Neisseria

Arzneimittelforschung, 1989 Jan, 39(1), 31 - 3
Bactericidal effect of cefodizime against beta-lactamase-producing Neisseria gonorrhoeae in vitro . A comparison of level profiles in serum and tissue after intramuscular and intravenous administration in man; Korting HC et al.; Serum and skin suction blister fluid (SBF) level profiles as well as the profile in the hypothetical peripheral compartment in man after the single intravenous application of 1 g of cefodizime and the corresponding serum level profile after intramuscular application were simulated in the presence of beta-lactamase-producing gonococci . A rapid reduction of bacterial density was observed under each of these conditions indicating clinical efficacy of both treatment protocols in uncomplicated gonorrhoea . Considering the different level profiles in more detail both serum level profiles after intravenous and intramuscular injection turned out similarly effective: while the time needed for a 99% reduction of gonococcal density (t99%) was slightly shorter with the intravenous profile (1.45 vs . 1.68 h), the maximum relative reduction was somewhat smaller, expressed by a higher kn value (0.00024 vs . 0.00010%) . The drug level profile in the hypothetical peripheral compartment proved on the whole equally effective as the serum level profiles . The suction blister fluid level profile, however, showed an inferior antigonococcal activity (kn = 0.00076%, t99% = 2.08 h) . This demonstrates the value of the determination of SBF levels and their inclusion in in-vitro simulation experiments.

Mol Microbiol, 1989 Jan, 3(1), 49 - 55
The virulence-associated gonococcal H.8 gene encodes 14 tandemly repeated pentapeptides; Baehr W et al.; H.8 is a virulence-associated, surface-exposed immunogenic macromolecule composed of lipid and protein, common to Neisseria gonorrhoeae and Neisseria meningitidis . The H.8 DNA sequence predicted a 6.9 kD peptide comprising 14 tandemly repeated pentameric sequences . Ten were identical: Pro, Ala, Ala, Glu, Ala . Also predicted was a lipoprotein leader consensus sequence which probably specified acylation since the Escherichia coli-expressed protein was tightly associated with lipid . Lipid appeared to contribute significantly to H.8 antigen's electrophoretic mobility . This is the first description of a prokaryotic outer membrane protein composed solely of tandem repeats . Furthermore, DNA encoding this repeat appears to have been duplicated and translocated into another neisserial gene encoding an azurin.

Mol Microbiol, 1989 Jan, 3(1), 43 - 8
Conserved lipoprotein H.8 of pathogenic Neisseria consists entirely of pentapeptide repeats; Woods JP et al.; The pathogenic Neisseria, N . gonorrhoeae and N . meningitidis, possess an outer membrane protein (OMP), designated H.8, with a conserved monoclonal antibody (MAb)-binding epitope . We determined the DNA sequence of a gonococcal H.8 gene, and confirmed the relationship between the cloned gene and the H.8 OMP by constructing a gonococcal mutant lacking H.8 . The predicted H.8 OMP is a lipoprotein 71 amino acids in length, composed of 13 repeats of a consensus sequence AAEAP with perfect 5-residue periodicity . The AAEAP units form a repeating epitope that comprises the entire predicted sequence of the protein.

Mol Microbiol, 1989 Jan, 3(1), 35 - 41
Penicillin-binding protein 2 genes of non-beta-lactamase-producing, penicillin-resistant strains of Neisseria gonorrhoeae; Dowson CG et al.; Oligonucleotides that correspond to regions of the penicillin-binding protein 2 gene (penA) that differ between penicillin-sensitive and penicillin-resistant strains have been used as probes to classify the penA genes in a collection of penicillin-resistant gonococci isolated in Britain . 44/47 of those gonococcal strains that had minimal inhibitory concentrations of greater than or equal to 0.25 microgram benzylpenicillin per ml contained extensively altered penA genes which appeared to be very similar (or identical) to one or other of the two classes of altered penA genes that have been described previously . Since these two classes of altered penA genes are related, it appears that the great majority of the altered penA genes on non-beta-lactamase-producing penicillin-resistant gonococci have a clonal origin . The other three penicillin-resistant strains had altered penA genes that were different to those described previously . A crucial step in the development of the altered forms of PBP2 with decreased affinity for penicillin appears to have been the insertion of an extra codon within the transpeptidase domain of the penA gene . This insertion was found in the penA gene of all gonococci with minimal inhibitory concentrations of greater than 0.016 microgram benzylpenicillin per ml but was not found in any strains with minimal inhibitory concentrations of less than or equal to 0.016 microgram per ml.

Rev Epidemiol Sante Publique, 1989, 37(1), 7 - 12
{Epidemiologic aspects of infections due to Neisseria gonorrhoea in Belgium}; Walckiers D et al.; In the context of a surveillance programme for communicable diseases in Belgium, a network of microbiological laboratories has, since February, 1983, made weekly registrations of a number of pathogenic agents, among them, N . gonorrhoeae . Some epidemiological characteristics of N . gonorrhoeae in Belgium are discussed . Although only a portion of Belgian laboratories participate in the programme, the total of cases registered from 1983 through 1986 was 2 to 5 times greater than obtained through the notifiable diseases reporting system . More than 75% of the cases registered concerned those between 20 and 39 years of age, with a maximum for the 20-29-year age group . In 1985, 82% of the diagnoses were based on one culture alone (or one + ELISA); in 1986, this percentage was only 66%.

Genitourin Med, 1989 Jan, 65(1), 8 - 13
Utility of monoclonal antibody coagglutination to identify Neisseria gonorrhoeae; Young H et al.; The Phadebact monoclonal gonococcus coagglutination test was evaluated with 1367 (996 anogenital and 371 pharyngeal) neisserial isolates from patients who gave positive diagnostic test results for Neisseria gonorrhoeae . The overall correlation with carbohydrate utilisation was 99.7% . The Phadebact test had a specificity of 100% (286/286) and a sensitivity of 99.7% (1077/1080) . The three non-reactive strains were epidemiologically linked and were of a very unusual serovar . Unlike polyclonal antibody based tests, the monoclonal antibody test provides reliable identification of gonococci from anogenital and pharyngeal sites . Because non-reactive strains are rare, however, negative anogenital isolates from heterosexual patients should be tested biochemically . The use of two reagents comprising separate pools of monoclonal antibodies against gonococcal protein IA and IB permitted the identification of an appreciable number of double infections, which would otherwise have been missed . Genital, rectal, and pharyngeal isolates from the same patient should be identified individually.

J Clin Microbiol, 1989 Jan, 27(1), 227 - 8
Evaluation of a method for rapid detection of penicillinase-producing Neisseria gonorrhoeae in urethral exudates; Herve VM et al.; A substrate, pyridine-2-azo-p-dimethylaniline cephalosporin (PADAC; Diagnostic Pasteur, Marnes-La-Coquette, France), for detection of penicillinase-producing Neisseria gonorrhoeae (PPNG) on isolated colonies grown on agar was compared with the nitrocefin reference test (Cefinase; Biomerieux, Marcy l'Etoile, France) . The PADAC test was also used to detect PPNG directly on urethral exudates . All 38 PPNG-containing and 29 of 30 PPNG-negative urethral pus isolates gave results in agreement with those obtained on cultured isolates . We conclude that direct detection of PPNG in urethral exudates from males is simple, rapid, reliable, and sensitive.

Am J Obstet Gynecol, 1989 Jan, 160(1), 26 - 31
Interferon-gamma in the diagnosis and pathogenesis of pelvic inflammatory disease; Grifo JA et al.; Serologic markers were evaluated to determine if they could aid in the differential diagnosis of pelvic inflammatory disease in 48 consecutive women seeking evaluation for pelvic pain . On the basis of clinical and microbiologic parameters, 29 patients (60.4%) were diagnosed as having pelvic inflammatory disease . Neisseria gonorrhoeae only was isolated from the cervix of eight (27.6%) patients with pelvic inflammatory disease, five (17.2%) had only Chlamydia, and two (6.9%) had Neisseria and Chlamydia, whereas in 15 (48.3%) patients no pathogen was isolated . Interferon-gamma was present in significantly more sera (p less than 0.025) from patients with pelvic inflammatory disease (65.5%) than from women without pelvic inflammatory disease (15.8%) . Sera from 10 healthy women lacked detectable interferon-gamma . In patients with only Neisseria, seven (87.5%) had circulating interferon-gamma; three (60%) of the women with only Chlamydia, one (50%) woman with Neisseria and Chlamydia, and eight (57.1%) with no identified pathogens were also positive for interferon-gamma . Sera from 11 of 28 patients with pelvic inflammatory disease (39%) but only one of 19 sera from women without pelvic inflammatory disease (5%) also inhibited the Candida-induced proliferation of control lymphocytes . This immunosuppressive activity was prevented by immunoprecipitation of interferon-gamma by anti-interferon-gamma antibody but not by treatment with anti-interferon-alpha antibody . The persistence of interferon-gamma in the sera of patients with pelvic inflammatory disease may aid in the differential diagnosis of this disease and increase our understanding of the pathogenesis of microbial-mediated tubal damage.

Proc Natl Acad Sci U S A, 1989 Jan, 86(1), 17 - 21
Structure and heterogeneity of the oligosaccharides from the lipopolysaccharides of a pyocin-resistant Neisseria gonorrhoeae; Gibson BW et al.; The compositions and partial structures of the oligosaccharides from the lipopolysaccharides (LPS) of a pyocin-resistant Neisseria gonorrhoeae (strain JW31R) have been determined by liquid secondary ion mass spectrometry (LSIMS), tandem mass spectrometry, and methylation analysis . Four major structures were identified with Mr 2123, 2000, 1961, and 1838, as well as seven species of lower abundance of Mr 1758-1272 . The largest of the major oligosaccharides (Mr, 2122) consists of 3-deoxymanno-2-ketooctulosonic acid (KDO)-Hep2GalNAcGlcNAcGal4Glc2 (Hep, heptose) and phosphoethanolamine (PEA) . The smaller oligosaccharides are truncated versions of this larger oligosaccharide . The oligosaccharides consist of a common triantennary structure containing KDO at the reducing terminus attached to a heptose disaccharide . A hexose (Hex)2-3 branch is attached to the heptose linked directly to KDO and a GalNAc-Hex3, GlcNAc, and PEA are separately attached to the second heptose . These oligosaccharides are the first structures to be determined for a gonococcal LPS and should further our understanding of the structural and antigenic diversity of these glycolipids.

Med Microbiol Immunol (Berl), 1989, 178(1), 53 - 9
Failure of adherence to buccal cells and surface hydrophobicity as virulence markers in Neisseria meningitidis; Criado MT et al.; Surface hydrophobicity and adherence to buccal epithelial cells were studied in 33 carrier and 34 invasive Neisseria meningitidis strains . It was found that hydrophobicity is statistically similar in both groups (P = 0.0507) although it could be considered that carrier strains are slightly more hydrophobic than invasive ones . Adherence was similar in both groups although more homogeneous in the carrier strains . No correlation could be demonstrated between these two properties nor can they be considered relevant as markers of the carrier or invasive status of this bacterium, indicating that at least in N . meningitidis they are not good properties to discriminate virulent strains.

Rev Chil Obstet Ginecol, 1989, 54(2), 66 - 70
{Diagnosis of sexually transmitted diseases in Chilean pregnant adolescents}; Bernal JN et al.; We searched in 100 healthy pregnant women by isolation, the presence of Neisseria gonorrhoeae, Herpes simplex, Mycoplasma hominis, Ureaplasma urealyticum and Chlamydia trachomatis . Blood was also taken for examination of specific antibodies to these microorganisms . We studied only for antibodies titled Cytomegalovirus (CMV), Treponema pallidum and Human Immunodeficiency Virus, and Condyloma acuminatum by cervical cytology . In 85 adolescents we found 5 (6%) patients with C . trachomatis, four of these patients had another microorganism added, one with N . gonorrhoeae, M . hominis and U . Urealyticum, one with U . urealyticum and the last two with M . hominis and U . urealyticum, In relation to Mycoplasmas 69 (81%) out of 85 had Mycoplasmas, 4 (5%) had M . hominis, 46 (54%) U . urealyticum and 19 (22%) patients had both . The seropositivity to CMV was 96.25% . We didn't find any other microorganism . We concluded that the rate of STD in chilean pregnant adolescent women is high, especially with no traditional bacteria.

West Afr J Med, 1989 Jan-Mar, 8(1), 42 - 9
Sexually transmitted diseases in Nigeria . A review of the present situation; Ogunbanjo BO; PIP: Gonorrhea is the most prevalent sexually transmitted disease (STD) in Nigeria . In fact, in 1963, WHO found Lagos to have the highest gonorrhea rate in the world . Recent surveys report gonorrhea prevalence to be as high as 28.1% . Further some studies show a clear association between gonorrhea and male and female infertility . Penicillinase producing Neisseria gonorrhea prevalence varies from 44.4% in Zaria to 80% in Ibadan . There is an increase in the prevalence of gonorrhea among girls, mostly due to sociocultural factors such as the belief that sexual intercourse with a girl who has urethritis cures the condition . Gonorrhea is not always the most common form of urethritis, however . For example, in a study in Ibadan, 61% of male urethritis cases had nonspecific urethritis . Further schistosomiasis often causes urethral symptoms like those of gonorrhea . Most women at STD clinics have vaginitis and vaginal discharge . Even though the prevalence of trichomoniasis and candidiasis are rather high (10.2-22.3% and 4.33.1% respectively), bacterial vaginosis is the leading cause of vaginitis and vaginal discharge in Nigeria . The predominant malignancy of women in Nigeria is cervical cancer which my be due to the high rates of infection of trichomoniasis and Herpes virus II . Another prevalent STD is syphilis, yet many people with the infection are asymptomatic . For example, a study reports that 10.3% of women in a prenatal clinic in Lagos tested positive for syphilis, but the physician believed only 1.5% had syphilis . Tropical venereal diseases still cause genital ulcers in Nigeria . Dermatophyte infection, genital warts, and pedicubsis pubis also occur, but scant data exist . Many people believe they have an STD and do not, yet they insist they do . This phenomenon may be a result of the common fear of infertility which results from STDs . In conclusion, the government should allocate adequate funds for health programs and research, particularly those associated with STDs .

J Immunoassay, 1989, 10(4), 373 - 94
Detection of Neisseria gonorrhoeae by dot-enzyme immunoassay using monoclonal antibodies; Lussier M et al.; A highly sensitive and specific dot-enzyme immunoassay for the detection of Neisseria gonorrhoeae was developed using a pool of monoclonal antibodies (MAbs) . The MAbs were obtained following immunization of mice with lithium acetate extracted outer membrane (OM) preparations . Western immunoblotting experiments demonstrated that MAbs NG26 and NG38, both IgG2a, reacted with lipopolysaccharides (LPS) and with the major OM protein, P1, respectively, MAb NG28, an IgG3, did not react in Western immunoblotting, MAbs NG28 and NG38 failed to react with OM treated with proteolytic enzymes or with semi-purified preparation of LPS . MAb NG26 reacted with the same LPS preparation . Binding radioimmunoassay with live bacteria showed that all the MAbs adsorbed to cell surface-exposed antigenic determinants . The limit of detection of the dot-enzyme immunoassay was between 1 and 4 x 10(4) cfu per dot . Using a panel of 177 strains of N . gonorrhoeae, MAbs NG28 and NG38 recognized only P1A and P1B strains respectively . MAb NG26 reacted with P1A, P1B and non-typable strains . These MAbs did not react with other Neisseria species or other bacterial species . Using this pool, the dot-enzyme immunoassay had a sensitivity of 93.2% and a specificity of 100%.

Free Radic Res Commun, 1989, 7(2), 83 - 7
The role of hydroxyl radical in chromosomal and plasmid damage in Neisseria gonorrhoeae in vivo; Hassett DJ et al.; Viable Neisseria gonorrhoeae exposed to streptonigrin generate intracellular hydroxyl radical detected by spin-trapping with 5,5-dimethyl-l-pyrroline-N-oxide; gonococci exposed to paraquat generate primarily superoxide (J . Biol . Chem., 262: 13404-143048, 1987) . The use of streptonigrin and paraquat provide a model with which to examine the action and site(s) of hydroxyl radical-mediated damage . N . gonorrhoeae exposed to streptonigrin, but not paraquat, developed extensive chromosomal, plasmid, and RNA damage . Addition of excess Fe+3 to the reaction mixture enhanced intracellular hydroxyl radical formation by paraquat, detectable as DNA damage . Desferal and dimethyl sulfoxide allowed approximately 25% of protection of plasmid DNA damage as judged by linear scanning densitometry . These results demonstrate DNA and RNA damage in viable organisms exposed to intracellular redox stress and confirm the critical role of hydroxyl radical in this process.

Microbios, 1989, 59(238), 37 - 45
Neisseria meningitidis: heterogenicity in the outer membrane proteins released into the growth medium; Jascolt E et al.; Eight strains of Neisseria meningitidis belonging to different serogroups were analysed for their virulence in mice and their release of outer membrane proteins into the medium during growth . All strains released proteins . No detectable lipopolysaccharide was observed . However, SDS-PAGE showed a heterogenicity in the protein number and profile among the different strains of N . meningitidis tested.

Mol Microbiol, 1989 Jan, 3(1), 57 - 64
Probing the surface of Neisseria gonorrhoeae: immunoelectron microscopic studies to localize cyanogen bromide fragment 2 in gonococcal pili; Robinson EN Jr et al.; Common epitopes accessible to antibody on purified macromolecules or structurally altered gonococci may not be accessible to antibody when those macromolecules are in their native state on the surface of intact organisms . To determine the immunologic accessibility of cyanogen bromide fragment 2 (CNBr2), a portion of the gonococcal pilin molecule that is common to all gonococcal strains on the surface of viable gonococci, probes composed of specific CNBr2 antibodies linked to gold spheres were manufactured . When whole piliated gonococci were exposed to these anti-CNBr2 immunological probes and examined using transmission electron microscopy, no significant marketing of native pili was evident . These probes, however, detected CNBr2 in purified form . The epitopes encompassed within the CNBr2 portion of pili appear to be inaccessible to anti-CNBr2 probes within native gonococcal pili.

Gene, 1988 Dec 25, 74(1), 93 - 7
Neisseria gonorrhoeae M.Ngo AI DNA methyltransferase: physical and catalytic properties of the homogeneous enzyme; Piekarowicz A et al.; A DNA methyltransferase, M.NgoAI, was purified to homogeneity from Neisseria gonorrhoeae strain WR220 by successive column chromatography . Its Mr is 25,000, as determined by both gel filtration and denaturing polyacrylamide gel electrophoresis . Maximal enzymatic activity was obtained in 50 mM Tris.HCl (pH 7.4), 10 mM EDTA, with incubation at 37 degrees C . An apparent Km value for S-adenosylmethionine and 5' -GGCC sites was determined to be 1.25 microM and 89.6 nM, respectively.

EMBO J, 1988 Dec 20, 7(13), 4367 - 78
Pilin expression in Neisseria gonorrhoeae is under both positive and negative transcriptional control; Taha MK et al.; We have identified two closely linked genes, pilA and pilB, which act in trans on the pilin promoter . pilA-pilB map downstream of expression loci pilE1 and opaE1 in the gonococcal chromosome . Subcloning data indicate that pilB acts negatively on the pilin promoter, and insertional inactivation of pilB results in hyperpiliated gonococci . A pilA clone activates the pilin promoter in Escherichia coli, and a pilA-/pilA+ heterodiploid gonococcus exhibits a P- phenotype . Our inability to obtain simple pilA- mutants strongly suggests that pilA is an essential gene in the gonococcus . In an in vitro coupled transcription/translation system, inserts spanning the pilA and pilB region direct the synthesis of two proteins of 40 and 58 kd . DNA sequence analysis shows that the pilA and pilB loci encode proteins of 38.6 kd (with a putative DNA binding domain) and 57.9 kd respectively . The pilA and pilB genes are in opposite orientation relative to each other, and the 5' ends of the two genes overlap . We discuss how these two loci may interact to control pilin expression in the gonococcus.

J Immunol, 1988 Dec 15, 141(12), 4357 - 62
Murine immune response to the Neisseria meningitidis group C capsular polysaccharide . II . Specificity; Rubinstein LJ et al.; As a means of further understanding the regulation of diversity and the development of protective immunity to the Neisseria meningitidis group C capsular polysaccharide (MCPS), we have generated and characterized, in detail, a panel of mAb against MCPS, a homopolymer of alpha(2----9)-sialic acid . Whereas the serum response to MCPS is restricted to the IgM and IgG3 isotypes, the panel of mAb includes, in addition, both IgG1 and IgG2b . Among 15 mAb of four isotypes, seven different specificities were observed based on direct binding in a fluorescence ELISA and precipitation in gel . Although all the mAb were derived from mice immunized with bacteria encapsulated with the native MCPS (strain C11), only 7 of 15 reacted with MCPS alone . Seven of 15 reacted with a natural O-acetyl-negative variant (OAc-, strain MC19) polysaccharide as well as with MCPS . Five of these reacted as much as 3 logs better with OAc- than MCPS and the other two reacted better with MCPS than OAc- . One mAb appeared to be alpha(2----9)-linkage specific as it reacted not only with MCPS and OAc-, but also with the capsular polysaccharide of Escherichia coli K92, a polymer of sialic acid linked alternately alpha(2----8) and alpha(2----9) . None of the mAb reacted with the capsular polysaccharide of E . coli K1, a homopolymer of alpha(2----8)-sialic acid . In general, there was a good correlation between the ability to precipitate Ag in gel and to agglutinate bacteria; however, 3 of 15 mAb, all IgG3, did not conform to this rule in that they precipitated Ag but did not agglutinate bacteria of the relevant capsular specificity . Antibodies of both IgM and IgG isotypes and of both major specificities, MCPS-specific and those binding MCPS and OAc-, were bactericidal for strain C11, whereas only those reactive with OAc- were able to kill strain MC19.

J Immunol, 1988 Dec 15, 141(12), 4352 - 6
Murine immune response to the Neisseria meningitidis group C capsular polysaccharide . I . Ontogeny; Rubinstein LJ et al.; The immune response to polysaccharide Ag develops late in ontogeny and the underlying mechanisms of the infant unresponsiveness are poorly understood . The development of vaccines that will prove efficacious in infants has been hindered by the lack of animal systems suitable for studying immunity to human pathogens . We have examined the BALB/c murine response to the capsular polysaccharide of Neisseria meningitidis group C (MCPS), a homopolymer of alpha(2----9) sialic acid, as a model system for the development of immunity to bacterial polysaccharides in man . We have observed the appearance of natural antibody of both IgM and IgG classes which increases with age, and the transfer of maternal IgG to the offspring . Both the naturally occurring and postimmunization serum responses are restricted to the IgM and IgG3 isotypes, and include antibody titers to both MCPS as well as a natural O-acetyl-negative variant (OAc-) . The preimmune anti-OAc- antibodies, in contrast to anti-MCPS, were restricted to the IgM class, whereas after immunization with MCPS both IgM and low titers of IgG3 antibodies to OAc- were produced . These studies demonstrate that the BALB/c mouse strain shows a markedly similar immune profile to that observed in man.

J Immunol Methods, 1988 Dec 9, 115(2), 269 - 74
A spectrophotometric method for evaluating a latex agglutination assay of Salmonella typhi lipopolysaccharide; Lim PL et al.; A spectrophotometer set at a wavelength of 400 nm was used to read reaction mixtures containing a 0.01% suspension of antibody-sensitized latex particles and different amounts of soluble antigen, after incubation in tubes for 30 min . The antigen used was Salmonella typhi lipopolysaccharide, and the antibody was an O-9-specific monoclonal antibody . Agglutination was indicated by a fall in the turbidimetric measurement compared to control, unagglutinated latex . It was observed that agglutination increased with increasing concentrations of antigen to a maximum at 0.25-1.0 micrograms/ml, after which, the amount of agglutination decreased at a similar rate as far as 1 mg/ml of antigen, when no agglutination occurred at all . Thus, a bi-symmetrical curve was obtained, suggestive of a precipitation reaction . At the 'equivalence point', the turbidity of the reaction mixture compared to control fell from OD400 1.1 to OD400 0.3 . A similar inhibition of reaction at 'antigen excess' was observed visually in the reaction mixtures . Conventional slide tests performed in parallel could also be inhibited, but at higher antigen levels . Inhibition could be achieved with a commercially available latex used for the detection of Neisseria meningitidis antigen.

Med J Aust, 1988 Dec 5-19, 149(11-12), 710 - 1
Adult penicillinase-producing gonococcal keratoconjunctivitis; Saad N et al.; The case is described of a 22-year-old man who presented with ulcerative keratitis as a complication of conjunctivitis that was caused by penicillinase-producing Neisseria gonorrhoeae . The need for first-line treatment with antibiotic agents that are resistant to beta-lactamase breakdown is discussed.

Aust N Z J Med, 1988 Dec, 18(7), 874 - 6
A case of polymicrobial infective endocarditis involving Neisseria mucosa occurring in an intravenous drug abuser; Giles MW et al.; The incidence of polymicrobial endocarditis has increased markedly in recent years, in association with the increasing level of abuse of intravenous drugs . Neisseria mucosa, an upper respiratory tract commensal, is a rare cause of infective endocarditis . We report the first case of polymicrobial infective endocarditis involving Neisseria mucosa occurring in an intravenous drug abuser.

Genitourin Med, 1988 Dec, 64(6), 364 - 6
Enoxacin as one day oral treatment of men with anal or pharyngeal gonorrhoea; Bakhtiar M et al.; The efficacy of two regimens of oral enoxacin (400 mg as a single dose or two 200 mg doses 12 hours apart) to treat anal and pharyngeal gonorrhoea was compared . Fifty men with confirmed gonorrhoea (40 with anal, six with pharyngeal, and four with both) were treated and assessed three to five and seven to 14 days after treatment . Of 44 evaluable patients who attended the first follow up, including those who were infected with penicillinase producing Neisseria gonorrhoeae (PPNG), all were cured . No haematological or biochemical abnormality associated with enoxacin was observed . Nine patients reported minor adverse effects during the trial period, only one of which was considered probably related to the treatment . Both regimens of 400 mg enoxacin were effective in treating anal and pharyngeal gonorrhoea.

Am J Public Health, 1988 Dec, 78(12), 1583 - 4
Use of a leukocyte esterase dipstick to detect Chlamydia trachomatis and Neisseria gonorrhoeae urethritis in asymptomatic adolescent male detainees; O'Brien SF et al.; We tested 91 asymptomatic adolescent male detainees in a short-stay detention facility in Seattle, Washington for the presence of leukocyte esterase in first-catch urine and for Chlamydia trachomatis and Neisseria gonorrhoeae infection . C . trachomatis was isolated from 10 subjects (11 per cent) and N . gonorrhoeae from five (5 per cent) . Dipsticks detected leukocyte esterase in the urine of all 15 subjects with either infection and of 13 subjects with neither infection . Detection of leukocyte esterase was 100 per cent sensitive, 83 per cent specific, and 54 per cent predictive for the presence of either organism.

J Gen Microbiol, 1988 Dec, 134 ( Pt 12), 3285 - 94
Role of outer-membrane proteins and lipopolysaccharide in conjugation between Neisseria gonorrhoeae and Neisseria cinerea; Genco CA et al.; Little is known concerning the mechanism involved in cell contact between the donor and recipient during conjugation in Neisseria gonorrhoeae . The formation of stable mating pairs during conjugation in Escherichia coli appears to require a specific protein as well as LPS in the outer membrane of the recipient cell . To attempt to identify the cell surface components necessary for conjugation in the neisseriae, we began a comparison of the outer membrane of Neisseria cinerea strains that can (Con+) and cannot (Con-) serve as recipients in conjugation with N . gonorrhoeae . There were no differences in outer-membrane protein profiles on SDS-polyacrylamide gel electrophoresis between Con+ and Con- strains that could be correlated with the ability to conjugate . However, whole outer membrane isolated from Con+ strains specifically inhibited conjugation while those from Con- strains did not . Proteolytic cleavage of outer-membrane proteins by trypsin, pronase or alpha-chymotrypsin abolished the inhibitory effect of Con+ outer membranes, suggesting that these outer membranes contained a protease-sensitive protein(s) involved in conjugation . Although periodate oxidation of Con+ outer-membrane carbohydrates did not abolish the inhibitory action of these membranes, purified LPS from both Con+ and Con- strains inhibited conjugation when added at low concentrations . These results suggest that conjugation requires the presence of a specific conjugal receptor that consists of both LPS and one or more outer-membrane proteins . Both Con+ and Con- strains contain the necessary LPS, but only Con+ strains contain the required protein(s).

J Gen Microbiol, 1988 Dec, 134 ( Pt 12), 3277 - 83
Transfer of a gonococcal beta-lactamase plasmid to conjugation-deficient Neisseria cinerea strains by transformation; Genco CA et al.; We have previously shown that some strains of Neisseria cinerea can serve as recipients in conjugation (Con+) with Neisseria gonorrhoeae while others cannot (Con-) . To determine if a replication defect contributes to the inability of certain strains of N . cinerea to serve as recipients in conjugation, we attempted to introduce a naturally occurring gonococcal beta-lactamase plasmid into N . cinerea by transformation . Various methods were employed, and all proved unsuccessful . Since specific sequences are required for DNA uptake in transformation of N . gonorrhoeae, we constructed a number of hybrid plasmids containing N . cinerea chromosomal DNA inserted into the N . gonorrhoeae/Escherichia coli beta-lactamase shuttle vector, pLES2 . When nine randomly selected plasmids with inserts were used to transform an N . cinerea strain which did not accept the gonococcal beta-lactamase plasmid by conjugation, transformants were observed with four of the hybrid plasmids . The presence of one of the hybrid plasmids, pCAG9, in transformants was confirmed by agarose gel electrophoresis, Southern hybridization, and beta-lactamase production . When an N . gonorrhoeae donor strain containing pCAG9 was used in conjugation with several N . cinerea strains, only those strains that were previously shown to act as recipients could accept and maintain pCAG9 . The ability of pCAG9 and the other three hybrid plasmids to transform Con- strains demonstrates that the beta-lactamase plasmid can replicate in Con- strains, and, therefore, the Con- phenotype is due to a block in some other stage of the conjugation process.

Diagn Microbiol Infect Dis, 1988 Dec, 11(4), 209 - 13
Neisseria meningitidis and Moraxella osloensis: dual infection in blood and peritoneal fluid; Tiosejo LL et al.; The clinical course of a malnourished alcoholic in which Neisseria meningitidis was isolated from the blood and Moraxella osloensis from the peritoneal fluid is described . Following bacteriologic diagnosis, the patient was treated and responded to a course of penicillin therapy . To our knowledge, this represents the first case of peritonitis associated with M . osloensis . Clinical reports of the isolation of this organism are rare; its pathogenicity is not clearly established, and the presence of the organism may often be unrecognized.

J Clin Microbiol, 1988 Dec, 26(12), 2544 - 8
Selective medium for Branhamella catarrhalis with acetazolamide as a specific inhibitor of Neisseria spp; Vaneechoutte M et al.; Several semiselective media for Branhamella catarrhalis have been proposed . These media allow growth of all members of the family Neisseriaceae, and further differentiation is necessary . By addition of 10 micrograms of acetazolamide, a carbonic anhydrase inhibitor, per ml and incubation in air, a medium was created which reduced growth of Neisseria spp . When saliva samples from 178 healthy schoolchildren were screened for the presence of B . catarrhalis, the carrier rate for this organism was estimated to be 48.9% with the selective medium compared with 12.4% when a semiselective medium, which contains only 10 micrograms of vancomycin, 5 micrograms of trimethoprim, and 2 micrograms of amphotericin B per ml, was used and 6.2% when a nonselective blood agar plate was used . The number of Neisseria spp . isolated dropped from 297 on the semiselective agar to 55 on the selective agar.

J Immunol, 1988 Dec 1, 141(11), 3902 - 9
Assembly of the membrane attack complex promotes decay of the alternative pathway C3 convertase on Neisseria gonorrhoeae; Densen P et al.; C3, C4, factor B, properdin, and C2 binding to serum-sensitive and serum-resistant gonococci was quantitated in C8-deficient and normal human serum by using fluorescein-conjugated antibodies and 3H-labeled components . Organism and serum-specific differences were noted, the most striking of which involved factor B and properdin binding to the serum-sensitive strains in the different sera . C3 binding to these organisms was quantitatively and kinetically equivalent in C8-deficient and normal human serum . In contrast, factor B and properdin binding reached a plateau after 5 min in C8-deficient serum but peaked and fell to control values in normal human serum . Identical results were obtained with normal human serum immunochemically depleted of C8 . Between 7 and 15% of the bound C3 participated in formation of the alternative pathway convertase C3bBb/P . Reconstitution of the C cascade by adding purified C8 to C8-deficient serum led to the loss of factor B previously bound to the organisms . Factor B loss occurred coincident with bacterial killing and membrane disruption as observed by electron microscopy . Prevention of membrane disruption by depleting normal human serum of lysozyme had no effect on killing and failed to prevent factor B loss . Stabilization of the C3bBb complex with Ni2+ prevented factor B loss as well as gross membrane disruption but not bacterial killing . C2 (the classical pathway analog of factor B) binding to gonococci was equivalent in C8-deficient and normal human serum peaking within 2.5 min and falling to control values in both sera thereafter . We conclude that the assembly of the membrane attack complex promotes decay of C3bBb/P with release of factor B and properdin but not C3 from the organism surface . Membrane disruption does not appear to be required for this effect . This activity may represent a mechanism to limit continued C consumption.

Antimicrob Agents Chemother, 1988 Dec, 32(12), 1788 - 92
Differential effects of DNA gyrase inhibitors on the genetic transformation of Neisseria gonorrhoeae; Parham C et al.; Inhibitors of DNA gyrase in Escherichia coli exerted differential effects on the genetic transformation of Neisseria gonorrhoeae . When competent cells of the gonococcus were exposed to novobiocin before the uptake of transforming antibiotic resistance DNA, there was a 50 to 60% reduction in the number of transformants compared with the number of control untreated cells . Norfloxacin, a more potent inhibitor of DNA gyrase and an analog of nalidixic acid, nearly abolished the production of transformants by recipient cells . On the contrary, exposure of competent cells to nalidixic acid had no effect on transformant yield . The target of these inhibitors appears to be at the level of recombination . Possible mechanisms are discussed.

