J Appl Bacteriol, 1987 Oct, 63(4), 335 - 41 Production and specificity of monoclonal antibodies and polyclonal antibodies to Escherichia coli; Kaspar CW et al.; Monoclonal antibodies were produced to whole cells of heat-treated Escherichia coli . Balb/c mice were immunized with a pool of five strains of heat-treated E . coli, and the resulting hybridomas were screened by indirect immunoassay . E . coli strains other than those used for immunization were used for screening to detect hybridomas producing antibody that reacted with a large number of E . coli strains . Of 864 hybridomas, 32 reacted strongly with either two or all three of the strains used for screening; 15 were successfully cloned . Antibody from hybridoma 6H2 reacted with 35 of 68 (51%) E . coli; of 13 non-E . coli tested, only Enterobacter agglomerans was weakly positive . Hybridoma 9B12 antibody reacted with all six E . coli tested . Hybridoma 9B12, however, stopped producing antibody . Five hybridomas produced antibody which reacted with a majority of the bacteria tested whereas antibodies from two other hybridomas reacted with several E . coli and non-E . coli . Polyclonal antibodies produced to two strains of E . coli varied in the numbers of E . coli with which they reacted; both antisera cross-reacted with several non-E . coli. Antimicrob Agents Chemother, 1987 Oct, 31(10), 1491 - 6 Prospective randomized controlled study of ciprofloxacin versus imipenem-cilastatin in severe clinical infections; Lode H et al.; In a randomized prospective study, 66 patients with serious bacterial infections--mainly lower respiratory tract infections--were treated with either imipenem plus cilastatin (32 patients) or ciprofloxacin (34 patients); 30 patients in each group were evaluable for efficacy . Substantial underlying disease was present in most of the patients; pathogens isolated prior to treatment (77 isolates) consisted mainly of members of the family Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, and streptococci . Of the etiologic bacteria, 67% were eradicated by ciprofloxacin treatment and 79% by imipenem therapy; however, two patients (6.7%) failed in the ciprofloxacin group, and six patients (20%) did not respond to imipenem treatment (P = 0.25) . All patients with therapeutic failures suffered from severe fatal underlying diseases, which had substantial impact on the outcome of treatment . Therapeutic drug monitoring in the ciprofloxacin patients revealed higher concentrations in serum at days 4 and 8 in comparison with day 1 of treatment, indicating that steady-state conditions were reached between days 1 and 4 . The total number of side effects was relatively high--eight imipenem patients (25%) and six ciprofloxacin patients (18%) had reactions . Treatment had to be discontinued due to adverse reactions for three ciprofloxacin patients and two imipenem patients . Major side effects in both groups were gastrointestinal and central nervous system-related symptoms . In terms of clinical and bacteriological efficacy and safety, there was no statistical difference between the two groups, and both groups gave good to excellent results for bacterial infections that were difficult to treat. Chemioterapia, 1987 Oct, 6(5), 364 - 73 International experiences with ceftriaxone in the treatment of lower respiratory tract infections; Grassi C et al.; The clinical efficacy and tolerability of ceftriaxone in the treatment of pneumonia and other lower respiratory tract infections were evaluated in 827 patients (515 pneumonia, 312 other lower respiratory tract infections) reported in the international literature (daily dose: 1 of 2 g.i.v . or i.m . in most patients) . Therapeutic success was achieved in 738 patients (89.2%) . Microbiological results were evaluated in 295 patients . Eradication of the most common respiratory pathogens was achieved in 100% of cases and of Enterobacteriaceae in 85.7%-100% . Adverse effects occurred in 4.9% of patients . A large multicenter trial was carried out in Italy using a single daily dose of 1-2 g by i.v . or i.m . Six hundred ninety-six patients were admitted to the study (370 pneumonia, and 326 other lower respiratory tract infections) . Therapeutic success was achieved in 668 cases (96%) . Pathogens were eradicated in 88% of cases (184 pts evaluated) . Side effects were observed in 4.6% of cases. Chemioterapia, 1987 Oct, 6(5), 329 - 36 In vitro antibacterial activity and beta-lactamase stability of CL 118523, an aminothiazolyl iminomethoxy cephalosporin; Chin NX et al.; CL 118523 is an aminothiazolyl cephalosporin which