Haemophilus

Pediatr Infect Dis, 1985 Sep-Oct, 4(5), 472 - 5
Bacterial infection in the acquired immunodeficiency syndrome of children; Bernstein LJ et al.; We have followed 46 children with acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related complex . Twenty-six patients had at least one episode of serious bacterial infection . Twenty-seven episodes of sepsis were documented in 21 patients . Soft tissue infection was common in both the presence and the absence of documented bacteremia . Urinary tract infection commonly presented as worsening diarrhea in the absence of sepsis . Organisms commonly isolated included Streptococcus pneumoniae, Haemophilus influenzae and Salmonella sp . Staphylococcal infection accompanied episodes of cellulitis/abscess . Escherichia coli commonly caused urinary tract infection in the absence of sepsis . Enteric and nosocomial sepsis was limited to hospitalized, instrumented patients or to individuals who had received prior antibiotic therapy as outpatients . We conclude that bacterial infection causes serious morbidity in acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related complex and may be further evidence for altered humoral immunity in the disorder.

Pediatrie, 1985 Sep, 40(6), 451 - 9
{Neonatal Haemophilus influenzae infection . Apropos of 4 cases}; Garcia P et al.; Four cases of neonatal haemophilus influenzae have been reported in Intensive Care Unite of Timone's Hospital (Marseille) during a 2 year period . Three of the cases were due to non typable organism, one was a type III . Hemoculture was positive twice . None of the patients had meningitis . Clinically it was a neonatal septicemia without particularity . Prognosis is bad (50% mortality) . Several hypothesis have been proposed to explain the increase of the frequency of this neonatal infection . One of the major problem is the choice and the moment of prescription of antibiotherapy.

Antimicrob Agents Chemother, 1985 Sep, 28(3), 404 - 12
Influence of four modes of administration on penetration of aztreonam, cefuroxime, and ampicillin into interstitial fluid and fibrin clots and on in vivo efficacy against Haemophilus influenzae; Lavoie GY et al.; The extravascular penetration and bactericidal activity of aztreonam, cefuroxime, and ampicillin against beta-lactamase-positive and -negative Haemophilus influenzae strains were compared in a rabbit model . All groups of animals received an identical total dose of 100 mg of either antibiotic per kg given by four different intravenous modes of administration including a single large injection, four intermittent injections, a continuous infusion, and an injection followed by an infusion . Aztreonam had a higher degree of penetration in interstitial fluid and fibrin clots and was the most effective agent against beta-lactamase-positive and -negative H . influenzae . A single large injection of either drug resulted in significantly higher peak levels and higher initial area under the curves of concentrations of drugs in serum, the interstitial fluid, and fibrin clots than those by other modes of administration . Continuous infusions of antibiotics resulted in poor in vivo bactericidal activity . Other modes of administration exhibited good antibacterial activity within the first 6 h of the study . Thereafter, a single large injection of aztreonam resulted in a much more rapid killing of H . influenzae than that by injection of the other drugs . Aztreonam and cefuroxime showed good in vivo stability to beta-lactamase produced by H . influenzae while ampicillin was rapidly hydrolyzed in vivo.

J Infect, 1985 Sep, 11(2), 109 - 17
Haemophilus influenzae meningitis: a 5-year study in Ibadan, Nigeria; Nottidge VA; A total of 131 children with Haemophilus influenzae meningitis was studied over a period of 5 years . Of these, 92% and of those who died from this disease, 94% were 2 years old or less . Mortality was 26% and morbidity among the survivors was 36% . Most of the children studied were marasmic . The seasonal incidence is discussed since incidence peaked mainly in the dry season with a secondary peak in the rainy season . Haemoglobin (H6) electrophoresis, done in respect of a few children, showed a significantly higher incidence of Hb SS among patients than in the general population . This relationship is being studied further . The prognosis did not appear to be significantly affected by the choice between a combination of penicillin and chloramphenicol on the one hand and ampicillin alone on the other . A combination of penicillin and chloramphenicol is preferred to chloramphenicol alone in initiating therapy because 100% of strains of H . influenzae isolated in our laboratory are susceptible to chloramphenicol but only 75% of strains of Streptococcus pneumoniae are susceptible to this drug.

Eur J Pediatr, 1985 Sep, 144(3), 259 - 60
Fatal meningitis due to multi-resistant Haemophilus influenzae type b; Moulin D et al.; We report the case of a 3-month-old boy suffering from an acute bacterial meningitis due to a multi-resistant strain of Haemophilus influenzae type b . Also presented is our current strategy of treatment and chemoprophylaxis of Haemophilus influenzae meningitis in children.

J Pediatr, 1985 Sep, 107(3), 346 - 51
Immunization of 2-month-old infants with protein-coupled oligosaccharides derived from the capsule of Haemophilus influenzae type b; Anderson P et al.; We studied an immunogen consisting of oligosaccharides derived from Haemophilus influenzae type b capsular polysaccharide (PRP) coupled to CRM197, a nontoxic relative of diphtheria toxin . Subcutaneous injections were given to eight subjects at ages 2, 4, and 6 months, simultaneously with conventional diphtheria-tetanus-pertussis (DTP) vaccine . After the first immunization, total serum anti-PRP antibodies declined in all subjects, but increased in most after the second immunization and after the third in seven of seven subjects analyzed . In these seven infants, the geometric mean level at age 9 months (0.73 micrograms/ml) exceeded by at least 40 times the means of historical control groups given DTP only or DTP plus (uncoupled) PRP vaccine . An isotype-specific assay showed that IgM antibodies increased after the first immunization with the coupled vaccine in all eight infants . Against the background of declining maternal IgG antibody, elevations in IgG antibody were detected after the second or third immunization in six of the eight . These six at age 9 to 11 months were immunized with (uncoupled) PRP vaccine, and a "boost" in anti-PRP antibody, including an IgG component, was found.

J Infect Dis, 1985 Sep, 152(3), 485 - 92
Alteration of the cell wall of Haemophilus influenzae type b by transformation with cloned DNA: association with attenuated virulence; Zwahlen A et al.; A virulent strain of Haemophilus influenzae type b was used to construct a lambda library of chromosomal DNA in Charon 4, amplified in Escherichia coli . From this library a recombinant (I-69) phage was isolated that contained a 10.2-kilobase-pair fragment of DNA eliciting H . influenzae transformants whose colonies had a distinctive opaque phenotype . Compared with their H . influenzae parent strains the opaque I-69 transformants had two defined cell wall alterations: one in the lipopolysaccharide (greater mobility on sodium dodecyl sulfate-polyacrylamide gel electrophoresis) and one in the outer membrane proteins . The I-69 transformant of virulent type b strain Rd-/b+ had stable expression of type b capsule . In contrast to strain Rd-/b+, the Rd-/b+/I-69 transformant was serum sensitive in vitro and avirulent in vivo in rats . Thus the potential of H . influenzae type b organisms to cause invasive infection can be substantially attenuated by altering the expression of one or more genes that affect the cell wall composition.

Infect Immun, 1985 Sep, 49(3), 819 - 27
Coprecipitation of lipopolysaccharide and the 39,000-molecular-weight major outer membrane protein of Haemophilus influenzae type b by lipopolysaccharide-directed monoclonal antibody; Gulig PA et al.; The major outer membrane protein of Haemophilus influenzae type b (Hib) with an apparent molecular weight of 39,000 (39K) was purified from three different Hib strains and was shown to be free from detectable contamination with other proteins . However, these purified 39K protein preparations were found to contain Hib lipopolysaccharide (LPS) . Immunization of rats with these 39K protein preparations resulted in the production of antisera containing both 39K protein-directed and LPS-directed antibodies, as determined by Western blot analysis . The reactivity pattern of the LPS-directed serum antibodies with different Hib strains was identical to the reactivity of these Hib strains with a set of monoclonal antibodies (mabs) previously shown to immunoprecipitate the 39K protein in a radioimmunoprecipitation (RIP) system . Examination of the antigenic specificities of the 39K protein-immunoprecipitating mabs by using Western blot analysis showed that these mabs were actually directed against Hib LPS . RIP analysis of 125I-labeled Hib cells and 32P-labeled Hib cells revealed that the 39K protein and LPS existed as a complex in a RIP system, which resulted in the coprecipitation of both antigens by LPS-directed mabs . The interaction between LPS and the 39K protein was highly selective for this protein and did not involve other outer membrane proteins . The LPS/39K protein complex could be reconstituted by mixing purified LPS and purified 39K protein; it could also be reconstituted with 39K protein from one Hib strain and LPS from another Hib strain . These findings have necessitated the reinterpretation of previous studies involving the 39K protein-immunoprecipitating mabs . Of primary importance is the fact that the demonstrated immunoprotective ability of a 39K protein-immunoprecipitating mab (E . J . Hansen, S . M . Robertson, P . A . Gulig, C . F . Frisch, and E . J . Haanes, Lancet i:366-368, 1982) must now be regarded as evidence that antibody directed against Hib LPS can be protective against experimental Hib disease.

J Antimicrob Chemother, 1985 Sep, 16(3), 379 - 88
Pefloxacin in acute exacerbations of chronic bronchitis; Maesen FP et al.; Forty-three patients admitted to hospital with acute purulent exacerbations of chronic bronchitis were treated with 400 mg pefloxacin twice daily for ten days . The first 20 patients were given the first dose of the drug as a 60 min intravenous infusion . Serum and sputum concentrations of pefloxacin were measured microbiologically at intervals on the first treatment day and the sputum was cultured before, during, and after the course of pefloxacin . Two patients died from unrelated causes during the follow-up and one refused to continue treatment . All strains of Haemophilus influenzae and Branhamella catarrhalis were eradicated at end-of-treatment but eight strains of Streptococcus pneumoniae and three of Pseudomonas aeruginosa were cultured and the sputum remained purulent despite the pefloxacin . Peak serum concentrations averaged approximately 4.5 mg/l after the infusion and 5 mg/l on oral administration, the corresponding sputum concentrations being 3.8 and 4.6 mg/l, respectively . MICs for H . influenzae were 0.06 mg/l, or less . Mode MICs for the pre- and post-treatment strains of Str . pneumoniae were 4 and 16 mg/l, and the corresponding values for Ps . aeruginosa were 2 and 16 mg/l . The poor results in pseudomonas and pneumococcal infections could largely be explained by the degree of resistance among these organisms.

Pediatr Med Chir, 1985 Sep-Oct, 7(5), 693 - 700
{Antibiotic therapy in bronchopulmonary diseases in children}; Battistini A; With a wide-spectrum antibiotic the results obtained are not as satisfactory as those obtained with an aimed antibiotic therapy . It is for this reason that a physician must always keep up to date on all the antibiotics and their field of action . Apart the antituberculosis drugs we can currently count on three large families, the penicillins, the cephalosporins, the aminoglycosides, and on a polymorph group made up of erythromycin, chloramphenicol, vancomycin and trimethoprim-sulfamethoxazole (TMP-SMZ) . Of all the lung diseases, pneumoniae is without doubt the disease in which the choice of the antibiotic is most difficult and also most determinant . Using a scheme made up of three successive stages could be useful . In the first stage we exploit our knowledge of the prevalence of certain infectious agents in single age group . In the first two months of life gram negative rods, B and D Streptococci and Pneumococcus are the most probable agents, therefore an association of ampicillin and aminoglycoside is recommended . In the pre-school age we find a predominance of Haemophilus influenzae and Pneumococcus and therefore the antibiotic of choice is amoxicillin . In the school age there remains only the Pneumococcus so that the first choice antibiotic is now penicillin . All of this is true for those clinical situations that do not present peculiar characteristics . When this is not the case, we pass on to the second stage which consists of suspecting, on the basis of clinical and instrumental data, of a certain etiologic agent and in choosing an appropriate antibiotic.(ABSTRACT TRUNCATED AT 250 WORDS)

Tohoku J Exp Med, 1985 Sep, 147(1), 1 - 13
Clinical significance of respiratory infection caused by Branhamella catarrhalis with special reference to beta-lactamase producing strains; Nagatake T; I found the recent increase during the past eight years of the incidence of respiratory infections caused by Branhamella catarrhalis . Namely, I experienced 74 cases (93 episodes) of the respiratory infections; 5 pneumonia, 14 acute bronchitis, 1 lung abscess, 36 chronic bronchitis, 7 chronic bronchiolitis, 21 bronchiectasis and 9 chronic pulmonary emphysema with infection . In 65 of 93 infectious episodes, Branhamella catarrhalis was isolated as a pure culture and in 28 episodes it was associated with other organisms, 13 Haemophilus influenzae etc . In all the cases, a positive correlation was found between beneficial clinical results and disappearance of the organism from the sputum . Minimum inhibitory concentrations of the representative beta-lactam and other antibiotics against 104 strains were determined . All of these strains were obtained during last four years from 1980 to 1983 from the purulent sputa as the main pathogen . Annually, this organism has significantly acquired resistance to beta-lactams . By 1983, 74% of Branhamella catarrhalis isolated from the purulent sputa became a beta-lactamase producers . And the failure cases of Branhamella catarrhalis infections treated with beta-lactams have increased during the last two years . These results have clearly showed also the importance of Branhamella catarrhalis as the common pathogen for respiratory organ.

J Hosp Infect, 1985 Sep, 6(3), 281 - 4
Prophylaxis in bacterial meningitis; Davies AJ et al.; A questionnaire about the use of prophylactic antibiotics in bacterial meningitis was sent to medical officers of environmental health and microbiologists in England . There was broad agreement that prophylaxis should be offered to close contacts of acute meningitis due to Neisseria meningitidis but not to contacts of meningitis caused by Streptococcus pneumoniae . Overall 28% of those who replied said they could consider giving prophylaxis to contacts of meningitis due to Haemophilus influenzae . Rifampicin was the most common choice of drug . The indications for prophylaxis in bacterial meningitis are discussed.

Infect Immun, 1985 Sep, 49(3), 544 - 9
Purification and partial characterization of outer membrane proteins P5 and P6 from Haemophilus influenzae type b; Munson RS Jr et al.; The major outer membrane proteins of Haemophilus influenzae type b (Hib), designated P5 and P6 (R.S . Munson, Jr., J.L . Shenep, S.J . Barenkamp, and D.M . Granoff, J . Clin . Invest . 72:677-684, 1983), were purified to homogeneity and partially characterized . P5 was insoluble in octylglucoside-NaCl and could be extracted with 1% sodium dodecyl sulfate (SDS) in 20 mM phosphate (pH 7.5) . Solubilized P5 was further purified on hydroxylapatite in 0.1% SDS . The purified protein had an apparent molecular weight of 27,000 as determined by SDS-polyacrylamide gel electrophoresis after sample preparation at room temperature . The protein migrated with an apparent molecular weight of 35,000 after heating for 30 min at 100 degrees C in the presence of 10% beta-mercaptoethanol (beta ME) . Rabbit antisera prepared against the purified preparation immunoprecipitated solubilized protein P5 but had no protective activity in the infant rat bacteremic model . The SDS-insoluble residue was further extracted with 1% SDS-0.5 M NaCl-0.1% beta ME at 37 degrees C . A single outer membrane protein, designated P6, with an apparent molecular weight of 16,000, remained insoluble under these conditions . Antiserum prepared against this insoluble fraction contained antibodies which, after removal of anti-lipopolysaccharide antibody, immunoprecipitated P6 and protected infant rats challenged with Hib . Protein P6 could be released from the insoluble cell wall in the presence of SDS-NaCl-beta ME at 60 degrees C . Thus, proteins P5 and P6 could be purified from the cell envelope of Hib . Based on the results from infant rat passive protection experiments, antigens in the P6-cell wall fraction merit further investigation as possible vaccine components . In contrast, epitopes on protein P5 did not appear to elicit protective antibody.

Lancet, 1985 Aug 31, 2(8453), 468 - 71
Immunological paralysis to pneumococcal polysaccharide in man; Pichichero ME; A 9-month-old infant had severe pneumococcal meningitis and for the next two years showed immunological paralysis to the causal serotype . He remained normally responsive to a protein antigen (tetanus toxoid) and to polysaccharide antigens (Haemophilus influenzae type b capsule and pneumococcal capsule antigens other than the infecting/paralysing serotype) . By the fourth year of life the child was spontaneously producing antibody to the infecting/paralysing pneumococcal serotype, at which time rechallenge with the previously tolerising antigen resulted in a secondary response . The occurrence of pneumococcal immunological paralysis in man is therefore validated.

Lancet, 1985 Aug 24, 2(8452), 417 - 9
Uridine monophosphate kinase 3: a genetic marker for susceptibility to Haemophilus influenzae type B disease; Petersen GM et al.; Alaskan Eskimos have the highest known prevalence of invasive Haemophilus influenzae type b (Hib) disease, primarily meningitis, affecting 1-5% of all children in the first two years of life . In this population a polymorphic genetic variant of the pyrimidine pathway enzyme, uridine monophosphate kinase-3 (UMPK-3), was found to be positively associated with invasive Hib disease (relative risk 3.3) and a tendency towards a younger age at onset of illness . There was no difference in levels of naturally acquired Hib anticapsular antibody between persons with Hib disease and healthy controls in this population . This suggests that UMPK-3 may have a role in mediating non-humoral immunity to Hib . However, unlike other enzyme variants in the nucleoside synthesis pathways which result in syndromes of severe immunodeficiency, this gene appears to confer a more subtle disease susceptibility.

Vet Rec, 1985 Aug 17, 117(7), 143 - 7
Prevalence of pig herds affected by pleuropneumonia associated with Haemophilus pleuropneumoniae in eastern England; Brandreth SR et al.; A survey for the macroscopic lesions indicative of pneumonic infection in the pig with Haemophilus pleuropneumoniae was made in an abattoir in eastern England . A total of 78 herds located in 11 counties of eastern or central England were seen between December 1982 and August 1983 . Lesions were noted in the batches submitted by 44 (56 per cent) of the 78 herds . A further 16 herds (21 per cent) submitted batches containing pigs affected by pleurisy principally of the caudal lobes but without the pneumonic lesions . Lesions suggestive of enzootic pneumonia were also seen in 61 herds (78 per cent) . Circumstances restricted corroborative bacteriological examinations to 53 and serological examinations to 33 herds . Strains of H pleuropneumoniae (predominantly serotype 3 but also serotype 2) were isolated from 26 herds . These comprised 22 out of 42 (51 per cent) of those where typically affected plucks, or plucks with caudal lobe pleurisy, were encountered, and four out of 11 (36 per cent) in which there was either no observable thoracic disease or enzootic pneumonia only . Complement fixing antibodies to serotype 3 or 2 antigens occurred in 26 out of 33 herds (79 per cent) . These comprised 25 (83 per cent) of 30 herds with batches exhibiting either typical pulmonary lesions and, or, caudal lobe pleurisy and one of three herds without such lesions . Collectively these data indicate that herds containing pigs with pleuropneumonia are common at least in the more easterly parts of England and that H pleuropneumoniae, usually but not always associated with disease, is also widespread.

Int J Pediatr Otorhinolaryngol, 1985 Aug, 9(3), 249 - 56
Progressive hearing loss following Haemophilus influenzae meningitis; Silkes ED et al.; Loss of hearing is a sequelae of meningitis . This hearing loss has been known to fluctuate for as long as one year following the acute infection . This paper presents a case of an 11-year documented downward fluctuating hearing loss following Haemophilus influenzae meningitis . The case indicates that patients should be followed audiologically for years following meningitis . A review of the literature of hearing loss in meningitis is presented with special emphasis on cases in which the hearing loss fluctuated . The cases in the literature were usually not followed for more than one year . In this case of acquired hearing loss secondary to Haemophilus influenzae meningitis, the patient's hearing fluctuated over 11 years, in a downward progression . It is not clear what type of mechanism is involved in the ongoing damage to the cochlea that could account for this gradual fluctuation . It is suggested that as the possibility of long-term fluctuation exists, patients with meningitis should be monitored audiologically for many years.

Eur J Clin Microbiol, 1985 Aug, 4(4), 419 - 21
Meningitis and brain abscess due to Haemophilus paraphrophilus; Jensen KT et al.; A case of meningitis and brain abscess due to Haemophilus paraphrophilus in a patient with congenital heart disease is reported . The abscess communicated with the cerebral ventricular system . Although the infecting strain was found to be highly sensitive to ampicillin, the patient died despite appropriate antimicrobial therapy . Characteristics distinguishing Haemophilus paraphrophilus and related species are discussed.

J Clin Microbiol, 1985 Aug, 22(2), 192 - 8
Serum susceptibility of Haemophilus somnus from bovine clinical cases and carriers; Corbeil LB et al.; The serum susceptibility of 64 isolates of Haemophilus somnus from cattle was determined in a bactericidal assay with undiluted fresh or inactivated bovine serum with serial dilutions of bacterial suspension in RPMI 1640 medium . A total of 27 strains isolated from cattle with clinical disease (4 with thromboembolic meningoencephalitis, 13 with pneumonia, and 10 with reproductive failure) were compared with 35 strains from asymptomatic carriers (11 from the vagina and 24 from the prepuce) . Essentially, all clinical isolates were serum resistant, whereas approximately 25% of preputial isolates were serum susceptible, as judged after 1 h of incubation in serum; a majority of vaginal isolates showed delayed serum susceptibility . Lysozyme played no role in serum killing, and the alternative complement pathway played only a minor role . Iron saturation, however, appeared to impart greater serum resistance to serum-susceptible strains from the vagina and prepuce . Perhaps the serum-susceptible strains from carriers would be useful vaccine candidates, but resistant strains from carriers may be pathogenic.

J Bacteriol, 1985 Aug, 163(2), 769 - 73
Evidence for covalent attachment of phospholipid to the capsular polysaccharide of Haemophilus influenzae type b; Kuo JS et al.; Cells of Haemophilus influenzae type b were grown in a liquid medium containing {3H}palmitate or {14C}ribose or both for two generations of exponential growth . Radiolabeled type-specific capsular polysaccharide, polyribosyl ribitol phosphate (PRP), was purified from the culture supernatant by Cetavlon precipitation, ethanol fractionation, and hydroxylapatite and Sepharose 4B chromatography . The doubly labeled ( {3H}palmitate and {14C}ribose) PRP preparation was found to coelute in a single peak from a Sepharose 4B column, suggesting that both precursors were incorporated into the purified PRP . A singly labeled ( {3H}palmitate) purified PRP preparation was found to be quantitatively immune precipitated by human serum containing antibody against PRP . The radioactivity of this preparation could not be dissociated from PRP by treatment with chloroform-methanol, 6 M urea, sodium dodecyl sulfate, or Zwittergent . Only after acid, alkaline, or phospholipase A2 treatment of PRP labeled with {3H}palmitate or {3H}palmitate and {14C}ribose followed by chloroform-methanol extraction could most of the 3H-radioactivity be recovered in the organic phase . The chloroform-soluble acid-hydrolyzed or phospholipase A2-treated product was identified as palmitic acid after thin-layer chromatography . These results strongly suggest that a phospholipid moiety is covalently associated with the H . influenzae type b polysaccharide PRP.

J Clin Microbiol, 1985 Aug, 22(2), 225 - 8
Comparison of radiometric and conventional culture systems in detecting Haemophilus influenzae type b bacteremia in rats; Mitchell MJ et al.; To compare the efficiency of detecting Haemophilus influenzae type b bacteremia by the BACTEC radiometric system (RS; Johnston Laboratories, Inc., Towson, Md.) and a conventional Trypticase soy broth (BBL Microbiology Systems, Cockeysville, Md.) blood culture system (TSB), we developed an in vivo model of bacteremia in rats . After intravenous injection of 50 to 200 CFU into adult rats, there was a linear logarithmic increase in CFU per milliliter of rat blood during the first 10 h (r = 0.98), allowing accurate prediction of the level of bacteremia with time . Culture bottles were inoculated with 0.5 ml of blood obtained by cardiac puncture and processed as clinical samples in the microbiology laboratory with our RS and conventional protocols . We found the following . (i) The first detection of bacteremia by RS was similar to that by TSB if a Gram stain of the TSB was done on day 1 and was superior if that smear was omitted (P less than 0.01) . (ii) The detection times in both systems were comparable at different magnitudes of bacteremia (10(1) to 10(4) CFU/ml) . (iii) Supplementation of inoculated bottles with 2 ml of sterile rat blood interfered with Gram stain detection in TSB but resulted in increased 14CO2 production in RS . (iv) No difference in detection time was found between RS and TSB for four different clinical isolates . These studies show that, in a biologically relevant model, the detection of positive blood cultures for H . influenzae type b by RS was comparable to or better than detection by TSB when blood was processed analogously to clinical specimens.

Am J Dis Child, 1985 Aug, 139(8), 766 - 70
Erythromycin-sulfisoxazole vs amoxicillin in the treatment of acute otitis media in children . A double-blind, multiple-dose comparative study; Rodriguez WJ et al.; A fixed combination of erythromycin ethylsuccinate and sulfisoxazole acetyl (erythromycin-sulfa) was compared with amoxicillin for the treatment of acute otitis media (AOM) in children . Of 145 patients studied, 76 boys and 69 girls were compliant and were evaluated for drug efficacy (72 amoxicillin, 73 erythromycin-sulfa) . Based on otoscopic and tympanometric results, cure rates at ten to 14 days for AOM due to all organisms were 83% (63/72) for amoxicillin and 89% (65/73) for erythromycin-sulfa; for Haemophilus species (including mixed infections), they were 84% for amoxicillin (26/31) and 83% for erythromycin-sulfa (20/14) . Cure rates for ampicillin-resistant Haemophilus were 1/1 for amoxicillin and 7/8 (88%) for erythromycin-sulfa; one patient (12%) had persistent AOM at day 10 . Of the patients with AOM due to Streptococcus pneumoniae, 82% (29/35) in the amoxicillin-treated group and 98% (39/40) in the erythromycin-sulfa-treated group were cured . Patients with S pneumoniae as the initial infecting organism who were treated with amoxicillin had significantly more clinical recurrences then their erythromycin-sulfa-treated counterparts, 66% (8/12) vs 33% (3/9) . There was no difference between treatment groups in recurrence rates for patients with Haemophilus as the initial infecting organism . On the treatment day indicated, the following number of patients had middle ear effusion: by days 10 to 14, 38% (27/72) amoxicillin-treated patients and 48% (35/73) erythromycin-sulfa-treated patients; by day 28, 10% (7/71) amoxicillin-treated patients and 16% (11/70) erythromycin-sulfa-treated patients . There were no significant differences in adverse reactions . The erythromycin-sulfa combination is safe and effective treatment for AOM, including ampicillin-resistant Haemophilus.

Antimicrob Agents Chemother, 1985 Aug, 28(2), 343 - 6
In vitro antibacterial activity of SK&F 88070 against aerobic gram-positive and gram-negative cocci and Haemophilus influenzae; Gooch WM 3rd et al.; The inhibitory activity of SK&F 88070, a cephalosporin whose kinetic characteristics in animals suggest the possibility of once-daily doses, was determined against 345 clinical isolates, and results were compared with the activities of ceftizoxime, ceftriaxone, moxalactam, methicillin, and ampicillin . The spectrum of SK&F 88070 is similar to that of ceftizoxime.

Antimicrob Agents Chemother, 1985 Aug, 28(2), 320 - 5
Tolerance of Haemophilus influenzae to beta-lactam antibiotics; Bergeron MG et al.; Two hundred clinical isolates of Haemophilus influenzae were tested for tolerance (MBC/MIC greater than or equal to 32) to ampicillin and cefotaxime by broth dilution tests . Of 200 strains, 9 were tolerant to ampicillin, and 10 were tolerant to cefotaxime . Tolerant organisms were identified in both systemic and nonsystemic infections and among different biotypes and serotypes of H . influenzae . These tolerant isolates were compared with nontolerant isolates by broth dilution and killing curves with log-phase and stationary-phase inocula . Both tolerant and nontolerant bacteria in log phase were killed more rapidly by antibiotics than bacteria in stationary-phase growth . When tested against 11 different beta-lactams, several patterns of tolerance were observed . Six of the ten strains were tolerant to aztreonam, four were tolerant to cefuroxime, three were tolerant to cefamandole, and two were tolerant to cefoxitin . Strain H130 was tolerant to all beta-lactam antibiotics studied . None of the 10 tolerant H . influenzae isolates were tolerant to chloramphenicol, rifampin, tobramycin, ciprofloxacin, enoxacin, and trimethoprim-sulfamethoxazole . Although the clinical significance of tolerance is not determined, this study suggests that the bactericidal activity (MBC) of beta-lactam antibiotics against H . influenzae should be determined in cases of severe infections in which clinical response is slow or unsatisfactory.

Antimicrob Agents Chemother, 1985 Aug, 28(2), 176 - 80
Molecular characterization of chloramphenicol-resistant Haemophilus parainfluenzae and Haemophilus ducreyi; Roberts MC et al.; We examined chloramphenicol-resistant Haemophilus parainfluenzae and Haemophilus ducreyi strains isolated in various parts of the world . The antibiotic resistance determinants were located on conjugative plasmids in H . ducreyi, but were chromosomally located in H . parainfluenzae . Both species produced chloramphenicol acetyltransferases (CATs) that were sensitive to 5,5'-dithiobis(2-nitrobenzoic acid) like the enteric type II and Haemophilus influenzae CAT enzymes, but differed from these enzymes in elution patterns and subunit molecular weight . Southern blot analysis showed the H . parainfluenzae and H . ducreyi CAT genes were molecularly related to the enteric type II class as well as the H . influenzae CAT . Heterogeneity of the physiochemical properties of the CATs was observed; however, the data suggested that all three Haemophilus spp . have a common ancestral source for the CATs.

J Antimicrob Chemother, 1985 Aug, 16(2), 165 - 8
The comparative in-vitro activity of twelve 4-quinolone antimicrobials against Haemophilus ducreyi; Wall RA et al.; We have compared the in-vitro activity of 12 quinolone antibiotics against 50 recent isolates of Haemophilus ducreyi from The Gambia . While these isolates were relatively resistant to the parent compounds, the newly synthesized quinolones exerted significant activity against H . ducreyi . Ciprofloxacin and ofloxacin were the most active compounds (MIC90 0.03 mg/l).

Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi, 1985 Aug, 18(3), 184 - 9
Viability and growth of clinical isolates of Haemophilus influenzae; Flournoy DJ et al.; Studies were done on clinical isolates of Haemophilus influenzae to investigate viability and determine the effects of disc-agar diffusion (DAD) medium modification on antimicrobial susceptibility results . Most isolates were viable for two days in distilled water, up to a week on chocolate agar and months when frozen in skim milk at -70 degrees C . Differences in viability were not related to biotype, serotype, beta-lactamase production or site of isolation of isolates . Several medium modifications resulted in better growth of isolates for antimicrobial susceptibility testing by DAD, but the zone sizes of inhibition differed from those of the recommended medium.

J Infect Dis, 1985 Aug, 152(2), 307 - 14
Role of intravascular replication in the pathogenesis of experimental bacteremia due to Haemophilus influenzae type b; Rubin LG et al.; The potential role of extravascular and intravascular replication was studied in initiation of sustained bacteremia in experimental infection due to Haemophilus influenzae type b . When organs and fluid from rats were cultured after intranasal inoculation of the rats with H . influenzae type b, the organism was not recovered from any putative extravascular focus before development of bacteremia . To evaluate the potential contribution of intravascular replication in initiation of bacteremia due to H . influenzae type b, we obtained serial blood cultures after intravenous or intranasal inoculation . Bacterial counts increased exponentially immediately after intravenous and 12-18 hr after intranasal inoculation . Using the same model system, we observed bacteremia due to Streptococcus pneumoniae after intraperitoneal but not intravenous inoculation . After intraperitoneal inoculation, the magnitude of bacteremia in individual rats did not regularly increase exponentially over time . These findings are consistent with extravascular replication leading to bacteremia due to S . pneumoniae and efficient intravascular replication leading to sustained bacteremia due to H . influenzae type b.

Proc Natl Acad Sci U S A, 1985 Aug, 82(15), 5078 - 82
A population genetic framework for the study of invasive diseases caused by serotype b strains of Haemophilus influenzae; Musser JM et al.; One hundred seventy-seven isolates of serotype b Haemophilus influenzae recovered largely from children with invasive disease in the United States were characterized by the electrophoretic mobilities of 16 metabolic enzymes, the NaDodSO4/PAGE pattern of outer-membrane proteins (OMP), and biotype . Thirty-two distinctive multilocus genotypes (electrophoretic types, ETs) were distinguished on the basis of allele profiles at the enzyme loci . Twenty-eight OMP types and five biotypes were identified, but only 55 distinctive combinations of ET, OMP type, and biotype were represented . The strong nonrandom associations of characters and the recovery of isolates with identical properties in widely separated geographic regions and over a 40-year period suggest that the population structure of H . influenzae is basically clonal . Examination of nonserotype b isolates indicated that clones of serotype b are a restricted subset of the genotypes in the species as a whole . Currently, most of the invasive H . influenzae disease in the United States is caused by serotype b strains of two related ETs, and, more specifically, much of it is attributable to two subclones marked by OMP type . There is evidence that the frequency of the ET-1/OMP 1H/biotype I subclone has increased dramatically in the United States since the 1939-1954 period . The hypothesis that populations of H . influenzae are subject to marked temporal variation in clonal composition is supported by evidence of major differences in the genetic structure of populations in the United States and the Netherlands.

J Bacteriol, 1985 Aug, 163(2), 629 - 34
Reexamination of phenotypic defects in rec-1 and rec-2 mutants of Haemophilus influenzae Rd; Barouki R et al.; Radiolabeled donor DNA is efficiently taken up into competent H . influenzae Rd rec-2 mutant cells but does not undergo the rapid degradation observed in wild-type cells . Furthermore, donor label is not recovered in the chromosome even after 1 h . The donor DNA appears to remain in a protected state in a compartment that can be separated from the rest of the cell . We interpret this as a failure of the donor DNA to be translocated out of the transformasome . In contrast, rec-1 cells translocate labeled donor DNA normally . The donor label accumulates in the recipient chromosome, but, as expected for cells with a recombination defect, there is no preferential localization of the label in sites homologous to the donor DNA . In addition, we have observed two enzymatic activities that act on transformasome-associated DNA of rec-2 cells, an endonuclease which may play a role in the translocation of closed circular DNA and a phosphatase.

Antimicrob Agents Chemother, 1985 Aug, 28(2), 315 - 9
Plasmid-mediated aminoglycoside phosphotransferases in Haemophilus ducreyi; Sanson-le Pors MJ et al.; Three clinical isolates of Haemophilus ducreyi, representing at least two subtypes, were shown to be resistant to streptomycin and kanamycin . They also produced a beta-lactamase and chloramphenicol acetyltransferase and were resistant to tetracycline . In the three strains the resistance to both aminoglycoside antibiotics was encoded by a plasmid of ca . 4.7 kilobases which apparently did not carry ampicillin, chloramphenicol, or tetracycline resistance genes, as determined after transfer to Escherichia coli by transformation . Resistance to streptomycin and kanamycin was due to the presence of two aminoglycoside phosphotransferases (APH) . The enzyme modifying kanamycin was a 3',5"-APH of type I {APH(3',5")-I}, as inferred from its substrate profile and immunological cross-reactivity with the APH(3',5")-I encoded by the transposable element Tn903 . However, the APH(3',5")-I gene in H . ducreyi did not appear to be carried by Tn903.

