretin was administered intravenously and pancreatic juice aspirated from within the duct was cultured . Bacterial infections were detected in 11 of 35 patients with pancreatitis and 3 of 5 with pancreatic cancer . The pancreatic juice was sterile in 25 controls . Cultures from the common bile duct in 9 controls were also sterile whereas 4 of 6 with pancreatitis showed infected bile . The infecting organisms were principally gram-negative and the infections were usually polymicrobial . Antibiotics, where used, successfully eradicated the infecting organisms but did not appear to affect the patient's clinical course.

Minerva Chir, 1977 Oct 31, 32(20), 1297 - 9
{Use of chlorhexidine in surgery}; Zabbia V; The extensive literature on the efficacy of chlorhexidine is reviewed . Personal experience with the substance in the daily and preoperative disinfection of the hands of medical and paramedical personnel in a surgical department, and the medication of surgical wounds, over a period of one year confirmed its low toxicity and long effectiveness against notoriously intractable Gram-negative forms.

Med J Aust, 1977 Oct 8, 2(3 Pt 2 Suppl), 30 - 3
Management of bacterial infections in severely neutropenic subjects; Vincent PC et al.; The safety and efficacy of tobramycin, a new aminoglycoside, have been evaluated in combination antibiotic therapy in 49 episodes of infection in 25 neutropenic patients . Tobramycin was used in combination with a cephalosporin in 40 episodes and with carbenicillin in 6 . The most common infections were respiratory (21 episodes) and septicaemic (16 episodes) . One or more pathogens were identified in 38 episodes, of which 36 were due to Gram-negative organisms . The clinical response was satisfactory in 71% of episodes, and the pathogens were eliminated in 50% of episodes in which follow-up bacteriological investigation was available . No renal, auditory, or vestibular toxicity was observed.

JAMA, 1977 Oct 3, 238(14), 1547 - 50
Evaluation of amikacin sulfate (Amikin) . A new aminoglycoside antibiotic; Schiffman DO; Amikacin sulfate, the first semisynthetic aminoglycoside antibiotic introduced in this country, is resistant to the bacterial enzymes that specifically inactivate kanamycin sulfate, gentamicin sulfate, and tobramycin sulfate . This agent is potentially effective, therefore, against many serious infections caused by Gram-negative organisms resistant to other aminoglycosides . It appears to be similar to gentamicin in its in vitro spectrum, in clinical applications, and in the incidence and severity of adverse reactions reported . Like the other drugs in this class, amikacin can cause renal and otic toxic reactions.

J Gen Microbiol, 1977 Oct, 102(2), 263 - 8
Host factor for coliphage Qbeta RNA replication as an aid in elucidating phylogenetic relationships: the genus Pseudomonas; Dubow MS et al.; Host Factor (HF) is a heat-stable RNA-binding protein required along with Qbeta replicase for in vitro transcription of coliphage Qbeta RNA . We have found that HF activity and antigenicity are conserved among certain Gram-negative bacterial species . We examined selected species within the genus Pseudomonas for the presence of the HF polypeptide's antigenicity and Qbeta RNA replication function . While we were unable to detect either of these in Pseudomonas diminuta or Pseudomonas vesicularis, the other eleven species tested contained cross-reacting material to Escherichia coli HF . Furthermore, in six of these eleven species we were able to detect HF activity . The detection of HF structure and function allowed the examined species to be grouped into three categories which we have called 'sets' . The results correlate well with those of previous studies on ribosomal RNA homology (Palleroni et al., 1973).

Immun Infekt, 1977 Oct, 5(5), 184 - 92
{Adjuvant activity of gram-negative bacteria and their structural components (author's transl)}; Finger H; Regarding the adjuvant activity of gram-negative bacteria we have to distinguish at least 4 different potencies, i.e., 1) increase in the production of circulating antibodies during the primary and secondary immune responses; 2) induction of susceptibility to systemic anaphylaxis; 3) prompt production of experimental "allergic" diseases, and 4) increase in resistance to infections . Although all gram-negative bacteria contain several structural components with adjuvant potencies, the immunopotentiating effectiveness of the corresponding whole bacteria becomes--with the exception of killed cells of Bordetella pertussis--only detectable to a weak degree.

Am J Dis Child, 1977 Oct, 131(10), 1094 - 6
Gonorrhea: diagnosis by gram stain in the female adolescent; Wald ER; The Gram-stained smear of secretions in female children and adolescents was evaluated as a diagnostic aid in acute gonorrhea . A positive smear was defined as the presence of at least eight or more pairs of Gram-negative, kidney-bean-shaped diplococci in each of at least two polymorphonuclear leukocytes . When the Gram-stained smear was compared with culture results in female patients it detected two thirds of infections and had a very high specificity . When the smear was positive, the culture was positive in 96% of the cases . The Gram-stained smear of cervical secretions is recommended as a guide to the early diagnosis of gonorrhea and its prompt therapy in the pediatric age group.

JAMA, 1977 Sep 26, 238(13), 1389 - 90
Gram-negative sepsis with acute renal failure . Occurrence from acute glomerulonephritis; Zappacosta AR et al.; Acute intrinsic renal failure occurred in an adult patient with Escherichia coli septicemia . The clinical course did not include any of the circumstances usually present when acute renal failure complicates Gram-negative sepsis . A renal biopsy showed acute proliferative glomerulonephritis . There was no evidence to support other known causes of acute parenchymal renal failure, such as poststreptococcal glomerulonephritis, subacute bacterial endocarditis, or vasculitis . The patient recovered completely with antibiotic therapy, and renal function returned to normal within two weeks . An immunologic mechanism involving E coli was considered responsible for the acute renal failure.

J Trauma, 1977 Sep, 17(9), 714 - 8
A new limulus assay for the detection of endotoxin; Harris NS et al.; The limulus amebocyte lysate (LAL) assay has proven to be a highly sensitive and reliable indicator of endotoxin in most biological fluids; however, it has not been a reliable indicator when used with blood because of different inhibitors present in the blood . To avoid these problems, investigators have used difficult extraction procedures, but but even with these, results were oftentimes not uniform . It was found that a recently developed inert polymer (PSI-HAP 100) has a specific affinity for endotoxin, so that is was possible to develop a simple, reliable, reproducible method for the detection of endotoxin in blood . In the assay procedure, the polymer, compressed into a 3-mm diameter bead, is incubated with 0.2 cc of heparinized whole blood . The bead is then removed from the blood, washed in pyrogen-free saline to remove any inhibitors of the LAL, and placed in a tube containing LAL . The LAL and bead are incubated together; after incubation the LAL is examined for gellation . Using this new method, it was possible to predict Gram-negative septic episodes in burn patients several days before sepsis evolved clinically.

Ann Microbiol (Paris), 1977 Aug-Sep, 128(2), 177 - 205
{Cytochemical and freeze-etching studies of the ultrastructure of a Rickettsiella in a crustacean (author's transl)}; Louis C et al.; Several characteristics of the intracellular cycle of Ricketsiella are elucidated, particularly regarding the envelope and the cytoplasm of dense forms (elementary bodies) as well as the proteinic inclusions of giant bodies . Cleavage faces have been displayed by freeze-etching, both at the level of cell wall and of plasma membrane . Their characteristics approach those of Gram-negative bacteria and are pratically common to all the stages . Appearance and significance of a polysaccharidic cement joining the outer membrane of the cell wall to the inner membrane (plasma membrane) in the dense forms are discussed . The arrangement of ribosomes and the structure of the nucleoid are described . A 6 nm lattice periodical structure is shown in the proteinic inclusion . Significance of these data for a classification of Rickettsiella and chlamydias is discussed.

Am J Clin Nutr, 1977 Aug, 30(8), 1355 - 6
Impaired gluconeogenesis in extensively injured patients with gram-negative bacteremia; Wilmore DW; Glucose kinetics and gluconeogenic precursors were studied in burned patients with or without gram-negative bacteremia . Gram-negative sepsis in burned patients impairs the increased rate of hepatic glucose production which characteristically occurs after thermal injury.

Aust N Z J Surg, 1977 Aug, 47(4), 438 - 41
Recent advances in general surgery; Nanson EM; In order to give an overview of recent advances in general surgery, it is necessary to define: (i) what is general surgery; (ii) what is recent; and (iii) what constitutes an advance . General surgery appears to have entered an era of conservatism . This is particularly evident in the surgery of breast cancer, peptic ulceration, varicose veins, liver trauma, portal hypertension, upper gastrointestinal bleeding, and hiatal hernia . Controlled clinical trials in surgery have become popular . The following are considered to be advances: parenteral nutrition, suction drainage, control of Gram-negative sepsis, bypass surgery for pathological obesity, and a discriminatory approach to transplant surgery.

An Esp Pediatr, 1977 Aug-Sep, 10(8-9), 605 - 14
{Burns in children . Experience of 53 cases (author's transl)}; Crespo JG et al.; A series of 53 children admitted during a 20-month period to the Hospital for burns due to hot liquids is reported 88.6% were under three . 34 children were seen during spring and fall months . Most patients were recently burnt and in the majority of cases (27) burned surface was under 20% . l.v . fluids were used in 17 cases and management protocol included: Closed local care after the 3rd or 4th day with nitrofurazone cream and antibiotics only in selected cases . Mortality was 5.5% (three cases) due to acute renal failure at the 3rd, 5th and 10th days . 24.5% had a local infection in the first two weeks, gram negative bacteria being present in 75% of these cases . 33.2% (18 cases) required grafting . This was more frequently needed in boiling oil burns . In seven cases, grafting was necessary before the 30th day (average 23.2 days), and in the remaining patients after this time (average 42.1 days) . Authors advise a strict prevention of acute rend failure and early grafting.

J Infect Dis, 1977 Aug, 136 Suppl, S246 - 51
Chemically defined bacterial products with immunopotentiating activity; Chedid L et al.; The adjuvant activity of two chemically well-defined bacterial products is reviewed: (1) lipopolysaccharides of gram-negative bacillis and their acylated detoxified derivatives, and (2) mycobacterial water-soluble fractions and synthetic analogues . Water-soluble adjuvant can substitute for mycobacteria in Freund's adjuvant, but if it is administered in saline, it has little activity . In contrast, lipopolysaccharide under the same conditions markedly increases the humoral antibody response . However, the use of lipopolysaccharide is limited by its toxicity . Water-soluble adjuvant treated with phthalic or succinic anhydride was shown to be an adjuvant when administered in saline . Furthermore, synthetic M-acetyl-muramyl-L-alanyl-D-isoglutamine also increased the humoral immune response when given in aqueous medium instead of in the usual water-in-oil emulsion . This compound, which has a small molecular weight, is not mitogenic, immunogenic, or toxic in mice, and was shown to have adjuvant activity even when given by the oral route.

Infect Immun, 1977 Aug, 17(2), 325 - 9
Enhanced susceptibility of mice to combinations of delta 9-tetrahydrocannabinol and live or killed gram-negative bacteria; Bradley SG et al.; Combinations of delta 9-tetrahydrocannabinol (delta 9-THC) and bacterial endotoxin were shown to be hyperadditively toxic for mice . A variety of purified lipopolysaccharide (LPS) preparations elicted enhanced mortality in combination with delta 9-THC . Escherichia coli O26:B6 LPS (Boivin preparation) at an essentially nonlethal dose of 2.5 mg/kg reduced the dose of delta 9-THC required to kill 50% of the treated mice from ca . 350 to 150 mg/kg . Inbred BALB, DBA, and C3H/HeCr mice, noninbred ICR mice, and hybrid CDF1 and BDF1 mice were hyperreactive to combinations of delta 9-THC and LPS . Moreover, a variety of heat-killed intestinal and gram-negative bacteria, live E . coli, and complexes of lipid A with a variety of proteins substituted for LPS in the synergistic toxicity of LPS and delta 9-THC . Extracts of marijuana also elicited hyperreactivity to LPS . The hyperadditive lethality of combinations of delta 9-THC and LPS was markedly less in mice rendered refractory to LPS or delta 9-THC by repeated administration of LPS or delta 9-THC, respectively.

Acta Chir Belg, 1977 Jul-Aug, 76(4), 407 - 15
{Abscess of the liver (author's transl)}; Eyskens E et al.; A case of liver abscess is analysed in the light of recent data from the literature . The attention is drawn on the increase in frequency of this disease over the last 10 years . The diagnosis is difficult to set on clinical and biological grounds but can be established with certainty by means of scintigraphy and hepatic angiography . Identification of the micro-organism is difficult and impossible in more than half of the cases . Treatment which is essentially surgical, in association with antibiotherapy specific of the anaerobic and gram negative micro-organisms, can reduce total mortality to 10%.

Am J Med Sci, 1977 Jul-Aug, 274(1), 83 - 6
Case report: low-dose intravenous heparin in the treatment of disseminated intravascular coagulation; Gurewich V et al.; A critically ill patient with disseminated intravascular coagulation (DIC) secondary to gram negative septicemia is reported . Low dose (5-10 mu/kg/h) heparin by intravenous infusion promptly inhibited intravascular coagulation, as reflected by laboratory studies . Fibrin monomer (FM) became undetectable, concentration of fibrin degradation products (FDP) fell, fibrinogen rose, and the activated partial thromboplastin time (PTT) shortened . Unintentional, temporary interruption of heparin resulted in transient return of abnormal laboratory values . The patient went on to make a complete recovery . Although the therapeutic contribution of heparin could not be proven in this patient, the laboratory data suggested that it was a valuable adjunct and in the dosage given unlikely to potentiate bleeding . The monitoring of heparin therapy in DIC by measurement of FDP, FM, and fibrinogen rather than clotting time is recommended.

Urologe A, 1977 Jul, 16(4), 241 - 3
{Septic shock in the urologic patient . II . Pathomechanisms of hemostatic disorders (author's transl)}; Marx FJ et al.; In urosepsis endotoxins usually deriving from gram-negative bacteria can initiate primary disturbances of hemostasis by activation of coagulation up to clinically manifest consumption coagulopathy . The reaction is triggered by an endotoxin induced alteration of granulocytes, endothelial cells, and platelets, thereby releasing procoagulant activities that possibly cause diffuse intravascular coagulation with impairment of vital organs . Additional negative effects on hemostasis can be caused by secondary hyperfibrino(geno)lysis . Secondary disturbances of hemostasis occur in urosepsis as a consequence of an impairment of liver (hypoproduction of coagulation factors, decrease of the clearance of activated coagulation factors) and kidney function (thrombocytopathy by uremic toxins) . Disturbances of hemostasis induced by the treatment of urosepsis are the K-hypovitaminosis in parenteral feeding accompanied by antibiotics affecting the intestinal bacterial growth and the alteration of platelet function and fibrin formation by carbenicillin.

J Bacteriol, 1977 Jul, 131(1), 314 - 22
Characterization of bdellocysts of Bdellovibrio sp; Tudor JJ et al.; Bdellovibrio sp . strain W will infect and produce resting cells, termed bdellocysts, in a variety of gram-negative bacteria . Bdellocysts appeared to be produced only within susceptible prey and never in their absence . Optimum conditions for encystment included infection of stationary-phase prey cells in 0.05 M potassium phosphate buffer (pH 7.5) at concentrations of prey and bdellovibrios of 2 X 10(9) cells per ml with a multiplicity of infection of unity . Bdellocysts contained more deoxyribonucleic acid, ribonucleic acid, protein, and carbohydrate per cell than did vegetative cells . Poly-beta-hydroxybutyrate and dipicolinic acid were not detected . Bdellocysts were more resistant than vegetative cells to effects of elevated temperatures, sonic treatment, and desiccation . Bdellocysts remained viable for extended periods when incubated in the absence of prey, whereas vegetative cells lost viability rapidly under the same conditions . Their survival under starvation conditions may be due to the low rate of endogenous respiration by the bdellocysts . Bdellocysts are capable of germination in the presence or absence of prey cells in rich medium such as peptone-yeast extract.

J Bacteriol, 1977 Jul, 131(1), 306 - 13
Morphology and ultrastructure of Crenothrix polyspora Cohn; Volker H et al.; Naturally grown cell material of Crenothrix polyspora from the well of a waterworks was studied by means of phase-contrast and Nomarski interference microscopy as well as by transmission electron microscopy . The material consisted of clusters of sheathed filaments up to 2 cm long . Propagation forms observed were nonmotile, spherical cells that arose by simple ("macrogonidia") or multiple ("microgonidia") septation of the filamental tips . Ultrastructural analysis revealed Crenothrix to be procaryotic and gram negative, with several layers of sheath material surrounding the filaments . On thin sections, individual cells had elaborate membrane systems in the form of lamellar stacks . They resembled thylakoids of photosynthetic bacteria . Spectrophotometric analysis gave no indication of photosynthetic pigments . The cells also contained large hexagonal bodies, rod-shaped fibrillar elements, and polyphosphate granules.

J Cardiovasc Surg (Torino), 1977 Jul-Aug, 18(4), 361 - 6
The management of infected arterial aneurysms; Jarrett F et al.; Infected aneurysms involve the aorta, visceral and peripheral arteries and are associated with a high morbidity and mortality . Prompt confirmation of the suspicion of infection, resection of all infected tissue, and prolonged antibiotic therapy based on appropriate sensitivity studies are crucial to successful management . Patients whose aortic aneurysms grew Gram negative organisms were more likely to suffer early rupture of an aortic aneurysm, and had a higher mortality . Superior mesenteric aneurysms are preferably treated by resection . Upper extremity aneurysms can often be excised without distal ischemia . Lower extremity aneurysms were more likely to require reconstruction which can be accomplished through non-infected tissue planes, preferably with autogenous tissue.

Pahlavi Med J, 1977 Jul, 8(3), 305 - 17
Flexibility of gram-negative bacterial cell wall; Alemohammad MM; Addition of salts (NaCl and MgCl2) to isolated cell wall of E . coli cause appreciable contraction in volume . This contraction in volume of the cell walls is probably due to binding of the ions to wall polymers, including the peptidoglycan layer and the concomitant release of protons . The peptidoglycan layer of the cell wall is thus an elastic rather than a rigid layer.

N Z Med J, 1977 Jun 22, 85(590), 514 - 7
Skin infections in Kaimai Rail Tunnel construction workers; Smith CA; Skin lesions in Kaimai Rail Tunnel workers were noted to respond poorly to treatment and investigations revealed that this was because the lesions were either gram-negative infections or Trichophyton rubrum infections.