contains a 1, 2, 3-thiadiazol radical at position 3 of the cephem nucleus . It was as active as cefotaxime, ceftazidime and aztreonam against most Enterobacteriaceae, MIC 90% less than 1 mg/l, and more active, 8 to 32-fold, than cefoperazone and cefoxitin . Enterobacter species resistant to the other agents were resistant to CL 118523 . CL 118523 did not inhibit Pseudomonas aeruginosa, Pseudomonas maltophilia, MIC greater than 128 mg/l . It had excellent activity against hemolytic streptococci of groups A, B, C, and G, and methicillin-susceptible Staphylococcus aureus, but failed to inhibit enterococci and methicillin-resistant staphylococci . CL 118523 was minimally hydrolyzed by plasmid and chromosomally-mediated beta-lactamases, and was a poor beta-lactamase inducer. Am J Perinatol, 1987 Oct, 4(4), 324 - 6 Acute pyelonephritis in pregnancy; Fan YD et al.; There were 107 episodes of pyelonephritis associated with pregnancy or the early puerperium occurring in 103 gravidas investigated retrospectively for information concerning prematurity, low birthweight, and antibiotic susceptibility patterns in the recovered microorganisms . No difference was found in the incidence of prematurity on low birthweight between that group and a control group of gravidas from the same population . Members of the Enterobacteriaceae genus were the most common bacterial isolates from the urine, with a large portion of E . coli being resistant to both ampicillin (33%) and cephalothin (13%) . Treated pyelonephritis associated with pregnancy does not appear to predispose to prematurity or low birthweight in this population . Also, initial therapy with a first-generation cephalosporin may no longer be appropriate, because a significant number of isolates (11%) were resistant to cephalothin. Mikrobiyol Bul, 1987 Oct, 21(4), 301 - 7 {Microbiological analysis of some cosmetics on the market}; Ergun H et al.; In this study we have examined contamination of cosmetics by microorganisms . 14 samples from 64 cosmetics were found bacteria more than normally . 9 of 38 shampoo, 2 of 15 hand cream, 1 of 5 hair cream and 2 of 14 hair tonic have been isolated microorganisms more than 10(3) bacteria . Of 14 isolates were 3 Pseudomonas aeruginosa, 2 Escherichia coli, 2 Staphylococcus aureus, 5 Bacillus subtilis and 2 Enterobacter . In addition, antibiotic susceptibility of bacteria were presented in Table 2. J Clin Microbiol, 1987 Oct, 25(10), 1920 - 5 Optimal dilution susceptibility testing conditions, recommendations for MIC interpretation, and quality control guidelines for the ampicillin-sulbactam combination; Jones RN et al.; The ampicillin-sulbactam combination was evaluated in vitro to determine the optimal susceptibility testing conditions among five combination ratios and four fixed concentrations of sulbactam . The organisms tested were markedly resistant to aminopenicillins and most other beta-lactams . The ratio of 2:1 is recommended to assure recognition of the ampicillin-sulbactam spectrum and minimize false-susceptible results among strains known to be resistant to this combination . Proposed MIC breakpoint concentrations were compatible with levels in serum achieved with recommended clinical doses . Cross-resistance analyses comparing ampicillin-sulbactam and amoxicillin-clavulanate showed comparable activity and spectra . However, the major interpretive disagreement was sufficient to require separate testing of these aminopenicillin-inhibitor combinations . The recommended ampicillin-sulbactam MIC susceptibility breakpoints are as follows: (i) less than or equal to 8.0/4.0 micrograms/ml for tests against members of the family Enterobacteriaceae, anaerobes, nonenteric gram-negative bacilli, staphylococci, Haemophilus influenzae, and Branhamella catarrhalis; (ii) the ampicillin MICs alone interpreted by National Committee for Clinical Laboratory Standards criteria should predict ampicillin-sulbactam susceptibility for the enterococci, streptococci, and Listeria monocytogenes . MIC quality control ranges were determined by multiple laboratory broth microdilution trials for the ampicillin-sulbactam 1:1 and 2:1 ratio tests. Int J Oral Maxillofac Surg, 1987 Oct, 16(5), 559 - 65 Ecological effects of penicillin prophylaxis in orthognatic surgery; Bystedt H et al.; A study was conducted to evaluate 2 prophylactic penicillin regimens in 18 patients undergoing orthognathic surgery . The effects on the oral microflora were also studied . All patients received 3 g benzyl-penicillin as infusion from the beginning of operation and then 3 g every 6th hour during 24 h . One group of 9 patients then received 1 g phenoxymethylpenicillin as oral suspension twice daily for 6 days postoperatively . The second group of 9 patients received no further penicillin . One infection occurred in this second group, but the patient was cured with metronidazole . 