J Gen Microbiol, 1985 Aug, 131 ( Pt 8), 2041 - 5
Studies of the 2':3'-cyclic nucleotide phosphodiesterase of Haemophilus influenzae; Anderson BM et al.; The 2':3'-cyclic nucleotide phosphodiesterase:3'-nucleotidase of Haemophilus influenzae was purified from a periplasmic preparation by affinity chromatographic techniques . The enzyme-catalysed hydrolysis of 2':3'-cyclic AMP to adenosine without accumulation of the intermediate substrate 3'-AMP was demonstrated by high performance liquid chromatography . Competitive inhibition of the enzyme by a variety of nucleosides and mononucleotides indicated the presence of either purine or pyrimidine bases to be essential for selective interactions with the enzyme, and confirmed the need for a 3'-position phosphate for the functioning of mononucleotides as substrates for the enzyme . The enzyme had a molecular weight of 79 000, was stable at low temperatures and was thermally denatured at temperatures above 50 degrees C.

Infect Immun, 1985 Aug, 49(2), 389 - 95
Genetics of spontaneous, high-frequency loss of b capsule expression in Haemophilus influenzae; Hoiseth SK et al.; We determined that the frequency of spontaneous capsule loss in Haemophilus influenzae type b is 0.1 to 0.3% . All of 10 independent capsule-deficient variants (derived from four different type b strains) were found to be missing an identical 9-kilobase EcoRI restriction fragment when probed with a cloned piece of DNA containing sequences known to be necessary for type b capsule expression . These results suggest the existence of a specific mechanism for shutting off type b capsule synthesis at a high frequency . Intranasal infection of infant rats showed that capsule loss occurred in vivo at frequencies comparable to those observed in vitro.

Genitourin Med, 1985 Aug, 61(4), 266 - 9
The microbial aetiology of genital ulcers in black men in Durban, South Africa; Coovadia YM et al.; The microbial aetiology of genital ulcers was assessed in 100 black men attending a sexually transmitted disease (STD) clinic in Durban, South Africa . Forty patients harboured Haemophilus ducreyi, one hepes simplex virus, and one Neisseria gonorrhoeae . Syphilis was diagnosed in 44 patients on the basis of dark field microscopy or positive syphilis serology test results, or both . Of these 44 patients, eight also harboured N ducreyi, one herpes simplex virus . Lymphogranuloma venereum was diagnosed in one patient . No cause of ulceration could be found in the remaining 16 patients.

J Med Microbiol, 1985 Aug, 20(1), 33 - 8
Serum factors for opsonisation of non-typable Haemophilus influenzae; Lever AM et al.; Neutrophil chemiluminescence was used to assess the opsonins required for phagocytosis of non-typable Haemophilus influenzae isolated from sputum samples of patients with hypogammaglobulinaemia . Immunoglobulin was the major opsonin, whereas complement was relatively unimportant . Evidence was found for a heat-labile opsonin other than complement that enhanced phagocytosis of these organisms . Tuftsin was shown to aid phagocytosis of H . influenzae without triggering chemiluminesence.

JAMA, 1985 Jul 26, 254(4), 509 - 14
Secondary Haemophilus influenzae type b in day-care facilities . Risk factors and prevention; Fleming DW et al.; The risk factors for acquisition of secondary day-care-associated Haemophilus influenzae type b disease were evaluated in a cohort of children in Seattle-King County, Washington; Atlanta; and the state of Oklahoma . During the study period, 129 primary cases were identified in children less than 5 years old who attended day-care facilities . In ten instances (8%), a secondary case occurred between one and 60 days after a primary case in the same classroom . Risk of secondary disease in classroom contacts was strongly age related: 2.4% in children 0 to 11 months old, 1.2% in children 12 to 23 months old, and 0.0% in children 24 to 59 months old . Controlling for age, children attending day-care more hours per week were more likely to transmit or acquire secondary disease . Risk of secondary disease for children in other classrooms at a center where a case had occurred was not significantly greater than risk of primary disease . Administration of rifampin to classroom contacts of a child with invasive H influenzae was effective in preventing secondary cases (95% confidence interval for rifampin efficacy, 47% to 100%) . For children 0 to 23 months old not treated with rifampin, risk of secondary disease was 2.7% (95% confidence interval, 1.1% to 4.3%), a risk approaching that reported in household contacts.

J Chromatogr, 1985 Jul 12, 342(1), 13 - 23
Differentiation between major species of the Actinobacillus--Haemophilus--Pasteurella group by gas chromatography of trifluoroacetic acid anhydride derivatives from whole-cell methanolysates; Brondz I et al.; A method based on whole-cell methanolysis and trifluoroacetic acid anhydride derivatization was developed for routine laboratory differentiation between isolates from the Actinobacillus--Haemophilus--Pasteurella group . All species, except Haemophilus aphrophilus, contained D-glycero-D-mannoheptose, although in varying concentrations . The distribution of this sugar could be used to distinguish H . aphrophilus from Actinobacillus actinomycetemcomitans, H . paraphrophilus, H . influenzae type b, Pasteurella haemolytica, P . multocida and P . ureae, and also H . influenzae type b from Pasteurellae . The pattern of major sugars in P . ureae and P . haemolytica resembled that of A . actinomycetemcomitans . Major fatty acids of the whole-cell methanolysates provided no basis of interspecies differentiation.

Avian Dis, 1985 Jul-Sep, 29(3), 601 - 12
Genetic and phenotypic comparison of three new avian Haemophilus-like taxa and of Haemophilus paragallinarum Biberstein and White 1969 with other members of the family Pasteurellaceae Pohl 1981; Piechulla K et al.; In the course of post-mortem bacteriological examinations, several previously unreported bacterial strains were isolated from budgerigars, pigeons, kestrels, and a goose . They have been separated into three distinct collectives according to their cultural, morphological, and biochemical characteristics . Since they require V factors, they were tentatively assigned to the genus Haemophilus Winslow et al . 1917 . This preliminary classification was checked by determination of guanine + cytosine contents and genome sizes and by DNA:DNA hybridization tests among reference strains of the three new avian taxa and recognized species of the family Pasteurellaceae Pohl 1981 . With the same methods, the genetic relationships of Haemophilus paragallinarum Biberstein and White 1969 within the family were determined . It could be shown that the three avian Haemophilus-like taxa have to be regarded as new species within the family Pasteurellaceae not affiliated with the recognized genera Actinobacillus, Haemophilus and Pasteurella . H . paragallinarum must be excluded from the genus Haemophilus because of its closer relationship to the actinobacilli . All strains investigated can be differentiated from each other and from recognized species of Pasteurellaceae using an appropriate set of biochemical tests.

Nord Vet Med, 1985 Jul-Aug, 37(4), 217 - 27
Haemophilus pleuropneumoniae (Actinobacillus pleuropneumoniae) . Serotypes 8, 3 and 6 . Serological response and cross immunity in pigs; Nielsen R; Immunity obtained by vaccination with Haemophilus pleuropneumoniae is type specific and protection will only be obtained against the serotype contained in the vaccine . Serotype 8 is closely related to serotypes 3 and 6 and the objective of the present study was therefore to examine if cross immunity between the three serotypes could be obtained at vaccination.

J Laryngol Otol, 1985 Jul, 99(7), 629 - 35
Bacteriological features and chemotherapy of adult acute purulent otitis media; Sugita R et al.; Eighty-eight patients from 16 to 79 years old, with acute purulent otitis media, were bacteriologically examined at the Otorhinolaryngology Department of a primary care hospital in Tokyo from July 1979 to May 1983 . Fifty-six patients underwent paracentesis, and 32 patients exhibited otorrhea due to previous spontaneous perforation of the tympanic membrane . Bacteriologic cultures revealed the presence of Streptococcus pneumoniae (62.5 per cent), including S . pneumoniae Type III (28.1 per cent), Haemophilus influenzae (10.5 per cent), Staphylococcus aureus (11.5 per cent), and Streptococcus pyogenes (7.3 per cent) . S . pneumoniae Type III had a notably high detection rate in patients from 50 to 79 years old (50-75 per cent) . Because Haemophilus influenzae was detected at a relatively high rate in patients of all ages, if can be considered as a major causative pathogen of AOM . In 44 patients, selected mainly from those who underwent paracentesis, a comparative study of bacteria found in middle ear fluid and naso-pharyngeal mucus revealed the same bacteria in 43 out of 44 cases (97.7 per cent), indicating the presence of bacterial infection through the auditory canal . Antibiotics were selected according to an Expected Efficacy Index (EEI), the antibiotic of first choice being Ampicillin or Cefaclor.

J Antimicrob Chemother, 1985 Jul, 16 Suppl A, 221 - 3
The in-vitro activity of pristinamycin against Haemophilus influenzae and Neisseria meningitidis; Lafaix C et al.; The in-vitro activity of erythromycin, oleandomycin, spiramycin, josamycin and pristinamycin was tested by a plate-dilution method against strains of Haemophilus influenzae and Neisseria meningitidis . Pristinamycin was the most active product tested with minimal inhibitory concentrations (MIC) ranging between 0.5 and 4 mg/l for H . influenzae (modal value 1 mg/l) and between 0.03 and 0.12 mg/l for N . meningitidis (modal value 0.06 mg/l).

Rev Infect Dis, 1985 Jul-Aug, 7 Suppl 3, S513 - 7
Therapy for lower respiratory tract infections with imipenem/cilastatin: a review of worldwide experience; Acar JF; The worldwide experience with imipenem/cilastatin as of November 7, 1983, in the intravenous therapy for severe and moderately severe infections of the lower respiratory tract is reviewed . Of 204 assessable patients treated in 77 studies conducted by 70 investigative groups (43 in the United States, 27 in other countries), 173 (85%) were cured of their infections or showed improvement . Imipenem was tested against 289 of 303 bacterial pathogens isolated before therapy, and 284 (98%) were found to be susceptible . Principal pathogens were Pseudomonas aeruginosa, Streptococcus pneumoniae, Klebsiella species, Haemophilus influenzae, Escherichia coli, and Staphylococcus aureus . A total of 76% of infecting pathogens were eradicated during therapy . Of 54 imipenem-susceptible infecting strains of P . aeruginosa, however, 57% were eradicated, 19% acquired resistance to imipenem, and 17% were replaced by new resistant strains of P . aeruginosa . Higher doses of imipenem/cilastatin and/or combined therapy with an aminoglycoside may improve these results . Imipenem/cilastatin compares well with the most active agents available for therapy for lower respiratory tract infections.

Clin Exp Immunol, 1985 Jul, 61(1), 183 - 8
Assessment of biological activity of immunoglobulin preparations by using opsonized micro-organisms to stimulate neutrophil chemiluminescence; Munro CS et al.; We have used the ability of opsonised bacteria to stimulate luminol enhanced chemiluminescence of human neutrophils to examine the opsonic capabilities of normal and hypogammaglobulinaemic sera for four common bacterial pathogens . Preparations of human immunoglobulin modified for i.v . use have then been compared with unmodified Cohn Fraction II for their effectiveness in improving opsonization when added to antibody deficient sera in vitro . Hypogammaglobulinaemic sera exhibited impaired opsonisation of Haemophilus influenzae, and severely antibody deficient sera also opsonized Streptococcus pneumoniae and Pseudomonas aeruginosa poorly . The opsonization of these organisms was improved by Cohn Fraction II, and by pH 4 and beta-propionolactone treated immunoglobulins, in descending order of effectiveness . Pepsin digested immunoglobulin was inactive, and in some cases impaired opsonic capacity . The opsonisation of Staphylococcus aureus by hypogammaglobulinaemic sera was near normal, and was not improved by any immunoglobulin . This technique, which assesses biological activity of immunoglobulin, is useful in comparing preparations, and may help to establish appropriate dosage and frequency for intravenous immunoglobulin replacement therapy.

Antimicrob Agents Chemother, 1985 Jul, 28(1), 146 - 8
Comparison of ceftazidime with cefamandole for therapy of community-acquired pneumonia; Engle JC et al.; Ceftazidime and cefamandole were compared in the treatment of pneumonia . The median MIC of ceftazidime for all Streptococcus pneumoniae (n = 17) and Haemophilus influenzae (n = 10) isolates was 0.125 microgram/ml . All other isolates were inhibited by less than 0.5 microgram of ceftazidime per ml, with the exception of a group B streptococcus (MIC = 4 micrograms/ml) . Satisfactory clinical responses were observed in 91% (20 of 22) of cefamandole-treated patients and 85% (17 of 20) of ceftazidime-treated patients.

J Infect, 1985 Jul, 11(1), 19 - 24
Recovery of blood-borne bacteria from human urine; Eng RH et al.; Recovery from the urine of organisms causing bacteraemia may depend on the bacterial species involved . The survival of the more common species of bacteria which cause bacteraemia was examined in human urine, serum and normal saline . All species survived well or grew in serum . Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus sanguis and group A streptococci were killed in all urine samples . The number of colony-forming units of Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus and group B streptococci either remained the same or increased in the urine, while the numbers of Escherichia coli and Klebsiella pneumoniae increased rapidly . These data suggest that the observed differences in recovery from urine of these bacterial species that cause bacteraemia are related to the viability of the species in human urine.

Acta Paediatr Scand, 1985 Jul, 74(4), 560 - 3
Cerebrospinal fluid C-reactive protein in the laboratory diagnosis of bacterial meningitis; Macfarlane DE et al.; Samples of cerebrospinal fluid from 112 cases of suspected meningitis were tested for the presence of C-reactive protein (CRP), using a qualitative and quantitative slide test . Bacterial meningitis was confirmed in 34 patients, based on CSF and blood culture results, and/or elevated CSF white blood cell (WBC) count and typical biochemical profile . There were 8 patients with early onset, and 3 who had received prior antimicrobial therapy among the 5 neonates, 23 children, and 6 adults with bacterial meningitis . Organisms recovered from CSF, and/or blood, included Haemophilus influenzae 14, Streptococcus pneumoniae 9, Streptococcus group B-5, Staphylococcus aureus 2, E . coli 2 and Klebsiella pneumoniae 1 . Slide test was positive for CRP in 33 cases, giving a sensitivity of 97% which compared favourably with elevated CSF protein 33%, decreased CFS glucose 64.7% CSF glucose/blood glucose less than 1/2, 85%, raised CSF WBC 38.2%, raised CSF PMN 61.7%, CSF culture positive 88.2%, and CSF gram-positive 82.5% . Slide test was positive for CRP in 1 of 78 CSF samples negative for bacterial meningitis, giving a specificity of 98% . It was concluded that testing of CSF for CRP is a simple, rapid and accurate method for the laboratory diagnosis of bacterial meningitis, which is particularly appropriate for areas lacking adequate laboratory facilities.

Pediatr Infect Dis, 1985 Jul-Aug, 4(4), 362 - 8
Prospective comparative trial of ceftriaxone vs . conventional therapy for treatment of bacterial meningitis in children; Barson WJ et al.; Fifty children with bacterial meningitis were prospectively evaluated in a randomized comparative trial of twice daily ceftriaxone with conventional ampicillin and chloramphenicol therapy . The groups were comparable in age, sex, days of illness before admission, severity of illness at admission, etiology and admission cerebrospinal fluid (CSF) parameters and bacterial colony counts . The pathogens were Haemophilus influenzae type b (34 beta-lactamase-negative, 8 beta-lactamase-positive); Streptococcus pneumoniae (4); Neisseria meningitidis (3); and Streptococcus agalactiae (1) . Initial CSF colony counts ranged from 2.5 X 10(2) to 1 X 10(10) colony-forming units/ml . In 44 children a lumbar puncture was repeated 10.5 to 18 hours after starting treatment; 16 of 24 (67%) ceftriaxone patients and 12 of 20 (60%) conventional therapy patients had sterile cultures . The reduction in the CSF bacterial colony counts (6.3 log10 colony-forming units/ml) was similar in both groups . Ceftriaxone CSF levels ranged from 1.0 to 8.0 micrograms/ml, representing a mean CSF penetration of 11.3% (range, 3.0 to 24.5%) of the simultaneous serum concentration . The median ceftriaxone bactericidal titer in CSF was 1:1024 compared with 1:4 achieved with conventional therapy . There were no significant differences in clinical responses or in frequency of complications, except for diarrhea which occurred in 59% of the ceftriaxone group and in 22% of the other (P less than 0.01) . Despite one H . influenzae type b relapse occurring in the ceftriaxone group, ceftriaxone appears to be safe and as effective as conventional therapy for bacterial meningitis in children older than 2 months of age.

Br J Dis Chest, 1985 Jul, 79(3), 258 - 61
A single dose of sulfametopyrazine versus 7 days of ampicillin in acute on chronic bronchitis; Anderson G et al.; Forty-two patients with acute on chronic bronchitis received in double-blind fashion either a single dose of 2 g of sulfametopyrazine or ampicillin 250 mg thrice daily for 7 days . There were no significant differences between treatments in the number of patients achieving white sputum, the time to do so, or the incidence of pathogens at the end of treatment . Blood levels of sulfametopyrazine between 8 and 24 hours and on the seventh day were likely to result in sputum concentration adequate to kill Haemophilus influenzae.

Laryngoscope, 1985 Jul, 95(7 Pt 1), 802 - 5
Meningitis and sensorineural hearing loss; Baldwin RL et al.; A 12 month retrospective study was conducted on 54 children discharged from the Children's Hospital, Birmingham, Alabama, with a diagnosis of generalized meningitis, a major cause of post-natal sensorineural hearing loss (SNHL) . Of these high risk patients, 38 or 70% had Haemophilus influenza meningitis and fully 40% of those children tested audiometrically were determined to have SNHL . Because there would appear to be an increase in SNHL in the post meningeal population, all children with a diagnosis of Haemophilus influenza, pneumococcal, or meningococcal meningitis should have an audiological workup, preferably prior to discharge from the hospital.

J Antimicrob Chemother, 1985 Jul, 16(1), 103 - 9
Trimethoprim sulphamoxole in the treatment of chancroid . Comparison of two single dose treatment regimens with a five day regimen; Dylewski J et al.; In a prospective blinded study, 135 men with genital ulcers culture positive for Haemophilus ducreyi, were randomized to one of three regimens . Two single dose regimens, either the combination of sulphamoxole 3200 mg/trimethoprim 640 mg or trimethoprim 700 mg alone were compared to a five day regimen of sulphamoxole 800 mg/trimethoprim 160 mg twice daily . All 31 treated with a five day regimen of trimethoprim sulphamoxole healed without further treatment . Of 27 patients treated with the single dose sulphamoxole/trimethoprim regimen, only 21 were cured and of 34 treated with trimethoprim alone, 25 responded . Antibacterial susceptibilities were performed on 31 H . ducreyi isolates . The laboratory susceptibility of these strains to trimethoprim correlated with the clinical response to the single agent . Trimethoprim alone in a dose of 700 mg or the combination of sulphamoxole (3200 mg) and trimethoprim (640 mg) is not satisfactory for the single dose treatment of genital ulcer disease . However, when prescribed for five days, sulphamoxole/trimethoprim is effective and compares favourably with other treatment regimens.

Int J Pediatr Otorhinolaryngol, 1985 Jul, 9(2), 101 - 14
Longitudinal studies of experimental otitis media with Haemophilus influenzae in the gerbil; Fulghum RS et al.; Haemophilus influenzae non-typable strain 119 was found to cause severe otitis media with sequellae when inoculated into the middle ear cavities of the Mongolian gerbil, Meriones unguiculatus . Acute inflammation was followed by the development of highly vascular granulation tissue and formation of new bone within the middle ear bulla . These changes persisted throughout the 14-week study in the untreated animals . The gerbil was variably susceptible to otitis media caused by inoculating 30-3000 bacterial cells and 100% susceptible to greater than 3000 cells . The susceptibility of the gerbil to common etiological agents of otitis media allows its use as an appropriate model of the disease.

J Clin Pathol, 1985 Jul, 38(7), 750 - 3
Distribution of biotypes of Haemophilus influenzae and H parainfluenzae in patients with cystic fibrosis; Watson KC et al.; One hundred and eighty eight isolates of Haemophilus influenzae and 187 isolates of H parainfluenzae from patients with cystic fibrosis, patients with respiratory infections but without cystic fibrosis, and patients with neither cystic fibrosis nor respiratory infections were biotyped . Biotype I of H influenzae were found significantly more often in patients with cystic fibrosis compared with those with normal respiratory tracts . On the other hand, biotype II strains of H influenzae were found less often in the cystic fibrosis group . Half of the biotype V strains produced beta-lactamase.

J Clin Invest, 1985 Jul, 76(1), 52 - 9
Immunogens consisting of oligosaccharides from the capsule of Haemophilus influenzae type b coupled to diphtheria toxoid or the toxin protein CRM197; Anderson P et al.; Haemophilus influenzae type b (Hib) capsular polysaccharide (PRP) was selectively hydrolyzed to reducing oligosaccharides, and the fraction containing 3-10 ribosylribitolphosphate repeating units (VS) was conjugated by reductive amination to diphtheria toxin (DTx), its nontoxic derivative CRM197 (Dcr), or diphtheria toxoid (DTd) . Conjugate DTx-VS retained approximately 1% of native toxicity, which was eliminated by treatment with formalin . Immunization of rabbits with the conjugates elicited antibody (Ab) to PRP and to DTx but not to a model for the linkage determinant . Human adults given single subcutaneous injections had rises in serum Ab to PRP and in bactericidal activity in vitro; the Ab protected infant rats challenged with Hib . Adults had rises also in Ab to DTd, and these Ab protected rabbits against DTx . A series of two injections of the conjugates Dcr-VS and DTd-VS was tested in infants beginning at 19-23 mo of age . Rises in anti-PRP Ab after the primary resembled the rises after PRP vaccine . In contrast to PRP, the conjugates elicited large rises after the secondary vaccinations and a substantial IgG component . Development of bactericidal activity paralleled the rises in anti-PRP Ab . Secondary rises after Dcr-VS were higher than after DTd-VS . In infants 12-16 mo of age, Dcr-VS (but not DTd-VS) elicited strong primary and secondary Ab responses that included IgG and bactericidal activity . Both conjugates produced consistent rises in Ab to DTd.

Pediatrics, 1985 Jul, 76(1), 26 - 8
Bacterial etiology of conjunctivitis-otitis media syndrome; Bodor FF et al.; Simultaneous cultures of conjunctivae and middle ear exudates were obtained from 20 episodes of the syndrome of purulent conjunctivitis and otitis media . Paired cultures from 18 episodes yielded Haemophilus influenzae at both sites . In two cases with prior topical antibacterial therapy of the conjunctivitis, H influenzae was isolated from the middle ear exudate only . Biotyping and outer membrane protein analysis of H influenzae isolates from five patients demonstrated that: conjunctival and middle ear strains were concordant in all cases, and all five patients had different strains . The conjunctivitis-otitis media syndrome is most often caused by strains of nontypable H influenzae of diverse clonotype.

J Infect Dis, 1985 Jul, 152(1), 4 - 13
Phagocytosis and killing of common bacterial pathogens of the lung by human alveolar macrophages; Jonsson S et al.; To investigate factors that determine susceptibility of the lungs to infection with common respiratory pathogens, we studied phagocytosis and killing of nontypable Haemophilus influenzae, H . influenzae type b, Streptococcus pneumoniae types III, VI, and XIV, an unencapsulated variant of S . pneumoniae type III, and Staphylococcus aureus Cowan I, by using human alveolar macrophages obtained by bronchoalveolar lavage of healthy nonsmokers . After opsonization with 10% pooled human serum, mean uptake (+/- standard deviation) of nontypable H . influenzae (67.5% +/- 15.0%), unencapsulated S . pneumoniae type III (71.2% +/- 4.8%) and S . aureus (79.1% +/- 10.2%) was significantly greater (P less than .01) than that of H . influenzae type b (40.1% +/- 15.0%), and S . pneumoniae types III (4.4% +/- 3.1%), VI (11.8% +/- 9.6%), or XIV (8.7% +/- 7.0%) . Nontypable H . influenzae was ingested after opsonization with much less pooled human serum than was H . influenzae type b, and uptake of encapsulated S . pneumoniae was not enhanced by as much as 80% pooled human serum . Intracellular killing of unencapsulated S . pneumoniae type III and nontypable H . influenzae was rapid and complete and corresponded to the degree of phagocytosis, but despite a high uptake, S . aureus were killed slowly and incompletely . The virulence of S . pneumoniae and H . influenzae as lung pathogens is thus determined jointly by encapsulation and the inadequate opsonizing effect of normal human serum, whereas that of S . aureus may be related to the organism's relative resistance to intracellular killing by alveolar macrophages.

J Pediatr, 1985 Jul, 107(1), 129 - 33
A prospective randomized comparison of cefotaxime vs ampicillin and chloramphenicol for bacterial meningitis in children; Jacobs RF et al.; Fifty children with bacterial meningitis were prospectively randomized to receive cefotaxime (50 mg/kg/dose every 6 hours) or ampicillin and chloramphenicol in standard doses . Twenty-three patients received cefotaxime and 27 received standard therapy . Bacterial isolates included: Haemophilus influenzae (29), Streptococcus pneumoniae (eight), Neisseria meningitidis (eight), group B streptococci (three), and Salmonella enteritidis (two) . Ten (34%) of the H . influenzae isolates were resistant to ampicillin, nine on the basis of beta-lactamase production . All strains were susceptible to cefotaxime . Clinical cure rates for the cefotaxime (100%) and standard therapy (96%) groups were similar; survival without detectable sequelae was similar, at 78% and 77%, respectively . The duration of therapy, 11.1 +/- 2.4 days (range 10 to 21 days) vs 11.9 +/- 3.9 days (range 10 to 21 days), and days to defervescence, 4.7 +/- 2.6 days (range 1 to 14 days) vs 5.6 +/- 2.9 days (range 2 to 17 days), were similar in the cefotaxime and standard therapy groups, respectively . No adverse drug reactions or side effects were noted in either group . Cefotaxime was found to be as safe and effective as standard therapy for the treatment of bacterial meningitis in children.

Pediatr Infect Dis, 1985 Jul-Aug, 4(4), 379 - 82
Increased susceptibility to infection in hypothermic children: possible role of acquired neutrophil dysfunction; Clardy CW et al.; The addition of hypothermia to regimens to control cerebral edema in children at our institution has been associated with a substantial incidence of infectious complications . Of the 13 children maintained at 30 degrees C to prevent cerebral edema, 3 developed Haemophilus influenzae pneumonia and 2 developed Streptococcus pneumoniae sepsis (one with pneumonia) . The importance of neutrophil (PMN) function for elimination of bacterial pathogens prompted in vitro studies of PMN function at clinically attainable hypothermic temperatures . Neutrophils at 30 degrees C had significantly less ability to migrate towards a chemotactic stimulus (45 +/- 10% inhibition; P less than 0.02), to ingest staphylococci (22 +/- 5% inhibition; P less than 0.01) and to be metabolically activated as measured by superoxide production (35 +/- 10% inhibition; P less than 0.01) or by chemiluminescence (18 +/- 8% inhibition; P less than 0.05) . These in vitro findings support the clinical observation that persons with decreased body temperature may be at an increased risk for bacterial infections secondary to PMN dysfunction.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Jul, (7), 10 - 3
{IgA protease activity of microbes in the genus Bordetella}; Shakirova RG et al.; Monoclonal IgA paraproteins of subclasses 1 and 2, isolated from the sera of myeloma patients, were incubated for 4, 24, 48 and 72 hours with B . pertussis, B . parapertussis, B . bronchiseptica cultures, as well as Haemophilus influenzae strain . The fragmentation of IgA was studied by immunielectrophoresis with antisera to alpha-chain, to Fab alpha + Fc alpha, to Fab alpha and with antisera to light chains corresponding to the type of paraprotein . B . pertussis and B . parapertussis were found to have subclass-unspecific IgA protease which splitted off a cathode fragment, similar to Fab-fragment and, probably, corresponding to the variable domain of alpha-chain (Fv), after 48-hour incubation . Similar IgA protease was detected in H . influenzae, found to have classical IgA1 protease as well . All Bordetella species under study splitted off anode components from IgA paraproteins of both subclasses . These components, containing the determinants of heavy and light IgA chains, were either IgA - alpha I-antitrypsin complexes or some IgA fragments with high electrophoretic motility . None of the strains under study splitted monoclonal IgG.

Infect Immun, 1985 Jul, 49(1), 98 - 103
Frequency and properties of naturally occurring adherent piliated strains of Haemophilus influenzae type b; Mason EO Jr et al.; We found that 41 of 75 (55%) children with Haemophilus influenzae type b disease (70 cases of meningitis, 2 of cellulitis, 2 of septic arthritis, and 1 of epiglottitis) and 2 of 120 (1.7%) children with upper respiratory infection were colonized with H . influenzae type b in the nasopharynx (NP) . Of these 43 NP strains from children with systemic H . influenzae type b disease, 7 (16%) adhered to human buccal epithelial cells . The strains isolated from the systemic site of all children, including children from whose NP adherent bacteria were isolated, did not adhere to buccal epithelial cells in vitro . Each adherent NP strain had biotype (I), serotype (b), and antibiotic susceptibility (sensitive) similar to that of the corresponding nonadherent systemic isolate . With one exception, all NP-systemic pairs had similar major outer membrane proteins . Six of the seven NP strains had a protein band in the whole cell lysate preparation with a molecular weight between 22,000 and 23,000, which could not be seen in the nonadherent cerebrospinal fluid strains . Electron micrographs of all adherent strains showed that more than 95% of the organisms examined were highly piliated, whereas the nonadherent strains were not piliated . All piliated strains agglutinated human erythrocytes . Adherence to buccal epithelial cells and agglutination of erythrocytes could not be blocked by mannose or alpha-methyl-D-mannoside . We speculate that piliation is not important for NP colonization by H . influenzae type b and that the loss of pili may be required for host invasion.

JAMA, 1985 Jun 28, 253(24), 3559 - 63
Seven days of ceftriaxone therapy is as effective as ten days' treatment for bacterial meningitis; Lin TY et al.; Seventy-nine children were enrolled in a study to compare seven vs ten days of ceftriaxone therapy for bacterial meningitis . On the basis of a computer-generated list of therapy assignments, 35 children with Haemophilus, pneumococcal, or group B streptococcal meningitis each were assigned to seven- or ten-day treatment regimens; nine children with meningococcal meningitis received seven days of therapy . The population characteristics and etiologic agents were similar for the two treatment groups, as were also the findings on examination and culture of cerebrospinal fluid at completion of therapy . There were no significant differences in the frequency and types of neurological complications between the two treatment groups; four patients in each group had two or more neurological abnormalities . The rates of nosocomial infections and prolonged and secondary fever were similar in those who received seven days of therapy compared with patients treated for the conventional ten days . Diarrhea occurred in 44% of those receiving the drug . Patients treated with the seven-day regimen were discharged from the hospital approximately two days earlier than those with the ten-day regimen.

N Z Med J, 1985 Jun 26, 98(781), 494 - 7
Treatment of pneumonia with imipenem/cilastatin; Beasley CR et al.; This pilot study assessed the efficacy, safety and tolerance of intravenously administered imipenem/cilastatin in the treatment of adults hospitalised with community acquired pneumonia . Thirteen patients were treated with 500 mg imipenem and 500 mg cilastatin eight hourly for a minimum of five days . Eleven patients (85%) had a clinical cure; (Legionella pneumophila was the pathogen in four, Streptococcus pneumoniae in one, Branhamella catarrhalis in one, no pathogen identified in five) . One patient had a partial response (Staphylococcus aureus); and one patient was a treatment failure (Haemophilus influenzae and Klebsiella ozaenae) . Clinical and laboratory side effects were mild, reversible and did not require treatment to be stopped . We conclude that the combination of imipenem and cilastatin was effective as a single agent in the treatment of the majority of these patients with hospital referred community acquired pneumonia.

J S Afr Vet Assoc, 1985 Jun, 56(2), 97 - 8
Thromboembolic meningoencephalitis diagnosed in Natal; Kitching JP et al.; Nine feedlot cattle showed clinical signs consistent with those expected in thromboembolic meningoencephalitis . These signs included pyrexia, ataxia, posterior paresis, paralysis and coma . Brown necrotic foci with haemorrhagic borders were observed in the brains of three animals that had died . In these foci vasculitis, thrombosis, infarction and neutrophil infiltration were observed during microscopical examination . Haemophilus somnus was isolated in pure culture from the brains.

Eur J Clin Microbiol, 1985 Jun, 4(3), 268 - 72
Etiology of community-acquired pneumonia in patients requiring hospitalization; Berntsson E et al.; The etiology of community-acquired pneumonia was studied in 127 patients with roentgenologically verified pneumonia who needed hospitalization . Etiology was determined on the basis of a positive blood culture and/or a significant antibody titer increase . Streptococcus pneumoniae was the probable etiological agent in 69 patients, nontypeable Haemophilus influenzae in five patients, Streptococcus pyogenes in two patients, and Legionella pneumophila and Staphylococcus aureus in one patient each . Evidence of Mycoplasma pneumoniae infection was found in 18 patients and of Chlamydia psittaci infection in three patients . Influenza virus type A was the cause of infection in 15 patients . One patient had infection with influenza virus type B, one patient with parainfluenza virus type 1, and three patients with respiratory syncytial virus . In 20 patients there was evidence of infection with more than one microorganism . No etiological agent was found in 27 patients . Since Streptococcus pneumoniae was the predominant etiological agent penicillin should be drug of first choice in patients with pneumonia who need treatment in hospital . In young adults, however, the high frequency of Mycoplasma pneumoniae infection would justify the use of erythromycin or doxycycline as drug of first choice.

J Pediatr, 1985 Jun, 106(6), 907 - 12
Spontaneous bacterial peritonitis in children with chronic liver disease: clinical features and etiologic factors; Larcher VF et al.; We analyzed the clinical and bacteriologic features of 12 episodes of spontaneous bacterial peritonitis (SBP) in 11 children (four boys, median age 5.5 years) with chronic liver disease . All patients had cirrhosis and ascites; four had hypersplenism, and one was asplenic . Symptoms included increasing abdominal distention, pyrexia, abdominal pain, gastrointestinal disturbance, and encephalopathy . Nine had rebound tenderness on abdominal palpation, and 12 had reduced bowel sounds . The most frequent organisms isolated from culture of ascitic fluid were Streptococcus pneumoniae (nine) . Klebsiella (two), and Haemophilus influenzae (one); blood cultures grew identical organisms in nine . Seven patients died despite intensive antibiotic therapy . In the 3 months prior to onset of SBP, defective yeast opsonization and reduced serum concentration of C4 were found in all nine children tested; eight had reduced concentration of C3 . Functional deficiency of all complement components was present in four tested within 1 to 5 months of the onset . In contrast, only eight of 59 cirrhotic children without SBP had low C3, and eight had defective yeast opsonization, although 35 had low C4 values . Four of the patients with SBP and low C3 and C4 concentrations had normal concentrations at the time of diagnosis of liver disease 2 to 5 years previously . Opsonization of type III pneumococci was reduced in sera from three patients who subsequently developed pneumococcal peritonitis . The incidence of SBP in children with chronic liver disease is similar to that in adults, as are the clinical features . Our observations suggest that complement deficiency induced by chronic liver disease may be important in the pathogenesis of SBP.