Arch Microbiol, 1977 Jun 20, 113(3), 197 - 204
Dorsal-ventral differentiation in Simonsiella and other aspects of its morphology and ultrastructure; Pangborn J et al.; The morphology and ultrastructure of the aerobic, Gram-negative multicellular-filamentous bacteria of the genus simonsiella were investigated by scanning and transmission electron microscopy . The flat, ribbon-shaped, multicellular filaments show dorsal-ventral differentiation with respect to their orientations to solid substrata . The dorsal surface, orientated away from the substrate, is convex and possesses an unstructured capsule . The ventral surface, on which the organisms adhere and glide, is concave and has an extracellular layer with fibrils extending at right angles from the cell wall . The cytoplasm in the ventral region contains a proliferation of intracytoplasmic membranes and few ribosomes in comparison to the cytoplasm in other parts of the cell . Centripetal cell wall formation is asymmetrical and commences preferentially in the ventral region . Quantitative differences in morphology and cytology exist among selected Simonsiella strains . Functional aspects of this dorsal-ventral differentiation are discussed with respect to the colonization and adherence of Simonsiella to mucosal squamous epithelial cells in its ecological habitat, the oral cavities of warm-blooded vertebrates.

Br J Dermatol, 1977 Jun, 96(6), 577 - 86
Oriented fibrin crystallization: A phenomenon of hypersensitivity to bacteria in psoriasis, vasculitis and other dermatoses; Juhlin L et al.; Heparinized blood from patients with a variety of dermatological problems was incubated with killed bacteria, bacterial extracts or Gram-negative bacterial endotoxin . Within 18-24 h asteroid bodies consisting of an amorphous centre with fine radiating needle crystals were seen . These bodies, not found in the blood of healthy volunteers, were most consistently observed in blood from patients with psoriasis, vasculitis and bacterial infections . Immunofluorescent studies disclosed the asteroid formations to be crystals of fibrin radiating presumably from a central platelet aggregate . The failure to demonstrate IgG, A, M or D suggests that the phenomenon results from the bacterial activation of complement by a non-immune yet specific pathway which in turn involves white cells, platelet aggregation and release of procoagulants.

Am J Med, 1977 Jun, 62(6), 940 - 4
Review of 152 patients with bacteremias treated with amikacin; Tally FP et al.; The efficacy of amikacin treatment of 152 patients with bacteremia was reviewed from case reports submitted by 53 investigators . Eighty-one per cent of these patients had a favorable outcome; 73% were cured and 8% partially cured . Analysis of the 29 treatment failures revealed that the majority (21) were in patients with either pneumonia, leukemia or mixed aerobic-anaerobic infections . Forty-five patients were infected with gentamicin-resistant organisms; 66% of these patients were cured following amikacin therapy, and 14% had a partial cure . These results indicate that amikacin is effective in the therapy of gram-negative bacteremia, even in seriously ill patients with gentamicin-resistant pathogens.

Am J Med, 1977 Jun, 62(6), 930 - 5
Amikacin therapy for gram-negative septicemia; Meyer RD et al.; Amikacin was administered to 18 patients with gram-negative septicemia . Ten of the patients had blood culture isolates highly resistant to gentamicin; six of these patients had persistent bacteremia while receiving gentamicin alone or in combination with other agents . Fourteen of the 18 patients were cured with amikacin therapy and adjunctive measures . Nine of the 10 patients with gentamicin-resistant pathogens were cured . The occurrence of nephrotoxicity in four patients with elevated amikacin serum levels and serious underlying disease indicates the desirability of monitoring serum amikacin levels . Minor ototoxicity occurred in two patients and was associated with prolonged therapy and high serum amikacin levels . Amikacin is a highly effective agent for treating patients with gram-negative bacteremia; it is the agent of choice in the therapy of patients with suspected or documented gram-negative bacteremia caused by pathogens resistant to gentamicin and susceptible to amikacin.

Gastroenterology, 1977 Jun, 72(6), 1268 - 70
Endotoxin and bacteria in portal blood; Jacob AI et al.; In order to determine whether endotoxin is normally found in the portal system, intraoperative samples of portal and peripheral blood were drawn from 34 consecutive elective abdominal surgery patients . The limulus lysate test was used to detect endotoxin . Ninety-seven per cent of patients had a positive limulus test in portal blood . Twelve of these patients were tested for portal bacteremia and only one showed growth . Four patients also had systemic endotoxemia . Three of these had liver disease and one had a gram-negative sepsis . This study demonstrates that endotoxin is a normal constituent of portal venous blood in man and does not represent a pathological process . It is suggested that the Kupffer cells of the liver normally protect the systemic circulation from endotoxin, and that endotoxin is present in systemic blood only when liver function is impaired or gram-negative bacteremia is present.

Zh Mikrobiol Epidemiol Immunobiol, 1977 Jun, (6), 108 - 11
{Characteristics of the functional activity of human blood neutrophils using the nitroblue tetrazolium reduction test}; Maianskii AN et al.; A study was made of the test of restoration of the nitroblue tetrazolium (NBT) by the intact blood neutrophils and the neutrophils stimulated with various endotoxin doses of Gram-negative bacteria in 70 healthy persons . A high sensitivity of the test with the NBT for the quantitative assessment of the neutrophil response under conditions stimulating the phagocytic activity was demonstrated . A functional nonhomogeneity of the neutrophil population, the most distinct with the minimal stimulating action, was noted.

Appl Environ Microbiol, 1977 Jun, 33(6), 1265 - 9
Comparison of limulus amebocyte lysates and correlation with the United States Pharmacopeial pyrogen test; Wachtel RE et al.; Six limulus amebocyte lysate (LAL) preparations obtained from five different suppliers were evaluated for sensitivity, dependability, cost, convenience of use, and correlation with the United States Pharmacopeial (USP) rabbit pyrogen test method . Endotoxins from various gram-negative microorganisms were used for the evaluation . Major differences among the LAL preparations lie in the area of sensitivity . Differences, up to 100-fold, exist in the sensitivity of the various LAL preparations to the same endotoxin . The LAL tests in general were 3 to 300 times more sensitive than was the USP rabbit pyrogen test method . The LAL and the USP rabbit pyrogen test data correlated well when the endotoxin in a relatively pure and undegraded form was examined . However, large discrepancies in correlation were found when partially degraded endotoxins were compared . One LAL preparation responded to both intact and degraded endotoxin, whereas others responded only to intact endotoxin; the latter closely correlated with the febrile response of the rabbit . Therefore, proper selection of an LAL preparation is important for its application in clinical, pharmaceutical, public health, and environmental areas.

Surg Gynecol Obstet, 1977 Jun, 144(6), 915 - 7
The predisposition to infection following hemorrhagic shock; Esrig BC et al.; Subsequent life threatening gram-negative infection in patients successfully resuscitated from hemorrhagic shock is becoming increasingly common . Following hemorrhagic shock and resuscitation, Sprague-Dawley rats were given Escherichia coli intraperitoneally to simulate the clinical setting in which peritoneal contamination and hypovolemic shock occur concurrently . A sublethal dosage of bacteria resulted in a 100 per cent mortality . This suggests that hemorrhagic shock, even when treated promptly and effectively, predisposes to infection.

Can J Microbiol, 1977 Jun, 23(6), 790 - 7
The structure of cellulose-producing bacteria, Acetobacter xylinum and Acetobacter acetigenus; Colvin JR et al.; The structure of the pellicles and cells of the cellulose-producing bacteria, Acetobacter xylinum and Acetobacter acetigenus, was studied by transmission electron microscopy of thin sections and freeze-etch replicas of glucose-stimulated cell suspensions, quiescent cell suspensions, and discrete pellicles . These bacteria have a relatively thin cell wall in section, with several irregular features superimposed on an otherwise simple, Gram-negative morphology . There are no flagella or pili . Unfixed, unextracted cells, viewed as whole mounts, show spherical or ellipsoidal bodies of undetermined composition which disappear after extraction with water or ethanol and propylene oxide . For both species, there are several kinds of cell surface irregularities, some of which are localized protrusions of the cell envelope . A variety of irregularities is seen frequently on cells in the first minutes of glucose incubation, on cells in a discrete pellicle, on quiescent cells, and on starved cells . Immediately after the addition of glucose to cellulose-free cells in suspension culture, fine fibrils appear on and (or) near the cell envelope . The fine fibrils are frequently as small as 3 nm in diameter in both freeze-etch and thin-section preparations and are frequently associated with freshly synthesized cellulose fibrils . Starved cells in suspensions free of (classical) microfibrils sometimes reveal stubs of an extracellular structure whose morphology resembles that of a nascent cellulose fibril.

S Afr Med J, 1977 May 21, 51(21), 746 - 8
Clinical experience with amikacin, a new aminoglycoside antibiotic; Theron FP et al.; Amikacin, a new semisynthetic aminoglycoside antibiotic, was administered parenterally to 20 patients suffering from severe Gram-negative bacterial infections . The antibiotic was found to be highly effective in controlling infection . It was well tolerated and no signs of nephro- or otoxicity were observed . The few side-effects which were seen appeared to be dose-related . The recommended 12-hourly dosage regimen has also proved useful in medium- to long-term management of refractory pulmonary infections.

J Am Vet Med Assoc, 1977 May 15, 170(10 Pt 2), 1196 - 8
Role of teat dips and hygiene in mastitis control; Natzke RP; The primary sources of mastitis pathogens are infected quarters, chapped, sore, or eroded teat ends, and the environment . The major means of transfer of the most predominant mastitis pathogens is the milking routine . Methods are available to reduce the number of organisms normally transferred during each of the procedures . However, with the exception of teat cup pasteurization, the application of hygienic procedures in herds where teat dipping is practiced did not result in additional beneficial effects . Effectiveness of 4% chlorine, 0.5 and 1% iodine, and 0.5% chlorhexidine teat dips has been demonstrated in field trials and should be the preferred products in a mastitis control program . Most gram-negative organisms get on teats by direct contact with the bedding . In herds with clinical coliform mastitis, changing the bedding material has been associated with fewer clinical mastitis cases.

C R Acad Sci Hebd Seances Acad Sci D, 1977 May 9, 284(18), 1847 - 9
{Unexpected antibiotic properties of a cephalosporin}; Bucourt R et al.; The presence of an oximino group on the methylene of the (2-aminothiazol 4-yl)-acetyl side chain bound to the 7-amino cephalosporanic acid affords derivatives with syn or anti configuration . Whereas the anti isomers display low antibiotic activities, the syn isomers possess a surprising high efficiency against gram negative bacteria, enhanced a factor of 10 to 100 as compared with the cephalosporins known at the moment.

JAMA, 1977 May 2, 237(18), 1938 - 41
Septicemia in a Community Hospital 1970 through 1973; Scheckler WE; Septicemia developed in 34 patients per 10,000 admissions to a community hospital during 1970 through 1973 . Two thirds of the 207 patients had community-acquired septicemia, and one third had nosocomial septicemia . Septicemia-related mortality was 20.3% . Mortality and incidence of septicemia was substantially higher in patients with ultimately fatal and rapidly fatal underlying diseases . Septicemia was associated with shock in 9.7% of the patients . Foley catheterization and prophylactic antibiotic therapy could not be implicated as major risk factors for the development of septicemia . This study shows an incidence of Gram-negative bacteremia, septic shock, and mortality substantially less than that described in published data from noncommunity hospitals.

Mikrobiologiia, 1977 May-Jun, 46(3), 500 - 5
{Ultrastructural organization of trichomes of a new group of multicellular gram-negative bacteria}; Duda VI et al.; Peculiar trichome multicellular gram-negative bacteria were found in several types of soil, and were isolated as pure cultures . The bacteria are characterized by the following properties: (a) the presence of large regions of the periplasm, 200-300 nm thick, in the cells, the volume of the periplasm being greater than that of the cytoplasm; (b) a peculiar structure of multicellular trichomes in which the cells are surrounded by a common cell wall and a common periplasmic space; (c) a specific structure of trichome septa formed by membrane leaves and including no material of the cell wall; (d) the ability of protoplasts to divide within the trichome cell wall; (e) the ability to grow under anaerobic conditions . Therefore, these organisms belong to a new group of trichome multicellular bacteria.

Geburtshilfe Frauenheilkd, 1977 May, 37(5), 432 - 7
{The diagnosis and treatment of mixed anaerobic vaginal dischargs (authors' transl)}; Popp W; In about 5% of 3355 patients the microscopic examination of the vaginal discharge in normal saline showed a characteristic fast moving rod . More than 80% of these patients complained of a discharge with a foul smell during the menstrual period . Bactriology showed an anaerob gram negative rod which was difficult to grow and is as yet unclassified . Following treatment with one gram of Mimorazol every 12 hours for 3 doses, 71,5% of the patients were cured and showed a normal vaginal flora without further treatment . In around 24,13% of the patients the gram negative rod disappeared but a persistent mixed flora required further treatment . In 4.3% of the patients a recurrence occurred . An attempt was made to prevent recurrent infection prior to the follow-up examination by prohibition of sexual intercourse with an untreated partner, bathing in public swimming pools, and the use of sponges or wash cloths . In the course of the investigation the suspicion of contamination from the water of public pools became apparent . The diagnosis, treatment and transmission and the pathogenecity of the fast moving negative rod is discussed.

J Trauma, 1977 May, 17(5), 376 - 80
Hand infections in patients with diabetes mellitus; Mann RJ et al.; In a study of diabetic patients with hand infections reviewed at Jackson Memorial Hospital, University of Miami School of Medicine, 20 such diabetic patients with hand infections were found . The most outstanding result was that seven of the 20 had amputation either to control infection or because the function of the extremity was impaired by the remaining ravaged part . Pathologic examination of tissue removed showed the same changes commonly seen in diabetic gangrene of the lower extremity . Electromyographic studies, when done, have been confirmatory of a peripheral neuropathy with delayed nerve conduction studies . The bacterial organisms of the infections were variable, but a predominance of Gram-negative organisms were cultured in twelve of the 20 patients . Early aggressive management, including surgical debridement and intravenous antibiotics, is recommended to prevent unnecessary amputations and improve residual function.

J Virol, 1977 May, 22(2), 315 - 20
Effects of temperature and host cell genetic characteristics on the replication of the lipid-containing bacteriophage PR4 in Escherichia coli; Sands JA et al.; The lipid-containing bacteriophage PR4 is of special intest because it can replicate in various gram-negative bacteria, including Escherichia coli, that carry one of a group of drug resistance plasmids . PR4 grown in E . coli strain PS2R contains about 10% lipid by weight, with the negatively charged phospholipid phosphatidylglycerol being the most abundant lipid in the virion . We now report the following . (i) PR4 attaches to E . coli with an attachment rate constant of Ka approximately 6.2 X 10(-10) ml/min, which is about twice that of the enveloped phage phi6 (to Pseudomonas phaseolicola), but a factor of 5 less than that of phage PM2 (to Pseudomonas BAL-31) . (ii) Use of an E . coli glycerol auxotroph indicated that a normal amount of PR4 replication occurs only if glycerol starvation (inhibition of all phospholipid synthesis) begins no earlier than about halfway through the lytic cycle . (iii) Use of an E . coli fatty acid synthesis temperature-sensitive mutant and an E . coli phosphatidylethanolamine synthesis temperature-sensitive mutant indicate that PR4 replication can occur in the absence of either normal fatty acid synthesis or normal phospholipid synthesis if the infection takes place prior to the termination of overall cell growth and the onset of cell death, (iv) Whereas PR4 burst size in nutrient media at 30 degrees C to 42%C is about 40, the burst size at 20 degrees C is less than 3, Temperature-shift experiments show that the temperature late in infection determines the burst size.

Med J Aust, 1977 Apr 2, 1(14), 473 - 5
The management of febrile episodes in-neutropenic cancer; Bishop JF et al.; The management of 33 febrile episodes in neutropenic patients suffering from acute leukaemia and other cancers is described . In 32 out of 33 episodes, the fever subsided . One patient died of cerebral haemorrhage while infected . The most common clinical sites of infection were, in order of frequency, the chest, the throat and the skin . Positive cultures were obtained in about half the episodes, the most common site being the throat followed by blood and sputum . The most common organisms isolated were Gram negative . Eighty-four per cent of febrile episodes occurred with neutrophil counts of less than 500/mm3, and in the majority of these, less than 100 neutrophils per cubic millmetre . All patients were reverse barrier nursed and on becoming febrile were given 48 hours of parenteral antibiotic therapy . The most common antibiotic combination used was gentamicin and cephalothin . At 48 hours, granulocyte transfusion and a third antibiotic were added to the regimen of patients not responding . The percentage response to antibiotics alone, in this series, at 58% was similar to that of other series, but the mortality experienced was lower.

Acta Hepatogastroenterol (Stuttg), 1977 Apr, 24(2), 64 - 81
Significance of endotoxaemia in experimental "galactosamine-hepatitis" in the rat; Grun M et al.; The course of galactosamine hepatitis induced by 1.0 g/kg i.p . injected galactosamine (Ga1N) was investigated a sequential study in normal rats, in colectomized rats, and in rats being endotoxin resistent against both exogenous and endogenous endotoxin . Clinical symptoms of Ga1N-hepatitis such as pyrogen reaction, disseminated intravascular coagulation, arterial hypotension, and hypoglycaemia correlated significantly with the development of endotoxaemia, which was detected by means of the limulus gelation test (L.G.T.) Ga1N refractoriness was found after colectomy, a situation, in which gram negative bacterias and their endotoxins were eliminated . Ga1N refractoriness was also observed in case of endotoxin resistence . It is concluded that endotoxins contribute significantly to the pathogenesis of "Ga1N-hepatitis" and its clinical symptoms.