7 of the 9 patients who received penicillin for 1 week, showed pronounced decreases in the number of streptococci and micrococci . In the 9 other patients who received only benzylpenicillin for one day, much smaller changes in the aerobic microflora were observed . Colonization with different enterococci, enterobacteria or yeasts was greater in the group receiving 1-week treatment . No major differences between the 2 groups of patients, concerning the impact on the anaerobic microflora were observed . The results indicate that benzylpenicillin is still a suitable prophylactic antibiotic in maxillofacial surgery . Extension of the antibiotic coverage to 1 week is doubtful because of the increased ecological risks . The clinical significance of anaerobes was obvious, as one postoperative infection occurred caused by an anaerobic micro-organism. Microbiologia, 1987 Oct, 3(3), 149 - 62 Molecular and ecological aspects of antibiotic resistance in the Bacteroides fragilis group; Martinez-Suarez JV et al.; Current problems of antibiotic resistance in the Bacteroides fragilis group are reviewed . The original susceptibility (before 1976) of this group of strict anaerobic microorganisms to some beta-lactams, tetracyclines and lincosamides is presently severely damaged, and new mechanisms of resistance, such the enzymatic inactivation of chloramphenicol, seem to arise . Conjugative transfer of chromosomal resistance genes appears to be the main strategy for the spread of resistance and in various cases plasmids are involved . The origin of such resistance genes remains obscure . There is a possibility of gene exchange between Bacteroides and Enterobacteriaceae, but there are problems of plasmid maintenance and/or gene expression . In some cases a striking homology of the Bacteroides resistance determinants with those of Gram-positive organisms can be documented. Acta Pathol Microbiol Immunol Scand {B}, 1987 Oct, 95(5), 315 - 21 The porin protein of the outer membrane of Escherichia coli: reactivity in immunoblotting, antibody-binding by the native protein, and cross-reactivity with other enteric bacteria; Henriksen AZ et al.; The experimental conditions for antibody-binding by the 38.5 kD porin protein of an E . coli 055 strain in immunoblotting were investigated . A non-ionic detergent in the buffer which contained the primary antibody was required for antibody-binding by electroblots of the SDS-denatured protein . Immunoblotting, using antiserum absorbed with bacteria or the outer membrane (OM) of the E . coli 055 strain, showed results concordant with inaccessibility to antibodies of the 38.5 kD porin protein in its native configuration in the bacterial cells, but immunoreactivity when contained in the OM . OM from strains of different genera of the Enterobacteriaceae and antisera against these strains when used in immunoblot analyses showed that the E . coli 055 porin protein harboured antigenic determinants which are common to the various genera of the enteric bacilli . Cross-reactivity with non-enteric Gram-negative bacteria was not observed. Proc Natl Acad Sci U S A, 1987 Oct, 84(19), 6825 - 9 Heterologous enzyme function in Escherichia coli and the selection of genes encoding the catalytic RNA subunit of RNase P; Lawrence NP et al.; The gene for the catalytic RNA subunit of RNase P has been isolated from several Enterobacteriaceae by complementation of an Escherichia coli strain that is temperature-sensitive for RNase P activity . The selection procedure relies on the ability of the heterologous gene products to function enzymatically in E . coli . This procedure obviates the need for positive results in DNA blot hybridization experiments or for the purification of holoenzyme to identify the RNA component of RNase P and its corresponding gene from organisms other than E . coli . Comparisons of the variations in sequences provide the basis for a refined two-dimensional model of the secondary structure of M1 RNA. FEBS Lett, 1987 Sep 28, 222(1), 154 - 8 Effect of lipid fluidity upon the activity and structure of the 39 kDa porin from Enterobacter cloacae 908S; Ghosh R et al.; The 39 kDa porin from Enterobacter cloacae 908S was isolated in a lipopolysaccharide-free form using the non-ionic detergent, octylpentaoxyethylene, and reconstituted