Vet Microbiol, 1985 Jun, 10(4), 393 - 7
Biochemical and serological identification of strains of Haemophilus pleuropneumoniae; Lombin LH et al.; Eighteen field isolates of Haemophilus pleuropneumoniae were studied biochemically and serotyped using the complement fixation test (CFT), agglutination test and the immunodiffusion test . Three biochemical tests (V-dependency, CAMP-reaction and urease activity) were found to be very useful for the biochemical characterization of the H . pleuropneumoniae . Haemolysis on blood agar plates, although present, was not sufficiently pronounced in all cases to warrant absolute dependence on this characteristic . Serological typing revealed the isolates belong to Serotypes 1 and 5 . The immunodiffusion test proved to be the most serotype specific, while a marked cross-reaction was observed with the CFT.

J Clin Invest, 1985 Jun, 75(6), 1935 - 42
Correlation between G2m(n) immunoglobulin allotype and human antibody response and susceptibility to polysaccharide encapsulated bacteria; Ambrosino DM et al.; To determine whether genetic factors influence the human antibody response to polysaccharides, we correlated Ig allotypes with the concentrations of antibody to 14 bacterial capsular antigens in 130 actively immunized Caucasian adults . The 88 individuals possessing G2m(n), an allotype antigen of IgG2 subclass heavy chains, had significantly higher postimmunization antibody levels to Haemophilus influenzae type b (Hib) and 8 of 11 pneumococcal types (P less than 0.05) than the 42 lacking this antigen . For Hib, pneumococcus type 14, and meningococcus group C, an increased response was observed in IgG class but not in IgM or IgA classes of antibody . The G2m(n) positive individuals also had higher preimmunization antibody levels to most polysaccharide antigens . Total IgG2 concentrations were correlated with the mean postimmunization antibody concentrations to pneumococci (P = 0.005), but this correlation was independent of G2m(n) by multiple regression analysis . To determine if the lack of G2m(n) was associated with increased susceptibility to infection, we compared the frequencies of various Ig allotypes in 98 children infected with Hib and 98 matched controls . Caucasian children with Hib infections other than epiglottitis were significantly more likely to lack the G2m(n) allotype than controls (P less than 0.05) . G2m(n) negative Caucasian children less than or equal to 18 mo old have a 5.1-fold higher risk of nonepiglottitic Hib infections than G2m(n) positive children (P less than 0.01) . We conclude that allotypic variants of the gamma-2 heavy chain genes, or genes in linkage equilibrium with them, exert a regulatory influence on the caucasian antibody response to a variety of immunologically distinct bacterial polysaccharide antigens . Young Caucasian children of the low responder phenotype, i.e., those lacking the G2m(n) allotype, are genetically predisposed to Hib and perhaps other bacterial infections.

Pathol Biol (Paris), 1985 Jun, 33(5 Pt 2), 557 - 63
{Evaluation of the sensitivity of Haemophilus to antibiotics by the modified API-ATB system}; Bourlioux P et al.; A simple micromethod in a liquid medium using the API-ATB system was developed for testing the susceptibility of Haemophilus to antibiotics . To evaluate this method, 50 strains, including 12 beta-lactamase producers, were studied . Results were compared to those obtained using MIC determination in a liquid medium (reference) and an agar diffusion method (routine) . For all three techniques, a Mueller-Hinton medium enriched in hemoglobin and NAD was used, and cultures were incubated at 37 degrees C for 24 hours in normal atmosphere . Influence of the inoculum on results was evaluated using the API-ATB method for all antibiotics and MIC determination for ampicillin; the optimal inoculum was found to be 8.10(5) CFU/ml . Beta-lactamase was looked for using the chromogen cephalosporin test associated with the API-ATB system . Values of MICs for the various antibiotics were consistent with previous reports . Paired comparison of techniques showed a 5.3% disagreement rate between API-ATB and MIC, with only 0.5% major discrepancies; in contrast, the disagreement rate exceeded 10% when disk diffusion was compared with the two other techniques . We conclude to the reliability and reproducibility of the API-ATB method which seems capable of improving current routine evaluations of the susceptibility of Haemophilus to antibiotics.

Drug Intell Clin Pharm, 1985 Jun, 19(6), 415 - 20
Amoxicillin-potassium clavulanate: a novel beta-lactamase inhibitor; Smith BR et al.; Potassium clavulanate is a novel beta-lactamase inhibitor, which, in combination, expands the spectrum of amoxicillin to include many amoxicillin-resistant organisms . Potassium clavulanate is excreted 30-50 percent unchanged renally and its plasma time-course parallels that of amoxicillin . Several studies suggest that an increased incidence of gastrointestinal side effects may occur with this combination . In the current oral formulation, its greatest utility may be in pediatric infections due to beta-lactamase-producing Haemophilus influenzae and B . cattarhalis . In adults, the combination has not been adequately studied against other effective antibiotics.

Jpn J Antibiot, 1985 Jun, 38(6), 1685 - 92
{In vitro antimicrobial activity of various antibiotics against Haemophilus influenzae isolated from clinical specimens in 1983}; Matsuo K et al.; In vitro susceptibilities of 73 strains of Haemophilus influenzae isolated from clinical specimens in 1983 to various antibiotics were studied . The following antibiotics were evaluated; ampicillin (ABPC), piperacillin (PIPC), cefotaxime (CTX), cefoperazone (CPZ), ceftizoxime (CZX), cefmenoxime (CMX), latamoxef (LMOX), tetracycline (TC), doxycycline (DOXY), minocycline (MINO), chloramphenicol (CP) and erythromycin (EM) . Susceptible strains to ABPC and PIPC with MICs less than 3 micrograms/ml were 80.3 and 84.1%, respectively . With this break point of MIC, all strains showed susceptibility to CPZ, CZX, and CMX, but resistant strains were observed in 1.5% against CTX and LMOX . Susceptible strains to TC, DOXY and MINO at MICs less than 2 micrograms/ml were 86.3, 80, and 87.7%, respectively . Those to CP at MICs less than or equal to 4 micrograms/ml and to EM at MICs less than or equal to 1 microgram/ml were 86.2 and 71.9%.

Acta Pathol Microbiol Immunol Scand {B}, 1985 Jun, 93(3), 175 - 9
Subtyping of Danish Haemophilus influenzae type B by their 45000 and 46000 molecular weight proteins; Honberg PZ; In order to obtain a way of subtyping Haemophilus influenzae type b strains, outer-membrane protein patterns were investigated . Outer-membrane proteins from 45 different Haemophilus influenzae type b strains were examined by sodium dodecyl sulfate polyacrylamide gel electrophoresis . The non-heated sarkosyl insoluble outer-membrane preparations all contained four major proteins with molecular weights (Mr) of 39,000, 33,000, 30,000, and 28,000, except for one strain which possessed a protein weighing approximately 32,000 . After heating the samples a 45,000 Mr protein appeared in 43 of the strains, and a 46,000 Mr in two . The 39,000 Mr protein remained unchanged, whereas the 33,000 Mr protein disappeared . The 30,000 and the 28,000 Mr proteins became more clearly separated . A faint 16,000 Mr band was observed in both heated and non-heated samples . 42 strains with the light heat-modified protein band had identical protein patterns and could not be subdivided by the methods used and may therefore constitute a clone . The remaining strains had individual patterns.

Vaccine, 1985 Jun, 3(2), 103 - 8
Enhancement of immunogenic activity of ribosomal preparations from Haemophilus influenzae by various adjuvants; Cabrera-Contreras R et al.; Ribosomes from Haemophilus influenzae type b have been reported to have immunoprotective activity in animals that can be enhanced by adjuvants . In this report we evaluated the adjuvant activity of several compounds in conjunction with ribosomes from the b and c serotypes of H . influenzae . Alhydrogel, saponin, and DPT were found to significantly enhance the immunoprotective response in mice, equalling or exceeding the activity of Freund's incomplete adjuvant . All of these adjuvants also enhanced significantly the IgM response of mice to sheep red blood cells . Ribosomes were also found to enhance this response . Among the compounds failing to provide adjuvant activity for ribosomes were poly(A:U), muramyl dipeptide, mycobacterial extract, dimethylglycine, methylated bovine serum albumin, sodium diethylthiocarbamate, and cetyltrimethylammonium bromide.

Antimicrob Agents Chemother, 1985 Jun, 27(6), 912 - 5
Amoxicillin-clavulanic acid in the treatment of lower respiratory tract infections caused by beta-lactamase-positive Haemophilus influenzae and Branhamella catarrhalis; Wallace RJ Jr et al.; Twenty-one adult patients hospitalized with lower respiratory tract infections due to Branhamella catarrhalis or Haemophilus influenzae or both were treated with the combination of oral amoxicillin and potassium clavulanate (Augmentin) in an open, noncomparative clinical trial . Diseases included pneumonia, empyema, and exacerbations of bronchiectasis and chronic lung disease . Thirteen of 16 B . catarrhalis and six of nine H . influenzae isolates were beta-lactamase positive . The patients with B . catarrhalis were treated for a mean of 5.3 days, and those with H . influenzae were treated for a mean of 7.0 days . The overall response to therapy was excellent, with 18 of 19 beta-lactamase-producing strains eradicated on therapy . One patient secondarily infected with Pseudomonas aeruginosa was a clinical failure, and two patients with H . influenzae who became culture positive again after therapy were considered microbiologic failures . Gastrointestinal side effects (especially nausea) were common, although all patients completed a course of therapy . Sputum levels of amoxicillin were surprisingly low (less than 0.05 to 0.54 micrograms/ml), a finding which may explain the high relapse rate (22%) seen with H . influenzae, as these are below the usual MICs of amoxicillin for this organism . The combination of amoxicillin plus potassium clavulanate appears to be an excellent drug for treatment of beta-lactamase-producing strains of these two species, although mild gastrointestinal side effects are common.

Eur J Clin Microbiol, 1985 Jun, 4(3), 310 - 5
Method for testing adherence of Haemophilus influenzae to human buccal epithelial cells; Porras O et al.; A method for testing adherence of Haemophilus influenzae strains to buccal mucosal cells is described . Bacteria grown in broth for 4 h were mixed with buccal mucosal cells . After elimination of unattached bacteria by repeated cycles of centrifugation and resuspension in PBS, the number of attached bacteria was counted microscopically . Optimal results were obtained with an early log-phase bacterial culture at a concentration of 10(9) bacteria/ml mixed with 2 X 10(4) cells/ml and incubated at 37 degrees C for 60 min . This assay showed an at least ten times higher rate of adherence for Haemophilus influenzae than previous studies . Nontypeable strains attached in higher numbers than strains with the type b capsule . Adherence was related to the frequency of nontypeable strains rather than to the site of isolation or type of infection . Thus all the isolates from middle ear fluid were nontypeable, and all but one adhered . The results suggest a difference in virulence mechanisms between type b and nontypeable Haemophilus influenzae strains.

J Clin Microbiol, 1985 Jun, 21(6), 899 - 901
Preparation of urine samples for use in commercial latex agglutination tests for bacterial antigens; Weinberg GA et al.; The use of latex agglutination (LA) tests for bacterial antigen detection in urine specimens is hindered by troublesome reactions such as nonspecific agglutination . Therefore, procedures such as boiling or membrane filtration of urine specimens are often used before LA testing . We discovered that the composition of the membrane filter used in filtration has a marked effect on the performance of an LA test used for detection of Haemophilus influenzae type b antigen . False-positive LA reactivity was common in urine specimens from pediatric patients that were processed by membrane filtration through certain filters; furthermore, such reactivity also occurred in LA tests for antigens other than those of H . influenzae . A protein present in urine at low concentrations appeared to be responsible for these phenomena.

South Med J, 1985 Jun, 78(6), 759 - 60
Haemophilus influenzae endocarditis; Blair TP et al.; Haemophilus influenzae endocarditis on a prosthetic valve has previously been reported only once . Routine physical and laboratory evaluation does not distinguish endocarditis from this organism from other causes of endocarditis . Our patient with prosthetic mitral valve endocarditis was successfully treated with antibiotics, but surgery was subsequently required for congestive heart failure from valve dehiscence.

South Med J, 1985 Jun, 78(6), 643 - 6
Beta-lactamase-positive strains of Haemophilus influenzae: susceptibility to and inactivation of beta-lactam antibiotics; Anderson EL et al.; Susceptibility and time-kill studies were done with low and high inocula of both beta-lactamase-positive and -negative strains of Haemophilus influenzae with cefamandole, ampicillin, cefoperazone, mezlocillin, moxalactam, and ceftriaxone . Bioassay was done to test for antibiotic inactivation by beta-lactamase-positive strains . All six antibiotics were highly active against the low inoculum (10(4) to 10(5) colony-forming units/ml) of beta-lactamase-negative strains; ceftriaxone, moxalactam, and cefoperazone were equally active against the same inoculum concentration of beta-lactamase-positive strains . In contrast, cefamandole, mezlocillin, and ampicillin were less active against the low inoculum of beta-lactamase-positive H influenzae . A marked inoculum effect occurred with the high inoculum (10(7) to 10(8) CFU/ml) with all six antibiotics, regardless of beta-lactamase production . In time-kill studies, marked differences in bacterial killing resulted after low and high inocula . Ampicillin, cefamandole, cefoperazone, and mezlocillin were rapidly inactivated by the high inoculum of beta-lactamase-positive H influenzae.

Jpn J Antibiot, 1985 Jun, 38(6), 1638 - 42
{Serum levels and sputum levels of cefmenoxime in respiratory tract infections}; Matsumoto Y et al.; In 11 patients with respiratory tract infections, the concentrations of cefmenoxime (CMX) in serum and sputum after 1 hour intravenous administration of 2 g of CMX were investigated . The peak serum level of CMX was 102.2 +/- 11.4 micrograms/ml after 1 hour drip infusion, then declined and was 3.51 +/- 0.55 micrograms/ml after 5 hours . Sputum level of CMX was lower than serum level but it was able to cover enough for MIC of Haemophilus influenzae, Klebsiella pneumoniae, Escherichia coli, Streptococcus pneumoniae and the peak sputum level of CMX was 0.77 +/- 0.17 micrograms/g after from 2 hours to 4 hours . Among the 11 patients with respiratory tract infections, 2 patients showed excellent, 6 patients good, 3 patients poor results (isolated organisms of sputum were normal flora) and no side effects observed.

Proc Natl Acad Sci U S A, 1985 Jun, 82(11), 3731 - 5
Processing of donor DNA during Haemophilus influenzae transformation: analysis using a model plasmid system; Pifer ML et al.; A plasmid system was used to investigate the processing of donor DNA during transformation of competent Haemophilus influenzae . Using biochemical and genetic methods, we have determined that portion of a donor plasmid molecule that, on average, can become integrated into a homologous recipient plasmid during transformation . Our results show that (i) transformation efficiency decreases linearly with donor DNA length over the range of 11 to 3.5 kilobase pairs, (ii) transformation efficiency decreases exponentially with size for donor molecules less than 3.5 kilobase pairs in length, and (iii) 5'-end label, but not 3'-end label, can be specifically incorporated into the resident homologous region . We present a model for donor processing during entry that encompasses and explains these observations.

J Infect Dis, 1985 Jun, 151(6), 1061 - 72
Molecular epidemiology of plasmid-mediated ampicillin resistance in Haemophilus influenzae type b isolates from Alaska; Mendelman PM et al.; Native Alaskans have a high incidence of disease caused by invasive Haemophilus influenzae type b and represent an isolated population for epidemiological study . We used plasmid DNA analysis and subtyping of outer membrane proteins as markers to characterize 29 ampicillin-resistant, invasive strains and seven ampicillin-resistant, noninvasive strains of this organism from distinct geographic regions . All 36 strains produced beta-lactamase; 34 strains transferred resistance by conjugation . Seven of the 36 strains harbored detectable plasmid DNA: four had a molecular mass of 40 MDa, and three had a molecular mass of 3 MDa . Furthermore, 20 transconjugants had a similar large plasmid, and four had a similar small plasmid . Ten of 12 transconjugants with either the large, small, or undetectable plasmid DNA were able to retransfer resistance . Transformation of resistance was successful with two large plasmids . DNA-DNA hybridization studies revealed that 33 of 36 strains had DNA homology . Restriction endonuclease digestion of 10 large plasmids revealed five patterns; identity was evident within a geographic region, and similarity existed between regions . Seven restricted plasmids demonstrated an identical pattern with a small beta-lactamase probe . Ampicillin resistance in these isolates from Alaska is primarily due to a common, 40-MDa conjugative plasmid that mediates beta-lactamase production, a finding which differs from that for ampicillin-resistant plasmids isolated elsewhere in the United States . Despite variable outer membrane protein profiles of the distinct strains of H . influenzae type b, the plasmids shared significant DNA homology . It appears that a common genetic element was responsible for the dissemination of this phenotype for resistance in Alaska.

J Bacteriol, 1985 Jun, 162(3), 918 - 24
Transmembrane permeability channels across the outer membrane of Haemophilus influenzae type b; Vachon V et al.; Outer membranes of Haemophilus influenzae type b were fractionated to yield Triton X-100-insoluble material and lipopolysaccharide and phospholipids . Liposomes reconstituted from lipopolysaccharide and phospholipids were impermeable to sucrose (Mr, 342) and to a high-molecular-weight dextran (average Mr, 6,600) . When the Triton X-100-insoluble material was introduced into the reconstituted liposomes, the vesicles became permeable to sucrose, raffinose (Mr, 504), and stachyose (Mr, 666) and fully retained dextrans of Mr greater than 1,500 . Inulin (average Mr, 1,400) was tested for its efflux from the reconstituted outer membrane vesicles; 62% of the added inulin was trapped . The molecular weight exclusion limit for the outer membrane of H . influenzae type b was therefore estimated at approximately 1,400 . A protein responsible for the transmembrane diffusion of solutes was purified from H . influenzae type b by extraction of whole cells with cetyl trimethyl ammonium bromide . When this extract was passed over DEAE-Sepharose, three protein-containing peaks (I, II, and III) were eluted . Peaks I and II contained mixtures of proteins as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis; when tested for their pore-forming properties, these proteins were unable to render liposomes of lipopolysaccharide and phospholipid permeable to sucrose . Peak III contained only one molecular species of protein of molecular weight 40,000; this protein acted as a porin in reconstituted vesicles . The molecular weight exclusion limit for 40,000-molecular-weight protein matched the estimate of approximately 1,400 which was determined for outer membranes . A series of homologous saccharides of increasing degree of polymerization was prepared from agarose by hydrolysis with beta-agarase and fractionation on gel filtration chromatography . These oligosaccharides of Mr, 936, 1,242, 1,548, and 1,854 were assayed for retention by the complete vesicles containing 40-kilodalton protein and lipopolysaccharide and phospholipids . All of these oligosaccharides were lost by efflux through the porin . Since the molecular conformation of the largest oligosaccharide is an elongated semirigid helix, it is suggested that the pore formed by the 40-kilodalton protein does not act as a barrier to the diffusion of this compound.

Lancet, 1985 May 25, 1(8439), 1184 - 6
Antibody levels achieved in infants by course of Haemophilus influenzae type B polysaccharide/diphtheria toxoid conjugate vaccine; Eskola J et al.; A Haemophilus influenzae type b (Hib) capsular polysaccharide (polyribosylribitol phosphate, PRP)/diphtheria toxoid (D) conjugate vaccine was given to 71 infants . The level of anti-PRP antibody believed to predict long-term protection, 1.0 microgram/ml, was reached in 50% of the infants who were vaccinated at 3, 5, and 7 months, and in 57% of the infants who received PRP-D at 7 and 9 months of age . A lower level of antibody, 0.15 micrograms/ml, which has been associated with protection at the time of assay, was reached in 92% and 87% of the two groups . Thus, the seroresponse was dependent upon both the frequency of immunisation and age of the infant . Comparison of these results with previous experience with PRP immunisation in Finland showed that PRP-D induced substantial antibody rises at an earlier age than did PRP.

J Clin Lab Immunol, 1985 May, 17(1), 45 - 8
NBT-reduction for detection of specific, opsonizing antibodies against haemophilus parainfluenzae; Julander I et al.; Specific, opsonizing antibodies against Haemophilus parainfluenzae were demonstrated in serum by measuring their enhancing effect on the nitroblue tetrazolium (NBT)-reduction of normal human granulocytes, phagocytizing the homologous bacteria . Patients with septicemia and/or endocarditis and carriers of H . parainfluenzae were studied . In late phase sera of the first group such antibodies were detected in 6 of 9 cases . Opsonizing antibodies against H . parainfluenzae were not detected in any of the carrier sera . A dose-response effect was observed when a positive late phase serum was tested in serial 2-fold dilutions . The enhancement of the NBT-reduction was eliminated by absorption of serum with homologous antigen . The detection of opsonizing antibodies, essential for the immune defense against H . parainfluenzae might be helpful for evaluation of the pathogenicity of this organism, which so far is considered as a rare causative agent.

Pediatrics, 1985 May, 75(5), 819 - 26
Comparative treatment trial of augmentin versus cefaclor for acute otitis media with effusion; Odio CM et al.; A total of 150 children with acute otitis media were randomly allocated to treatment with amoxicillin-potassium clavulanate (Augmentin) or with cefaclor . Each drug was given in a daily dosage of approximately 40 mg/kg in three divided doses for ten days . Tympanocentesis done before treatment yielded specimens that contained pneumococcus or Haemophilus sp or both in 67% of specimens . Viridans group streptococci were isolated from 10% of specimens and Branhamella catarrhalis from 6% . Patients were scheduled for follow-up examinations at midtreatment, end of therapy, and at 30, 60, and 90 days . Of the 150 children, 130 were evaluable . Five of 60 patients (8%) treated with cefaclor were considered therapeutic failures because of persistent purulent drainage and isolation of the original pathogen or suprainfection . There were no failures among patients treated with Augmentin (P = .019) . Rates of relapse, recurrent acute otitis media with effusion, and persistent middle ear effusion were comparable in the two groups of patients . Diaper rash, or loose stools, or both were significantly more common in children treated with Augmentin (34%) than in those taking cefaclor (12%), but in no case was it necessary to discontinue medication because of these mild side effects (P = .002) . Cefaclor therapy was discontinued in one patient because of severe abdominal pain and vomiting . In this study, treatment with Augmentin was superior to treatment with cefaclor in the acute phase of acute otitis media with effusion, but Augmentin produced more adverse effects . The rates of persistent middle ear effusion and recurrent acute otitis media with effusion were comparable with the two regimens.

Am J Vet Res, 1985 May, 46(5), 1185 - 91
Lesions induced in the respiratory tract of chickens by encapsulated or nonencapsulated variants of Haemophilus paragallinarum; Sawata A et al.; Lesions induced in chickens by an encapsulated or nonencapsulated strain of Haemophilus paragallinarum were investigated . In terms of lesion severity, major differences in pathogenicity were observed between the encapsulated and nonencapsulated variants . The principal lesion manifested by the encapsulated variant was an acute catarrhal inflammation of the upper respiratory tract, mainly of the nasal cavity and paranasal sinus . Infiltration of a large number of mast cells into the lamina propria of the mucous membrane of the nasal cavity was also characteristic . Numerous organisms were found on the cilia or on the surface of the epithelial cells of the nasal mucosa . Chickens with these histologic lesions had severe clinical signs of coryza, and organisms were recovered in high numbers from the nasal cavity and paranasal sinus . In contrast, chickens that were given the nonencapsulated variant did not have clinical signs of coryza, and the organisms were recovered in low numbers from the inoculated sites; slight histopathologic lesions were observed in the nasal mucosa at postinoculation day 1 . Mast cell infiltration in the chickens inoculated with the encapsulated variant indicated that mast cells may be responsible for producing clinical signs of coryza via the activation of pharmacologic mediators . Adherence to and colonization of the encapsulated variant on the nasal mucosa seems to be a first step of the infection.

Pediatr Infect Dis, 1985 May-Jun, 4(3), 336 - 41
Skin and soft tissue infections: pharmacologic approaches; Blumer JL et al.; Skin and soft tissue infections are common infectious problems in pediatric practice . Recent clinical and pharmacologic evaluations of several new antimicrobial agents have shed new light on the pathogenesis and management of these infections . Staphylococcus aureus now appears to be the most common bacterial isolate in children with impetigo . In patients hospitalized because of skin and soft tissue infections, S . aureus and Haemophilus influenzae type b remain the predominant pathogens . Rational therapeutic approaches to these infections require a recognition of the interplay among the pharmacodynamic, pharmaceutic and pharmacokinetic determinants of effective antimicrobial therapy . Using this approach the therapeutic questions regarding "what drug," "what dose" and "how long to treat" can be approached . Drugs such as the aminopenicillin-beta-lactamase inhibitor combinations may offer rational outpatient therapeutic alternatives, while parenteral cefuroxime and ceftriaxone are more probably the drugs of choice for parenteral therapy . In an age when cost effectiveness must prevail, strategies using ceftriaxone for both inpatient and outpatient management may provide the safest and most cost-effective therapy.

Pediatrics, 1985 May, 75(5), 827 - 31
Early detection of bacteremia in an outpatient clinic; Liu CH et al.; A total of 570 patients, aged less than 24 months, who were seen in the emergency room at Texas Children's Hospital for evaluation of acute febrile illness had a WBC count, differential count, and a blood culture obtained . Bacteremia occurred in 7.7% (n = 44) (22 Haemophilus influenzae; 17 Streptococcus pneumoniae; three Escherichia coli; one group B Streptococcus; one Staphylococcus aureus) . The sensitivity, specificity, and positive predictive value of morphologic changes (vacuolization and toxic granulation) of polymorphonuclear neutrophils (segmented neutrophils plus band cells), WBC count greater than or equal to 15,000/microL and band cells greater than or equal to 500/microL were examined . Additionally, abnormalities in three of four tests (WBC count greater than or equal to 15,000/microL, band cells greater than or equal to 500/microL, segmented neutrophils greater than or equal to 10,000/microL, and/or total polymorphonuclear neutrophils greater than or equal to 10,500/microL) were evaluated . Morphologic changes of polymorphonuclear neutrophils were noted frequently in patients with culture-proven bacteremia (63% and 51% positive predictive value for vacuolization and toxic granulation, respectively) and were more predictive of bacterial infection than traditional tests . If both vacuolization and toxic granulation were present, the positive predictive value increased to 76% . Examination of the peripheral blood smear may provide important adjunctive information for the presence of bacteremia prior to bacteriologic confirmation.

Pathol Biol (Paris), 1985 May, 33(5), 435 - 9
{Antibiotic therapy of pneumopathies in intensive care and protected distal bronchial samples}; Laudat P et al.; Bacteriology was performed on 57 specimens collected by the Wimberley protected catheter bronchoscopy technique (PCB) from 42 ventilated patients with severe head trauma hospitalized in the neurosurgical intensive care unit to determine the etiology of their pneumopathy . All patients had a nasotracheal tube upon arrival at the intensive care unit . For each sample, smears were examined and cultures under aerobic and anaerobic conditions as well as with CO2 were performed . In 34 (59%) of the 57 cases, examination of smears allowed rapid diagnosis and appropriate chemotherapy . In 47 (82%) cases, culture was positive, with a single pathogen being recovered in half of cases . The most prevalent organisms among the 75 species isolated were S . aureus (38%), P . aeruginosa (15%), Klebsiella (12%), Haemophilus (8%), and Pneumococcus (9%) . Consistency with positive cultures of blood or pleural effusion samples was recorded in 92% of cases . Narrow spectrum antibiotic therapy can be chosen according to the results of PCB bacteriology and rapid automated antibiotic sensitivity testing obtained within 24 hours . PCB is therefore recommended in pulmonary infections in intensive care units.

Tohoku J Exp Med, 1985 May, 146(1), 105 - 17
Invasion of Haemophilus influenzae and Pseudomonas aeruginosa in humans; Suzuki H et al.; Levels of serum IgG antibodies to somatic antigens of Haemophilus influenzae and Pseudomonas aeruginosa were determined in 127 healthy people, 37 patients with chronic bronchitis and 20 patients with bronchiectasis by enzyme-linked immunosorbent assay . The logarithmic mean titers of antibodies to Haemophilus influenzae and Pseudomonas aeruginosa were significantly higher in the patients with chronic bronchitis and bronchiectasis than in healthy people . The invasion rate of Haemophilus influenzae was identical in healthy people, chronic bronchitis and bronchiectasis, while that of Pseudomonas aeruginosa was significantly lower in healthy people than in chronic bronchitis and bronchiectasis patients . These results indicate that patients with chronic bronchitis and bronchiectasis may often have recurrence and are easily infected because of lowered defense mechanisms in the respiratory tract.

J Clin Pathol, 1985 May, 38(5), 561 - 4
Evaluation of Bactigen latex agglutination and Phadebact coagglutination for detection of bacterial antigens in cerebrospinal fluid; Coovadia YM et al.; The Bactigen latex agglutination and Phadebact coagglutination tests were evaluated for their ability to detect bacterial antigens of Haemophilus influenzae type b, Streptococcus pneumoniae (83 serotypes) and Neisseria meningitidis groups A, B, C, and Y in 214 samples of cerebrospinal fluid (CSF) . Bactigen latex agglutination was more sensitive than Phadebact coagglutination: it detected 87% (59/68) of culture positive CSF specimens, whereas Phadebact detected 72% (52/72) . Bactigen detected all cases of meningitis caused by S pneumoniae and H influenzae . Of the 19 specimens that were positive for N meningitidis, 74% were detected by Phadebact and only 53% by Bactigen . Gram stain results were positive for 85% of all specimens positive on culture . Bactigen was slightly more specific (97%) than Phadebact (96%) . Bactigen, however, showed less specificity (81%) than Phadebact (94%) on 31 CSF specimens that were culture positive for organisms other than the test organisms . These included two CSF specimens from patients with tuberculous meningitis which gave false positive results for S pneumoniae with the Bactigen reagents . No false positive results were obtained on 104 culture negative CSF samples . Bactigen latex agglutination was superior to Phadebact coagglutination and Gram stain for the detection of S pneumoniae and H influenzae in CSF specimens from patients with bacteriologically proved meningitis.

Pathol Biol (Paris), 1985 May, 33(5), 426 - 9
{Haemophilus influenzae infections in infants and macrolides . Importance of the choice of an effective antibiotic and compliance with its administration schedule}; Pesnel G et al.; Five cases of meningitis due to Haemophilus influenzae type b are reported . In four, the same pathogen was recovered from blood . In every case, meningitis developed despite administration of macrolides for ENT infections (4 cases) or pneumonia (1 case) . These five observations are conclusive evidence that macrolides failed to prevent meningeal diffusion of Haemophilus influenzae presumptively responsible for the initial focal infection . In vitro activity of macrolides against Haemophilus influenzae is poor . For the treatment of ENT infections in pediatric patients aged 2 months to 5 years, the age group most susceptible to infection by Haemophilus influenzae, we recommend amoxicillin which is more active and bactericidal . An adequate dosage should be used (50 to 100 mg/kg/24 h) divided into four oral doses given at six hour intervals . This therapeutic attitude may need to be revised if the prevalence of beta-lactamase-producing H . influenzae strains (5 to 10% as of now) were to increase . In this case, use of an amoxicillin-clavulanic acid combination under the same conditions as outlined above may prove satisfactory . Correct administration of judiciously chosen antibiotics in ENT infections in infants and children is the most effective means of preventing meningitis due to H . influenzae.

Pathol Biol (Paris), 1985 May, 33(5), 396 - 8
{Comparison of the growth curves of Escherichia coli and Haemophilus influenzae subjected to ampicillin and amoxicillin}; Yourassowsky E et al.; Results of conventional techniques indicate that most non-beta-lactamase producing Haemophilus influenzae strains are "susceptible" to ampicillin and amoxicillin . A previous study of growth curves established using the MS-2 system has demonstrated a faster bacteriolytic activity on Escherichia coli of amoxicillin as compared to ampicillin . A similar study on Haemophilus influenzae ATCC 9795 showed a) significant residual growth subsequent to contact of cultures with antibiotics in concentrations approximating minimal inhibitory concentrations; b) persistent residual growth for all concentrations from 1 to 500 micrograms/ml, with little concentration-dependency . Concentrations of amoxicillin needed to achieve identical inhibition of Haemophilus growth curves were twice those of ampicillin.

Pathol Biol (Paris), 1985 May, 33(5), 391 - 5
{Changes in the antibiotic sensitivity of Haemophilus (H . influenzae and H . parainfluenzae) colonizing the upper respiratory tract of the child}; Dabernat H et al.; Haemophilus strains recovered from the upper respiratory tract in children were investigated by three one-month studies, in 1982, 1983 and 1984 respectively . Strains were recovered from nose and throat swabs in children hospitalized in a pediatric department during March/April . H . influenzae and H . parainfluenzae exhibited very different patterns of resistance to antibiotics . Little resistance was found among H . influenzae strains: percentage of ampicillin-resistant (beta-lactamase producing) and/or tetracycline-resistant strains did not exceed 4% and showed no change over the three study years . H . parainfluenzae was considerably more resistant, with percentages of strains resistant to one antibiotic or more reaching 25% in 1982 and 1983 and 36% in 1984 . Resistance to ampicillin rose from 20-22% in 1982-1983 to 31% in 1984 . Resistance to chloramphenicol emerged in 1984 and was found in 4.5% of strains; these strains were also resistant to ampicillin and tetracycline . Resistance to tetracycline was found in 18% of strains in 1983 and in 14% in 1982 and 1984 . In 1983, three cases of meningitis due to an ampicillin-resistant strain (one of which was also resistant to chloramphenicol) were seen . Although one type b ampicillin-resistant strain was isolated in this study, such an occurrence seems difficult to predict and strains infecting the upper respiratory tract apparently do not become invasive under normal conditions . The possibility that H . parainfluenzae may be a reservoir of resistance genes for H . influenzae is considered.

Pathol Biol (Paris), 1985 May, 33(5), 359 - 62
{Bronchial diffusion of piperacillin in 18 intensive care patients}; Mouton Y et al.; Eighteen patients (13 under mechanical ventilation) in an intensive care unit received piperacillin for pneumonia (7 cases) or bronchial infection (11 cases), related to Haemophilus influenzae (7), Streptococcus pneumoniae (4) or miscellaneous pathogens (7) including Staphylococcus, E . coli, Klebsiella pneumoniae and Proteus mirabilis . Each patient was given 2g piperacillin intravenously every six hours . Concentrations in serum and bronchial secretion samples were assayed by the agar diffusion technique using a susceptible strain of Bacillus subtilis ATCC 6633 . Maximum concentrations were 157 micrograms/ml in serum and 3.60 micrograms/ml in bronchial secretions . These results are similar to those obtained with the same dosage by 0 . Cars in serum (150 micrograms/ml) and by G.E . Marlin in the bronchial secretions (3.78 micrograms/ml) . They approximate those published for other penicillins with the same dosage.