Pediatrics, 1977 Apr, 59(4), 614 - 8
Gram-negative cerebrospinal fluid shunt-associated infections; Sells CJ et al.; Twenty hydrocephalic children with cerebrospinal fluid (CSF) shunts over an 11-year period were seen with Gram-negative central nervous system (CNS) infections . Seventeen infections were with single organisms and three were mixed . Sixteen of 20 (80%) of the infections occurred within five months of shunt surgery . Complete shunt removal or replacement in a new site plus systemic and intraventricular antibiotics resulted in a 100% (9/9) cure rate . Systemic and intraventricular antibiotics alone or in combination with incomplete shunt removal generally were unsuccessful . Significant morbidity and mortality were associated with these infections . Of the 18 patients with follow-up data, seven (39%) died with the infection, four (22%) sustained definite CNS damage, three (17%) were retarded after infection but their preinfection status was unknown, and only four (22%) patients escaped without definite sequela . Early recognition and appropriate therapy, hopefully, will improve the current bleak prognosis

Infect Immun, 1977 Apr, 16(1), 213 - 7
Protective role of complement in experimental Escherichia coli endocarditis; Durack DT et al.; Fourteen strains of Escherichia coli were tested for ability to cause infective endocarditis in rabbits prepared by prior placement of an intracardiac catheter . Strains that were resistant to the bactericidal action of serum caused E . coli endocarditis in 91.4% of rabbits, whereas serum-sensitive strains usually failed to cause persisting infection (11.3% infected, P less than 0.001) . Although serum-sensitive E . coli lodged on heart valves within 1 h after intravenous injection, they survived less than 24 h in most normal rabbits . In contrast to normals, all five C6-deficient rabbits injected with a serum-sensitive strain of E . coli developed infective endocarditis (P less than 0.005) . No correlation was found between the presence of K1 antigen and the incidence of experimental E . coli endocarditis . Thus, the ability of strains of E . coli to establish persisting endocardial infection in rabbits appears to be directly associated with resistance to the complement-mediated serum bactericidal system . These findings may explain in part the rarity of gram-negative bacillary endocarditis in patients; they also indicate that in certain special circumstances the serum bactericidal system can play a decisive role in host defense.

Appl Environ Microbiol, 1977 Apr, 33(4), 940 - 6
Determination of bacterial number and biomass in the marine environment; Watson SW et al.; Three techniques for the measurement of bacterial numbers and biomass in the marine environment are described . Two are direct methods for counting bacteria . The first employs an epifluorescence microscope to view bacteria that have been concentrated on membrane filters and stained with acridine orange . The second uses a transmission electron microscope for observing replicas of bacteria that are concentrated on membrane filters . The other technique uses Limulus amebocyte lysate, an aqueous extract from the amebocytes of the horseshoe crab, Limulus polyphemus, to quantitate lipopolysaccharide (LPS) in seawater samples . The biomass of gram-negative (LPS containing) bacteria was shown to be related to the LPS content of the samples . A factor of 6.35 was determined for converting LPS to bacterial carbon.

Zh Mikrobiol Epidemiol Immunobiol, 1977 Apr, (4), 53 - 9
{Morphologic mutant of Escherichia coli K12 having disorders in morphology, division and cell wall biosynthesis}; Androsov VV et al.; A study was made of the properties of a spherical mutant obtained from the E . coli K12 HfrC strain under the effect of N-nitroso-N-methyl-urea . The growth of the mutant of full value media was characterized by a marked reduction of the cell division at the rest phase, but exponential growth phase failed to differ from the growth of the parental strain . Electron microscopic study of surface structures of the mutant cells which grew under physiological conditions permitted to distinguish two types: the first type had a typical structure of the cell wall characteristic of Gram negative microbes; the second type was framed by a bicontour membrane without any distinct structure . The presence of these two types of cells was also confirmed by their different sensitivity to the ionic detergents . On the basis of chemical analysis of peptidoglycan of the cell wall (which was markedly decreased in amount in the mutant cells), and also of the unsually high accumlation of the UDP-precursors of peptidoglycan under conditions of penicillin action it is supposed that normal regulation of metabolism of the cell walls was deranged . Mutation designated by 11rA symbol was plotted by phase PI transduction alongside of strA gene.

Health Lab Sci, 1977 Apr, 14(2), 83 - 94
A scheme for identification of nonfermentative gram-negative bacteria; Shayegani M et al.; A scheme was designed to speed the identification of 50 nonfermentative gram-negative bacteria to genus, species, and biotype using a minimal numer of biochemical tests . When the scheme was evaluated in our laboratory, one technologist identified 93.6% of 188 known isolates (46 species) . Later another technologist, given 161 of the same isolates (46 species) as unknowns, identified 91.9% . The isolates that were misidentified in both cases were atypical organisms with aberrant biochemical reactions, plus 1 typical organism with a delayed oxidation of glucose.

J Immunol, 1977 Apr, 118(4), 1435 - 40
Regulation of lipopolysaccharide-induced granulopoiesis and macrophage formation by spleen cells . I . Relationship between colony-stimulating factor release and lymphocyte activation in vitro; Apte RN et al.; Addition of bacterial lipopolysaccharide (LPS), a B cell mitogen, to mouse spleen cultures strongly stimulated production of colony-stimulating factor (CSF), the humoral regulator of granulopoiesis, and macrophage formation in vitro . Secretion of CSF from LPS-stimulated spleen cells coincided with cellualr DNA synthesis and cell transformation and both activities could be attributed to the lipid A moiety of the molecule . Different experimental approaches were used to study the relationship of CSF release and lymphocyte activation in response to LPS: a) modification of LPS with polymyxin B, an antibiotic bactericidal for most Gram-negative bacteria, caused a marked reduction in mitogenic activity, although the ability to induce CSF was not significantly altered; b)spleen cells from CBA/N mice, a mutant strain with an x-linked genetic defect in immunologic and mitogenic responses to polyclonal activators including LPS, showed diminished mitogeinc responses; however, high levels of CSF were produced; c) mitotic and DNA inhibitors (colchicine and cytosine arabinoside) did not affect CSF release although they completely inhibited mitogenicity . Thus, the spleen cell population participating in the process of LPS-induced CSF generation is probably a nondividing, terminally differentiated one without need for DNA synthesis . In addition, it was also shown that active RNA and protein synthesis are needed in this process.

N Engl J Med, 1977 Mar 31, 296(13), 701 - 5
Successful granulocyte transfusion therapy for gram-negative septicemia . A prospectively randomized controlled study; Herzig RH et al.; We prospectively randomized 27 granulocytopenic patients who experienced a total of 30 episodes of gram-negative septicemia . The control group received an appropriate antibiotic regimen alone, whereas the "transfusion" group received infusions of granulocytes in addition to the antibiotics . Five of 14 controls survived, and 12 of 16 in the transfusion group survived, and 12 of 16 in the transfusion group survived (P less than 0.04) . An important factor in the outcome of treatment was the recovery of bone-marrow function (return of peripheral granulocyte count greater than or equal to 1000 per microliter) . Eighty-three per cent (five of six) of the control group and all (four of four) of the transfusion group with recovery of granulocyte levels survived the episode of sepsis . In contrast, none of the eight control patients, as compared to 67 per cent (eight of 12) of the transfusion group, survived persistent granulocytopenia (P less than 0.005) . Granulocyte transfusions appear to complement appropriate antibiotic treatment of gram-negative-septicemia due to granulocytopenia.

J Biol Chem, 1977 Mar 25, 252(6), 2077 - 81
Effect of variations in lipopolysaccharide on the fluidity of the outer membrane of Escherichia coli; Rottem S et al.; The lipid hydrocarbon chains in the outer membrane of gram-negative bacteria appear from previous experiments to be less mobile than in the cytoplasmic membrane . To determine whether lipopolysaccharide, a unique outer membrane component, is a cause of this restricted mobility, outer membranes differing in the amount of lipopolysaccharide, and the length of the polysaccharide side chain, were prepared from Escherichia coli J5 . Cytoplasmic membranes were prepared for comparison . The probes, 5- and 12-doxylstearate, were introduced into these membranes, electron spin resonance spectra were analyzed, and the order parameter (S) and empirical motion parameter (tau0) were calculated . Outer membrane preparations containing long chain lipopolysaccharide were much less fluid by these criteria than were preparations containing short chain lipopolysaccharide . Removing about 40% of the lipopolysaccharide from the former preparations greatly increased their fluidity . The lipid in the cytoplasmic membrane preparations was more fluid than in the outer membrane and cytoplasmic membranes were similar to each other regardless of the composition of the outer membrane . These results indicate that lipopolysaccharide, and especially the polysaccharide portion, directly or indirectly causes the restricted mobility of the lipid hydrocarbon chains observed in the outer membrane.

Mikrobiologiia, 1977 Mar-Apr, 46(2), 329 - 34
{Fine structure of Chloroflexus aurantiacus var . mesophilus (nom . prof.) grown in the light under aerobic and anaerobic conditions}; Pivovarova TA et al.; The fine structure was studied in two mesophilic strains of Chloroflexus aurantiacus var . mesophilus (nom . prof.): KN-4 and BR-1 . Trichomes are covered with a mucous fibrillar sheath which is more developed in the KN-4 strain . Photosynthetic structures, "chlorobium-vesicles", are located at the periphery of the cells of both strains . The structure of the cell was is typical of gram-negative microorganisms . By their electron density and dimensions, inner cytoplasmic structures are identified as poly-beta-hydroxybutyric acid, polyphosphates, and polysaccharides . When the strain BR-I was grown in aerobic conditions in the light, "chlorobium-vesicles" were not synthesized and intracytoplasmic membranes were represented by small tubular-vesicular invaginations . When the cells were grown under anaerobic conditions in the lgiht, numerous "chlorobium-vesicles" were formed, and additional large vesicular membrane systems appeared; these systems occupied over 20 per cent of the cell volume . Possible relationship between the membrane structures and the synthesis of bacteriochlorophyll a and c is discussed.

J Clin Microbiol, 1977 Mar, 5(3), 336 - 40
Clinical laboratory evaluation of a system approach to the recognition of nonfermentative or oxidase-producing gram-negative, rod-shaped bacteria; Isenberg HD et al.; The Oxi-ferm tube, an eight-compartment system suitable for the recognition of nonfermentative, gram-negative, rod-shaped bacteria, was evaluated in conjunction with the oxidase test in a clinical microbiology laboratory setting . A comparison between this system and the 17-test routine examination was performed with 265 cultures representing 21 species . The results obtained with the Roche systems were supplemented with simple additional tests in accordance with Computer Identification Data rovided by the manufacturer . The Oxi/ferm tube approach worked satisfactorily in establishing the identity of the bacteria isolated from clinical specimens augmented with some representatives from culture collections . Reactions within the Oxi/ferm system were reproducible and comparable to laboratory prepared and controlled substrates.

Naturwissenschaften, 1977 Mar, 64(3), 126 - 32
{Membrane permeability and antibiotic resistance in bacteria}; Braun V; The resistance of mainly gram-negative bacteria against antibiotics is discussed with respect to new discoveries on the permeability barrier of the outer membrane . Proteins originally characterized as virus receptors have been found to be involved in the translocation of certain substrates across the membrane . Antibiotics can reach their target by the same "pores".

Surg Gynecol Obstet, 1977 Mar, 144(3), 347 - 50
A study of the critical bacterial inoculum to cause a stimulus to wound healing; Raju DR et al.; Results of previous work have shown that wounds infected with gram-negative bacteria may be stronger than uninfected wounds . The inoculum in these studies was about 2 X 10(7) organisms . Laparotomy wounds were swabbed with inocula of from 10(2) to 10(9) organisms, Escherichia coli . Only with inocula of 10(6) or greater were all parts of all wounds infected by gross inspection . All wounds inoculated with 10(7) organisms, or more, were significantly stronger than the wounds of the control group on the 14th day . A smaller inoculum--10(3) to 10(6)--also resulted in stronger wounds, but not consistently so.

South Med J, 1977 Mar, 70(3), 320 - 4
Granulocyte transfusion therapy in children; Maybee DA et al.; A prospective study of 45 granulocyte transfusions in children using continuous flow centrifugation is reported . During 13 episodes of proven or presumed infection, only two children failed to show a favorable response to granulocyte transfusion . The neutropenic child shows a significantly increased absolute granulocyte count one hour after transfusion . The granulocyte counts at one hour after transfusion are inversely proportional to the child's size . A child with chronic granulomatous disease who had documented Nocardia asteroides sepsis and pneumonia exhibited complete recovery following granulocyte transfusion . Dramatic responses to the nonrandom use of granulocyte transfusion have been observed in children with major gram-negative bacterial infections . Endorsement of granulocyte transfusion for instances of presumed, but unproven, infection in the neutropenic child will require randomization to control the variables of antibiotic therapy and bone marrow remission.

Schweiz Med Wochenschr, 1977 Feb 12, 107(6), 198 - 200
{Cellular reactions in the lungs after inhalation of cotton dust and of endotoxin}; Snella MC et al.; The free lung cell count has been studied in guinea pigs after exposure to extracts of various cotton dusts . A good correlation was found between the increase in leukocyte count in the airways and the number of gram-negative bacteria in the different dusts . The importance of endotoxin in the acute effects following exposure to cotton dust is discussed.

Appl Environ Microbiol, 1977 Feb, 33(2), 427 - 33
Reduction of sulfur by spirillum 5175 and syntrophism with Chlorobium; Wolfe RS et al.; A small spirillum, designated 5175, was isolated from an anaerobic enrichment culture for Desulfuromonas in which the major medium constituents were acetate and elemental sulfur . The organisms grew only under anaerobic or microaerophilic conditions . Elemental sulfur was formed anaerobically in a malate-sulfide medium, and cell densities of 10(8) cells/ml were obtained . Hydrogen and formate were actively oxidized as substrates for growth under anaerobic conditions; S0, S032-, or S2O32-, but not SO42-, served as electron acceptors and were stoichiometrically reduced to sulfide . Malate or fumarate likewise served as electron acceptors and were reduced to succinate . Nutritional requirements were simple, no vitamins or amino acids being required . For growth in inorganic media when carbon dioxide was the only carbon source, the addition of acetate was required as a source of cell carbon . The organism is gram negative . Cells had a diameter of 0.5 mum and a wavelength of 5.0 mum . Cell suspensions exhibited an absorption spectrum indicative of a cytochrome with peaks in the reduced form at 552, 523, and 416 nm . Well growing syntrophic cultures with Chlorobium were established with formate as the substrate.

J Clin Microbiol, 1977 Feb, 5(2), 208 - 20
Characterization and identification of gram-negative, nonfermentative bacteria; Oberhofer TR et al.; The morphological and physiological characteristics of 593 strains of nonfermentative, gram-negative bacteria are described . A battery of 46 tests was used to identify and differentiate strains representing 8 genera and 31 species of named and group-designated bacteria . Seven selected amides and organic salts were closely examined to determine their usefulness, individually or as a battery, in characterizing and identifying the organisms . Of these, allantoin and acetamide showed the most promise in differentiating the more commonly occurring organisms from biochemically similar species . Susceptiblilty patterns to 12 antimicrobics also proved useful in differentiation, especially among atypical strains.

J Bacteriol, 1977 Feb, 129(2), 1059 - 65
Distribution of lipopolysaccharide and the detection of a new subfraction in the cell envelope of a marine pseudomonad; Nelson JD Jr et al.; The three outer layers of the cell envelope of marine pseudomonad B-16, the loosely bound outer layer, the outer membrane, and the periplasmic space layer, are the only ones containing appreciable amounts of both lipid and carbohydrate . These layers and a fraction released into the medium during growth of the cells were examined for the presence of common antigens by double immunodiffusion using anti-whole serum . Each of the layers, the medium fraction, and lipopolysaccharide (LPS) isolated from the organism were shown to contain two or more diffusible components showing reactions of identity . Thus LPS is found in each of the three outer layers of the cell envelope of this gram-negative bacterium . The periplasmic space layer was found to contain a fraction accounting for 20% of the dry weight of the layer, which was sedimentable at 30,000 x g and contained lipid, protein, and carbohydrate . Double-immunodiffusion tests indicated that the fraction contained at least one of the two antigens present in isolated LPS . A particulate material was released by the cells during growth which gave a positive test for 2-keto-3-deoxyoctulosonic acid and cross-reacted serologically with LPS.

Br J Pharmacol, 1977 Feb, 59(2), 261 - 8
The role of bacterial contamination in the isolation of apparent anti-inflammatory factors from rabbit anti-lymphocytic serum; Maguire ED et al.; 1 Rabbit anti-guinea-pig lymphocytic serum was fractionated by gel filtration to obtain partially purified materials possessing anti-inflammatory activity . The pharmacological properties of these materials were then studied . 2 Two fractions were found which reproducibly contained significant activity . One of these activities caused inflammation at the site of injection and was associated with high molecular weight protein (2008000) . The other activity was found in low molecular weight fraction but was shown to be due to small amounts of endotoxin from Gram negative bacteria . These organisms contaminated the fractions in spite of the recommended precautions for gel filtration having been taken . 3 The endotoxin-containing fraction completely abolished leucocyte infiltration into the rat foot which had been injected with kaolin . It had no apparent effect on circulating haemolytic complement . It caused maximal elevation of serum 11-hydroxycorticosteroid concentrations and was found to cause the release of pharmacologically active amines . Many of the previously reported naturally occurring anti-inflammatory substances have similar pharmacological properties to those of the endotoxin-containing fraction . 4 It was concluded that doubt will exist about the presence of anti-inflammatory factors in mammalian body fluids unless stringent precautions are taken to exclude measurable bacterial contamination . 5 These experiments also cast doubt on the validity of accepted procedures for excluding microbial growth from columns used in the fractionation of serum.

Surgery, 1977 Feb, 81(2), 193 - 7
Hepatic reticuloendothelial protection against bacteremia in experimental hemorrhagic shock; Pardy BJ et al.; Gram-negative septicemia is an increasingly common problem, and various suggestions have been made about the cause . One not often considered is that it may be the result of failure of hepatic removal of organisms which have crossed the intestinal mucosal barrier from the large bowel lumen to the portal blood stream . Splanchnic hypoperfusion both increases mucosal permeability and reduces the ability of the hepatic reticuloendothelial system (RES) to remove particulate matter from the blood . If RES funciton is reduced further by blockade with colloidal carbon, then any tnedency for bacteremia to occur in shock might be enhanced . Splenectomized greyhounds, who had received a portal perfusion of either colloidal carbon or saline, were subjected to a period of hypovolemia and then were resucitated . Peripheral blood cultures were sterile at all times in the control animals and before bleeding in the dogs that recived carbon . However, all the RE-blockaded animals developed bacteremia during shock, It was condluded that hepatic RES funciton was essential in the prevention of bacteremia in the hypovolemic dog and that investigation should be directed toward studies of RES function in man with a view to determining the importance or otherwise of the RES in relation to gram-negative bacteremia.