into vesicles of dimyristoylphosphatidylcholine (DMPC) and dioleoylphosphatidylcholine (DOPC), respectively . Porin activity, measured by the rate of hydrolysis of the lipid-impermeant beta-lactam cephazoline by entrapped lactamase, could be demonstrated for porin-DMPC but not for porin-DOPC vesicles, and for the former was significantly lower in the gel than in the liquid-crystalline phase . The fluorescence changes are thought to arise from lipid phase-induced structural/dynamic changes of the porin structure. J Antimicrob Chemother, 1987 Sep, 20(3), 383 - 7 Aminoglycoside resistance patterns in clinical isolates of Enterobacteriaceae from Czechoslovakia; Kettner M et al.; Multi-resistant Enterobacteriaceae isolated mainly from urine specimens from patients at the Department of Urology, Kramare Hospital, Bratislava, were characterized for resistance phenotype . Seventeen gentamicin-resistant isolates were further studied for the presence of aminoglycoside-modifying enzymes . Five enzymes were detected: AAC(2'), AAC(3)-II, AAC non-characterized, ANT(2") and APH(3')-I . The substrate range of these enzymes was found to correlate with the resistance phenotype in most isolates . In our collection the AAC(3)-II enzyme that inactivates gentamicin, sisomicin, tobramycin and netilmicin was predominant . Predominance of this type of modifying enzyme has been observed also in resistant Gram-negative strains in Belgium, The Netherlands and Chile, in contrast to the United States, Federal Republic of Germany, Switzerland, Greece and Turkey, where ANT(2") has been the most common enzyme. J Antimicrob Chemother, 1987 Sep, 20(3), 335 - 41 Rapid detection of a specific trimethoprim resistance gene using a biotinylated DNA probe; Carter GI et al.; A DNA probe specific for the dihydrofolate reductase (DHFR) type I gene was labelled with biotin by the process of nick-translation and used to screen 83 independently-derived trimethoprim R plasmids from Enterobacteriaceae . Hybridization was detected using streptavidine and a biotin-conjugated alkaline phosphatase to generate an insoluble coloured precipitate following the addition of an appropriate dye . Sixty-eight plasmids (81.9%) hybridized with the probe for DHFR type I . The method could be adapted for use with any antibiotic resistance gene for which a suitable DNA probe is available and has none of the drawbacks associated with the use of radioactively-labelled DNA in hybridization techniques. Am J Gastroenterol, 1987 Sep, 82(9), 903 - 5 Isolation of Vibrio fluvialis, and unusual pathogen in acute suppurative cholangitis; Yoshii Y et al.; We report a case of acute suppurative cholangitis, from which were isolated Enterobacter aerogenes and Vibrio fluvialis . There have been no previous reports of the isolation of V . fluvialis in this disease . It is usually found in seawater and various seafoods and may cause acute diarrhea, but this is the first report in which it has been associated with acute suppurative cholangitis. Infect Immun, 1987 Sep, 55(9), 2311 - 3 Absence of lipopolysaccharide in the Lyme disease spirochete, Borrelia burgdorferi; Takayama K et al.; We were unable to demonstrate the presence of the classic enterobacterium-type lipopolysaccharide in the cells of the Lyme disease spirochete, Borrelia burgdorferi B31 . This finding was primarily based on chemical analysis and the absence of free lipid A upon mild acid hydrolysis of the appropriate cell extracts . These results do not preclude the possible existence of an unusual lipopolysaccharide-like compound(s) in B . burgdorferi. Chest, 1987 Sep, 92(3), 517 - 9 Methods of treatment of childhood empyema in a Turkish university hospital; Solak H et al.; In the last ten years, 120 patients were admitted to our clinic with empyema . Empyema and effusion have been investigated for pathogenesis . Microbiologic studies of pleural aspiration fluid showed that Staphylococcus aureus was the most common pathogen, found in 44 patients (36.7 percent) . Other pathogens found were streptococci in 23 (19.2 percent) and Pneumococcus in 18 (15 percent) in sequence . No production occurred in cultures of 19 (15.8 percent) patients . In 16 (13.3 percent), Pseudomonas and Enterobacteria such as E coli, Klebsiella and Proteus occurred . Surgical intervention has been carried out depending on clinical conditions . In the 24 (20 percent) patients, pleural aspiration and lavage, decortication in 23 (19.2 percent), pulmonary resection (segmentectomy, lobectomy) in seven (5.8 percent), and only drainage and thoracic lavage in 66 (52.5 percent) have