J Clin Microbiol, 1985 May, 21(5), 711 - 4
Comparison of a new, rapid enzyme-linked immunosorbent assay with latex particle agglutination for the detection of Haemophilus influenzae type b infections; Macone AB et al.; A new, rapid enzyme-linked immunosorbent assay (ELISA) for the detection of polyribosylribitol phosphate of Haemophilus influenzae type b was compared with a commercially available latex particle agglutination (LPA) system (Bactigen; Wampole Laboratories, Cranbury, N.J.) . By adding specimens and the anti-polyribosylribitol phosphate immunoglobulin-enzyme conjugate to the solid phase in a single step, it was possible to complete the ELISA procedure in 30 min . The ELISA was capable of detecting 0.3 ng of polyribosylribitol phosphate per ml in cerebrospinal fluid, 0.6 ng/ml in urine, and 1.2 ng/ml in serum; the in vitro sensitivity of LPA in these body fluids was 0.6, 0.3, and 0.3 ng/ml, respectively . Both procedures detected polyribosylribitol phosphate in specimens from 25 patients with bacteriologically confirmed H . influenzae type b infections . The specificity of ELISA appeared to be superior to that of LPA . ELISA was positive in only one of seven patients who had a positive LPA test and a clinical illness that was not compatible with haemophilus infection . Moreover, five patients with bacteriologically confirmed infections due to other pathogens (Streptococcus pneumoniae type 14 {two patients}, Neisseria meningitidis group C, Escherichia coli K100, and Staphylococcus aureus) had false-positive LPA tests; only two (E . coli and S . aureus) were positive by ELISA . A total of 108 samples from 61 patients who had no evidence of haemophilus infections were negative by both procedures . The ELISA is a rapid, sensitive, and specific alternative to LPA for the detection of haemophilus polyribosylribitol phosphate.

Infect Control, 1985 May, 6(5), 203 - 5
Haemophilus ducreyi; Daly JA; Haemophilus ducreyi is the etiologic agent of chancroid, an infection which is endemic in tropical and subtropical areas of the world and which is becoming more prevalent in Europe and North America . Recently, several strains have demonstrated resistance to several antimicrobials by plasmid acquisition and cell envelope alteration making control of the spread of this organism a challenge . Equally challenging is the growth of this organism in the clinical microbiology laboratory because of its in vitro fastidious nature . Currently, the therapy of choice for Haemophilus ducreyi infection is trimethoprim sulfamethoxazole or erythromycin . Plasmid enumeration and restriction endonuclease fingerprinting in addition to outer membrane protein profiles may provide a basis for subtyping which would be useful in epidemiologic studies.

Infection, 1985 May-Jun, 13(3), 137 - 9
The use of acridine orange as a rapid method for the quantitation of bacteremia in laboratory animals; Greenfield MD et al.; A rapid technique has been developed to quantitate the degree of bacteremia in laboratory animals . Direct staining of blood smears with acridine orange and enumeration using fluorescent microscopy allowed quantitation of Haemophilus influenzae in blood at densities from 10(5) to 10(8) cfu/ml . This technique will facilitate the accuracy with which therapeutic trials are conducted in laboratory models of infection.

J Pediatr, 1985 May, 106(5), 712 - 6
Pharyngeal colonization with Haemophilus influenzae type b in children in a day care center without invasive disease; Murphy TV et al.; During an 18-month period, monthly pharyngeal cultures for Haemophilus influenzae type b (Hib) were obtained from 66 children and their caretakers in a day care center in which no systemic disease caused by Hib occurred . The average colonization rate for Hib was 10%, and ranged from 0% to 23% for a single month . Infants housed in a separate building with a cohorted staff were not colonized by Hib . However, 71% of the toddler group and 48% of the preschool group became colonized by Hib at some time during the 18-month-study . Of 89 Hib isolates, 93% were biotype 1 (Kilian), and 90% of these had a similar outer membrane protein profile, designated subtype 1L . This strain was recovered from children at the center for 15 of 18 months . No invasive disease occurred . Thus, Hib may be widespread among preschool children in a day care center and persist for longer than a year without resulting in systemic disease.

J Clin Invest, 1985 May, 75(5), 1645 - 58
Characterization of antigens from nontypable Haemophilus influenzae recognized by human bactericidal antibodies . Role of Haemophilus outer membrane proteins; Gnehm HE et al.; Major outer membrane antigens, proteins, and lipopolysaccharides (LPSs), from nontypable Haemophilus influenzae were characterized and examined as targets for complement-dependent human bactericidal antibodies . Outer membranes from two nontypable H . influenzae isolates that caused otitis media and pneumonia (middle ear and transtracheal aspirates) were prepared by shearing organisms in EDTA . These membranes were compared with membranes prepared independently by spheroplasting and lysozyme treatment of whole cells and found to have: similar sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) patterns of the proteins; identical densities (rho = 1.22 g/cm3); and minimal d-lactose dehydrogenase activity indicating purity from cytoplasmic membranes . Outer membranes were solubilized in an LPS-disaggregating buffer and proteins were separated from LPS by molecular sieve chromatography . The SDS-PAGE patterns of outer membrane proteins (OMPs) from the two strains differed in the major band although other prominent bands appeared similar in molecular weight . LPS prepared by hot phenol water extraction of each of the strains contained 45% (pneumonia isolate) and 60% (otitis isolate) lipid (wt/wt), 49% and 50% carbohydrate (wt/wt), respectively, and less than 1%, 3-deoxy-manno octulosonic acid . Immunoglobulin M (IgM) purified from normal human serum (NHS) plus complement was bactericidal for both strains . Purified immunoglobulin G (IgG) from NHS killed the middle ear isolate and immune convalescent IgM from the serum of the patient with pneumonia killed his isolate . NHS or convalescent serum were absorbed with OMPs and LPS (0.6-110 micrograms) from each of the strains and immune specific inhibition of bactericidal antibody activity by each antigen was determined . OMPs from the pulmonary isolate inhibited bactericidal antibody activity directed against the isolate in both NHS (1.5 microgram of antigen) and immune serum (0.75 microgram of antigen) . OMPs (60 micrograms) from the ear isolate also inhibited bactericidal activity in the respective immune serum . LPSs exhibited minimal inhibition (greater than 110 micrograms) . Three human sera (two normal, one immune) were selectively depleted of 80% of antibody activity against OMPs (measured by enzyme-linked immunosorbent assay) by affinity chromatography using OMPs from the pulmonary isolate coupled to a solid phase . These OMP antibody-depleted sera also showed an 88% reduction of bactericidal activity against this strain . Immunopurified antibody against OMPs eluted from the solid phase was bactericidal.

Infect Immun, 1985 May, 48(2), 343 - 9
Effect of systemic immunization on pulmonary clearance of Haemophilus influenzae type b; Toews GB et al.; The effect of systemic immunization on pulmonary clearance of Haemophilus influenzae type b (Hib) was studied in a mouse model system . Immunization of mice by intraperitoneal injection of viable Hib cells resulted in the appearance of Hib-directed antibodies in both serum and bronchoalveolar lavage fluid . The development of this Hib-directed antibody activity was associated with significant enhancement of early pulmonary clearance of Hib . Systemic immunization did not affect the recruitment of polymorphonuclear leukocytes to the alveoli, suggesting that the enhanced clearance of Hib observed in immunized animals was due to specific antibodies which promote either phagocytosis or extracellular killing of Hib . The spectrum of Hib-directed antibody specificities detected in sera from immunized animals was essentially identical to that detected in bronchoalveolar lavage fluids from these same animals . Similarly, intravenous administration of an immunoglobulin G monoclonal antibody specific for Hib lipopolysaccharide resulted in the subsequent appearance of this antibody in the alveolar spaces where it enhanced pulmonary clearance of Hib . This study shows that this mouse model system can be used to measure the effect of both active and passive immunization on the clearance of Hib from the lower respiratory tract.

Infect Immun, 1985 May, 48(2), 324 - 30
Composition and antigenic activity of the oligosaccharide moiety of Haemophilus influenzae type b lipooligosaccharide; Inzana TJ et al.; The oligosaccharide moiety of the lipooligosaccharide of Haemophilus influenzae type b strain Eag was isolated from the lipid component by mild acid hydrolysis and purified by gel filtration . Fast atom bombardment-mass spectrometry indicated that the lipid-free oligosaccharide had a basic molecular weight of 1,768; polysaccharides comparable to high-molecular-weight O side chains were not found . Glucose, galactose, galactosamine, heptose, 3-deoxy-D-manno-2-octulosonic acid (KDO), ethanolamine, and phosphate were identified in the lipid-free oligosaccharide by colorimetric assays, gas chromatography-mass spectrometry, or an amino acid analyzer . The presence of KDO was not clearly established by a thiobarbituric acid assay or by growth inhibition by a diazaborine derivative thought to block KDO synthesis . However, the semicarbizide assay and gas chromatography-mass spectrometry confirmed the presence of KDO . Lectin precipitation by Eag lipooligosaccharide in gels indicated that beta-D-galactose was present and that some of this monosaccharide was a terminal, nonreducing residue linked to N-acetyl-D-galactosamine . The lipid-free oligosaccharide was antigenic and completely inhibited lipooligosaccharide antibody (predominantly immunoglobulin G {IgG} and IgM) in an enzyme-linked immunosorbent assay, whereas the solubilized lipid A moiety did not . H . influenzae type b lipid-free oligosaccharide differed from core oligosaccharide of Salmonella lipooligosaccharide by the presence of galactosamine and a smaller percentage of heptose and KDO.

Pathol Biol (Paris), 1985 May, 33(5), 385 - 8
{Effect ofloxacin on Haemophilus influenza, Streptococcus pneumoniae and Neisseria meningitidis . Comparison with similar molecules}; Dabernat H et al.; The in vitro activities of the new quinolone derivatives ofloxacin, ciprofloxacin, norfloxacin, and pefloxacin against strains of Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis were compared to that of nalidixic acid . Determination of minimal inhibitory concentrations (MICs) was done by agar dilution tests . The new drugs were more active than nalidixic acid . N . meningitidis and H . influenzae (regardless of beta-lactamase production) were highly susceptible . All H . influenzae strains were inhibited by less than or equal to 0.12 mg/l; mode MICs were 0.03 mg/l for norfloxacin and pefloxacin, and 0.50 mg/l for nalidixic acid . All N . meningitidis strains were inhibited by 0.06 mg/l and mode MICs of the new drugs were less than or equal to 0.03 mg/l . Mode MICs for S . pneumoniae were 4 mg/l for norfloxacin and pefloxacin (range 1-16 and 2-8 mg/l respectively) and 1 mg/l for ofloxacin (range 1-4 mg/l) . Ofloxacin exhibited a bactericidal activity on H . influenzae (range MBC 0.06-0.50 mg/l; mode MBC: 0.06 mg/l).

J Infect Dis, 1985 May, 151(5), 840 - 4
An outbreak of chancroid in Orange County, California: descriptive epidemiology and disease-control measures; Blackmore CA et al.; From May 1981 through February 1983, greater than 1,700 patients were examined for genital ulcers at the Orange County Special Diseases Clinic in Santa Ana, California . Of these patients, 923 had either confirmed chancroid or genital ulcers of unknown etiology . Haemophilus ducreyi was recovered from lesions or inguinal buboes of 271 patients . In the previous year, no cases of chancroid were reported in this community . Men accounted for 266 (98%) of the confirmed cases; 95% of the men were Hispanic, and at least 53% had had sexual contact with a prostitute . All five culture-positive women were prostitutes . Antimicrobial sensitivity testing showed resistance to both sulfamethoxazole and tetracycline but susceptibility to erythromycin and to the combination trimethoprim-sulfamethoxazole . Treatment of patients with chancroid, their sex partners, and temporarily incarcerated prostitutes contributed to the successful control of this outbreak.

Infect Immun, 1985 May, 48(2), 565 - 8
Enhanced nasopharyngeal colonization of rats by piliated Haemophilus influenzae type b; Anderson PW et al.; Piliated Haemophilus influenzae type b strains display an enhanced adherence to human epithelial cells in vitro . However, clinical isolates, even from mucosal sites, are seldom piliated, although piliated populations can be selected from them . Experiments with rats have led some authors to suggest that piliation does not implement colonization by H . influenzae type b . Piliated populations were obtained from 35 strains by selection for adherence to human erythrocytes . One strain, H . influenzae H305, simultaneously acquired an increased adherence to rat erythrocytes and buccal epithelial cells . In contrast to other strains, H . influenzae H305 in piliated form was more effective than in nonpiliated form in the colonization of rats by intranasal inoculation . After the piliated inoculum, however, the colonies cultured from the nasal washes were negative for erythrocyte adherence . Thus, piliated H . influenzae type b strains have an apparent advantage to initiating colonization in the rat model but may give rise to nonpiliated progeny that are more readily cultivable from the mucosal surface.

J Infect Dis, 1985 May, 151(5), 869 - 77
Serum factor-dependent resistance of Haemophilus influenzae type b to antibody to lipopolysaccharide; Inzana TJ et al.; Haemophilus influenzae type b (Hib) grown in broth is much more sensitive to killing by antibody to lipopolysaccharide (LPS) and complement than is Hib in bacteremic rats; upon brief incubation with low-molecular-weight components of plasma or serum, however, broth-grown cells are phenotypically converted to a resistance resembling that in vivo . This conversion was found to consume a limiting factor in serum filtrate, to require protein synthesis, and to occur independently of the presence of capsule . Less antibody to LPS bound to cells of the resistant (Res) phenotype than to cells of the sensitive (Sen) phenotype . In electrophoretic analysis the mobility of LPS bands was identical, but the staining density of the LPS bands extracted from Res cells (with phenol-water) was two-to fourfold greater than from an equal number of Sen cells . A similar differential was found in an immunologic assay of LPS in the extracts . Thus, Hib in the Res phenotype (and perhaps Hib in vivo) contains more LPS than Hib in the Sen phenotype, but its LPS appears less accessible to antibody.

Can J Microbiol, 1985 May, 31(5), 456 - 62
Production of RNA-dependent haemolysin by Haemophilus pleuropneumoniae; Martin PG et al.; Five strains of Haemophilus pleuropneumoniae, out of eight strains tested, produced extracellular haemolysin(s) when grown in liquid culture in the presence, but not in the absence, of RNA . The haemolysin produced by the neotype strain was unstable, heat labile, and sensitive to degradation by pronase, trypsin, and chymotrypsin; moreover, trypan blue treated haemolysin preparations were less effective at causing erythrocyte lysis than were untreated preparations . Following growth in the absence of RNA, washed suspensions of the neotype strain produced extracellular haemolysin when incubated in the presence of RNA, glucose, and casein acid hydrolysate; extracellular haemolysin could not be detected if the incubation mixture contained chloramphenicol . The haemolysin produced by washed bacterial suspensions was similar to that produced by growing cultures in that it was unstable, heat labile, and sensitive to inactivation by the same complement of enzymes . Erythrocyte lysis induced by either haemolysin preparation was preceded by a prelytic phase, the duration of which was dependent upon haemolysin concentration and the initial temperature of the haemolysin--erythrocyte mixture . It is concluded that the haemolysin(s) produced by the neotype strain of H . pleuropneumoniae is distinct from, but closely related to both streptolysin S and the haemolysin produced by Treponema hyodysenteriae.

Med J Aust, 1985 Apr 15, 142(8), 472 - 4
Abscess of the nasal septum after trauma; Close DM et al.; Although the disorder is said to be uncommon, three cases of abscess of the nasal septum, two in adults, one in a child, were seen during a period of four months . Each patient had a recent history of nasal trauma and presented with severe nasal obstruction . In each case, the septal cartilage was also found to be extensively destroyed when the abscess was drained . Staphylococcus aureus was isolated in the two adult patients, Haemophilus influenzae and Streptococcus pneumoniae in the child . When two of the three patients were examined a few months later, the septal cartilages appeared to have completely regenerated . In all cases of nasal trauma, the septum must be examined to exclude a haematoma or abscess which, if detected, must be treated urgently with antibiotic therapy and drainage to prevent nasal and intracranial complications.

Br Med J (Clin Res Ed), 1985 Apr 6, 290(6474), 1033 - 7
Acute otitis media: a new treatment strategy; van Buchem FL et al.; The incidence of acute otitis media and its response to treatment only with nose drops and analgesics (but without antibiotics or myringotomy) were assessed over three months by 45 doctors in and around Tilburg . In addition, over 17 months 60 general practitioners assessed the effects of this limited treatment in children aged 2 to 12 years and referred all those in whom the condition took an unsatisfactory course (either a severe course--illness continuing beyond three to four days with high temperature or pain, or both--or persistent discharge after 14 days) to an ear, nose, and throat specialist . Those referred because of appreciable illness continuing beyond three or four days were entered into a further study, comparing the effects of myringotomy alone, antibiotics alone, and myringotomy and antibiotics combined . Bacteriology was assessed in all children in whom the course of the condition was unsatisfactory . More than 90% of an estimated 4860 children seen over 17 months (estimation based on incidence of severe course in the three month study) recovered within a few days . The course of the condition was severe in only 126 (2.7%) patients; haemolytic streptococci group A were identified in 30 of these 126 patients but Haemophilus influenzae in only one . One hundred of these patients with a severe course entered the trial of treatment, which showed antimicrobial treatment either alone or in combination to be more effective than myringotomy alone . Whether combined treatment was more effective than antibiotics alone remained unconfirmed . Acute otitis media in children can be treated with nose drops and analgesics alone for the first three to four days . Patients in whom this regimen is not accompanied by satisfactory recovery can be recognised within a short time and treated by the general practitioner.

Can J Comp Med, 1985 Apr, 49(2), 149 - 51
Comparison of tissue reactions produced by Haemophilus pleuropneumoniae vaccines made with six different adjuvants in swine; Straw BE et al.; Tissue damage caused by six different adjuvants incorporated in a Haemophilus pleuropneumoniae vaccine was compared in swine . The adjuvants compared were four mineral oil compounds, one peanut oil compound and aluminum hydroxide . Inoculations were given in the neck, quadriceps and semitendinosus muscles . The mineral oil adjuvants were highly irritant and caused extensive areas of granulomatous inflammation that were present at eight weeks after injection . The aluminum hydroxide produced smaller lesions that also persisted for eight weeks . Only the peanut oil adjuvant did not produce significant lesions at the site of injection . At two and four weeks, but not at eight weeks postinoculation, lesions in the quadriceps and semitendinosus muscles were approximately twice as extensive as those in the muscles of the neck.

Can J Comp Med, 1985 Apr, 49(2), 129 - 37
Microorganisms associated with pneumonia in slaughter weight swine; Morrison RB et al.; The lungs of 334 pigs were obtained from two slaughter plants in Minnesota and examined in detail . Macroscopic and microscopic evaluation, direct fluorescence for Mycoplasma hyopneumoniae and bacterial culture were done on all of them and a subsample of 50 were selected for virus culture . Mycoplasma hyopneumoniae, Pasteurella multocida and Haemophilus spp . were detected in 24.0%, 34.1% and 27.0% of the lungs, commonly in conjunction with each other . One isolate of Haemophilus pleuropneumoniae serotype 2 was detected and this represents the first report of its presence in the United States . No virus was detected in any of the lungs . Lungs with both M . hyopneumoniae and Pasteurella multocida had the greatest amount of macroscopic pneumonia (9.8% of the lung) . Lungs with M . hyopneumoniae or P . multocida alone had 4.9% and 5.2% of the lung involved with pneumonia respectively . Lungs with Haemophilus sp . Taxon "minor group" had 3.8% of the lung involved which was not significantly different from lungs with none of these organisms being detected (1.6%) . There was a positive correlation between the extent of M . hyopneumoniae infection, as scored by FAT and the amount of macroscopic pneumonia present (r = 0.46; P less than 0.001) . Likewise, there was a positive correlation between the estimated concentration of P . multocida present, as scored by the relative number of colonies on blood agar and the amount of macroscopic pneumonia present (r = 0.60; P less than 0.001) . Microscopically, the amount of lymphoreticular proliferation, polymorphonuclear cells and alveolar macrophages were evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)

Vet Microbiol, 1985 Apr, 10(3), 259 - 68
Contagious equine metritis: experimental infection in the donkey; Timoney PJ et al.; Contagious equine metritis (CEM) was reproduced in 3 of 4 donkey mares with an Irish streptomycin-resistant strain of Haemophilus equigenitalis isolated from an experimental case of the disease in a pony mare . Although some variability in clinical response occurred, there was no evidence that semen enhanced the clinical severity of the infection . Variable amounts of vaginal discharge and associated inflammatory changes of the vagina and/or cervix, similar to those seen in the horse, were observed . All the affected donkeys made spontaneous clinical recoveries and so far as could be detected, subsequent persistence of H . equigenitalis in the genital tract was of limited duration . Recovery of the bacterium was not associated with oestrus and there was no evidence that it persisted in the clitoral area after it could no longer be cultured from the anterior genital tract . Cytological examination of smears of intra-uterine or cervical swabs was of diagnostic value only during the clinical phase of the infection . Serological responses demonstrated in 3 of the 4 donkey mares by the agglutination, complement-fixation and passive haemagglutination tests, were of low magnitude and short duration . The diagnostic value of the agglutination and complement-fixation tests was limited by the presence of low levels of non-specific reactivity and pronounced anti-complementary reactivity, respectively, in many of the donkey sera . The passive haemagglutination test proved superior for demonstrating elevation in antibody and for confirming infection . The overall results indicate that the donkey has the potential to act as a source of CEM infection and under certain circumstances, could have a role to play in the epidemiology of this disease.

Sex Transm Dis, 1985 Apr-Jun, 12(2), 64 - 7
Prostitutes are a major reservoir of sexually transmitted diseases in Nairobi, Kenya; D'Costa LJ et al.; Prostitutes are a major reservoir of sexually transmitted diseases in many developing nations . In Nairobi we found that 16%, 28%, and 46%, respectively, of upper-, middle-, and lower-social strata prostitutes were infected with Neisseria gonorrhoeae . Genital ulcers and infections with Haemophilus ducreyi were more prevalent among prostitutes of the middle and lower social strata . A group of 97 prostitutes of the lower social strata were followed longitudinally to determine the rate of reinfection with N . gonorrhoeae . The mean time to acquisition of a new infection was 12.0 +/- 9.2 days . These results show that in Nairobi prostitutes are a readily identifiable group of high-frequency transmitters of gonococcal infection . Strategies based on intervention in the prostitute reservoir could prove to be an effective means of control of gonococcal infections in developing nations.

Can J Comp Med, 1985 Apr, 49(2), 164 - 70
Serological cross-reactivity between a porcine Actinobacillus strain and Haemophilus pleuropneumoniae; Rosendal S et al.; During serological screening of a closed SPF-herd free of pleuropneumonia, more than half of the pigs were positive for complement-fixing antibodies to Haemophilus pleuropneumoniae . Actinobacillus bacteria closely related to A . suis were isolated from tonsillar tissue of 14 out of 20 slaughtered pigs submitted for pathological and bacteriological evaluation . None of the pigs had evidence of respiratory disease . Two pigs inoculated endobronchially with a selected Actinobacillus strain developed mild focal pneumonia and complement-fixing antibodies cross-reacting with H . pleuropneumoniae . Five pigs exposed and vaccinated with the Actinobacillus strain and five pigs spontaneously infected with the strain also developed complement-fixing antibodies against H . pleuropneumoniae and appeared to be less susceptible to experimental Haemophilus pleuropneumonia than pigs not exposed to the Actinobacillus infection . The agglutination test applied on serum treated with 2-mercaptoethanol detected antibodies against H . pleuropneumoniae serotype 5 but not against serotype 1 in pigs exposed to the Actinobacillus strain . Antibodies reactive with the Actinobacillus strain were also found in pigs hyperimmunized against H . pleuropneumoniae serotypes 1-5 in 2-mercaptoethanol tube agglutination test and rabbits hyperimmunized against serotypes 1,2 and 7, and strain 73567 in the immunodiffusion test . Conversely rabbits immunized against the Actinobacillus strain had antibodies against H . pleuropneumoniae serotypes 1, 3, 4, 5 and 6 . It is concluded that pigs infected with Actinobacillus organisms may become false positive reactors against H . pleuropneumoniae.

Antimicrob Agents Chemother, 1985 Apr, 27(4), 495 - 8
Antibacterial activity of mupirocin (pseudomonic acid), a new antibiotic for topical use; Sutherland R et al.; Mupirocin (pseudomonic acid A), an antibiotic produced by Pseudomonas fluorescens, showed a high level of activity against staphylococci and streptococci and against certain gram-negative bacteria, including Haemophilus influenzae and Neisseria gonorrhoeae, but was much less active against most gram-negative bacilli an anaerobes . Nearly all clinical isolates of Staphylococcus aureus and Staphylococcus epidermidis, including multiply resistant strains, were susceptible (mupirocin MIC, less than or equal to 0.5 microgram/ml) . There was no cross-resistance between mupirocin and clinically available antibiotics, and the selection of resistant variants in vitro occurred at a low frequency . Mupirocin was highly bound (95% bound) to the protein of human serum, and activity was reduced 10- to 20-fold in the presence of human serum . The activity of mupirocin was not greatly influenced by inoculum size but was significantly enhanced in acid medium . In tests of bactericidal activity, MBCs were 8- to 32-fold higher than MICs and the antibiotic demonstrated a slow bactericidal action in time-kill tests, resulting in 90 to 99% killing after 24 h at 37 degrees C.

Vet Med (Praha), 1985 Apr, 30(4), 247 - 54
{Serological diagnosis of the species Haemophilus equigenitalis using the rapid agglutination and coagglutination method}; Mazurova J; The method of rapid slide agglutination and coagglutination was tested in the detection of Haemophilus equigenitalis (Taylorella equigenitalis)--the causal agent of contagious equine metritis (CEM) . It was demonstrated that both methods were suitable for the serological diagnosis of the species under study . The antisera obtained from rabbits immunized with Haemophilus equigenitalis strains treated in different ways were specific, but with different antibody titres . When cross reactions with other species of microorganisms were verified, the antisera did not react with any of the strains, even after binding them to protein A of the positive strain Staphylococcus aureus--Cowan I . Coagglutination was much more rapid and pronounced than the ordinary rapid agglutination test . It was characterized by a low consumption of specific antiserum . The specific antibodies bound to staphylococci were kept at the temperature of 4 degrees C for several months without losing agglutinin activity.

Antimicrob Agents Chemother, 1985 Apr, 27(4), 655 - 6
Aztreonam therapy in experimental meningitis due to Haemophilus influenzae type b and Escherichia coli K1; McCracken GH Jr et al.; The penetration of aztreonam into cerebrospinal fluid was 7 to 15% and 9 to 25%, respectively, in experimental Haemophilus influenzae type b and Escherichia coli K1 meningitis . Aztreonam was effective in reducing the number of organisms in cerebrospinal fluid after single-dose and continuous infusion administration, and the median bactericidal titers in cerebrospinal fluid were 1:32 against both meningeal pathogens.

Monatsschr Kinderheilkd, 1985 Apr, 133(4), 225 - 30
{Latex and coagglutination test of serum and urine in childhood pneumonia}; Simon C et al.; 41 children with pneumonia (proven by X-ray) and 271 children with upper respiratory tract infections were examined for bacterial antigens (Haemophilus influenzae type b and pneumococci) in serum and urine . In patients with pneumonia blood cultures, deep nasal swabs and antibody assay in serum (against Mycoplasma pneumoniae and Chlamydia) were made . In 271 patients with an upper respiratory tract infection also a deep nasal swab for bacterial cultures was performed . In 29 of 41 patients with pneumonia latex agglutination test was positive (in 15 patients for Haemophilus antigen, in 14 patients for pneumococcal antigen) . Coagglutination test was positive in 6 patients (in 1 patient for Haemophilus antigen, in 5 patients for pneumococcal antigen) . In 12 patients latex agglutination was negative; there were other causes of pneumonia (partially viral infections) . In 5 of 271 patients with an upper respiratory tract infection (purulent otitis media) latex agglutination was positive (4 times for Haemophilus, once for pneumococcal antigen) . Bacteriological investigations confirmed the results of latex agglutination test in serum and urine . To avoid false positive reactions we recommend heating of serum to 65 degrees C, of urine to 100 degrees C for 5 min . Urine should be concentrated 25 times (there were 3 times more positive results than with unconcentrated urine).

Genitourin Med, 1985 Apr, 61(2), 123 - 6
Typing Haemophilus ducreyi by indirect immunofluorescence assay; Slootmans L et al.; Rabbits were inoculated with untreated whole cells of 16 strains of Haemophilus ducreyi . Homologous titres in an indirect immunofluorescence test ranged from 1/320 to 1/1280 . No cross reactions, or very few, were observed between antisera to these strains and 22 other (possible taxonomically related) species, strains, and genera . A large diversity in types of antigen was observed among the strains of H ducreyi . Antiserum from two antigens (35000 and 3138), however, reacted with all 16 H ducreyi antigens tested . At least nine of the strains of H ducreyi examined could be identified as determining the type of antigen.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Apr, (4), 11 - 5
{Etiology of acute and chronic bronchopulmonary diseases in children . II . A study of the specific immune response by counterimmunoelectrophoresis and the complement fixation and passive hemagglutination reactions}; Katosova LK et al.; Specific immune response to Streptococcus pneumoniae and Haemophilus influenzae has been studied in 158 children with acute pneumonia and pleuritis and 128 children with chronic pneumonia by countercurrent immunoelectrophoresis (CIE) and in the complement fixation (CFT) and passive hemagglutination (PHA) tests . The use of CIE leads to the detection of antibodies to H . influenzae in 23.7% of children with acute pneumonia and in 46.9% of children with chronic pneumonia . In the CFT antibodies to H . influenzae are also more often detected in children with chronic pneumonia (48%) than in those with acute respiratory infections (12.2%) . In the PHA test high titers of antibodies to type b H . influenzae capsular polysaccharide occur in 11.9% of children with acute pneumonia and in 8.2% of children with chronic pneumonia.

J Clin Microbiol, 1985 Apr, 21(4), 638 - 40
Detection of Haemophilus influenzae type b antigenuria by Bactigen and Phadebact kits; Riera L; Two commercially available reagents, latex particles (Bactigen) and Staphylococcus aureus suspensions (Phadebact), were compared for the detection of the capsular polyribitol phosphate antigen of Haemophilus influenzae type b in 18 pediatric patients with proven infections due to H . influenzae type b . Whereas both tests nearly equally detected the antigen in the first urine specimens from the patients, the latex test remained positive significantly longer than did the Phadebact test for serial urine specimens . We conclude that the Bactigen test is slightly more sensitive than the Phadebact test for detecting urinary H . influenzae type b antigen.

J Bacteriol, 1985 Apr, 162(1), 1 - 4
Transfer of genetic information within a colony of Haemophilus influenzae; Stuy JH; Different Haemophilus cultures were mixed and then spotted onto an agar plate . These mixed colonies were incubated at 37 degrees C and then scored for the presence of recombinants . It was found that conjugative plasmids transferred very efficiently and quickly under these conditions, but only between cells of the same species . Four small plasmids did not transfer at all, nor were they mobilized by the two conjugative plasmids studied . Chromosomal markers transferred very inefficiently . The evidence favored transfer by genetic transformation rather than by conjugation . When mixed cultures were inoculated into broth and then incubated, the transfer of conjugative plasmids was not observed . Transfer of chromosomal markers occurred only when the media used contained Eugonbroth in addition to brain heart infusion, and even then it was very inefficient . The addition of DNase completely eliminated such transfers . This and other evidence indicate that in cell suspensions, chromosomal marker transfer also occurs through transformation . A corrected map of several genetic markers is presented.

Infect Immun, 1985 Apr, 48(1), 248 - 51
Haemophilus influenzae can use human transferrin as a sole source for required iron; Herrington DA et al.; Haemophilus influenzae grown on enriched medium containing protoporphyrin IX rather than hemin was iron starved by the addition of the chelator ethylenediamine di-o-hydroxyphenylacetic acid . Iron starvation could be overcome in each of 33 H . influenzae type b isolates by 30% Fe-saturated human transferrin but not by human lactoferrin . Among nontypeable H . influenzae, 28 of 35 isolates, including 2 of 3 systemic isolates, were able to utilize Fe-transferrin . None of 18 H . parainfluenzae isolates was able to use Fe-transferrin . Iron starvation of H . influenzae type b resulted in increased amounts of three membrane proteins of 94,000 to 98,000 daltons.

Infect Immun, 1985 Apr, 48(1), 183 - 9
Serum opsonic activity after immunization of adults with Haemophilus influenzae type b-diphtheria toxoid conjugate vaccine; Cates KL et al.; We measured the uptake of radiolabeled Haemophilus influenzae type b by human polymorphonuclear leukocytes . Haemophilus influenzae type b strains were preopsonized in individual sera from six adults immunized with type b polysaccharide vaccine (PRP) or six adults immunized with PRP covalently coupled to diphtheria toxoid (PRP-D vaccine) . Serum was heat inactivated before use, and exogenous human complement was added . Of the 12 subjects, 3 had high levels of opsonic activity (greater than 40% of immune control) in their preimmunization serum . This activity did not correlate with the concentrations of anti-PRP antibody and was unaffected by absorption of anti-PRP antibody . At 1 month after vaccination, the serum of PRP-D subjects had higher opsonic activity than that from subjects who received PRP (5% serum, mean PRP-D = 86%, mean PRP = 53%, P = 0.001) . After 12 months, both groups had higher serum opsonic activity than before immunization (P less than 0.02), but there was no difference between the two groups (mean PRP-D = 48%, mean PRP = 51%) . In postimmunization serum, opsonic activity induced by PRP-D or PRP vaccines correlated directly with anti-PRP antibody concentrations as measured by a radioantigen binding assay . We conclude that both vaccines induce opsonic activity, opsonic activity induced by immunization of adults correlates well with the concentration of anti-PRP antibody achieved, and in preimmune sera with low concentrations of anti-PRP antibody, factors other than anti-PRP antibody contribute to opsonic activity.

Antimicrob Agents Chemother, 1985 Apr, 27(4), 548 - 54
Binding of polymyxin B nonapeptide to gram-negative bacteria; Vaara M et al.; The binding of the outer membrane-disorganizing peptide polymyxin B nonapeptide (PMBN) to gram-negative bacteria was studied by using tritium-labeled PMBN . Smooth Salmonella typhimurium had a binding capacity of ca . 6 nmol of PMBN per mg (dry weight) of bacteria, which corresponds to ca . 1 X 10(6) to 2 X 10(6) molecules of PMBN per single cell . The binding was of relatively high affinity (Kd, 1.3 microM) . The isolated outer membrane of S . typhimurium bound ca . 100 nmol of PMBN per mg of outer membrane protein (Kd, 1.1 microM), whereas the cytoplasmic membrane bound 9 to 10 times less . Other bacteria which are susceptible to the action of PMBN (Escherichia coli strains, Pseudomonas aeruginosa, Haemophilus influenzae) also bound large amounts of PMBN . The S . typhimurium pmrA mutant, Neisseria gonorrhoeae, and Proteus mirabilis (all known as resistant to polymyxin and PMBN) bound 3.3, 4, and 12 times less than S . typhimurium, respectively . The binding of PMBN to S . typhimurium was effectively inhibited by low concentrations of polymyxin B, compound EM49 (octapeptin), polylysine, and protamine . Spermine, Ca2+, and Mg2+ also inhibited the PMBN binding although they were ca . 160, 700, and 2,400 times less active (based on molarity) than polymyxin B, respectively . No binding inhibition was found at the tested concentrations of streptomycin, tetralysine, spermidine, or cadaverine.

Genitourin Med, 1985 Apr, 61(2), 109 - 13
Anaerobic bacteria and herpes simplex virus in genital ulceration; Masfari AN et al.; Of 91 patients with genital ulceration, herpes simplex virus was isolated from 52 (57%) and Haemophilus ducreyi from 12 (13%); none had syphilis . The difference in incidence of other aerobes in patients and controls was not significant . Anaerobes, predominantly Bacteroides spp, were isolated from a large proportion (77%) of men and women patients with ulcers but from few control men . The most common anaerobic species were B asaccharolyticus and B ureolyticus, with fewer isolates of the melaninogenicus/oralis group . The bacterial flora of herpetic and non-herpetic ulcers were similar, but Candida albicans was isolated significantly more often from non-herpetic ulcers . Anaerobic bacteria may contribute to the pathogenesis of genital ulcers.