Nature, 1988 Nov 24, 336(6197), 392 - 5
DNA transformation leads to pilin antigenic variation in Neisseria gonorrhoeae; Seifert HS et al.; Many pathogenic bacteria express pili (fimbriae) on their cell surfaces . These structures mediate binding of bacteria to host tissues, and may also be involved in other aspects of pathogenesis . Neisseria gonorrhoeae pili are mainly composed of a single protein, pilin, whose expression is controlled at chromosomal expression loci (pilE) . An intact pilin gene and promoter sequences are only found at pilE . Strain MS11 contains two expression sites (pilE1 and pilE2), whereas several of its derivatives and other clinical isolates contain only one . Silent pilin loci (pilS1-pilS7) contain truncated variant pilin genes lacking the promoter and conserved pilin gene sequences . Pilin antigenic variation in N . gonorrhoeae occurs by DNA recombination between one of he silent partial variant gene segments in pilS and an expressed pilin gene in pilE . The recombination reactions are nonreciprocal, and therefore the mechanism has been classified as gene conversion . We report that much of the recombination between pilin loci actually occurs after transformation of living piliated cells by DNA liberated from lysed cells within a population . This constitutes a new molecular mechanism for an antigenic variation system, as well as the first specific function for a DNA transformation system.

Z Hautkr, 1988 Nov 15, 63(11), 897 - 8, 905-6
{Detection of antibodies to Neisseria gonorrhoeae in cervicovaginal secretion and in serum}; Koch HJ et al.; In 33 female patients suffering from gonorrhoea, we searched for specific antibodies (IgA, IgG, IgM) directed against gonococci by means of the indirect immunofluorescence technique . This investigation was performed both before and after specific treatment . In comparison to 17 healthy women, we found increased rates of IgA and IgG antibodies in the secretion of our patients, the IgA rate being slightly higher than the IgG count; IgM was not detectable at all . In the serum, IgG antibodies clearly dominated over IgA and IgM . After successful treatment, IgA antibodies showed a more rapid reduction than IgG in both secretion and serum.

Microb Pathog, 1988 Nov, 5(5), 381 - 90
Presence of antibodies to the major anaerobically induced gonococcal outer membrane protein in sera from patients with gonococcal infections; Clark VL et al.; Anaerobically grown Neisseria gonorrhoeae induces and represses the synthesis of outer membrane proteins . One of the anaerobically induced proteins, Pan 1, reacted strongly on Western blots with sera from patients with uncomplicated gonococcal infection, pelvic inflammatory disease, and disseminated gonococcal infection, but not with normal human serum . The pattern of reactivity of the sera against Pan 1 from several gonococcal strains suggested that the protein was antigenically heterogeneous, containing both common and unique epitopes . Staphylococcus aureus V8 protease digestion of Pan 1 from four gonococcal strains revealed the presence of common peptides, with one strain also containing some unique peptides and lacking others . The class of the antibody reactive with gonococcal outer membrane antigens was examined; anti-Pan 1 antibody was found to be IgG or IgM, but not IgA . The IgM antibody present reacted predominantly with Pan 1 . These data indicate that the Pan 1 protein is expressed in vivo and strongly suggest that N . gonorrhoeae can grow anaerobically in vivo.

J Clin Microbiol, 1988 Nov, 26(11), 2283 - 6
Serologic confirmation of Neisseria gonorrhoeae by monoclonal antibody-based coagglutination procedures; Anand CM et al.; Two commercially available monoclonal antibody coagglutination tests, Phadebact Monoclonal GC OMNI Test (PMGOT; Pharmacia Diagnostics AB, Uppsala, Sweden) and GonoGen (GG; New Horizons Diagnostics, Columbia, Md.), for the confirmation of Neisseria gonorrhoeae were evaluated . The sensitivities of PMGOT and GG were 99.2 and 98.7% and the specificities were 91.5 and 100.0%, respectively . False-positive reactions were observed with Neisseria lactamica and Neisseria meningitidis in PMGOT . A modification of the procedure recommended by the manufacturer for PMGOT was done by substituting Todd-Hewitt broth for 0.9% saline to prepare the suspension of the test organism . This eliminated technical difficulties with the test and resulted in a sensitivity and a specificity of 99.3 and 100.0%, respectively . Advantages offered by the modified PMGOT over GG were the better predictive value of the negative test, the lower cost, the ease of reading of the test, and the lack of noninterpretable results.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Nov, 269(4), 506 - 12
{Lectin typing as an efficient epidemiological marker system for Neisseria gonorrhoeae infections}; Korting HC et al.; A total of 102 Neisseria gonorrhoeae isolates from Munich with known nutritional requirements were examined for lectin agglutination patterns using Taxonolectin panels containing 14 different plant originated lectins with known specificity . 29 different lectin agglutination patterns were found (in comparison auxotyping showed 17 different groups) . All strains reacted with Concanavalin A and Trichosanthes kinlowii and did not show positive reactions with Limax flavus and Ulex europaeus I . 49 Isolates (48%) had lectin agglutination patterns associated with only four lectin groups (in comparison the four major auxotyping groups comprised 58 (57%) of the tested isolates) . A correlation between auxotype and lectin agglutination pattern could not be demonstrated . Reproducibility of lectin agglutination patterns was excellent.

Mol Microbiol, 1988 Nov, 2(6), 797 - 806
Three copies of a single protein II-encoding sequence in the genome of Neisseria gonorrhoeae JS3: evidence for gene conversion and gene duplication; van der Ley P; Gonococci express a family of related outer membrane proteins designated protein II (P.II) . These surface proteins are subject to both phase variation and antigenic variation . The P.II gene repertoire of Neisseria gonorrhoeae strain JS3 was found to consist of at least ten genes, eight of which were cloned . Sequence analysis and DNA hybridization studies revealed that one particular P.II-encoding sequence is present in three distinct, but almost identical, copies in the JS3 genome . These genes encode the P.II protein that was previously identified as P.IIc . Comparison of their sequences shows that the multiple copies of this P.IIc-encoding gene might have been generated by both gene conversion and gene duplication.

J Exp Med, 1988 Nov 1, 168(5), 1883 - 97
Characterization and specificity of antibodies to protein I of Neisseria gonorrhoeae produced by injection with various protein I-adjuvant preparations; Wetzler LM et al.; A major goal of gonococcal research is the development of a gonorrheal vaccine . A vaccine candidate is the major outer membrane protein (PI) of the gonococcus, which has limited antigenic variability . Two main subtypes, PIA and PIB, and nine main serotypes have been described . To avoid raising anti-protein III (PIII)-blocking antibodies and limit potential lipooligosaccharide toxicity, PI was chromatographically isolated with minimal PIII contamination (less than 1%) from Pgh 3-2 (PIB), a serum-sensitive gonococcal strain and UU1 (PIA), a serum-resistant gonococcal strain . Alum was used as an adjuvant and the antibodies raised in rabbits did not agglutinate the organisms, were not opsonic, and bactericidal titers were not increased . To present PI in a form mimicking its in vivo disposition, it was inserted into liposomes . The resulting antisera did agglutinate the organism and contained opsonic and bactericidal activity greater than the preimmune sera or alum-generated sera . The PIB liposome antisera also had higher ELISA titers to a synthetic peptide equivalent to an exposed portion of PIB and a higher percentage of antibodies absorbed by whole organisms than the PIB alum antisera . We speculate that when PI is presented in liposomes, the antibodies raised are mainly to surface-exposed epitopes of the protein as opposed to when PI is presented absorbed to alum, where the antibodies are produced mainly to buried epitopes.

Rev Med Interne, 1988 Nov-Dec, 9(5), 534 - 7
{Hereditary C5 deficiency and recurrent Neisseria meningitidis meningitis}; Ducret F et al.; Deficiencies of the terminal C fragments of the complement system are known to be associated with a remarkable increase in the frequency of Neisseria infections . The correlation is even closer between deficiency of C5 and recurrent N . meningitidis meningitis . The reasons for this bacterial specificity and the immunopathological mechanisms involved have not been clearly established . However, it is known that only adult subjects with homozygous deficiency are affected and that the deficiency is transmitted as an autosomal recessive trait unrelated to the HLA system.

Plasmid, 1988 Nov, 20(3), 232 - 40
Construction of miniplasmids from the 7.2-kb and 5.1-kb penicillinase-producing plasmids of Neisseria gonorrhoeae reveals two replication regions; Yeung KH et al.; Two replication regions have been identified on a 7.2-kb penicillinase-producing plasmid (pJD4) of Neisseria gonorrhoeae . Through construction of mini-plasmids, one replication region of pJD4 was located on a 1.5-kb fragment, designated region "a," that included the unique HindIII site of this plasmid . This region is absent from the 5.1-kb naturally occurring gonococcal penicillinase-producing plasmid (pJD5) which is considered to be a deletion-derivative of the 7.2-kb plasmid . A 1.5-kb fragment (region "b"), part of a 2.5-kb fragment essential for the replication of the 5.1-kb plasmid (pJD5), was found to be responsible for incompatibility . Incompatibility studies showed that in vitro-derived deletion-derivatives from pJD4 and pJD5 containing either region "a" or region "b" were compatible . The DNA sequence of part of region "a" showed that this region was A-T rich . It contained seven sets of A-T rich multiple direct repeats and two putative dnaA boxes, suggesting that the mechanism of replication of region "a" was similar to that of OriC in Escherichia coli.

Mol Microbiol, 1988 Nov, 2(6), 827 - 9
Specificity of the lactoferrin and transferrin receptors in Neisseria gonorrhoeae; Lee BC et al.; Lactoferrin (LF) and transferrin (TF) are postulated to be important physiological sources of iron for Neisseria gonorrhoeae . A dot binding assay involving the use of gonococcal total membranes derived from cells grown in iron-limited conditions demonstrated the presence of separate receptors for LF and TF . The ligand and functional specificities of these receptors were examined in competition-binding and growth experiments . The results indicate that the LF and TF receptors are highly specific for the human protein, suggesting that this property may be partially responsible for conferring the human host specificity of N . gonorrhoeae.

Hum Reprod, 1988 Oct, 3(7), 861 - 9
Effects of antimicrobial therapy on sperm-mucus interaction; Eggert-Kruse W et al.; Sperm-mucus interaction under in-vitro or in-vivo conditions might be affected by microorganisms colonizing the reproductive tract . In order to study the influence of antimicrobial therapy, an extensive microbial screening was performed including Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Neisseria gonorrhoeae, a broad spectrum of potentially pathogenic aerobic and anaerobic bacteria, Trichomonas vaginalis, herpes simplex virus and yeasts . One-hundred-and-six couples with a mean duration of infertility of 5.5 years (range 1-12 years) and with isolation of potentially pathogenic microorganisms in semen samples and/or cervical swabs were submitted to a prospective pilot study . None of the patients displayed signs or symptoms of infection in the lower genital tract . Before and after specific therapy, based on antimicrobial susceptibility testing, sperm analyses and in-vitro sperm penetration meter tests (SPMT) (Kremer) were performed . SPMT was evaluated with cervical mucus of patients' wives, collected after a standardized oral treatment with oestrogens and, additionally, in a crossed manner with cervical mucus and spermatozoa of fertile donors . The success of antimicrobial therapy was controlled by repeating the same microbial screening and was 96% . However, there was a marked change in the microbial pattern . A comparison of the results of sperm analyses before and after treatment revealed neither significant differences for sperm volume, sperm count, propulsive motility, morphology, vitality, pH, fructose concentration or number of round cells, nor was there a significant influence on the cervical index and the number of leukocytes in cervical mucus.(ABSTRACT TRUNCATED AT 250 WORDS)

Microb Pathog, 1988 Oct, 5(4), 303 - 9
Cytidine 5'-monophospho-N-acetyl neuraminic acid and a low molecular weight factor from human blood cells induce lipopolysaccharide alteration in gonococci when conferring resistance to killing by human serum; Parsons NJ et al.; Recently evidence has been obtained that a minute amount of cytidine 5'-monophospho-N-acetyl neuraminic acid (CMP-NANA) or a closely related compound is the low Mr factor in human red blood cells which induces Neisseria gonorrhoeae (BS4(agar} to resistance to killing by fresh human serum . Induction of gonococci to resistance by both CMP-NANA and semi-purified low Mr factor from red blood cells was accompanied by a 35-55% reduction of silver staining of lipopolysaccharide separated in SDS-PAGE gels of proteinase K digests . These alterations in lipopolysaccharide are probably responsible for conferring serum resistance . However, lipopolysaccharide-containing digests from resistant as well as from susceptible gonococci neutralised serum bactericidal activity . These observations may have wider implications since CMP-NANA is a sialylating agent wide-spread in mammalian tissues and LPS is ubiquitous amongst Gram-negative pathogens.

Sex Transm Dis, 1988 Oct-Dec, 15(4), 234 - 43
Therapy of uncomplicated gonorrhea due to antibiotic-resistant Neisseria gonorrhoeae; Kraus SJ et al.; Antibiotics available to treat uncomplicated anogenital infections due to beta-lactamase-producing Neisseria gonorrhoeae include spectinomycin, ceftriaxone, and clavulanic acid added to aqueous procaine penicillin G or amoxicillin . Important variables in deciding which antibiotic regimen to use include effectiveness against urethral, cervical, pharyngeal, and rectal infections; cost; eradication of coexisting incubating syphilis; adverse effects; efficacy against strains of N . gonorrhoeae with chromosomally mediated resistance to antimicrobial agents; ease of administration; patient acceptance; and the potential for inducing resistance to antimicrobial agents in pathogens other than those causing sexually transmitted diseases . This review outlines the advantages and disadvantages of the various regimens.

Sex Transm Dis, 1988 Oct-Dec, 15(4), 225 - 33
Laboratory methods for the detection and phenotypic characterization of Neisseria gonorrhoeae strains resistant to antimicrobial agents; Knapp JS; Strains of Neisseria gonorrhoeae that are resistant to antimicrobial agents have emerged after the use of these agents . Antimicrobial resistance can be either chromosomal or plasmid-mediated . Arbitrary methods, both agar-dilution and disk-diffusion procedures, have been developed to measure the in-vitro antimicrobial resistance of gonococcal isolates . These methods must be performed by use of standard procedures and the quality of the process must be controlled by use of reference strains with known susceptibilities . Results of antimicrobial susceptibility tests must be interpreted with caution . Phenotypic characterization of gonococcal isolates using auxotyping, serotyping, and plasmid content has permitted us to compare susceptible and resistant strains in an effort to understand the diversity of antimicrobial resistance in N . gonorrhoeae and the dynamics of epidemics of gonorrhoea associated with resistant strains.

Sex Transm Dis, 1988 Oct-Dec, 15(4), 217 - 24
Antibiotic resistance in Neisseria gonorrhoeae: genetics and mechanisms of resistance; Johnson SR et al.; In recent years the emergence and spread of antibiotic resistance in Neisseria gonorrhoeae has increased markedly . Chromosomal resistance to penicillin and tetracycline is due to the effects of one or more mutations and is generally low-level . However, the effects of these mutations are additive . Thus, the level of resistance in strains with several mutations is often high enough to yield significant rates of treatment failure . Resistance to aminoglycosides (e.g., streptomycin and kanamycin) and spectinomycin, an aminocyclitol antibiotic is not due to the inactivation of the antibiotic but to an alteration in the sensitivity of the 30S ribosomal subunit to the drug . At least five beta-lactamase plasmids of N . gonorrhoeae have been described . Some of these plasmids can be mobilized by the 24.5-MDa gonococcal conjugative plasmid and transferred to other gonococcal strains . Gonococci have recently acquired high-level resistance to tetracycline due to the streptococcal tetM determinant . This determinant is located on a 25.2-MDa plasmid that possesses a considerable degree of homology with the 24.5-MDa conjugative plasmid . The 25.2-MDa plasmid has retained the ability to transfer beta-lactamase plasmids as well as to mobilize and transfer itself to suitable recipient strains.

Sex Transm Dis, 1988 Oct-Dec, 15(4), 211 - 6
Epidemiologic aspects of control of penicillinase-producing Neisseria gonorrhoeae; Rothenberg R et al.; Although first identified in 1976, penicillinase-producing Neisseria gonorrhoeae (PPNG) began to have significant epidemiologic impact in the United States only after 1980 . The epidemic curve has been marked by a series of successive sigmoidal increases, the result of staggered epidemic activity in Los Angeles, California, New York, New York, and Miami . The most recent increase and current plateau has led to a provisional total of 16,608 cases for 1986, with the proportion of PPNG isolates as high as 30% in some communities . The intensity of PPNG transmission appears to parallel that of gonorrhea in general, with high attack rates in central city areas (i.e., among core groups) and with a dimmishing gradient outward from the center . The endemicity of PPNG is related in a general way to the size of the inoculum . A county experiencing seven cases in a month at the time of introduction, for example, has less than a 50% probability of reverting to zero cases during the next 12 months . It would appear that the inoculation of PPNG organisms into a community leads to a "take" when high-level transmitters of gonorrhea are affected . Though current projections suggest as many as 35,000-40,000 cases of PPNG infections by 1991, control programs that focus resources on core-group transmitters of gonorrhea may alter that course.

Sex Transm Dis, 1988 Oct-Dec, 15(4), 202 - 10
Trends in resistance of Neisseria gonorrhoeae to antimicrobial agents in the United States; Whittington WL et al.; Resistance of Neisseria gonorrhoeae to antimicrobial agents is increasing in the United States . The number of cases of gonorrhea caused by beta-lactamase-producing strains of N . gonorrhoeae (PPNG) increased for the second consecutive year, and 16,608 were reported in 1986; these accounted for greater than 1.6% of all cases of gonorrhea . PPNG is endemic in Florida, New York City, and Los Angeles, and these areas may serve as foci for spread of PPNG strains in the United States . In 1985 N . gonorrhoeae strains that exhibited high-level resistance to tetracycline (TRNG; MIC, greater than or equal to 16.0 micrograms/ml) were reported . Tetracycline resistance was due to the tetM determinant in a 25.2-MDa tetM-conjugative plasmid . The prevalence of TRNG infections was greater than 4% in at least two communities . Strains with chromosomally-mediated resistance to several antimicrobial agents have been isolated more often; 399 cases were reported during the first half of 1986 . Spectinomycin-resistant strains have been isolated in several cities, and strains with decreased susceptibility to ceftriaxone have been isolated . Phenotypic characterizations of strains of N . gonorrhoeae by auxotype and serovar, plasmid content, and antibiograms have permitted more detailed study of the heterogeneity and dynamics of strain populations . Characterization of outbreaks caused by resistant strains and surveillance of regional and temporal changes in antimicrobial resistance in gonococcal strain populations may be used in design of innovative strategies for gonorrhea control and for making anticipatory changes in recommended therapies for gonorrhea.

Sex Transm Dis, 1988 Oct-Dec, 15(4), 186 - 91
A prospective randomized trial of ofloxacin vs . doxycycline in the treatment of uncomplicated male urethritis; Boslego JW et al.; One hundred fourteen men with uncomplicated urethritis were randomized to receive 1 week of therapy with either doxycycline (100 mg twice daily) or ofloxacin (300 mg twice daily) . Of the 109 men completing the post-treatment visit, 56 received ofloxacin and 52 (93%) were clinically cured . Forty four (83%) of the 53 men treated with doxycycline were cured . All 30 patients with gonorrhea (including three with penicillinase-producing Neisseria gonorrhoeae {PPNG} isolates) who were treated with ofloxacin became culture-negative, as compared with 32 of 34 patients receiving doxycycline . In contrast, three of 18 patients with Chlamydia trachomatis were microbiologic failures after ofloxacin therapy, while all ten treated with doxycycline were cured . Adverse effects of both treatment regimens were generally mild, and compliance was excellent except for one patient receiving doxycycline . These results show that ofloxacin, in a dosage of 300 mg taken orally twice daily for seven days, is an effective treatment for uncomplicated urethritis in men but may not reliably cure chlamydial infections.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Oct, (10), 52 - 5
{The composition of immune sera against Neisseria meningitidis studied by high-performance liquid chromatography}; Filatova TN et al.; The comparative study of the composition of immune rabbit sera to N . meningitidis, as well as nonimmune sera, has been made by the methods of HPLC and radial immunodiffusion . The quantitative evaluation of the main serum proteins by the two methods has shown the coincidence of the results yielded by these methods . To study the total level of IgM and IgG in the sera under study, a simple and rapid HPLC technique is proposed . The study of the stability of sera during storage (at 4-6 degrees C) has revealed that immune sera show greater stability during storage under such conditions in comparison with sera obtained from nonimmune animals.

J Antimicrob Chemother, 1988 Oct, 22 Suppl D, 223 - 5
Fleroxacin versus standard therapy in gonococcal urethritis; Lassus A et al.; Eighty male patients with gonococcal urethritis were randomly allocated to receive, in an open study, either a single oral 400 mg dose of fleroxacin, or, as standard therapy, a single intramuscular dose of 2.4 million units of penicillin G plus 1.0 g of probenecid orally . Microbiological analysis of the urethral smear and complete physical examination with blood and midstream urine samples was carried out before and after therapy (day 7 or 8) . Urethral Neisseria gonorrhoeae was the only pathogen in 50 patients while 29 presented with mixed infections of both N . gonorrhoeae and Chlamydia trachomatis . In one case, the culture was not positive for either of the pathogens . N . gonorrhoeae was eradicated by both regimens in all 78 evaluable patients . However, the 29 patients with mixed infections remained clinically symptomatic and still showed C . trachomatis irrespective of the treatment regimen . Two patients failed to return for follow-up . No adverse reactions were reported.

J Antimicrob Chemother, 1988 Oct, 22(4), 463 - 71
The effect of media on antimicrobial susceptibility testing of Neisseria gonorrhoeae; Woodford N et al.; We have investigated the effect of four different media on the results of susceptibility tests for clinical and reference strains of Neisseria gonorrhoeae . Diagnostic Sensitivity Test (DST) agar supplemented with 5% lysed horse blood and 1% IsoVitaleX was regarded as the 'standard' and three other media were compared with it--DST plus 5% lysed blood, GC agar supplemented with 1% IsoVitaleX and Proteose agar plus 1% haemoglobin and 1% IsoVitaleX . We found no significant differences between the two DST media when testing penicillin, cefuroxime, tetracycline or erythromycin . Proteose agar compared well with the 'standard' for all antibiotics except erythromycin for which MICs were significantly increased . GC agar showed the poorest agreement with the 'standard' medium . Gonococci appeared more sensitive to tetracycline and less sensitive to erythromycin on this medium . The use of GC agar did not significantly affect susceptibilities to the beta-lactam agents tested, although MICs measured on GC agar did tend to be higher than on the 'standard' DST medium.

Genitourin Med, 1988 Oct, 64(5), 303 - 7
Characterisation by plasmid profiles, serogroups, and auxotypes of Neisseria gonorrhoeae from Harare, Zimbabwe; Mason PR et al.; (ABSTRACTOne hundred and fifty five strains of Neisseria gonorrhoeae were regrown from 216 freeze dried cultures originally isolated in Zimbabwe . The gonococci were from men (61 strains) and women (39 strains) attending a referral sexually transmitted diseases (STD) clinic, from women presenting for delivery at hospital with signs of sepsis (22 strains) or with an asymptomatic infection (16 strains), and from babies with ophthalmia neonatorum (17 strains) . Seventy five of the 100 isolates from STD clinic patients and 29 of the 55 isolates from hospital patients were penicillinase producing N gonorrhoeae (PPNG) . Two thirds of all PPNG strains contained the 24.5 megadalton conjugative plasmid . The 3.2 megadalton resistance plasmid, usually associated with PPNG strains originating in Africa, was present in only one third of the PPNG strains . The 2.6 megadalton cryptic plasmid was present in all strains . Prototrophic and proline requiring auxotypes predominated in both PPNG and non-PPNG strains . Arginine requiring auxotypes were found in four of the 16 isolates from asymptomatic women, whereas three of the 22 strains from women with puerperal sepsis and four of the 61 strains from men with urethritis required both proline and arginine . Fifty eight out of 66 PPNG strains with the 4.4 megadalton plasmid required proline compared with 22/38 PPNG strains with the 3.2 megadalton plasmid and 20 of the 51 non-PPNG strains . Three quarters (38/51) of non-PPNG strains belonged to serogroup WII/III as did 42/66 PPNG strains with the 4.4 megadalton plasmid but only 10/38 PPNG strains with the 3.2 megadalton plasmid . In all, 23 different strain types could be recognized on the basis of plasmid content, auxotype, and serogroup . There was, however, a high degree of homogeneity between PPNG and non-PPNG isolates.

Eur J Clin Microbiol Infect Dis, 1988 Oct, 7(5), 635 - 8
Chlamydia trachomatis genital infections in Tahiti; Chungue E et al.; The rate of Chlamydia trachomatis infection was determined in three populations in Tahiti by means of a direct immunofluorescence test performed in specimens, tissue culture and detection of chlamydial antibody in serum specimens using a single-serotype indirect immunofluorescence test . Chlamydia trachomatis was recovered in 53% of 53 bar girls, 24% of 75 women attending a public maternity clinic for routine care, and 37% of 71 men attending a sexually transmitted disease clinic with acute or subacute urethritis . The presence of chlamydial antibody in a high proportion of the groups studied confirmed the high frequency of chlamydial infections (62.3%, 66.6% and 83.1% respectively) . Neisseria gonorrhoeae infection was often associated with chlamydial infection in both bar girls and men with urethritis (11.4% and 18.3% respectively) . With regard to clinical manifestations, 58.3% (7/12) of bar girls and 23.2% (10/43) women at the maternity clinic without clinical complaints were found to be Chlamydia trachomatis-positive . The presence of Chlamydia trachomatis in these asymptomatic persons highlights their important role in spread of this organism in Tahiti . The findings indicate that routine testing for Chlamydia trachomatis is warranted in patients attending the sexually transmitted disease and public maternity clinics in Tahiti.

APMIS, 1988 Oct, 96(10), 941 - 9
A reference procedure to study chemiluminescence induced in polymorphonuclear leukocytes by Neisseria meningitidis; Fredlund H et al.; Luminol-enhanced chemiluminescence (CL) was used to study the ability of various strains of Neisseria meningitidis (MC) to induce oxidative metabolism of polymorphonuclear leukocytes (PMNL); an indirect measure of phagocytic activity . To circumvent variations related to different PMNL donors, a MC serogroup X strain was used as a control for indexing the CL responses induced by other MC strains . This procedure, with pooled serum from healthy blood donors to standardize opsonising conditions, gave reproducible and comparable results, irrespective of PMNL donors . Under these conditions, there was a highly significant difference between pathogenic and non-pathogenic MC strains as regards their ability to induce CL responses (p less than 0.001) . The results indicated that the differences were due partly to opsonizing antibodies, partly to other differences related to pathogenicity of tested MC strains . These differences in leukocyte/MC interaction were also confirmed by phagocytic-killing experiments . The index procedure of CL measurements may be a suitable method to study the appearance of natural immunity to MC disease, as well as the pathogenicity of particular MC strains.

Clin Microbiol Rev, 1988 Oct, 1(4), 415 - 31
Historical perspectives and identification of Neisseria and related species; Knapp JS; The pathogenic Neisseria spp., N . gonorrhoeae and N . meningitidis, have been studied extensively and rapid identification procedures have been designed to distinguish these species from the commensal Neisseria and related species that are normal flora of the oro- and nasopharynx . The commensal Neisseria spp . have been largely ignored except for isolated studies . It is important that we know about these species, however, because not only may some be misidentified as pathogenic species if identified with inappropriate procedures, but also they may occasionally be isolated from unusual sites and must be correctly identified to the species level for clinical purposes.

Sex Transm Dis, 1988 Oct-Dec, 15(4), 196 - 9
Antimicrobial susceptibility of Neisseria gonorrhoeae isolates from a military population in San Diego; Papadimos TJ et al.; Neisseria gonorrhoeae isolates were studied to determine their patterns of antimicrobial susceptibility and possible chemotherapeutic implications . Of 370 consecutive isolates, 32 (8.7%) were penicillinase-producing N . gonorrhoeae (PPNG) . The remaining 338 were subjected to disk-diffusion tests, and those apparently resistant to penicillin, tetracycline, or spectinomycin were tested by an agar-dilution method . The dilution test showed that 5.4% (20/370) were penicillin-resistant, non-PPNG strains, of which 100%, 90%, and 45% were also resistant to tetracycline, cefoxitin, and erythromycin, respectively . No resistance to spectinomycin or ceftriaxone was demonstrated, although there was an association between minimum inhibitor concentrations (MICs) of penicillin of greater than or equal to 1.0 microgram/ml and increased MICs of ceftriaxone . The overall incidence of penicillin resistant isolates, including PPNG, was 14.1% (52/370) . Of the 20 penicillin-resistant, non-PPNG strains, all were also resistant to tetracycline, and another 21 exhibited tetracycline resistance but were sensitive to penicillin . The in-vitro data suggested that: (1) neither penicillin, tetracycline, nor cefoxitin were acceptable drugs for routine treatment of gonorrhea in our population during the study period; (2) spectinomycin and ceftriaxone continue to demonstrate adequate in-vitro activity against N . gonorrhoeae despite increasing in-vitro resistance to penicillin; and (3) non-plasmid-mediated resistance to penicillin may predict future resistance to ceftriaxone.

Carbohydr Res, 1988 Oct 1, 181, 163 - 74
Neisseria perflava amylosucrase: characterization of its product polysaccharide and a study of its inhibition by sucrose derivatives; Tao BY et al.; Neisseria perflava amylosucrase forms from sucrose a polysaccharide very similar to glycogen, except that a larger proportion of its D-glucosyl residues are in short branches . Iodine staining of samples taken during polysaccharide formation indicate that the initial product is less branched than that formed at longer times . This glycogen-like polysaccharide has an estimated molecular mass range of 1 MD to 20 MD . Sucrose derivatives modified at C-3 (3-deoxysucrose and alpha-D-allopyranosyl beta-D-fructofuranoside), C-6 (6-deoxysucrose and 6-deoxy-6-fluorosucrose), and both C-4 and C-6 (4,6-dideoxysucrose) were tested as inhibitors of amylosucrase . Derivatives modified at C-6 were potent competitive inhibitors, with Ki values of 6.2 +/- 0.3 mM (6-deoxysucrose) and 0.50 +/- 0.06 mM (6-deoxy-6-fluorosucrose) . The KM value of sucrose is 26.5 +/- 4.6 mM . Sucrose derivatives modified at C-3 were not significantly inhibitory over the concentration range tested . 4,6-Dideoxysucrose gave an unusual, non-competitive inhibition, in that, increasing its concentration did not produce a commensurate increase in the level of inhibition, which instead appeared to approach a limit . None of these sucrose derivatives was a substrate for amylosucrase, nor were they glycosyl donors to maltotriose.

Int J Gynaecol Obstet, 1988 Oct, 27(2), 177 - 80
Sexually transmitted diseases in women with urethral syndrome; Vitoratos N et al.; Frequency of micturition and dysuria were prominent symptoms in 135 (57%) of 237 women with urethral syndrome . Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis were the principal organisms associated with the urethral syndrome (38.41%, 28.14% and 11.11%, respectively) . Escherichia coli was cultured from four patients and Herepes genitalis and Neisseria gonorrhoea were isolated from five patients . Infections with more than one organism were frequent . Thirty-one of 135 patients were infected by two organisms, 27 by three and 4 patients by four microorganisms . Vaginitis due to Garnerella vaginalis, Candida spp . and Trichomonas vaginalis was discovered in 52 (39%) of 135 patients.

J Gen Microbiol, 1988 Oct, 134 ( Pt 10), 2703 - 11
Nonbactericidal antibodies against Neisseria gonorrhoeae: evaluation of their blocking effect on bactericidal antibodies directed against outer membrane antigens; Virji M et al.; Nonbactericidal monoclonal antibodies (MAbs) directed against gonococcal surface antigens were examined for their effect on complement-mediated bactericidal killing by other MAbs and normal human serum . One MAb, SM73, directed against the H.8 antigen activated complement only moderately well and had little influence on bactericidal antibodies . Two antibodies directed against an epitope on protein III had very different effects . Antibody SM51 activated complement poorly and had no effect on bactericidal killing, whereas antibody SM50, although itself nonbactericidal, activated complement and blocked the bactericidal effect of other antibodies . The extent of the blocking ability of MAb SM50 was studied using MAbs of different specificities as well as polyclonal antisera raised against gonococcal surface antigens . Antibody SM50 blocked IgG MAbs of all specificities, but several MAbs of the IgM class retained their bactericidal effect . Each of these IgM MAbs reacted with lipopolysaccharide, but with different epitopes.

Infect Immun, 1988 Oct, 56(10), 2631 - 8
Electromorphic characterization and description of conserved epitopes of the lipooligosaccharides of group A Neisseria meningitidis; Kim JJ et al.; We studied the lipooligosaccharides (LOS) of 28 group A Neisseria meningitidis of epidemiologically diverse origins to investigate whether each of the LOS serotypes found in serogroup A could be identified physically as well as antigenically . Using a dot blot assay with LOS-specific monoclonal antibodies (MAbs), we identified four epitopes that were serotype specific . The LOS from strains of each serotype were electromorphically and antigenically distinct when analyzed by silver-stained sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting . The LOS of L8 strains contained a 3,600-Mr component that bound the L8 MAb . The LOS of L9 strains contained two major components of 4,500 and 4,200 Mr . They bound the L9 MAb to the larger component . The LOS of L10 strains had a single major component of 4,000 Mr that bound the L10 MAb . The LOS of L11 strains contained a major 3,600-Mr component that could not be distinguished from the 3,600-Mr LOS of L8 strains by SDS-PAGE but that bound the L11 MAb . LOS of group A strains contained a highly conserved epitope in addition to a serotype-specific epitope . This was identified by a MAb that bound to all the strains on dot-blots and to multiple LOS components of various Mrs on immunoblots . We conclude that the LOS which bear the L9, L10, and L11 determinants are physically distinct and can be identified by SDS-PAGE or MAb binding or both . L8 and L11 are both borne on a 3.6-kilodalton LOS and can only be distinguished serologically.