Surg Gynecol Obstet, 1977 Feb, 144(2), 259 - 69
Post-traumatic pulmonary insufficiency; Pardy BJ et al.; Pulmonary insufficiency is occasionally a life-threatening sequel to severe nonthoracic trauma . A similar disturbance of pulmonary function may be a feature of hepatic cirrhosis, fulminant hepatic failure, liver homotransplantation and major hepatic resection for blunt injury . In addition to the respiratory changes, other associations common to both post-traumatic pulmonary insufficiency and liver disease are disturbance of consciousness and susceptibility to infection by organisms normally found in the gastrointestinal tract . If failure of some aspect of liver function is responsible for the development of pulmonary insufficiency, it is likely that it is the hepatic reticulo-endothelial cells rather than the parenchymal cells which are concerned, because hepatic parenchymal cell failure is not a feature of post-traumatic pulmonary insufficiency . It is suggested that the hepatic reticuloendothelial system normally protects the lungs by acting as a prepulmonary filter removing and inactivating noxious macromolecular and particulate matter in the blood, such matter arising mainly from the intestine and the blood coagulation and fibrinolytic systems . Experimental evidence indicates that hypovolemia increases the load of circulating phagocytosable material and depresses activity of the hepatic reticuloendothelial system, while trapping of the pulmonary reticuloendothelial system is considerably enhanced . This noxious material, normally dealt with by the hepatic reticuloendothelial system, may accumulate during and after hypovolemia in active form in the lungs as a result of the action of three mechanisms: direct pulmonary reticuloendothelial phagocytosis from the blood, transfer in hepatic reticuloendothelial cells from liver to lungs and uptake from the blood by polymorphonuclear leukocytes which become sequestered in the lungs . The ensuing pulmonary injury caused by this material may then be manifested by progressive pulmonary insufficiency and the impairment of activity of the hepatic reticuloendothelial system by the presence of gram-negative infection . The reticuloendothelial system has been largely neglected in man, and it is considered that evaluation of reticuloendothelial activity in injured patients may lead to the definition of a syndrome of failure of the reticuloendothelial system of which pulmonary insufficiency may be an integral part.

J Bacteriol, 1977 Feb, 129(2), 599 - 605
Glucan common to the microcyst walls of cyst-forming bacteria; Sutherland IW et al.; Chemical analysis indicated that D-glucose is tha major neutral monosaccharide present in the microcysts of a range of gram-negative bacteria . Varying amounts of other neutral sugars were found . The glucose was mainly present as a glucan that could be extracted from microcysts of representative strains with alkali or mild acid treatment . The glucan could be identified as an alpha-1,3-linked polymer on the basis of (i) periodate resistance of the extracted polymer and the material present in microcysts; (ii) lectin agglutination of the microcysts; (iii) lectin precipitation of the extracted glucans; and (iv) susceptibility of the glucan either in the walls or after extraction to a specific alpha-1,3-glucanase from Aspergillus nidulans, yielding glucose as the sole hydrolysis product . The galactosamine found in microcysts of Myxococcus xanthus by other workers is clearly a component of another polymer, distinct from the glucan . The presence of an alpha 1,3-linked glucan, common to microcyst walls of various bacterial genera, probably contributes to the rigidity of the walls of these forms and, inter alia, to their resistance to ultrasonic treatment . Preliminary experiments indicate that the gulcan is discarded on germination of the microcysts rather than being broken down by specific enzymes.

Infect Immun, 1977 Feb, 15(2), 556 - 9
Killing of Escherichia coli by a granulocyte fraction occurs without recognizable ultrastructural alterations in the bacterial envelope, as studied by freeze-fracture electron microscopy; Van Houte AJ et al.; Concentrations of a highly purified rabbit polymorphonuclear leukocyte fraction that rapidly caused irreversible loss of viability of Escherichia coli (S15) but reversible envelope alterations produced no recognizable morphological changes as studied by freeze-fracture electron microscopy . These findings support previous evidence that the killing of certain gram-negative microorganisms by granulocyte fractions occurs with minimal structural or functional disorganization of cytoplasmic and outer membranes.

Circ Shock, 1977, 4(1), 41 - 53
Cerebral hemodynamics, vascular reactivity, and metabolism during canine endotoxin shock; Parker JL et al.; Cerebral hemodynamics, vascular reactivity, and metabolic alterations were studied in anesthetized, spontaneously respiring dogs for 4-6 hr of gram-negative endotoxin shock . Cerebral venous outflow (cerebral blood flow) was measured directly from the cannulated confluence of the sagittal, straight, and lateral sinuses, with the lateral sinuses occluded . Cerebral blood flow and cerebral perfusion pressure decreased immediately upon administration of 1,2, or 5 mg/kg endotoxin and consistently remained below control values . By the fourth hour of shock, cerebral blood flow was decreased 37, 48, and 45% respectively . Cerebral vascular resistance initially decreased, then progressively increased to levels significantly above control, and it was primarily responsible for the reduced cerebral blood flow in the later stages of shock . Cerebral autoregulatory and "venous-arteriolar" responses were well maintained, although cerebral vascular reactivity to arterial hypercapnia was depressed . Cerebral venous blood pH and pO2 decreased, and arterial-venous differences of percentage oxygen saturation, total CO2, and HCO3 increased . These alterations in cerebral vascular hemodynamics and tissue acid-base balance indicate that cerebral ischemia and resulting acidosis occur during canine endotoxin shock.

Infection, 1977, 5(2), 104 - 6
Actinobacillus actinomycetemcomitans endocarditis in a patient with a prosthetic aortic valve; Panwalker AP et al.; Bacterial endocarditis caused by Actinobacillus actinomycetemcomitans is a rare disease . A 48-year-old man who had a Starr-Edwards aortic valve prosthesis inserted in 1972 was admitted for evaluation of confusion, headaches, anorexia, weight loss, diarrhea and weakness . Six blood cultures yielded gram-negative organisms which were subsequently identified as A . actinomycetemcomitans . Treatment with ampicillin and gentamicin resulted in cure which has been maintained after an observation period of eleven months . This represents the second report of A . actinomycetemcomitans endocarditis in a patient with a prosthetic valve.

Sex Transm Dis, 1977 Jan-Mar, 4(1), 22 - 6
An evaluation of the microcult gonorrhea detection system; Judson FN; The Microcult Gonorrhea Detection System employs a dehydrated selective medium adsorbed into a cellulose matrix . The medium is rehydrated before use, then incubated in a foil pouch with a tablet that releases carbon dioxide . Duplicate specimens were plated in parallel on modified Thayer-Martin media and Microcult media . In all, 131 urethral specimens which contained gram-negative intracellular diplococci, 311 cervical specimens and 308 anal specimens were studied . Gonococci were isolated on modified Thayer-Martin media from 128 urethral, 63 cervical, and 29 anal specimens . In contrast 109 urethral, 48 cervical, and 5 anal specimens were shown to contain gonococci using the Microcult system . The Microcult system is inferior to fresh modified Thayer-Martin media for detecting gonococci.

J Immunol Methods, 1977, 16(1), 91 - 6
Affinity chromatography of antiserum to a gram negative organism; Fine DH et al.; An immunoadsorbent method is described for the purification of antibody directed against gram negative bacteria . Two anion exchange materials were compared for their ability to immobilize whole cells of Veillonella alcalescens, a gram negative oral bacterium . Purified antibody preparations were applied to the columns and subsequently eluted with various combinations of desorbing buffers . The quantity of recovered antibody was measured and its activity assayed, using a microagglutination technique . The highest levels of protein and specific antibody activity were recovered from Dowex-1-acetate columns desorbed by a combination of borate buffer pH 10 and 3 M KSCN pH 6, followed by levels of specific antibody activity obtained from a DEAE cellulose column desorbed by glycine--HC1, PBH 2.3.

Immunology, 1977 Jan, 32(1), 65 - 74
The response of protein-deficient mice to tetanus toxoid . Effects of antigen dose, adjuvants, period of deprivation and age on antibody production; Price P et al.; The effects of a 4% albumin diet initiated at weaning on primary and secondary responses to AIPO4-adsorbed and soluble tetanus toxoid (TT) were studied in C57BL mice . Responses of both groups were directly proportional to the dose of antigen over most of the range tested, but at very low doses protein-deficient mice produced higher primary titres than normal mice . In the primary response AIPO4-adsorption of the antigen essentially increased the effective dose irrespective of the diet, but after secondary challenge responses to soluble TT were more severely affected by the diet . Normal secondary titres to AIPO4-adsorbed TT were achieved when deficient mice were given high doses of antigen . Diet also affected the relative proportions of IgG and IgM produced in most responses . Gram-negative bacterial vaccines and lipopolysaccharide increased antibody production in both groups of mice . The low protein diet produced less dramatic effects when initiated at the time of inoculation or later, and mice maintained for longer on the diet produced more nearly normal titres . Mechanisms which may explain these findings are discussed.

J Wildl Dis, 1977 Jan, 13(1), 103 - 6
Histopathology of an acute fin lesion in the summer flounder, Paralichthys dentatus, and some speculations on the etiology of fin rot disease in the New York Bight; Murchelano RA et al.; The histopathology of acute fin rot disease in summer flounder, Paralichthys dentatus, from the New York Bight is described . Grossly, caudal and dorsal fin lesions appeared ragged or frayed with no evidence of resolution . Microscopically, there was epidermal and dermal necrosis, congestion, edema, focal and diffuse hemorrhage, and Zenkers necrosis of underlying muscle . Gram-negative bacteria were present in the fin tissues as well as in heart muscle and liver parenchyma . The inflammatory response consisted mostly of macrophages . The significance of the acute disease in summer flounder is discussed in relation to the etiology of fin rot disease in winter flounder from the Bight.

Dev Biol Stand, 1977, 34, 27 - 36
Comparison of the pyrogen tests in rabbits and with limulus lysate; Ronneberger HJ; In the past years an assortment of samples of plasma proteins, enzymes, vaccines and blood substitutes were tested comparatively in rabbits (pyrogen test, European Pharmacopoeia) and with the LAL test (Pyrogent, Byk-Mallinckrodt, Inc.) . Specificity and sensitivity were tested with endotoxins and lipid A of gram-negative bacteria . The limulus amebocyte lysate (LAL) test gave similar results or was tenfold more sensitive than the assay in rabbits . More than 300 samples of drugs were examined by both tests . All preparations positive in the rabbit test were positive in the LAL test too . In the testing of plasma proteins the LAL test was more sensitive . The examination of 45 samples of vaccines for pyrogens gave the same result in both assays . Streptokinase does not inhibit the LAL test unspecifically . The LAL test is not an alternative but an additional method in the detection of lipopolysaccharides in drugs.

J Bacteriol, 1977 Jan, 129(1), 9 - 14
Chemical structure of the lipid A component of lipopolysaccharides from Fusobacterium nucleatum; Hase S et al.; The lipid A component of lipopolysaccharides from Fusobacterium nucleatum Fev 1 consists of beta-1',6-linked D-glucosamine disaccharides, which carry two phosphate groups: one in glycosidic and one in ester linkage . The amino groups of the glucosamine disaccharides are substituted by D-3-hydroxyhexadecanoic acid . The hydroxyl groups of the disaccharide backbone are acylated by tetradecanoic, hexadecanoic, and D-3-hydroxytetradecanoic acids . Part of the ester-bound D-3-hydroxytetradecanoic acid is 3-O-substituted by tetradecanoic acid . Whereas a similar pattern of fatty acids was detected in lipopolysaccharides from two other F . nucleatum strains, the amide-bound fatty acid in F . varium and F . mortiferum was D-3-hydroxytetradecanoic acid . The chemical relationships of lipid A from Fusobacteria and other gram-negative bacteria are discussed.

Mikrobiyol Bul, 1977, 11(4), 563 - 75
{Identification and differentiation of nonfermentative gram-negative bacteria in the clinical laboratory (author's transl)}; Baykal M; Identification of nonfermentative gram negative rods encountered in medical bacteriology exhibit some difficulties in the clinical laboratory . However, we believe that, if identification procedures are applied systematicaly and step by step more than 90% of nonfermentative gram negative bacteria can be identified within 72 hours.

Acta Chir Scand, 1977, 143(2), 85 - 9
A 14-month study of severe non-wound infectious complications in general surgery; Hojer H et al.; A retrospective study of serious non-wound infectious complications in general surgery during at 14-month period is reported . A prospective study on wound infections in available from the same institution and period . Septicemia, intraabdominal and intrathoracal abscesses and rare cases of osteomyelitis occurred in 1.3% of all treated patients, whereas postoperative wound infection developed in 7.5% of primarily non-infected patients . Mortality was significantly higher among patients with serious infections than in all patients nursed during the same period . Severe postoperative infectious complications was in fact the third most common cause of death and accounted for 14% of the mortality of the clinic . This rate rises to close to 50% when death from incurable disease is excluded . Septicemia carried a significantly higher mortality rate than intraabdominal abscesses . The risk of a serious infection developing was significantly higher in operations on the small or large intestine than after appendectomies or biliary operations . Gram negative bacteria dominated, especially in cases with a fatal outcome . Contributing factors such as malignancy, preoperative infection or macroscopic peroperative wound soiling, were more common in patients where a serious infectious complication developed postoperatively.

Zh Mikrobiol Epidemiol Immunobiol, 1977, (1), 94 - 9
{Ultrastructure of LLR-mutants of E . coli K12}; Androsov VV et al.; The author studied the ultrastructure of two spherical E . coli K12 mutants (llr) obtained under the effect of N-nitroso-N-methylurea . Seven morphological types of cells differing from one another by shape, size and cytoarchitectonics were distinguished . Superficial structures of the majority of the cells were represented by the membranes of the cell wall and the cytoplasmic membrane of common structure . Some of the cells had only one membrane coat and a high electron optic density of the cytoplasm . Transitional forms of cells were also encountered . The ultrastructure of each morphological type in the population of the llr-mutants was described in detail . The capacity of the mutants to vacuolization, to the intra- and extracellular budding, and also the ability to form multiple membrane structures resembled analogous structures of stable L-forms of the Gram-negative microbes . The problems of morphological differentiation of the L-forms and of the llr-mutants, and also problems connected with the formation of the multiple membrane structures and small elemental bodies in the cells of the llr-mutants are discussed.

Scand J Infect Dis, 1977, 9(1), 37 - 9
Ubiquity of R factor-mediated antibiotic resistance in the healthy population; Widh A et al.; An attempt was made to assess the occurrence of R factor-mediated antibiotic resistance in the healthy population . Samples of aerobic, gram-negative intestinal bacteria from men from various parts of the country at military conscription were analysed for transferable drug resistance . The obtained frequency, about 15% of R factor carriers in the studied group, was interpreted to reflect the existence of a reservoir of R factors, from which resistant, pathogenic bacteria could be selected under antibiotic therapy . Resistance to tetracycline, streptomycin and sulfonamides dominated among the identified R factor-borne resistance traits.

Ann Surg, 1977 Jan, 185(1), 64 - 6
Toothpick perforation of the intestines; Schwartz JT et al.; Toothpicks have been used since antiquity as instruments for mouth cleansing and as eating utensils . Toothpick injury to the gastrointestinal tract is often suspected only at the time of operation because patients rarely relate a history of swallowing toothpicks and most toothpicks are not radiopaque . The spectrum of toothpick injury to the gastrointestinal tract is illustrated by 5 patients who developed toothpick perforation of the gastrointestinal tract . Two patients died as a result of complications of toothpick injury, one of these presenting with recurrent gram negative sepsis with multiple organisms due to a duodenal-inferior vena caval toothpick fistula . In two instances the toothpicks were removed at operation and one that was penetrating the duodenum was removed with a fiberoptic duodenoscope.

J Periodontol, 1977 Jan, 48(1), 13 - 20
Production and origin of oral malodor: a review of mechanisms and methods of analysis; Tonzetich J; Organoleptic studies indicate that the oral cavity is usually the principal source of physiologic malodor associated with the early morning halitosis . In all individuals, regardless of the age or health status of the oral tissues, the most intense oral malodor is exhibited after prolonged periods of reduced saliva flow and abstinence from food and liquid . This results from normal metabolic activity in the oral cavity and is accentuated in cases with periodontal involvement . Physiologic oral malodor is transient in duration as it can be controlled to varying degrees in most individuals by oral hygiene measures, such as tooth brushing, dental prophylaxis, tongue scraping and rinsing with antiseptic mouth washes . Experimental evidence strongly suggests that putrefaction of sulphur-containing proteinaceous substrates by predominantly gram-negative oral microorganisms is the primary cause of oral malodor . Optimum putrefactive activity occurs in low carbohydrate environment, physiological pH, and anaerobic conditions . Salivary sediment containing the exfoliated epithelial cells is the primary source of substrate which exists in a disulphide state . Proteolysis and reduction of disulphide bonds precedes the formation of odor . The odor intensity of putrescent saliva and plaque head-space vapor has been correlated with the concentration of volatile sulphur compounds consisting of hydrogen sulphide, methyl mercaptan, dimethyl sulphide and dimethyl disulphide . Except for dimethyl disulphide, the same sulphur-containing compounds have been found in mouth air of all tested individuals . Hydrogen sulphide and methyl mercaptan emanate an offensive putrid odor and account for approxiamtely 90% of the total sulphur content of mouth air . In half of the population tested, methyl mercaptan and hydrogen sulphide content of early morning mouth air is sufficiently high to account for the oral malodor . Brushing studies indicate that both plaque and tongue are important sources of malodor with most of the odor emanating from the dorso-posterior surface of the tongue . None of the gas chromatographic or mass spectrometric analyses have detected the presence of amines, indole, or skatole in the head-space, mouth air, or breath vapor samples.