Infect Immun, 1985 Apr, 48(1), 119 - 23
Variable adherence of fimbriated Haemophilus influenzae type b to human cells; Sable NS et al.; The attachment of isogenic fimbriated and nonfimbriated Haemophilus influenzae type b variants to human cells was studied by using a radioactive assay and an indirect immunofluorescent assay . As described previously, fimbriated H . influenzae variants adhered to a greater extent than nonfimbriated variants to human buccal epithelial cells (2.1 and 0.29 bacteria per cell, respectively, as determined by the radioactive assay {P less than 0.05}; 7.6 and 1.6 bacteria per cell, respectively, as determined by the immunofluorescent assay {P less than 0.01}) . As the concentration of fimbriated bacteria was increased, so were the numbers of adherent bacteria; in contrast, increasing the bacterial concentration had a much smaller effect on adherence of nonfimbriated H . influenzae type b . The distribution of bacteria on the buccal cells also differed . Whereas 37% of the buccal cells failed to bind nonfimbriated H . influenzae type b, failure to bind was observed for only 4% of the buccal cells exposed to fimbriated H . influenzae . In contrast, adherence to human foreskin fibroblasts was low regardless of the presence of fimbriae . On the other hand, fimbriated H . influenzae type b adhered less well than nonfimbriated variants to HEp-2 cells (1.6 and 3.8 bacteria per cell, respectively, as determined by the radioactive assay {P less than 0.05}; 1.3 and 4.8 bacteria per cell, respectively, as determined by the immunofluorescent assay {P less than 0.02}) . Whereas adherence to HEp-2 cells increased considerably as the concentration of nonfimbriated bacteria was increased, there was only a small enhancement of adherence with an increase in the concentration of fimbriated H . influenzae type b . Furthermore, only 16% of the HEp-2 cells failed to bind nonfimbriated H . influenzae type b, whereas 50% failed to bind fimbriated H . influenzae type b . These data indicate that H . influenzae type b may contain two adhesins . One is associated with fimbriae and enables adherence to buccal cells, whereas the other is nonfimbrial and is associated with adherence to HEp-2 cells . It is not known whether either of these adhesins plays a role in pathogenesis.

Med Clin North Am, 1985 Mar, 69(2), 269 - 80
Prophylaxis for bacterial meningitis; Shapiro ED; Close contact of patients with bacterial meningitis that is caused by either Haemophilus influenzae type b or Neisseria meningitidis are at an increased risk of developing invasive infections with these bacteria . Chemoprophylaxis with rifampin and immunoprophylaxis with vaccines may prevent some secondary infections.

Vet Pathol, 1985 Mar, 22(2), 131 - 6
Microscopic lesions associated with the isolation of Haemophilus somnus from pneumonic bovine lungs; Andrews JJ et al.; Sixty-one of 68 sets of bovine lungs from which only Haemophilus somnus was isolated had microscopic lesions of purulent bronchiolitis and bronchopneumonia . In 37 of 61 lungs, the bronchiolar exudates were markedly necrotic with accompanying necrosis of the adjacent bronchiolar epithelium . Bronchiolitis obliterans was prominent in 23 of 28 lungs affected with chronic lesions with abscesses present in seven . Alveolar filling with inflammatory cells (neutrophils with fewer macrophages) was limited to peribronchiolar alveoli in 25 of 61 lungs and was multifocal to diffuse in the other 36 . Lesions in the remaining lungs (7 of 68) were classified as fibrinous pneumonia with bronchiolitis (2), fibrinous pleuritis (2), suppurative interstitial pneumonia with vasculitis (2), and diffuse congestion (1).

Clin Pediatr (Phila), 1985 Mar, 24(3), 143 - 5
Pneumococcal osteomyelitis . An unusual cluster of cases; Hadari I et al.; Between 1979 and 1981, 22 children with osteomyelitis and/or septic arthritis were hospitalized at Soroka University Hospital . Streptococcus pneumoniae was cultured in five of the children, four of whom were under 2 years of age . In four other children under 2 years of age, Haemophilus influenzae was cultured . Staphylococcus aureus was identified less frequently in the younger age group . In deciding on initial antibiotic therapy, the possibility of such a bacteriological spectrum should be considered.

J Antimicrob Chemother, 1985 Mar, 15(3), 375 - 84
Aztreonam in patients with acute purulent exacerbations of chronic bronchitis: failure to prevent emergence of pneumococcal infections; Davies BI et al.; A group of 36 patients, all requiring hospital admission because of acute purulent exacerbations of chronic bronchitis, were treated with 1 or 2 g intramuscular injections of aztreonam for ten days . Patients with Streptococcus pneumoniae infections were excluded from the study . Sputum cultures before treatment revealed the other usual respiratory pathogens but repeat cultures on days 3, 10 and 17 sometimes yielded Str . pneumoniae, occasionally combined with Haemophilus influenzae or Branhamella catarrhalis . Ten patients had to be given other antimicrobial agents for Str . pneumoniae infections which developed during the study or follow-up periods . Pseudomonas aeruginosa failed to respond well to aztreonam . All the H . influenzae strains were sensitive to aztreonam (MIC 0.25 mg/l, or less) but all strains of Str . pneumoniae were resistant (MIC greater than 32 mg/l) . Ps . aeruginosa strains were moderately resistant (MIC generally 4-16 mg/l) and Bran . catarrhalis strains only moderately sensitive (MICs generally 0.5-4 mg/l) . Peak serum concentrations averaging approximately 37 mg/l were observed after the 1 g injections (55 mg/l after 2 g) and the corresponding mean peak concentrations in the sputum were 1.3 mg/l and 2.5 mg/l, respectively . The penetration from blood to sputum was thus approximately 3.5% and 4.6% after the 1 g and 2 g doses . No unwanted local or general reactions were observed . The disappointing clinical results (only 23 out of 36 patients with excellent or good clinical results) one week after the end of the treatment were mainly due to the emergence of pneumococcal infections during (and immediately after) therapy . Considering that Str . pneumoniae is still one of the most important organisms associated with acute purulent exacerbations of chronic bronchitis, and that conventional sputum cultures may not always reveal its presence, there is considerable doubt if aztreonam has any place in the treatment, especially as the results in Ps . aeruginosa infections have also been much poorer than expected.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Mar, (3), 3 - 6
{Etiological diagnosis of suppurative bacterial meningitis today}; Demina AA et al.; As the result of laboratory examination of 2165 patients with virulent bacterial meningitides, including cases of meningococcal infection, the etiological diagnosis was confirmed in 1407 patients (65.0%), the number of cases confirmed by the laboratory examination being significantly greater among adults than among children: 67.5 +/- 1.37% and 63.1 +/- 1.53%, respectively, (t = 2.1) . Meningococcal infection was confirmed in 1111 (70.6%) out of 1572 patients under examination . Of the patients with purulent meningitides, pneumococcal etiology was determined in 27.4%, type b of Haemophilus influenzae in 13.5%, other infective agents in 10.0% . The comparison of the results obtained in the examination, carried out by different methods, of 946 children and 770 adults with meningococcal infection revealed a considerable difference in the number of positive results yielded by the bacteriological method and countercurrent immunoelectrophoresis (CIE) . Among adults meningococci were isolated twice as frequently (41.1 +/- 2.5% - 19.4 +/- 1.6%), and the results yielded by CIE were predominantly positive (55.1 +/- 2.5% and 40.1 +/- 2.5%) . CIE and the immunoenzyme assay were shown to have advantages in the diagnosis of the disease . Under the conditions of intensive antibiotic therapy the methods based on the detection of specific antigens in body fluids can greatly assist in diagnosis.

Drug Intell Clin Pharm, 1985 Mar, 19(3), 188 - 98
Review of the new second-generation cephalosporins: cefonicid, ceforanide, and cefuroxime; Tartaglione TA et al.; The new second-generation cephalosporins, cefonicid, ceforanide, and cefuroxime, have recently become available . These agents are generally less active against gram-positive cocci than first-generation cephalosporins and, at best, equal to cefoxitin and cefamandole against many gram-negative bacteria . Cefuroxime, however, is the most active cephalosporin for beta-lactamase-producing Haemophilus influenzae . These newer agents have superior pharmacokinetic characteristics over cefoxitin and cefamandole . Smaller doses, longer dosing intervals and, potentially, a reduction in total drug cost may be the real advantage of these agents . Open trials and a limited number of comparative studies have documented the effectiveness of cefonicid, ceforanide, and cefuroxime in the treatment of most mild-to-serious infectious diseases, although failures with cefonicid in the treatment of staphylococcal infections have been reported . Notably, cefuroxime has received approval for the treatment of common pediatric bacterial meningitis infections . Replacement of cefamandole or cefoxitin with one of these "longer-acting" agents may be cost-beneficial; however, clinicians must be on alert for the development of bacterial resistance or decreased efficacy.

J Gen Microbiol, 1985 Mar, 131 ( Pt 3), 515 - 20
The effect of serum-factor induced resistance to somatic antibodies on the virulence of Haemophilus influenzae type b; Rubin LG et al.; Studies on the pathogenesis of Haemophilus influenzae b infection have used bacteria grown in vitro which are relatively serum-sensitive (using serum devoid of anticapsular antibody) compared to organisms taken from infected hosts . We compared the virulence of relatively serum-sensitive and serum-factor induced serum-resistant H . influenzae b by inoculating rats with organisms having one or the other phenotype . The serum-resistant phenotype was more virulent following intraperitoneal or intravenous inoculation; however, there was no difference in the incidence of colonization or bacteraemia following intranasal inoculation . Furthermore, organisms colonizing the pharynx of rats had the serum-resistant phenotype . Thus, different phenotypes of the same strain of H . influenzae b differed in virulence following parenteral, but not intranasal, inoculation of bacteria . This could be explained by a change from serum-sensitive to serum-resistant phenotype shortly after entering the nasopharynx . The phenotype of micro-organisms grown in vitro may differ from organisms in infected individuals and these differences may be of critical importance in studies of immunity to infection and the pathogenesis of infection.

Infection, 1985 Mar-Apr, 13(2), 73 - 7
Characterization of clinical isolates of Haemophilus influenzae type b for heterogeneous populations of susceptibility to ampicillin; La Scolea LJ Jr et al.; In this study 80 clinical isolates of Haemophilus influenzae type b from 60 patients were used to analyze if heterogeneous populations of ampicillin resistant and sensitive cells were simultaneously present within each strain and to determine how common this phenomenon was among clinical isolates . A total of 50 ampicillin sensitive clinical isolates were screened for resistance to this antibiotic . It was observed that 32 ampicillin sensitive strains did not contain resistant subpopulations . Furthermore, even with the inducement of resistant subgroups to proliferate under antibiotic-mediated selection using maximum subinhibitory concentrations of ampicillin, no subpopulations of resistant cells were discovered among 18 additional strains . In order to determine whether ampicillin resistance was stable in beta-lactamase-producing H . influenzae clinical isolates, 20 strains from 16 patients were examined . No tendency to segregate into a heterogeneous population of sensitive and resistant clones was found . Furthermore, ampicillin resistance was still uniformly expressed after the treatment of ten strains with the curing agent acridine orange . These results suggest that after extensive evaluation no heterogeneous populations existed with ampicillin resistant and sensitive H . influenzae clinical isolates, indicating that this phenomenon is not a prevalent one.

J Pediatr Orthop, 1985 Mar-Apr, 5(2), 167 - 70
Counterimmunoelectrophoresis of synovial fluid in the diagnosis of septic arthritis; DeLuca PA et al.; The evaluation by counterimmunoelectrophoresis (CIE) of joint fluid for bacterial antigen from 16 children with suspected septic arthritis is reported . Joint fluid from six children contained capsular antigen of Haemophilus influenzae type b (four) or Streptococcus pneumoniae (two) . One child was infected with S . pneumoniae but was positive by CIE for both H . influenzae type b and S . pneumoniae . Five of six children who were less than 2 years of age were infected with H . influenzae . Two children had negative cultures of joint fluids, and a presumptive etiology for their infection was proposed only by demonstration of bacterial antigen . CIE, which has been widely applied to cerebrospinal fluid, urine, and serum, is a helpful adjunct to the evaluation of joint fluid from children with suspected septic arthritis.

J Clin Microbiol, 1985 Mar, 21(3), 442 - 4
Antimicrobial susceptibility and characterization of outer membrane proteins of Haemophilus ducreyi isolated in Thailand; Taylor DN et al.; One hundred strains of Haemophilus ducreyi isolated in Thailand from patients with chancroid were tested by the agar dilution method against 10 antimicrobial agents and typed by outer membrane protein pattern by using sodium dodecyl sulfate gel electrophoresis . All strains produced beta-lactamase and were resistant to tetracycline, kanamycin, and sulfonamides . Most had a decreased susceptibility to trimethoprim (MIC for 50% of the strains {MIC50}, 0.5 micrograms/ml) and chloramphenicol (MIC50, 8 micrograms/ml) . Strains were susceptible to ciprofloxacin (MIC90, 0.001 micrograms/ml), ceftriaxone (MIC50, 0.0015 micrograms/ml), erythromycin (MIC50, 0.015 micrograms/ml), rosoxacin (MIC50, 0.03 micrograms/ml), and spectinomycin (MIC50, 8 micrograms/ml) . The degree of antimicrobial resistance found in Thailand is higher than that reported for H . ducreyi isolated in other regions . Five different outer membrane protein patterns were found by analyzing proteins in the range of 29 to 61 kilodaltons, but 98% of the Thai strains fell into three patterns which did not differ greatly . Outer membrane protein patterns of Thai strains were also seen in strains from other geographic areas . A new outer membrane protein type was found among nine strains isolated in Singapore.

Am J Dis Child, 1985 Mar, 139(3), 280 - 3
Prevalence of beta-lactamase-producing bacteria in chronic suppurative otitis media; Brook I; Aspiration of the exudate through open perforation was performed in 48 children with chronic suppurative otitis media . Eighty-two aerobic and 93 anaerobic isolates were recovered . Aerobic bacteria only were involved in 22 patients (46%), and anaerobic organisms only were involved in five patients (10%) . Mixed aerobic and anaerobic isolates were recovered from 21 patients (44%) . The most common bacteria isolated were Bacteroides melaninogenicus group (40% of patients), Pseudomonas aeruginosa (29%), Klebsiella pneumoniae (10%), and Staphylococcus aureus (10%) . There were 50 beta-lactamase-producing organisms (26 anaerobes and 24 aerobes) recovered from 33 patients (69%) . Forty-four of these bacteria were isolated from the 37 patients recently treated with a penicillin . These included all ten isolates of S aureus and Bacteroides fragilis group, 11 of 19 of B melaninogenicus group, five of the 14 P aeruginosa, three of ten K pneumoniae, three of six of Bacteroides oralis, four of six of Haemophilus influenzae, two of three of Staphylococcus epidermidis, and two of four of Branhamella catarrhalis . The beta-lactamase-producing organisms have a possible role in the failure of penicillin therapy.

Infect Immun, 1985 Mar, 47(3), 843 - 6
Outer membrane proteins of nontypable Haemophilus influenzae and reactivity of paired sera from infected patients with their homologous isolates; Hansen MV et al.; Normal human serum and acute or convalescent serum from patients infected with nontypable Haemophilus influenzae were tested for reactivity with electroblotted outer membrane proteins obtained from the homologous nontypable H . influenzae isolates . Of 12 patients, 8 had immunoglobulin G antibodies to outer membrane proteins from their own infecting nontypable H . influenzae isolates that were not present in normal human serum . Three patients had immunoglobulin antibody in convalescent serum that had been absent in acute serum, but no consistent outer membrane protein was involved in the sets of patient sera with outer membrane proteins examined.

Infect Immun, 1985 Mar, 47(3), 648 - 53
Role of nasopharyngeal colonization with and without bacteremia in the protection of infant rats against Haemophilus influenzae type b challenge; Gilsdorf JR et al.; Nasopharyngeal colonization of infant rats with Haemophilus influenzae type b was investigated by two methods of intranasal inoculation . After traumatic instillation of the bacteria, 100% of the animals became colonized, compared with 75.5% of animals after atraumatic instillation . Among colonized rats, significantly more animals in the traumatic group developed bacteremia compared with those in the atraumatic group . Rats in the traumatic group had an onset of bacteremia at a mean of 2.6 days after inoculation compared with 7.3 days in the atraumatic group . The duration of colonization and bacteremia was the same in both groups . The majority of heavily colonized rats developed bacteremia compared with none of the lightly colonized rats . Thus, the development of bacteremia appeared to be related independently to both heavy colonization and traumatic instillation . Protection against intraperitoneal bacterial challenge with H . influenzae type b developed in rats that had been bacteremic; in the majority of animals, this correlated with the development of serum bactericidal activity . Protection and bactericidal activity were only rarely observed in nonbacteremic rats that had been either heavily or lightly colonized . The development of serum bactericidal activity was not related to either the duration or peak level of bacteremia . Thus, in this rat model, H . influenzae type b nasopharyngeal colonization without bacteremia did not appear to stimulate circulating antibodies that protected the animals against challenge.

J Biochem (Tokyo), 1985 Mar, 97(3), 811 - 20
Partial purification and characterization of type I DNA topoisomerase from Bacillus stearothermophilus; Yamamoto N et al.; Type I DNA topoisomerase was partially purified from Bacillus stearothermophilus by ammonium sulfate precipitation and column chromatographies on phosphocellulose, DEAE-cellulose and heparin-agarose . On heparin-agarose chromatography, topoisomerase I activity was separated into three fractions (designated Fractions A, B, and C) . Each fraction was further subjected to gel filtration on Sephacryl S-200 . From electrophoretic analysis on polyacrylamide gel, Fraction A was found to contain two enzyme species having molecular weights of 110,000 and 100,000, and Fraction B one enzyme species with a molecular weight of 80,000 . The molecular weight of the enzyme in Fraction C was estimated to be around 150,000 by gel filtration . The enzymes in Fractions A and B exhibited little activity in the presence of Mg2+, while the activity was increased remarkably by NaCl with Mg2+ . No activity was observed in the presence of NaCl alone . The enzyme in Fraction C required only Mg2+ for full activity . With Fraction A, the topoisomerase I-induced cleavage sites on tetracycline-resistant plasmid pNS1 (2.55 megadaltons) were mapped . Fraction A cleaved the DNA at ten specific sites . These sites were compared to those of the Haemophilus gallinarum enzyme, which have already been mapped (Shishido et al . (1983) Biochem . Biophys . Acta 740, 108) . The results showed that there is a remarkably coincidence between the cleavage sites induced by the B . stearothermophilus and H . gallinarum enzymes.

J Antimicrob Chemother, 1985 Mar, 15(3), 345 - 51
Pharmacokinetics and bactericidal activity of sultamicillin in infants and children; Ginsburg CM et al.; The pharmacokinetics of sultamicillin and ampicillin suspensions were studied in 20 infants and children 8 months to 69 months of age (mean age, 27 months) . Mean peak plasma concentrations of ampicillin and sulbactam occurred at 90 minutes after administration of 42.5 mg of sultamicillin (25 mg of ampicillin/kg and 17.5 mg of sulbactam/kg) per kg to fasting and non-fasting patients . Co-administration of milk usually resulted in higher concentrations of ampicillin and sulbactam, however, the differences in the AUC values between the fasting and fed groups were not statistically significant . Sultamicillin and ampicillin were administered in cross-over fashion to ten children . Plasma concentrations of ampicillin after 42.5 mg of sultamicillin per kg were greater at 20, 40, and 60 min than those after 25 mg of ampicillin per kg alone and the AUC was 39% larger in subjects who received sultamicillin than in those who received ampicillin . Plasma bactericidal activity against a non-beta-lactamase producing Haemophilus influenzae strain was similar for children who were given sultamicillin or ampicillin . Against a beta-lactamase-producing Haemophilus strain the median bactericidal titres were 1:8 at 40, 60 and 90 min after sultamicillin and less than 1:2 at the same intervals after ampicillin.

Infect Immun, 1985 Mar, 47(3), 780 - 5
Effect of piliation on interactions of Haemophilus influenzae type b with human polymorphonuclear leukocytes; Tosi MF et al.; Piliated, adherent (P+) and nonpiliated, nonadherent (P-) strains of Haemophilus influenzae type b (Hib) were compared with respect to their ability to induce polymorphonuclear leukocyte (PMN) chemiluminescence (CL) and superoxide (O2-) generation and their susceptibility to phagocytosis by PMNs . P+ strains opsonized in normal human serum (NHS) induced significantly greater CL than did P- strains (500 X 10(5) +/- 112 X 10(5) versus 242 X 10(5) +/- 65 X 10(5) total counts per 60 min; P less than 0.001) when reacted with normal PMNs . Contributions of immunoglobulin and complement to CL activity in these mixtures were shown by findings of lower overall levels of CL when hypogammaglobulinemic serum or heat-inactivated NHS was used to opsonize either P+ or P- organisms . Results obtained with mixtures of hypogammaglobulinemic plus adsorbed heat-inactivated NHS (with P+ or P- organisms) suggested a role for an antipilus antibody in the enhancement of CL by these strains . NHS-opsonized P+ strains also induced significantly greater (P less than 0.002) O2- generation than did P- strains (2.83 +/- 0.08 versus 1.94 +/- 0.14 nmol of ferricytochrome c reduced per 10 min/10(6) PMN) . Comparable ingestion of P+ or P- strains opsonized in NHS by PMNs was demonstrated by a radiolabeled uptake technique and transmission electron microscopy, and primary granule release (beta-glucuronidase) was comparable during ingestion of P+ or P- strains . The basis for the observed enhanced capacity of P+ Hib to stimulate PMN oxidative metabolism as compared with P- organisms is uncertain . Possible clinical implications of these findings deserve further study.

Ann Trop Paediatr, 1985 Mar, 5(1), 33 - 6
Latex agglutination: an appropriate technology for the diagnosis of bacterial meningitis in developing countries; Venkatesh VC et al.; We evaluated prospectively the utility of a latex agglutination technique for the diagnosis of Haemophilus influenzae type b meningitis in a paediatric ward in India . Eight of 44 children had H . influenzae grown from cerebrospinal fluid . These proven cases plus four additional cases of H . influenzae meningitis were detected by the latex agglutination test . There were no cross reactions with other organisms . The high degree of sensitivity and specificity, combined with the speed and simplicity of this technique make it an appropriate method for developing countries.

Vet Rec, 1985 Feb 23, 116(8), 215 - 7
Selective medium for isolation of Haemophilus somnus from cattle and sheep; Slee KJ et al.; Incorporation of vancomycin (5 micrograms/ml), neomycin (5 micrograms/ml), sodium azide (50 micrograms/ml), nystatin (100 iu/ml) and cyclohexamide (100 micrograms/ml) into 5 per cent horse blood agar results in a selective medium for the primary isolation of Haemophilus somnus from cattle and sheep . Addition of thiamine monophosphate (1 microgram/ml) to the medium enhanced growth of this bacterium . Gram-positive bacteria did not grow on the medium and colonies of many Gram-negative bacteria were eliminated or reduced in numbers and size . Colonies of H somnus were larger on the selective medium than on sheep blood agar but retained typical morphology . Recovery of 18 laboratory strains was 73 to 166 per cent (mean 112) on selective medium compared to sheep blood agar . H somnus was isolated from the vagina of a total of 136 (28.6 per cent) of 476 cows surveyed, 79 (16.6 per cent) on sheep blood agar and 129 (27.1 per cent) on selective medium . The selective agents and thiamine were stable indefinitely as a freeze dried mixture while prepared plates were stable for two weeks.

Presse Med, 1985 Feb 16, 14(7), 409 - 11
{Gynecological infections caused by Haemophilus influenza in adults . 3 cases}; Nuchowicz A et al.; Three cases, recently observed, of non-obstetrical gynaecological infections in adults caused by Haemophilus influenzae have prompted us to reconsider this rare pathology . Non-encapsulated strains of H . influenzae, particularly those belonging to biotype IV, might have special affinity and virulence for the genital tract . It seems, therefore, that such strains should systematically be looked for in samples collected from genital organs.

Jpn J Antibiot, 1985 Feb, 38(2), 269 - 86
{Experimental and clinical evaluation of the BRL 25000 (clavulanic acid-amoxicillin) granules in the pediatric field}; Shinozaki T et al.; BRL 25000 granules containing 2 parts amoxicillin and 1 part potassium clavulanate were administered to children suffering from acute infections at a daily dose of 50 mg/kg in 3 or 4 divided doses for at least 3 days . Infections included acute airway infections (81), scarlet fever and suspected scarlet fever (4), urinary tract infections (4), impetigo contagiosa (1) and acute colitis (1) . Bacteria were eradicated in 91.3% (63/69) of cases treated with the BRL 25000 granules, with only 2 strains of Staphylococcus aureus, 2 of Escherichia coli, 1 of Haemophilus influenzae and 1 of Streptococcus pneumoniae remaining . Eight beta-lactamase producing strains were detected amongst the 49 clinical isolates studied and of these, 6 were eradicated after administration of the BRL 25000 granules . Good clinical efficacy was obtained in 97.8% of cases (89/91), with 1 case of acute tonsillitis and 1 of acute colitis showing no improvement . Adverse reactions were limited to 1 case of vomiting and 3 of diarrhea, and no abnormal laboratory findings were detected.

Thorax, 1985 Feb, 40(2), 125 - 31
Effect of bacterial products on human ciliary function in vitro; Wilson R et al.; Ciliary activity protects the respiratory tract against inhaled particles, including bacteria, by transporting them trapped in mucus towards the pharynx . We have studied the effect of bacteria (Haemophilus influenzae, Staphylococcus aureus, and Pseudomonas aeruginosa) on human nasal cilia, measuring their in vitro ciliary beat frequency by a photometric technique . Supernatant fluids were obtained from 18 hour broth cultures by centrifugation alone, by filtration, and by lysis . Supernatants obtained from Ps aeruginosa and H influenzae caused a significantly lower ciliary beat frequency than controls (broth alone) . Slowed cilia were dyskinetic and at times of maximal slowing ciliostasis occurred in some areas of the epithelium . A dose related effect was demonstrated . Abrogation of cilioinhibitory properties was achieved by heating the lysate to 56 degrees C for 30 minutes and by allowing the filtrate to stand at 37 degrees C for 120 minutes . Staphylococcal products were not cilioinhibitory . It is concluded that Ps aeruginosa and H influenzae release a factor (or factors) which causes slowing of human nasal cilia in vitro . The role of this factor in the pathogenesis of infection is discussed.

Infect Immun, 1985 Feb, 47(2), 370 - 4
Physical and genetic analysis of DNA regions encoding the immunoglobulin A proteases of different specificities produced by Haemophilus influenzae; Bricker J et al.; The structural gene for immunoglobulin A protease (iga) from Haemophilus influenzae serotype d was cloned in pBR322 . The gene was used as a probe for Southern hybridization analysis of chromosomal DNA from the five other H . influenzae serotypes (a, b, c, e, and f) . In most cases strains from a single serotype exhibited a distinct pattern of restriction fragment(s) homologous to the iga gene probe which was unique for that serotype . Serotype f strains were unique in that they gave two distinct patterns of homologous restriction fragments which correlated well with the production of two different protease types by members of this group . An iga mutant of H . influenzae serotype d was isolated by introducing a 4-base-pair insertion into the cloned iga gene and using the altered DNA for transformation of an H . influenzae recipient . The resulting iga- mutant produced no immunoglobulin A protease but was otherwise indistinguishable from its iga+ parent in growth characteristics . Transformation of mutant cells with chromosomal DNA isolated from either a serotype d or a serotype c strain gave rise to iga+ transformants . Those obtained with serotype d DNA produced a type 1 protease, whereas those obtained with serotype c DNA produced either a type 1 protease (characteristic of serotype d) or a type 2 protease (characteristic of serotype c) . Southern analysis of the latter transformants, using the iga gene probe, indicated that the type 1 transformants had a serotype d pattern of restriction fragments whereas the type 2 transformants had either a serotype c or a novel pattern of restriction fragments . These results indicate that there is considerable homology between the iga genes of the various serotypes and that the homologous sequences identified with the serotype d probe are the immunoglobulin A protease-coding sequences in each case.

J Antimicrob Chemother, 1985 Feb, 15(2), 187 - 91
Antibiotic susceptibility of blood and cerebrospinal fluid isolates of Haemophilus influenzae; Bannatyne RM et al.; One hundred and sixty-nine blood and cerebrospinal fluid isolates of Haemophilus influenzae, collected in the Province of Ontario from children and adults from 1976 to 1983, were tested for susceptibility to six conventional and eight newer antibacterial drugs . Most active were ceftriaxone, ceftizoxime and cefotaxime (MIC90 less than or equal to 0.02 mg/l); latamoxef (moxalactam), acrosoxacin and ceftazidime were close behind with MIC90s in the 0.05-0.09 mg/l range . Twenty-five strains (14.8%) were beta-lactamase-producing and thus resistant to ampicillin . There were no chloramphenicol-resistant strains . The isolates showed intermediate but still clinically useful susceptibility to trimethoprim, rifampicin, cefuroxime, piperacillin and chloramphenicol and were least susceptible to gentamicin and sulphamethoxazole.

J Antimicrob Chemother, 1985 Feb, 15(2), 139 - 49
Characterization of the plasmid-mediated beta-lactamase in Branhamella catarrhalis, with special reference to substrate affinity; Eliasson I et al.; The plasmid-mediated Branhamella catarrhalis beta-lactamase BRO-1, also found in Moraxella nonliquefaciens, was characterized as regards substrate profile, isoelectric point and relative substrate affinity index (RSAI) to various substrates and compared in these aspects with the TEM-1 enzyme of Haemophilus influenzae . As measured by a biological assay and with high performance liquid chromatography (HPLC), BRO-1 was found to hydrolyse carbenicillin, mecillinam, methicillin and cefaclor with a higher rate than TEM-1 . The only substrates having a relative rate of hydrolysis higher for TEM-1 than for BRO-1 were ampicillin and cephaloridine . The rates of hydrolysis registered with these two methods were comparable for all but 2 of 13 tested substrates . Isoelectric focusing yielded a main band at pH 5.6 and several satellite bands consistent with those reported by other authors for Branhamella enzymes having a substrate profile similar to that of BRO-1 . A tenfold or higher difference in RSAI between BRO-1 and TEM-1 was recorded for five of the 15 compounds tested . BRO-1 seems to be the most common beta-lactamase in Bran . catarrhalis, irrespective of geographic origin . Its substrate profile, isoelectric pattern and RSAI differ from those of other known plasmid-mediated beta-lactamases described, thus justifying a specific designation.

Am J Med Sci, 1985 Feb, 289(2), 61 - 4
Bacteremia due to nontypable Haemophilus influenzae--three cases in a community hospital; Liston TE; Nontypable Haemophilus influenzae is a normal inhabitant of the upper respiratory tract and a common pathogen in diseases limited to mucosal surfaces . Nontypable H . influenzae has only occasionally been reported to cause invasive disease locally or systemically . In a period of two years, three patients of 17 with positive blood cultures for H . influenzae were found to have nontypable strains, two of which were resistant to ampicillin . The presumed sites of entry were an oral mucosal lesion, sinus mucosa, and female genital tract . All three patients responded rapidly to antibiotics to which their isolates were susceptible.

J Clin Microbiol, 1985 Feb, 21(2), 158 - 60
Comparison of methods for serotyping isolates of Haemophilus influenzae; Himmelreich CA et al.; This study compared four methods for serotyping isolates of Haemophilus influenzae . Slide agglutination with commercial antisera (Difco Laboratories and Wellcome Diagnostics), coagglutination (Phadebact Haemophilus Test {Pharmacia Fine Chemicals}), latex agglutination with affinity-purified anticapsular antibody, and counterimmunoelectrophoresis with multiple antisera were used to serotype 80 isolates of H . influenzae . Coagglutination and counterimmunoelectrophoresis correctly identified all 80 isolates as either type b or not type b . Slide agglutination and latex agglutination each successfully identified 76 of the 80 isolates; however, each of these two methods failed to type four isolates because of agglutination of controls . We recommend slide agglutination or coagglutination as the serotyping methods of choice in most laboratories because they are simple, accurate, and rapid . Slide agglutination with Difco antiserum can be performed at the lowest cost.

Am J Obstet Gynecol, 1985 Feb 1, 151(3), 338 - 9
Haemophilus influenzae causes purulent salpingitis; Paavonen J et al.; We describe two patients with laparoscopically diagnosed, severe acute salpingitis who had nontypable Haemophilus influenzae isolated directly from the fallopian tubes . Nontypable H . influenzae should be recognized as an important genital pathogen.

Pediatrics, 1985 Feb, 75(2), 254 - 9
Haemophilus influenzae type b septic arthritis in children: report of 23 cases; Rotbart HA et al.; Twenty-three cases of Haemophilus influenzae type b septic arthritis seen over a recent 5-year period are reviewed . The natural history of the disease includes a mean three days of fever and joint symptoms prior to hospitalization, often accompanied or immediately preceded by a viral illness and/or otitis media . Concurrent H influenzae type B meningitis was present in 30% of patients and concurrent osteomyelitis in 22% . Infants remained febrile in the hospital for a mean of 3.6 consecutive days . However, secondary and prolonged fevers were common . Clinical improvement in the joint examination was first seen at a mean of 2.5 days . Characteristic laboratory findings during recovery included a decline in total WBC count, neutrophil count, ESR, and hematocrit, with a concomitant increase in lymphocyte and platelet counts . Outpatient follow-up for a mean duration of 20 months found only two of 21 infants with residual impairment . The time to total healing in the remaining 19 infants, however, varied widely--from nine days to 17 months (mean of 4 months).

J Pediatr, 1985 Feb, 106(2), 190 - 5
Risk factors for primary invasive Haemophilus influenzae disease: increased risk from day care attendance and school-aged household members; Istre GR et al.; From November 1, 1981, through April 30, 1982, we performed a case-control study of primary invasive Haemophilus influenzae infections in children in Colorado . Information was collected for 121 (83%) of 146 children with positive cultures and for 196 (67%) of 292 age-matched controls selected at random from birth certificates . Infected children were more likely to have attended a day care center or nursery (DCC/N) and to have an elementary school-aged household member . For attendance at DCC/N, the relative risk was significantly increased only for children 12 months of age or older, and increased with the size of the DCC/N . After controlling for DCC/N attendance and school-aged siblings, children younger than 6 months of age with infection were significantly less likely to have been breast-fed, suggesting a protective effect of breast-feeding . We identified DCC/N attendees, especially those older than 1 year of age, to be at increased risk of primary H . influenzae disease . They could benefit from immunization.