J Biol Chem, 1988 Sep 5, 263(25), 12194 - 8
A family of small repeated elements with some transposon-like properties in the genome of Neisseria gonorrhoeae; Correia FF et al.; A physical technique known as two-dimensional S1 nuclease heteroduplex mapping has been applied to genomic DNA from the Gram-negative coccus Neisseria gonorrhoeae . This has resulted in the detection of two novel types of repetitive sequences . The first type is a repetitive sequence family of 152 base pairs (bp), whose ends are composed of inverted repeats of 26 bp . There are approximately 20 copies of this sequence, in both N . gonorrhoeae and Neisseria meningitidis (Correia, F., Inouye, S., and Inouye, M . (1986) J . Bacteriol . 167, 1009-1011) . The second type of sequence is a 1443-bp duplication in the N . gonorrhoeae genome . The two classes of sequence are linked positionally . Each copy of the long duplicated sequence is adjacent to a member of the 152-bp repetitive sequence . In one instance two copies of the 152-bp repetitive sequence are separated by a 436-bp central region and are in an inverted orientation with respect to one another, resembling a compound transposable element.

J Antimicrob Chemother, 1988 Sep, 22 Suppl C, 149 - 53
The efficacy of ofloxacin against infection caused by Neisseria gonorrhoeae and Chlamydia trachomatis; Richmond SJ et al.; Ofloxacin was used to treat patients with gonorrhoea and/or Chlamydia trachomatis infection . Gonorrhoea was treated with a single 400 mg dose and chlamydial infection with a seven day course (200 mg bd) . Fifty of 84 patients with gonorrhoea (60 men and 24 women) returned for two follow-up examinations 7 and 14 days after treatment, 17 patients returned for only one follow-up examination and 17 defaulted . Neisseria gonorrhoeae was re-isolated from three patients who had probably become re-infected . Treatment was successful in 64 patients, 58 of whom were assessed after a single 400 mg dose of ofloxacin . Chlamydial infection was identified in 30 patients with gonorrhoea (13 men and 17 women) and in 35 other patients (17 men and 18 women) . C . trachomatis was not recovered from any of the 49 patients who returned for two follow-up examinations, or from the ten patients who attended for one follow-up visit only . Sixteen patients did not return for follow-up examination . Our results suggest a seven day course of ofloxacin would eradicate N . gonorrhoeae and C . trachomatis in patients infected with both organisms . Such treatment may be advisable in patients with gonorrhoea if microbiological tests for C . trachomatis are not available.

Antimicrob Agents Chemother, 1988 Sep, 32(9), 1430 - 2
Transfer of beta-lactamase plasmids from Neisseria gonorrhoeae to Neisseria meningitidis and commensal Neisseria species by the 25.2-megadalton conjugative plasmid; Roberts MC et al.; Two highly tetracycline-resistant, beta-lactamase-producing Neisseria gonorrhoeae strains were used as donors for conjugation with Neisseria meningitidis and commensal Neisseria species . We found that both strains were able to transfer the 4.4- and 3.2-megadalton beta-lactamase plasmids to the recipients tested, with frequencies between 10(-1) and 10(-9).

Anal Biochem, 1988 Sep, 173(2), 307 - 16
Purification of outer membrane proteins of the gram-negative bacterium Neisseria gonorrhoeae; Judd RC; A system of protein purification, using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and electroblotting, that results in purified outer membrane proteins of the gram-negative bacterium Neisseria gonorrhoeae is described . The proteins, which ranged in apparent molecular mass from approximately 31,000 to approximately 92,000 Da, were located by naphthol blue black staining, eluted from nitrocellulose membranes using 88% formic acid, and precipitated by the addition of concentrated ammonium hydroxide . Up to 65% of the original protein present was recovered by this procedure . The resultant purified protein could then be resuspended in aqueous buffer by brief sonication, making it available for further structural and in vivo immunological analyses . Proteins purified in this manner retain their original antigenicity when probed with polyclonal and monoclonal antibodies, and are structurally unaltered by the purification process . This procedure makes it possible to acquire easily usable quantities of highly insoluble outer membrane proteins of gram-negative bacteria.

J Clin Microbiol, 1988 Sep, 26(9), 1898 - 900
Serum antibody response to the 70,000-molecular-weight neisserial common antigen in humans infected by Neisseria gonorrhoeae; Aoun L et al.; We evaluated the presence of antibodies directed against a 70,000-molecular-weight (70K) common neisserial antigen in sera from patients with first or repeated gonococcal infections and in sera from healthy controls . Sera were taken as soon as possible after the onset of disease, and anti-70K antibodies were detected by Western blot (immunoblot) . Results show that significantly fewer patients with gonococcal infection possessed anti-70K antibodies than controls (P less than 0.001) . This suggests a possible role of anti-70K antibodies in natural immunity against Neisseria gonorrhoeae.

J Antimicrob Chemother, 1988 Sep, 22 Suppl C, 21 - 5
In-vitro activity of ofloxacin against isolates of Neisseria gonorrhoeae; McEwen A et al.; A total of 1186 clinical isolates of Neisseria gonorrhoeae were tested for in-vitro disc susceptibility to ofloxacin, one of the new generation of fluorinated quinolones . All isolates appeared susceptible . Minimum inhibitory concentrations were determined for a random sample of 122 strains and all were equal to or less than 0.02 mg/l.

Proc Natl Acad Sci U S A, 1988 Sep, 85(18), 6982 - 6
Identification and arrangement of the DNA sequence recognized in specific transformation of Neisseria gonorrhoeae; Goodman SD et al.; DNA segments from Neisseria gonorrhoeae, cloned and propagated in Escherichia coli, were tested for the ability to competitively inhibit gonococcal transformation . The nucleotide sequences of active segments were determined and compared; these sequences contained the sequence 5' GCCGTCTGAA 3' in common . Subcloning studies confirmed the identity of this sequence as the gonococcal DNA recognition site . The three instances of the recognition sequence isolated from N . gonorrhoeae chromosomal DNA contain the sequence in the immediate neighborhood of its inverted repeat . Because a single copy of the sequence functions as a recognition site, the inverted duplication is not required for specific binding . The dyad symmetric arrangements of the chromosomal recognition sequences may form stable stem-loop structures that can function as terminators or attenuators of transcription . These inverted repeats are located at the boundaries of long open reading frames . The recognition sequence also constitutes part of two other probable terminators of gonococcal genes . We conclude that the signal for recognition of transforming DNA by gonococci is a frequent component of transcriptional terminator sequences . This regulatory function might account for the origin and maintenance of recognition sequences in the chromosomes of Gram-negative transformable bacteria.

Infect Immun, 1988 Sep, 56(9), 2512 - 4
Induced engulfment of Neisseria gonorrhoeae by tissue culture cells; Richardson WP et al.; Engulfment of gonococci by mammalian tissue culture cells was examined as a model of the penetration of host cells in gonorrhea . Engulfment required viable organisms; killing the gonococci with heat or refrigeration abolished the process . Engulfment also required tissue culture cell microtubule- and microfilament-dependent movement; treating the cells with cytochalasin B (0.5 micrograms/ml) or demecolcine (Colcemid; Ciba-Geigy AG, Basel, Switzerland) (10 micrograms/ml) also prevented his process.

Clin Orthop, 1988 Sep, (234), 209 - 10
Neisseria gonorrhoeae foot abscess . A case report; Speer KP et al.; A cutaneous abscess involving Neisseria gonorrhoeae is extremely rare outside the perineum . Such remote lesions are a result of disseminated gonococcal disease . A 12-year-old girl with arthrogryposis multiplex congenita developed a gonococcal abscess on the plantar aspect of her lateral forefoot after a two-week prodrome of pain, erythema, and swelling . The infection was successfully treated with open drainage, acetic acid dressing changes, and the administration of penicillin.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Sep, (9), 33 - 40
{Species-forming involution of pathogenic bacteria as a biological pattern (exemplified by bacteria of the genus Moraxella)}; Kalina GP; The author advances a hypothesis stating that a species disappearing as a result of new conditions evolving in a colonized animal or human body, unfavorable for the existence of this species, does not become extinct, but reverts into newly developing species due to the loss of its properties and acquiring new properties corresponding to new conditions . Thus the genus is preserved through the loss of species characteristics by individual organisms . The advanced hypothesis is substantiated by the analysis of the relevant processes observed in cases of infectious keratoconjunctivitis in humans and cattle, caused by bacteria of the genus Moraxella . The data indicating the possibility of such reversion in the genera Neisseria and Bordetella are presented.

J Antibiot (Tokyo), 1988 Sep, 41(9), 1243 - 52
A40926 aglycone and pseudoaglycones: preparation and biological activity; Selva E et al.; A40926 antibiotics are new glycopeptides which are much more active than other members of this class against Neisseria gonorrhoeae . Their activity against Gram-positive bacteria, including coagulase-negative Staphylococci, is similar to that of other glycopeptides . An A40926 preparation containing factors A and B ("A40926 A + B complex") was hydrolyzed to the aglycone and to the mannosyl and N-acylaminoglucuronyl aglycones . The mannosyl aglycone and the aglycone were less active than A40926 A + B complex against Streptococci and Gram-positive anaerobes and lost the anti-gonorrheal activity . In contrast, the N-acylaminoglucuronyl aglycones were as active as the parent complex against these Gram-positive bacteria and were moderately active against N . gonorrhoeae . The aglycone and, even more so, the N-acylaminoglucuronyl aglycones, had better activity than the parent complex against coagulase-negative Staphylococci . In experimental septicemia in the mouse, A40926 A + B complex and its derivatives had activity proportional to their MIC for the test organism.

J Clin Pathol, 1988 Sep, 41(9), 978 - 82
Susceptibility testing of Neisseria gonorrhoeae to penicillin and spectinomycin in a diagnostic laboratory; Gill MJ et al.; Agar dilution breakpoint susceptibility testing using GC, DST, and proteose agars, was performed on consecutive clinical isolates of non-penicillinase producing Neisseria gonorrhoeae to examine the feasibility of using such a system in a diagnostic laboratory . The incidence and level of resistance to penicillin and spectinomycin was also assessed . On DST medium 93 of 200 (46.5%) of isolates were of intermediate resistance to penicillin (MIC 0.12-0.5 mg/l) and 21 of 200 (10.5%) were resistant to penicillin (MIC greater than or equal to 1.0 mg/l) . Ninety two of 200 (46%) of isolates had an MIC to spectinomycin of 32 mg/l on DST agar . Isolates seemed to be more resistant when tested on the two other media . The methods used in this study could be applied in a routine diagnostic laboratory for immediate clinical benefit and long term epidemiological studies . To enable direct comparisons to be made between populations at different centres, however, methods for gonococcal susceptibility testing need to be standardised.

J Infect Dis, 1988 Sep, 158(3), 518 - 23
A clinical trial of nonoxynol-9 for preventing gonococcal and chlamydial infections; Louv WC et al.; A randomized, double-blind, placebo-controlled trial was conducted to evaluate the spermicidal agent nonoxynol-9 as prophylaxis for cervical infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae . Eight hundred eighteen women were recruited from a sexually transmitted disease clinic . Only subjects who were using reliable birth control methods (oral contraceptives, intrauterine device, or sterilization) were eligible . Subjects were randomly assigned to use either a commercially available spermicidal agent containing nonoxynol-9 or a placebo preparation . Subjects were followed up for six months; specimens were collected monthly for culture of the two pathogens . Women assigned to the nonoxynol-9 group were less likely to become infected with N . gonorrhoeae (relative rate, 0.75; 90% confidence limits, 0.58 and 0.96) and C . trachomatis (relative rate, 0.79; 90% confidence limits, 0.64 and 0.97) . Among women who used their assigned gel for the majority of coital episodes, a stronger protective effect was observed.

Ann Inst Pasteur Microbiol, 1988 Sep-Oct, 139(5), 515 - 25
The envelope structure of Branhamella catarrhalis as studied by transmission electron microscopy; Hellio R et al.; The envelope structure of Branhamella catarrhalis was studied by electron microscopy and compared with that of other bacteria of the family Neisseriaceae, such as Moraxella lacunata subsp . liquefaciens and Neisseria gonorrhoeae . Negative staining of B . catarrhalis showed a mamilliform surface similar to that of Moraxella . On thin sections, the cell wall appeared to be made up of a wavy outer membrane tightly linked to a straight peptidoglycan layer . Spicule-like structures protruded from the cell surface . Ruthenium red staining revealed that they contained polysaccharides . While the outer polysaccharide layer of N . gonorrhoeae was unstable after repeated subcultures in vitro, this layer remained stable in B . catarrhalis and in Moraxella lacunata subsp . liquefaciens.

Proc Natl Acad Sci U S A, 1988 Sep, 85(18), 6841 - 5
Genetics of protein I of Neisseria gonorrhoeae: construction of hybrid porins; Carbonetti NH et al.; Protein I (PI), the major outer membrane protein of Neisseria gonorrhoeae, is a porin and occurs in two major immunochemical classes, A and B . By using shuttle mutagenesis to insert a selectable marker close to the PI structural gene, evidence was obtained from transformation experiments to demonstrate that the PI structural gene is equivalent to the defined locus nmp and that the genes for PI class A and PI class B are alleles of the same locus . The PI class B gene of strain MS11 was cloned and sequenced, and comparison of this sequence with the gene sequence of PI class A of FA19 revealed a number of regions of significant divergence . By selection for the closely linked marker in transformations between the two strains, a series of strains with a hybrid PI was obtained . Analysis of these strains with monoclonal antibodies and oligonucleotides specific to PI class A or PI class B elucidated the nature and location of some of the surface-exposed epitopes, a thorough characterization of which is a prerequisite for understanding the role of PI in gonococcal pathogenesis and its possible use as a component of a vaccine.

J Infect Dis, 1988 Sep, 158(3), 529 - 36
Neisseria gonorrhoeae recombinant strains expressing hybrid serological reactivities of outer membrane proteins IA and IB; Shinners EN et al.; The inheritance of epitopes of protein I, the principal protein of the outer membrane of Neisseria gonorrhoeae, was investigated by DNA-mediated transformation . Protein I transformants were isolated by selection for the linked spectinomycin-resistance determinant . Twelve monoclonal antibodies used in coagglutination tests identified epitopes of the two forms of protein I (P.IA and P.IB) . A given gonococcal culture from patients expresses epitopes of either P.IA or P.IB and rarely, if ever, exhibits hybrid P.IA/P.IB reactivities . Nevertheless, we found 35 P.IA/P.IB recombinants among 1506 transformants . Transmission by DNA of the hybrid reactivities and the apparent molecular mass characteristic of a given P.IA/P.IB species verified the genetic basis of the phenotypic changes . A recombinant that expressed six P.IA and two P.IB epitopes is of interest as a possible component of a gonococcal vaccine, because one or more of these epitopes are shared with 99.8% of a worldwide collection of 1858 clinical strains.

Am J Epidemiol, 1988 Aug, 128(2), 298 - 308
Factors related to genital Chlamydia trachomatis and its diagnosis by culture in a sexually transmitted disease clinic; Magder LS et al.; The authors cultured 2,320 patients who attended the Denver Metro Health Clinic for Sexually Transmitted Diseases from September 1981 to June 1983 to determine clinical and epidemiologic factors associated with genital chlamydial infection . Among consecutive heterosexual men with urethral discharge, 226 of 849 (27%) had positive urethral cultures, with rates significantly lower among those with profuse (18%) or purulent (19%) discharges, and higher (37%) among those with symptoms for more than seven days . In a subgroup of men without gonococci, those who had polymorphonuclear leukocytes on smear had higher isolation rates (33%) than those who did not (3%) . Among consecutive female patients, 172 of 1,031 (17%) had positive cervical cultures, with rates significantly lower in those who were white (13%), married (7%), or using a diaphragm (0 of 77), and higher in those who were positive for Neisseria gonorrhoeae (38%) . There was a marginally significant increased rate of chlamydial isolation among oral contraceptive users only for women aged 20 years or younger . Younger age was significantly associated with chlamydial isolation in both men and women after controlling for sexual activity and other factors . Various patient characteristics can be combined to define subgroups of men and women, with rates of isolation ranging from under 4% to over 60% . These results can be useful in deciding whom to test and whom to treat presumptively in a public health settingPIP: To increase knowledge of the prevalence of genital chlamydia trachomatis infection and the associated epidemiologic and clinical factors, cultures were obtained from 2320 patients at a Denver clinic for sexually transmitted diseases . Specific subsamples examined included 96 consecutive male clinic attendees with no urethral discharge on examination, 1193 consecutive male attendees with urethral discharge, and 1031 consecutive female attendees . Only 4 (4%) of the men attending the clinic who did not have a discharge on examination were positive for chlamydial infection compared with 275 (23%) of men with a discharge . Of the men with discharge, the isolation rate of chlamydia was 27% among heterosexuals but only 14% among homosexuals and bisexuals . Of the female attendees cultured, 172 (17%) had positive cervical findings . Younger age was associated with chlamydial infection in both men and women even after controlling for sexual activity . In a subgroup of men without gonococci, those who had polymorphonuclear leukocytes on smear had higher isolation rates (33%) than those who did not (3%) . Among women, chlamydia rates were significantly lower for whites (13%), married women (7%), and diaphragm users (0%) . There was a marginally significant increased rate of chlamydial isolation among oral contraceptive users only for women aged 20 years or below . Significantly fewer (18%) men with profuse discharge were positive for chlamydial infection compared with men with a scant or moderate discharge (27% and 31%, respectively), and those with a purulent discharge were less likely to be positive than men with a clear or white discharge . Stepwise multiple logistic regression suggested the following risk factors for chlamydial infection in men: polymorphonuclear leukocytes, gram-stained smear negative for intracellular diplococci, age under 25 years, history of discharge, discharge for more than 7 days, and no dysuria . Risk factors for women included age less than 25 years, unmarried status, gonorrhea, an abnormal cervix, pelvic inflammatory disease, and no recent antibiotic use .

J Pediatr Surg, 1988 Aug, 23(8), 714 - 7
Staging laparotomy for Hodgkin's disease in children; Schneeberger AL et al.; Staging laparotomy in patients with Hodgkin's disease continues to be a controversial procedure in their management . Between 1970 and 1986, 67 patients up to 18 years of age were seen with Hodgkin's disease . The results of staging laparotomy performed on 39 of these children are reviewed . The clinical stage was changed as a result of laparotomy in 43.6% of cases, with 12.8% of cases upstaged and 30.8% of cases downstaged . All changes in stage modified the proposed treatment for the patient . In 20.5% of patients the laparotomy was positive, and in all cases the spleen was involved . Preoperative lymphangiography did not accurately identify nodal disease . Of the patients with negative laparotomies, 10% developed relapse in the abdomen . Major complications included three episodes of bacterial sepsis, with one death due to Streptococcal pneumonia and one to Neisseria gonorrhea . All septic events occurred prior to the use of pneumococcal vaccine and prophylactic antibiotics . One patient required reoperation for intestinal obstruction with bowel resection . None of the currently used noninvasive tests accurately identifies intraabdominal disease . Therefore, staging laparotomy continues to play an important role in the early management of Hodgkin's disease.

Genitourin Med, 1988 Aug, 64(4), 233 - 4
In vitro activity of eight antimicrobial agents against non-penicillinase-producing gonococci isolated in Munich; Abeck D et al.; The susceptibility of 119 strains of Neisseria gonorrhoeae isolated in Munich in 1986 to eight antibiotics was assessed . Although some degree of resistance to penicillin and tetracycline, as well as high minimum inhibitory concentrations (MIC) of spectinomycin, were observed, all the strains were sensitive to ciprofloxacin, enoxacin, fleroxacin, cefotaxime, and FCE 22250.

Am J Obstet Gynecol, 1988 Aug, 159(2), 397 - 404
The association of Chlamydia trachomatis, Neisseria gonorrhoeae, and group B streptococci with preterm rupture of the membranes and pregnancy outcome; Alger LS et al.; There is conflicting evidence regarding a possible causal role for Chlamydia trachomatis in the development of preterm premature rupture of the membranes . We investigated the relative prevalence of endocervical infection with C . trachomatis and group B streptococci in patients with preterm premature rupture of membranes compared with a control group taken from the same obstetric population . C . trachomatis was isolated from 23/52 (44%) patients with preterm premature rupture of membranes versus 13/84 (15%) women in the control group (p less than 0.001) . This association was independent of infection with group B streptococci or Neisseria gonorrhoeae . Group B streptococci were isolated from 16% of the patients with preterm premature rupture of membranes versus 4% of the control population (p less than 0.05) . The risk of preterm premature rupture of membranes associated with group B streptococcal infection was independent of infection with C . trachomatis and N . gonorrhoeae . Endocervical infection with C . trachomatis did not significantly affect early maternal complication rates after delivery.

Am J Med, 1988 Aug, 85(2), 177 - 82
Gonorrhea in women seen for routine gynecologic care: criteria for testing; Phillips RS et al.; PURPOSE: This study was initiated to determine risk factors for Neisseria gonorrhoeae infection of the cervix in women seen for routine care in a hospital-based obstetrics and gynecology practice . PATIENTS and METHODS: Extensive clinical data and cervical culture specimens for N . gonorrhoeae were obtained prospectively from 1,441 women between the ages of 18 and 50 . Fifty clinical factors were evaluated by multivariate analysis . RESULTS: Of the 1,441 patients tested, 25 (1.7 percent) had a positive culture result . The majority of infected women were asymptomatic . The following five factors were found to be associated independently with gonococcal infection: (1) sex with a partner who may have had gonorrhea or a urethral discharge within the prior three months, (2) endocervical bleeding induced by the initial swab, (3) age at first intercourse less than or equal to 16, (4) method of payment (Medicaid), and (5) low abdominal or pelvic pain . Race, a univariate risk factor, was not associated with gonorrhea when these other factors were considered . The risk of infection for women with none, one, two, or three or more of these multivariate risk factors was 0.2, 0.8, 2.9, and 9.8 percent, respectively . CONCLUSION: Clinical data are helpful in identifying women at risk for gonorrhea . If resources are insufficient to evaluate all sexually active women, we suggest routine testing based on the presence of the multivariate risk factors identified.

J Med Chem, 1988 Aug, 31(8), 1647 - 51
Substrate analogue inhibitors of the IgA1 proteinases from Neisseria gonorrhoeae; Burton J et al.; Substrate analogues based on the amino acid sequence of the hinge region of human IgA1 around the cleavage site of the IgA1 proteinases secreted by Neisseria gonorrhoeae are competitive inhibitors of these enzymes . The octapeptide Thr-Pro-Pro-Thr-Pro-Ser-Pro-Ser, which occurs between residues 233 and 240, has an IC50 value of 0.26 mM for the type 1 proteinase and 0.50 mM for the type 2 enzyme . Acetylation of the octapeptide N-terminal amino group lowers affinity for the type 1 proteinase sixfold but does not change binding to the type 2 enzyme . Amidation of the C-terminal carboxyl group does not change binding to the type 1 proteinase but improves IC50 for the type 2 enzyme . Simultaneous blockade of both the N- and C-termini drastically lowers affinity of the octapeptide for both proteinases . Sequential replacement of the hydroxy amino acids in the blocked octapeptide with cysteine yields a series of inhibitors that generally bind to the neisserial IgA1 proteinases as well as or better than the unblocked octapeptide . The most effective inhibitor contains a cysteine residue at position 6 (P3') and has an IC50 value for the type 2 IgA1 proteinase of 50 microM . Dimerization of the cysteine-containing octapeptides significantly diminishes inhibitory properties . The substrate analogues described here are the first synthetic inhibitors of the neisserial IgA1 proteinases to be reported.

Obstet Gynecol, 1988 Aug, 72(2), 240 - 2
Isolation of Chlamydia trachomatis from sexually abused female adolescents; Dattel BJ et al.; Cultures for Chlamydia trachomatis were obtained from 127 female adolescents (13-17 years of age) evaluated for reported sexual abuse . The rate of positive cultures for C trachomatis in this population was 14% (18 of 127) . Neisseria gonorrhoeae was found in 12% (15 of 127) of these patients . All but two of the culture-positive patients admitted sexual activity before the abuse, and it is likely that most of the infections were acquired during this previous sexual activity . Concomitant infection with N gonorrhoeae was found in seven adolescents positive for C trachomatis . No adolescents in this study exhibited a positive VDRL . Victims of abuse should be tested for both gonococcal and chlamydial infection . These data show that if antibiotic prophylaxis is used for the sexually abused adolescent, it should be directed against both C trachomatis and N gonorrhoeae.

Genitourin Med, 1988 Aug, 64(4), 235 - 40
Single dose oral norfloxacin or intramuscular spectinomycin to treat gonorrhoea (PPNG and non-PPNG infections): analysis of efficacy and patient preference; Panikabutra K et al.; Norfloxacin, a new oral quinolone, was compared with intramuscular spectinomycin for treating culture proved gonorrhoea (caused by penicillinase producing strains of Neisseria gonorrhoeae (PPNG) and non-PPNG strains . A total of 547 infected men and women were randomly allocated to treatment with either single dose norfloxacin (800 mg by mouth) or spectinomycin (2 g intramuscularly) . Patient preference for tablets or injections was noted at this visit . Patients returned four to eight days later for assessment of efficacy, safety, and preference . Of the 482 patients who attended follow up, all those treated with norfloxacin (94 infected with PPNG strains, 145 with non-PPNG strains) and all 82 infected with PPNG strains and treated with spectinomycin were cured . Of 161 infected with non-PPNG strains and treated with spectinomycin, 159 (99%) were cured . Side effects (headache, nausea, and sleepiness) occurred in three patients receiving norfloxacin and in 17 (16 pain at injection site, 1 giddiness) receiving spectinomycin . Most patients preferred tablets to injection both on day 1 (313 v 200) and at follow up (373 v 104) . This study showed that norfloxacin was a highly effective alternative to spectinomycin, produced fewer side effects, and was the preferred mode of administration.

Genitourin Med, 1988 Aug, 64(4), 226 - 32
Genotypes and phenotypes of beta lactamase producing strains of Neisseria gonorrhoeae from African countries; Falk ES et al.; The phenotypes and genotypes of 26 beta lactamase (penicillinase) producing strains of Neisseria gonorrhoeae (PPNG) from African countries were investigated . Using the restriction enzyme technique nine different restriction enzyme patterns were found, two of them in 15 strains . Of the 26 strains, 16 belonged to serogroup WI (containing protein type IA) and 10 to serogroup WII/III (containing protein IB) . Among the IA strains four different serovars were represented, whereas six serovars were found among the IB strains . Five different auxotypes were identified, of which proline requiring (found in 12 strains) and prototrophic (found in 10 strains) dominated . Twelve strains harboured a 4.4 megadalton as well as a 24.5 megadalton plasmid . A 3.2 megadalton plasmid was found in 14 strains, one of which also harboured a 24.5 megadalton plasmid . The 2.8 megadalton cryptic plasmid was present in all 26 strains . The MICs of doxycycline ranged from 0.25 to 2.0 mg/l; the MIC 50% for WI strains was 0.25 mg/l and for WII/WIII strains 1.0 mg/l . A total of 10 different combinations of restriction enzyme pattern, serovar, auxotype, and plasmid were seen in the 16 WI strains compared with eight such combinations in the 10 WII/WIII strains . As expected, the restriction enzyme technique and serological classification gave better differentiation than plasmid profiles and susceptibility to doxycycline . More relevantly, however, these techniques also compared favourably with auxotyping . When the different systems were combined, the sensitivity was greatly increased.

Mol Immunol, 1988 Aug, 25(8), 799 - 809
Epitope expression of gonococcal lipooligosaccharide (LOS) . Importance of the lipoidal moiety for expression of an epitope that exists in the oligosaccharide moiety of LOS; Yamasaki R et al.; Antigenic expression of lipooligosaccharide (LOS) of strain F62 of Neisseria gonorrhoeae, was investigated with mouse monoclonal IgM antibody 3F11 . F62 LOS was modified in various ways in order to understand structural requirements for expression of the 3F11-defined epitope . When the LOS was partially deacylated by treating it with 50 mM NaOH at 80 degrees C for 20 min or with anhydrous hydrazine at 80 degrees C for 20 min, the binding of 3F11 to those deacylated LOS samples decreased significantly . Removal of phosphate groups by treatment of the LOS with HF (4 days at 4 degrees C) did not affect the antigenicity at all . Neither did reduction of carboxyl groups in the LOS molecule (by activation of carboxyl groups with a carbodiimide followed by treatment with NaBH4) alter epitope expression . On oxidation with NaIO4, the LOS lost its antigenicity completely . The presence of Mg2+ did not change the circular dichroism (CD) behavior of F62 LOS . However, the partially deacylated LOS samples showed significantly different CD patterns in the 190-200 nm region compared with F62 LOS, which suggests conformational changes of F62 LOS due to the loss of fatty acids in the lipoidal moiety . Oligosaccharide (OS) and lipoidal components obtained after hydrolysis of F62 LOS with 1% acetic acid, were not recognized by the antibody . The antigenicity of OS was not retained by non-stereospecific acylation of OS with decanoyl chloride . We conclude the following: (1) 3F11-defined epitope exists in the OS moiety of F62 LOS; however, for it to be expressed, the carbohydrate moiety must be in a certain conformation that is defined by an overall structure of the LOS molecule . This structure is significantly influenced by some of the fatty acids in the lipoidal moiety of the LOS molecule; (2) the presence of phosphate or 3-deoxy-manno-2-octulosonic acid (dOclA) is not essential for expression of the 3F11-defined epitope; (3) the presence of divalent cations does not affect epitope expression.

APMIS, 1988 Aug, 96(8), 735 - 40
Attempts to demonstrate a polysaccharide capsule in Neisseria gonorrhoeae; Reimann K et al.; The presence or absence of a polysaccharide capsule on the human pathogen Neisseria (N.) gonorrhoeae is still a topic of controversy . For this reason we compared the results obtained by light microscopy (dry India ink-Fuchsin stain) and electron microscopy (Alcian blue-lanthanum nitrate stain) of encapsulated strains of N . meningitidis and Streptococcus (S.) pneumoniae and of non-encapsulated strains of S . pneumoniae and Escherichia (E.) coli with those obtained using the same methods on strains of pilliated and non-pilliated N . gonorrhoeae . After staining with India ink-Fuchsin no capsules could be demonstrated on any of the N . gonorrhoeae strains studied . If present the capsules on these cells are too delicate to be identified by light microscopy . After treatment with Alcian blue-lanthanum nitrate sections of cells of N . meningitidis and S . pneumoniae generally showed the presence of a capsular layer . Sections of cells of the non-encapsulated strain of S . pneumoniae which possess C (common)-polysaccharide also showed surface associated capsule-like material . Similarly the surface of the cells of the E . coli strain showed material which appeared to be tufts of pili and/or M (mucoid)-antigen . In experiments where the N . gonorrhoeae cells were harvested as early as after six hours of growth a capsule-like material was demonstrated on cells of all strains studied.

Nucleic Acids Res, 1988 Jul 11, 16(13), 5957 - 72
Purification and characterization of DNA methyltransferases from Neisseria gonorrhoeae; Piekarowicz A et al.; Three DNA methyltransferases, M.NgoAI, and M.NgoBI and M.NgoBII, free of any nuclease activities were isolated from Neisseria gonorrhoeae strains WR220 and MUG116 respectively . M.NgoAI recognizes the sequence 5' GGCC 3' and methylates the first 5' cytosine on both strands . M.NgoBI and M.NgoBII recognize 5' TCACC 3' and 5' GTAN5CTC 3' respectively . M.NgoBII methylates cytosine on only one strand to produce 5' GTAN5mCTC 3'.

J Adolesc Health Care, 1988 Jul, 9(4), 291 - 5
Predominant sexually transmitted diseases among different age and ethnic groups of indigent sexually active adolescents attending a family planning clinic; Smith PB et al.; The present study analyzed a group of 113 sexually active, indigent female adolescents attending a family planning clinic, for age, ethnic, or racial trends in the recovery of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma species, and Ureaplasma urealyticum . The overall recovery rate for N . gonorrhoeae was 8/112 (7.1%), with the highest rate occurring in black patients (7/82, 8.5%) . The overall recovery rate for C . trachomatis was 31/113 (27.4%), with the highest rate occurring in Hispanics (7/21, 33.3%) . The isolation of C . trachomatis was evenly divided among patients grouped by reason for visit . Neisseria gonorrhoeae, on the other hand, was isolated more frequently from patients coming for a sexually transmitted disease screen than from those attending for other reasons . There was a significant (p less than 0.05) increase in isolation of Mycoplasma species from 18-19-year-old patients, but no such difference was observed for U . urealyticum when compared to younger age groups . Factors associated with venereal disease prevalence in our teenage indigent population as well as implications for the future reproductive health of such patients are discussedPIP: The present study analyzed a group of 113 sexually active US indigent female adolescents attending a family planning clinic in a large urban area for age, ethnic, or racial trands in the recovery of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma species, and Ureaplasma urealyticum . The overall recovery rate for N . gonorrhoeae was 8/112 (7.1%), with the highest rate occurring in black patients (7/82, 8.5%) . The overall recovery rate for C . trachomatis was 31/113 (27.4%), with the highest rate occurring in Hispanics (7/21, 33.3%) . The isolation of C . trachomatis was evenly divided among patients grouped by reason for visit . Neisseria gonorrhoeae, on the other hand, was isolated more frequently from patients coming for a sexually transmitted disease screen than from those attending for other reasons . There was a significant (p 0.05 increase in isolation of Mycoplasma species from 18-19-year-old patients, but no such difference was observed for U . urealyticum when compared to younger age groups . C . Trachomatis may be a relatively common cause of pelvic inflammatory disease (PID) and PID attributed to Chlaymdia may have mild intial manifestations . Hence, many sexually active young females may unknowingly be infected and at risk for developing PID and its potential sequelae . Thus the high incicence of C . trachomatis when compared to gonorrhea suggests that rountine screening for C . trachomatis is as important as gonorrhoeae screening in adolescents . Culture for specimens of Mycoplasma species in patients with PID is a prudent measure if a laparoscopy specimen is available but it is impractical to screen all patients routinely for these organisms . Further research should focus on variables associated with racial/ethnic differences in relation to different aspects of sexual behavior and attitudes .

Br J Ophthalmol, 1988 Jul, 72(7), 518 - 20
Single-dose cefotaxime intramuscularly cures gonococcal ophthalmia neonatorum; Lepage P et al.; Nine neonates with culture proved gonococcal ophthalmia neonatorum were treated with a single intramuscular injection of 100 mg/kg of cefotaxime without topical antibiotic therapy . Five of the nine strains were penicillinase-producing Neisseria gonorrhoeae . All nine cases were clinically and microbiologically cured, and no side effects were observed.