Circ Shock, 1977, 4(2), 143 - 52
The influence of venous return on cardiac mechanical and sarcoplasmic reticulum function during endotoxemia; Hess ML et al.; E . coli endotoxin (0.03 mg/ml) added to blood perfusing a heart-lung preparation with a venous return of 600 ml/min produced a significant depression in ventricular function within 4 hours . Fragmented sarcoplasmic reticulum isolated from the myocardium of the endotoxin-perfused heart-lung preparations showed depressed calcium uptake rates and ATPase activity . When venous return was increased to 1,200 ml/min, gram-negative endotoxin had no effect on ventricular function, isolated fragmented sarcoplasmic reticulum calcium uptake, or ATPase activity . These observations suggest that gram-negative endotoxin or a product thereof acts in synergism with low venous return in order to depress myocardial function.

Am J Med, 1976 Dec, 61(6), 892 - 6
Mediastinal irradiation for chronic lymphocytic leukemia; Sawitsky A et al.; Thirty-one patients with chronic lymphocytic leukemia were treated with mediastinal radiation . In none of the patients was complete remission achieved; either partial remission or clinical improvement was achieved in 52 per cent, but the duration of response was short . The response rate was 77 per cent for the patients receiving a total radiation dose greater than 3,000 rads and 45 per cent for those receiving less than 3,000 rads . Severe life-threatening toxicity was noted in 11 patients and seven of these patients died; two patients died with progressive disease . Severe toxicity was manifested by one or more of the following: bone marrow aplasia, pancytopenia, gram-negative sepsis, generalized herpes zoster and severe esophagitis . Neither the total dose of radiation nor the dose per week correlated withe the severity of reaction or death.

Br Med J, 1976 Dec 11, 2(6049), 1415 - 8
Endotoxaemia and renal failure in cirrhosis and obstructive jaundice; Wilkinson SP et al.; An investigation into the possible role of endotoxins in the pathogenesis of renal failure in cirrhosis and obstructive jaundice showed the two to be closely related . None of the patients with cirrhosis who had endotoxaemia had other evidence of Gram-negative infection at the time of the study, and the endotoxaemia was therefore probably due to impaired hepatic clearance of toxins normally absorbed from the gastrointestinal tract . In contrast, bacteriological evidence of Gram-negative infection was found in most of the patients with obstructive jaundice and endotoxaemia.

J Biochem (Tokyo), 1976 Dec, 80(6), 1453 - 5
Amino acid composition of peptidoglycan in Caulobacter crescentus; Fujiki K et al.; Peptidoglycan of a gram-negative stalked bacterium, Caulobacter crescentus CB13, contained alanine, diaminopimelic acid, and glutamic acid, in molar ratios of 2 : 1 : 1 . The amino acid compositions of peptidoglycans isolated from cultures enriched in swarmer and stalked cells, and from a stalk-less mutant were similar . This finding conflicts with a previous observation that swarmer peptidoglycan does not contain diaminopimelic acid (Goodwin and Shedlarski (1975) Arch . Biochem . Biophys . 170, 23-36) . It appears that, despite the morphological differences, the Caulobacter cells all contain a similar peptidoglycan in the cell wall.

Arch Microbiol, 1976 Dec 1, 111(1-2), 155 - 9
The characterization of the rumen bacterium Eadie's oval, Magnoovum gen . nov . eadii sp . nov; Orpin CG; The rumen bacterium Eadie's Oval was examined by means of cell wall analysis and biochemical tests with a view to determine its taxonomic position . The purified cell walls contained components consistent with the organism being a Gram-negative bacterium, and despite its large size no abnormal cell wall constituents were found . The biochemical tests indicate that Eadie's Oval is not a member of a previously described family . The name Magnoovum gen . nov . eadii sp . nov . is proposed.

Am J Epidemiol, 1976 Dec, 104(6), 621 - 6
Multivariate analysis of risk of perinatal telencephalic leucoencephalopathy; Leviton A et al.; The hospital and autopsy records of 40 infants who died with perinatal telencephalic leucoencephalopathy (PTL) (hypertrophic astrocytes and amphophilic globules in telencephalic white matter) were compared to those of 76 control infants who had no white matter abnormality . A linear discromination procedure, which takes into account multiple confounding factors, was used to estimate risk ratios . PTL was found more commonly in infants who (a) had bacteria isolated from blood at autopsy, (b) received intravenous glucose and water for more than one day, or (c) received kanamycin or streptomycin . Infants were at reduced risk if they received penicillin, atropine, mercurhydrin or a transfusion of whole blood . It is hypothesized that endotoxin from bacteremia adversely affects developing white matter and that the other risk factors of PTL are markers of, or contributors to, increased risk of gram negative infection . No evidence was found for antibiotic-endotoxin interaction . The factors that are associated with reduced risk of PTL may be markers of, or contributors to reduced risk of gram negative infection.

Am J Clin Pathol, 1976 Dec, 66(6), 1012 - 5
Limulus amebocyte lysate test in neonates; Goldstein JA et al.; The limulus amebocyte lysate test for endotoxin was done on samples of blood from 22 well babies and 33 neonates in an intensive-care nursery . The objective was to determine whether falsely positive test results occurred in samples from newborn infants during acquisition of usual bowel flora . One neonate had a transiently positive limulus amebocyte lysate test; he had clinical signs of spesis, but no bacteremia could be documented . Unlike the nitroblue tetrazolium test, the limulus amebocyte lysate test does not appear to be regularly positive in neonates . The sensitivity of the test in detection of endotoxemia associated with gram-negative spesis in the neonate remains to be determined in a large prospective study.

AJR Am J Roentgenol, 1976 Dec, 127(6), 989 - 96
Radiologic features of gram-negative pneumonias in the neutropenic patient; Zornoza J et al.; While gram-negative pneumonia is a frequent complication in immunosuppressed patients with malignant disease, the diagnosis is difficult to establish . Clinical and radiographic study of 195 episodes of pneumonia in 175 consecutive patients was undertaken . Chest radiographs were negative in 19% of the episodes, probably due to absence of alveolar inflammatory cell infiltrate . Radiographic patterns were classified as either alveolar or mixed alveolar and interstitial; no case of interstitial pattern alone was identified . A positive correlation was found between the neutrophil count and the presence of radiographic abnormalities . The different types of organisms could not be distinguished by the radiographic appearance . The importance of early diagnosis and prompt specific treatment is stressed.

Acta Pathol Microbiol Scand {B}, 1976 Dec, 84B(6), 395 - 400
Cross-reactions between Bordetella pertussis and twenty-eight other bacterial species; Holby N et al.; Cross-reactions between B . pertussis and 28 other bacterial species were studied by various quantitative immunoelectrophoretic methods . A sonicated B . pertussis antigen preparation and a corresponding pooled rabbit antiserum were used as reference system . Two of the B . pertussis antigens were cross-reactive with antigens from 17, respectively 19, other bacterial species mainly gram-negative species . As judged by absorption of antibodies, the degree of cross-reactivity of these B . pertussis antigens with antigens from other species was found to be in the range 25-30% . Antigens from B . parapertussis and B . bronchiseptica were found to cross-react very extensively with B . pertussis, and only 4, respectively 2, of the 44 antigens of the B . pertussis reference system could not be absorbed with antigens from these two Bordetella species.

J Infect Dis, 1976 Nov, 134 SUPPL, S286 - 90
Amikacin in treatment of infections caused by gram-negative bacteria resistant to gentamicin and other aminoglycosides: clinical and bacteriologic results; Daikos GK et al.; Amikacin (250 or 500 mg) was administered intramuscularly twice daily at 12-hr intervals to 34 patients with infections due to various gram-negative bacteria . Usually one or more aggravating factors were present, such as serious underlying pathology or therapy with steroids or immunosuppressants . Clinical isolates from most patients were resistant to gentamicin and other aminoglycosides . The overall response to therapy was excellent in 20 patients; in eight patients clinical response was good, but the organism persisted . Six patients showed some improvement without complete resolution of the infection or eradication of the causative organism . There were no complete clinical or bacteriologic failures . Ototoxicity was not observed in any patient . Levels of blood urea nitrogen and serum creatinine increased in two patients but returned to pretreatment levels within two weeks after therapy . No other adverse reactions were noted . Amikacin may replace gentamicin as initial therapy in serious gram-negative bacillary infections, particularly when resistance to gentamicin is a problem.

Surg Gynecol Obstet, 1976 Nov, 143(5), 720 - 4
Impaired glucose flow in burned patients with gram-negative sepsis; Wilmore DW et al.; Fifteen thermally injured patients with positive blood stream cultures for gram-negative organisms demonstrated a decreased mass flow of glucose through the glucose space when compared with 17 patients without sepsis studied at a comparable time after injury . Amino acid concentrations determined in ten burned patients with sepsis and nine burned patients without sepsis revealed an increase in the gluconeogenic precursors alanine, glycine, methionine and phenylalanine in those patients with sepsis . The administration of alanine consistently increased serum glucose in seven patients without sepsis but exerted no effect on glucose concentrations in six person with sepsis . These data, taken together, indicate that gram-negative sepsis in burned patients impairs the increased rate of glucose production and flow to peripheral tissue which characteristically occurs after thermal injury.

Acta Otolaryngol, 1976 Nov-Dec, 82(5-6), 451 - 4
Microscopy of tonsillar smears and sections in tonsillar gonorrhoea; Veien NK et al.; Microscopy of methylene-blue and Gram-stained smears from the tonsillar surface and an immunofluorescence (IF) test were carried out for 130 patients, 129 with genital and/or anal gonorrhoea, 27 of whom also had tonsillar gonorrhoea . One patient had only tonsillar gonorrhoea . 5 of the 28 patients with tonsillar gonorrhoea had acute tonsillitis and for these, agreement was found between culture, light microscopy and IF test, while only 5 of the remaining 23 patients had positive microscopy . Among the 102 patients who did not have tonsillar gonorrhoea a few false-positive light microscopies and IF tests were found . Microscopy of haematoxylin-eosin stained sections of 8 tonsils from 4 patients with recurrent tonsillitis and tonsillar gonorrhoea showed subacute tonsillitis . Methylene-blue and Gram-stained sections revealed gram-negative diplococci morphologically similar to gonococci . The bacteria were located in the superficial layers of the mucous membrane (frequently intracellularly in leukocytes) and occasionally in cellular debris in the crypts.

J Trauma, 1976 Oct, 16(10), 824 - 8
Increased dosage requirements of gentamicin in burn patients; Zaske DE et al.; In 14 burn patients treated for serious Gram-negative infections, the use of the previously recommended gentamicin dose of 5 mg/kg/day was found to result in subtherapeutic serum concentrations (peak concentration less than 4 mg/L) . The gentamicin half-life was found to be unusually short especially in the younger burn patients . Because of this shorter half-life the dosage interval was decreased to 4 hours to prevent extended periods of subtherapeutic serum concentrations . In addition, the daily dose of gentamicin was increased to achieve therapeutic peak concentration . Individualizing each patient's gentamicin regimen was thought to be instrumental in the favorable response of two patients with Pseudomonas ecthyma gangrenosum . The results of this study would strongly support the measurement of serum gentamicin levels in all burn patients with life-threatening infection . The gentamicin dosage regimen should then be individualized for each patient to provide optimal peak concentrations . In addition, patients demonstrating a short drug half-life may require a decreased dosage interval to prevent prolonged periods of sub-therapeutic concentrations.

Surgery, 1976 Oct, 80(4), 523 - 9
Delineation of critical factors in the treatment of pancreatic trauma; Heitsch RC et al.; An analysis of 100 patients sustaining multiple injury and pancreatic trauma was completed . Sixteen patients with penetrating injury died within the first 24 hours, 14 of whom died intraoperatively from major hepatic and/or retroperitoneal venous injury . Eighty-four patients survived long enough to permit evaluation of treatment . There was no statistically significant relationship between mode (p = 0.3) or anatomic area (p = 0.5) of injury and death . However, death was more common in the presence of duct injury (p less than 0.0001) . Thirty-nine patients were determined to have duct injury and 45 did not . These two groups were equivalent, with the exception of a higher incidence of concomitant bowel injury (p less than 0.05) in those with duct violation . Combined sump and Penrose drainage was found to be adequate treatment of both proximal and distal nonductal injury with no significant difference in mortality or morbidity rates (p = 0.5) . Resection of distal ductal injuries as opposed to drainage alone resulted in significantly lower morbidity and mortality rates (p less than 0.05), comparable to those of drained nonductal injuries . No conclusions could be made relevant to proximal duct injuries, except that drainage alone is inadequate . Seventeen (20 percent) of the 84 patients evaluated died . Pancreatic related mortality rate was 17 percent (14 patients) . Two of 23 patients with blunt injury (9 percent) and 12 of 61 patients with penetrating injury (20 percent died) . Gram-negative sepsis (82 percent) was the most common cause of death (p less than 0.01), and sepsis was correlated with the presence of pancreatic duct (p less than 0.0001) and bowel (p less than 0.001) injury.

Surg Gynecol Obstet, 1976 Oct, 143(4), 539 - 45
Kinin activation in the blood of patients with sepsis; O'Donnell TF Jr et al.; To determine whether or not kinin activation in the blood during severe infection with gram-negative bacteria may be related to hemodynamic abnormalities encountered, blood prekallikrein, kallikrein inhibitor and kinin values in 2l surgical patients with sepsis were compared with those in normotensive and hypotensive states . Because of reduced prekallikrein synthesis in patients with hepatic insufficiency, the normotensive and hypotensive groups were each subdivided according to the presence or absence of liver dysfunction, as indicated by elevated blood bilirubin, serum glutamic-oxalacetic transaminase or alkaline phosphatase levels . The mortality was zero in group 1, normotensive normal liver function; 80 per cent in group 2, hypotensive-normal liver function; 20 per cent in group 3, normotensive liver dysfunction, and 67 per cent in group 4, hypotensive liver dysfunction . Ultimately, the majority of deaths were due to respiratory failure . Although the blood prekallikrein level, was below normal in all groups and was significantly less in all patients with liver dysfunction, it was reduced proportionately in hypotensive patients to less than 30 per cent of the values noted in the two normotensive groups . This finding suggests prekallikrein consumption in the hypotensive groups to be the result of the process of activating kallikrein and bradykinin . This concept is supported by finding elevated kinin values, above 3 nanograms per milliliter of plasma, in only 28 per cent of those in group 1 and 12 per cent of those in group 3, while in the hypotensive patients, groups 2 and 4, the kinin level was elevated in 60 and 66 per cent, respectively.

J Bacteriol, 1976 Oct, 128(1), 325 - 36
Outer membrane of gram-negative bacteria . XII . Molecular-sieving function of cell wall; Decad GM et al.; The permeability function the cell wall of gram-negative bacteria such as Salmoenlla was investigated by producing cells with an expanded periplasmic volume, and incubating them with radioactive non-utilizable oligo- and polysaccharides or polyethylene glycols . To quantitative the extent of penetration of these hydrophilic compounds into the periplasm, the radioactivity of the cell pellet was determined after centrifugation . We found that only di- and trisaccharides could fully diffuse into the periplasm, whereas higher-molecular-weight saccharides were nonpenetrable . In addition, low-molecular-weight polyethylene glycols rapidly diffused across the cell wall . Kinetics experiments also showed that both sucrose and raffinose in the periplasm exchanged rapidly with sugars in the medium, even at 0 degrees C . These results suggest that the cell wall acts as a molecular sieve, with an exclusion limit near 550 to 650 daltons for saccharides . We also suggest that the diffusion of these hydrophilic compounds most likely occurs through water-filled pores present in the cell wall of gram-negative bacteria.

Acta Pathol Microbiol Scand {B}, 1976 Oct, 84B(5), 259 - 64
The bactericidal action of benzoic acid and sodium acetate on the gram-negative flora of dialysis fluid; Kolmos HJ; Benzoic acid in concentrations from 0.18 per cent and upwards exerted a bactericidal action on the gram-negative flora of dialysis fluid at pH 4.75 in vitro . At a concentration of 0.32 per cent, a reduction of 10(5) was obtained with 24 hours . Sulphonamide resistance did not affect the bactericidal action . The killing effect was hardly more than directly proportional to the concentration of benzoic acid . Increasing inoculum decreased the bactericidal effect . Therefore, benbzoic acid should not be used as an artificial kidney disinfectant when the concentration of microorganisms exceeded 10(5.5)/0.1 ml.

Zh Mikrobiol Epidemiol Immunobiol, 1976 Oct, (10), 88 - 94
{Isolation of various structural elements of gram-negative bacteria of the Bordetella genus and a study of their properties . II . Isolation of the cytoplasmic membrane fraction from the protoplasts of B . pertussis and a study of their chemical and enzymatic properties}; Gureeva AA et al.; A possibility of obtaining a fraction of cytoplasmic membranes maximally purified of the cell wall material was for the first time shown on a model of Gram negative bacteria (B . pertussis) . The results of electron microscopy, chemical analysis for the presence of the cell wall material--hexosamines, and of the activity of the respiratory chain enzymes served as control.

Med J Aust, 1976 Sep 25, 2(13), 481 - 4
Treatment with gentamicin monitored by serum antibiotic assay; Bell SM; Gentamicin is very widely accepted as the most effective antibiotic for treatment of a number of serious Gram-negative infections, but one disadvantage associated with its use is the risk of toxicity particularly affecting the eighth nerve . An account is given of eight years' experience with this antibiotic in which obvious ototoxicity was avoided in hospitalized patients in whom gentamicin treatment was monitored by assay of the residual amounts of antibiotic present in the serum . The relationship between accumulation of gentamicin in patients with renal impairment and ototoxicity is discussed . Attention is drawn also to the presence of an increased risk of ototoxicity in patients, particularly the elderly, in whom mild-to-moderate degrees of renal impairment may be overlooked . In such patients modification of the frequency of the dose of gentamicin is necessary and a schedule of treatment based on the results of assay of residual serum levels of gentamicin is given.

Med Klin, 1976 Sep 3, 71(36), 1429 - 33
{Lactic acidosis and biguanid therapy (author's transl)}; Thimme W et al.; Ten case histories of patients with lactic acidosis and biguanide therapy are presented . 6 patients received phenformin, 4 buformin . The symptomatology was characterized by somnolence or unconsciousness with hyperventilation, renal insufficiency, signs of infection occasionally with detection of gram negative rods and in later stages circulatory insufficiency with high central venous pressure . Glucose, insulin, bicarbonate, dialysis, antibiotics and katecholamines were the therapeutic measurements . It is the proposal of this communication to call attention again to the potential toxicity of biguanids which makes necessary the strict observation of contraindications.