J Pediatr, 1985 Feb, 106(2), 185 - 9
Safety and immunogenicity of Haemophilus influenzae type b-polysaccharide diphtheria toxoid conjugate vaccine in infants 9 to 15 months of age; Lepow ML et al.; Sixty 9- to 15-month-old infants were randomly assigned to receive two doses, 1 month apart, of a Haemophilus influenzae type b capsular polysaccharide-diphtheria toxoid conjugate vaccine (PRP-D) or PRP vaccine, each containing 20 micrograms PRP . There were no significant local or systemic reactions . After one dose of PRP-D, 93% of the subjects attained levels of greater than or equal to 0.15 microgram/ml and 59% achieved greater than or equal to 1 microgram/ml antibody protein . These percentages rose to 100% and 86%, respectively, after the second dose, at which time the geometric mean titer of anti-PRP antibody was 4.8 micrograms/ml . IgG anti-PRP levels were 4.3 times higher than IgM . The proportion of IgG to IgM antibody induced by PRP-D increased with age . After two doses, 33% of the PRP recipients responded with a level of greater than or equal to 0.15 microgram/ml and only 19% responded to a level of greater than or equal to 1.0 microgram/ml . One year later, all of the PRP-D recipients tested still had greater than or equal to 0.15 microgram/ml and more than half had greater than or equal to 1.0 microgram/ml antibody protein.

J Infect Dis, 1985 Feb, 151(2), 273 - 9
Modification of otitis media in chinchillas rechallenged with nontypable Haemophilus influenzae and serological response to outer membrane antigens; Karasic RB et al.; Otitis media was produced in chinchillas by right-sided intrabullar inoculation with nontypable Haemophilus influenzae, and susceptibility to reinfection was investigated . After resolution of initial right-sided infection, animals underwent ipsilateral or contralateral intrabullar rechallenge with the same strain . After ipsilateral rechallenge right ears were completely protected against reinfection; previously uninfected left ears were similarly protected on contralateral rechallenge . Previously infected ears remained fully susceptible to infection with a heterologous strain of nontypable H . influenzae . Using an enzyme-linked immunosorbent assay, we measured the serological response to outer membrane protein and lipopolysaccharide antigens during initial infection . A greater than or equal to 10-fold rise in titer of antibody to homologous outer membrane proteins was observed in all 11 animals tested . Most animals exhibited a minimal serological response to lipopolysaccharide . Thus experimental otitis media due to nontypable H . influenzae induces strain-specific protective immunity and a concomitant serological response to outer membrane proteins.

J Clin Microbiol, 1985 Feb, 21(2), 143 - 5
Evaluation of Gonodecten for the presumptive diagnosis of gonococcal urethritis in men; Janda WM et al.; Gonodecten (Gd; U.S . Packaging Corp., LaPorte, Ind.) is a commercially available test for the presumptive diagnosis of gonococcal urethritis in men . With this test, urethral discharge is collected on a swab, placed in a plastic tube, and moistened with oxidase reagent . Development of a purple color on the swab within 3 min indicates the presence of gonococci . This system was compared with culture and Gram-stained smear for the diagnosis of gonorrhea . Of 240 specimens tested, 174 were positive with culture, Gram stain, and the Gd test and 48 were negative with all tests . For eight specimens, cultures and smears were positive, but the Gd test was negative . Nine specimens produced positive Gd tests with negative smears and cultures . Only one specimen was positive on culture and with the Gd test and negative on Gram-stained smear . Haemophilus species were isolated from 14 specimens; 5 produced positive Gd test reactions, with gonococci being coisolated from 4 . The sensitivity and specificity of the Gd test compared with culture were 95.6 and 84.2%, respectively, whereas the Gram stain was 99.5% sensitive and 100% specific compared with culture . The Gd test may be a useful screening test for the diagnosis of gonorrhea in men with urethral discharge, particularly in settings where a microscope, Gram stain reagents, or technological expertise is not readily available.

Vet Med Nauki, 1985, 22(7), 15 - 21
{Isolation of Haemophilus somnus from cattle}; Buchvarova Ia; Studied were a total of 220 samples of material taken from the respiratory tract of calves and from fetuses of cows that miscarried for the presence of Haemophilus bacteria . Haemophilus somnus was isolated for the first time in this country from the respiratory tract of calves (10.1 per cent) and from fetuses of cows with abortions (6.2 per cent) . Haemophilus somnus was found in calves that had contracted respiratory diseases in 13 per cent of the cases, and in clinically normal calves--in 3.5 per cent of the cases . It was isolated both in pure culture and in mixed culture with P . multocida, M . bovirhinis, M . arginini, V . fetus, and C . pyogenes . As many as 21 strains of Haemophilus somnus were isolated, having the same morphologic, cultural, and biochemical properties characteristic of the species.

Clin Ther, 1985, 7 Suppl A, 1 - 18
Respiratory infection: the disease; Lode H; Infectious pneumonias are inflammations of the lung that can be localized in the alveoli or interstitial tissue or both . The pathogenic agent is usually airborne; more rarely it is hematogenous . Important distinctions are between bacterial and nonbacterial forms, between diseases acquired outside and inside hospitals, and between patients who are basically healthy and those with a previous illness . Pneumococci continue to be the dominant pathogens outside hospitals . In hospitals, gram-negative, anaerobic, and fungal pathogens are more often found . Usually, purulent chronic bronchitis or an acute exacerbation of chronic bronchitis is based on a prior viral infection or an impairment of bacterial clearance mechanisms of the respiratory tract . The dominant pathogens are Haemophilus influenzae and pneumococci . Worldwide, viral infections of the upper respiratory tract have great epidemiological significance . With 12 different groups of viruses and more than 150 serotypes, there can be many causes of symptoms of rhinitis, tonsillitis, pharyngitis, laryngitis, and tracheitis as well as bronchitis.

Scand J Infect Dis, 1985, 17(3), 327 - 9
Severe pulmonary infection by Haemophilus aphrophilus in a non-compromised child; Arneborn P et al.; A Haemophilus aphrophilus pulmonary infection with abscess formation in a previously healthy 9-year-old girl is reported . This has not been reported earlier in the literature . The clinical features were extremely severe with respiratory, circulatory and renal insufficiency . Artificial ventilation for 10 days was necessary, initially with 100% oxygen and extremely high airway pressure . The girl is now in perfect health again.

Prog Clin Biol Res, 1985, 189, 369 - 85
Chromogenic Limulus amebocyte lysate assay as an aid in the diagnosis of meningitis; Saubolle MA; Cerebrospinal fluids (CSFs) from 146 patients with suspected meningitis were screened by a recently introduced, rapid and sensitive chromogenic Limulus amebocyte lysate (CLAL) assay for endotoxin . Fifty-eight of these CSFs were screened as well for bacterial antigens by CIE, latex and/or coagglutination techniques . A total of 68 CSFs were positive by either culture and/or at least one of the antigen screens . The overall sensitivity of the CLAL assay was 93% with a specificity of 100% . However, the assay's sensitivity for community - acquired meningitis due to Haemophilus influenzae type b and Neisseria meningitidis was 100% . In this group the assay's sensitivity was better than those of direct gram stain (62%), culture (80%), and commercially available, rapid antigen detection methods (89%) . Used judiciously, the CLAL assay is a cost-effective, helpful adjunct test for the diagnosis of gram-negative meningitis.

J Neurol, 1985, 232(3), 157 - 61
Apurulent bacterial meningitis (compartmental leucopenia in purulent meningitis); Felgenhauer K et al.; Meningococci and Haemophilus influenzae may invade the subarachnoid space during the bacteriaemic phase without impairment of the blood-CSF barrier and in the absence of any leucocyte reaction . In pneumococcal meningitis the CSF may also contain less than 100 cells/microliter despite the presence of "pure bacterial cultures", but the barrier is completely broken when the serum/CSF concentration ratio is below 10 . A clinical analysis of eight patients with fewer than 100 cells/microliter revealed that the first symptoms of meningitis appeared at least 3 days prior to the diagnostic lumbar puncture . There was a strong neutrophilic reaction in the blood with a prevalence of juvenile forms in most cases, indicating intact antibacterial defence mechanisms . Within 24 h after the start of antibiotic therapy the cell number rose above 2000/microliter accompanied by disappearance of pneumococci . Six of the eight patients died . In three cases autopsy revealed thick layers of pus over the convexities, indicating a compartmental separation of the ventricles and the spinal subarachnoid space . In one case of late diagnosed bacterial meningitis with a pleocytosis of 430/microliter the CSF lysozyme level was seven times higher than compatible with this cell number . Hyperphagocytosis and cellular disintegration is thought to cause the leucopenia within the spinal CSF compartment . "Apurulent bacterial meningitis" can be seen as a disease entity that is a diagnostic pitfall and also a prognostic sign.

Drugs, 1985, 29 Suppl 5, 197 - 200
Temocillin in the treatment of chest infections; Gray JM et al.; In our study, 16 patients with acute infection complicating severe respiratory disease were treated with temocillin 2g or 3g daily for 5 to 10 days . In 10 patients, a recognised respiratory pathogen, either Haemophilus influenzae (temocillin-sensitive) or Streptococcus pneumoniae (temocillin-resistant), was isolated from sputum before the start of treatment . 13 patients improved clinically but 5 subsequently relapsed . Two patients failed to respond, and 1 died of respiratory failure . There was no clearcut relationship between the clinical progress and sensitivity of the isolated pathogen to temocillin, and there were no adverse effects associated with the administration of temocillin.

Can J Comp Med, 1985 Jan, 49(1), 68 - 74
Comparative virulence of porcine Haemophilus bacteria; Rosendal S et al.; The virulence of strains of Haemophilus pleuropneumoniae serotype 1, 2, 3, 7 and strains of the "minor-group" and Haemophilus parasuis were compared by inoculating specific pathogen-free pigs into the lower airways with specified doses of bacteria . Haemophilus pleuropneumoniae, strain W, serotype 1, given in 1 X 10(8) colony-forming units, produced a lethal acute pleuropneumonia in four pigs . Nonlethal localized pulmonary necrosis was induced in four groups of two pigs given 1 X 10(7), 1 X 10(6), 1 X 10(5) and 1 X 10(4) respectively of the same strain . Two groups of four pigs developed chronic lesions when inoculated with 1 X 10(7) colony-forming units of H . pleuropneumoniae, strain Shope 4074, serotype 1 and 1 X 10(7) colony-forming units of H . pleuropneumoniae, strain WF83, serotype 7, respectively . Of 20 pigs given 1 X 10(8) colony-forming units of strain 1536, serotype 2, two died of acute pleuropneumonia and 18 had lesions of pulmonary necrosis or abscessation and pleuritis . A dose of 4 X 10(9) colony-forming units of strain BC181, serotype 3, induced pulmonary necrosis similar to the lesions in pigs given 10(7) colony-forming units or less of strain W, serotype 1, suggesting that the serotype 3 strain is less virulent . No clinical signs, but focal areas of pulmonary fibrosis and pleural adhesions were induced in four pigs inoculated with 4 X 10(9) colony-forming units of the "minor-group" strain 7ATS . Similarly, four pigs inoculated with "minor-group" strain 33PN did not show clinical signs, but had focal necrotic and fibrotic pulmonary lesions and pleural adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Can J Comp Med, 1985 Jan, 49(1), 63 - 7
Characterization of Pasteurella species isolated from lungs of calves with pneumonia; Madsen EB et al.; During routine bacteriological examination of pneumonic calf lungs it was experienced that many Pasteurella multocida-like isolates had a fermentation pattern different from what is generally accepted for P . multocida sensu stricto . Forty-one out of 50 strains selected for further investigation were phenotypically related and formed a group of indole-, mannitol-and sorbitol-negative P . multocida-like strains, which was tentatively designated taxon 13 . Deoxyribonucleic acid/deoxyribonucleic acid hybridizations including both ornithine positive and ornithine negative strains of taxon 13 allowed the classification of the former as P . multocida biovar 6 and the latter as V factor independent strains of Haemophilus avium.

Vet Microbiol, 1985 Jan, 10(2), 125 - 31
An evaluation of commercial discs for the determination of the growth factor requirements of avian haemophili; Blackall PJ et al.; The ability of 2 brands of growth factor discs (Oxoid and Mast) to identify correctly the growth factor requirements of 41 isolates of Haemophilus paragallinarum and 17 isolates of H . avium was evaluated . The percentage of isolates correctly identified as requiring V factor varied with both the brand of the disc and the medium used . On basic nutrient media both brands gave low percentages of correct results: on Isosensitest Agar (Oxoid) the Oxoid discs gave 26% and the Mast discs 24% while on Heart Infusion Agar (Gibco) the Oxoid discs gave 54% and the Mast discs 28% . However, on a more complex medium (TM/S) the percentage of correct results was considerably higher with the Oxoid discs 100% and the Mast discs 52% accurate.

J Comp Pathol, 1985 Jan, 95(1), 15 - 23
Histopathological evaluation of disseminated intravascular coagulation in Haemophilus somnus infection in cattle; Momotani E et al.; The frequency and distribution of fibrin thrombi (microthrombi) in the main organs of spontaneously infected cattle were investigated to evaluate disseminated intravascular coagulation (DIC) in Haemophilus somnus infection . This infection is well known as infectious thrombo-embolic meningo-encephalitis (ITEME) and is characterized histopathologically by formation of thrombi, necrosis of blood vessels and neutrophil infiltration . The precise pathogenic mechanism of this disease has not yet been fully elucidated . The liver, spleen, kidney, lung, heart and brain of 11 cattle showing thromboembolic meningo-encephalitis were examined histopathologically and special attention was paid to fibrin thrombi . PTAH staining showed a high frequency of fibrin thrombi in the small vessels and capillaries in more than 3 organs and all the cases were regarded as falling within the histopathological criterion of DIC . The results of the present study indicate that the pathogenesis of the infection is closely related to the DIC.

Pediatr Infect Dis, 1985 Jan-Feb, 4(1), 22 - 6
Ceftriaxone administered once or twice a day for treatment of bacterial infections of childhood; Higham M et al.; Twenty-six children received a single daily intravenous dose of ceftriaxone, 50 mg/kg, for a variety of bacterial infections including abscess (5), cellulitis (5), periorbital cellulitis (5), bacteremia without focus (4), osteomyelitis (2), pneumonia (2), pyelonephritis (2) and otitis media (1) . Organisms isolated from infectious foci were Staphylococcus aureus (9), Streptococcus pneumoniae (6), Streptococcus pyogenes (3), Escherichia coli (2); and Haemophilus influenzae type b, nontypable H . influenzae, Group B streptococcus, Pasteurella multocida, Haemophilus parainfluenzae and satelliting streptococcus (1 each) . Microbiologic cure was achieved in 20 of 22 (91%) infections and clinical cure in 25 of 26 (96%) . Fifteen possible adverse reactions occurred in 34 patients evaluable for drug safety; most were mild and self-limited . Neutropenia developed in two patients necessitating discontinuation of ceftriaxone in one, followed by prompt resolution . Seventeen children received ceftriaxone, 75 mg/kg/day, in two divided doses for a similar variety of infections . Bacteriologic and clinical cure rates of 100 and 94%, respectively, were demonstrated . Leukopenia developed in one patient and resolved when ceftriaxone was discontinued . Once a day dosing of ceftriaxone in pediatric patients provides greater ease of administration combined with efficacy equal to that achieved with a divided dosage schedule.

Ann Allergy, 1985 Jan, 54(1), 60 - 4
Studies of bronchial secretion . The influence of inflammatory response and bacterial infection; Pryjma J et al.; Bronchial secretions obtained during bronchoscopic examination of 60 children suffering from respiratory tract infections were studied for the concentration of immunoglobulins, anti-proteolytic factors, lactoferrin, and lysozyme . Eleven children having bronchial asthma without a history of chronic or recurrent infections of the respiratory tract were designated as a control . The results were analysed in relation to clinical diagnosis (chronic bronchitis, bronchitis, bronchiectasis) or to the local status of bronchial mucosa at the time of bronchoscopy (no inflammation, inflammation, inflammation with documented bacterial infection) . The statistical analysis of the results revealed a decrease of lactoferrin and locally produced IgA in the group of children suffering from bronchitis and chronic bronchitis . Samples infected with Haemophilus species had significantly higher concentration of lactoferrin than any other group . Similarly, albumin in this group was higher than in the other group except that other bacteria were present . Samples infected with Haemophilus also had increased concentrations of S-IgA, IgG, and anti-proteolytic factors when compared with the group without local inflammation.

Scand J Infect Dis, 1985, 17(4), 367 - 70
Phenoxymethylpenicillin and therapeutic failure in acute otitis media; Laurin L et al.; The aim of the present investigation was to determine to what extent beta-lactamase producing Haemophilus influenzae (H.i.) and Branhamella catarrhalis (B.c.) were isolated in cases of failure of treatment of acute otitis media (AOM) with phenoxymethylpenicillin . Among children with suspected therapeutic failure referred to an ENT specialist altogether 11, 15% of those referred, fulfilled the criteria of AOM . Three of them were on erythromycin, 1 on ampicillin and 7 on phenoxymethylpenicillin . In 5 of the children treated with phenoxymethylpenicillin H.i . was isolated from middle ear exudate and/or the nasopharynx . All H.i . isolates were non-capsulated and beta-lactamase negative . One beta-lactamase producing B.c . was isolated from the nasopharynx in a patient with pure culture of H.i . in the ear exudate . The present investigation did not support the suggestion that beta-lactamase producing H.i . or B.c . are major causative agents in therapeutic failures of AOM treated with phenoxymethylpenicillin and did not produce any evidence supporting a change from the recommended ampicillin esters/amoxycillin in therapeutic failures.

Microbiol Immunol, 1985, 29(7), 591 - 600
Detection of mucosal and serum antibodies specific for the capsular polysaccharide of Haemophilus influenzae type b by enzyme-linked immunosorbent assay; Harada T et al.; A sensitive enzyme-linked immunosorbent assay (ELISA) with rough-surfaced glass beads used as the solid phase was developed for detection of IgG, IgM, and IgA antibodies to Haemophilus influenzae type b capsular polysaccharide (HITB-CP) . A successful method for indirect coating of glass bead surfaces with HITB-CP, and parameters affecting the specificity and sensitivity of the assay are described . This ELISA system proved to be 100 times as sensitive as the standard indirect fluorescent-antibody assay . The assay was applied to the measurement of antibodies to HITB-CP in serum and nasal secretions and proved to be a useful tool in the evaluation of immunological response to HITB infection.

Pediatr Pharmacol (New York), 1985, 5(1), 7 - 16
A multicenter comparison of related pharmacologic features of cephalexin and dicloxacillin given for two months to young children with cystic fibrosis; Harrison CJ et al.; Twenty-one cystic fibrosis patients under 3 years of age were enrolled in an open multicenter study to assess the feasibility of the study design and to compare selected pharmacologic features of cephalexin or dicloxacillin administered orally for 2 months . Patient tolerance and compliance were significantly less for dicloxacillin (p less than .01 and p less than .001, respectively) . Superficial Candida infections were more common in the cephalexin group (p = 0.02), however increased stool frequency and nonspecific diaper rashes were more prevalent in patients receiving dicloxacillin (p less than .05) . Staphylococcus aureus was isolated from respiratory secretions after 2 months from two dicloxacillin and no cephalexin patients . Areas under the curve and peak serum concentrations were higher for cephalexin (p less than .05 and p = .02), but antistaphylococcal activity in serum was higher for dicloxacillin (p less than .05) due to a lower mean MIC compared to cephalexin . Deep pharyngeal plus routine throat culture yielded more pathogens than either method alone . Express mail and central processing of respiratory specimens was efficient for most organisms, however there was some loss of Streptococcus pneumoniae and Haemophilus influenzae . Cephalexin was associated with better patient acceptance and compliance despite higher rates of superficial fungal infections as compared to dicloxacillin . Cephalexin, routine bacteriologic throat swabs processed locally or centrally, mail-in urine compliance assessment and a multicenter design are feasible components for a long-term prospective evaluation of antibiotic prophylaxis in patients with cystic fibrosis.

Thorax, 1985 Jan, 40(1), 23 - 6
Newly diagnosed cystic fibrosis in middle and later life; Hunt B et al.; Four patients with cystic fibrosis diagnosed in middle and later life are presented . All had chronic bronchopulmonary infection with a high sweat sodium concentration, and chest radiographic evidence of upper zone bronchiectasis . Two patients had pancreatic dysfunction . Sputum culture grew mucoid Pseudomonas aeruginosa in three patients and Haemophilus influenzae in one . Ages at diagnosis were 63, 42, 40, and 35 years . These patients confirm the possibility of occasional longevity in cystic fibrosis and emphasise the need to consider the diagnosis at all ages . They also provide encouragement for younger patients.

Drugs Exp Clin Res, 1985, 11(6), 369 - 72
Position of ceftazidime in respiratory diseases; Ando' F et al.; Twenty patients (10 males and 10 females), ranging in age from 53 to 81 years, were treated with ceftazidime, 2-3 g/day i.m., for 12 to 15 days . All patients were suffering from moderate to severe infections of the lower respiratory tract (6 cases of pneumonia and 14 cases of acute exacerbation of chronic bronchitis) . In addition, almost all patients presented severe local and general predisposing factors (three patients with lung cancer, two with bronchiectasis and 14 with respiratory insufficiency) . The aetiological agents responsible for the infections were mainly Gram-negative bacteria (6 Klebsiella pneumoniae, 4 Haemophilus influenzae, 4 Pseudomonas aeruginosa and 3 Proteus strains) . The clinical and microbiological results of the treatment were good . With the exception of one case of maculopapular rash, none of the patients complained of adverse reactions and no toxic effects were observed.

Ann Chir Gynaecol, 1985, 74(4), 183 - 4
Group A streptococcal peritonitis in infancy; Serlo W et al.; Primary peritonitis in infancy is a rare condition . It is usually associated with a severe pathological process, such as nephrotic syndrome . When it affects previously healthy infants it causes diagnostic and therapeutic difficulties . Pneumococci, streptococci and Haemophilus influenzae are possible causative agents, other causes are rare . The clinical course of two infants with group A streptococcal peritonitis is described.

J Clin Periodontol, 1985 Jan, 12(1), 1 - 20
Actinobacillus actinomycetemcomitans in human periodontal disease; Zambon JJ; Recent evidence implicates Actinobacillus actinomycetemcomitans in the etiology of localized juvenile periodontitis . This paper reviews the morphological, biochemical and serological charcteristics of A . actinomycetemcomitans, evidence incriminating it as a periodontopathogen, its importance in human nonoral infections, and virulence factors which may be involved in the pathogenesis of A . actinomycetemcomitans infections . A . actinomycetemcomitans is a non-motile, gram-negative, capnophilic, fermentative coccobacillus which closely resembles several Haemophilus species but which does not require X or V growth factors . The organism has been categorized into 10 biotypes based on the variable fermentation of dextrin, maltose, mannitol, and xylose and into 3 serotypes on the basis of heat stable, cell surface antigens . A . actinomycetemcomitans' primary human ecologic niche is the oral cavity . It is found in dental plaque, in periodontal pockets, and buccal mucosa in up to 36% of the normal population . The organism can apparently seed from these sites to cause severe infections throughout the human body such as brain abscesses and endocarditis . There is a large body of evidence which implicates A . actinomycetemcomitans as an important micro-organism in the etiology of localized juvenile periodontitis including: (1) an increased prevalence of the organism in almost all localized juvenile periodontitis patients and their families compared to other patient groups; (2) the observation that localized juvenile periodontitis patients exhibit elevated antibody levels to A . actinomycetemcomitans in serum, saliva and gingival crevicular fluid; (3) the finding that localized juvenile periodontitis can be successfully treated by eliminating A . actinomycetemcomitans from periodontal pockets; (4) histopathologic investigations showing that A . actinomycetemcomitans invades the gingival connective tissue in localized juvenile periodontitis lesions; (5) the demonstration of several pathogenic products from A . actinomycetemcomitans including factors which may: (a) facilitate its adherence to mucosal surfaces such as capsular polysaccharides; (b) inhibit host defense mechanisms including leukotoxin, a polymorphonuclear leukocyte chemotaxis inhibiting factor, and a lymphocyte suppressing factor (c) cause tissue destruction such as lipopolysaccharide endotoxin, a bone resorption-inducing toxin, acid and alkaline phosphatases, collagenase, a fibroblast inhibiting factor and an epitheliotoxin.(ABSTRACT TRUNCATED AT 400 WORDS)

Am J Vet Res, 1985 Jan, 46(1), 185 - 92
Serotyping of Haemophilus pleuropneumoniae by rapid slide agglutination and indirect fluorescent antibody tests in swine; Rapp VJ et al.; One hundred and forty-one isolates of Haemophilus pleuropneumoniae from Iowa and Illinois swine were characterized morphologically and biochemically and serotyped by rapid slide agglutination (RSA) and indirect fluorescent antibody (IFA) tests . Hyperimmune antisera were produced in rabbits using inactivated whole-cell suspensions of the reference strains for H pleuropneumoniae serotypes 1 to 7 and strain 202, representing the taxon "minor group." Cross testing of the reference strains and reference antisera indicated the antisera to be essentially serotype-specific, although reactivity of some antisera with heterologous strains was observed . Cultures of the 141 isolates formed adherent or smooth colonies or mixtures of these colony forms . Adherent and smooth colony types were found in all serotypes identified . Microscopic and biochemical characteristics of all isolates were typical of those previously described for H pleuropneumoniae . The overall incidence of H pleuropneumoniae serotypes was serotype 5, 55.3%; serotype 1, 34.0%; serotype 7, 7.8%; and nontypeable, 2.8% . Comparing the 2 test procedures, 87.2% of the isolates could be typed by RSA, and 66.0% could be typed by IFA . Cross-reactions between serotype 4 antisera and serotype 5 and 7 isolates were common with the IFA test . The reactions with serotype 7, but not serotype 5, were eliminated by cross adsorption of serotype 4 antisera . There was good correlation between the 2 test procedures, but RSA was judged to be more specific and sensitive than IFA.

J Hyg Epidemiol Microbiol Immunol, 1985, 29(4), 417 - 25
Haemophilus influenzae: the current status of its in vitro susceptibility to antimicrobials; Janovska D et al.; Continuous surveillance of the antimicrobial susceptibility patterns of strains of Haemophilus influenzae (H . i.) is part of a routine surveillance of bacterial sensitivity to antibiotics . In this study a major attention was given to the clinically important antimicrobials used in the treatments of H . i . infections, namely ampicillin, chloramphenicol and some cephalosporin preparations . Antimicrobial susceptibility determinations carried out in 1983 and before on H.i . strains isolated in different Czech regions show a clear-cut tendency towards the higher incidence of strains resistant to ampicillin and its derivative amoxycillin . The rise in resistance to erythromycin was also observed . Susceptibility to chloramphenicol continues to remain unchanged . Of the cephalosporin antimicrobials tested (cephalothin, ceftriaxone, cefaperazone, cefsulodine and cefadroxil) the most active were ceftriaxone and cefaperazone . The need of a further continuation of surveillance of H.i . drug susceptibility patterns is strongly emphasized; to ensure effective treatment results antibiograms should be done in each case of H.i . infection.

Med Microbiol Immunol (Berl), 1985, 174(4), 197 - 203
Antibody assay of rabbit sera for outer membrane vesicles of Haemophilus influenzae by enzyme-linked immunosorbent assay; Harada T et al.; Enzyme-linked immunosorbent assay (ELISA) was applied to the detection of IgG and IgM antibodies against outer membrane vesicles (OMV) antigen of Haemophilus influenzae type b . In this ELISA system, IgG antibody titers were about 40 fold higher than those in indirect hemagglutination assay (IHA) . The IgG antibody titers by this ELISA of rabbit sera obtained after immunization were comparable with those by radioimmunoassay (RIA) of the same sera . A significant correlation was established between these two assays (r = 0.973, P less than 0.001).

Scand J Infect Dis, 1985, 17(1), 115 - 20
A prospective study demonstrating an association between plasma IgG2 concentrations and susceptibility to otitis media in children; Freijd A et al.; Plasma IgG subclass levels of 20 children, 12 and 32 months of age, who were susceptible to acute purulent otitis media, were compared with those of 20 age-matched control children . The IgG2 levels were significantly lower in the otitis-prone group, with a mean of 0.58 +/- 0.30 g/l at 12 months of age (controls 0.85 +/- 0.39) and 0.82 +/- 0.30 at 32 months of age (controls 1.38 +/- 0.49) . Otitis-prone children with IgG2 levels less than or equal to 0.58 g/l (at 12 months of age) were found to suffer from Haemophilus influenzae infections 2.6 times as often as those with IgG2 levels greater than 0.58 g/l . On the other hand pneumococci were found 1.9 times as often in the group with IgG2 level greater than 0.58 g/l, as in the group with IgG2 level less than or equal to 0.58 g/l . Otitis proneness seems partly to be due to an immunological incompetence of IgG2, which also influences the bacterial spectrum of the infections.

Postgrad Med J, 1985 Jan, 61(711), 67 - 8
Waterhouse-Friderichsen syndrome without purpura due to Haemophilus influenzae group B; Morrison U et al.; A second recorded case of Waterhouse-Friderichsen syndrome, without purpura, due to Haemophilus influenzae is described . It is suggested that the absence of purpura should not preclude the diagnosis of the Waterhouse-Friderichsen syndrome due to this organism.

Infection, 1985 Jan-Feb, 13(1), 12 - 4
Invasive infections caused by Haemophilus species other than Haemophilus influenzae; Trollfors B et al.; In a retrospective study covering a 13-year period and a population of 817,900 inhabitants, 13 cases of invasive infection caused by Haemophilus species other than Haemophilus influenzae were found . Ten of the infectious episodes were caused by Haemophilus parainfluenzae and three by Haemophilus aphrophilus . The clinical manifestations comprised endocarditis, meningitis, pleuropneumonia, epiglottitis and septicaemia from an unknown focus . These 13 infectious episodes caused by uncommon Haemophilus species constituted less than 3% of the total number (473) of invasive Haemophilus infections registered during the same period of time . Invasive H . influenzae infections were more common in all age groups than infections caused by other Haemophilus species . In contrast to H . influenzae infections, which predominate in childhood, invasive infections due to uncommon Haemophilus species had no predilection for any age group.

Br J Dis Chest, 1985 Jan, 79(1), 95 - 7
Lobar pneumonia caused by Haemophilus influenzae type B; Ashworth M et al.; Haemophilus influenzae type b is a rare cause of adult lobar pneumonia and we are unaware of any reported British cases . However in the United States this condition is well described and the incidence is increasing (Levin et al . 1977).

Antimicrob Agents Chemother, 1985 Jan, 27(1), 46 - 54
A permeability barrier as a mechanism of chloramphenicol resistance in Haemophilus influenzae; Burns JL et al.; Chloramphenicol resistance in Haemophilus influenzae occurs most frequently via plasmid-mediated chloramphenicol acetyltransferase production . We studied four strains with high-level chloramphenicol resistance (MIC greater than 20 micrograms/ml) which did not have detectable chloramphenicol acetyltransferase activity . The chloramphenicol resistance determinant was transformed into a chloramphenicol-susceptible laboratory H . influenzae strain from each of the four wild-type strains, enabling isogenic comparisons . By thin-layer chromatography and a bioassay, there was no evidence of non-chloramphenicol acetyltransferase modification of chloramphenicol . In vitro protein synthesis in the presence of chloramphenicol was equivalently inhibited in the chloramphenicol-resistant transformants and in the susceptible recipient . Chloramphenicol uptake by these strains during logarithmic growth was compared by high-pressure liquid chromatographic quantitation; at chloramphenicol concentrations of 5, 10, and 20 micrograms/ml the four transformants showed a decreased rate of uptake of chloramphenicol compared with the isogenic chloramphenicol-susceptible recipient . Sodium dodecyl sulfate-polyacrylamide gel electrophoretic analysis of outer membrane proteins revealed a markedly diminished 40-kilodalton protein in the resistant transformants . We propose that the mechanism of chloramphenicol resistance in these strains is a relative permeability barrier due to the loss of an outer membrane protein.

Med Microbiol Immunol (Berl), 1985, 173(6), 345 - 53
Capsular variation in experimental strains of Haemophilus influenzae; Huber PS et al.; This study sought to demonstrate that clinically untypable strains of Haemophilus influenzae are derivable from previously capsulated ones . Penicillin-induced forms were employed to explore in vivo and in vitro a possible mechanism of the reversible cycle vegetative to L-phase revertant . Normal H . influenzae type b (Rab), capsule-deficient strain ATCC 9333, and experimental L-phase and its revertants were used in this investigation . Capsular antigens, polyribose phosphate (PRP) content of each strain was assayed by orcinol and rocket immunoelectrophoretic methods . Intra- and inter-strain PRP differences were statistically analysed . Strain differences between in vivo and in vitro passaged extracts of strain 9333 and 9333 were significant (t-test P less than 0.01) . There were also significant differences in vivo and in vitro between penicillin-treated, L-phase infected mouse isolates and penicillin-free, L-phase infected mouse isolates; and also between penicillin-treated, L-phase infected mouse isolates and revertant Rab infected mouse isolates (Mann-Whitney U-test P less than 0.02, P less than 0.01, respectively) . These findings suggest that untypable isolates of H . influenzae are derivable from otherwise capsulated strains, depending on decapsulating factors in the microenvironment . Clinical implications of the findings are discussed.

Med Microbiol Immunol (Berl), 1985, 173(6), 303 - 9
In vitro susceptibilities of Haemophilus influenzae isolates from a Veterans Administration Medical Center; Flournoy DJ; One hundred and one consecutively occurring clinical isolates of H . influenzae, from adult male patients, were tested for quantitative antimicrobial susceptibility (by broth microdilution) and classification properties . Almost all were susceptible to a variety of antimicrobials, except erythromycin and ampicillin; 14% were ampicillin resistant . Beta-lactamase was produced by all the ampicillin-resistant strains . Most isolates were biotype II (68%) or III (24%) . Only 6% were serotype b, while 94% were from the lower respiratory tract . When isolates were grouped according to biotype, serotype, B-lactamase production and site of isolation, there were some significant differences in susceptibilities among the groups.

Mikrobiyol Bul, 1985 Jan, 19(1), 23 - 8
{Relation between serum and salivary IgA and oral aerobic bacterial flora in patients with chronic bronchitis}; Misirligil Z et al.; Serum and salivary IgA and oral bacterial flora was determined in specimens collected from 28 patients with chronic bronchitis and 7 healthy persons . However, in serum IgA levels, the difference between the patients and controls was not found statistically significant, the mean salivary IgA level was significantly higher in the patients with spastic bronchitis than in infectious bronchitis and controls (p less than 0.01) . The mean salivary IgA level was significantly higher in the patients from whom Haemophilus influenzae was isolated, it was lower in the specimens in which gram negative bacilli were isolated (p less than 0.01).

ORL J Otorhinolaryngol Relat Spec, 1985, 47(1), 32 - 6
A microbiological study of secretory otitis media using an anaerobic technique; Edstrom S et al.; A serious anaerobic sampling and cultivation technique was used in order to obtain representative samples from 45 middle ear effusions in 30 patients with longstanding secretory otitis media (SOM) . Despite the fact that an accurate sterilizing procedure was performed, 16% disclosed contaminated samples from the ear canal and tympanic membrane . Among the remaining samples, middle ear bacteria were found in 30% of which Staphylococcus epidermidis and Haemophilus influenzae contributed to the major part . Anaerobes were only occasionally found . The amount of bacteria found was sparse in all cases . It can be concluded that the inflammatory process in SOM is not maintained by anaerobic bacteria within the middle ear cavity.