Br J Urol, 1988 Jul, 62(1), 76 - 8
The frequency of Chlamydia trachomatis in acute epididymitis; De Jong Z et al.; Twenty-five patients with bacteriologically proven epididymitis were studied between 1984 and 1986 . Thirteen were less than 35 years old and in 11 of them Chlamydia trachomatis was isolated; of the 2 remaining patients Escherichia coli was found in 1 and Neisseria gonorrhoeae in the other . In patients more than 35 years old, gram negative bacteria were the cause of infection in 10 and only 1 case was attributable to Chlamydia trachomatis . These results suggest that Chlamydia trachomatis is much more frequent in men under the age of 35 and the difference is statistically significant.

South Med J, 1988 Jul, 81(7), 851 - 4
Gonococcal infections in women attending the Venereal Disease Clinic of the Nashville Davidson County Metropolitan Health Department, 1984; Quinn RW et al.; During the first six months of 1984, slightly more than a third (34.1%) of the 1,549 women who attended the Venereal Disease Clinic of the Nashville Davidson County Health Department in this study were found to be infected with Neisseria gonorrhoeae . Infection prevalence was 36.7% for black women and 27.1% for white . The frequency of sexual intercourse and the number of sexual partners during the previous 30 days were similar for black and white patients . Fewer women were using contraceptives (67.8%) than in 1979 (87%) . Exceptionally high rates of infection were found in women whose sexual partners had gonorrhea . Even with similar levels of sexual activity, black women faced greater risk of infection than white women, possibly because they were much more likely to be exposed to an infected man.

Sex Transm Dis, 1988 Jul-Sep, 15(3), 158 - 63
Penicillinase-producing Neisseria gonorrhoeae in Dade County, Florida: phenotypic characterization of isolates from 1983, 1984, and 1986; Zenilman JM et al.; Penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) have been endemic in Miami, Florida, since 1981 . Strains of PPNG isolated in Miami during 1983 (60 isolates), 1984 (41 isolates), and 1986 (107 isolates) were characterized by plasmid content, auxotype/serovar (A/S) class, and susceptibility to antimicrobial agents . In 1986, 95 isolates (89%) possessed the 3.2-Megadalton (MDa) beta-lactamase plasmid; 36 (34%) of these isolates also possessed the 24.5-MDa conjugative plasmid . These results contrast with those from 1984, when 37 PPNG isolates (90%) possessed the 4.4-MDa plasmid, and most possessed the 24.5-MDa conjugative plasmid . This in turn was a reversal of the pattern seen in 1983, when only 42 (69%) possessed the 3.2-MDa plasmid, and the conjugative plasmid was rare . In 1983 and 1986, isolates possessing the 4.4-MDa plasmid were more resistant to penicillin than were isolates containing the 3.2-MDa plasmid . All isolates were susceptible to spectinomycin and ceftriaxone . In early 1986, two A/S classes accounted for 66% of all isolates . Pro/IA-1,2 and Pro/IB-2 accounted for 31 (29%) and 40 (37%), respectively, and were isolated during every week in early 1986 . In contrast, isolates belonging to 14 and six A/S classes possessing the 3.2- and 4.4-MDa beta-lactamase plasmid, respectively, were isolated sporadically . The composition of the PPNG strain population in Miami is dynamic, a factor that may have important implications for the use of traditional disease intervention strategies.

Sex Transm Dis, 1988 Jul-Sep, 15(3), 150 - 1
Urethritis caused by Neisseria meningitidis group B: a case report; Hartmann AA et al.; We describe a case of acute urethritis caused by Neisseria meningitidis group B in a heterosexual man . The symptoms started five days after intercourse that included fellatio with a casual female partner . No other urethral pathogens could be isolated . After intramuscular administration of penicillin G, clinical signs and symptoms of urethritis disappeared, and despite repeated attempts, N . meningitidis could no longer be isolated from the urethra . This case illustrates the need for careful diagnostic procedures.

Sex Transm Dis, 1988 Jul-Sep, 15(3), 141 - 3
Penicillinase-producing Neisseria gonorrhoeae in various seaport cities of Latin America; Escamilla J et al.; One hundred fifteen acute cases of gonorrhea were documented in U.S . military personnel during a five-month cruise in which 22 port cities of Latin America were visited in 1985 . Penicillinase-producing Neisseria gonorrhoeae (PPNG) was isolated from 23 (20%) of the 115 cases . No penicillin-resistant, beta-lactamase-negative gonococci were encountered . None of the ten cases of gonorrhea acquired in the Caribbean region was due to PPNG . In South America, the PPNG infection rate was 35% (19/54) in ports along the Pacific Ocean and 8% (4/51) in those along the Atlantic . Infections incurred in four cities of three countries on the Pacific coast of the South American continent accounted for 78% of all PPNG isolates . Although the study did not deal directly with infections in the local populations, the data suggest that PPNG are common in coastal South America and that hyperendemic foci exist in some cities of the continent's western coast.

Antimicrob Agents Chemother, 1988 Jul, 32(7), 971 - 7
Mutation in a locus linked to penB-nmp causes suppression of the Mtr phenotype of Neisseria gonorrhoeae; Shinners EN et al.; The chromosomal locus mtr, which encodes low-level resistance to multiple antibacterial agents in Neisseria gonorrhoeae, is subject to phenotypic suppression by env mutations that increase the permeability of the envelope . We have identified a new locus, mom (for modifier of Mtr), which is located on the chromosome very close to penB and nmp, loci known to be linked to each other and to spc . Phenotypic suppression of Mtr was recognized by reductions of resistance to benzylpenicillin and also to oxacillin and the hydrophobic agents novobiocin and erythromycin . The resistance to each of these antibiotics returned to the Mtr levels in mom+ transformants isolated by selection for increased resistance to either novobiocin or erythromycin; the accompanying change of the outer membrane protein I seroreactions confirmed the proximity of nmp and mom . Thus, some mutant gonococci display wild-type antibiotic susceptibilities but can express multiple resistance following a mom+ mutation that releases the suppressed Mtr phenotype.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Jul, 269(1), 56 - 63
Gardnerella vaginalis is associated with other sexually transmittable microorganisms in the male urethra; Elsner P et al.; In a prospective study, urethral swabs were taken from 544 men presented to an STD clinic, 118 with and 426 without urethritis, and examined by microscope and/or culture for G . vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Ureaplasma urealyticum, Mycoplasma hominis, Candida species and Trichomonas vaginalis . G . vaginalis was isolated from 4.2% of the males with urethritis and from 6.3% of those without urethritis . Using loglinear analysis, the following associations were significant (p less than 0.05): three-way: G . vaginalis, U . urealyticum, C . trachomatis; two-way: G . vaginalis, U . urealyticum and G . vaginalis, M . hominis and U . urealyticum, M . hominis . It is concluded that G . vaginalis is associated with genital mycoplasmas not only in the female, but also in the male urogenital tract.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 Jul, 269(1), 34 - 42
Surface immunolabeling of Neisseria gonorrhoeae employing monoclonal antibodies to proteins IA and IB; Layh G et al.; The technique of immunomarking intact bacteria with monoclonal antibodies (MAb) and gold-labeled anti-IgG provides a rapid and reliable method for localization of surface-exposed antigens . Cell suspensions of Neisseria gonorrhoeae were incubated with monoclonal antibodies directed against different epitopes of protein I as shown by ELISA inhibition test (unpublished data) . The bound IgG molecules were detected with gold labeled anti-mouse IgG or protein A . MAbs against various epitopes of protein I showed differences in their reaction pattern with intact bacteria . We compared the results achieved by the gold immunomarking technique with coagglutination (CoA) and immunofluorescence (IF) tests . The results of the three methods correlated for some antibodies and were ambiguous for other MAbs . The advantage of the immunogold method over immunofluorescence and coagglutination is that distribution and localization of antigen on the surface of gonococci can be exactly determined using electron microscopy.

Obstet Gynecol, 1988 Jul, 72(1), 7 - 12
A comparison of two antibiotic regimens for treatment of pelvic inflammatory disease; Soper DE et al.; Sixty-two women were randomized in a double-blind fashion to receive one of two antibiotic regimens for the treatment of clinically diagnosed pelvic inflammatory disease . Thirty of 31 patients (96.8%) receiving a combination of cefoxitin with doxycycline and 28 of 31 (90.3%) receiving a combination of clindamycin with amikacin responded to therapy (P = not significant) . Chlamydia trachomatis, Neisseria gonorrhoeae, or both were isolated from 13.3, 7.0, and 4.8% of patients, respectively . Of the four patients not responding to therapy, all had inflammatory complexes . Cefoxitin/doxycycline and clindamycin/amikacin are both effective in the treatment of pelvic inflammatory disease.

Sex Transm Dis, 1988 Jul-Sep, 15(3), 137 - 40
Epidemiologic and clinical studies of Chlamydia trachomatis infection in northeastern Poland; Zdrodowska-Stefanow B et al.; We tested a total of 735 men and women, who either had clinical symptoms of lower urogenital tract infection or were considered for epidemiological reasons to be at high risk for sexually transmitted diseases, for Chlamydia trachomatis infection . Microbiologic examinations were performed by tissue culture with cycloheximide-treated McCoy cells . C . trachomatis infection was diagnosed in approximately 50% of men with nongonococcal urethritis, 23.5% of men with gonococcal urethritis, 69% of men with postgonococcal urethritis, and in 45% of male partners of C . trachomatis-positive women . Among men under 35 years of age with epididymitis, C . trachomatis was isolated from 42%, whereas Neisseria gonorrhoeae was found in only 21 men . C . trachomatis was isolated from 59% of women with nongonococcal cervicitis, 46% of those with gonococcal cervicitis, and 74% of those with postgonococcal cervicitis . Among female partners of men with nongonococcal urethritis, 68% were C . trachomatis-positive, as were 73.5% of the female contacts of C . trachomatis-positive men . In the groups of men and women without clinical or epidemiologic evidence of sexually transmitted infection, C . trachomatis-positive cultures were obtained from 3.8% and 3.6%, respectively . These studies revealed that the prevalence of C . trachomatis infection in northeastern Poland is high and is similar to that reported in Western countries.

Sex Transm Dis, 1988 Jul-Sep, 15(3), 133 - 6
Prevalence of Chlamydia trachomatis cervical infection in a college gynecology clinic: relationship to other infections and clinical features; Swinker ML et al.; A total of 479 sexually active college women presenting for routine gynecologic care were screened for gonorrheal and chlamydial infection of the cervix . Most of these women were asymptomatic; those with symptoms had minor complaints related to the lower genital tract . A direct fluorescent antibody test (DFA) showed the prevalence of chlamydial infection to be 8.1%, while culture for Neisseria gonorrhoeae indicated that the prevalence of gonorrhea was 1.5% . DFA-positive women had some minor alterations in the appearance of their cervix, but only 10% had overt mucopurulent cervicitis . The presence of purulent cervical discharge was four times more common in DFA-positive women, but only one-fourth of positive women had this finding . The use of an endocervical gram stain showing ten or more white cells per oil immersion field (x970) did not appear to be clinically useful in diagnosing suspected chlamydial infection because there was no significant difference in the number of white cells seen in specimens from DFA-positive (16 polymorphonuclear leukocytes) and DFA-negative women (ten polymorphonuclear leukocytes) . Thus, use of the gram stain as an initial screening mechanism would not markedly reduce the number of women to be tested for Chlamydia trachomatis; half of all women met the gram-stain criterion, and nearly a quarter of the DFA-positive women would be overlooked.

Rev Infect Dis, 1988 Jul-Aug, 10(4), 699 - 711
Penicillin-binding proteins of gram-negative bacteria; Spratt BG et al.; beta-Lactam antibiotics exert their antibacterial effects by inactivating the high-molecular-weight penicillin-binding proteins (PBPs) that are responsible for the final stages of peptidoglycan biosynthesis . The availability of the amino acid sequences of several low-molecular-weight PBPs, high-molecular-weight PBPs, and active-site serine beta-lactamases has provided evidence that these groups of enzymes have a common, but distant, evolutionary origin . This view is strongly supported by the recent finding of a similarity in the three-dimensional structures of a low-molecular-weight PBP and class A beta-lactamases . The high-molecular-weight PBPs of Escherichia coli are believed to possess an amino-terminal peptidoglycan transglycosylase domain and a carboxy-terminal penicillin-sensitive transpeptidase domain . These enzymes are inserted in the cytoplasmic membrane only at their amino termini, and water-soluble forms have been obtained that should be suitable for crystallization and X-ray analysis . Resistance to beta-lactam antibiotics mediated by alterations of PBPs has been reported in some gram-negative bacteria . In isolates of Neisseria gonorrhoeae with chromosomally mediated resistance, penicillin-resistant PBPs have arisen from the introduction of multiple amino acid substitutions within the transpeptidase domain of the enzymes.

J Antimicrob Chemother, 1988 Jul, 22 Suppl B, 1 - 11
Early studies on in-vitro and experimental activity of spiramycin: a review; Chabbert YA; This review of spiramycin activity in vitro is based mainly on early studies . The MICs of spiramycin for common pathogenic bacteria such as staphylococci, streptococci and pneumococci are higher than those of erythromycin . Conversely, in experimental models, the activity of spiramycin is equal to or greater than that of erythromycin . In addition, the activity of spiramycin on Neisseria, Legionella, Mycoplasma, Chlamydia, and Toxoplasma spp . completes its antimicrobial spectrum and shows that spiramycin covers the majority of agents responsible for respiratory tract infections . The 'spiramycin paradox'-the discrepancy between the relatively modest activity of spiramycin in vitro and its excellent activity in vivo will be explained by other papers . Its high tissue and intracellular concentrations, and the slow recovery of bacteria submitted to spiramycin are of great importance to account for its activity in vivo.

Proc Natl Acad Sci U S A, 1988 Jul, 85(13), 4902 - 6
Identification of carbohydrate structures that are possible receptors for Neisseria gonorrhoeae; Stromberg N et al.; Different strains and isogenic variants of Neisseria gonorrhoeae were assayed for their ability to bind glycolipids extracted from various sources . Among a large number of reference glycolipids, binding was observed only to lactosylceramide {Gal(beta 1-4)Glc(beta 1-1)Cer}, isoglobotriaosylceramide {Gal(alpha 1-3)Gal(beta 1-4)Glc(beta 1-1)Cer}, gangliotriaosylceramide {GalNAc(beta 1-4)Gal(beta 1-4)Glc(beta 1-1)Cer}, and gangliotetraosylceramide {Gal(beta 1-3)GalNAc(beta 1-4)Gal(beta 1-4)Glc(beta 1-1)Cer} . The latter two glycolipids bound gonococci with the highest affinity . Lactosylceramide and gangliotriaosylceramide were found in glycolipid preparations from ME180 cells, an epithelial cell line derived from a human cervical carcinoma, and thus are possible receptors for gonococci . The gonococcal surface component that bound the above glycolipids is a protein distinct from pilin and protein II.

Infect Immun, 1988 Jul, 56(7), 1743 - 7
Proteins that appear to be associated with pili in Neisseria gonorrhoeae; Muir LL et al.; Pili of Neisseria gonorrhoeae are thought to be composed entirely of identical subunits, called pilin, that self-assemble in vitro . Previous pilus purification methods have relied on this latter point, and dissociation and reassociation of pilin subunits has yielded pilin preparations of high purity . Such a procedure could result in the loss of any pilus-associated proteins . We have developed a procedure for the isolation of intact native pili in a deoxycholate-urea buffer in which the pili are fractionated on the basis of size and hydrophobicity . Electron microscopy indicates that the pili are largely free from outer membrane vesicles and other cellular material . Electrophoretic analysis has shown that a number of proteins copurify with pilin . Antibodies to these proteins could be removed from an antiserum against whole piliated cells by absorption with piliated cells but not by absorption with nonpiliated cells . Hence, our results indicate that these proteins could be pilus associated.

Rev Infect Dis, 1988 Jul-Aug, 10 Suppl 2, S287 - 95
Lipooligosaccharides: the principal glycolipids of the neisserial outer membrane; Griffiss JM et al.; The outer-membrane glycolipids of bacteria that colonize mucosal surfaces that are not routinely bathed by bile acids often lack the long, hydrophilic and neutral polysaccharides that protect the lipid membranes of enteric bacteria from dispersal . The glycolipid from these organisms is properly termed a lipooligosaccharide . A Neisseria strain makes from two to six lipooligosaccharide molecules that range in Mr from 3,150 to 7,100 . Different species of Neisseria commonly make lipooligosaccharides of identical Mr and epitope content . Differences in oligosaccharides account for most of the observed physical heterogeneity . Oligosaccharides consist of (1) partially conserved and highly substituted basal oligosaccharides that branch at heptose residues; (2) a linear segment consisting of (hexose)n residues that determines the length of the oligosaccharide; and (3) terminal sequences that are similar to those of glycosphingolipids . Epitope expression is linked to physical heterogeneity and is modified by the molecular environment of the outer membrane . Serotype epitopes are present only on lipooligosaccharides of a certain Mr . Certain lipooligosaccharides regulate complement activation onto the bacterial surface and, hence, immune lysis.

J Exp Med, 1988 Jul 1, 168(1), 107 - 26
Lipooligosaccharides (LOS) of Neisseria gonorrhoeae and Neisseria meningitidis have components that are immunochemically similar to precursors of human blood group antigens . Carbohydrate sequence specificity of the mouse monoclonal antibodies that recognize crossreacting antigens on LOS and human erythrocytes; Mandrell RE et al.; We have used mouse mAbs, 3F11 and 06B4, that are specific for highly conserved epitopes of Neisseria gonorrhoeae lipooligosaccharides (LOS) to identify immunochemically similar structures on human erythrocytes . mAb 3F11 agglutinated erythrocytes from all randomly selected adult humans, while mAb 06B4 agglutinated only 80% of the same specimens . The antibodies had an activity with erythrocytes similar to human cold agglutinins in that agglutination occurred at 4 degrees C and decreased with increasing incubation temperature . Human infant erythrocytes were agglutinated less well, but enzymatic treatment of either infant or adult cells resulted in an increase in expression of the 3F11- and 06B4-defined epitopes . Both antibodies bound to a series of neutral glycosphingolipids from human erythrocytes and neutrophils that have a type 2 (Gal beta 1----4GlcNAc) or N-acetyllactosamine structure . Neither antibody bound to glycosphingolipids from human meconium, which have a type 1 (Gal beta 1----3GlcNAc) structure . The antibodies were unable to bind to N-acetyl-lactosamine glycosphingolipids with a nonreducing terminal sialic acid or a Gala1----3Gal disaccharide . Antibody binding also was blocked by the presence of fucose linked to the penultimate glucosamine residue of N-acetyllactosamine glycosphingolipids . Although both antibodies bound to linear and branched-chain N-acetyllactosamine glycosphingolipids, 3F11 had a higher affinity for branched structures than did 06B4 . The activity of 3F11 with human adult and infant treated and untreated erythrocytes with N-acetyllactosamine glycosphingolipids, and with LOS was very similar, if not identical, in specificity to 1B2, an mAb prepared from mice inoculated with a linear N-acetyllactosamine glycosphingolipid.

Cutis, 1988 Jun, 41(6), 425 - 6
Gonococcal urethritis with bilateral tysonitis; el-Benhawi MO et al.; A case of gonococcal urethritis with bilateral tysonitis is presented . Results of gram's stain and positive culture for Neisseria gonorrhoeae confirmed the diagnosis . The patient was treated successfully with aqueous procaine penicillin with probenecid followed by oral ampicillin for ten days.

J Clin Pathol, 1988 Jun, 41(6), 691 - 3
Rapid identification of bacterial antigen in blood cultures and cerebrospinal fluid; Williams RG et al.; The ability of antibody coated latex particle suspensions to aid the diagnosis of septicaemia and meningitis in children was assessed in 272 blood culture sets and 85 cerebrospinal fluid specimens . This was also assessed in cases caused by Neisseria meningitidis group B infection . The method was 100% sensitive and 99% specific, with good predictive values (range 63% to 100%) and provided valuable support to the routine bacteriological examination of blood culture and cerebrospinal fluid.

Clin Orthop, 1988 Jun, (231), 222 - 4
Neisseria mucosa bursitis . A rare cause of gas in soft tissue; Linquist PR et al.; A 24-year-old woman with shoulder pain had an expanding gas-containing radiolucency adjacent to the glenoid . She had been treated with prednisone intermittently for asthma . After unsuccessful attempts at percutaneous drainage, open exploration was performed with resection of a bursa containing gelatinous material and gas bubbles . The culture grew Neisseria mucosa, an organism that infrequently causes infections and is often categorized as nonpathogenic . This case illustrates that soft tissue gas accumulation is not always ominous but may be due to fastidious low virulence organisms . Appropriate surgical drainage and persistent microorganism cultures are required for definitive diagnosis and therapy.

Diagn Microbiol Infect Dis, 1988 Jun, 10(2), 131 - 4
Branhamella catarrhalis: fatty acid and lipopolysaccharide analysis of an atypical strain from blood culture; Wust J et al.; A Branhamella catarrhalis-like organism was isolated from blood cultures; it was atypical in showing negative nitrate and nitrite and positive gamma-glutamylaminopeptidase reactions, in agglutinating with Neisseria meningitidis antisera, and in forming butyrous colonies . Cell-wall fatty-acid and lipopolysaccharide analysis provided evidence that this isolate was an atypical B . catarrhalis.

Pathol Biol (Paris), 1988 Jun, 36(5 Pt 2), 639 - 42
{Penicillinase-producing Neisseria gonorrhoeae isolated in Lisbon 1982-1987}; Vaz Pato MV et al.; PPNG strains were first detected in Lisbon in 1982 . Most of the 88 PPNG strains isolated since then in our laboratory were obtained from prostitutes . In this population, PPNG prevalence underwent a dramatic increase, rising from 1.1% in 1983 to 8.2% in 1984, 19.2% in 1985, 13.1% in 1986 and 27% in 1987 (ten months) . MICs determined by agar dilution in a sample of 45 non-PPNG strains were as follows: 0.063 less than MIC mg/l less than 2 for penicillin, 0.125 less than MIC mg/l less than 1 for ampicillin, 8 less than MIC mg/l less than 32 for spectinomycin, 0.125 less than MIC mg/l less than 2 for tetracycline, and MIC less than 0.063 for cefotaxime . In contrast, MICs among PPNG strains were 4 less than MIC mg/l less than 64 for penicillin, 4 less than MIC mg/l less than 64 for ampicillin, 16 less than MIC mg/l less than 32 for spectinomycin, 0.250 less than MIC mg/l less than 2 for tetracycline, and MIC mg/l less than 0.063 for cefotaxime . Two different inocula were used, ie . 2 X 10 CFU/spot, and 10 CFU/spot . A significant increase in MICs was found with the heavier inoculum, especially for beta-lactam antibiotics . Plasmid analysis of the PPNG strains found 44% type AFR-, 27% type Afr+, 13% type Asia-, and 13% type Asia+; one strain isolated in 1987 was similar to the "RIO" type (The Netherlands, 1985) with 3.05 Mdal . Distribution of auxotypes among studied strains was NR pheni, 44%, NR 14%; prol-, 31%; and other types, 11%.

Pathol Biol (Paris), 1988 Jun, 36(5 Pt 2), 635 - 8
{Surveillance of Neisseria gonorrhoeae strains isolated in Toulouse . In vitro antibiotic sensitivity and plasmid content}; Lefevre JC et al.; The minimal inhibitory concentration (MIC) of twelve antibiotics was determined by the method of dilution in agar for 50 non penicillinase-producing and 15 penicillinase-producing Neisseria gonorrhoeae (PPNG) strains . The commonly used antibiotics are active in vitro against all the strains . For the non PPNG stains, no difference was observed between the MICs with a previous investigation, in 1980 . New quinolones are highly active against all the strains tested but two, with decreased sensitivity . Since 1980, 16 PPNG strains were isolated (2.2%) and analysed for plasmid content . Asian type plasmid (7.4 kb) was present in 9 strains and african type (5.3 kb) in 7 strains . The conjugative plasmid (39 kb) was present in 5 strains and the cryptic plasmid (4.4 kb) in all the strains.

J Antimicrob Chemother, 1988 Jun, 21(6), 737 - 44
Surveillance of the antibiotic susceptibility of non-penicillinase producing Neisseria gonorrhoeae in The Netherlands from 1983 to 1986; van Klingeren B et al.; From 1983 to 1986 more than 2000 non-penicillinase producing Neisseria gonorrhoeae from Amsterdam, The Hague and Rotterdam were auxotyped and screened for susceptibility to 10 antibiotics by MIC determination . By far the commonest auxotypes were N.R . (non-requiring; 40%) and Pro- (proline requiring; 30%) . During that period there was a substantial shift in the ratio of both auxotypes-roughly from 1:2 to 2:1-in The Hague . Pro- isolates were generally less susceptible than N.R . isolates, and there was a strong positive correlation between the MICs of the different drugs . The prevalence of isolates with a penicillin MIC equal to or above 0.5 IU/ml amounted to 14%, while in only 1% was the MIC above 1 IU/ml . Comparing our results with an earlier study by Stolz, Zwarte & Michel (1975, British Journal of Venereal Diseases 51, 257-64), the level of resistance to penicillin among non-PPNG has not significantly increased in The Netherlands since 1972 . The prevalence of isolates showing relative resistance towards tetracycline and thiamphenicol (MIC 2-4 mg/l) decreased from approximately 20% in 1983/84 to approximately 10% in 1985/86, coinciding with a drop in the prevalence of Pro- isolates . All strains were susceptible to cefuroxime and spectinomycin and highly susceptible to cefotaxime and ciprofloxacin.

Genitourin Med, 1988 Jun, 64(3), 172 - 5
Microbial aetiology and diagnostic criteria of postpartum endometritis in Nairobi, Kenya; Temmerman M et al.; Using a protected triple lumen device, Neisseria gonorrhoeae or Chlamydia trachomatis, or both, were isolated from the endometriums of five out of 35 women with clinical postpartum endometritis compared with none of a control group of 30 puerperal women without endometritis (p less than 0.05) in Nairobi, Kenya . These sexually transmitted agents were also found in 12 cervical specimens from women with and three without postpartum endometritis (p = 0.04) . Mycoplasma hominis and Ureaplasma urealyticum were equally isolated from the endometrium in both groups . Histology showed plasma cell infiltration in 6/25 patients compared with 1/22 controls (p = 0.06) . A history of foul lochia (p less than 0.01) and abdominal pain (p = 0.02) were associated with postpartum endometritis . Sexually transmitted agents appear to be major causes of puerperal upper genital tract infections in NairobiPIP: In Nairobi, Kenya, researchers enrolled 35 women at 7-9 days postpartum who delivered vaginally and had clinical endometritis (purulent lochia, fever, uterine tenderness, or uterine subinvolution) and 30 puerperal women without endometritis in a case control study . The study aimed to examine the association between clinical criteria and microbial and histological findings in diagnosing postpartum endometritis and the role of various microorganisms in the etiology of this infection . Cases were significantly more likely to have foul lochia (51.1% vs . 20%; p = .005) and abdominal pain (77.1% vs . 46.7%; p = .02) . Laboratory personnel were able to isolate both Neisseria gonorrhoeae and Chlamydia trachomatis significantly more often from the cervices and the endometria of the patients than from the controls . Each of these 2 microorganisms were also isolated more often from the endometria of patients than of controls (3 patients vs . 0 patients for both N . gonorrhoeae and C . trachomatis), but the difference was not significant . The researchers could not determine the etiology of postpartum endometritis in the remaining two-thirds of cases . Isolation rates for Mycoplasma hominis and Ureaplasma urealyticum from the cervices and endometria were essentially the same in both patients and controls . Moderate or severe plasma cell infiltration occurred in 24% of cases and 4.5% of controls (p = .06) . No correlation between histology and microbiology existed, however . These findings suggest that controlling maternal sexually transmitted disease would reduce postpartum pelvic infections and secondary infertility .

Genitourin Med, 1988 Jun, 64(3), 169 - 71
Mucopurulent cervicitis: a clinical entity?
Willmott FE.
Of 297 women attending a sexually transmitted disease clinic who were examined for the presence of mucopurulent cervicitis, 96 (32%) satisfied the diagnostic criteria . Mucopurulent cervicitis was strongly associated with the isolation of Chlamydia trachomatis and Neisseria gonorrhoeae . It was also associated with bacterial vaginosis, the use of oral contraceptives, and sexual contact with men who had non-gonococcal urethritis . Conversely, the presence of opaque cervical secretions did not show these associations, and the results indicated no difference in genital infections in women with clear cervical secretions whether or not more than 10 polymorphonuclear leucocytes per field (at a magnification of x 1000) were present . The findings support the suggestion that mucopurulent cervicitis is a definite clinical entity that requires investigation and treatment.

Genitourin Med, 1988 Jun, 64(3), 156 - 8
Isolation of Neisseria gonorrhoeae from urine obtained by suprapubic puncture of bladders of men with gonococcal urethritis; Pec J Jr et al.; The authors examined three urine specimens from each of 24 men with acute gonococcal urethritis . Gonococcal concentrations in urine were 7 X 10(3)/ml to 9 X 10(8)/ml in first samples, 1 X 10(2)/ml to 5 X 10(6)/ml in midstream samples, and, in the terminal samples from only 22 men, 8 X 10(4)/ml . A further 17 men with symptomless gonococcal urethritis were examined . Seven of them yielded 1 X 10(2)/ml to 2.5 X 10(5)/ml in first samples and 5 X 10(5)/ml in midstream samples, and only two yielded 5 X 10(1)/ml in final samples . All 24 men with acute gonococcal urethritis, and seven of the men with symptomless gonococcal urethritis who had yielded N gonorrhoeae in midstream urine samples, were examined by suprapubic puncture before morning voiding . Four of the 24 men with acute gonococcal urethritis were found to have infection that had ascended into the bladder.

Genitourin Med, 1988 Jun, 64(3), 152 - 5
Serovars, auxotypes, and plasmid profiles of PPNG strains with Asian type plasmid isolated in Amsterdam; Ansink-Schipper MC et al.; In 1982 an increase of penicillinase producing strains of Neisseria gonorrhoeae (PPNG), carrying the 4.5 megadalton Asian type plasmid and the 24 megadalton transfer plasmid (Asia+), was observed in Amsterdam . The main auxotypes were proline requiring (Pro-) and proline and hypoxanthine requiring (Pro-Hyx-) . Using two monoclonal antibody systems, it was shown that the serovars of strains with these auxotypes isolated in 1981 were different from those isolated in 1982, which indicated the start and end of microepidemics . Different serovars were also observed in Pro- and non-requiring (NR) Asia- PPNG strains isolated in 1981-2 and 1985 respectively . Only one serovar (Aedih/Arst) was common in strains isolated in 1981-2 as well as in 1985.

Genitourin Med, 1988 Jun, 64(3), 147 - 51
Penicillin sensitivity of gonococci isolated in Australia, 1981-6 . Australian Gonococcal Surveillance Programme; Myopericarditis with cardiac tamponade caused by Neisseria meningitidis serogroup W135; Department of Clinical Microbiology, Aalborg Hospital, DenmarkA case of primary myopericarditis in a previously healthy 19-year-old man is described . The patient presented with chest pain, fever, dyspnoea and arthalgia . Cardiac tamponade developed on the fifth day with recurrence on the seventh day, while meningitis never developed . Blood cultures grew Neisseria meningitidis serogroup W135 . The patient was treated with penicillin, pericardiocentesis and prednisone . He recovered without sequelae.

J Clin Microbiol, 1988 Jun, 26(6), 1227 - 8
Rapid identification of Branhamella catarrhalis with 4-methylumbelliferyl butyrate; Vaneechoutte M et al.; Branhamella catarrhalis can be distinguished from Neisseria spp . by the presence of butyrate esterase . This enzyme can be rapidly detected when 4-methylumbelliferyl butyrate is used as the substrate . All B . catarrhalis strains tested gave a positive fluorescence reaction within 5 min, while Neisseria spp . remained negative, even after 18 h of incubation.

Infect Immun, 1988 Jun, 56(6), 1661 - 4
Immunogenicity of liposomes and iscoms containing the major outer membrane protein of Neisseria gonorrhoeae: influence of protein content and liposomal bilayer composition; Kersten GF et al.; The influences of Neisseria gonorrhoeae protein IB content and bilayer composition of liposomes and protein content of iscoms on immunogenicity were investigated . Changes in the protein content of liposomes did not influence the immunoglobulin G response, whereas the response was lowered when the amount of protein in iscoms was increased . Bilayer composition only influenced the primary immunoglobulin G response; immunological memory was not affected.

Infect Immun, 1988 Jun, 56(6), 1625 - 32
Model for invasion of human tissue culture cells by Neisseria gonorrhoeae; Shaw JH et al.; A tissue culture model has been developed for studying the ability of Neisseria gonorrhoeae to invade eucaryotic cells . The cell line HecIB, a human adenocarcinoma endometrial cell line, was found to support gonococcal invasion . The bactericidal antibiotic gentamicin was used to kill those bacteria that had not entered the HecIB cells, allowing us to quantitate internalized bacteria . Kinetic studies showed an increase in the titer of gentamicin-protected gonococci at 4 h postinfection followed by a decrease; a second increase occurred after 6 h . The state of piliation did not affect the degree of invasion when the bacteria were spun down onto the monolayer . Gonococcal invasion was inhibited when the HecIB cells were preincubated with cytochalasin D before bacterial infection . N . lactamica was used as a negative control . No internalized N . lactamica cells were observed by electron microscopy . Electron microscopy documented the intracellular location of the gonococci in HecIB cells and the eventual destruction of the invaded HecIB cells . After 24 h, clusters of gonococci encased in a matrix of cell debris were observed.