Heart Lung, 1976 Sep-Oct, 5(5), 765 - 71
Sepsis--the Wayne State University Symposium--part III . Bacteremia and endotoxemia: a discussion of their roles in the pathophysiology of gram-negative sepsis; Sibbald WJ; Bacteremia, or the presence of live bacteria in the bloodstream, does not seem a prerequisite for septic shock . Indeed, only a small portion of all patients who sustain gram-negative bacteremia ever develop the shock syndrome . Endotoxin in the laboratory model is capable of producing a number of pathophysiological alterations which can partly explain the varied picture of septic shock seen in man . Endotoxin is released from gram-negative bacteria upon their death, and it probably acts as an antigen which reacts with antibody and subsequently activates the complement cascade . The resultant production of vasoactive polypeptides and release of histamine from mast cells might account for the increased vascular permeability and early hyperdynamic cardiovascular function seen in septic shock . These changes may also contribute to ultimate stagnation and pooling in the peripheral microcirculation . Endotoxin is a potent stimulus to the sympathoadrenal system which causes varying effects on the periphery . Continued catecholamine stimulation at the periphery may ultimately contribute to stagnant anoxia by an effect on pre- and postcapillary sphincters . Endotoxin, by itself, will not directly impair cardiac contractility, but evidence for depressed function implies an interaction of endotoxin with other biochemical systems, such as vasoactive polypeptides, to indirectly produce the observed effects . Expression of a hemodynamic model closely approximating human septic shock requires, in addition to a source of endotoxin, a focus of inflammation . Such a focus, in all probability, supplies some as yet unidentified factor(s) which help produce the observed increase in cardiac output . The Limulus test has confirmed the presence of endotoxemia in gram-negative shock and has raised questions about the contribution of gut flora to the propagation of the syndrome . An enterogenous source of endotoxin may also be important in patients in whom a source of inflammation is not readily observable . Gram-negative shock remains an important and grave clinical problem . Knowledge about the relative roles of endotoxin various foci of inflammation, and generation of vasoactive peptides is accumulating slowly . Hopefully, by creating a clearer understanding of the pathophysiology, such knowledge will ultimately result in further improvement in our efforts to prevent and treat this syndrome.

J Bacteriol, 1976 Sep, 127(3), 1529 - 37
Simple agarose gel electrophoretic method for the identification and characterization of plasmid deoxyribonucleic acid; Meyers JA et al.; Agarose gel electrophoresis may be employed effectively for the detection and preliminary characterization of plasmid deoxyribonucleic acid (DNA) present in clinical isolates and laboratory strains of gram-negative microorganisms . The method is sensitive and does not require radioisotopes or ultracentrifugation . The estimation of plasmid mass from the extent of DNA migration in gels compares favorably with results obtained by electron microscopy of plasmid DNA purified by equilibrium density centrifugation . The method has proved to be a useful tool for survey work and the epidemiological investigation of plasmid dissemination, as well as an important adjunct to the genetic analysis of plasmids.

J Exp Med, 1976 Sep 1, 144(3), 821 - 7
Endotoxin protein: a B-cell mitogen and polyclonal activator of C3H/HeJ lymphocytes; Sultzer BM et al.; A cell wall protein that is ordinarily complexed to the lipopolysaccharide endotoxin in gram-negative bacteria has been separated by the use of aqueous phenol . The protein is active as a B-cell mitogen and polyclonal activator of murine lymphocytes including the C3H/HeJ strain which is a nonresponder to lipoplysaccharide or lipid A.

J Bacteriol, 1976 Sep, 127(3), 1286 - 91
Membrane-bound respiratory of Spirillum itersonii; Dailey HA Jr; The membrane-bound respiratory system of the gram-negative bacterium Spirillum itersonii was investigated . It contains cytochromes b (558), c (550), and o (558) and beta-dihydro-nicotinamide adenine dinucleotide (NADH) and succinate oxidase activities under all growth conditions . It is also capable of producing D-lactate and alpha-glycerophosphate dehydrogenases when grown with lactate or glycerol as sole carbon source . Membrane-bound malate dehydrogenase was not detectable under any conditions, although there is high activity of soluble nicotinamide adenine dinucleotide: malate dehydrogenase . When grown with oxygen as the sole terminal electron acceptor, approximately 60% of the total b-type cytochrome is present as cytochrome o, whereas only 40% is present as cytochrome o in cells grown with nitrate in the presence of oxygen . Both NADH and succinate oxidase are inhibited by azide, cyanide, antimycin A, and 2-n-heptyl-4-hydroxyquinoline-N-oxidase at low concentrations . The ability of these inhibitors to completely inhibit oxidase activity at low concentrations and their effects upon the aerobic steady-state reduction levels of b- and c-type cytochromes as well as the aerobic steady-state reduction levels obtained with NADH, succinate, and ascorbate-dichlorophenolindophenol suggest that presence of an unbranched respiratory chain in S . itersonii with the order ubiquinone leads to b leads to c leads to c leads to oxygen.

Jpn J Antibiot, 1976 Sep, 29(9), 841 - 9
{The safety evaluation of fradiomycin-gramicidin S troches "Meiji" (author's transl)}; Yokota M et al.; The troches "Meiji" contain fradiomycin (neomycin), an aminoglycoside antibiotic, and gramicidin S, and are effective against gram-negative and -positive bacteria . In this paper the safety evaluation of the troches is reported . In this study male guinea pigs of Hartley strain were used, and fradiomycin (FRM) and gramicidin S (GRMN) were administered orally for 35 days consecutively except Sunday . The PRYER'S reflex test was carried out with frequency range of 10,000 approximately 15,000 Hz before, during and after the administration . After the last administration the animals underwent vital perfusion with physiological saline and then with Wittmack's fixative . Bilateral temporal bones were removed and fixed in the same fixative for several days . Using a conventional method, serial celloidin horinzontal sections were prepared and stained with hematoxyline-eosine to observe histopathological effect of the medicines on the organs of CORTI . The results were as follows: 1) There were no remarkable differences in the treated animals from the initial states . No animal died at all the doses tested . 2) All of the guinea pigs received 10 and 50 mg/kg of FRM and 4 and 20 mg/kg of GRMN for 35 days indicated positive pinna reflex in the extensive frequency range of 10,000 approximately 15,000 Hz . There was no remarkable damage in the organ of CORTI on histopathological examination . 3) It was concluded from these results that the troches are highly safe.

S Afr Med J, 1976 Aug 7, 50(34), 1318 - 22
{Pancytopenia and aplastic anemia: a retrospective study}; Retief FP et al.; During January 1971--June 1975 we examined 195 patients with pancytopenia . The cause was bone marrow failure in 67.7% of cases (classic aplastic anaemia in 11.3%) hypersplenism in 7.7%, massive blood transfusions in 1.5%, severe infections in 9.7% (Gram-negative in 3%), and various other conditions in 7.8% . Records were insufficient for diagnosis in 5.6% of cases . Analysis of the 22 patients with aplastic anaemia showed no apparent aetiology in 16 (72.7%), previous phenylbutazone ingestion in 2, and Fanconi-type anaemia in 4 of 7 children . One-year survival was 73.7%, 2-year survival 71.4%, 3-year survival 63.6% and 4-year survival 57.1% . Marrow-investigation of the 21 available samples showed that 6 were acellular, 11 hypocellular and 4 normocellular . All patients received at least temporary therapy with anabolic steroids but its effectivity could not be satisfactorily assessed . Five patients died within 7 months and 5 patients went into remission, needing no further therapy . The initial haematological features of the 5 patients who died were not significantly different from those of the rest of the patients.

Aust N Z J Surg, 1976 Aug, 46(3), 206 - 8
Traumatic retroperitoneal rupture of the duodenum; Vellar DJ et al.; A report of six cases of retroperitoneal rupture of the duodenum is presented . A high index of suspicion is necessary to enable early diagnosis to be made and appropriate treatment carried out . Early treatment will prevent the extremely rare, but at present uniformly fatal complication of gas gangrene . Plain X-ray and Gastrografin studies may help to elucidate the situation in particular cases, but are no substitute for repeated careful abdominal examination . It is suggested that large doses of penicillin be employed where possible in the management of these cases, in addition to such antibiotic therapy as may be expected to be effective against the usual Gram-negative bowel flora.

Br J Ind Med, 1976 Aug, 33(3), 175 - 80
Acute inhalation toxicity of cotton plant dusts; Rylander R et al.; The number of free lung-cells was studied in guinea-pigs after acute exposure to extracts of various cotton dusts . A good correlation was found between the increase in number of leucocytes in the airways and the number of Gram-negative bacteria in the different dusts . Experiments using the Shwartzmann reaction and the Limulus titration test demonstrated a relationship between the content of different endotoxins in the dusts and the pulmonary reaction . A model for the acute exposure effects after exposure to cotton dust is proposed.

Am J Med, 1976 Aug, 61(2), 295 - 7
A case of bilateral Escherichia coli endogenous endophthalmitis; Fanning WL et al.; The first reported case of bilateral endogenous endophthalmitis is presented and discussed with reference to pertinent literature . Diagnostic and therapeutic recommendations for suspected gram-negative endophthalmitis are presented and include: immediate paracentesis of the eye for gram stain and culture, systemic therapy with an antibiotic such as gentamicin and either subconjunctival, subtenon or intraocular injection of antibiotics . Despite these measures vision may be lost, and, as in this case, enucleation necessary.

Geriatrics, 1976 Jul, 31(7), 61 - 7
The value of endoscopic study of the bile ducts and the pancreas in the elderly; Wong KH et al.; Endoscopic retrograde cholangiopancreatography was performed in 46 patients age 60 or older with various suspected pancreaticobiliary or duodenal diseases . Thirty-one patients (67.4%) had diagnostically satisfactory opacification of a duct system . Pathologic conditions obstruction injection of the contrast medium prevented opacification in eight patients (17.4%) . Seven cannulations (15.2%) were technical failures . There was one complication, a Gram-negative septicemia that was successfully treated . The procedure is of value in the geriatric patient because it may provide preoperative evidence of pancreatic or biliary disease that cannot be diagnosed by any other technique . In jaundiced patients, identification of the site of obstruction facilites the surgical approach and thus reduces operating time . If the common bile duct is shown to be patent, the patient is spared exploratory surgery or a prolonged hospital stay for observation . Although a normal pancreatic duct does not exclude cancer of the pancreas, it should influence the physician to search for other explanations for abdomianl pain or weight loss befror proceeding with abdominal surgery.

Crit Care Med, 1976 Jul-Aug, 4(4), 186 - 92
The effect of PEEP on oxygenating capacity in acute respiratory failure with sepsis; Cotev S et al.; We report an evaluation of the effect of postive-end-expiratory-pressure (PEEP) on improving pulmonary oxygenating capacity in the adult respiratory distress syndrome (ARDS), when the latter is associated with generalized gram-negative sepsis . Fifty-seven cases treated in our RICU with PEEP ventilation (April 1972 to January 1975) were retrospectively reviewed . Oxygenating capacity improvement was evaluated in terms of the changes in PaO2/FIO2 and AaDO2 (FIO2 = 1.0) . Both the short term (2-3 hours from the initiation of PEEP) and the overall effects of PEEP were evaluated . A mean PEEP of 5.6 cm H2O initially increased PaO2/FIO2 by a mean of 94 torr and decreased AaDO2 (FIO2 = 1.0) by 105 torr in the 28 nonseptic patients . In the 29 septic patients, 5.1 cm H2O PEEP initially increased PaO2/FIO2 by 32 torr and decreased AsDO2 (FIO2 = 1.0) by 38 torr . The differences between the septic and nonseptic patients were statistically significant (P less than 0.001) . Likewise, the long-term effect of similar levels of PEEP was in increasing PaO2/FIO2 by 142 torr and by 75 torr in the nonseptic and septic patients, respectively . The final reduction in AaDO2 (FIO2 = 1.0) was 163 torr and 87 torr in the nonseptic and septic patients, respectively . These differences between patient groups were also statistically significant (P less than 0.02) . Mortality during PEEP was 15/29 and 3/28 in the septic and nonseptic patients, respectively . Overall mortality in the septic and nonseptic groups was 18/29 and 5/28, respectively . We conclude that ARDS with sepsis constitutes a more severe pulmonary insult than ARDS without sepsis, and/or that generalized sepsis creates a more prolonged pulmonary insult that makes it less amenable to PEEP . Thus, high levels of PEEP may be needed to treat ARDS associated with sepsis.

J Urol, 1976 Jul, 116(1), 1 - 7
Disseminated intravascular coagulation in the urologic patient; Pergament ML et al.; Gram-negative septicemia and metastatic prostatic cancer are frequent causes of disseminated intravascular coagulation . The clinical manifestations of this condition as well as the laboratory data vary considerably, depending on the patient's compensatory mechanisms in relation to the magnitude and duration of the thromboplastin or endotoxin release . Treatment centers primarily on correcting the underlying disorder . Secondly, deficient clotting factors and platelets should be replaced in the appropriate patient . Heparinization is often unnecessary . The use of drugs that inhibit the protective fibrinolytic mechanism is contraindicated in disseminated intravascular coagulation.

N Z Med J, 1976 Jun 23, 83(566), 441 - 2
Kasabach-Merritt syndrome with terminal gram negative infection; Ogle J et al.; A case of giant haemangioma with disseminated intravascular coagulation (Kasabach-Merritt) syndrome) is presented . Death occurred despite therapy and postmortem evidence of clinically unrecognised gram negative bacteraemia was seen.

JAMA, 1976 Jun 7, 235(23k0), 2513 - 6
Early debridement in pit viper bites; Glass TG Jr; From my observations of snakebite over the last 22 years and the studies I have done, several things are important: (1) Pit viper envenomation is a surgical emergency as is any disease in which gangrene of human tissue occurs . (2) Severe pit viper envenomation causes complex problems similar to those seen in Gram-negative septicemia, and they require complex methods of treatment . (3) Early surgical inspection of the snakebite wound is as essential as early appendectomy in appendicitis . Its results are as gratifying . (4) Present knowledge of anesthesia, coagulation problems, infections and antibiotics, blood gas changes, electrolytes and fluid therapy, and other advances in the surgical field allow the physician to treat severe pit viper envenomation by scientific means rather than by hocus-pocus . (5) Crippling from pit viper envenomation is caused by too little treatment, too much first aid, or both.

J Bacteriol, 1976 Jun, 126(3), 1316 - 25
Membranes of Rhodospirillum rubrum: isolation and physicochemical properties of membranes from aerobically grown cells; Collins ML et al.; Highly purified preparations of cytoplasmic and outer membrane were isolated from aerobically grown Rhodospirillum rubrum lysed by sequential treatment with lysozyme, ethylenediaminetetraacetate, and Brij 58 . The membranes were resolved and separated from other cellular constitutents by a combination of velocity and isopyknic sedimentation in sucrose density gradients . On the basis of their appearance in electron micrographs and their protein profiles in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, these preparations appear to be quite similar to those obtained from other gram-negative bacteria . The cytoplasmic membrane fraction contained the majority of the total membrane-bound succinic dehydrogenase activity and was 10-fold enriched in b- and c-type cytochrome with respect to the outer membrane . The latter fraction was characterized by a much greater carbohydrate content and the presence of arachidic acid, which is typical of R . rubrum lipopolysaccharide . Their protein fatty acid, and overall chemical compositions suggested that these preparations were freer from cross-contamination than those obtained from R . rubrum with currently available methods.

J Immunol, 1976 Jun, 116(6), 1652 - 5
Influence of colony type on susceptibility of gonococci to killing by human serum; McCutchan JA et al.; The virulence of gonococci is related to colony morphology and has been attributed to pili found only on the virulent types . Because complement-mediated serum killing is a major defense against other Gram-negative bacteria, we tested the resistance to normal human serum of virulent and avirulent types from two strains . Virulent types were more resistant than avirulent types . This stable, relative serum resistance of virulent colony types persisted during prolonged passage on agar . In addition, virulent types acquired complete resistance after exposure to serum which was rapidly lost during passage on agar . This acquired, complete resistance helps explain the observation that freshly isolated gonococci are resistant to their host's serum, but lose this resistance when passed on agar . The capacity to become resistant to the serum of newly infected patients may contribute to virulence of T1 and T2 gonococci.

Infect Immun, 1976 Jun, 13(6), 1749 - 60
In vitro studies on Rickettsia-host cell interactions: lag phase in intracellular growth cycle as a function of stage of growth of infecting Rickettsia prowazeki, with preliminary observations on inhibition of rickettsial uptake by host cell fragments; Wisseman CL Jr et al.; Two Rickettsia prowazeki seeds, an "early" seed in the logarithmic or exponential growth phase and a "late" seed in the stationary or possibly early decline phase, were prepared in chicken embryo (CE) cell cultures and compared with respect to morphology and infection cycle in CE cells in culture . Differences in size and ultrastructure of the organisms in the two seeds were similar to those seen in other gram-negative bacteria at comparable stages to growth . Vacuolar structures, rare in log-phase organisms, were common in stationary-phase organisms . Minute spherical forms reminiscent of minicells were seen in the stationary-phase preparations . In quantitative uptake experiments, organisms, typical in size and morphology of each preparation, had comparable capacity per plaque-forming unit to penetrate into CE cells in suspension when the seeds had been depleted of host cell membrane fragments and other debris . This suggests that host cell fragments, presumably of membrane origin, competitively inhibit rickettsial uptake by intact CE cells . Organisms of the log-phase organisms displayed a lag phase of about 7.5 h, during which they enlarged and increased in intensity of staining, before entering the log phase of growth.

MMW Munch Med Wochenschr, 1976 May 21, 118(21), 683 - 6
{The effect of modern therapy on the course of purulent meningitides (author's transl)}; Kunst H; No fundamental change in the pathogen spectrum of purulent meningitis in adults has occurred between 1951 and 1974 . It should be noted, however, that there is an increase in gram-negative pathogens . The lethality has in fact decreased during the period of observation, but the prognosis of pneumococcal meningitis has not been decisively improved by high dosage therapy with penicillin or ampicillin.