J Bacteriol, 1985 Jan, 161(1), 141 - 6
Differential behavior of plasmids containing chromosomal DNA insertions of various sizes during transformation and conjugation in Haemophilus influenzae; Balganesh M et al.; Plasmids with chromosomal insertions were constructed by removal of a 1.1-kilobase-pair piece from the 9.8-kilobase-pair vector plasmid pDM2 by EcoRI digestion and inserting in its place various lengths of chromosomal DNA (1.7, 3.4, and 9.0 kilobase pairs) coding for resistance to novobiocin . A fourth plasmid was constructed by insertion of the largest piece of chromosomal DNA into the SmaI site of pDM2 . The plasmids without inserts were taken up poorly by competent cells and thus were considered not to contain specific DNA uptake sites . The presence of even the smallest insert of chromosomal DNA caused a large increase in transformation of Rec+ and Rec- strains . The frequency of plasmid establishment in Rec+ cells by transformation increased exponentially with increasing insert size, but in Rec- cells there was less transformation by the larger plasmids . Conjugal transfer of these plasmids was carried out with the 35-kilobase-pair mobilizing plasmid pHD147 . The frequency of establishment of plasmids by this method not only was not markedly affected by the presence of the insertions, but also decreased somewhat with increase in insert size and was independent of rec-1 and rec-2 genes . Recombination between plasmid and chromosome was readily detected after transformation, but could not be detected after transconjugation even when the recipient cells were Rec+ and made competent . These data suggested that there is a special processing of plasmid DNA that enters the competent cells in transformation that makes possible recombination of homologous regions of the plasmid with the chromosome and pairing with the chromosome that aids plasmid establishment.

Diagn Microbiol Infect Dis, 1985 Jan, 3(1), 73 - 5
Meningitis and septicemia due to Haemophilus influenzae serotype e, biotype IV; Schlossberg D et al.; Haemophilus influenzae, serotype e, biotype IV, is a rare cause of infection . We studied a 22-year-old white male who developed septicemia and meningitis due to this pathogen . It is most probable that cerebrospinal fluid (CSF) rhinorrhea caused by a defect in the medial sphenoid region provided the portal of entry.

Pediatrics, 1985 Jan, 75(1), 8 - 13
In vivo sensitivity test in otitis media: efficacy of antibiotics; Howie VM et al.; During a 10-year period, antibiotics were assigned in random, double-blind fashion in six combinations to treat 948 episodes of otitis media in children . Exudate from the middle ear of all patients was cultured before treatment . Three follow-up visits were conducted; the first follow-up visit was three to five days after the start of therapy, and the second and third visits were 14 and 31 days after onset of treatment . Exudates were recultured for 75% of the patients on the first follow-up visit . Comparison of treatment results showed that triple sulfonamide combined with either phenoxymethyl penicillin, or benzathine and procaine penicillin G given intramuscularly (IM) was as effective as was ampicillin or amoxicillin . Phenoxymethyl penicillin and cyclacillin alone were usually effective against pneumococci but relatively ineffective against Haemophilus influenzae . Cefaclor and trimethoprim-sulfamethoxazole produced unsatisfactory results in about half the cases caused by pneumococci or H influenzae . Although production of beta-lactamase by some otitis-causing Haemophilus and Staphylococcus species may explain the ineffectiveness of some treatments, the percentage of organisms positive for beta-lactamase was too small to be responsible for the poor results with certain drugs.

Infect Immun, 1985 Jan, 47(1), 142 - 8
Decreased protective efficacy of reduced and alkylated human immune serum globulin in experimental infection with Haemophilus influenzae type b; Schreiber JR et al.; Conventionally prepared immune serum globulin frequently produces severe side effects when administered intravenously . A modified preparation in which 4 to 5 interchain disulfide bonds have been reduced and alkylated has been made for intravenous use . However, reduction and alkylation may affect Fc-mediated functions of immunoglobulin G, particularly its ability to fix complement by the classical pathway . To determine whether reduction and alkylation alters the protective activity of immune serum globulin in vivo we compared it with two less harshly prepared globulins (pH 4 treated or ultrafiltered) in an infant rat model of Haemophilus influenzae b infection . Antibody binding to the capsular and noncapsular components of H . influenzae b and in vitro bactericidal activity were similar in the globulin preparations . Infant rats were treated with various doses of globulins adjusted to provide identical concentrations of anticapsular antibodies as measured by the Farr radioactive antigen binding assay . At high doses of anticapsular antibody (greater than 1,500 ng per pup), all preparations protected well . At marginal doses (750 ng per pup), however, rats given reduced and alkylated globulin had a significantly greater incidence of bacteremia (P less than 0.05), meningitis (P less than 0.01), and death (P less than 0.05) and a higher magnitude of bacteremia (P less than 0.02) than rats who received pH4-treated or ultrafiltered globulins . These differences were not due to differences in anticapsular antibody concentrations achieved in the serum . The 50% protective serum concentrations of anticapsular antibody in this model were 200 to 300 ng/ml for reduced and alkylated globulin and 100 to 200 ng/ml for acid-treated globulin . Absorption of the globulins with purified H . influenzae b capsule reduced in vitro bactericidal activity and rat protective activity . However, the magnitude of bacteremia was lower in rats receiving absorbed pH 4-treated globulin than in those receiving absorbed reduced and alkylated globulin (P less than 0.05) . We conclude that reduced and alkylated immunoglobulin G provides significantly less protective activity against H . influenzae b infection in this model than globulins not so modified, and we suggest that the altered Fc function of the immunoglobulin G, such as the decreased ability to fix complement by the classical pathway or decreased Fc-mediated opsonization, may be responsible for this impairment.

Arch Oral Biol, 1985, 30(11-12), 843 - 8
Influence of endogenous catalase activity on the sensitivity of the oral bacterium Actinobacillus actinomycetemcomitans and the oral haemophili to the bactericidal properties of hydrogen peroxide; Miyasaki KT et al.; Actinobacillus actinomycetemcomitans and the genetically-related oral haemophili (Haemophilus segnis, Haemophilus aprhophilus and Haemophilus paraphrophilus) exhibit a range of sensitivities to the lethal effect of hydrogen peroxide (H2O2), A . actinomycetemcomitans being the most resistant . To extend this information, susceptibility to a range of H2O2 concentrations (10(-6)-10(-3) M) was assessed by incubating bacterial suspensions for 1 h at 37 degrees C in the presence of H2O2 and spreading the suspensions on chocolate agar plates to determine the concentration of H2O2 producing a 50 per cent reduction in colony-forming units (LD50) . Catalase activity was quantified with a Clark-type oxygen electrode, which polarographically monitored the formation of dissolved oxygen in bacterial suspensions or sonicates following addition of reagent H2O2 . Sensitivity to H2O2 did not correlate with catalase activity, either in intact cells or in bacterial sonicates . Specifically, some bacterial strains with undetectable catalase activity were highly resistant to H2O2 . Micromolar concentrations of sodium azide which completely inhibited cell-associated catalase activity did not affect the resistance of A . actinomycetemcomitans to H2O2 . Thus, the endogenous catalase activity of A . actinomycetemcomitans and certain oral haemophili is not an important determinant of resistance to the bactericidal effects of H2O2.

Acta Otolaryngol Suppl, 1985, 424, 13 - 6
The effect of cefaclor on the nasopharyngeal flora in children with chronic OME; Anari M et al.; About 80% of children with chronic OME carry respiratory pathogens in the nasopharynx, with a remarkably stable spectrum and frequency . In a randomized clinical trial the nasopharyngeal flora was determined in 45 untreated cases and in 32 cases treated with cefaclor (Kefolor), 20 mg/kg body weight b.i.d . for 10 days . Compared to the untreated children, the treated group showed a significantly decreased frequency of Streptococcus pneumoniae and Branhamella catarrhalis, and a reduced number of cultures with mixed pathogens . An approximate quantitative survey showed a decreased growth of Haemophilus influenzae, but the frequency of isolation was unchanged . The results are put in relation to the penetration of cefaclor to adenoid tissue and middle ear effusion in chronic OME.

Jpn J Antibiot, 1985 Jan, 38(1), 41 - 4
{Transference of cefmenoxime from serum to lung tissue}; Nagae N et al.; Ten patients who were performed pulmonary resection for the disease of the lung, were administered 2 g of cefmenoxime (CMX) by intravenous injection before their operation . The concentrations of CMX in serum and lung tissue were determined . The CMX concentrations in lung tissue were observed to be higher than the MIC of CMX for Klebsiella pneumoniae, Haemophilus influenzae and Serratia . These results suggested that CMX will be useful agent for the prevention and treatment of pulmonary infection.

Bull Soc Pathol Exot Filiales, 1985, 78(5 Pt 2), 945 - 51
{Treatment of acute pneumopathies in a tropical zone}; Coulaud JP et al.; This treatment must take into account the high frequency of Streptococcus pneumoniae and Haemophilus influenzae which represent over 50% of causes of all bacterial pneumopathies, up to 75% in children under 2 years old . Benzyl-penicillin and injectable delayed action penicillin are drugs of choice and early utilisation reduces considerably the mortality . Other possible antibiotics are macrolides because of their wide range of efficacy and low toxicity, and chloramphenicol which is still one of the best drugs against penicillin-resistant Haemophilus influenzae.

Auris Nasus Larynx, 1985, 12 Suppl 1, S97 - 9
Quantitative determination of bacterial endotoxin in middle ear effusions by chromogenic substrate method; Jinnin T et al.; It is known that bacterial endotoxin on the outer surface of most gram-negative bacteria (GNB) is not only biologically active material, but also the modulator of the immune response . The earlier experiment documented that the endotoxin of killed Haemophilus influenzae was responsible for induction of chronic otitis media with effusion (OME) . Recent study by DeMaria et al . determined the endotoxin of human middle ear effusion (MEE) by means of limulus amebocyte lysate assay . It was concluded the endotoxin was present in a high percentage of the effusion in human tympanic cavities . The present study was undertaken to quantitatively determine the endotoxin in human MEE by use of chromogenic substrate technique which is more sensitive and accurate than limulus assay . Sixty samples of mucoid and serous effusion were subjected to chromogenic substrate method . It was revealed that the mucoid effusion showed a significantly high level of endotoxin at 282 pg/ml in average, though the serous effusion contained only 35.9 pg/ml . It is assumed that the bacterial endotoxin may greatly contribute to the pathogenesis of otitis media with mucoid effusion.

Auris Nasus Larynx, 1985, 12 Suppl 1, S180 - 2
Secretory IgA, secretory component and pathogen specific antibodies in the middle ear effusion during an attack of acute and secretory otitis media; Sipila P et al.; The total concentration of secretory IgA (SIgA) and secretory component (SC) as well as the occurrence of pathogen specific serum type (IgG, IgA and IgM) and secretory type antibodies against Streptococcus pneumoniae and Haemophilus influenzae in the middle ear effusion during an attack of otitis media were studied by using the ELISA method . The middle ear effusion samples were taken at 2 to 4 weeks' intervals from patients with recurrent acute otitis media (RAOM) or secretory otitis media (SOM) . In the samples of the RAOM patients the SC/SIgA ratio was 2.2, while in the SOM samples the ratio was 13.6 . Both serum and secretory type antibodies to the infecting bacteria could be detected in the middle ear effusions in both of the patient groups . The results of this study show that the middle ear can develop antigenic specific antibodies against the infecting bacteria . The increased production of SC seems to be related to the pathogenesis of SOM.

Ann Otolaryngol Chir Cervicofac, 1985, 102(5), 333 - 6
{Laryngitis in newborn infants . Apropos of 3 cases}; Contencin P et al.; Laryngoscopic examination of new-born infants with laryngeal dyspnea or dysphonia usually reveals a congenital lesion, but true infections laryngitis, although rare, does still exist . Three cases are reviewed and the literature searched . Functional laryngeal signs are non-pathognomonic, all three levels of the larynx may be affected by inflammation, and pathogenic agents may be viral (herpes), bacterial (Haemophilus Para-Influenzae) or mycotic . In two of the cases reported confirmation of diagnosis was by local swab under laryngoscopic guidance . Recovery occurred after medical treatment alone and intubation was not required in any of the three patients . These findings emphasize the value of laryngoscopy with swab in all neonates with dyspnea or dysphonia in an infectious context.

J Bacteriol, 1985 Jan, 161(1), 72 - 9
Comparison of transformation mechanisms of Haemophilus parainfluenzae and Haemophilus influenzae; Barany F et al.; Transformation pathways in two closely related bacterial species, Haemophilus parainfluenzae and Haemophilus influenzae, were studied . Both organisms rapidly take up transforming DNA within minutes into specialized membranous structures on the cell surface (transformasomes) . DNA within transformasomes is in a protected state, inaccessible to external DNase or internal restriction and modification enzymes . However, the subsequent processing of donor DNA differs in these two organisms . In H . influenzae, linear DNA immediately undergoes degradation from one end at a constant rate, leaving a lower-molecular-weight intermediate in the transformasome . The end undergoing degradation is searching for homologous regions of the chromosome . Once pairing is initiated, the remaining lower-molecular-weight DNA exits from the transformasome, and a single strand undergoes efficient integration . In contrast, in H . parainfluenzae little degradation of donor DNA is observed, with the majority remaining intact within the transformasomes after 1 h . Thus, whereas only 10% of donor DNA molecules leave the protected state after 1 h, portions of each molecule appear to become quantitatively integrated.

Drugs Exp Clin Res, 1985, 11(4), 259 - 62
The comparative activity of twelve 4-quinolone antimicrobials against Haemophilus influenzae and Streptococcus pneumoniae; Ridgway GL et al.; The minimal inhibitory concentrations (MICs) of twelve 4-quinolone antimicrobials were determined for 100 isolates of Haemophilus influenzae (including 30 beta-lactamase producing strains) and 100 isolates of Streptococcus pneumoniae . MICs were determined using an agar dilution technique in Mueller-Hinton agar supplemented with 10% lysed horse blood . The inoculum used was approximately 10(4) colony-forming units, contained in 10 microliters of Mueller-Hinton broth, which was applied to the agar plates using a multipoint inoculator . Following inoculation, plates were incubated at 37 degrees C for 18 h in an atmosphere enriched to 10% carbon dioxide . The MIC of each antimicrobial for each isolate examined was determined as the lowest concentration of the antimicrobial which completely inhibited growth of the inoculum . The minimum concentrations required to inhibit the growth of 50% (MIC50) and 90% (MIC90) of the organisms examined were also determined . The more recently synthesised 4-quinolones showed considerably greater activity than nalidixic acid and pipemidic acid against clinical isolates of Haemophilus influenzae and Streptococcus pneumoniae . There was no apparent difference between the MICs observed for beta-lactamase producing and non-beta-lactamase producing strains of Haemophilus influenzae . Ciprofloxacin was the most active 4-quinolone examined (MIC90 for Haemophilus influenzae 0.008 microgram/ml; Streptococcus pneumoniae 2 micrograms/ml) . Clinical studies on a possible role for some of the more recently synthesised 4-quinolones in the management of patients with respiratory infection are indicated.

Dev Biol Stand, 1985, 61, 3 - 10
Bordetella adenylate cyclase: host toxicity and diagnostic utility; Confer DL et al.; Two toxins from Bordetella pertussis, pertussis toxin and Bordetella adenylate cyclase, cause profound disruptions of cAMP metabolism in mammalian cells . While the role of each toxin in the whooping cough syndrome is unknown, it is highly likely that together they confer on the organism an important proliferative advantage . Intact B . pertussis cells express large amounts of adenylate cyclase activity on their exterior surface . In a presently unknown fashion, this enzyme can enter human phagocytes, elevate cellular cAMP and impair host defense . We reasoned that this unusual enzyme might serve to signal the presence of B . pertussis in nasopharyngeal swabs from infected persons . Here we report a series of in vitro experiments which confirm the feasibility of such an approach . We find that calcium alginate swabs containing as few as 100 B . pertussis organisms produce readily detectable amounts of cAMP in our assay . Nasopharyngeal secretions swabbed from healthy volunteers, however produced no detectable cAMP alone and did not affect the production of cAMP by B . pertussis . We have also tested pure cultures of four common bacterial pathogens (Haemophilus influenzae, Streptococcus pyogenes, Staphylococcus aureus, and Escherichia coli) which may be co-isolated in clinical whooping cough and find that none interferes with the detection of B . pertussis . We conclude that the unique adenylate cyclase of B . pertussis might be a valuable diagnostic device.

J Exp Med, 1985 Jan 1, 161(1), 145 - 59
Purification and characterization of Haemophilus influenzae pili, and their structural and serological relatedness to Escherichia coli P and mannose-sensitive pili; Guerina NG et al.; Haemophilus influenzae pili were purified, and their physical and serological properties were examined . The solution properties of the pili were determined, and then a purification scheme involving repeated cycles of precipitation and solubilization was developed . The purified pili from one type b isolate (A02) were found to consist of multiple copies of a 25,000 mol wt subunit . Amino-terminal sequence analysis of A02 pili was carried out to 40 amino acid residues, and a remarkable degree of sequence homology was found with E . coli P and mannose-sensitive (MS) pili (27.5 and 25% homology, respectively) . Purified A02 pili were found to be highly immunogenic, and serological analysis by enzyme-linked immunosorbent assay and whole piliated cell agglutination revealed significant cross-reactivity between A02 pilus antiserum and the pili of seven other H . influenzae strains tested (heterologous titers = 2-100% of the homologous titer) . Cross-reactivity was also observed between the H . influenzae pili (five of eight strains tested) and the P pili from E . coli strains HU849 and 3669; no cross-reactivity was detected with MS pili from E . coli strain H10407 and C94 . The structural similarities between H . influenzae and E . coli P and MS pili suggest a common gene ancestry.

Infect Immun, 1985 Jan, 47(1), 253 - 9
A minor high-molecular-weight outer membrane protein of Haemophilus influenzae type b is a protective antigen; Kimura A et al.; Cell surface-exposed antigenic determinants of several high-molecular-weight outer membrane proteins of Haemophilus influenzae type b (Hib) have been shown to be consistently immunogenic in human infants convalescing from Hib meningitis . A monoclonal antibody (mab), 6G12, directed against one of these cell surface-exposed outer membrane proteins that has an apparent molecular weight of 98,000 (98K) was identified by radioimmunoprecipitation analysis . Of 120 clinical isolates of Hib, 83 were found to possess antigenic determinants which reacted with mab 6G12 in a colony blot-radioimmunoassay procedure, indicating that the antigenic determinant recognized by mab 6G12 is present in the majority of Hib strains . A different radioimmunoassay, which uses whole Hib cells as antigen, confirmed that strains reactive with mab 6G12 in the colony blot-radioimmunoassay procedure possessed a cell surface-exposed and antibody-accessible antigenic determinant recognized by this mab . Hib strains which did not react with mab 6G12 were found to lack a 98K protein . Passive immunization with mab 6G12 reduced the level of bacteremia that developed in infant rats challenged with the homologous Hib strain against which this mab was raised . In contrast, no protection was observed when the challenge strain was one which lacks the antigenic determinant recognized by mab 6G12 . Radioimmunoprecipitation analysis of sera from human infants convalescing from Hib meningitis detected an antibody response directed against the 98K protein . The protection against experimental Hib disease provided by antibody to the 98K protein, the immunogenicity of this protein in human infants, and its presence in a majority of Hib strains indicate that the 98K outer membrane protein may have potential for vaccine development.

Schweiz Med Wochenschr, 1984 Dec 22, 114(51), 1909 - 15
{Haemophilus influenzae isolated in Switzerland: antibiotic sensitivity and biotyping}; Borer-Bigliardi B et al.; 208 H . influenzae (HI) strains originating from the whole of Switzerland have been analysed for capsular serotype, biotype, and susceptibility to the following antibiotics: ampicillin, chloramphenicol, tetracycline, co-trimoxazole, and ceftriaxone . Serotype b is the commonest of the encapsulated strains . Biotypes II and III (respiratory tract) and I (invasive diseases) are the biotypes most encountered . Ceftriaxone is the most active among the antibiotics tested: 0.03 microgram inhibits 100% of strains, whether penicillinase producers (PP) or not . To evaluate the rate of resistant HI in Switzerland, 1883 isolates, 206 of which originated from invasive diseases (meningitis, epiglottitis, septicemia) have been considered . The PP rate is about 4%, irrespective of the group considered . Among the isolates from the invasive diseases, 3 were resistant to chloramphenicol, and 1 to ampicillin and chloramphenicol . The value of 4% for the PP strains is not very high; however, because of its powerful antibacterial activity and its high penetration into the cerebrospinal fluid, it seems reasonable to consider the use of a third generation cephalosporin, such as ceftriaxone, for the early treatment of meningitis in infants . If such a drug is indicated as a first-choice antibiotic for this meningitis it should be confined to this use only, to avoid the emergence of resistant strains.

Pathol Biol (Paris), 1984 Dec, 32(10), 1024 - 8
{Rhino- and oropharyngeal carriage of Haemophilus sp . in children}; Pinon G et al.; The occurence of Haemophilus sp . and other potential pathogens: Streptococcus pneumoniae, Streptococcus pyogenes and Neisseria meningitidis has been investigated in 79 children from rhino and oropharyngeal material . H . parainfluenzae is only isolated from the oropharynx . H . influenzae and S . pneumoniae may be isolated from the rhinopharynx but are associated to signs of infection in the upper respiratory tract . The capsule of H . Influenzae represents a colonization factor of the rhinopharynx from an oropharyngeal carriage . 6.1% of H . influenzae and 28% of H . parainfluenzae isolates were found resistant to penicillin by production of betalactamase.

Infect Immun, 1984 Dec, 46(3), 778 - 86
Distribution of oral Haemophilus species in dental plaque from a large adult population; Liljemark WF et al.; The periodontal status of maxillary first molars in 284 young adults demonstrating near-health to early disease was evaluated, and supragingival and subgingival plaque samples were collected . Plaque samples were processed anaerobically, enumerated microscopically for bacterial morphotypes, and cultivated on various media to enumerate the microflora . Although haemophili were ubiquitous (recovered in 98.5 and 96.2% of the supragingival and subgingival plaque samples, respectively), 50% of the respective samples had proportions of less than or equal to 1.5% and less than or equal to 0.33% total Haemophilus spp . based on total cultivable microflora . To study the distribution of Haemophilus spp., 377 colonies were identified from modified chocolate agar (selective for oral haemophili) from 14 supragingival and corresponding subgingival samples from 14 subjects . The most prevalent species, Haemophilus parainfluenzae, was found in significantly higher proportions, based on total haemophili on modified chocolate agar, in supragingival and subgingival samples from teeth with shallower probing depths (less than or equal to 3.0 mm) versus deeper probing depths (greater than or equal to 3.0 mm) . Additional statistically significant findings included Haemophilus segnis in higher proportions in supragingival samples from deeper sites, Haemophilus aphrophilus in higher proportions in subgingival samples from deeper sites, and Haemophilus paraphrophilus in higher proportions in subgingival samples from shallower sites . Scatter diagrams illustrating the bivariate distributions of proportions of haemophili with proportions of dark-pigmented Bacteroides spp., spirochetes, and streptococci demonstrated that high proportions of haemophili were never recovered from sites with high proportions of Bacteroides spp . or spirochetes . All levels of haemophili, however, were recovered from sites with all levels of streptococci . Two potential systems for interpreting haemophili data were hypothesized for predicting periodontal probing depths . There was highly significant agreement between the two systems . Small but statistically significant correlations were found between the gingival index, probing depth, and attachment level, and proportions of total Haemophilus species in the respective samples.

Infect Immun, 1984 Dec, 46(3), 644 - 8
Resistance of Actinobacillus actinomycetemcomitans and differential susceptibility of oral Haemophilus species to the bactericidal effects of hydrogen peroxide; Miyasaki KT et al.; We compared the sensitivities of oral and nonoral isolates of Actinobacillus actinomycetemcomitans, Haemophilus segnis, H . aphrophilus, and H . paraphrophilus to the bactericidal action of reagent hydrogen peroxide (H2O2) . Susceptibility to a range of H2O2 concentrations (10(-6) to 10(-3) M) was assessed by incubating bacterial suspensions for 1 h at 37 degrees C in the presence of H2O2 and plating on chocolate agar to determine the concentration of H2O2 that would produce a 50% reduction in CFU (50% lethal dose) . As a group, A . actinomycetemcomitans was more resistant to H2O2 than the oral haemophili, and H . aphrophilus was much more sensitive than all other organisms tested . The range of 50% lethal dose values for A . actinomycetemcomitans was between 8.5 X 10(-5) and 10(-3) M H2O2 or above . In contrast, H . aphrophilus exhibited 50% lethal dose values from below 1 X 10(-6) to 3.4 X 10(-4) M H2O2 . The resistance of A . actinomycetemcomitans to H2O2 may be sufficient to protect these organisms from direct H2O2-mediated killing by host phagocytes.

Zh Mikrobiol Epidemiol Immunobiol, 1984 Dec, (12), 32 - 6
{Etiology of suppurative bacterial meningitis}; Demina AA et al.; The results of the laboratory examination of 2034 patients with meningococcal infection and purulent meningitides, hospitalized during the period of June 1980 to October 1983, revealed that three main etiological agents were responsible for these diseases: meningococci, pneumococci and Haemophilus influenzae . The susceptibility of the patients to different etiological agents was found to depend on their age . Children aged up to 3 years constituted 75% of the patients with meningitis caused by H . influenzae; 50% of the patients with meningococcal infection were children aged up to 5 years; pneumococcal meningitis occurred more frequently in adults . Serogroup A meningococci were found to prevail in patients with meningococcal infection . Besides, in children serogroup C meningococci could be isolated in 24% of cases . Since 1983 the cases of the isolation of strains belonging to serogroup B increased in number . Among the pneumococci responsible for the disease serotypes 1, 19, 6 and in children serotype 12 occurred most frequently.

Aust Vet J, 1984 Dec, 61(12), 392 - 5
Experimental infection of mares with Haemophilus equigenitalis; Rogerson BA et al.; Inoculation of Haemophilus equigenitalis into the uterus of 7 mares caused a disease clinically indistinguishable from contagious equine metritis . The duration of clinical signs varied from 4 to 11 days . The causative organism persisted for a relatively short time (2 to 10 weeks) in 5 mares, but in 2 others it established a carrier status and persisted until they were killed 6 and 10 months after infection . H . equigenitalis was recovered from the vestibule of the vagina and from a combined swab of the clitoral fossa and sinuses throughout the course of the infection . In some mares there were extended periods (2 weeks) when it could not be reisolated . All mares experienced a transitory serological response to infection . The complement fixation test was generally negative 12 weeks after infection whereas antibodies detected by the passive haemagglutination test and serum agglutination test were more persistent . In some animals the PHT and SAT titres increased during the breeding season following infection . The serological response did not appear to be related to the duration of infection.

J Clin Microbiol, 1984 Dec, 20(6), 1154 - 8
Antibody responses to capsular polysaccharide, lipopolysaccharide, and outer membrane in adults infected with Haemophilus influenzae type b; Lagergard T et al.; The antibody response to Haemophilus influenzae type b antigens as capsular polysaccharide, lipopolysaccharide, and outer membrane components was studied by enzyme-linked immunosorbent assay in 10 adults infected with this bacterium . Almost all patients had detectable amounts of immunoglobulins G and M antibodies specific to capsular polysaccharide, lipopolysaccharide, or outer membrane in their first serum sample . A significant antibody response in one or more antibody subclasses to capsular polysaccharide, lipopolysaccharide, and outer membrane was noted in 9 of 10, 7 of 10, and 7 of 10 patients, respectively . The occurrence of H . influenzae type b infections in adults cannot be completely explained either by the absence of antibodies against H . influenzae type b in their serum or by the failure to develop specific antibodies to the capsule or certain cell wall components even if these factors probably are important in some cases, e.g., in one patient who was splenectomized.

J Clin Microbiol, 1984 Dec, 20(6), 1102 - 4
Biotypes of serologically nontypable Haemophilus influenzae isolated from the middle ears and nasopharynges of patients with otitis media with effusion; DeMaria TF et al.; A biotype analysis was performed on serologically nontypable Haemophilus influenzae isolates from the middle ear effusions and nasopharynges of 33 children with chronic otitis media with effusion (serous otitis media) . Over 50% of the H . influenzae isolates from the middle ears belonged to biotype II . The incidence of beta-lactamase production was 17% . The results of this study indicate that future clinical or experimental investigations of chronic otitis media with effusion induced by serologically nontypable H . influenzae should focus on this clinically important biotype.

Pediatrics, 1984 Dec, 74(6), 1054 - 7
Isolated uvulitis due to Haemophilus influenzae type b; Li KI et al.; Infections of the uvula are infrequently recognized and have been previously described only in association with group A streptococcal pharyngitis or Haemophilus influenzae type b epiglottitis . Three cases of H influenzae type b bacteremic uvulitis are described . In suspected cases of H influenzae type b uvulitis, a lateral neck radiograph should be performed and parenteral antibiotics initiated.

Infect Immun, 1984 Dec, 46(3), 787 - 96
Characterization of Haemophilus influenzae type b fimbriae; Stull TL et al.; We confirmed that the fimbriae of Haemophilus influenzae type b conferred hemagglutinating activity (HA) towards human erythrocytes, and erythrocytes of certain other species . Most (17/25) cerebrospinal fluid isolates lacked detectable HA on direct testing, but selective enrichment for fimbriation (f+) indicated that 22 of 25 strains could produce these surface structures . HA was unchanged from pH 4.5 to 9.5 and was not inhibited by mannose or certain other simple sugars . The HA titer of a suspension of three f+ strains was slightly decreased at 50 degrees C; HA was lost by heating at 60 degrees C for 3 min . Growth on a variety of solid and liquid media and under differing degrees of oxygenation did not change the HA titer of a suspension of three f+ strains . Fimbriation was not lost on repeated subculture . Wild-type fimbriated strains, and those derived by transformation, did not contain detectable plasmid DNA . Transformation of a strain lacking fimbriae to f+ was associated with the appearance of an outer membrane protein of 24 kilodaltons . This protein was purified from one strain to homogeneity on sodium dodecyl sulfate-polyacrylamide gel electrophoresis by selective detergent solubilization and ammonium sulfate fractionation . Colonization capacity was equivalent with an isogenic untypable strain lacking or possessing fimbriae . Fimbriae of type b H . influenzae possess characteristics similar to those structures on other gram-negative bacteria; their role in cell physiology or pathogenesis of invasive disease is unknown.

Pediatrie, 1984 Dec, 39(8), 639 - 44
{Haemophilus influenzae meningitis in infants . Apropos of 22 recent cases}; Deiber M et al.; In a three years retrospective evaluation, the authors point out an important increase of hemophilus influenzae meningitis . This germ, who seem to be actually the first cause in infants bacterial meningitis, set the problem of his Ampicillin resistance (10-15% of cases) . It is therefore necessary to change first treatment of these meningitis . Cefotaxime which has been prescribed to 50% of cases gives satisfactory results.

Vet Microbiol, 1984 Dec, 10(1), 33 - 42
Perchloric acid treatment and use of chromogenic substrate in the Limulus test: application to veterinary diagnosis; Hakogi E et al.; The Limulus test was carried out for endotoxin determination using a synthetic chromogenic substrate after perchloric acid(PCA) treatment to remove inhibiting substances in the blood . PCA treatment completely removed non-specific amidolytic activity and other factors which interfered with the Limulus test . The recovery of added endotoxin was about 100% irrespective of animal species . Endotoxin levels in PCA-treated blood plasma of healthy domestic animals were invariably below 1 pg ml-1 . Many of the cows with gangrenous mastitis, from which Gram-negative rods were isolated, showed high endotoxin levels ranging from 22.8 to 138.0 pg ml-1 . Endotoxin was also detected in the blood of cows affected with salmonellosis, colibacillosis, Haemophilus somnus infection and urethritis associated with Proteus.

Br Med J (Clin Res Ed), 1984 Nov 24, 289(6456), 1409 - 12
Isolation of spheroplastic forms of Haemophilus influenzae from sputum in conventionally treated chronic bronchial sepsis using selective medium supplemented with N-acetyl-D-glucosamine: possible reservoir for re-emergence of infection; Roberts D et al.; The isolation rate of Haemophilus influenzae from patients with persistent production of purulent sputum has been increased by the routine use of a selective medium . Nevertheless, some purulent sputum still fails to yield a pathogen . The selective medium was supplemented with N-acetyl-D-glucosamine to encourage primary isolation of colony forming, spheroplastic H influenzae, which reverted to normal forms on subculture . On the basis of in vitro experiments it is postulated that these spheroplastic forms of H influenzae may be induced by inadequate antimicrobial chemotherapy and may be responsible for re-emergence of symptoms in these patients during or shortly after stopping chemotherapy.

Anal Biochem, 1984 Nov 15, 143(1), 196 - 204
Immunoblot method for identifying surface components, determining their cross-reactivity, and investigating cell topology: results with Haemophilus influenzae type b; Loeb MR; Methods currently used for identifying exposed membrane components of gram-negative bacteria can give false positive results, and also do not provide information on nonprotein components such as lipopolysaccharide and polysaccharide capsules . A method, described within, has been developed to overcome these limitations . Briefly an outer membrane preparation derived from encapsulated (type b) Haemophilus influenzae was resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and the separated components were then transferred electrophoretically to nitrocellulose . The nitrocellulose was cut into vertical strips, which were then each incubated with rabbit antiserum to the whole bacterium or with the same antiserum after absorption with any of the following: the same strain of H . influenzae, a capsule-deficient mutant of that strain, other strains of H . influenzae, or other bacteria . The strips were then incubated with 125I-protein A, and the bound antibodies were detected by autoradiography . The autoradiograph of the strip exposed to unabsorbed antisera revealed the identity of those individual outer membrane components that bound antibodies . A comparison of the intensity of the various bands on this strip with those on the strips exposed to absorbed antisera was then used to identify (1) surface-exposed components, (2) those components occluded by capsule, and (3) cross-reactivity of exposed components . This method should be applicable to other cells and subcellular particles . Its major disadvantage is that it can provide false negative results.

S Afr Med J, 1984 Nov 3, 66(18), 677 - 9
Bacterial meningitis in Johannesburg--1980-1982; Liebowitz LD et al.; A 2-year retrospective study of aetiology, age distribution, seasonal variation and antimicrobial sensitivity patterns of bacteria isolated from patients with meningitis in five Johannesburg hospitals for White, Black, Coloured and Asian patients was performed . Neisseria meningitidis was isolated most frequently, followed by Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli and Streptococcus group B . In the Black population 73% of the meningococcal infections occurred in patients over 3 years of age, and the majority of these infections were caused by serogroup A organisms . Virtually all (93%) of the H . influenzae infections occurred in children of less than 3 years of age . Of the isolates tested, 16% of the meningococci, 4,5% of the H . influenzae and 47% of the pneumococci were resistant to sulphadiazine, ampicillin and penicillin respectively.

Pediatr Infect Dis, 1984 Nov-Dec, 3(6), 514 - 7
Intravenous antibiotic therapy in ambulatory pediatric patients; Goldenberg RI et al.; Eighty-nine pediatric patients (median age, 12.0; range, 1.5 to 18 years) were treated with antibiotics given intravenously by self- or parent administration for a variety of infections, under close physician supervision . Patients with infections involving bone and joint (53), respiratory tract (16), soft tissue (9), abdominal cavity (4), genitourinary tract (4) and bloodstream (3) were treated for a mean period of 19.0 days . Staphylococcus aureus, Pseudomonas aeruginosa and Haemophilus influenzae were the most frequent pathogens . Favorable clinical outcomes occurred in 85 patients (96%) . Adverse clinical and laboratory events occurred at a frequency commensurate with that of hospitalized patients . A total of 1700 patient days were managed in this outpatient setting at significant cost savings, and the method allowed early return to school for 83 patients (93%) . Intravenous antibiotic therapy in ambulatory patients can provide a successful, safe, cost-effective alternative to inpatient care under conditions of diligent patient screening and physician-centered follow-up.