Infect Immun, 1988 Jun, 56(6), 1574 - 9
Gonococci possessing only certain P.II outer membrane proteins interact with human neutrophils; Fischer SH et al.; We investigated the role of the protein II (P.II) family of gonococcal outer membrane proteins in the interaction of seven single P.II variants of Neisseria gonorrhoeae FA1090 with human neutrophils in vitro . The abilities of nonpiliated gonococci to adhere to and be killed by neutrophils and to stimulate luminol-dependent chemiluminescence (CL) depended on the possession of at least one P.II . Gonococci lacking P.II (i.e., P.II-) adhered poorly to and were not killed by neutrophils and induced only minimal CL . Although most P.II-containing (i.e., P.II+) variants adhered to, stimulated, and were readily killed by neutrophils, one variant, containing P.IIa, possessed none of these characteristics; it acted just like a P.II- variant . No correlation was found between the colony opacity phenotype and the interaction of gonococci with neutrophils . Data from CL experiments suggest that the stimulatory effect of P.II was dominant over that of pili; i.e., piliated P.II+ gonococci were much more stimulatory than piliated P.II- gonococci . The results indicate that most but not all P.II proteins mediate, in part or in full, the interaction of N . gonorrhoeae with human neutrophils, including adherence, stimulation of the neutrophil respiratory burst, and phagocytic killing.

Pathol Biol (Paris), 1988 Jun, 36(5 Pt 2), 643 - 6
{Tetracycline resistance and beta-lactamase production in pharyngeal commensal Neisseria}; Prere MF et al.; Commensal Neisseria may constitute a potential source of resistance genes transferable to pathogenic Neisseria . We tested 150 strains of commensal Neisseria isolated from throat cultures for resistance to tetracycline and beta-lactamase production . Seven strains were high level tetracycline resistant (MIC greater than 16 mg/ml), and minocycline resistant . Only one strain carries a 40 kilobases plasmid . Seven strains were tetracycline resistant (MIC = 8 or 16 mg/l) and minocycline susceptible . Three strains were beta-lactamase producers . These strains were identified as Neisseria perflava or Neisseria sica.

Int J Gynaecol Obstet, 1988 Jun, 26(3), 423 - 8
Infertility in Central Africa: infection is the cause; Collet M et al.; Determinants of infertility were studied in 340 women in Eastern Gabon, an area situated in the "infertility belt" of Central Africa . Fallopian tube occlusion was diagnosed in 82.8% of cases, showing the importance of infection-related causes . Women with tubal occlusion did not differ significantly from women with normal tubes in obstetrical history or prevalence of Neisseria gonorrhoeae or Chlamydia trachomatis on endocervical culture . Antecedents of pelvic inflammatory disease or a pelvic mass were significantly more common in the group with tubal occlusion . This group also had a significantly higher prevalence of serum chlamydial antibodies at a titer of 1/64 or higher . Hormonal factors were found in 31.7% of women, a cervical factor in 29.0% and mechanical factors in 5.6% . No diagnosis could be made in 12.2% of cases . During the investigation, 4.4% of women became pregnant . The predominance of infectious related causes of infertility makes it imperative to focus resources on prevention programs of upper genital tract infections in womenPIP: Determinants of infertility were studied in 340 women in Eastern Gabon, an area situated in the "infertility belt" of Central Africa . Fallopian tube occlusion was diagnosed in 82.8% of cases, showing the importance of infection-related causes . Women with tubal occlusion did not differ significantly from women with normal tubes in obstetrical history or prevalence of Neisseria gonorrhea or Chlamydia trachomatis on endocervical culture . Antecedents of pelvic inflammatory disease or a pelvic mass were significantly more common in the group with tubal occlusion . This group also had a significantly higher prevalence of serum chlamydial antibodies at a titer of 1/64 or higher . Hormonal factors were found in 31.7% of women, a cervical factor in 29.0% and mechanical factors in 5.6% . No diagnosis could be made in 12.2% of cases . During the investigation, 4.4% of women became pregnant . The predominance of infectious related causes of infertility makes it imperative to focus resources on prevention programs of upper genital tract infections in women . The study sample is from a small semi-urban center of 25,000 inhabitants and consisted of all women consulting for infertility at the gynecology department of the Franceville hospital from January 1983 until December 1984 .

Infect Immun, 1988 Jun, 56(6), 1602 - 7
Endotoxin-associated protein: a potent stimulus for human granulocytopoietic activity which may be accessory cell independent; Bjornson BH et al.; Proteins coextracted with endotoxin, termed endotoxin-associated protein (EAP), have been shown to exert interleukin 1-like activities . The present studies demonstrate that EAP also exerts potent granulopoietic colony-stimulating activity (CSA) on human peripheral blood and bone marrow progenitor cells, comparable to that seen with various types of conditioned media . The CSA observed with EAP appeared to be heat (100 degrees C, 30 min) and trypsin resistant and partially pronase resistant . Similar resistance was observed with the porin proteins of the outer membrane of gram-negative bacteria, and similar CSA activity was observed with a purified porin preparation of Neisseria gonorrhoeae . The CSA of EAP could be demonstrated in human peripheral blood and bone marrow leukocytes rigorously depleted of monocytes, T lymphocytes, and B lymphocytes by treatment with specific monoclonal antibodies and complement.

Nucleic Acids Res, 1988 May 25, 16(10), 4369 - 87
Sequence analysis of the NgoPII methyltransferase gene from Neisseria gonorrhoeae P9: homologies with other enzymes recognizing the sequence 5'-GGCC-3'; Sullivan KM et al.; Recombinant plasmids harbouring the functional M.NgoPII methyltransferase (specificity 5'-GGCC-3') were isolated from amplified gene libraries of gonococcal chromosomal DNA cloned in pBR322 and in Escherichia coli RR1 . The M.NgoPII gene was localized by sub-cloning and the nucleotide sequence of a cloned 1.6 kb segment of Neisseria gonorrhoeae DNA harbouring the methylase gene was determined . This data, coupled with sub-cloning experiments and in vitro transcription-translation studies, indicates a theoretical size of 38.5 kd for the methylase protein . The predicted amino acid sequence of the methylase contains significant regions of homology with the projected sequences of other cytosine-modifying methylases, upon which the activity of these enzymes is likely to depend.

Int J Pediatr Otorhinolaryngol, 1988 May, 15(2), 157 - 62
Microbial flora of surface versus core tonsillar cultures in recurrent tonsillitis in children; Almadori G et al.; Surface and 'core' tonsillar specimens were collected from 60 children, between 2 and 14 years of age, suffering from recurrent tonsillitis, in order to establish the reliability of surface tonsillar swabbing technique and to define the most frequently involved aerobic and anaerobic microorganisms . From the qualitative point of view, the same mixed aerobic and anaerobic flora were obtained in both samples thus demonstrating the reliability of the surface swabbing technique . From the quantitative point of view, 187 microorganisms, 129 (69.2%) aerobes and 58 (30.8%) anaerobes were isolated from surface cultures while 184, 109 (59.2%) aerobes and 75 (40.8%) anaerobes from the core cultures, thus demonstrating a greater number of anaerobes in the core of the tonsil . The most common isolated aerobic microorganisms were the alpha- and beta-hemolytic Streptococci, the Neisseriae and the Staphylococcus aureus; the predominant anaerobic ones were the Fusobacterium nucleatum, the Bacteroides sp . and the Veillonella parvula . The isolated staphylococcus aureus and the bacteroides sp . were all beta-lactamase producers.

Antimicrob Agents Chemother, 1988 May, 32(5), 773 - 4
Treatment of uncomplicated gonorrhea with single-dose imipenem-cilastatin; Verdon MS et al.; Single 500-mg intramuscular doses of imipenem-cilastatin cured 116 (95%) of 122 men and 9 of 9 women with uncomplicated gonorrhea due to beta-lactamase-negative Neisseria gonorrhoeae . Most co-existing Chlamydia trachomatis infections persisted . Imipenem-cilastatin is effective for uncomplicated gonorrhea in men but has no advantages over other available regimens.

J Clin Microbiol, 1988 May, 26(5), 896 - 900
Prevalence and persistence of Neisseria cinerea and other Neisseria spp . in adults; Knapp JS et al.; Neisseria cinerea is a commensal Neisseria sp . which was first described in 1906 but was subsequently misclassified as a subtype of Branhamella catarrhalis . N . cinerea resembles Neisseria gonorrhoeae in both cultural and biochemical characteristics and, thus, may also have been misidentified as N . gonorrhoeae . Of 202 patients whose oropharynges were colonized by Neisseria spp., N . cinerea was isolated in 57 (28.2%) patients, including 25 (30.1%) of 83 women, 22 (23.9%) of 92 heterosexual men, and 10 (37.0%) of 27 homosexual men in Seattle, Wash., in 1983 to 1984 . N . cinerea was isolated from the urethra of only one (1.1%) patient . The oropharynges of many individuals were colonized persistently by strains of N . cinerea and other Neisseria spp.

APMIS, 1988 May, 96(5), 428 - 32
Bacterial adherence to endothelial cells from rat heart, with special regard to alpha-hemolytic streptococci; Schollin J et al.; Endothelial cells were prepared from rat heart, and the ability of various bacterial species to adhere to these cells was investigated, with special regard to alpha-hemolytic streptococci . The endothelial cells were identified by morphology and by the presence of F VIII antigen . Seventeen bacterial strains representing various species were used in the in vitro adherence tests; 10 strains represented various strains of alpha-hemolytic streptococci, 5 of which were isolated from patients with infective endocarditis and 5 from the throats of healthy individuals; 2 were Neisseria meningitidis, 2 N . gonorrhoeae, 2 S . aureus and 1 E . coli . The highest adherence rate was found for alpha-hemolytic streptococci isolated from patients with infective endocarditis . The difference compared to carrier strains of alpha-hemolytic streptococci and to the other tested strains was statistically highly significant.

Urology, 1988 May, 31(5), 391 - 4
Gonococcal infections of penile prostheses; Nelson RP et al.; The first two known cases of Neisseria gonorrhoeae infection of a penile implant are reported . The literature regarding periprosthetic infections is reviewed, and the mode of transmission of the gonococcal organism to the corpora is discussed.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1988 May, 268(3), 318 - 24
Evaluation of three commercial systems for the identification of pathogenic Neisseria and Branhamella species against the conventional method; Durussel C et al.; We compared three commercial systems for the identification of Neisseria and Branhamella spp . with the conventional method using cystine-tryptic digest agar (CTA) supplemented with carbohydrates, DNase production, and nitrate reduction . We evaluated the API quadFerm+ {( API}, Analytab Products, Inc., Plainview, N.Y.), NEISSERIA {( Pasteur}, Diagnostics Pasteur, Marnes-la-Coquette, France), and Neisseria Identification Discs {( Oxoid}, Oxoid Ltd., Basingstoke, England) using the conventional method as a reference . One hundred and twenty-nine strains were included in this study . The conventional method identified 125 strains (96.9%) . Four strains of N . gonorrhoeae remained glucose-negative in the CTA media but gave positive reactions in the API system . API, Pasteur, and Oxoid identified 126 (97.7%), 124 (96.1%), and 62 strains (48.1%), respectively . API and Pasteur seem to be very useful systems for the differentiation of clinically significant species of Neisseria and Branhamella . API has the additional advantage of requiring only a 3 h incubation period.

Mol Gen Genet, 1988 May, 212(2), 215 - 8
pUB307 mobilizes resistance plasmids from Escherichia coli into Neisseria gonorrhoeae; Piffaretti JC et al.; The plasmid pUB307, a derivative of RP1, is a conjugative, broad-host-range plasmid . We have shown that this element mobilizes gonococcal resistance plasmids from Escherichia coli to Neisseria gonorrhoeae, thus providing evidence that extrachromosomal elements can efficiently enter gonococci by conjugation . Furthermore, pUB307 can also be used as a helper element to mobilize the cloning vector pLES2 into N . gonorrhoeae . This finding significantly increases the usefulness of pLES2 as a shuttle vector between E . coli and gonococcus.

J Antimicrob Chemother, 1988 May, 21(5), 571 - 9
Antibiotic resistance, plasmid content and auxotypes of Neisseria gonorrhoeae in Greece; Mavrommati L et al.; The antibiotic resistance pattern, the plasmid content and the auxotypes of 27 PPNG and 200 non-PPNG isolates obtained in 1984-1985 were examined . The well-known plasmid patterns, the most frequent was the combination of 4.5 and well-known plasmid patterns, the most frequent was the combination of 4.5 and 2.6 Mdal plasmids . The strains with the Asian-type (4.5 Mdal) plasmid belonged to the auxotypes Pro and Zero, whereas those with the African type (3.2 Mdal) plasmid were of auxotypes Zero, Arg and Pro, Arg . All PPNG strains exhibited reduced sensitivity at least to one of the other antibiotics tested (cefotaxime, spectinomycin, thiamphenicol, tetracycline) . Among non-PPNG strains, 19% harboured the conjugative and the cryptic plasmid, 67.5% only the cryptic, 1% only the conjugative and 12% were plasmid-free . The most frequent auxotypes of non-PPNG strains were Zero (65.5%) and Pro (21%), while the uncommon auxotype Pro, Arg degree, Ura was found only in plasmid-free strains with reduced sensitivity to penicillin . Susceptibility testing revealed a large number of non-PPNG strains with decreased sensitivity to antibiotics, the Pro and Zero isolates being less sensitive than those of other auxotypes.

Arch Pathol Lab Med, 1988 May, 112(5), 485 - 8
The identification and antimicrobial susceptibility testing of Neisseria gonorrhoeae, 1980-1987 . Results from the College of American Pathologists Microbiology Surveys Program; Jones RN et al.; The results of the College of American Pathologists (Skokie, III) Microbiology Surveys from 1980 through 1987 indicate subscriber laboratories have continued to improve their ability to identify and test the antimicrobial susceptibility of Neisseria gonorrhoeae . Bacteriology and Comprehensive Surveys participants correctly identified this organism more frequently (95% to 96%) than did the Basic Surveys Laboratories . Neisseria gonorrhoeae samples in mixed cultures were slightly more difficult (3% to 5% decreased accuracy) to identify . Antimicrobial susceptibility testing by the disk-diffusion and beta-lactamase tests were more accurate (98% to 99%) than minimum inhibitory concentration-dilution methods (92%) . Currently, most laboratories use the commercially prepared beta-lactamase reagents and the disk-diffusion test . The National Committee for Clinical Laboratory Standards is currently standardizing methods for the susceptibility testing of several antibiotics against gonococci . The College of American Pathologists Microbiology Surveys will continue to monitor participant accuracy for the identification and resistance recognition of this epidemiologically important pathogen.

Diagn Microbiol Infect Dis, 1988 May, 10(1), 49 - 55
Antimicrobial agent resistance in Neisseria gonorrhoeae in St . Paul Minnesota; Lally RT et al.; In a prospective survey of 283 Neisseria gonorrhoeae isolated in St . Paul, Minnesota, 5% were found to produce beta-lactamase, and 11% were resistant to penicillin by chromosomal mediation, thus indicating a hyperendemic level of resistance according to Centers for Disease Control guidelines . A significant level of chromosomal resistance (30%) was noted for tetracycline, and MICs for spectinomycin approached the upper limits of susceptibility for a large number of isolates . The need for uniformity in agar dilution test methodology is discussed, and the variability in antimicrobial agent interpretive breakpoint criteria is illustrated by comparing penicillin breakpoints published by the Centers for Disease Control with those of the National Committee for Clinical Laboratory Standards as applied to the study isolates.

Antimicrob Agents Chemother, 1988 May, 32(5), 775 - 6
Spectinomycin disk zone diameter as a predictor of outcome in clinical treatment of gonorrhea; McChesney DG et al.; The MICs for 41 Neisseria gonorrhoeae strains from patients receiving spectinomycin treatment were determined by the agar dilution method and compared with the zones of inhibition produced by disks containing 100 micrograms of spectinomycin . Our data demonstrated a good correlation between the two methods . Moreover, a zone of inhibition of less than or equal to 15 mm was a good predictor of clinical treatment failures with spectinomycin.

J Gen Microbiol, 1988 May, 134 ( Pt 5), 1289 - 97
Antibodies to the C epitope of Neisseria gonorrhoeae are present in patients with gonorrhoea and absent in normal sera; Demarco de Hormaeche R et al.; We have previously described a surface oligosaccharide antigen (epitope C) present in fresh isolates of Neisseria gonorrhoeae and in variants grown in subcutaneous chambers, but poorly formed by variants repeatedly subcultured in vitro . We have now investigated the presence of antibodies to epitope C in sera from normal individuals and from patients with gonorrhoea . Sera were analysed by Western blotting and ELISA, and compared with a pool of sera from normal individuals with no known history of gonorrhoea . Antigenic extracts and monoclonal antibody to the C epitope were used for competition and inhibition studies . Only the sera from patients contained antibodies to epitope C . Antibodies to several other gonococcal antigens were found in sera from patients, and also in normal sera . Collectively, the results indicate that epitope C is expressed in humans, that patients with gonorrhoea develop antibodies to it, and that such antibodies are absent in sera of normal individuals.

Z Hautkr, 1988 Apr 15, 63(4), 326 - 30
{Urogenital chlamydial infections: significance and diagnosis}; Krech T; Chlamydia are common agents of sexually transmitted diseases and in this country more frequent than Neisseria gonorrhoeae . Approximately 10% of all infections with chlamydia trachomatis are followed by complications, which can lead to infertility and other sequelae . Therefore, early recognition of the infection and subsequent effective therapy are important . The dermatologist is often the first physician consulted and the outcome of the infection may depend on his diagnostic and therapeutic measures . The experienced microbiologist can provide an etiologic diagnosis . For this, isolation of Chlamydia trachomatis in optimally performed tissue culture still is the most sensitive and specific method . Currently available commercial IF- and ELISA-tests for direct detection of the agent in secretions are less sensitive and less specific.

Antimicrob Agents Chemother, 1988 Apr, 32(4), 426 - 9
Randomized comparative study of 0.5 and 1 g of cefodizime (HR 221) versus 1 g of cefotaxime for acute uncomplicated urogenital gonorrhea; van der Willigen AH et al.; Uncomplicated urogenital and concomitant oropharyngeal gonorrhea in 424 male and female patients was treated in a randomized comparative study with 0.5 g of cefodizime (89 men and 54 women), 1 g of cefodizime (87 men and 52 women), or 1 g of cefotaxime (86 men and 56 women) . The cure rates were 100% for men and women in the group given 0.5 g of cefodizime, 100% for men and women in the group given 1 g of cefodizime, and 99% for men and 100% for women in the group given 1 g of cefotaxime . The MICs of cefodizime and cefotaxime for the isolate of Neisseria gonorrhoeae ranged from 0.004 to 0.06 micrograms/ml . Chlamydia trachomatis was isolated before treatment in 15% and after treatment in 13% of all patients . Side effects, such as nausea, diarrhea, abdominal pain, genital candidiasis, and pain at the site of injection, developed in 4% of the patients given cefodizime . Side effects, such as vertigo, genital candidiasis, fatigability, and diarrhea, developed in 4% of the patients treated with cefotaxime . In both groups of patients, the side effects were mild and transient . Cefodizime and cefotaxime are safe and effective agents in the treatment of uncomplicated urogenital gonorrhea.

Obstet Gynecol, 1988 Apr, 71(4), 595 - 600
Outpatient treatment of pelvic inflammatory disease with cefoxitin and doxycycline; Wolner-Hanssen P et al.; Sixty-three women with abdominal pain and adnexal tenderness were enrolled in a study of ambulatory treatment of acute pelvic inflammatory disease . Treatment consisted of 2 g of cefoxitin intramuscularly and 1 g of probenecid orally, followed by doxycycline, 100 mg by mouth twice daily for 14 days . Patients were stratified into groups indicating whether pelvic inflammatory disease was probable, possible, or unlikely, based upon endometrial biopsy and clinical criteria . Among 52 women who were evaluated, Chlamydia trachomatis and/or Neisseria gonorrhoeae were initially recovered from 16 (67%) of 24 with probable pelvic inflammatory disease, three (33%) of 11 with possible pelvic inflammatory disease, and three (18%) of 17 in whom pelvic inflammatory disease was considered unlikely . Of the 24 patients with probable pelvic inflammatory disease, 22 (92%) were clinically cured or improved . Of 22 patients initially infected with C trachomatis and/or N gonorrhoeae, 20 were culture-negative for both organisms after therapy . Both microbiologic failures had been reexposed . This study suggests that the combination of cefoxitin and doxycycline is effective for ambulatory treatment of pelvic inflammatory disease.

APMIS, 1988 Apr, 96(4), 289 - 93
Blood-monocyte functions in acute bacterial meningitis; Nielsen H et al.; The blood-monocyte chemotactic, phagocytic and microbicidal activities were studied in 20 patients with acute bacterial meningitis . The cell functions were measured on admission, during treatment and after clinical recovery . In general, monocyte functions were within normal range on admission . However, in 2/2 patients with Neisseria meningitidis meningitis, complicated by disseminated intravascular coagulation, defective chemotaxis was observed . Other patients had normal or enhanced monocyte chemotaxis . Two patients died: one had normal monocyte functions, one had initially defective chemotaxis and microbicidal activity . During treatment, cell functions normalized and after recovery all but one patient had a normal blood-monocyte function profile . In conclusion, acute bacterial meningitis is not due to, or followed by, abnormal nonspecific functions of blood monocytes . However, development of disseminated intravascular coagulation is associated with depressed chemotactic responsiveness.

Microb Pathog, 1988 Apr, 4(4), 289 - 97
Gonococcal variants selected by growth in vivo or in vitro have antigenically different LPS; Demarco de Hormaeche R et al.; Lipopolysaccharide (LPS) was extracted from two variants of strain gc40 of Neisseria gonorrhoeae obtained by repeated subculture in vitro or by growth in vivo in a subcutaneous chamber . Sodium dodecyl sulphate-polyacrylamide gel electrophoresis followed by silver stain analysis revealed that both variants had three main LPS components, but the large size components were predominant in gonococci selected in vivo and the smallest size in those selected in vitro . Western blotting, ELISA and ELISA inhibition using monoclonal and polyclonal antibodies showed that the two variants had antigenically different LPS and that serum sensitivity may be due to the antigenic specificity of the large components . These results indicate that during infection clones of gonococci are selected with LPS of antigenic and physicochemical composition different from those seen after repeated subcultures.

J Gen Microbiol, 1988 Apr, 134 ( Pt 4), 1005 - 8
The production and characterization of monoclonal antibodies against the protein III of Neisseria gonorrhoeae; Copley CG et al.; Monoclonal antibodies were produced against gonococcal protein III . Antibodies of two different specificities were obtained . One reacted with all Neisseria species tested (N . gonorrhoeae, N . meningitidis and five non-pathogenic species), whereas the other was specific for Neisseria gonorrhoeae and may provide the basis for improved diagnostic reagents.

Sex Transm Dis, 1988 Apr-Jun, 15(2), 78 - 84
Value of the gram-stained urethral smear in the management of men with urethritis; Landis SJ et al.; The value of the gram-stained urethral smear in clinical decision-making was assessed in a study of 250 men attending a clinic for sexually transmitted diseases . Of the 250 men, 132 (52.8%) had objective evidence of urethritis . Neisseria gonorrhoeae and/or Chlamydia trachomatis was isolated from 94 patients (37.6%) . No pathogens were isolated from 38 patients (15.2%) who were diagnosed as having urethritis . Although the specificity (0.95) and positive predictive value (0.95) of the gram smear for culture-proved urethral infection was high, the relatively low sensitivity (0.66) and negative predictive value (0.63), led us to conclude that the test was of limited value in diagnosis and therapeutic decision-making when the patient was first seen . The decision to treat a patient should be based on a reliable history of dysuria and/or a urethral discharge in a patient at risk of infection, with or without an observable urethral discharge . Nevertheless, a gram smear should be done for all patients who are diagnosed presumptively as having urethritis, because it may be the only objective evidence of urethritis.

Sex Transm Dis, 1988 Apr-Jun, 15(2), 110 - 3
Lower genital tract infections in women: comparison of clinical and epidemiologic findings with microbiology; Lefevre JC et al.; We screened 392 women attending the Laboratory of Microbiology of Toulouse Purpan Hospital for symptoms of lower genital tract infection for six microorganisms . Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Candida albicans, Mycoplasma hominis, and Gardnerella vaginalis were 1%, 7.7%, 29.8%, 23.8%, and 37.5%, respectively . Trichomonas vaginalis was detected by direct examination in specimens from 3.1% of patients . Another goal of this study was to determine the relative prevalence of these microorganisms in relation to clinical and epidemiologic findings . C . trachomatis was isolated significantly more often from patients under 25 year old (P less than 0.001), from those who use oral contraceptives (P less than 0.01), from those who have a male sexual partner with symptoms of sexually transmitted disease (P less than 0.001), and from those who present signs of cervicitis (P less than 0.05) . Isolation of C . albicans was significantly associated with vulvar pruritis (P less than 0.01), vulvitis (P less than 0.01), and vaginitis (P less than 0.001) . G . vaginalis and M . hominis are significantly associated with bacterial vaginosis (P less than 0.001) . This syndrome was diagnosed clinically in 27.2% of our study population and was highly correlated with use of an intrauterine device (P less than 0.05).

Sex Transm Dis, 1988 Apr-Jun, 15(2), 108 - 9
Management of gonococcal ophthalmia neonatorum with single-dose kanamycin and ocular irrigation with saline; Latif A et al.; Two hundred nineteen neonates with gonococcal ophthalmia neonatorum, including 40 infected with penicillinase-producing strains, were treated as outpatients with a single intramuscular injection of 100 mg of kanamycin and hourly ocular irrigation with saline . Neisseria gonorrhoeae was isolated from three (1.4%) of the 212 babies attending for follow-up, and post-gonococcal conjunctivitis developed in 22 (10.4%) of those who returned for follow-up.

Sex Transm Dis, 1988 Apr-Jun, 15(2), 103 - 7
Correlation of ultrasonography and bacteriology of the endocervix and posterior cul-de-sac of patients with severe pelvic inflammatory disease; Kirshon B et al.; We evaluated 30 patients admitted with a diagnosis of pelvic inflammatory disease (PID) by culdocentesis and ultrasonography to determine the severity of disease in relation to endocervical and culdocentesis bacteriology . Specimens from the endocervix were cultured for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum . In addition, culdocentesis fluid was cultured for aerobes and anaerobes . Patients with N . gonorrhoeae or C . trachomatis had significantly milder disease (P less than 0.05) compared with patients whose specimens were negative for those organisms . Furthermore, those patients with ultrasound confirmation of a tubo-ovarian complex had significantly (P less than 0.0001) greater recovery of aerobes and anaerobes from culdocentesis fluid than did patients with milder disease.

Eur J Clin Microbiol Infect Dis, 1988 Apr, 7(2), 175 - 6
Pulmonary cavitation due to Neisseria mucosa in a child with chronic neutropenia; Hussain Z et al.; A case of spontaneous pulmonary abscess with cavitation caused by Neisseria mucosa in a chronically neutropenic child is reported . Neisseria mucosa was isolated as the sole pathogen from a percutaneous needle aspirate . It appears that the clinical course of the pulmonary lesion was indolent . Interestingly, a gallium scan was diagnostic for pulmonary abscess even though the child was neutropenic.

APMIS, 1988 Apr, 96(4), 325 - 8
Multilocus genotypes of two strains of Neisseria meningitidis and their presumed variants obtained upon subcultivation; Caugant DA et al.; Loss of sulfonamide resistance and endotoxin liberation have been described in two strains of Neisseria meningitidis serogroup B, upon subcultivation every 1 to 2 months over an 18-month period . Subsequently, the two laboratory variants, designated 270E- and 840E-, were also found to differ from the parent strains, 270E+ and 840E+, in serotype, outer membrane protein pattern, and virulence in mice . We report here the multilocus genotypes determined by enzyme electrophoresis, of the four isolates 270E+, 270E-, 840E+, and 840E-, and demonstrate that 270E- and 840E- strains could not have originated from subcultivation of 270E+ and 840E+, respectively, but that a mix-up of strains has occurred.

J Clin Pathol, 1988 Apr, 41(4), 462 - 4
Evaluation of a rapid method for identifying Branhamella catarrhalis; Richards J; The speed and precision of hydrolysis of tributyrin to butyric acid as a test to detect Branhamella catarrhalis were evaluated . The test proved consistently reliable in the identification of strains and correctly differentiated B catarrhalis from Neisseria sp . The combination of Gram stain, oxidase, and catalase tests to tributyrin hydrolysis provides a means of positive same day identification of B catarrhalis.

J Bacteriol, 1988 Apr, 170(4), 1866 - 73
Purification, characterization, and comparison of the immunoglobulin A1 proteases of Neisseria gonorrhoeae; Simpson DA et al.; Each isolate of Neisseria gonorrhoeae produces one of two distinct immunoglobulin A1 (IgA1) proteases, type 1 or type 2, which are known to possess different cleavage specificities for peptide bonds in the hinge region of human IgA1 . Both proteases were secreted into the culture medium throughout exponential growth; however, the activity level of the type 2 protease was 10-fold that observed for the type 1 enzyme . The type 2 protease was quite stable and resistant to a variety of inhibitors . In contrast, the type 1 enzyme was highly unstable and inhibited by low concentrations of metal chelators, salts, and thiol- or serine-specific chemical reagents . Both types of gonococcal IgA1 protease were purified from broth culture supernatants by a combination of anion-exchange, chromatofocusing, and molecular sieve chromatography techniques . The stable type 2 enzyme comprised a 114-kilodalton (kDa) peptide which converted to a still active 109-kDa peptide during isolation . In contrast, the type 1 protease possessed a 112-kDa peptide which did not convert to a smaller form and which could not be dissociated from peptides of 34 and 31 kDa without complete loss of enzyme activity.

Infect Immun, 1988 Apr, 56(4), 942 - 6
Instability of expression of lipooligosaccharides and their epitopes in Neisseria gonorrhoeae; Schneider H et al.; We assessed variation in the expression of lipooligosaccharide (LOS) components and their epitopes within populations of a strain of Neisseria gonorrhoeae by using the monoclonal antibodies (MAbs) O6B4 and 3F11 and immunoenzymatic, immuno-colloidal gold electron microscopic, and sodium dodecyl sulfate-polyacrylamide gel electrophoretic procedures . Wild-type organisms varied in binding of both MAbs . We used the intensity of immunoenzymatic colony blot color to distinguish four binding variants for each MAb: red (R), pink (P), and colorless (nonreactive {N}) and an N back to R (N-R) revertant . R to P to R and R to N to R variation occurred at frequencies of 0.2% and 0.02%, respectively . The electrophoretic LOS profiles and MAb immunoblot patterns of the R, P, and N-R variants were the same as those of the wild type . LOSs of the N variants, in contrast, were of lower Mr, bound neither 3F11 nor O6B4 MAb, and contained as their major component the 3.6-kilodalton LOS that bears the L8LOS epitope of N . meningitidis . Results of immunoelectron microscopic studies were consistent with LOS binding patterns . Large number of colloidal gold particles were deposited about both R and P variants, distally from R organisms, but proximally from P organisms . N variant organisms, like their LOS, bound neither of the MAbs . N-R variant organisms were like the wild type in that they showed much variation in the amounts of MAb they bound.

Infect Immun, 1988 Apr, 56(4), 808 - 14
Multiple protein differences exist between Neisseria gonorrhoeae type 1 and type 4; Klimpel KW et al.; Neisseria gonorrhoeae undergoes a spontaneous conversion from a form which is virulent, competent for DNA-mediated transformation, and piliated (type 1) to a form which is avirulent and neither piliated nor competent (type 4) . This phase variation has become thought of as simply a conversion from piliated to nonpiliated . Using the techniques of cell fractionation, two-dimensional electrophoresis, and nonequilibrium pH gradient gel electrophoresis, we identified differences in the expression levels of multiple proteins between type 1 and type 4 cells . A total of 26 type 1-specific (T1S) and 23 type 4-specific (T4S) cytoplasmic or cytoplasmic membrane proteins were identified in O'Farrell two-dimensional gels . Using nonequilibrium pH gradient gel electrophoresis, we detected a minimum of eight T1S outer membrane proteins and four T4S outer membrane proteins which were not detected in the O'Farrell gels . Thus, the conversion from type 1 to type 4 is a complex event involving many different proteins of all cellular locations.

Infect Immun, 1988 Apr, 56(4), 762 - 5
Use of transformation to construct Neisseria gonorrhoeae strains with altered lipooligosaccharides; Stein DC et al.; DNA isolated from a nalidixic acid- and rifampin-resistant derivative of Neisseria gonorrhoeae serum-resistant strain 302 (MUG116), a strain that reacts with monoclonal antibody (MAb) 2-1-L8, was used to transform N . gonorrhoeae DOV, a serum-sensitive strain, to antibiotic resistance and/or reactivity with the MAb . MAb 2-1-L8 binds to a 3.6-kilodalton lipooligosaccharide (LOS) . Reactivity with MAb 2-1-L8 transformed as a single marker and was unlinked to either of the antibiotic resistance markers . Immunoblot analysis of LOSs separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that new LOSs were synthesized in the transformed cells and that these LOSs corresponded to those of the DNA donor . Although multiple LOS components were made by the transformants, the MAb recognized only one . All transformants that were selected for on the basis of strong reactivity with MAb 2-1-L8 were serum resistant; however, the level of resistance correlated with the apparent loss of recipient LOS components . MAb 2-1-L8-reactive transformants that still produced DOV LOS components remained serum sensitive.

Infect Immun, 1988 Apr, 56(4), 1003 - 6
Immunoelectron microscopic localization of outer membrane proteins II on the surface of Neisseria gonorrhoeae; Robinson EN Jr et al.; To determine the ultrastructural distribution and immunological accessibility of proteins II (P.IIs) on the surfaces of whole gonococci, anti-P.II gold probes were developed and used in electron microscopic studies of viable P.II-expressing variants of Neisseria gonorrhoeae FA1090 . Anti-P.II probes clearly marked the surfaces of organisms and their associated outer membrane blebs . The surface-exposed portion of P.II is antigenically variable . With the use of two different sizes of gold probes, it was demonstrated that individual gonococcal cells can express more than one antigenic type of P.II simultaneously.