Ann Thorac Surg, 1976 May, 21(5), 442 - 4
Sternal osteomyelitis and mediastinitis after open-heart operation: pathogenesis and prevention; Weinstein RA et al.; Sternal osteomyelitis and mediastinitis caused by Pseudomonas cepacia developed in a patient undergoing coronary artery bypass two weeks after the operation . P . cepacia bacteremia from a contaminated pressure transducer had preceded and probably caused the chest infection . While other authors have suggested that postoperative sternal osteomyelitis and mediastinitis result from local wound contamination, this case suggests the importance of bacteremia as a cause of such gram-negative infections . Since patients undergoing open-heart operation are exposed to many sources of bacteremia, prevention of severe postoperative chest infections may depend in large part on careful preoperative evaluation of each patienc antibiotic regimens, and, as shown in this patient, on very thorough periodic review of equipment sterilization and intravascular monitoring practices.

J Thorac Cardiovasc Surg, 1976 May, 71(5), 800 - 6
Methylprednisolone . Pharmacologic doses in shock lung syndrome; Sladen A; Patients with shock lung syndrome were identified as those who developed acute respiratory failure after a profound episode of hypotension secondary to hemorrhagic, gram-negative, or endotoxic shock . In this study, each of the 10 patients with shock lung syndrome received methylprednisolone sodium succinate, 30 mg . per kilogram, intravenously every 6 hours for 48 hours . In addition, all patients were supported with mechanical ventilation, with or without positive end-expiratory pressure (PEEP) . Arterial oxygenation improved markedly, and pulmonary edema resolved in all patients . Nine were discharged from the hospital and one died subsequently of disseminated intravascular coagulation . This study demonstrated a significant improvement in mortality rate with repeated pharmacologic doses of methylprednisolone compared to previously reported mortality rates of 60 to 90 per cent in patients with shock lung syndrome treated without repeated pharmacologic doses of steroid therapy.

J Dairy Sci, 1976 May, 59(5), 823 - 7
Effect of psychrotrophic bacteria from raw milk on milk proteins and stability of milk proteins to ultrahigh temperature treatment; Adams DM et al.; The effects of psychrotroph growth in raw milk on proteins of mils and on the response of milk proteins to heat treatments with ultrahigh temperature were studied . Ten gram-negative psychrotrophs isolated from raw milk readily attacked raw milk proteins . Kappa- and beta-casein were most susceptible although some of the isolates also attacked the whey proteins . Detectable proteolysis did not require large psychrotroph populations . A 10 to 20% decrease in kappa-casein during 2 days at 5 C accompanied growth of one isolate to a population of only 10,000/ml . Growth of psychrotrophs in raw milk predisposed the proteins to deleterious effects of ultrahigh temperature treatments . Ultrahigh temperature treatment by direct steam injection had little effect on raw milk caseins and decreased alpha-lactalbumin and beta-lactoglobulin by 21% and 34%, respectively . Milk that had undergone proteolysis exhibited decreased detectable kappa-, beta-, and alphas-caseins and increased loss of beta-lactoglobulin as a result of ultrahigh temperature treatment . Milk suffering extensive kappa-casein degradation coagulated during ultrahigh temperature treatment . Coagulation during or shortly after heating increased with severity of heat treatment and size of psychrotroph population.

Ann Microbiol (Paris), 1976 May-Jun, 127(4), 487 - 91
{Distinction between beta-lactamases of immunotypes 1 or 2 using a new beta-lactam antbiotic (author's transl)}; Philippon A et al.; The resistance of Gram negative bacteria to ampicillin and carbenicillin is often associated with the presence of plasmidic transferable beta-lactamase (class III of Richmond and Sykes) . Using immunological and physico-chemical tests, two sub-classes have been identified . The sensitivity of Escherichia coli K12 with plasmid P111 (immunotype 1) or plasmid P453 (immunotype 2) determined by means of the minimal inhibitory concentrations, contrasts significantly with a new beta-lactam antibiotic, X-587 . Study of the kinetic constants (Km, Vmax) of the beta-lactamases confirms and explains this difference . Thus we have a simple and rapid method for differentiation of these 2 types of enzymes.

Am J Vet Res, 1976 May, 37(5), 513 - 6
Clinical pharmacology of oxolinic acid in young dairy calves; Ziv G; The in vitro sensitivity to oxolinic acid shown by pathogenic gram-negative bacterial isolates from young calves with diarrhea, pneumonia, and septicemia was investigated by the bute dilution method . Minimal bactericidal concentrations of the drug for 65.5% of the isolates were less than or equal to 1.56 mug/ml and for 90%, less than or equal to 6.25 mug/ml . Cross resistance between oxolinic acid and chloramphenicol, streptomycin, neomycin, colistin, ampicillin, gentamicin, and oxytetracycline was not observed . Oxolinic acid was orally administered to a group of calves at dose levels of 12.5 to 57.0 mg/kg, and sodium oxolinate was intramuscularly injected in another group of calves at dose levels of 12.5 and 20 mg/kg . In the 1st group, oxolinic acid was detected in blood serum 15 minutes later; peak serum concentrations averaged 25 mug/ml at 10 hours after treatment with 50 mg of the drug/kg and 3 mug/ml at 7 hours, with 12.5 mg of the drug/kg . In the 2nd group, the dose level of 20 mg of sodium oxolinate/kg resulted in mean peak serum concentration of 4 mug/ml, observed 1 hour after the drug was injected . The half-life of the drugs in serum was approximately 3.5 hours after they were orally or intramuscularly given . These investigations indicate that oxolinic acid could be used in the treatment of the common calf diseases.

Zh Mikrobiol Epidemiol Immunobiol, 1976 May, (5), 106 - 8
{New structural components detected in B . pertussis of different serotypes}; Pereverzev NA et al.; The authors present electron microscopic data on the study of morphological peculiarities of the strains belonging to various serological types . All the strains studied had a structure characteristic of Gram-negative bacteria . Two types intracellular membranes and intracytoplasmic crystal-like structures were revealed in a number of strains (No . 222, No . gZ353, No . 475), irrespective of the serological types . Dynamics of formation of the crystal-like structures in the bacterial cell was described . Marked changes occurred in the cells with the formation of crystal-like structures: cytoplasmic membrane became detached from the cell wall with the resultant contraction of the cytoplasm; large periplastic spaces formed.

Nouv Presse Med, 1976 Apr 23, 6(17), 1451 - 4
{Contribution of the "limulus test" to the diagnosis of endotoxemias and meningitis due to gram negative bacteria}; Clumeck N et al.; The "limulus test" may be used to detect the endotoxins of Gram negative organisms . Applied to the cerebrospinal fluid (79 specimens from 64 patients) it proved itself to be a very important contribution to the differential diagnosis of purulent meningitis (95% positive results, no false positives) . However it can be used on the plasma only in patients with shock of suspected endotoxic origin.

Can J Ophthalmol, 1976 Apr, 11(2), 115 - 21
Complications of corticosteroid therapy in presumptive temporal arteritis; Brownstein S et al.; Two elderly patients presented with symptoms suggestive of occult temporal arteritis . Both were treated with high doses of corticosteroids although subsequent biopsies of the arteries did not show evidence of arteritis . After 5 months of corticosteroid therapy, the first patient died of Gram-negative bacterial pneumonia and cystitis and disseminated intravascular coagulation . The second patient, six days after the biopsy, died of pneumococcal meningitis which had presumably spread from a focus about the left optic nerve . In the first patient, necropsy studies showed that the loss of vision appeared to be due to arteriosclerosis of the nutrient vessels of the optic nerve while in the second patient, the visual symptoms appeared to be due to a localized optic perineuritis . Corticosteroid therapy in elderly patients carries a high morbidity, as is illustrated by the first case and may mask unsuspected underlying disease processes, as presumably occurred in the second . We discuss the importance of obtaining a biopsy diagnostic of temporal arteritis in order to justify the continuation of corticosteroid therapy and the significance of a negative biopsy.

J Pediatr, 1976 Apr, 88(4 Pt . 1), 553 - 6
Cerebrospinal fluid endotoxin concentrations in gram-negative bacterial meningitis; Berman NS et al.; The limulus lysate assay was utilized to detect and quantitate endotoxin in cerebrospinal fluid from 232 patients with suspected meningitis . The assay was positive in initial specimens of CSF from all 86 patients with gram-negative bacterial meningitis and was uniformly negative in the remaining 146 patients with a variety of infectious and noninfectious processes . Endotoxin concentrations in initial specimens of CSF from patients with gram-negative meningitis ranged from 4 to 2,000 ng/ml . No correlation between initial CSF levels of endotoxin and initial clinical or laboratory variables of infection was noted . With antibiotic therapy, CSF concentrations of endotoxin fall rapidly to undetectable levels after five days.

Acta Virol, 1976 Apr, 20(2), 152 - 8
Characterization of an endotoxic lipopolysaccharide from Coxiella burnetii; Schramek S et al.; Phase I Coxiella burnetii antigen isolated by phenol extraction from purified suspensions of C . burnetii in phase I is a complex lipopolysaccharide (LPS) molecule containing substances typical of the bacterial LPS . Some endotoxic properties of this C . burnetii LPS, namely pyrogenicity and skin epinephrine reaction in rabbits, hypothermia in white rats, lethal effect on chicken embryos or on actinomycin-D-treated mice are similar to those of LPS isolated from other Gram-negative bacteria.

Schweiz Med Wochenschr, 1976 Mar 27, 106(13), 450 - 5
{Aminoglycoside antibiotics from a clinical viewpoint}; Luthy R; Indications, side effects, dosage and pharmacokinetic properties of gentamicin, tobramycin, sisomicin, kanamycin and amikacin are reviewed . Different aspects of aminoglycoside antibiotics in combination with beta-lactam antibiotics are briefly discussed . Finally, the indications for the assay of serum levels of aminoglycosides are listed . Gentamicin, tobramycin and sisomicin appear to be very similar with regard to in vitro performance, clinical efficacy and pharmacology . Ototoxic and nephrotoxic side effects are observed - in decreasing order of frequency - with sisomicin, gentamicin and tobramycin . The advantage of amikacin is its stability against enzymatic inactivation, which should make it an agent of first choice against aminoglycoside-resistant gram-negative bacteria.

J Urol, 1976 Mar, 115(3), 299 - 301
Renal abscess: a changing concept; Timmons JW et al.; Gram-negative organisms are not the most prevalent bacterial species found in renal abscesses . We postulate an ascending pathway for establishment of gram-negative abscesses . Voiding cystourethrography should be used in search of reflux . Surgical treatment remains the standard but early diagnosis may increase the effectiveness of parenteral antibiotics as definitive therapy.

J Bacteriol, 1976 Mar, 125(3), 1163 - 71
Change in quantity of lipids and cell size during intracytoplasmic membrane formation in Gluconobacter oxydans; Heefner DL et al.; Electron microscopy previously revealed that Gluconobacter oxydans differentiates by forming quantities of intracytoplasmic membranes at the end of exponential growth . It was also shown that the formation of these membranes appears concurrently with an increased rate of polyol oxidation . In the present study, exponential-phase cells devoid of intracytoplasmic membranes were harvested and the quantity of free lipid was determined . This quantity was compared with that extracted from cells harvested 4 and 16 h into the stationary phase that contained intracytoplasmic membranes . Cells harvested 4 and 16 h into the stationary phase contained 58 and 43% more free lipid per 100 mg of cell weight than found in undifferentiated exponential-phase cells . These same cultures were used to compare the quantity of lipid extracted per cell . This analysis revealed 89 and 142% more lipid per cell in 4 and 16 h stationary-phase cells . Further study demonstrated that cells increased in length and decreased in density with time after they entered the stationary phase . We estimated, however, that intracytoplasmic membrane development in G . oxydans is accompanied by a 57 to 62% increase in free-lipid that cannot be attributed to a change in cell size . These results suggest that the traditional expression of extracted lipid per milligram of cellular dry weight should not be used for comparative purposes during differentiation in gram-negative bacteria, unless it is first established that both cell size and cell density remain constant throughout differentiation.

J Natl Cancer Inst, 1976 Mar, 56(3), 541 - 6
Bacterial lipopolysaccharides as helper factors for Friend spleen focus-forming virus in mice; Steeves RA et al.; Lipopolysaccharide (LPS) from several gram-negative bacteria significantly increased the spleen focus-forming efficiency of N-topic Friend virus complex in mice by different mechanisms . One effect was associated with an increase in the number of availability of potential target cells for spleen focus-forming virus (SFFV) in fully susceptible mouse strains . This enhancing effect was optimal when LPS was injected 5 days before SFFV but was nil when LPS and SFFV were given at the same time . In contrast, in mice genetically resistant to the native helper virus of SFFV, the helper effect of LPS was optical when it was injected with SFFV and oil when given 5 days before or after the virus . LPS did not affect helper virus expression in a standard cell culture (XC) assay, but it did increase helper virus replication in mice . Mice lacking T cells or complete endogenous murine leukemia virus genomes were just as sensitive to the helper effects of LPS on SFFV expression as were control animals . Most of the helper activity of LPS is associated with the lipid A component . The mechanism of the helper effect of lipid A is still unknown, but hypotheses must take into account that this effect did not occur in fully susceptible hosts, but only in hosts carrying resistance alleles at either the FV-1 or the FV-2 locus.

Ann Sclavo, 1976 Mar-Apr, 18(2), 207 - 10
{Considerations on the bacterial flora in patients with infections of the respiratory tract and in immunosuppressed patients (author's transl)}; Lechi A et al.; Epidemiological features of pathogenic mycetes have been investigated with regard to their relationship with bacterial flora in patients with acute and chronic bronchopulmonary diseases and in immunosuppressed patients . Opportunistic mycetes (Candida and Aspergillus) have been found frequently associated with Gram-negative pathogenic bacteria . In immunosuppressed patients, the plenty of mycetic flora is related to the degree of immunoglobulin deficiency especially to the IgG and IgA levels.

J Immunol, 1976 Mar, 116(3), 595 - 9
A simple method for the determination of complement receptor-bearing mononuclear cells; Gelfand JA et al.; A simple method is described for the identification of mononuclear cells bearing the complement receptor . Gram-negative bacteria are directly fluoresceinated and then incubated in non-immune human serum, which leads to complement fixation via activation of the alternative complement pathway . Complement receptor-bearing mononuclear cells (CRMC) will form easily readable rosettes with these bacteria . The method requires no antibody preparation or purification, uses human serum rather than purified complement components or mouse serum, and gives results that correlate closely (r = 0.9015) with the EAC method of identifying CRMC . Furthermore, these indicator cells cannot bind to mononuclear cells via the E or IgG Fc receptors, eliminating this source of possible error . This method may be used for the identification of CRMC in suspension or frozen tissue sections.

Rev Epidemiol Sante Publique, 1976 Mar-Apr, 24(2), 165 - 84
{Sterilization by ionizing radiations (author's transl)}; Transy MJ et al.; The first part summarizes the general characteristics of ionizing radiations and their activity on microorganisms: lethal and mutagenic effects, sensitivity conditions . Different microbial species have different sensitivities: gram negative bacteria are more sensitive (D10 approximately 5-10 Krads), bacterial spores and viruses are more resistant (D10 approximately 1 Megarads) . The second part considers the main applications of radiosterilization: some are at present in full development (medical and surgical disposable equipment); others are still at the experimental stage . Practical aspects, determination of sterilizing doses and control of radiosterilization are also described.

Urology, 1976 Mar, 7(3), 256 - 9
Nonstaphylococcal bacteria in renal cortical abcess; Khashu BL et al.; Five cases of renal cortical abscess are presented, of which four yielded gram-negative pathogens . Along with a review of the recent literature, this suggests that nonstaphylococcal bacteria are a more common cause of this disease.

Biochem J, 1976 Feb 1, 153(2), 499 - 501
Activities of citrate synthase and other enzymes of Acetobacter xylinum in situ and in vitro; Swissa M et al.; The activities of a number of enzymes, extracted from Acetobacter xylinum, that are involved in carbohydrate metabolism may be accounted for in situ in permeabilized cells . The kinetic properties of citrate synthase and glycerokinase observed in vitro are also retained in situ . So is the regulatory sensitivity of these enzymes . Both in vitro and in situ, (a) citrate synthase, in contrast with the enzyme for other Gram-negative bacteria, is inhibited by ATP and is insensitive to NADH, and (b) glycerokinase is inhibited by fructose diphosphate and the ratio of its activities towards glycerol and dihydroxyacetone is the same.

Can J Microbiol, 1976 Feb, 22(2), 221 - 7
Microbial utilization of raw and hydrogenated shale oils; Westlake DW et al.; The biodegradability of raw and hydrogenated shale oils prepared by a retort process were studied under psychrophilic and mesophilic conditions . Changes in bacterial numbers and the chemical composition of the oils were monitored using a plate count and chromatographic techniques respectively . Raw shale oil was found to be relatively resistant to microbial attack whereas hydrogenated shale oil was readily utilized for microbial growth . Populations enriched on raw shale oil had a reduced ability to use hydrogenated shale oil under similar conditions . Gram-negative rods predominated in all enrichment populations . It is recommended that to facilitate clean up of shale oil spills, raw shale oil be reduced at the extraction site before transport.

J Clin Microbiol, 1976 Feb, 3(2), 137 - 42
Evaluation of the rapid decarboxylase and dihydrolase test for the differentiation of nonfermentative bacteria; Oberhofer TR et al.; A rapid medium for the detection of lysine and ornithine decarboxylase and arginine dihydrolase activity of 439 strains of gram-negative, nonfermenting bacteria was evaluated and compared with Moeller decarboxylase medium . Results were obtained in 4 to 24 h using the rapid medium, whereas Moeller medium often required extended (3 to 7 days) incubation . There was 100% agreement in the lysine tests with both media and almost 100% agreement in the ornithine tests . There was 91% agreement in the arginine tests, with the significance of discrepant results discussed . The sensitivity, specificity, and quick results obtained by the rapid test make it a suitable substitute for Moeller medium for the identication of gram-negative, nonfermenting bacteria.