Thorax, 1984 Nov, 39(11), 813 - 7
Penetration of cefaclor into bronchial mucosa; Marlin GE et al.; Bronchial mucosal biopsy specimens were obtained during fibreoptic bronchoscopy in 30 patients receiving a new oral cephalosporin antibiotic, cefaclor (10 had 250 mg, 10 had 500 mg, and 10 had 1000 mg every eight hours) . In 10 patients (from all dosage groups) cefaclor was undetectable in the bronchial mucosa but in every case the serum concentration was low, suggesting incomplete absorption . The mean (SD) bronchial mucosal concentration after 250 mg was 3.78 (1.77) micrograms/g (range 2.1-5.8 micrograms/g, n = 4), after 500 mg 4.43 (2.04) micrograms/g (range 2.0-7.1 micrograms/g, n = 8), and after 1000 mg 7.73 (2.76) micrograms/g (range 5.0-12.7 micrograms/g, n = 6) . A significantly higher concentration in the bronchial mucosa was achieved with 1000 mg than with 250 mg (p less than 0.05) or 500 mg (p less than 0.025) . These concentrations should be effective against Streptococcus pneumoniae, most strains being inhibited below 1.0 microgram/ml . The concentrations were within one dilution of the minimal inhibitory concentration for Haemophilus influenzae, most strains being inhibited below 4.0 micrograms/ml . Some strains of H influenzae will not be inhibited by the concentrations of cefaclor found in the bronchial mucosa, particularly those that are ampicillin resistant.

J Pediatr, 1984 Nov, 105(5), 706 - 11
Microbial causes of neonatal conjunctivitis; Sandstrom KI et al.; We assessed the microbial causes of neonatal conjunctivitis by comparing 55 infants with purulent conjunctivitis and 60 healthy control infants . A mean of greater than 5 leukocytes per 1000X microscopic field was seen in Gram-stained smears obtained from the more inflamed eye in 77% of 30 untreated patients but none of 57 controls . Pathogens isolated more often from untreated patients than from controls included Haemophilus spp . (17% vs 2%, P = 0.01), Staphylococcus aureus (17% vs 2%, P = 0.01), Chlamydia trachomatis (14% vs 0%, P = 0.01), enterococci (8% vs 0%, P = 0.05), and Streptococcus pneumoniae (11% vs 2%, P = 0.06) . One or more of these pathogens were isolated from the conjunctivae in 58% of patients and 5% of controls (P less than 0.001) . Bacterial morphology seen on smear correlated with the pathogens cultured . Isolation of Haemophilus spp . or S . pneumoniae was associated with dacryostenosis . We conclude that several microbial pathogens are implicated in neonatal conjunctivitis . These organisms have differing susceptibilities to antimicrobial agents, so culture and sensitivity testing are required as a guide to therapy.

J Clin Microbiol, 1984 Nov, 20(5), 981 - 4
Improved detection of bacterial antigens by latex agglutination after rapid extraction from body fluids; Smith LP et al.; Nonspecific agglutination of antibody-coated latex particles, unrelated to the presence of specific bacterial antigens, is a major difficulty with commercial latex particle agglutination tests . Rheumatoid and other factors are known to interfere with latex tests . We studied the use of six chelating, reducing, and anticoagulatory reagents in a rapid extraction of antigen procedure to free heat-stable antigens of Haemophilus influenzae type b and group B streptococcus which had been added to human sera . We also screened sera for the incidence of nonspecific agglutination from the three following groups: 123 patients with positive serology tests, 112 hospitalized patients, and 87 blood donors . The rapid extraction of antigen procedure involved a 1:4 dilution of the sera with each of the six reagents, incubation at 100 degrees C for 3 min, and centrifugation at 13,000 X g for 5 min . Two commercial latex kits were tested (Bactigen and Wellcogen) . Nonspecific agglutination was entirely eliminated by each of the six extraction reagents . Sera from 52% of the patients with positive serology tests, 29% of the hospitalized patients, and 28% of the blood donors showed nonspecific agglutination with Bactigen before extraction . Nonspecific agglutination was eliminated in all but one sample after the rapid extraction of antigen procedure . This simple, rapid extraction procedure eliminated nonspecific reactions in cerebrospinal fluids and amniotic fluids and reduced this problem in urines and sera with each commercial kit used on clinical specimens.

J Clin Microbiol, 1984 Nov, 20(5), 884 - 6
Use of the directigen latex agglutination test for detection of Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis antigens in cerebrospinal fluid from meningitis patients; Sippel JE et al.; Cerebrospinal fluid specimens from 257 persons were tested for the presence of bacterial antigens by counterimmunoelectrophoresis and the Directigen meningitis test (Hynson, Westcott & Dunning, Div . Becton Dickinson & Co., Baltimore, Md.) . The specimens were obtained from 162 patients with meningitis caused by Haemophilus influenzae type b, Streptococcus pneumoniae, or Neisseria meningitidis serogroups A and C and from 95 patients without bacterial meningitis or meningitis caused by other bacterial agents . Directigen detected H . influenzae type b antigen in 83% (69 of 83) of the specimens obtained from patients with H . influenzae disease, pneumococcal antigen in 77% (30 of 39) of the specimens from patients with pneumococcal disease, and N . meningitidis antigen in 93% (37 of 40) of the specimens from patients with disease caused by N . meningitidis serogroups A and C . The comparable figures for counterimmunoelectrophoresis were 66% (55 of 83), 79% (31 of 39), and 78% (31 of 40), respectively . No false-positive reactions were reported with the Directigen reagents . Nonspecific reactions (agglutination with more than one of the four Directigen latex reagents) were noted with five specimens . The nonspecific reactions were resolved in four of the five specimens by heating (100 degrees C for 3 min) . The accumulated data demonstrate that the sensitivity of the Directigen meningitis test is better than or at least equivalent to the sensitivity of counterimmunoelectrophoresis for the detection of antigens in cerebrospinal fluid.

Rev Infect Dis, 1984 Nov-Dec, 6 Suppl 4, S847 - 52
Comparison of cefonicid and cefamandole for the treatment of community-acquired infections of the lower respiratory tract; Geckler RW et al.; Cefonicid is a new "second-generation" parenteral cephalosporin with an antibacterial spectrum similar to that of cefamandole . It has, however, somewhat less activity in vitro against gram-positive cocci . Because of high blood levels and long serum half-life, daily dosing with cefonicid is feasible . Patients with community-acquired infections of the lower respiratory tract were randomized in a ratio of 2:1 to receive cefonicid once daily or cefamandole every 6 hr . All doses were 1,000 mg except for 13 patients given 500 mg of cefonicid . Of 100 patients evaluated, 66 received the study drug . Most infections were due to Streptococcus pneumoniae or Haemophilus influenzae . One-fourth of the patients had no demonstrable pathogen . Ninety-four percent of both groups were cured or improved by therapy . No significant toxicity or adverse effects were seen with cefonicid . One dose per day of cefonicid is adequate therapy for many patients having community-acquired pneumonia who might otherwise be treated with cefamandole.

Clin Pharm, 1984 Nov-Dec, 3(6), 591 - 9
Amoxicillin-potassium clavulanate, a beta-lactamase-resistant antibiotic combination; Stein GE et al.; The chemistry, microbiology, pharmacokinetics, therapeutic use, adverse effects, and dosage of amoxicillin-potassium clavulanate, a beta-lactamase-resistant antibiotic combination, are reviewed . Clavulanic acid is a "suicide" inhibitor of bacterial beta-lactamase enzymes and has been effective in preventing destruction of penicillins by these enzymes . Clavulanic acid alone has weak antibacterial activity against most organisms . After oral administration, clavulanic acid is rapidly absorbed; amoxicillin appears to increase its absorption . Absorption of amoxicillin-clavulanic acid is not affected by food . Amoxicillin-clavulanic acid is effective in treating both acute uncomplicated and complicated urinary-tract infections and exacerbations of chronic bronchitis caused by amoxicillin-resistant organisms in adults . It appears to be comparable in efficacy to cefaclor for treating uncomplicated urinary-tract infections in adults and children, acute bronchitis and bronchopneumonia, and acute sinusitis, otitis media, and skin and soft-tissue infections in children . Other infections for which the combination has been effective include cellulitis and intra-abdominal and pelvic sepsis caused by mixed aerobic/anaerobic organisms . Amoxicillin-clavulanic acid has also successfully cured urethritis in men caused by penicillinase-producing Neisseria gonorrhoeae and is superior to amoxicillin alone for beta-lactamase-positive Haemophilus ducreyi infections (chancroid) . Diarrhea or loose stools is the most common side effect seen with amoxicillin-clavulanic acid; nausea, vomiting, and skin rash may also occur . Nausea, vomiting, and diarrhea may be lessened by taking the combination with food.(ABSTRACT TRUNCATED AT 250 WORDS)

Infect Immun, 1984 Nov, 46(2), 570 - 7
Haemophilus influenzae type b isolates show antigenic variation in a major outer membrane protein; Erwin AL et al.; Antigenic variation of the outer membrane proteins among isolates of Haemophilus influenzae was examined by immunoblotting . Rabbit antisera were raised against six strains of H . influenzae type b and tested against outer membrane preparations of 50 isolates . The principal outer membrane band was not reactive on immunoblotting, so its antigenic heterogeneity could not be examined . Most of the other outer membrane proteins shared common determinants among all strains tested . Absorption of serum with heterologous bacteria removed antibody to nearly all proteins, confirming the extensive cross-reactivity among isolates . The greatest antigenic variation was seen in one major outer membrane band, a heat-modifiable, Zwittergent-soluble protein with a molecular weight of 49,000 to 51,000 . One antiserum reacted with the 49,000-to-51,000-molecular-weight protein of the homologous isolate only; the remaining five antisera showed differing patterns of reactivity with heterologous 49,000-to-51,000-molecular-weight proteins . We were able to divide the 50 H . influenzae isolates into 13 antigenic groups based on their reaction patterns . The antigenic groupings may provide an epidemiological tool for studying the prevalence and transmission of strains of H . influenzae type b.

Pediatrics, 1984 Nov, 74(5), 857 - 65
Serum antibodies after vaccination with Haemophilus influenzae type b capsular polysaccharide and responses to reimmunization: no evidence of immunologic tolerance or memory; Kayhty H et al.; Haemophilus influenzae type b capsular polysaccharide vaccine was given in Finland in 1974 to approximately 50,000 infants and children, whose serum anti-H influenzae type b capsular polysaccharide levels have been followed for 3 1/2 years . The serum antibodies induced by the vaccination proved short-lived (less than 6 months) in the infants younger than 18 months . Elevated serum antibody levels were detectable for 1 1/2 years but less than 3 1/2 years in the children who were vaccinated when 18 to 35 months old . In the children who were 3 to 5 years old when vaccinated, the elevated anti-H influenzae type b capsular polysaccharide levels persisted for at least 3 1/2 years . Therefore, children vaccinated at the age of 18 months may need a new dose of vaccine 1 to 1 1/2 years after the first dose in order to be protected for the period of high susceptibility, until the age of approximately 7 years . Some of the vaccinated children were reimmunized 3 1/2 years after the first dose, and the anti-H influenzae type b capsular polysaccharide levels in their sera were studied in a similar manner . At no time did the anti-H influenzae type b capsular polysaccharide levels after the reimmunization differ from the anti-H influenzae type b capsular polysaccharide levels seen after the first vaccination in children of the same age.(ABSTRACT TRUNCATED AT 250 WORDS)

Gene, 1984 Nov, 31(1-3), 197 - 203
Nucleotide sequence and properties of the cohesive DNA termini from bacteriophage HP1c1 of Haemophilus influenzae Rd; Fitzmaurice WP et al.; The termini of the mature DNA of phage HP1c1 of Haemophilus influenzae Rd have been characterized by DNA ligation, nucleotide sequencing, and deoxynucleotide incorporation experiments . A hybrid plasmid containing the joined phage termini (the cos site) inserted into pBR322 has been constructed . The phage DNA has cohesive termini composed of complementary 5' single-stranded extensions which are seven residues long . The left cohesive terminal extension consists only of pyrimidines and the right only of purines . When the ends of the phage are joined, the terminal sequences constitute the central 7 bp of an 11 bp sequence containing only purines on one strand and pyrimidines on the other strand . This oligopyrimidine/oligopurine sequence does not possess rotational symmetry . A 10-bp sequence and its inverted repeat are located approx . 20 bp to the left and right of the fused ends.

Pediatr Infect Dis, 1984 Nov-Dec, 3(6), 539 - 47
Haemophilus influenzae disease in the White Mountain Apaches: molecular epidemiology of a high risk population; Losonsky GA et al.; Based on a 10-year retrospective and a 15-month prospective analysis, White Mountain Apache Indian children younger than 5 years were found to have an annual incidence of Haemophilus influenzae meningitis of 254 cases/100,000--an 8-fold higher incidence than that seen in the general United States population . In our prospective surveillance, H . influenzae isolates from cases of systemic disease were further characterized by capsular type, biotype and by outer membrane protein (OMP) and lipopolysaccharide (LPS) patterns on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) . Unexpectedly, H . influenzae type a strains were isolated in 3/18 cases of systemic disease . All other disease-producing strains were type b . H . influenzae b strains possessing common OMP, LPS, capsular and biotype characteristics were isolated from individuals in geographically distinct communities within the reservation . These apparently identical strains were isolated from different individuals who had systemic infections that occurred months apart (longest interval, 14 months) . Both OMP and LPS subtyping were necessary to discriminate among invasive H . influenzae isolates.

Pediatr Infect Dis, 1984 Nov-Dec, 3(6), 534 - 8
Incidence and prognosis of acute epiglottitis in children in a Swedish region; Claesson B et al.; Acute epiglottitis, which is almost exclusively caused by Haemophilus influenzae type b, was studied retrospectively in children 0 to 15 years old in a defined region of southwest Sweden from 1971 through 1980; 211 patients with clinically well-documented acute epiglottitis were found . The age-specific incidence was 14/100,000/year, which was higher than the incidence of H . influenzae meningitis . The median age was 4 years . Because 96% of the patients were older than 18 months, disease in those patients could theoretically have been prevented by the purified H . influenzae polysaccharide vaccine . Only a few patients had underlying diseases . In 186 patients an artificial airway was established . Even though all patients survived without sequelae, the large incidence of the disease emphasizes the importance of H . influenzae in older children.

J Clin Invest, 1984 Nov, 74(5), 1708 - 14
Response to immunization with Haemophilus influenzae type b polysaccharide-pertussis vaccine and risk of Haemophilus meningitis in children with the Km(1) immunoglobulin allotype; Granoff DM et al.; In experimental animals, immune responses to certain antigens are regulated by immunoglobulin allotype-linked genes . In an effort to detect such genes in humans, we examined the antibody responses of 74 healthy children with different Km(1) or Gm(23) allotypes to a Haemophilus influenzae type b vaccine (type b polysaccharide capsule-pertussis vaccine) . The anticapsular antibody responses of black or white children with the Km(1) allotype were 4.6- to 9.5-fold higher than those of children who lacked this determinant (P less than 0.004) . No significant differences were found in antibody response with respect to the Gm(23) allotype . The frequencies of Km(1) and Gm(23) also were examined in 170 patients with Haemophilus meningitis, 71 patients with epiglottitis, and 173 control children . Km(1) was detected less frequently in black patients with meningitis (38%) than in those with epiglottitis (81%, P less than 0.002) or in controls (66%, P less than 0.0007) . The relative risk of meningitis thus was 3.2-fold lower among black children with the Km(1) allotype than in those who lacked this allotype (odds ratio = 0.3, 95% confidence interval 0.2 to 0.6) . However, the risk of meningitis was not decreased in white children with the Km(1) allotype (odds ratio = 1.0) . There were no significant differences in the frequency of Gm(23) among the patient groups and controls . The Km(1) allotype but not the Gm(23) thus defines a subpopulation of children of both races who are high responders to this vaccine, and black children but not white children with the Km(1) allotype are at decreased risk of developing Haemophilus meningitis . These data indicate that in blacks, genes associated with Km(1) may affect immune response to a prototype type b Haemophilus vaccine, and perhaps interact with another factor related to race to affect susceptibility to Haemophilus meningitis.

Gene, 1984 Nov, 31(1-3), 187 - 96
Characterization of recognition sites on bacteriophage HP1c1 DNA which interact with the DNA uptake system of Haemophilus influenzae Rd; Fitzmaurice WP et al.; The 32.4-kb genome of the Haemophilus influenzae bacteriophage HP1c1 contains at least twelve sites, each conferring high affinity for the DNA uptake system of transformable H . influenzae Rd . Five of these high-affinity sites have been located and their nucleotide sequences determined . Three sites contained a contiguous 9-bp sequence identical to the first nine residues of the 11-bp site previously identified as conferring high affinity for the H . influenzae transformation receptor to DNA fragments . The remaining two sites contained complete 11-bp sequences . In contrast, an HP1c1 restriction fragment containing a sequence identical to the final nine residues of the 11-bp uptake site exhibits only a low affinity for the DNA uptake system . An 8-bp sequence consisting of the first eight residues of the 11-bp site was 1% as active as the longer, high-affinity sites . Thus the first 9-bp of the 11-bp site are sufficient to direct high-affinity uptake, while the first 8-bp or the distal 9-bp are not . These results provide an initial assessment of the relative contributions of the individual residues constituting the 11-bp site to the apparent affinity of DNA fragments for the receptor of Haemophilus transformation.

Gene, 1984 Nov, 31(1-3), 173 - 85
Nucleotide sequence of cloned DNA segments of the Haemophilus influenzae bacteriophage HP1c1; Benjamin RC et al.; Restriction fragments obtained by digestion of Haemophilus influenzae phage HP1c1 DNA with HaeIII have been cloned by insertion into the HindIII site of pBR322 using synthetic linkers . The nucleotide sequences have been determined for three adjacent fragments, HaeIII-E, HaeIII-C and HaeIII-K, which comprise and 8.2-kb segment of the HP1c1 genome . The distribution and location of restriction sites in the sequenced region were determined . Restriction sites containing the dinucleotides -GG- and -CC- occurred infrequently in the sequence . The region contains numerous sequences which are subsets of the high-affinity recognition sequence of Haemophilus transformation, including five sites which direct high-affinity uptake of fragments containing them . Shorter subsets of the uptake sequence, including those with little or no measurable affinity for the DNA transport system, are considerably over-represented in HP1c1 DNA . Nine open reading frames (ORFs) corresponding to presumed polypeptides longer than 90 amino acid residues were identified; all of these shared a common orientation, suggesting the probable direction of transcription in this segment of the phage genome . These ORFs were preceded by appropriately spaced polypurine stretches which might function as ribosome-binding sites . One ORF coincides with the site of a mutation affecting the production of phage tails.

J Bacteriol, 1984 Nov, 160(2), 815 - 7
Integration of plasmid DNA coding for beta-lactamase production in the Haemophilus influenzae chromosome; Murphey-Corb M et al.; Of beta-lactamase-producing strains of Haemophilus influenzae, 65% do not contain extrachromosomal plasmid DNA . These strains, however, conjugally transfer beta-lactamase production to a recipient strain from which a 30-megadalton plasmid can be isolated . Restriction enzyme analysis and Southern transfer of DNA from both donor and recipient strains revealed that chromosomal integration of plasmid sequences occurred in all donor strains examined.

J Bacteriol, 1984 Nov, 160(2), 662 - 7
Mechanism of acquisition of chromosomal markers by plasmids in Haemophilus influenzae; Setlow JK et al.; The hybrid plasmid pNov1 readily acquired genetic information from the chromosome of wild-type, but not rec-2, cells . Most of the recombination had taken place 1 h after entrance of the plasmid into the cell, as judged by transformation of rec-2 by lysates made from wild-type cells exposed to pNov1 . Measurement of physical transfer from radioactively labeled cellular DNA to plasmids recombining in wild-type cells failed, since there was little more radioactivity in plasmids from such cells than from labeled rec-2 recipients, in which no recombination took place . EcoRI digestion of pNov1 divided the DNA into a 1.7-kilobase-pair fragment containing the novobiocin resistance marker and a 13-kilobase-pair fragment containing all of the original vector and considerable portions homologous to the chromosome . Transformation by the large fragment alone resulted in a plasmid the size of the original pNov1 . Our hypothesis to explain the data is that genetic transfer from chromosome to plasmid took place by a copy choice mechanism.

Nucleic Acids Res, 1984 Oct 25, 12(20), 7677 - 92
HhaI methylase and restriction endonuclease as probes for B to Z DNA conformational changes in d(GCGC) sequences; Zacharias W et al.; The capacity of the modification methylase (MHhaI) and restriction endonuclease (HhaI) form Haemophilus haemolyticus to methylate and cleave, respectively, recognition sites which are in right-handed B or left-handed Z structures was determined in vitro . Plasmids containing tracts of (dC-dG) as well as numerous individual d(GCGC) sites distributed around the vector were studied . Negative supercoiling was used to convert the (dC-dG) tracts (approximately 30 bp in length) from a right-handed to a left-handed conformation . (Methyl-3H)-SAM was used to localize and quantitate modified d(GCGC) recognition sites, whereas cleavage by HhaI was used to detect unmethylated sites . In the left-handed Z-form, the (dC-dG) blocks were not methylated by MHhaI and not cleaved by HhaI . A two-dimensional gel analysis of a family of 33 topoisomers treated with MHhaI revealed that the lack of methylation in the (dC-dG) blocks was directly correlated to the supercoil-induced B to Z transition in these segments . These results are significant with respect to enzyme-DNA interactions in general and provide the basis for using HhaI and MHhaI as probes for different DNA structures and conformational transitions under physiological conditions.

J Chromatogr, 1984 Oct 12, 310(2), 261 - 72
Differentiation between Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus based on carbohydrates in lipopolysaccharide; Brondz I et al.; In the present study, the closely related facultative, Gram-negative rods, Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus, were distinguished taxonomically by means of their carbohydrate composition in phenol-extracted lipopolysaccharide . Both A . actinomycetemcomitans and H . aphrophilus lipopolysaccharide contained rhamnose, fucose, galactose, glucose, L-glycero-D-mannoheptose, galactosamine, and glucosamine . The content of galactose was approximately twice as high in lipopolysaccharide from H . aphrophilus as in lipopolysaccharide from A . actinomycetemcomitans . D-Glycero-D-mannoheptose was detected exclusively in lipopolysaccharide from A . actinomycetemcomitans where it constituted 11.8-16.7% of the sugar content . This aldoheptose may therefore serve as a marker for chemotaxonomic differentiation between A . actinomycetemcomitans and H . aphrophilus . The present study also describes fragmentation of methylheptoside derivatives of trifluoroacetic acid (D-glycero- and L-glycero-D-mannoheptose) from A . actinomycetemcomitans as suggested by mass spectrometry.

J Immunol Methods, 1984 Oct 12, 73(1), 109 - 23
The use of beta-lactamase in enzyme immunoassays for detection of microbial antigens; Yolken RH et al.; The sensitivity and performance characteristics of enzyme immunoassays (EIA) depend to a great extent on the kinetics of the enzyme-substrate system used as indicator . We labeled a variety of polyclonal and monoclonal immunoglobulins with purified beta-lactamase and used them in sensitive EIA systems for the detection of a number of microbial antigens . Polyclonal antibodies to rotavirus, adenovirus, and Haemophilus influenzae type b polyribitol phosphate and monoclonal antibodies to dengue virus were labeled with beta-lactamase and used to provide sensitive direct EIA systems for the detection of the corresponding antigens . In addition, antibodies directed at animal immunoglobulins were labeled with beta-lactamase and used in indirect EIA for the detection of viral antigens with unlabeled anti-viral monoclonal and polyclonal antibodies . Similarly, avidin from Streptomyces was labeled with beta-lactamase and used to detect viral antigens tested for in an avidin-biotin format . Enzyme immunoassay systems with beta-lactamase-labeled antibodies were also used to detect rotaviral and adenoviral antigens in rectal swab specimens from children with acute gastroenteritis . The sensitivity of the beta-lactamase EIA compared favorably with that of analogous EIA systems using alkaline phosphatase or horseradish peroxidase . The results of a beta-lactamase EIA were easily determined by naked eye and a permanent record of the qualitative results obtained by the use of a standard office photocopier, obviating the need for an expensive colorimeter . Enzyme immunoassays using beta-lactamase have potential as practical assay systems for the detection of a wide range of microbial antigens using monoclonal and polyclonal antibodies.

Can J Microbiol, 1984 Oct, 30(10), 1229 - 38
Porcine haemophili and actinobacilli: characterization by means of API test strips and possible taxonomic implications; O'Reilly T et al.; Thirty Haemophilus strains and six Actinobacillus strains, all of porcine origin, were examined for their biochemical reactivity on API 20E and API ZYM test strips using dense cell suspensions (supplemented with NAD as appropriate) as strip inocula . When combined with a test for V-factor dependency, the use of both strips allowed adequate differentiation of closely related organisms . Numerical taxonomic analysis of the data demonstrated that the majority of the haemophili and actinobacilli studied could be placed in one of four major clusters; these clusters contained, respectively, the H . pleuropneumoniae--A . pleuropneumoniae strains, the H . parasuis strains, strains belonging to Haemophilus taxon "minor group," and strains belonging to an unusual group of mannitol-positive, urease-negative haemophili . A representative of Haemophilus species taxon C and an unusual Actinobacillus isolate appeared to be comparatively unrelated to organisms in the four major clusters . Although it may, on occasion, be difficult to place an unusual isolate in any one particular group, owing to the uncertain taxonomy of some of these organisms, it is concluded that API test strips can serve as useful tools for the characterization and differentiation of porcine haemophili and actinobacilli.

Tijdschr Diergeneeskd, 1984 Oct 1, 109(19), 751 - 3
{Sleeper syndrome in beef cattle; meningoencephalitis caused by Haemophilus somnus}; Franken P et al.; Central nervous system disturbances, among which somnolence was a particularly marked feature, were observed in a herd of four-month-old beef cattle . Laboratory studies showed that the clinical picture was due to meningo-encephalitis, from which Haemophilus somnus was isolated . Other animals of this herd showed a serological response with regard to the micro-organism . The importance of further studies on the incidence of this infection in the Netherlands is stressed.

Cornell Vet, 1984 Oct, 74(4), 349 - 53
Atypical nervous lesion in Haemophilus somnus infection of cattle; Ishikawa Y et al.; Two cows affected with Haemophilus somnus were examined pathologically . Although manifested lesions were composed of fibrinopurulent meningitis without the usual parenchymatous lesions in the central nervous system, Haemophilus somnus was isolated in pure culture from the cerebral cortex of both cases . Presence of this atypical lesion in the nervous system should be kept in mind for the differential diagnosis of the disease.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 353 - 9
Introductory address: resistance to antimicrobial agents . What next for Neisseria gonorrhoeae?
Dillon JR, Pauze M.
The development of gonococcal resistance to antimicrobial agents, attributable to either chromosomal mutation or to the acquisition of plasmid-mediated penicillin resistance, has been a significant trend of the past several decades . Decreased susceptibility of Neisseria gonorrhoeae to therapeutically effective antibiotics, such as spectinomycin and some cephalosporins, has also been reported . Thus, the monitoring of antimicrobial susceptibility is critical to determine whether particular treatment regimens will be effective in a given geographic area . The association between auxotype and susceptibility to antimicrobial agents has often been overlooked as a rationale for changes in susceptibility patterns . For example, the dramatic increase in the prevalence of the Pro-,Cit-,Ura- auxotype in Canada since 1973 has been associated with an increase in penicillin-resistant isolates . The association between auxotype and plasmid carriage may also indirectly play a role in resistance of N . gonorrhoeae to antibiotics . Finally, the possibility that new plasmid-determined resistances may be acquired by N . gonorrhoeae from species of Haemophilus is reviewed.

J Pediatr, 1984 Oct, 105(4), 633 - 8
A randomized controlled trial of cefaclor compared with trimethoprim-sulfamethoxazole for treatment of acute otitis media; Marchant CD et al.; We performed a randomized controlled trial of cefaclor administered twice daily compared with trimethoprim-sulfamethoxazole (TMP-SMZ) administered twice daily for the treatment of acute otitis media . Pathogens were eradicated from the middle ear exudate after 3 to 6 days of therapy in 35 of 37 (95%) patients given TMP-SMZ compared with 28 of 40 (70%) given cefaclor (P = 0.017) . Haemophilus influenzae was eliminated in 13 of 14 (93%) patients given TMP-SMZ compared with 10 of 18 (56%) given cefaclor (P = 0.047) . Clinical outcomes failed to distinguish between patients given TMP-SMZ or cefaclor . Symptoms improved despite persistent infection in 11 of 13 (85%) patients; middle-ear effusion persisted after therapy in 38 of 61 (62%) patients despite eradication of pathogens . We conclude that twice daily TMP-SMZ is more efficacious than twice daily cefaclor for the treatment of acute otitis media and that clinical outcomes may fail to detect differences between antibacterial agents in comparative drug trials in acute otitis media.

Agents Actions, 1984 Oct, 15(3-4), 211 - 5
Bronchial hyperreactivity to histamine induced by Haemophilus influenzae vaccination; Schreurs AJ et al.; Bronchial hyperreactivity to histamine 4 days following vaccination with the human respiratory pathogen Haemophilus influenzae was tested in two in vivo and one in vitro models . Conscious vaccinated guinea pigs exposed to aerosolized histamine became asphyxial significantly faster than saline-treated controls . Also the bronchoconstriction in anaesthetized guinea pigs as a result of i.v . histamine was significantly potentiated in the H . influenzae pretreated group . Isoprenaline (30 micrograms/kg) partially inhibited the bronchoconstriction . The difference in histamine sensitivity between the two groups however remained . Protection against bronchoconstriction by atropine on the other hand was significantly enhanced in the vaccinated animals . This suggests a hyperreactivity of the parasympathetic, cholinergic pathways as a result of H . influenzae vaccination.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Oct, 258(1), 20 - 6
A newly discovered sialidase from Gardnerella vaginalis; von Nicolai H et al.; A sialidase (neuraminidase, acylneuraminosyl hydrolase, EC 3.2.1.18) has been discovered and isolated from Gardnerella vaginalis (ex . Haemophilus vaginalis), a possibly pathogenic inhabitant of the female genital tract . Bacteria were grown in peptone-yeast-extract medium with 2.0 mM N-acetylmannosamine as enzyme inductor under CO2 atmosphere . Sialidase activity was found in the bacterial sediment and in the culture medium . The enzyme was liberated from the cells by ultrasonic treatment . Purification was performed by 60-80% ammonium sulfate precipitation and by column chromatography on Sepharose CL-6B and Sephadex G 200 . The enzyme revealed a molecular weight in the range of Mr 75 000 and a pH optimum at 5.5 . Among the different types of NeuAc-containing glycoconjugates, the enzyme exhibits its highest activities towards the globular glycoproteins alpha 1-acid glycoprotein and fetuin . Taking their cleavage rate as 100, it is around 55 for II3NeuAc-Lac, 45 for bovine submaxillary mucin, 35 for II6NeuAc-Lac and IV3, III6NeuAc2-LcOse4 . The rates for III8,II3NeuAc2-Lac, gangliosides and colominic acid are below 20 . Due to its specificity pattern, the enzyme may play a role in the pathogenic process of G . vaginalis infections.

Sex Transm Dis, 1984 Oct-Dec, 11(4 Suppl), 454 - 5
Thiamphenicol in the treatment of chancroid in men; Latif AS et al.; Fifty-five men were treated for culture-positive chancroid with two 2.5-g doses of thiamphenicol given on each of two consecutive days . Forty-nine patients (89.1%) were cured on this regimen . No adverse effects were noted . Cultured strains of Haemophilus ducreyi were found to be sensitive to thiamphenicol.

Postgrad Med J, 1984 Oct, 60(708), 707 - 8
Fatal neonatal septicaemia and meningitis due to Haemophilus influenzae acquired from the mother; Chattopadhyay B; A fatal case of neonatal Haemophilus influenzae type b, septicaemia and meningitis is described . Although the mother was asymptomatic, maternal genital tract culture yielded H . influenzae which was indistinguishable from the strain found in the infant . Despite the rarity of this organism as a cause of neonatal sepsis, increased awareness is essential so that this important offending pathogen is not missed.

J Med Microbiol, 1984 Oct, 18(2), 181 - 7
Enzymic activity of Haemophilus ducreyi; Sturm AW et al.; The enzymic activity of 29 Haemophilus ducreyi strains on 28 substrates is described . The results are compared with those of seven other authors . There is agreement only about the presence of alkaline phosphatase and arginine aminopeptidase and the lack of glycosidases . Possible reasons for the contradictions in the eight reports are discussed.

J Clin Microbiol, 1984 Oct, 20(4), 815 - 6
Haemophilus influenzae biotype VIII; Sottnek FO et al.; Six Haemophilus influenzae strains could not be classified as biotypes I through VII . The strains were indole, urease, and ornithine decarboxylase negative . We propose that they be classified as biotype VIII, a previously unreported biotype.

What Is Staphylococcus Aureus?, What Is Yeast?, What Is MIC?, What Is Cell Biology?, What Is Functional Genomics?, c, Bacteriology, s, Bacteria, r, Microorganism, r, Microbe, i, Microbes, a, Bacteriophages, s, Flavobacterium, o, Escherichia coli, e, Schizosaccharomyces, s, Yeasts, s, Yeasts, i, Functional genomics, i, Haemophilus, n, Escherichia coli, s, Antibiotics, c, Bacillus subtilis, i, Salmonella, a, Multidrug resistant, e, Vibriosis, r, Bacteriophages, o, Fermentations, o, Haemophilus, a, Escherichia coli, c, Ps. fluorescens, o, Pseudomonas, a, Streptococci

Scientific Publications - Work Done by Microbiology Reader Bioscreen C
Agricultural Microbiology Anaerobic Microbiology Antimicrobial Susceptibility Artificial Atmosphere Bioassay of Antibiotics Biofilm Microbiology Bioreactor Technology Biotechnology Cell Biology Clinical Microbiology Environmental Microbiology Experiments with Yeast	Fermentation Food Microbiology Functional Genomics Gene Technology Growth Media Development Growth Rate and Lag Time Industrial Microbiology Medical/Pharmaceutical Field Microbiological Assay Microbiological Research Microbiology of Cosmetics go to a specific theme...	Military Microbiology Molecular Microbiology Mutagenicity and Genotoxicity Oral Microbiology Patents Postantibiotic Studies Soil Microbiology Spore Microbiology Veterinary Microbiology Waste/Wastewater Treatment Water Microbiology Wine Microbiology

� 2005 Transgalactic Ltd (manufacturer of Bioscreen C software) | Privacy Statement | P.O. Box 1393, 00101 Helsinki, Finland, phone: +358 9 85172920, fax: +358 9 8749481, e-mail: microbiology@bionewsonline.com

Last modified: May 25, 2005