Sex Transm Dis, 1988 Apr-Jun, 15(2), 73 - 7
Comparison of cefpimizole with cefotaxime and penicillin G for treatment of uncomplicated gonorrhea; Raad II et al.; One hundred sixteen patients (92 men and 24 women) with suspected uncomplicated gonorrhea were randomized in a double-blind manner to receive intramuscular treatment with 1.0 g of cefpimizole, 1.0 g of cefotaxime, or 4.8 x 10(6) units of aqueous procaine penicillin G (APPG) with 1 g of oral probenecid . Seventeen percent were nonassessable (cultures negative, co-existing syphilis, etc.) . Infection sites in 96 assessable patients were urethra (78), cervix (17), pharynx (two), and rectum (two) . Of 52 patients treated with cefpimizole, 46 (88%) were bacteriologically cured, as compared with 100% (24 of 24) treated with APPG (P = 0.18) and 90% (18 of 20) treated with cefotaxime (P greater than 0.20) . On a weight basis the in-vitro activity of cefpimizole against Neisseria gonorrhoeae was similar to that of APPG . Pain at the injection site was reported by 52% of patients treated with cefpimizole as compared with 27% of those given cefotaxime (P = 0.008) and 17% of those given APPG (P = 0.002) . No major organ toxicity was found with cefpimizole, cefotaxime, or APPG . Thus, for acute uncomplicated gonorrhea cefpimizole is similar in efficacy to cefotaxime and APPG but has a higher frequency of pain at the injection site.

J Antimicrob Chemother, 1988 Apr, 21(4), 413 - 6
Serogroup specificity and antimicrobial susceptibilities of Neisseria gonorrhoeae isolated in Mexico City; Conde-Glez CJ et al.; The serogroup pattern of 87 clinical isolates of Neisseria gonorrhoeae was determined by monoclonal coagglutination and the in-vitro activity of seven antimicrobial agents against the same strains was tested by an agar dilution method . The frequency of resistance to spectinomycin, ampicillin, penicillin, erythromycin, chloramphenicol and tetracycline was 14.9%, 33.3%, 34.4%, 30%, 40.2% and 41.3%, respectively . All strains were susceptible to cefotaxime . Out of 87 strains tested, 29.8% produced beta-lactamases and 4.5% were chromosomally resistant to penicillin . In all instances resistance to a drug was associated with serogroup 1-B except for erythromycin . The results presented here correlate with observations made worldwide.

Vaccine, 1988 Apr, 6(2), 107 - 9
Alternative model for Neisseria gonorrhoeae pilin variation; Seifert HS et al.; The pilus of Neisseria gonorrhoeae, a dominant outer membrane organelle, is a major virulence factor . The pilus undergoes phase variation and antigenic variation has also been observed, both in vitro and in vivo . The current model of pilus variation invokes a gene conversion type recombination between a silent pilin locus and the pilin expression site . Experimental results which led to the creation of this hypothesis are reviewed and data are presented which support an alternative model based on DNA transformation.

Infect Immun, 1988 Apr, 56(4), 773 - 8
Purification and characterization of H.8 antigen from group B Neisseria meningitidis; Bhattacharjee AK et al.; The surface antigen (H.8) common to the pathogenic Neisseria species was purified by a simple procedure by use of high-performance liquid chromatography . The purified H.8 antigen was characterized as to its amino acid composition, susceptibilities to several proteolytic enzymes, isoelectric point, and susceptibilities to an acid and a base . The amino acid composition of purified H.8 antigen from two strains of Neisseria meningitidis group B, namely, 44/76 and 8047, were compared . It was found that glutamic acid, alanine, and proline accounted for about 80% of the total amino acids in each case . A preliminary analysis of the lipid content of this protein was made . It showed the presence of a lipid component that moves between C9 and C11 straight-chain fatty acids in the gas chromatograph . Limited amino acid sequence data were obtained by sequencing a fragment of the H.8 antigen that was isolated after partial acid hydrolysis . The H.8 antigen epitope was found to be labile to treatment with both a mild acid and a mild base.

N Engl J Med, 1988 Mar 17, 318(11), 653 - 7
Prophylaxis of gonococcal and chlamydial ophthalmia neonatorum . A comparison of silver nitrate and tetracycline; Laga M et al.; We evaluated the use of silver nitrate drops and tetracycline ointment for the prophylaxis of ophthalmia neonatorum in a controlled trial involving 2732 newborns in Nairobi, Kenya . The overall rates of prevalence of intrapartum maternal gonococcal and chlamydial infection were 6.4 and 8.9 percent, respectively . After prophylaxis with silver nitrate, the incidence rates of gonococcal, chlamydial, and nongonococcal, nonchlamydial ophthalmia neonatorum were 0.4, 0.7, and 6.2 percent, respectively, whereas after prophylaxis with tetracycline, the rates were 0.1, 0.5, and 4.5 percent . The attack rates of gonococcal ophthalmia neonatorum in newborns exposed to Neisseria gonorrhoeae at birth were 7.0 percent in those receiving silver nitrate and 3.0 percent in those receiving tetracycline (95 percent confidence interval for the difference in rates, -3.4 to 11.4 percent) . As compared with historical controls, the incidence of gonococcal ophthalmia neonatorum decreased 83 percent among infants treated with silver nitrate and 93 percent among those treated with tetracycline . Failure of prophylaxis was associated with postpartum maternal endometritis (P = 0.05) . Among newborns exposed to maternal infection with Chlamydia trachomatis, chlamydial conjunctivitis developed in 10.1 percent given silver nitrate and in 7.2 percent given tetracycline (95 percent confidence interval for the difference in rates, -4.7 to 10.5 percent), yielding reductions in the incidence of chlamydial ophthalmia of 68 and 77 percent, respectively, as compared with the historical controls . We conclude that tetracycline is as effective as silver nitrate in preventing gonococcal ophthalmia neonatorum.

Nature, 1988 Mar 10, 332(6160), 173 - 6
Hybrid penicillin-binding proteins in penicillin-resistant strains of Neisseria gonorrhoeae; Spratt BG; Benzylpenicillin has been used extensively for approximately 40 years in the treatment of gonorrhoea . The intense selective pressures resulting from the continual exposure of Neisseria gonorrhoeae to penicillin have resulted in the emergence of resistant strains that produce altered forms of penicillin-binding proteins (PBPs) with decreased affinity for the antibiotic . A comparison of the sequences of the PBP-2 genes from penicillin-sensitive and penicillin-resistant strains, suggests that penicillin-resistant forms of PBP 2 may have arisen both by amino-acid substitutions and insertions, and by the exchange of a region encoding part of the penicillin-sensitive transpeptidase domain with the homologous region from a closely related species.

J Antibiot (Tokyo), 1988 Mar, 41(3), 308 - 15
Structure and biological activity of lipiarmycin B; Cavalleri B et al.; Actinoplanes deccanensis ATCC 21983, the producer of antibiotics lipiarmycin A3 and A4, furnished also a related antibiotic designated lipiarmycin B, active against Gram-positive bacteria, including anaerobes, and against Neisseria . The structures of the two major components, B3 and B4, were elucidated from their physico-chemical properties, 1H and 13C NMR spectra and fast atom bombardment mass spectra data in comparison with lipiarmycins A3 and A4.

Am J Obstet Gynecol, 1988 Mar, 158(3 Pt 1), 577 - 9
Ambulatory treatment of suspected pelvic inflammatory disease with Augmentin, with or without doxycycline; Wolner-Hanssen P et al.; Sixty-three women with suspected pelvic inflammatory disease were treated as outpatients with Augmentin with or without doxycycline . Initially, doxycycline was added only after a direct test for Chlamydia trachomatis was positive . Because chlamydial infections were frequent, all patients received doxycycline during the last two thirds of the study . Neisseria gonorrhoeae or Chlamydia trachomatis were recovered from 15 (65%) of 23 women classified as probably having pelvic inflammatory disease . Among 47 women reexamined after starting therapy, three rapidly became worse and were hospitalized, nine (20%) discontinued therapy because of gastrointestinal side effects, and all of the remaining 35 women who completed therapy were either cured or improved.

Rev Infect Dis, 1988 Mar-Apr, 10(2), 239 - 49
Prostatic abscess in the antibiotic era; Weinberger M et al.; The clinical and bacteriologic features of 269 cases of prostatic abscess (PA) reported during the last 40 years were reviewed . In the pre-antibiotic era, PA not uncommonly had a dramatic presentation and frequently was caused by Neisseria gonorrhoeae . Currently, PA may be difficult to differentiate from prostatitis and other diseases of the lower urogenital tract . Prostatic enlargement is found in 75% of cases, whereas fever and urinary retention each occur in only one-third of cases . The organisms most frequently isolated from PA are Escherichia coli and other gram-negative bacilli; other isolates include Staphylococcus species and an expanding spectrum of bacteria and fungi . PA due to Staphylococcus species may also occur in neonates . Transrectal ultrasonography and computerized tomography are valuable methods for the preoperative diagnosis of PA . Although transurethral resection of the prostate is the most commonly used therapy for PA, transperineal aspiration of pus guided by transrectal ultrasonography appears to be promising.

Drug Intell Clin Pharm, 1988 Mar, 22(3), 192 - 7
Bacterial vaccines for splenectomized patients; Kafidi KT et al.; The spleen is an important organ in the defense of the body against pathogenic bacteria . Major functions of the spleen include antibody production and mechanical filtration of blood . Anatomically or functionally asplenic individuals are at increased risk of fulminant infection by encapsulated bacteria, particularly Streptococcus pneumoniae, Hemophilus influenzae, and Neisseria meningitidis . Polysaccharide vaccines are available against some strains of these pathogenic bacteria . More data are required to define specific age and risk groups . A search for better and more immunogenic vaccines, which may prove effective in a wider variety of patients, is currently under way . Although the current vaccines are not always effective and future revaccination may increase the incidence of adverse effects, most asplenic persons should receive the currently available vaccines to minimize their risk of life-threatening infection.

Am J Obstet Gynecol, 1988 Mar, 158(3 Pt 2), 736 - 41
Treatment of hospitalized patients with acute pelvic inflammatory disease: comparison of cefotetan plus doxycycline and cefoxitin plus doxycycline; Sweet RL et al.; Acute pelvic inflammatory disease remains the major medical and economic consequence of sexually transmitted diseases among young women . The polymicrobial origins of pelvic inflammatory disease have been well documented and the major organisms recovered from the upper genital tract in patients with pelvic inflammatory disease include Chlamydia trachomatis, Neisseria gonorrhoeae, and mixed anaerobic and aerobic bacteria . This study was undertaken to compare the efficacy and safety of cefotetan plus doxycycline with that of cefoxitin plus doxycycline in the treatment of hospitalized patients with acute pelvic inflammatory disease . A total of 68 hospitalized patients with acute pelvic inflammatory disease were entered and randomized into two treatment groups: cefotetan (n = 32) and cefoxitin (n = 36) . There were six tuboovarian abscesses in each group . C . trachomatis was recovered from 7 (10%) and N . gonorrhoeae from 48 (71%) of the patients . Anaerobic and aerobic bacteria were recovered from the upper genital tract in 53 (78%) of the patients . Cefotetan plus doxycycline and cefoxitin plus doxycycline demonstrated high rates of initial clinical response in the treatment of acute pelvic inflammatory disease . Clinical cure was noted in 30 (94%) of the cefotetan plus doxycycline group and 33 (92%) of the cefoxitin plus doxycycline group . Four failures were sonographically diagnosed tuboovarian abscesses that responded to clindamycin plus gentamicin therapy . The fifth failure was an uncomplicated case that did not respond to cefoxitin and doxycycline and required additional therapy . At 1 week and 3 weeks, respectively, the posttreatment cultures demonstrated eradication, in all instances, of N . gonorrhoeae and C . trachomatis . These regimens also were very effective in eradicating anaerobic and aerobic pathogens from the endometrial cavity . Both regimens were well tolerated by the patients, and few adverse drug affects were noted.

Am J Obstet Gynecol, 1988 Mar, 158(3 Pt 2), 717 - 21
Results of noncomparative studies of cefotetan in the treatment of obstetric and gynecologic infections; Poindexter AN et al.; In a multicenter trial involving 11 centers, 160 women were enrolled to evaluate the safety and effectiveness of 1 or 2 gm of cefotetan administered every 12 hours in the treatment of obstetric and gynecologic infections . The 133 evaluable patients generally were under 25 years of age, were nonwhite, and had hospital-acquired endometritis or pelvic inflammatory disease caused by both aerobic and anaerobic bacteria . Escherichia coli, Neisseria gonorrhoeae, group D streptococci, Bacteroides sp., and Peptococcus sp . were among the most frequently isolated pathogens . The patients were treated for a mean of 5.6 +/- 1.6 days and received a total dose of 19.27 gm . The signs and symptoms of infection were cleared or improved in 93% of the 133 patients evaluable for clinical response . Of the 116 evaluated bacteriologically, 95% had a satisfactory or presumed satisfactory response; only six patients (5%) were considered to be bacteriologic failures . Differences in the results of several clinical laboratory tests performed before and after treatment were statistically, but not clinically, significant (p less than 0.05) . Safety was evaluated in the 158 patients who received cefotetan, and only four (3%) had adverse reactions considered related to the drug . Cefotetan was clearly effective and produced no untoward reactions in these women with obstetric and gynecologic infections caused by both aerobic and anaerobic organisms when administered at 1 or 2 gm every 12 hours.

Microb Pathog, 1988 Mar, 4(3), 213 - 22
Ultrastructural localization of gonococcal antigens in infected epithelial cells as visualized by post-embedding immuno-electronmicroscopy; Weel JF et al.; Since ultrastructural localization of bacterial antigens during infection might considerably contribute to the understanding of the infectious process, we investigated the usefulness of post-embedding immuno-electronmicroscopy in the visualization of neisserial antigens . With the use of proper fixation conditions in combination with ultracryomicrotomy, we have been able to specifically mark gonococcal antigens in ultrathin sections incubated with a polyclonal antiserum and subsequently with gold-labelled protein A . Electron microscopy of cryosections from infected Chang conjunctiva epithelial cells showed that gonococcal antigens could be marked during various stages of the infectious process . With the polyclonal antiserum used there appeared to be no difference in labelling between extracellular and intracellular bacteria, suggesting that the probed antigens were not altered during the internalization process . Our results indicate post-embedding immuno-electronmicroscopy as a useful technique to localize bacterial antigens during the adherence, the internalization and the intracellular degradation of bacteria in host cells.

J Gen Microbiol, 1988 Mar, 134 ( Pt 3), 547 - 57
Preferential uptake of restriction fragments from a gonococcal cryptic plasmid by competent Neisseria gonorrhoeae; Burnstein KL et al.; Factors involved in the specificity of DNA uptake by competent Neisseria gonorrhoeae were examined . Host-controlled modification did not affect uptake . Certain restriction fragments of the 4.2 kb gonococcal cryptic plasmid pFA1 and of the replicative form of the bacteriophage M13 were taken up in preference to others, independent of differences in fragment size . A 600 bp fragment from the 4.2 kb plasmid was cloned into pLES2, a gonococcal-Escherichia coli shuttle vector; the 600 bp fragment was taken up into a DNAase-I-resistant state in preference to the vector fragment . A second 370 bp fragment in pFA1 was also taken up preferentially . The 600 bp and 370 bp fragments share a 10 bp sequence, which is found in pFA1 only on fragments that were taken up readily . However, a fragment from M13 which was efficiently taken up did not contain this 10 bp sequence . In addition, this sequence was not sufficient to direct preferential DNA uptake by gonococci, since a recombinant plasmid containing this 10 bp sequence was not taken up appreciably better than the vector plasmid or another recombinant plasmid containing an unrelated 10 bp sequence . Sequence comparisons of the three restriction fragments which were preferentially taken up did not yield any consensus sequences greater than 7 bp . Although it is likely that efficient uptake of DNA by gonococci is determined by DNA structure, a single short sequence could not be found that accounted for specific uptake.

J Gen Microbiol, 1988 Mar, 134 ( Pt 3), 539 - 45
Lipopolysaccharide masking of gonococcal outer-membrane proteins modulates binding of bacterial cathepsin G to gonococci; Shafer WM; Human polymorphonuclear leucocyte (PMN) lysosomal cathepsin G exerts potent bactericidal action against Neisseria gonorrhoeae in vitro, independent of its serine esterase activity . The results presented demonstrate that (1) bactericidal, diisopropylfluorophosphate-treated cathepsin G binds in a specific and saturable manner to the surface of gonococci, (2) loss of carbohydrates in gonococcal LPS due to mutation increases total and specific binding of cathepsin G, and (3) at least three outer-membrane proteins (OMPs) (PIA, PIII, and a 45 kDa OMP) interact with cathepsin G . Taken together, the results suggest that gonococcal susceptibility to the lethal action of cathepsin G, and perhaps susceptibility of gonococci to oxygen-independent killing by PMNs, is controlled by LPS-masking of cathepsin-G-binding OMPs.

Can J Microbiol, 1988 Mar, 34(3), 281 - 6
An overview of some mechanisms of bacterial pathogenesis; Conway B et al.; The adherence of microorganisms to host surfaces is highly specific, and in many cases, essential for subsequent pathogenetic events to occur . A dynamic process leading to increased mucosal adherence of gram-negative bacilli to epithelial cell receptors in the oral cavity appears to be the initial step in the development of pneumonia . In infectious processes secondary to Streptococcus pneumoniae, adherence may also play a role in specific syndromes . In many cases, however, colonization of oropharyngeal mucus itself, the presence of capsular polysaccharide, and the release of various cell wall components appear to interact to cause clinical disease . In Neisseria gonorrhoeae infections, adherence is all important and is mediated by a number of cell surface structures . These have been studied extensively . Many of these structures, such as pili and protein II, exhibit great variability both between strains and in the same organism at different stages of infection . Others, such as protein I, are more constant . This information has been used in the production of specific vaccines to more preserved structures to inhibit adherence . These will be tested in the near future . It is our view that a better understanding of the many forms of bacterial adherence will be the key to our designing more effective strategies to detect early infection and to intervene more decisively to limit its spread.

Hinyokika Kiyo, 1988 Mar, 34(3), 569 - 73
{Studies of clinical efficacy of ofloxacin against male urethritis caused by Chlamydia trachomatis}; Matsuda T et al.; A multi-institutional clinical study was performed on the efficacy of Ofloxacin against chlamydial urethritis in males between January and June, 1987 . Chlamydia trachomatis was detected in 68 (38.2%) among 178 patients with male urethritis by the antichlamydial FITC monoclonal antibody technic (Micro Trak) . Neisseria gonorrhoeae was isolated in 51 patients (28.7%) and C . trachomatis was also detected in 8 of them . Ofloxacin was administered at a dosage of 600 mg divided into 3 doses for 14 days . One hundred and forty-eight patients including 53 with chlamydial urethritis were evaluable for clinical efficacy . C . trachomatis did not disappear in 6 patients (13.6%) and 2 (8.3%) after the therapy for 7 and 14 days, respectively . After 7 days of therapy, both the pathogen and urethral excretions had disappeared from 79.6% of the patients with chlamydial urethritis, and from 84.8% of those with gonorrheal urethritis; and after 14 days of therapy they had disappeared from 94.1 and 90.9% of the patients, respectively.

J Clin Microbiol, 1988 Mar, 26(3), 493 - 7
Evaluation of eight methods for identification of pathogenic Neisseria species: Neisseria-Kwik, RIM-N, Gonobio-Test, Minitek, Gonochek II, GonoGen, Phadebact Monoclonal GC OMNI Test, and Syva MicroTrak Test; Dillon JR et al.; The performance of eight methods in identifying Neisseria species, particularly N . gonorrhoeae, was evaluated . These methods included four rapid carbohydrate utilization tests (Gonobio-Test, Neisseria-Kwik, RIM-N, and Minitek); the Gonochek II, a test which is based on the utilization of chromogenic substrates; and three monoclonal antibody tests (Syva MicroTrak, GonoGen, and Phadebact Monoclonal GC OMNI Test) . In all, 182 isolates comprised in six species of Neisseria as well as Branhamella catarrhalis and Moraxella sp . were tested . Cystine-tryptic digest agar supplemented with sugars was included for reference purposes . In the carbohydrate utilization tests, the sensitivity and specificity of the Neisseria-Kwik and Minitek tests for the identification of N . gonorrhoeae were 100% . This compared with sensitivities and specificities, respectively, of 100 and 99.1% for the Gonobio-Test and 99.1 and 100% for cystine-tryptic digest agar sugars and the RIM-N test . The sensitivity and specificity of the Gonochek II test were 99.0 and 86.7%, respectively . Although most test kits did not claim to identify all Neisseria species, in several cases isolates of N . subflava were misidentified or could be misinterpreted as N . gonorrhoeae or N . meningitidis . With the monoclonal reagents, the Syva MicroTrak system was 100% sensitive and 100% specific . The GonoGen test was both 99.1% sensitive and specific, while the Phadebact Monoclonal GC OMNI Test was 99.1% sensitive but 91.2% specific . With this latter test, cross-reactions were observed with strains of B . catarrhalis, N . cinerea, and N . lactamica.

APMIS, 1988 Mar, 96(3), 218 - 22
Neisseria meningitidis: occurrence in non-pneumonic pulmonary infections; Christensen JJ et al.; A two-year survey at our hospital revealed 19 patients suspected of pulmonary infection from whom Neisseria meningitidis was isolated from lower respiratory tract specimens, in 17 cases in pure culture . Of the isolates, 16, two and one belonged to serogroup B, C and 29E, respectively . All except three patients suffered from chronic pulmonary disease, notably chronic bronchitis . It was found likely or possible that N . meningitidis was the causative agent in 12 patients with symptoms of acute bronchitis . Results of tests for complement-fixing antibodies against N . meningitidis (MAT) were generally not found to be useful when assessing the possible causative role of N . meningitidis in non-pneumonic pulmonary infections.

Mol Microbiol, 1988 Mar, 2(2), 227 - 36
Recombination among protein II genes of Neisseria gonorrhoeae generates new coding sequences and increases structural variability in the protein II family; Connell TD et al.; Expression of Neisseria gonorrhoeae Protein II (P.II) is subject to phase variation and antigenic variation . The P.II proteins made by one strain possess both unique and conserved antigenic determinants . To study the mechanism of antigenic variation, we cloned several P.II genes, using as probes a panel of monoclonal antibodies (MAbs) specific for unique determinants . The DNA sequences of three P.II genes showed that they shared a conserved framework, with two short hypervariable (HV) regions being responsible for most of the differences among them . We demonstrated that unique epitopes recognized by the MAbs were at least partially encoded by one of the HV regions . Moreover, we found that reassortment of the two HV regions among P.II genes occurs, generating increased structural and antigenic variability in the P.II protein family.

Eur J Epidemiol, 1988 Mar, 4(1), 75 - 82
Diagnosis of Chlamydia trachomatis infection--culture versus serology; Schoenwald E et al.; The diagnostic value of different laboratory methods in detecting Chlamydia trachomatis infections in high risk groups was analysed . The efficiency of a direct specimen test was compared with serology (IgG and IgM ELISA) and culture in L929 cells, stained either with fluorescein conjugated monoclonal antibodies or with iodine . Patients (no . = 1041) with localized genital infections attending a STD clinic, sexual contacts and patients with ascending infections from urological and gynecological clinics were examined . Chlamydia trachomatis was detected in 225 patients: 210 (93.3%) were reactive in the direct test (smears stained with monoclonal antibodies), whereas culture missed only 5 (sensitivity 97.8%) when stained by the same method . Cultures stained with iodine produced the lowest recovery rate (73.8%), but this rate increased to 80.9% when a second passage was performed . In addition the prevalence of Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, Candida albicans and Trichomonas vaginalis was investigated . In patients with non-gonococcal urethritis (no . = 331) and cervicitis (no . = 353), Chlamydia trachomatis was isolated in 32.3% and 12.8% respectively . However, this pathogen could be isolated in only 3 (15.8%) out of 19 patients with epididymitis and 15 (14%) out of 107 patients with adnexitis, although 66.7% and 93.3% respectively had specific IgG antibodies . Specific IgM could by detected with a sandwich ELISA in patients with adnexitis (46.7%), epididymitis (33.3%), cervicitis (22.2%), non-gonococcal urethritis (14%) and in the sexual partners of patients with genital infections (35.7%) . The direct specimen test with monoclonal antibodies is the method of choice for the diagnosis of a C . trachomatis infection in patients with urethritis and cervicitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Arch Intern Med, 1988 Mar, 148(3), 703 - 7
Evaluation of chronic urethritis . Defining the role for endoscopic procedures; Krieger JN et al.; We determined the prevalence of structural and functional abnormalities of the lower urinary tract in a carefully defined population of 36 men with chronic urethritis who were attending a sexually transmitted disease clinic . They had experienced symptoms for an average of 12.1 months and had been treated with an average of 5.1 courses of antimicrobial drugs . All had objective evidence of urethral inflammation and negative cultures for both Neisseria gonorrhoeae and Chlamydia trachomatis . Structural abnormalities were documented in nine (25%) of 36 patients but were considered clinically significant in only four . Physical examination and uroflow testing led to clinical suspicion of anatomic abnormalities in all four patients with significant lesions, which included urethral strictures in three patients and benign prostatic hypertrophy in one patient . Additional abnormal findings included wide-bore strictures in three patients and developmental abnormalities of doubtful significance in two patients . Increased numbers of inflammatory cells in expressed prostatic secretions were associated with the presence of structural abnormalities . We conclude that among men with chronic urethritis, careful physical examination and uroflow studies can be used to screen for evidence of structural abnormalities that merit endoscopic evaluation.

Carbohydr Res, 1988 Feb 15, 173(1), 53 - 64
Structural studies of the Escherichia coli K93 and K53 capsular polysaccharides; Bax A et al.; The structures of the Escherichia coli K93 and K53 capsular polysaccharides have been investigated by chemical and spectroscopic methods . The repeating unit of both polymers was found to be----3)-beta-D-Galf-(1----f)-beta-D-GlcAp-(1 . The O-5 and O-6 atoms of D-galactose are acetylated in the repeating unit of the K93 polymer, but only O-2 is acetylated in the K53 polymer . The K93 polysaccharide is cross-reactive with the Neisseria meningitidis Group A capsular polysaccharide (of known structure) . The K53 polysaccharide, although structurally similar to that from K93 organisms, does not cross-react with the Group A polymer.

Antimicrob Agents Chemother, 1988 Feb, 32(2), 246 - 9
Pharmacokinetics of A40926 in rats after single intravenous and subcutaneous doses; Bernareggi A et al.; A40926 is a new glycopeptide antibiotic with unique activity against Neisseria gonorrhoeae and high and prolonged levels in mouse blood (B . P . Goldstein, E . Selva, L . Gastaldo, M . Berti, R . Pallanza, F . Ripamonti, P . Ferrari, M . Denaro, V . Arioli, and G . Cassani, Antimicrob . Agents Chemother., 31:1961-1966, 1987) . We studied the pharmacokinetics of A40926 in rats after single intravenous and subcutaneous 10-mg/kg (body weight) doses . Concentrations in plasma and urine were determined by microbiological assay . After intravenous administration, high concentrations of A40926, ranging from 132 mg/liter at 3 min to 0.7 mg/liter at 96 h, were found in plasma . Concentrations declined with a three-exponential decay correlated with a prolonged, biphasic distribution and a slow elimination (terminal half-life, 61.22 h) . After completion of the distribution, the compound was widely distributed to the extravascular space . The rate-limiting step in the elimination of A40926 from the body appears to be the slow return from the deep compartment into the central one . A40926 was rapidly absorbed from the injection site after subcutaneous administration, and its availability was close to 90% . The percentage of the dose excreted in urine in 120 h was 35.9%.

Genitourin Med, 1988 Feb, 64(1), 49 - 51
Prevalence, incidence, and risk of acquiring urogenital gonococcal or chlamydial infection in prostitutes working in brothels; Ruijs GJ et al.; At two week intervals specimens were taken from 24 prostitutes working in two brothels and cultured for urogenital infection with Chlamydia trachomatis and Neisseria gonorrhoeae . Demographic and clinical data were also collected . C trachomatis was found initially in four and N gonorrhoeae in two of the 20 women at risk of infection . During the study period three new chlamydial and gonococcal infections were diagnosed, resulting from 949 unprotected contacts . Eight women (33%) had developed salpingitis, in contrast to 15% in the general female population . An attempt was made to estimate the infectivity of C trachomatis for the prostitutes . The epidemiological importance of the chlamydial and gonococcal reservoir in the prostitutes was also considered.

J Antimicrob Chemother, 1988 Feb, 21 Suppl B, 119 - 24
Enoxacin in the treatment of sexually transmitted diseases; Siboulet A et al.; Enoxacin was evaluated in two double-blind comparative trials in a total of 200 male and female patients with urethral and/or endocervical gonorrhoea . Single 400-mg doses were effective in eradicating Neisseria gonorrhoeae (including penicillinase-producing strains) from patients . Enoxacin was as effective as the parenteral drugs approved for treatment . Adverse events occurred in 3% of patients . Enoxacin has been shown to be an effective well tolerated and convenient treatment for gonorrhoea.

Genitourin Med, 1988 Feb, 64(1), 14 - 7
Ciprofloxacin treatment of chlamydial infections of urogenital tracts of women; Ahmed-Jushuf IH et al.; Ciprofloxacin was evaluated in chlamydial infections of the urogenital tracts of women treated with a dosage regimen of 500 mg orally twice a day for seven days . Of the 40 women evaluated, 30 were infected with Chlamydia trachomatis only, two were infected with Neisseria gonorrhoeae only, and a further eight had combined gonococcal and chlamydial infections . Ten were found to be harbouring Chlamydia trachomatis in the urethra as well as the cervix . Neisseria gonorrhoeae was eradicated from all patients with or without concomitant chlamydial infection . The overall chlamydial reisolation rates were 14% (5/35) four weeks after treatment and 23% (6/26) 11 weeks after treatment . The organism was not reisolated from the urethra of any of the patients after treatment . Ciprofloxacin was effective against Mycoplasma hominis, but almost completely ineffective against Ureaplasma urealyticum.

Ann Intern Med, 1988 Feb, 108(2), 238 - 51
Norfloxacin: a new targeted fluoroquinolone antimicrobial agent; Wolfson JS et al.; Norfloxacin is an oral fluoroquinolone antimicrobial agent recently released for the treatment of uncomplicated and complicated urinary tract infections . The drug antagonizes DNA gyrase, an enzyme essential for bacterial DNA replication . Norfloxacin is more potent and broader in spectrum than the earlier developed analogue, nalidixic acid, and is active in vitro against virtually all bacterial pathogens causing urinary tract and gastrointestinal infections, aerobic gram-negative bacilli causing sepsis in neutropenic patients, and Neisseria gonorrhoeae . The drug is administered orally twice daily and achieves high concentrations in urine, stool, renal tissue, and bile . Norfloxacin was at least as effective as currently used agents in treating urinary tract infections, and, in limited studies, bacterial gastroenteritis, gonorrhea, bacterial prostatitis, and prevention of gram-negative bacillary infection in neutropenic patients . Adverse drug effects were mild and included disturbances of the gastrointestinal tract and the central nervous system . Norfloxacin shows promise as an antibacterial agent for genitourinary and gastrointestinal infections.

J Gen Microbiol, 1988 Feb, 134 ( Pt 2), 509 - 19
Rapid damage to membranes of Neisseria gonorrhoeae caused by human neutrophil granule extracts; Rock JP et al.; Neisseria gonorrhoeae were exposed to extracts of human neutrophil granules and effects on gonococcal growth and membranes were determined . Enumeration of gonococci by phase-contrast microscopy at 0 and 60 min revealed that they underwent very limited cell division after exposure to granule extract . At 60 min, treated gonococci tended to clump, and some lost their refractivity under phase-contrast optics, indicating membrane damage . Treated and untreated gonococci utilized oxygen at similar rates at time 0; treated gonococci utilized oxygen at a relatively constant rate for 60 min, even though colony-forming ability (i.e . viability) decreased by 90%, whereas untreated gonococci showed a steadily increasing rate of oxygen consumption over the same period, which essentially paralleled increase in colony-forming ability . Membrane ultrastructure of untreated and treated gonococci was compared in thin section by transmission electron microscopy . Extract treatment resulted in a time-related increase in disruption of the bacterial outer membrane, which became apparent almost immediately after treatment . This was accompanied by increasingly aberrant septum structure . Extract treatment also increased the resolution of peptidoglycan by electron microscopy, as early as 10 min after treatment . These data suggest that extract treatment of gonococci caused a rapid loss of the ability to form colonies on agar concomitant with alteration of gonococcal peptidoglycan and outer-membrane structure, but with little alteration of inner-membrane function.

J Gen Microbiol, 1988 Feb, 134 ( Pt 2), 499 - 507
Protein changes associated with induced resistance of Neisseria gonorrhoeae to killing by human serum are relatively minor; Patel PV et al.; Serum-susceptible (SS) Neisseria gonorrhoeae were induced to resistance (SR) to complement-mediated killing by fresh human serum (FHS) by a small-Mr factor(s) from guinea-pig blood in 3 h at 37 degrees C, but not in the presence of bacteriostatic concentrations of chloramphenicol or neomycin, indicating that proteins mediated the acquisition of resistance . SDS-PAGE protein profiles of lysates of equal numbers of gonococci showed only two qualitative differences between SR and SS organisms, both in minor components (a protein A of about 205 kDa in the former and not the latter and vice versa for a protein B of about 16 kDa) . Many proteins, however, including the three principal outer-membrane proteins, were present in larger amounts in SR gonococci . The lack of major changes in proteins when resistance is acquired was confirmed by immunoblotting the two protein profiles with the IgG of hyper-immune rabbit anti-SR and anti-SS sera, of rabbit anti-SR serum after absorption by SS organisms and of FHS used alone and after absorption with SS organisms . The IgM of FHS, which is responsible for most of the bactericidal activity, showed only faint reactions with a few proteins common to both SS and SR gonococci and no reactions when the FHS was absorbed with SS gonococci . This is in contrast to the strong and different reactions given with lipopolysaccharide (LPS) components of SS and SR organisms, which, prepared from the former organisms, neutralize the bactericidal activity of FHS . Hence, the relatively small protein changes accompanying induction are less likely to be directly responsible for serum resistance than the more profound LPS changes.