Gastroenterology, 1976 Feb, 70(2), 248 - 53
Cholestatic effects of Escherichia coli endotoxin endotoxin on the isolated perfused rat liver; Utili R et al.; The effects of Escherichia coli endotoxin on the function of the ex vivo perfused rat liver were examined in order to investigate the possible role of circulating endotoxin in the pathogenesis of cholestatic jaundice observed in humans with gram-negative bacterial infections . Endotoxin led to a dose-dependent impairment of bile flow and of sulfobromophthalein (BSP) excretion . The demonstration that indocyanine green excretion was also significantly decreased by endotoxin suggests that the impaired dye excretion was not due to an inhibition of BSP conjugation in the hepatocyte . Analysis of the kinetic data suggested that the effects of endotoxin were on the excretory mechanisms of the hepatocyte . These effects did not seem attributable to endotoxin-mediated changes in perfusate flow since a mechanical reduction in perfusate flow caused no decrease in the excretion of bile or BSP . The results of the present study provide supportive evidence for the hypothesis that circulating endotoxin can adversely affect hepatic function and may contribute to the production of intrahepatic cholestasis seen during bacterial infection . Hepatocyte injury by endotoxin, as judged by the leakage of enzymes from hepatocyte suspensions or from the perfused rat liver, could not be demonstrated.

Biochem J, 1976 Feb 1, 153(2), 173 - 9
Factors affecting the activity of citrate synthase of Acetobacter xylinum and its possible regulatory role; Swissa M et al.; The citrate synthase activity of Acetobacter xylinum cells grown on glucose was the same as of cells grown on intermediates of the tricarboxylic acid cycle . The activity of citrate synthase in extracts is compatible with the overall rate of acetate oxidation in vivo . The enzyme was purified 47-fold from sonic extracts and its molecular weight was determined to be 280000 by gel filtration . It has an optimum activity at pH 8.4 . Reaction rates with the purified enzyme were hyperbolic functions of both acetyl-CoA and oxaloacetate . The Km for acetyl-CoA is 18 mum and that for oxaloacetate 8.7 mum . The enzyme is inhibited by ATP according to classical kinetic patterns . This inhibition is competitive with respect to acetyl-CoA (Ki = 0.9 mM) and non-competitive with respect to oxaloacetate . It is not affected by changes in pH and ionic strength and is not relieved by an excess of Mg2+ ions . Unlike other Gram-negative bacteria, the A . xylinum enzyme is not inhibited by NADH, but is inhibited by high concentrations of NADPH . The activity of the enzyme varies with energy charge in a manner consistent with its role in energy metabolism . It is suggested that the flux through the tricarboxylic acid cycle in A . xylinum is regulated by modulation of citrate synthase activity in response to the energy state of the cells.

Can J Microbiol, 1976 Feb, 22(2), 254 - 60
Characterization of a nitrogen-fixing bacterial strain from the roots of Digitaria sanguinalis; Barber LE et al.; Rates of nitrogen fixation of 3 to 10 g of N2 fixed per hectare per day were associated with root systems of Digitaria sanguinalis . A Gram-negative motile aerobic bacterial strain that was capable of N2 fixation was isolated from a washed root sample of one of these plants . Optimal growth and N2 fixation occurred at a pH of about 6.5, a temperature of 30-37 degrees C, and at a pO2 of about 0.01 atm . Increased rates of N2 fixation resulted when this strain was grown in mixed cultures with aerobic or facultative bacteria . Observations of cellular and cultural morphology and results of biochemical and physiological studies indicate that the isolate may be related to the Azotobacteraceae but that it is not identical with any of the members of this family . The importance of N2 fixation by this isolate in nature is unknown.

Sem Hop, 1976 Jan 9, 52(2), 91 - 7
{Bacterial infections and immunosuppression}; Armengaud M; Organ transplantation and the modern treatment of leukemia have created a new situation favouring bacterial infection under immunosuppressive drugs . Exceptionally, due to pathogenic bacteria, these infections are usually due to various germs normally considered as inoffensive saprophytes, which may thus reveal immune deficiency in the patient . This immune failure, which is very pronounced in treated leukemic patients and following transplantation, is on the contrary often localised at a precise level during common infections . Knowledge of these levels is thus essential for the clinician who, in all infected patients, should assess the state of the skin, mucosal and tissue and humoral defences whether specific or non-specific in the light of modern immunological data . Infection in the immunodepressed subject requires urget treatment . Antibiotics are not the only form of treatment, one should supervise, maintain and restore adequate immune levels . Furthermore, antibiotics alone, although they reduce the frequency, do not finally improve the mortality rate from gram-negative septicemia acquired in hospital.

Urologe A, 1976 Jan, 15(1), 30 - 2
{The dangers of antibiotic therapy in gram-negative pathogens (author's transl)}; Leisinger HJ; The increased occurrence of so-called gram-negative problem bacteria in urology compels us to use highly effective antibiotics in optimal doses . The danger of such therapy is illustrated by three cases in whom toxic damage was demonstrated following combined treatment with aminoglycosides and cephalosporins.

Res Vet Sci, 1976 Jan, 20(1), 16 - 23
Experimental respiratory disease in dogs due to Bordetella bronchiseptica; Thompson H et al.; Young dogs of two age groups, six weeks and 12 weeks respectively, were infected by aerosol with a strain of Bordetella bronchiseptica which had been isolated from a dog with pneumonia . Clinical respiratory disease characterised by coughing and in some cases purulent nasal discharge was induced in both groups of infected dogs and also in dogs kept in contact . B bronchiseptica was recovered from the nasal cavity, trachea, bronchi and lung parenchyma of infected and contact animals . At necropsy, masses of Gram-negative bacteria were found trapped in the cilia of the respiratory epithelia and there was an exudate containing neutrophils in the mucosae of the respiratory tract at all levels . A close similarity was noted between the lesions produced in the dog and those described in pertussis infection in man . Experimental respiratory disease in the dog due to B bronchiseptica may offer a model system for the study of the human disease.

Chemotherapy, 1976, 22(2), 75 - 83
Comparative assessment of cylacillin and ampicillin by experimental therapy and by serum level determinations in rats and mice; Freiesleben H et al.; Therapy of chronic E . coli pyelonephritis in rats was equally effective with cyclacillin and oral ampicillin, whereas intramuscular ampicillin had a significantly higher therapeutic activity than oral cyclacillin . Serum concentrations in rats and mice were consistently higher with cyclacillin than with ampicillin and showed great variations depending on the animal species . It was concluded that there is a good correlation between in vivo and in vitro activity of both antibiotics, provided that the serum levels are taken into consideration . On this basis it may be predicted that a man cyclacillin will exhibit lower therapeutic activity in gram-negative infections than ampicillin.

Med Pediatr Oncol, 1976, 2(4), 433 - 7
Emphysematous gastritis in a leukemic child; Rowen M et al.; Emphysematous gastritis associated with gram-negative sepsis is described in a leukemic child on chemotherapy and steroids . Bubbly-appearing air and thickening of the gastric wall were radiographically demonstrated . This is analogous to the demonstration of air within the thickened bowel wall in necrotizing enterocolitis, which is not unusual in seriously ill leukemic children . Gastric involvement has not been previously reported.

Int Arch Allergy Appl Immunol, 1976, 52(1-4), 136 - 44
Immune deposit nephritis in infectious mononucleosis; Andres GA et al.; A 22-year-old white male (L.V.) died of gram-negative septicemia complicating infectious mononucleosis (IM) that was associated with jaundice and oliguric renal failure . The kidney showed mesangial granular deposits of IgM and C3, mesangial electrondense deposits, and interstitial infiltrates of infiltrates of mononuclear cells, including atypical lymphocytes . Eluates obtained from kidney, spleen and liver contained Paul--Bunnell (PB) antibodies . Presence of PB antigens in these tissues was indicated by absorption of PB antibodies from IM sera, with the sediments resulting from tissue elutions . The IgM mesangial deposits were partially eluted with acid buffer at 56 degrees C and then reconstituted by incubation with IM sera or with immunoglobulins eluted from tissues of patient L.V . The presence in renal structures of PB antigens, IgM heterophile antibody, C3 and electron-dense deposits is consistent with the hypothesis that heterophile immune complexes were localized in the kidney and that they contribute in the pathogenisis of IM nephritis.

Microbios, 1976, 17(70), 213 - 20
Micro-organisms in the midgut of tsetse fly larvae; Roberts MJ et al.; Two types of micro-organisms were found in the midgut of Glossina morsitans larvae, a large Gram-negative bacterial rod and a small Gram-negative rickettsia-like micro-organism, although the occurrence of the rickettsial type is restricted . The location of these micro-organisms in a small area of the proventriculus of all three larval instars is discussed . The large micro-organisms resemble milk-gland bacteria, and further evidence is presented in support of a milk transmission hypothesis for these micro-organisms.

Folia Parasitol (Praha), 1976, 23(4), 301 - 7
First record of bacillary rickettsia-like organisms in European tick Dermacentor marginatus (Sulzer); Rehacek J et al.; Bacillary rickettsia-like organisms (BRLO) were found in the tick Dermacentor marginatus . They are gram-negative and differ from common bacteria and reckettsiae both in the cultivation conditions and morphology . BRLO are non-pathogenic for ticks and guinea pigs . In our studies they were isolated on half-engorged females of D . marginatus, on which they are still maintained.

Z Gastroenterol, 1976 Jan, 14(1), 14 - 23
{Endotoxinemia in liver cirrhosis}; Liehr H et al.; Endotoxins of gram-negative bacteria and of intestinal origin, insufficiently cleared by the hepatic reticulo-endothelial system are of an increasing interest within the pathogenesis of liver diseases . With purpose to obtain data concerning incidence and course of endotoxaemia in patients with liver cirrhosis an unselected group of these patients, sequentially admitted, was investigated by means of the Limulus-gelation test, regarded as most sensitive to endotoxins . At the admittance, 65% of the patients had endotoxaemia, further 14% developed endotoxaemia later . In total 79% of the patients investigated had endotoxaemia.---Bleeding from oesophageal varices was associated with endotoxaemia in 78%, functional renal impairment in 75%, consumption coagulopathy in 81%, encephalopathy in 77% and a pyrogen reaction in 82% of the patients . Regarding the Limulus assay, the dilution technique was more sensitive in detection of free endotoxaemia as opposed to the chloroform extract . It is concluded from the results that endotoxaemia in patients with liver cirrhosis is frequent and has to be viewed as relevant within the pathogeneses of chronic liver diseases.

Acta Chir Scand, 1976, 142(3), 191 - 200
Wound infections in clean and potentially contaminated surgery . Importance of bacterial and non-bacterial factors; Brote L; Postoperative wound infections in clean--and potentially contaminated surgery were studied with regard to demonstrable wound contamination and the occurrence of non-bacterial wound infection promoting factors . The incidence of demonstrable wound contamination in clean surgery was low, and observed rates of wound infection could not be related to differences in wound contamination, but to the occurrence of non-bacterial wound infection potentiating factors, e.g . implantation of foreign materials (osteosynthesis), cicatrical tissues or a compromized host . Corresponding studies in potentially contaminated surgery revealed a significantly higher incidence of wound contamination compared to clean surgery and a significant correlation between Gram negative wound contamination and rates of postoperative wound infections in certain types of gastrointestinal surgery . Patient factors, such as age or malignancy, did not influence the wound infection frequency when the incidence of wound contamination was taken into consideration.

Microbios, 1976, 16(64), 133 - 8
A comparison of three commercially available antiseptics against opportunist gram-negative pathogens; Caplin H et al.; Two test methods, a skin replica test and the Kelsey Sykes test have been used to compare the efficacy of three antiseptics against three Gram-negative micro-organisms in an attempt to select the most suitable . The results of both tests showed that an antiseptic containing added ethylenediaminetetraacetic acid was superior to the other two . The skin test showed that this superiority was apparent in both the immediate and the persistant bactericidal activity of the antiseptic towards all three Gram-negative micro-organisms.

Boll Ist Sieroter Milan, 1976, 55(6), 577 - 86
Platelet-endotoxin interaction: a review; Semeraro N et al.; The studies reviewed in the present manuscript outline the effects of bacterial endotoxins on human and animal platelets . In animals the endotoxin administration is followed by thrombocytopenia, presence of platelet aggregates in the blood vessels of several organs, appearance of appreciable quantities of serotonin in plasma and increased platelet factor 3 availability . These in vivo effects can readily be explained by the in vitro demonstration that endotoxin aggregates platelets, induces release of vasoactive amines and adenine nucleotides and activates platelet factor 3 . There is substantial evidence suggesting that the mechanism of this animal platelet-endotoxin interaction is immunological and complement dependent . In humans thrombocytopenia is frequently observed in endotoxemia as encountered during Gram-negative sepsis indicating that platelets are involved in some of the biological effects endotoxin . In vitro experiments demonstrate that several endotoxin preparations significantly enhance a weak procoagulant activity of human platelets different from platelet factor 3.

Scand J Gastroenterol, 1976, 11(8), 857 - 63
Portal venous and systemic endotoxaemia in patients without liver disease and systemic endotoxaemia in patients with cirrhosis; Prytz H et al.; Systemic endotoxaemia without evidence of gram-negative bacterial infection occurs in liver diseases in man . The endotoxaemia is probably due to impaired hepatic clearance of endotoxin absorbed from the gastrointestinal tract, but portal venous endotoxaemia has never been reported in man . By means of the limulus gelation test, portal venous blood from 21 patients without parenchymal liver disease and arterial blood from 21 patients without parenchymal liver disease and 31 patients with cirrhosis was examined for endotoxin . Portal venous endotoxaemia was found in 9 of 21 samples and systemic endotoxaemia was found in 2 of 21 samples from patients without liver disease . Systemic endotoxaemia in cirrhosis occurred with a frequency of 15/31 . No relationship to gram-negative bacteraemia was found . Leucocytosis was only seen in endotoxin-positive patients with cirrhosis . In cirrhosis higher levels of E . coli O antibodies were found in endotoxin-positive than in endotoxin-negative patients, supporting the view that the limulus gelation test specifically detects endotoxin (i.e . E . coli O antigen) . The study suggests that endotoxin is a normal constituent of portal venous blood in man . The normal human liver clears endotoxin from the portal venous blood . This effect is diminished in cirrhosis, most probably owing to decreased phagocytic function of the liver . The increased humoral immune response in cirrhosis may be related to spillover of endotoxin from the liver.

Z Allg Mikrobiol, 1976, 19(5), 385 - 94
{The anodically moving thermolabile antigen (ATA) of gram-negative bacteria: its molecular heterogeneity and its chemical composition}; Reissbrodt R et al.; The anodically-moving thermolabile antigen (ATA) of gram-negative bacteria represents a glycolipoprote in . In aqueous solution ATA exhibits heterogeneity of the molecular size, the range varying between 2.10(4) and 8.10(5) Daltons . In the molecular range between 5.10(4) and 8.10(5) all the molecular states give precipitation lines with the corresponding antisera . It could be shown that all the molecular states of ATA are formed by different aggregation of the same subunit with a molecular weight of approximatively 22000.

Zh Mikrobiol Epidemiol Immunobiol, 1976, (3), 86 - 8
{Interaction of different types of cells in production of anti-influenzal antibodies . IV . Stimulation of B-lymphocytes by several biologically active substances}; Ispolatova AV et al.; Various biologicall-active preparations such as extracts of syngenous and allogenous thymus and LP S of Gram negative bacteria were administered to sublethally irradiated mice ascertain a possibility of replacement of T-lymphocytes in the production of antibodies to influenza virus . It appeared that the function of T-lymphocytes participating in the production of antibodies to influenza virus in mice could be replaced by the administration to these animals of extracts of the syngenous and allogenous thymus and LP S of Gram negative bacteria.

Zh Mikrobiol Epidemiol Immunobiol, 1976, (3), 31 - 4
{Ultrastructure of B . pertussis using cryoultramicrotomy}; Pereverzev NA et al.; The authors pointed to a possibility of using the method of cryoultramicrotomy in studying the ultrastructure of Gram negative B . pertussis bacteria under the following conditions: a) fixationwith a 5% glutaraldehyde on cacodylate buffer (pH 7.5) for 30 min; b) replacement with a 30% dimethylsulfoxide in distilled water with a subsequent embedding of the material into tissue-tek; c) freezing in fluid nitrogen for 5 min; d) cutting at a temperature of -- 90% degrees C and at the temperature of glass knife of -- 40 degrees C, the knife angle of alpha = 45 degrees, beta = 6 degrees, and the cutting velocity of 5 mm/sec; e) placing of sections on copper grates covered with a 0.1% moulding membrane; d) contrasting with a 2% phosphotungstic acid queous solution (pH 7.5) for 5 sec and with a 3% uranil acetate on water for 5 min . Use of the mentioned method pemitted to detect structures localized in B . pertussis cytoplasm and also to trace the dynamics of their formation.

Science, 1975 Dec 19, 190(4220), 1226 - 8
Molecular vehicle properties of the broad host range plasmid RK2; Meyer R et al.; The pladmid RK2 is stably maintained in a broad range of gram-negative bacteria . The RK2 DNA has a single Eco RI restriction site . The insertion of a DNA fragment into this site does not interfere with either plasmid maintenance or self-transmissibility . Because RK2 has a broad host range, it should be useful for the construction in vitro of hybrid plasmid molecules capable of being established by conjugal transfer or transformation into many genera of gram-negative organisms.

N Engl J Med, 1975 Dec 11, 293(24), 1215 - 20
Aminoglycoside therapy of gram-negative bacillary meningitis; Kaiser AB et al.; The distribution of aminoglycosides in the cerebrospinal fluid (CSF) space was examined after intralumbar, intraventricular, and systemic administration during seven episodes of gram-negative bacillary meningitis . Six episodes were associated with culture proved ventriculitis . Parenteral therapy with gentamicin or tobramycin produced low concentrations of aminoglycoside (less than 1.0 mug/ml) in the lumbar, ventricular, and cisternal CSF . Administration of 5 to 10 mg of aminoglycoside into the lumbar intrathecal space resulted in 27-81 mug/ml in the lumbar CSF, but 0-2.1 mug/ml in the ventricular CSF . In contrast, aminoglycoside administered into the cerebral ventricles produced concentrations in the lumbar CSF of 11.5-27.5 mug/ml and ventricular CSF of 12.8-40 mug/ml . All six episodes treated via the ventricular route resulted in a bacteriologic cure . Intraventricular administration of aminoglycosides offers a reliable means of achieving high aminoglycoside concentrations throughout the subarachnoid space.

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