Eur J Clin Microbiol Infect Dis, 1988 Feb, 7(1), 25 - 9
Evaluation of a ten-minute chromogenic substrate test for identification of pathogenic Neisseria species and Branhamella catarrhalis; Janda WM et al.; A ten-minute chromogenic substrate test was evaluated for its ability to rapidly identify pathogenic Neisseria spp . and Branhamella catarrhalis . Identifications obtained with this system were compared to those obtained using conventional procedures . The test correctly identified 98.9% of 90 Neisseria gonorrhoeae, 98.3% of 60 Neisseria meningitidis, 96.2% of 26 Neisseria lactamica, and 100% of 36 Branhamella catarrhalis strains . Eight Neisseria subflava strains that grew on modified Thayer-Martin agar were prolyl aminopeptidase positive and were misidentified as Neisseria gonorrhoeae . Other strains of saprophytic Neisseria spp . also reacted with the chromogenic substrates . The system was accurate and reliable for identifying the commonly encountered pathogenic species . In light of recent reports describing new species and atypical Neisseria strains, however, careful attention to the salient features of both common and atypical organisms is necessary for proper use of rapid enzymatic identification tests.

Zh Mikrobiol Epidemiol Immunobiol, 1988 Feb, (2), 40 - 4
{Polysaccharide-protein complexes isolated from different strains of Neisseria meningitidis serogroup B}; Sivtseva LD et al.; Fractionation of the biomass of 3 serogroup B N . meningitidis strains, obtained from solid serum-free and liquid synthetic media, by increasing concentrations of cetavlone revealed that the formation of natural polysaccharide-protein complexes with the ratio of their components approaching 1:1 was possible under the conditions ensuring the intensive synthesis of capsular polysaccharide . Two strains, 125 and 1642, grown on a solid amino peptide-containing medium regularly produced two polysaccharide-protein complexes with the protein/polysaccharide ratio approaching 1:1 . One of these complexes passed easily into the supernatant fluid and could be precipitated with 0.1% cetavlone . The second complex was more firmly bound to the outer membrane of the cell and could be precipitated with 1% cetavlone . In most experiments an additional fraction with high protein content in relation to sialic acid was isolated from the biomass.

Immun Infekt, 1988 Feb, 16(1), 3 - 5
{Efficacy of ofloxacin against Neisseria gonorrhoeae}; Korting HC et al.; Two beta-lactamase producing Neisseria gonorrhoeae strains with differing susceptibility to ofloxacin according to the minimum inhibitory concentration were exposed to the serum level time course of this chemotherapeutic agent in vitro . Within one hour, the bacterial density was markedly reduced, after another hour gonococci could not be subcultured anymore . In a comparative experimental setting the new cephalosporins have not led to total gonococcal eradication although they are also most efficient in gonorrhea . Therefore, quinolones such as ofloxacin should be also considered when it comes to gonorrhea treatment.

Genitourin Med, 1988 Feb, 64(1), 3 - 6
Characterisation of penicillinase producing gonococci isolated in Munich, 1981-6; Abeck D et al.; Twenty three penicillinase producing strains of Neisseria gonorrhoeae (PPNG) isolated in Munich from 1981 to 1986 were characterised in terms of their plasmid content, auxotypes, protein I serovars, and sensitivity to antibiotics . Sixteen strains (70%) harboured a 4.4 megadalton plasmid, with 13 of these strains also containing a 24.4 megadalton plasmid . Seven strains (30%) contained a 3.2 megadalton plasmid, with only one of them containing a 24.4 megadalton plasmid . Thirteen strains (57%) were prototrophic, eight (35%) required proline, one required arginine, and one required proline and arginine for growth . Serovar analysis showed that 16 strains (70%) belonged to the protein IB serogroup and comprised four serovars (IB-1, IB-5, IB-7, and IB-8) . The seven strains belonging to the IA serogroup also comprised four serovars (IA-2, IA-4, IA-6, and IA-10) . Although 18 different categories of plasmid, auxotype, and serovar were found in the 23 PPNG strains, there was a similarity between the auxotypes in terms of the range of serovars they comprised . Measurement of minimum inhibitory concentrations (MICs) of antibiotics for the strains showed that they were all susceptible in vitro to spectinomycin (MIC less than or equal to 32 mg/l), enoxacin (MIC less than or equal to 0.25 mg/l), cefotaxime, ciprofloxacin, and ceftriaxone (MICs less than or equal to 0.064 mg/l), whereas about half showed some resistance to tetracycline or cefotiam, or both.

J Clin Microbiol, 1988 Feb, 26(2), 394 - 6
Cross-reactions between Neisseria meningitidis group H and Escherichia coli K2 and K62 polysaccharides; van Alphen L et al.; Neisseria meningitidis group H polysaccharide was found to cross-react in immunoprecipitation with cultures, culture supernatants, and purified polysaccharides from Escherichia coli O86:K62 and O6:K2 but not with those fractions from E . coli O6:K- . Antibodies to N . meningitidis group H polysaccharide could be absorbed completely with E . coli K62 and partly with E . coli K2 bacteria but not with E . coli K- bacteria . N . meningitidis H and E . coli K2 and K62 polysaccharides share the structure -phosphate----galactose (Gal)p----glycerol (Gro)-.

J Clin Microbiol, 1988 Feb, 26(2), 358 - 63
Characterization of Neisseria gonorrhoeae reference strains used in development of serologic classification systems; Evins GM et al.; Certain strains of Neisseria gonorrhoeae have been used by numerous investigators to develop serologic classification systems . Some of these strains have been used by investigators to study gonococcal virulence . A reference consisting of strain classification by auxotype and serovar, a strain history, and a selected bibliography are provided cohesively.

J Clin Microbiol, 1988 Feb, 26(2), 354 - 7
Panel of reference strains for evaluating serologic reagents used to identify gonococci; Evins GM et al.; A panel of strains for evaluating Neisseria gonorrhoeae serologic reagents was developed . The strains selected for the panel were antigenically diverse and representative of strains isolated worldwide and had been isolated from a variety of anatomic sites . A few strains with characteristics that can cause problems in serologic tests were included . The panel of 52 gonococcal and 20 nongonococcal strains was used to evaluate two commercially produced kits with monoclonal antibody reagents, GonoGen and Phadebact, and one Phadebact kit with absorbed rabbit antiserum . The GonoGen reagent correctly identified all gonococcal strains and did not react with any of the nongonococcal strains . The Phadebact absorbed antiserum reagent correctly identified 47 of 48 gonococcal strains but reacted with 2 of the 20 nongonococcal strains . The Phadebact monoclonal antibody reagent correctly identified all the gonococcal strains; however, it gave positive reactions with 8 and trace reactions with 4 of the 20 nongonococcal strains.

J Clin Microbiol, 1988 Feb, 26(2), 293 - 6
Fluorescent monoclonal antibody compared with carbohydrate utilization for rapid identification of Neisseria gonorrhoeae; Welch WD et al.; A commercially available fluorescein-conjugated monoclonal antibody (MAb) (Syva Co., Palo Alto, Calif.; Genetic Systems, Seattle, Wash.) against Neisseria gonorrhoeae was compared with a standard cystine Trypticase agar (CTA) sugar utilization method and with three rapid carbohydrate utilization tests, including the Minitek (BBL Microbiology Systems, Cockeysville, Md.), Neisseria-Stat (Richardson Scientific, Dallas, Tex.), and Neisseria-Kwik (Micro-Biologics, St . Cloud, Minn.) systems for the identification of Neisseria species . The MAb correctly identified all 86 clinical isolates of N . gonorrhoeae . Of these 86 isolates, 28 were found later (48 h after the initial inoculation) to be contaminated with non-Neisseria bacteria . In the other four test systems studied, the identification rates for pure and contaminated N . gonorrhoeae cultures were, respectively, as follows: CTA sugars, 88 and 32%; Minitek, 67 and 50%; Neisseria-Stat, 97 and 96%; and Neisseria-Kwik, 80 and 74% . The MAb did not identify any of the 50 nongonoccocal Neisseria isolates tested . The most expensive test system was the MAb, followed by the Neisseria-Kwik, Minitek, Neisseria-Stat, and CTA sugars systems . The MAb appears to be a rapid and accurate method to identify in vitro isolates of N . gonorrhoeae.

J Clin Invest, 1988 Feb, 81(2), 318 - 24
Phagocyte-derived lactate stimulates oxygen consumption by Neisseria gonorrhoeae . An unrecognized aspect of the oxygen metabolism of phagocytosis; Britigan BE et al.; O2 consumption resulting from interaction of Neisseria gonorrhoeae and human neutrophils represents a composite of O2 consumed by the two cell systems . Experiments studying the relative contribution of each system suggested the possibility that gonococci increased their metabolic activity in response to interaction with neutrophils . This hypothesis was confirmed by demonstrating that undifferentiated HL-60 cells, which are unable to undergo a respiratory burst, induce a two- to three-fold increase in gonococcal O2 consumption . Gonococcal capacity to adhere to HL-60 cells did not correlate with extent of metabolic stimulation . Stimulatory activity was demonstrable in cell-free supernatant from neutrophils or HL-60 cells, and increased with duration of incubation . Supernatant applied to a G-15 Sephadex column yielded fractions that stimulated gonococcal O2 consumption . Elution profiles were similar for HL-60 cells, neutrophils, and a stimulatory factor previously isolated from pooled human serum . This stimulatory factor(s) failed to adhere to DEAE or C-18 HPLC columns . Stimulatory activity release from myeloid cells was inhibited by incubation at 4 degrees C or in the presence of NaF, indicating a critical role for glucose metabolism . Lactate, the principal product of resting neutrophil glucose catabolism, was demonstrable in cell-free supernatants after incubation at 37 degrees C . Lactate accumulation was inhibited by NaF and decreased temperature of incubation . Lactate at levels present in cell-free supernatant increased gonococcal O2 consumption twofold and restored stimulatory activity to dialyzed serum . Live, but not heat-killed gonococci eliminated lactate released from neutrophils during phagocytosis . Gonococci are able to utilize host-derived lactate to enhance their rate of O2 metabolism.

Infect Immun, 1988 Feb, 56(2), 432 - 8
Incorporation of the major outer membrane protein of Neisseria gonorrhoeae in saponin-lipid complexes (iscoms): chemical analysis, some structural features, and comparison of their immunogenicity with three other antigen delivery systems; Kersten GF et al.; We incorporated the major outer membrane protein (PI) of Neisseria gonorrhoeae into immunostimulating complexes (iscoms) and examined some analytical, physicochemical, and immunological properties of these structures . The immunogenicity was compared with that of three other PI-containing structures, i.e., liposomes, outer membrane complexes produced by the bacterium, and protein-detergent-adjuvant complexes . AIPO4 and dioctadecyldimethylammonium bromide were used as adjuvants . Our results show that iscoms are much more immunogenic than liposomes and protein-detergent complexes but are also much more toxic . The localization of PI in iscoms was investigated . Therefore, the chymotrypsin susceptibility of PI in iscoms was tested, and the incorporation of fragments of PI was determined . Amphiphilic fragments of PI were incorporated in iscoms, but hydrophilic and hydrophobic fragments were not . Chymotrypsin degradation of PI in iscoms indicated that the protein is exposed to the environment in a similar manner as PI in outer membrane complexes, i.e., with both termini anchored in the iscom.

J Antimicrob Chemother, 1988 Feb, 21 Suppl B, 43 - 8
In-vitro activity of enoxacin against gonococcal isolates in comparison with that of five other antibiotics; Jephcott AE et al.; The in-vitro activity of enoxacin was investigated against 305 clinical isolates of Neisseria gonorrhoeae, including both penicillinase-producing strains (PPNG) and non-penicillinase producing strains (NPPNG), and compared with the activity of cefuroxime, acrosoxacin, spectinomycin, benzylpenicillin and ampicillin . Enoxacin was more active than the other antimicrobials tested, with an MIC90 value for the NPPNG organisms of 0.08 mg/l and for the PPNG organisms of 0.16 mg/l . Ten of the 305 isolates tested were resistant to spectinomycin; MICs of less than or equal to 0.08 mg/l were obtained for enoxacin against these organisms.

APMIS, 1988 Feb, 96(2), 109 - 16
Genotypic and phenotypic markers in the differentiation of Neisseria gonorrhoeae strains; Falk ES et al.; Restriction enzyme (RE) patterns, using Hind III enzyme, were analysed on 101 urogenital strains of Neisseria gonorrhoeae . The strains were also analysed serologically, using monoclonal antibodies, and tested for nutritional requirements by auxotyping . In addition, testing susceptibility to doxycycline was performed by an agar-dilution method . The strains were distributed into 23 RE patterns, of which the five most common accounted for 67.3% of all isolates . The same strains were distributed into 17 serovars, of which the four most common accounted for 77.3% of all isolates . Eleven auxotypes were demonstrated, of which the four most common accounted for 85.1% of all isolates . When the methods were combined, 38 combinations of RE patterns and serovars, 25 combinations of RE patterns and auxotypes, and 31 combinations of serovars and auxotypes were seen . Combining all three methods, 40 combinations of RE patterns, serovars and auxotypes were found . Correlations were particularly seen between RE patterns and auxotypes . The strains were moderately sensitive to doxycycline, those with serological markers for WII/WIII being less sensitive than those with markers for WI.

Proc Natl Acad Sci U S A, 1988 Feb, 85(4), 1071 - 5
Voltage gating of conductance in lipid bilayers induced by porin from outer membrane of Neisseria gonorrhoeae; Mauro A et al.; Porins, polypeptides of approximately 35 kDa, are present as integral membrane proteins in the outer membranes of a variety of Gram-negative bacteria . As reported previously for a purified porin from Escherichia coli, voltage gating of conductance was found to be induced in a lipid bilayer by the solubilized purified porin, protein I, from Neisseria gonorrhoeae . The unitary response to an applied potential showed a cascade of current from an initial level through at least three levels, more or less equal, to a persisting lower level . The initial level of current corresponded to 1.0-1.3 nS for 0.2 M NaCl on either side of the bilayer . Briefly reducing the potential to zero restored the current to its initial level . Interpretation of the unitary response is suggested by electron microscopic data obtained on negatively stained outer membranes of E . coli indicating the presence of "pores" appearing in triplets . Moreover, low-resolution x-ray and neutron diffraction studies on crystals obtained with an E . coli porin show that three polypeptides associate to form a unit . Combining such structural data with the present electrical data lends support for the hypothesis that the unitary response results from three pores acting as a unit in response to an applied potential . Evidence obtained with the patch-clamp technique is mounting for a similar mechanism of many channels operating as a unit in a variety of cell membranes . The porin channel holds promise as a concrete model for the analysis of voltage gating of ionic conductance.

S Afr Med J, 1988 Jan 23, 73(2), 81 - 2
{The microbiological etiology of acute pelvic inflammatory disease in Pelonomi Hospital, Bloemfontein}; Burchell HJ et al.; In 40 women with acute pelvic inflammatory disease (APID) specimens for microbiological study were obtained from the rectum, urethra, vagina, cervix and peritoneal cavity . In most patients (83%) the aetiology of the infection was polymicrobial . Chlamydia trachomatis was the most common invader (73.3%), followed by anaerobic organisms (46.6%), Neisseria gonorrhoeae (40%) and aerobic organisms (26.6%) . Only 1 patient had a positive peritoneal culture for N . gonorrhoeae . All the other positive Chlam . trachomatis and N . gonorrhoeae cultures were obtained from rectal, urethral and cervical specimens . The positive anaerobic and aerobic cultures were all from peritoneal cavity specimens.

J Biol Chem, 1988 Jan 15, 263(2), 945 - 51
Protein I, a translocatable ion channel from Neisseria gonorrhoeae, selectively inhibits exocytosis from human neutrophils without inhibiting O2- generation; Haines KA et al.; Protein I, the major outer membrane protein of Neisseria gonorrhoeae, is a voltage-dependent anion channel which can translocate from the gonococcus into human cells . Since granule exocytosis from neutrophils is regulated by ion fluxes, we examined the effect of protein I on neutrophil activation . Pretreatment with protein I (250 nM) impaired degranulation from neutrophils: beta-glucuronidase release decreased to 27 +/- 6% S.E . of cells treated with N-f-Met-Leu-Phe (fMLP, 0.1 microM) and to 13 +/- 4% of cells treated with leukotriene B4 (LTB4, 0.1 microM); lysozyme release decreased to 52 +/- 17% of fMLP-treated cells and 22 +/- 9% of LTB4-treated cells . Morphometric analysis was consistent: control neutrophils increased their surface membrane after fMLP (43.3 +/- 5.6 microns relative perimeter versus 71.4 +/- 3.7 microns) while protein I-treated neutrophils did not (29.4 +/- 2 (S.E.) microns relative perimeter versus 34 +/- 4 microns) . Enzyme release after exposure to phorbol myristate acetate was not affected (lysozyme: 86 +/- 27% of control) . Cell/cell aggregation in response to fMLP was inhibited by treatment with protein I . However, generation of O2 was not affected . Protein I altered the surface membrane potential (Oxonol V): protein I evoked a transient membrane hyperpolarization which was not inhibited by furosemide . After exposure to fMLP, protein I-treated neutrophils underwent a furosemide-sensitive hyperpolarization rather than the usual depolarization . Protein I did not alter increments in {Ca}i (Fura-2) stimulated by fMLP (460 +/- 99 nM (S.E.) versus 377 +/- 44 nM) nor decrements in {pH}i (7.22 +/- 0.04 S.E . versus 7.22 +/- 0.02, bis-(carboxy-ethyl)carboxyfluorescein) . The results suggest that degranulation and O2 generation have separate ionic requirements and that protein I interrupts the activation sequence proximal to activation of protein kinase C.

Microbios, 1988, 53(215), 91 - 100
Factors affecting the survival of Neisseria sicca; Fung C et al.; Cultures of Neisseria sicca incubated at 37 degrees C died rapidly (within 36 h) after growth ceased . Re-suspending cells in a brain heart infusion broth and storing at 4 degrees C greatly reduced the rate of decline in viability (decimal reduction time 6 days) . An important factor in maintaining viability was apparently the presence of external energy source(s) . Survival comparable to that in broth was obtained by incubation in Ringer's solution with pyruvate plus glucose (but not with pyruvate or glucose alone) . Medium pH had little effect on survival in the range pH 7.0 to 8.5 . Energy sources also promoted survival of cells in Ringer's solution or a buffered salts solution at 37 degrees C . Highest levels of survival (up to 30% at 24 h) were obtained with pyruvate, lactate, proline and glutamate . A number of other amino acids and the tricarboxylic acid cycle intermediates, isocitrate, oxoglutarate, succinate, fumarate, malate and oxaloacetate, enhanced survival to a lesser extent.

Sex Transm Dis, 1988 Jan-Mar, 15(1), 63 - 7
Association of coexisting vaginal infections and multiple abusers in female children with genital warts; Herman-Giddens ME et al.; All 11 girls less than 12 years of age presenting to the pediatric clinic between 1980 and 1986 with genital warts were evaluated by the Child Protection Team for possible sexual abuse . Nine of the 11 girls had condylomata acuminata, and two had verruca vulgaris . Ten of the 11 had historical and/or physical evidence other than the warts that confirmed sexual abuse . Six girls had coexisting vaginal infections such as bacterial vaginosis and infections due to various pathogens including Neisseria gonorrhoeae, Trichomonas vaginalis, Ureaplasma urealyticum, and Mycoplasma hominis . These six girls were known (three) or suspected (three) of being abused by multiple perpetrators . None of the five girls with a known or suspected single abuser had coexisting vaginal infections (P = less than 0.02, Fisher's exact test) . We conclude that almost all genital warts in girls are sexually transmitted and that girls presenting with anogenital warts should be evaluated for other genito-vaginal infections and sexual abuse . Multiple vaginal infections in childhood, with organisms that are sexually transmitted or associated with sexual activity, may be a marker for abuse by multiple perpetrators.

Sex Transm Dis, 1988 Jan-Mar, 15(1), 40 - 4
A 13-year longitudinal analysis of risk factors and clinic visitation patterns of patients with repeated gonorrhea; McEvoy BF et al.; A retrospective study of 2498 patients who made multiple visits to a sexually transmitted disease clinic over a 13-year period analyzed risk factors, default patterns, and repeated infections associated with gonococcal urethritis . An analysis of visitation patterns found that being young, black, and male and having a history of gonococcal urethritis before visiting the clinic was positively related to the total time a patient remained involved with the clinic . Default rates for all patients increased with successive clinic visits . A focused analysis was carried out on the records of 146 patients who returned to the clinic within 12 months with a second diagnosis of gonococcal urethritis . It was found that this group of "repeaters," who comprised 15% of the total population with gonococcal urethritis, accounted for approximately 29% of all diagnoses of this infection over the 13-year study period . Repeaters were found to be more frequently male, black, single, and to be less likely to return for a test-of-cure culture . Longitudinal analysis found that the median time repeaters remained involved with the clinic was approximately 130 days . The relatively brief clinic "half-life" and rapid rates of removal of repeaters are discussed in terms of the development of strain-specific immunity to Neisseria gonorrhoeae in a closed population of patients.

J Adolesc Health Care, 1988 Jan, 9(1), 76 - 81
An evaluation of urethral smear by Papanicolaou stain in men with urethritis; Saxena SB et al.; The objective of this study was to evaluate the usefulness of a Papanicolaou stained urethral smear (Pap smear) to identify sexually transmitted disease (STD) pathogens in men with urethritis . Specimens from the endourethra were obtained for Chlamydia trachomatis and Neisseria gonorrhoeae cultures, a Gram stain, and a Pap smear in 24 symptomatic men aged 16-22 years . All Pap smears were read independent of the culture results . Based on the laboratory techniques employed, nine subjects had gonococcal urethritis (GU), and 11 had nongonococcal urethritis (NGU) . Four subjects with GU had concomitant infection with another STD pathogen(s) . Papanicolaou smear alone identified four different pathogens in 16 subjects, chlamydia in ten, trichomonads in two, intracellular diplococci in two, multinucleate giant cells of herpes in one, and chlamydia and trichomonad together in one . Out of 11 chlamydia-positive Pap smears, three had a positive culture . One subject had a positive chlamydia culture and a negative Pap smear . Two subjects with intracellular diplococci on Pap smear had culture-confirmed gonorrhea . The Pap smear was useful in identifying some of the different pathogens in NGU, especially trichomonads and herpes, not recoverable by commonly used techniques and in the diagnosis of concomitant infection by more than one STD pathogen in GU . Adding the Pap smear to the diagnostic tests for urethritis increased the etiologic diagnoses from 37.5% to 79%.

J Adolesc Health Care, 1988 Jan, 9(1), 72 - 5
Asymptomatic Chlamydia trachomatis infections in teenage males; Brady M et al.; This study examined the prevalence of Chlamydia trachomatis infections of the urethra in asymptomatic teenage males in a juvenile detention setting . Gonorrhea cultures, chlamydia smears using the direct immunofluorescent antibody (DFA) technique, and 15-20 ml of a first-catch urine (FCU) sample were obtained . Of the 227 adolescent males screened, 205 had experienced sexual intercourse . Twenty-seven (13.2%) of the sexually active adolescents had positive DFA smears for C . trachomatis . Three (1.5%) had positive Neisseria gonorrhoeae cultures . A urine leukocyte count of greater than 10 per high-power field gave a 91% specificity but only a 26% sensitivity for a positive DFA . The high prevalence of chlamydia in this population and the relative low cost of the DFA screen for chlamydia make this a useful procedure for discovering unsuspected disease, particularly in a high-risk population . The FCU screen for leukocytes was of limited value in identifying asymptomatic infection.

J Adolesc Health Care, 1988 Jan, 9(1), 67 - 71
Sexually transmitted diseases and sexual behavior in urban adolescent females attending a family planning clinic; Oh MK et al.; Specimens from the lower genital tract of 102 sexually active urban adolescent females were tested for the common sexually transmitted diseases (STDs) . The results were correlated with concomitant clinical, demographic, and historic data . Forty-one percent (42/102) were infected with one or more of the following organisms: Chlamydia trachomatis (26/102), Trichomonas vaginalis (13/102), Neisseria gonorrhoeae (10/102), yeast (6/102), condyloma (5/102), and herpes simplex virus (1/44) . Mixed infections were found in 13% . Fifty-nine percent were negative for any infectious agents . The presence of genitourinary symptoms were of no value in predicting an STD . The rate of positive physical findings was significantly higher in the STD-positive group than in the negative group (p = 0.03), but 28% of the STD-negative group had positive physical findings, and 50% of the STD-positive group had normal physical findings . A history of genitourinary complaints or presence of physical findings was not predictive of a positive STD culture . Oral contraceptive use of more than six months appears to be a risk factor for an STD . No other factors, including the number of sexual partners, were significantly correlated with the presence of an STD . This study supports the need for routine screening of sexually active urban adolescent girls for an STD.

Scand J Infect Dis, 1988, 20(1), 33 - 6
A comparative study of aztreonam and procaine penicillin/probenecid in the treatment of uncomplicated gonorrhoea; Mohanty KC et al.; 236 patients with uncomplicated gonorrhoea were randomly allocated to receive either aztreonam or procaine penicillin plus probenecid . 115 patients (50 men and 65 women) with uncomplicated gonorrhoea were treated with 1 g aztreonam as a single intramuscular injection . The success rate among those who attended at least one follow up examination after treatment was 99% . The antibiotic was well tolerated and there were no side effects . The observed minimum inhibitory concentrations (MICs) of aztreonam in vitro were very much lower than obtainable serum concentrations . The penicillin treated patients who were evaluable showed a failure rate of 12.8% . We conclude that aztreonam is effective against Neisseria gonorrhoeae, including penicillinase-producing strains, both in vivo and in vitro.

J Reprod Med, 1988 Jan, 33(1 Suppl), 87 - 96
Microorganisms and premature labor; Dodson MG et al.; A number of organisms, including Mycoplasma, group B Streptococcus, Bacteroides, Neisseria gonorrhoeae and Chlamydia trachomatis, have been isolated more frequently from patients in premature labor than from controls . Prophylactic antibiotic treatment in some studies lowered the incidence of prematurity . Silent chorioamnionitis has been noted in 15% of patients in premature labor . Untreated pyelonephritis is clearly associated with premature labor; however, the association of asymptomatic bacteriuria, appropriately treated pyelonephritis and premature labor is less clear . Some microorganisms have been demonstrated to produce phospholipase A2 and possibly prostaglandins, which might be the mechanism for some of the associations between premature labor and bacteria.

J Reprod Med, 1988 Jan, 33(1 Suppl), 124 - 7
Microbiologic considerations in the treatment of serious pelvic infections in women; Venezio FR et al.; Antibiotic therapy in the woman with suspected pelvic inflammatory disease (PID) may often be empiric . Thus, an understanding of the microbiology of the female genital tract is important in the informed selection of therapy for PID . Chlamydia trachomatis plays an important role in PID, and tetracycline and erythromycins are the agents most active against those infections . Neisseria gonorrhoeae is also an important pathogen in PID, particularly in a lower socioeconomic, urban setting . The treatment regimens currently recommended for penicillinase-producing N gonorrhoeae are spectinomycin and a broad-spectrum cephalosporin . Other bacterial flora of the female genital tract, including the facultative enteric bacilli, gram-positive aerobes and anaerobes, play an important pathogenic role in PID . Among the broad-spectrum cephalosporins, ceftizoxime has been shown to possess greater activity against isolates of the Bacteroides fragilis group and enteric bacilli than do the related agents, cefoxitin and cefotetan.

Tokai J Exp Clin Med, 1988, 13 Suppl, 187 - 91
Structure and functions of the Bordetella tracheal cytotoxin; Goldman WE et al.; Of the various toxins and virulence-related factors produced by Bordetella pertussis, only one has been demonstrated to reproduce the specific respiratory epithelial cytopathology characteristic of the pertussis syndrome . That molecule is tracheal cytotoxin (TCT), which is released by B . pertussis during log phase growth . An HPLC-based method has allowed us to purify TCT from culture supernatants, resulting in a preparation with undetectable levels of endotoxin and which is homogeneous by all analytical criteria, including fast atom bombardment-mass spectrometry (FAB-MS) . Exposure to purified TCT specifically damages ciliated epithelial cells, causing ciliostasis and extrusion of these cells . Other species of Bordetella, which generate remarkably similar respiratory tract infections and ciliated cell-specific pathology, produce a chemically identical TCT . Compositional analysis and FAB-MS have unambiguously defined the structure of TCT as N-acetylglucosaminyl-1, 6-anhydro-N-acetylmuramylalanyl-gamma-glutamyl-diaminopimelylalanine+ ++ . This particular disaccharide-tetrapeptide composition and arrangement reveals that TCT is apparently formed by cleavage of peptidoglycan . Unlike other gram-negative bacteria, however, B . pertussis seems to be very selective in its release of cell wall fragments: greater than 95% of soluble peptidoglycan in culture supernatants is TCT . The structure of TCT places it in the "muramyl peptide" family, a group of structurally related molecules that are responsible for a diverse array of biological activities . Neisseria gonorrhoeae also releases muramyl peptides (one of which is identical to TCT) that can cause ciliated cell-specific damage like that seen during gonococcal infection of fallopian tube mucosa . In addition, TCT is absolutely identical in structure to FSu, a potent sleep-promoting factor isolated from humans.(ABSTRACT TRUNCATED AT 250 WORDS)

Microbios, 1988, 54(218), 15 - 21
Microcalorimetric determination of the kinetics of substrate utilisation by non-growing suspensions of Neisseria sicca; Nafi BM et al.; The metabolism of various substrates by non-growing suspensions of Neisseria sicca was investigated by a flow-microcalorimetric technique . Substrate utilisation showed Michaelis kinetics allowing determination of saturation constants (Km) and maximum specific rates of substrate utilisation (Vmax) . Pyruvate, lactate, a number of tricarboxylic acid cycle intermediates, and amino acids (aspartate, glutamate and proline) were rapidly metabolised {Vmax 5-35 mumol (g dry wt cells)-1 min-1}; Km values were between 4 and 20 microM . Glucose, glycerol, acetate and the other amino acids investigated gave only a slight or no increase in power . The pattern of substrate utilisation is discussed in relation to the role of carbonic anhydrase in N . sicca.

Sex Transm Dis, 1988 Jan-Mar, 15(1), 25 - 6
Ofloxacin, a new quinolone for the treatment of gonorrhea; Rajakumar MK et al.; Forty-three patients with uncomplicated gonorrhea were treated with 400 mg of ofloxacin . All had cultures negative for Neisseria gonorrhoeae at follow-up within two weeks of treatment . Minimal side effects were reported . Ofloxacin appears to be satisfactory as a single-dose oral drug for the treatment of gonococcal urethritis, including those cases caused by penicillinase-producing strains of N . gonorrhoeae.

Scand J Infect Dis Suppl, 1988, 56, 49 - 54
Norfloxacin in the treatment of gonorrhea due to penicillinase and non-penicillinase producing Neisseria gonorrheae: a review; Lee CT et al.; In 12 recent clinical studies, norfloxacin given in various dosage regimens was shown to be highly effective in treating 1,588 gonococcal infections in 1,486 patients . A single oral dose of norfloxacin 800 mg cured 99.2% of 783 patients with penicillinase producing strains of Neisseria gonorrheae (PPNG) and non-penicillinase producing N . gonorrheae (NPPNG) causing urethritis, cervicitis and anorectal infections . A single oral dose of 800 mg of norfloxacin was found to be an effective alternative to a 2 g intramuscular dose of spectinomycin and superior to a 2.5 g oral dose of thiamphenicol for the treatment of PPNG urethritis or cervicitis . Its efficacy in treatment of NPPNG infections was shown to be similar to that of a single oral dose of 3.5 g of ampicillin plus 1 g of probenecid . Mild and transient gastrointestinal and neurological adverse events occurred in 3.3% of patients treated with norfloxacin 800 mg . Norfloxacin 800 mg as a single dose is recommended as an effective and safe single-dose treatment of urethritis, cervicitis and anorectal infections caused by PPNG or NPPNG.

Ann N Y Acad Sci, 1988, 549, 180 - 6
Gonorrhea in the newborn; Alexander ER; Gonorrhea prevalence in pregnant women in the United States is generally low (less than 1%), although the prevalence in certain subsets of the population remains a matter of concern . Rates of 10% have been found in some central city adolescent prenatal clinics . Rates as high as this are quite often found in developing countries . The risks of transmission to the newborn are well studied for ophthalmia neonatorum and are 30%-40% . The risks of disseminated gonococcal infection of the newborn (sepsis or arthritis) are unmeasured, but are clearly rare events . In developing countries, maternal gonorrheal infection has been linked to premature delivery, which had been previously suggested in earlier studies in the United States . There is no evidence that the increasing occurrence of penicillinase-producing Neisseria gonorrheae (PPNG) affects maternal-neonatal transmission other than to require alternative therapy.

J Hyg Epidemiol Microbiol Immunol, 1988, 32(4), 425 - 31
Enzyme immunoassay (EIA) in the rapid diagnosis of gonorrhoea; Hossain A et al.; The diagnostic value of a new, modified enzyme immunoassay (EIA) (Gonozyme; Abbott Laboratories, North Chicago III) was evaluated for the rapid antigenic detection of Neisseria gonorrhoeae in endocervical and urethral specimens . EIA results were compared with those of Gram stain (GS) and conventional culture tests . EIA sensitivity and specificity for male patients attending dermatovenerological clinic were 100% and 96.8% respectively in comparison to 86.7% and 96.8% obtained by Gram staining . For female Obstetrics-Gynaecology patients EIA sensitivity of 100% was highly significant compared to 50% sensitivity by the Gram stain . In culture, 30 strains of N . gonorrhoeae were isolated from 125 male specimens and 2 from 105 specimens from females; this suggests a prevalence of N . gonorrhoeae of 24% in males and 1.9% in females . In vitro antibiotic sensitivity testing indicated 55% resistance to penicillin and 43% to ampicillin in these isolated strains; all were sensitive to erythromycin/tetracycline . 12% of the strains were beta-lactamase producers.

Microb Pathog, 1988 Jan, 4(1), 45 - 51
Comparison of clonal analysis and DNA restriction analysis for typing of Neisseria meningitidis; Olyhoek T et al.; We have formerly described a clonal analysis of 423 serogroup A isolates of Neisseria meningitidis which distinguished 21 clones and 34 electrophoretic types . The clones were found to be uniform within distinct epidemiological situations and distinct between different sets of epidemics . Strains representative of the 34 electrophoretic types have now been analyzed by restriction endonuclease digestion of their genomic DNA's . The results correlated partially with the clonal assignments; the discrepancies were epidemiologically more consistent with the interpretation of the clonal analysis than with that of the restriction endonuclease analysis.

APMIS Suppl, 1988, 3, 74 - 5
Branhamella catarrhalis meningitis following otolaryngologic surgery; Naqvi SH et al.; A case of pyogenic meningitis caused by Branhamella catarrhalis which occurred after pharyngoplasty, adenoidectomy and tympanostomy tube placement is reported . This organism is morphologically similar to Neisseria meningitidis but often produces beta lactamase . Therefore therapy should be directed by proper microbiologic identification and sensitivity results.

Graefes Arch Clin Exp Ophthalmol, 1988, 226(4), 341 - 5
The interaction between Neisseria gonorrhoeae and the human cornea in organ culture . An electron microscopic study; Tjia KF et al.; Explants of human corneas in organ culture were used to study the interaction between Neisseria gonorrhoeae and human corneal epithelium at an ultrastructural level . scanning electron microscopy revealed that infection of the corneal explants with N . gonorrhoeae resulted in a rapid adherence of the bacteria to the cell surface . This attachment was probably mediated by pili since only piliated strains were able to adhere to the cells . Upon attachment the bacteria appeared to become engulfed by the epithelial cells . Transmission electron microscopy revealed gonococci apparently lying within vacuoles inside the cells within 1 h after inoculation of the bacteria . At prolonged infection (8-24 h), the thickness of the epithelium was found to be considerably reduced . This thinning of the cornea was probably caused by a continuous desquamation of infected cells . Taken together, the present data demonstrate that Neisseria gonorrhoeae is able to adhere and penetrate into intact corneal epithelium and furthermore indicate that human cornea explants in organ culture are a useful model in studies of bacterial-epithelial cell interaction.

J Gynecol Obstet Biol Reprod (Paris), 1988, 17(3), 333 - 7
{The effect of amniotic fluid on Neisseria gonorrhoeae}; Mlyncek M et al.; This study shows the antibacterial effect of amniotic fluid collected on 10 women from 32 to 38 weeks . Two techniques were used . The first is a quantitative analysis of a bacterial culture with amniotic fluid as compared to controls, with inhibition by the amniotic fluid demonstrated . The second is a morphologic analysis of gonorrheal cultures by electron microscopy, showing alteration of the bacteria when amniotic fluid is present . These facts are of interest when one tries to understand the discrepancy between high rates of discovery of bacteria during pregnancy and low rates of intra-amniotic infection by Neisseria gonorrhoeae.

Antonie Van Leeuwenhoek, 1988, 54(2), 139 - 48
Comparative use of amino acids by three auxotypes of Neisseria gonorrhoeae; Pillon L et al.; Auxotypes of Neisseria gonorrhoeae are usually distinguishable by their particular requirements for growth; these requirements often include amino acids . It is possible that strains needing particular substrates to grow can be distinguished not merely by their growth requirements but also by their metabolism of these particular substrates . In this work amino acid utilization and oxidation studies were performed enabling prototype, pro- and thia-strains to be distinguished . The metabolism study also underlined the importance of proline as an energy source and pointed to the probability of distinct relationships with the metabolism of the key amino acids, glutamic and aspartic acids, for the three auxotypes . It is proposed that the specific amino acid required by the naturally occurring auxotype serves as an energy source at the site of infection and has important implications with respect to particular auxotypes at various sites.

Padiatr Padol, 1988, 23(1), 39 - 45
{Assessment of a commonly available latex particle agglutination test in rapid, bacteriologic cerebrospinal fluid diagnosis}; Grubbauer HM et al.; 36 cerebrospinal fluid specimens (CSF) from patients with bacterial meningitis were tested for the presence of bacterial antigens with the "Slidex Meningite Kit" (Bio Merieux) . This kit has latex particles coated with antibodies against hemophilus influenzae type B (Hib) streptococcus pneumoniae (SP) and neisseria meningitidis (NM) group A and C . With the LAT we could detect the bacterial antigens in 84% of bacterial meningitis cases, 23 of the 27 of Hib meningitis (85.2%), all of the 6 cases of SP meningitis (100%) and two of the three NM meningitis cases . The test is handicapped by the fact, that there is no antiserum against NM sero-group B, the main cause of NM meningitis in Austria . There were no false positive results with the LAT . False negative results were obtained in 19.2% of Hib and in one case of NM . Even under sufficient antibiotic therapy and with negative culture we could detect 9 Hib- and 1 NM-cases during the first 12-48 hours of therapy with this method . The LAT-Kit is a useful addition to standard methods of CSF examinations in bacterial meningitis . With the LAT a rapid bacteriological diagnosis is possible within 15 minutes . The Kit is also able to identify bacterial antigens even with negative culture and after initiation of antibiotic treatment.

Dermatologica, 1988, 176(4), 212 - 8
Presence of two strains of Neisseria gonorrhoeae in both the cervix and pharynx of a patient with disseminated infection caused by a single strain; Korting HC et al.; Neisseria gonorrhoeae was cultured from the cervix, pharynx and blood stream of an 18-year-old woman who had a disseminated gonococcal infection . Two different phenotypes of N . gonorrhoeae, distinguished on the basis of their protein I serovar, whole-cell protein profile, lectin-type and antibiotic susceptibility, were isolated from both the cervix and pharynx, whereas only one of these phenotypes was isolated from the blood . This finding stresses the importance of blood cultures as a prelude to determining appropriate antimicrobial therapy in cases of disseminated gonococcal infection.

Hinyokika Kiyo, 1988 Jan, 34(1), 130 - 6
{Detection of penicillinase-producing Neisseria gonorrhoeae from male patients with urethritis}; Ohkawa M et al.; Eighty-nine isolates of Neisseria gonorrhoeae from 89 male urethritis patients were studied for beta-lactamases (penicillinase) production, and their susceptibilities to benzylpenicillin, amoxicillin, piperacillin, clavulanic acid/amoxicillin (Augmentin), cephalexin, cefotaxime, spectinomycin and minocycline were determined by an agar plate-dilution method . Penicillinase activity was tested by a chromogenic cephalosporin method with nitrocefin as substrate (CefinaseTM discs, BBL, USA) and by a paper strip acidimetric method with benzylpenicillin as substrate (beta-Lactamase detection papers, Oxoid, UK) . In addition, 60 of the 89 patients were examined for Chlamydia trachomatis, using fluorescein-labeled monoclonal antibodies (Direct specimen test; Micro TrakTM, Syva Co., USA) . Penicillinase-producing N . gonorrhoeae (PPNG) were found in 12 of the 89 strains (13.5%) . Although all these strains of PPNG were highly resistant to benzylpenicillin and amoxicillin, the minimum inhibitory concentrations (MICs) of Augmentin markedly decreased . Piperacillin was highly active against not only non-PPNG but also PPNG strains . More than half the isolates were resistant to cephalexin (MICs greater than or equal to 12.5 micrograms/ml) while all strains including non-PPNG and PPNG were fully sensitive to cefotaxime (MICs less than or equal to 0.20 microgram/ml) . Spectinomycin and minocycline had MIC ranges of 6.25 to 25 micrograms/ml and 0.01 to 3.13 micrograms/ml, respectively; the ranges for non-PPNG and PPNG strains were fairly similar . C . trachomatis was detected in 11 (18.3%) out of 60 patients examined . The increasing incidence of PPNG and coexisting chlamydial infection should be taken into account in the treatment of gonococcal urethritis.

Sex Transm Dis, 1988 Jan-Mar, 15(1), 45 - 50
Penicillinase-producing Neisseria gonorrhoeae in Dade County, Florida: evidence of core-group transmitters and the impact of illicit antibiotics; Zenilman JM et al.; In 1985, 2,455 cases of infection due to penicillinase-producing Neisseria gonorrhoeae were reported from Dade County, Florida . These cases represent the largest concentration of PPNG infections reported to date in the United States . A zip code-based geographic analysis of morbidity caused by gonorrhea and PPNG identified a core area where the percentage of all gonorrhea cases due to PPNG was 31-36% . This percentage decreased in a radial pattern outward from the central core . A prospective study of patients presenting to the Dade County central clinic with gonorrhea found that men infected with PPNG were more likely to have medicated themselves with illicit antibiotics than were patients infected with penicillin-sensitive N . gonorrhoeae (odds ratio, 3.6; 95% confidence interval, 1.9-6.8) . Of all self-medicated patients, 42% obtained antibiotics via illicit over-the-counter purchase at pharmacies in the hyperendemic area . In contrast to previous reports, PPNG infection was not associated with either narcotic- or prostitution-related activities . The results show that PPNG is endemic in Dade County and is arrayed in a core distribution . Antibiotic abuse may have played an important role in the Miami epidemic and in the establishment of PPNG as an endemic strain.

Sex Transm Dis, 1988 Jan-Mar, 15(1), 30 - 4
Susceptibility of penicillinase-producing and non-penicillinase-producing strains of Neisseria gonorrhoeae isolated in Durban, South Africa, to 15 beta-lactam antibiotics; Coovadia YM et al.; Using two different inoculum sizes (10(4) and 10(7) organisms), we tested 35 penicillinase-producing (PPNG) and 72 non-PPNG strains of Neisseria gonorrhoeae falling into three categories (penicillin-sensitive, intermediately resistant, and resistant) by the agar-dilution method against 15 beta-lactam antibiotics . With the exception of penicillin, ampicillin, amoxicillin, and cephradine, the isolates were uniformly sensitive to all the other antibiotics tested (including spectinomycin, tetracycline, rosoxacin, sulfamethoxazole-trimethoprim {19:1 ratio}, and kanamycin) . Ceftriaxone and cefotaxime were the two most active compounds tested; all strains were inhibited at concentrations of 0.007 and 0.015 microgram/ml, respectively . Isolates with intrinsic resistance to penicillin were less susceptible to cefoxitin and cefuroxime than were PPNG strains . The effect of inoculum size varied for the different antibiotics; penicillin and cefaclor showed this effect only with PPNG strains, whereas for ampicillin and amoxicillin it was also seen with non-PPNG strains . Cephamandole showed this effect with both penicillin-sensitive and PPNG strains . In view of the increasing resistance to penicillin, we would recommend that alternative drugs be used as first line therapy for gonorrhea in South Africa.

J Antimicrob Chemother, 1988 Jan, 21(1), 117 - 24
The epidemiology of Neisseria gonorrhoeae isolates from Western Australia based on antibiotic resistance and plasmid profiles; Mee BJ et al.; Two collections of 90 distinct isolates of Neisseria gonorrhoeae were examined with respect to their plasmid profiles, auxotypes and antibiotic sensitivities to penicillin, erythromycin, streptomycin, spectinomycin, sulphamethoxazole, tetracycline and trimethoprim . The two series, collected from 1976-1981 and from 1985-1986 possessed similar sensitivity patterns except for erythromycin and trimethoprim . The earlier collection of penicillinase producing N . gonorrhoeae (PPNG) was found to be significantly more resistant to both these antibiotics . Within each series the PPNG isolates were more resistant to penicillin and streptomycin than the non-PPNG . All PPNG isolates had the 4.4 X 10(6) dalton penicillinase plasmid and frequently exhibited an auxotype which included a requirement for proline . The frequency of the 24.5 X 10(6) dalton transfer plasmid in the non-PPNG was found to have increased threefold from the early collection to the later one while amongst the PPNG the frequency of the transfer plasmid was seen to decrease . Auxotyping results indicated that the transfer plasmid played a significant role in the spread of the penicillinase plasmid in the early collection . In the later collection a transfer-plasmid-free strain, which required only proline, comprised almost half of the penicillinase producers and this PPNG strain now appears to be adapted to our environment.

J Med Chem, 1988 Jan, 31(1), 122 - 9
2,4-Diamino-5-benzylpyrimidines and analogues as antibacterial agents . 9 . Lipophilic trimethoprim analogues as antigonococcal agents; Roth B et al.; Lipophilic analogues of trimethoprim (1) bearing 3,5-dialkyl-4-hydroxy substituents in the benzene ring are much more active in vitro against Neisseria gonorrhoeae than is 1 . The 3,5-diisopropyl-4-hydroxy derivative (2) was selected as a candidate for clinical evaluation as an antigonococcal agent, and as part of the preliminary evaluation it was submitted to extended pharmacokinetic and metabolism studies in dogs . Although the compound was not extensively conjugated by metabolic enzymes, one of the methyl groups was metabolized to produce a 3-isopropyl-4-hydroxy-5-(alpha-carboxyethyl)benzyl derivative (43), which was rapidly excreted . Related analogues were likewise extensively metabolized.

J Infect Dis, 1988 Jan, 157(1), 118 - 26
Human monoclonal antibody with protective activity for Escherichia coli K1 and Neisseria meningitidis group B infections; Raff HV et al.; We produced human monoclonal antibody that demonstrated specific reactivity to the K1 capsule of Escherichia coli and the group B polysaccharide of Neisseria meningitidis . The antibody was nonreactive with several strains of K1- E . coli and other gram-negative bacteria . All E . coli K1 clinical isolates tested were reactive with the antibody . When assayed for in vitro opsonophagocytic ability, the antibody caused bacterial removal only in the presence of human complement and neutrophils, an observation suggesting a non-bacteriolytic, neutrophil-dependent killing mechanism . Finally, and perhaps most importantly, the antibody was highly protective for infectious disease when used prophylactically in three animal models . The data suggest a potential use for human monoclonal antibodies in preventing and/or treating infections of the blood.

Int Ophthalmol, 1988 Jan, 11(3), 189 - 96
Neonatal ophthalmia in the developing world . Epidemiology, etiology, management and control; Fransen L et al.; In the 19th century, the incidence of neonatal conjunctivitis varied between 1 and 14% in Europe, and the disease was a main cause of blindness at that time . Since then the epidemiology of ophthalmia neonatorum (ON) has changed and Chlamydia trachomatis is more frequent than Neisseria gonorrhoeae . Both are still very common causes of ON in the developing world . ON can not be differentiated clinically as to the etiology, but Intracellular Gram Negative Diplococci (IGND) on a Gram stain of an eye smear has an excellent validity and further differentiation can be made using microbiological cultures . All cases of presumed gonococcal conjunctivitis must be treated with effective systemic antibiotics . Systemic treatment with penicillin can still be used in areas where the percentage of beta-lactamase producing strains of gonococci is very low . For other areas a single dose of ceftriaxone intramuscular combined with saline eye washes is the treatment of choice . Chlamydial ON necessitates also systemic treatment with erythromycin . Parents of infants with gonococcal or chlamydia ON also need to be examined and treated . Prevention of gonococcal and chlamydial disease can be done following 3 strategies: antenatal diagnosis and treatment of maternal infections or disinfection of the infants eyes at birth or adequate treatment of infants and parents as soon as a ON has been diagnosed . Crede's eye prophylaxis with silver nitrate has become a controversial issue, because of concern about the occurrence of chemical conjunctivitis and its ineffectiveness against infections with C . trachomatis.(ABSTRACT TRUNCATED AT 250 WORDS)

Scand J Infect Dis Suppl, 1988, 53, 65 - 9
Second look laparoscopy after treatment of acute salpingitis with doxycycline/benzylpenicillin procaine or trimethoprim-sulfamethoxazole; Brihmer C et al.; To have their diagnosis verified, etiology determined and treatment evaluated, 64 patients with a suspected acute salpingitis underwent laparoscopy during which isolates were taken . The patients were then randomized to one of two groups for treatment; doxycycline/benzylpenicillin procaine (DC + BP) or trimethoprim-sulfamethoxazole (TMP-SMZ) . The results were evaluated three to six months later by second look laparoscopy when adhesions and tubal passage were looked for . Isolates from the cervix were culture positive for Chlamydia trachomatis (CT) in 37 (58%) patients and for Neisseria gonorrhoeae (NG) in 15 (23%) . Isolates from the oviducts were positive in 17 (27%) patients of whom 12 had CT and two had NG . Mild salpingitis (Grade I) was found in 16 patients, moderate (Grade II) in 26 and severe (Grade III) in 22 patients . At second look laparoscopy, two patients had totally occluded oviducts, 31 had adhesions but tubal passage on at least one side while 31 patients had healed without any signs of residue . Results at second look laparoscopy showed no statistical difference between the two treatment groups.

J Clin Pathol, 1988 Jan, 41(1), 97 - 102
Antimicrobial susceptibility testing of Neisseria gonorrhoeae: a trial organised as part of the United Kingdom national external quality assessment scheme for microbiology; Snell JJ et al.; Six strains of Neisseria gonorrhoeae were distributed to 411 United Kingdom laboratories who were asked to test the susceptibility of the strains to penicillin, cefuroxime, tetracycline and spectinomycin and to test for production of beta-lactamase . Details of methods used were requested by means of a questionnaire . The number of reports recording sensitive strains as resistant was 5% for penicillin, 0.7% for cefuroxime, 3% for tetracycline and 4% for spectinomycin . The number of reports recording resistant strains as sensitive was 7% for penicillin (0.2% with beta-lactamase producing strains, 20% with non-beta-lactamase producing strains), 96% for cefuroxime, 76% for tetracycline and 8% for spectinomycin . There was an association between greater error rates and the use of high content discs for testing tetracycline, the use of low content discs for testing spectinomycin, failure to dilute the inoculum, and use of acidimetric methods rather than methods that use a chromogenic cephalosporin for detecting beta-lactamase.

Chemotherapy, 1988, 34(4), 315 - 7
In vitro activity of six quinolone derivatives against Neisseria gonorrhoeae; Lefevre JC et al.; The in vitro activities of six quinolone derivatives, rosoxacin, pefloxacin, ofloxacin, ciprofloxacin, A-56619 and A-56620, were compared with those of penicillin, cefotaxime, spectinomycin, chloramphenicol, tetracycline and erythromycin against 50 nonpenicillinase-producing and 15 penicillinase-producing Neisseria gonorrhoeae strains . Ciprofloxacin was the most active compound in vitro (MIC50, 0.004 mg/l) followed by ofloxacin and A-56620 (MIC50, 0.008 mg/l), A-56619 and cefotaxime (MIC50, 0.016 mg/l) . The six quinolones are highly active against all the strains tested but 2, with decreased sensitivity.

Plasmid, 1988 Jan, 19(1), 39 - 45
A novel insertion sequence in the cryptic plasmid of Neisseria gonorrhoeae may alter the B protein at the translational level; Roy RN et al.; A variant of the cryptic plasmid of Neisseria gonorrhoeae, 4.4 kb in size, was isolated and characterized at the molecular level . This variant harbored a 156-bp insertion which was located between coordinates 3134 and 3135 within the putative cppB gene using the 4.2-kb cryptic plasmid, pJD1, as a reference . The insertion contained a novel EcoRI site and several elements of symmetry (both direct and inverted repeats) . Stop codons present in the insertion interrupted the coding capacity of the cppB gene . Although the insertion was within one of two previously characterized 44-bp repeats purportedly involved in site-specific recombination, it was distinct from a 54-bp segment deleted in some cryptic plasmids . The presence of the insertion suggests a mechanism of modulating the expression of the cppB gene at the translational level through DNA rearrangement.

Plasmid, 1988 Jan, 19(1), 30 - 8
Characterization of plasmid pAZ1 and the type III dihydrofolate reductase gene; Fling ME et al.; The plasmid pAZ1, which determines trimethoprim and sulfonamide resistance, was characterized by restriction endonuclease mapping . The restriction map was identical to that of the incQ plasmid RSF1010 over a 5.1-kbp region . The type III dihydrofolate reductase gene was cloned, and the DNA sequence was determined . The predicted protein had 162 amino acid residues, and it was more closely related to the gram-negative bacterial chromosomal dihydrofolate reductases than to other plasmid or vertebrate dihydrofolate reductases . Sequence identity was 51% with the Escherichia coli enzyme and 44% with the Neisseria gonorrhoeae enzyme.

Infect Immun, 1988 Jan, 56(1), 112 - 6
Restriction of plasmid DNA during transformation but not conjugation in Neisseria gonorrhoeae; Stein DC et al.; Neisseria gonorrhoeae strains WR302 and PGH3-2 were characterized with respect to their restriction-modification phenotype . WR302 DNA was cleaved by HaeIII, indicating the lack of methylation at the GGCC sequence . PGH3-2 produced NgoSI (an isoschizomer of NgoII) . WR302 produced a restriction enzyme with a recognition sequence different from that of NgoI, NgoII, or NgoIII . Plasmid pFT180 isolated from WR302 was unable to transform PGH3-2, whereas plasmid pFT180 isolated from PGH3-2 was able to transform PGH3-2 at a very high frequency . When plasmid pFT180 isolated from WR302 was methylated in vitro with meth M . HaeIII, this plasmid was able to transform PGH3-2 . NgoSI was able to restrict WR302 DNA in vitro, whereas it was incapable of restricting PGH3-2 DNA in vitro . When the self-transmissible R factor pFT6 was mobilized from WR302 to PGH3-2 by conjugation, a 1-order-of-magnitude difference in transfer frequencies was observed, as compared with an isogenic cross . The data indicate that host-mediated restriction can prevent the gonococcus from acquiring DNA via transformation but not via conjugation.

J Trop Med Hyg, 1987 Dec, 90(6), 301 - 5
Penicillin and tetracycline susceptibility of gonococci from Addis Ababa and incidence of penicillinase-producing strains; Gedebou M et al.; One hundred and nine Neisseria gonorrhoeae strains were isolated from urethral discharge of male patients in a health centre in Addis Ababa, identified following conventional procedures, and tested for penicillin and tetracycline susceptibility by the agar dilution technique . World Health Organization reference strains were also tested as controls . Penicillinase producing N . gonorrhoeae (PPNG) were identified using Oxoid beta-lactamase detection papers . Minimal inhibitory concentration (MIC) values of penicillin varied between less than 0.01 mg l-1 and greater than 10.24 mg l-1 while those of tetracycline, between less than 0.25 mg l-1 and 4.0 mg l-1 . About 64% of isolates were resistant to penicillin, requiring MICs of greater than or equal to 0.64 mg l-1: 26% were resistant to tetracycline, requiring greater than or equal to 2 mg l-1 for inhibition . The rate of simultaneous resistance to both antibiotics was 18% . PPNG comprised 49% of isolates, of which 23% were resistant also to tetracycline . Of 70 penicillin-resistant strains, 17 (24%) were non-PPNG.

J Clin Microbiol, 1987 Dec, 25(12), 2388 - 90
Fluorescent monoclonal antibody for confirmation of Neisseria gonorrhoeae cultures; Laughon BE et al.; We evaluated a monoclonal fluorescent-antibody (FA) reagent (Neisseria gonorrhoeae Culture Confirmation Test; Syva Co., Palo Alto, Calif.) for confirmation of N . gonorrhoeae isolates obtained from clinics for sexually transmitted diseases in four cities . The FA test was performed in parallel with established confirmation procedures on all organisms growing on 773 primary culture plates of modified Thayer-Martin agar . All N . gonorrhoeae isolates reacted with the FA reagent and produced a bright, easily interpretable fluorescence . The FA test correctly identified 533 N . gonorrhoeae isolates from 474 patients and did not react with 90 N . meningitidis or with 213 non-Neisseria isolates . In one city (Baltimore), Gonochek II (Du Pont Co., Wilmington, Del.) failed to identify four N . gonorrhoeae isolates reactive with the FA reagent and confirmed as N . gonorrhoeae by Phadebact (Pharmacia Inc., Piscataway, N.J.) and acid production from sugars . The FA test was rapid and specific and could be performed directly from primary isolation plates . The test requires 1 h to perform and is applicable to mixed-flora cultures.

Genitourin Med, 1987 Dec, 63(6), 365 - 70
Treatment of gonorrhoea and susceptibility to antimicrobials of PPNG and non-PPNG strains in Jamaica; King SD et al.; Of 1400 patients in Jamaica screened for uncomplicated gonorrhoea, 54% (753 patients) were culture positive . Of the 459 patients who complied with the terms of the study, 97% (211/218) of those treated with aqueous procaine penicillin G were cured compared with 94% (227/241) of those treated with ampicillin . Penicillinase producing Neisseria gonorrhoeae (PPNG) strains were identified for the first time during the study, and 10 patients infected with PPNG strains (two treated with penicillin, eight with ampicillin) contributed to the 21 treatment failures . The in vitro susceptibility of eight antimicrobial agents for 629 non-PPNG and 20 PPNG strains was estimated . Of the non-PPNG isolates, 8% had an MIC of 1 mg/l or more of penicillin, 11% were resistant to this concentration of ampicillin, 32% to tetracycline, and under 1% to the same concentration of cefuroxime and erythromycin . Fewer than 2% of the isolates were resistant to 2 mg/l or more thiamphenicol, and all isolates were susceptible to spectinomycin and trimethoprimsulphamethoxazole (at a ratio of 1:19) . Significantly more strains from the 21 treatment failures were resistant to penicillin (52%) or ampicillin (62%) compared with 7% strains resistant to penicillin and 4% to ampicillin from the successfully treated group.

Epidemiol Infect, 1987 Dec, 99(3), 669 - 74
Plasmid content, auxotype and protein-I serovar of gonococci isolated in the Gambia; Johnson AP et al.; Twenty-nine strains of penicillinase-producing Neisseria gonorrhoeae (PPNG) and 30 non-penicillinase-producing strains, all isolated in the Gambia, were characterized in terms of their plasmid content, auxotype and protein-I serovar . Sixty-two per cent of the PPNG strains contained the 3.2 MDa penicillinase-coding plasmid, and 38% had the 4.4 MDa plasmid . All the PPNG strains contained the 2.6 MDa cryptic plasmid but lacked the 24.4 MDa conjugative plasmid . In contrast, 46.7% of the non-PPNG strains harboured only the cryptic plasmid while 16.7% contained both the cryptic and conjugative plasmids . Seventeen per cent of the non-PPNG strains contained the conjugative plasmid only and 20% lacked plasmids . The PPNG and non-PPNG strains also differed in terms of their protein-I serovar . Eighty-six per cent of the PPNG strains belonged to serogroup 1 A, whereas the majority (60%) of non-PPNG strains belonged to serogroup 1 B . There was no significant difference in the auxotypes of the PPNG and non-PPNG strains, with both groups consisting predominantly of prototrophic and proline-requiring strains, with a minority of strains requiring arginine . When the 59 strains were each characterized in terms of their combined plasmid profile, auxotype and serovar, 39 different combinations were noted, which indicates the heterogeneous nature of the gonococcal population found in the Gambia.

Br J Exp Pathol, 1987 Dec, 68(6), 793 - 802
Histological examination of experimental arthritis induced by gonococcal peptidoglycan; Speer TW et al.; The course of hindpaw arthropathy induced by single intradermal tail injections of sonicated, extensively-o-acetylated peptidoglycan (S-o-PG) from Neisseria gonorrhoeae was studied in male Lewis rats . Following a latent period of approximately 2 weeks, the hindpaw skin became inflamed and the ankles and hindfeet became swollen . Swelling was greatest at 32 days after injection, and decreased somewhat by day 40 to a level which remained well above normal . An aggressive, acute arthritis accompanied the swelling through day 24 . The main features of the arthritis included the infiltration of periarticular tissues by many neutrophils, pannus formation, and the erosion of cartilage and subchondral bone . By day 32 the process had progressed and chronic inflammatory changes were becoming superimposed upon the acute changes . By day 40, chronic inflammatory changes predominated and fibrous ankylosis were established . In addition to the arthritis, deposition and absorption of bone occurred on surfaces unrelated to joints (e.g., the tibial shaft and plantar surface of the calcaneum), while tendons about the ankle developed adhesions following a severe tenosynovitis . This study supports the notion that cell-wall components may trigger severe arthropathy even in the absence of viable intraarticular gonococci.

Proc Natl Acad Sci U S A, 1987 Dec, 84(24), 9084 - 8
Molecular cloning and characterization of the structural gene for protein I, the major outer membrane protein of Neisseria gonorrhoeae; Carbonetti NH et al.; Protein I (P.I) is the major outer membrane protein of Neisseria gonorrhoeae and serves as a porin . By using oligonucleotide probes derived from the known amino-terminal sequence of the mature protein, we have cloned the gene encoding the P.I of gonococcal strain FA19 in three overlapping fragments and determined the DNA sequence . The gene sequence predicts a protein with characteristics typical of the porins of other Gram-negative bacteria . A clone expressing P.I in Escherichia coli was obtained by removing a portion of the P.I gene promoter and reconstructing the entire P.I gene in a position just downstream from a phage T7 promoter . Expression of P.I was then achieved by introducing this recombinant plasmid into an E . coli strain containing an inducible T7 polymerase gene . The clone produced a protein that was identical in size to native P.I and reacted with anti-P.I monoclonal antibodies . Prolonged expression of the protein apparently was lethal for E . coli, possibly explaining failures to clone an intact P.I gene with its own promoter.

J Med Microbiol, 1987 Dec, 24(4), 351 - 7
Plasmid stability and antibiotic resistance of Neisseria gonorrhoea during glucose-limited continuous culture; Keevil CW et al.; Clinical isolates of Neisseria gonorrhoeae harbouring resistance (R) plasmids of mol . wts 4.4 x 10(6) (Asian) or 3.2 x 10(6) (African) were grown in prolonged glucose-limited continuous culture to determine the segregation efficiency of each type of plasmid and their expression of penicillinase activity in the absence of antibiotic selective pressure . One strain contained the African plasmid and cryptic and conjugative plasmids, which were all retained after 96 generations in the chemostat . By contrast, the other strain lost all plasmids after 100 generations . Both strains showed increased sensitivity to a range of antibiotics, particularly to the penicillins . Loss of penicillinase activity as minimal inhibitory concentration decreased was confirmed for both strains by assaying the enzyme spectrophotometrically . Activity decreased with the number of generations and none was detectable at the time of complete plasmid loss . This decrease was apparently due to individual bacteria ceasing to produce enzyme rather than a gradual decline in production by the whole population . The sensitivities to a broad range of antibiotics also generally increased during glucose-limited growth, but one strain became more resistant to clindamycin and the other to tetracycline.

Infect Immun, 1987 Dec, 55(12), 3065 - 9
Human immunoglobulin G antibody response to the major gonococcal iron-regulated protein; Fohn MJ et al.; In humans, gonococcal infection occurs in environments limited with respect to free iron . Neisseria gonorrhoeae produces increased quantities of iron-regulated membrane proteins when grown under in vitro conditions which restrict the availability of free iron . Using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot (immunoblot) techniques, we studied the reactivity of specific antibodies to the 37-kilodalton (kDa) major iron-regulated protein (MIRP) of gonococci grown under iron-limiting conditions . Antibodies reactive with the 37-kDa MIRP were distinguished from those reactive with protein I by using purified 37-kDa MIRP or gonococcal protein preparations . Acute-phase sera from patients with disseminated gonococcal infection (DGI) reacted strongly to both the 37-kDa MIRP and protein I . Acute sera from nine patients with uncomplicated gonorrhea did not exhibit strong reactivity with the 37-kDa MIRP and were indistinguishable from five control sera . When compared with acute-phase sera, convalescent-phase sera from patients with DGI failed to demonstrate increased reactivity, whereas convalescent-phase sera from one of nine patients with uncomplicated gonorrhea developed reactivity to the 37-kDa MIRP . These data indicate that (i) the 37-kDa MIRP is expressed and antigenic in vivo and (ii) humans with DGI consistently develop a systemic antibody response to the 37-kDa MIRP.

Infect Immun, 1987 Dec, 55(12), 3017 - 22
A recombinant molecule from a disseminating strain of Neisseria gonorrhoeae that confers serum bactericidal resistance; McShan WM et al.; A cosmid gene library was prepared from Neisseria gonorrhoeae JC1, a serum-resistant clinical isolate from a patient with disseminated gonococcal infection . From this library a recombinant molecule, pWM3, was isolated which had the ability to transform F62, a serum-sensitive strain of N . gonorrhoeae, to serum resistance . This plasmid contained 2.2 kilobases of insert gonococcal DNA that coded for two peptides, one of 29 kilodaltons (kDa) and one of 17.5 kDa . Deletion of the region coding for the 29-kDa peptide resulted in the loss of the ability of the plasmid to transform F62 to serum resistance . N . gonorrhoeae F62 acquired the ability to bind blocking antibody when transformed with pWM3 or subclones that code for only the 29-kDa protein . Although similar in size, the cloned 29-kDa protein and protein III are antigenically distinct.

Antimicrob Agents Chemother, 1987 Dec, 31(12), 1961 - 6
A40926, a new glycopeptide antibiotic with anti-Neisseria activity; Goldstein BP et al.; In the course of a search for glycopeptide antibiotics having novel biological properties, we isolated A40926 . Produced by an actinomycete of the genus Actinomadura, A40926 is a complex of four main factors which contain a fatty acid as part of a glycolipid attached to the peptide backbone . Its activity was, in most respects, similar to that of other glycopeptides, such as vancomycin and teicoplanin . However, in addition to inhibiting gram-positive bacteria, A40926 was very active against Neisseria gonorrhoeae . A40926 was rapidly bactericidal for N . gonorrhoeae clinical isolates at concentrations equal to or slightly higher than the MIC . In mice, levels in serum were higher and more prolonged than those of an equivalent subcutaneous dose of teicoplanin . These properties suggest that A40926 may have potential in the therapy of gonorrhea.

Proc Natl Acad Sci U S A, 1987 Dec, 84(24), 9079 - 83
Release of soluble pilin antigen coupled with gene conversion in Neisseria gonorrhoeae; Haas R et al.; Gene conversion appears to be the frequent mechanism in Neisseria gonorrhoeae that leads to an altered expression of pilin, the subunit component of the pili . In this process segments of variable sequence information, the minicassettes, are transferred from silent storage loci into an expression locus . As a putative consequence of the rearrangement in the pilE gene, gonococci can enter a different phase of pilin production . Although the removal of a 7-amino acid leader peptide results in the production of typical P+ pilin used to form pili, the loss of an additional 39 amino acids yields S-pilin, a soluble form of pilin that is efficiently secreted into the extracellular environment . Both pilin types can coexist in an apparently homogeneous culture . Ps cells usually are piliated, although less extensively with regard to the length and the number of the pili when compared with P+ cells . Ps cells form T3/T4-type colonies also typical of nonpiliated cells (P-) . The observations further suggest that the classical nonsecretory P- phenotype is not generated as a rule by precise gene conversion but rather by genetic changes that cause the production of an over-length pilin (L-pilin).

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