been carried out . Three patients (2.5 percent) died due to respiratory failure and septic shock, and the others have been discharged with healing. J Infect Dis, 1987 Sep, 156(3), 471 - 7 Etiologic organisms as independent predictors of death and morbidity associated with bloodstream infections; Miller PJ et al.; We studied 385 episodes of nosocomial bloodstream infections occurring over 45 months to ascertain if the etiologic organisms were independent predictors of death and morbidity . Independent predictors of death included respiratory failure, oliguria, metabolic acidosis, hypotension, increased age, antibiotic therapy in cases where susceptibility data were unknown, and infection with Pseudomonas aeruginosa . If parameters associated with septic shock were excluded, increased age, severity of disease, and infection with Candida spp . or P . aeruginosa predicted death . Infection with P . aeruginosa, Enterococcus, and Klebsiella pneumoniae predicted hypotension; severity of disease, polymicrobial infection, and infection with Candida spp., Enterococcus, Enterobacter, or Serratia marcescens predicted oliguria; infection with Candida spp . or P . aeruginosa, increased age, severity of disease, and inability to meet hospital financial obligations without assistance predicted respiratory failure . Inability to meet hospital financial obligations without assistance and severity of disease predicted hypothermia; infection with Candida spp . or P . aeruginosa and sex (male) predicted metabolic acidosis. J Antimicrob Chemother, 1987 Sep, 20(3), 313 - 21 beta-Lactamase of Pseudomonas pseudomallei and its contribution to antibiotic resistance; Livermore DM et al.; beta-Lactamase production was examined in nine strains of Pseudomonas pseudomallei isolated from human, animal and environmental sources in Thailand and Hong Kong . All produced the same weakly inducible, membrane associated chromosomal cephalosporinase, which had a molecular weight of 29,500 and an isoelectric point of 7.4-7.7 . The enzyme resembled the cefuroximases of Ps . cepacia and Proteus vulgaris, but differed from the Class I cephalosporinases typical of Ps . aeruginosa and most enterobacteria, in being strongly active against carbenicillin, cefotaxime and cefuroxime and in being inactivated readily by clavulanic acid . Synergy experiments with clavulanic acid investigated the enzyme's contribution to antibiotic resistance, and these results broadly correlated with those of in-vitro hydrolysis assays . Thus, ampicillin, carbenicillin, cefoperazone, cefotaxime, cefuroxime and cephalothin, which were hydrolysed in vitro, were potentiated four to 64-fold by 2 mg/l clavulanic acid; but cefoxitin, ceftazidime, cloxacillin and imipenem, which appeared stable in vitro, were potentiated four-fold or less. J Clin Microbiol, 1987 Sep, 25(9), 1725 - 9 In vitro antimicrobial spectrum, occurrence of synergy, and recommendations for dilution susceptibility testing concentrations of the cefoperazone-sulbactam combination; Jones RN et al.; Broth microdilution tests and an antimicrobial interaction (synergy) studies using various combinations of cefoperazone and sulbactam were performed in an effort to determine the most appropriate in vitro dilution test system . The test results with cefoperazone and sulbactam were categorized as synergistic (complete or partial) for nearly 80% of the strains isolated from clinical trial patients . The results indicate that the cefoperazone-sulbactam fixed ratio (2:1) maximized the cefoperazone spectrum of activity and best approximated the parenteral formulation of the drug . The cefoperazone-sulbactam combination had a greater antimicrobial activity than did the other comparison beta-lactams, except for imipenem, tested against strains of the family Enterobacteriaceae . To be consistent with the National Committee for Clinical Laboratory Standards interpretive breakpoints for cefoperazone alone, the following MIC breakpoints should be applied to the combination (2:1 ratio): less than or equal to 16/8 micrograms/ml, susceptible; 32/16 micrograms/ml, moderately susceptible; and greater than or equal to 64/32 micrograms/ml, resistant. Diagn Microbiol Infect Dis, 1987 Sep, 8(1), 1 - 11 Direct susceptibility testing of blood culture isolates with the AutoMicrobic System (AMS); Sahm DF et al.; To decrease the time needed to obtain preliminary antimicrobial susceptibility results with blood culture isolates, we inoculated a suspension of centrifuged organisms from blood culture broth directly into the AutoMicrobic System Gram-Positive (GPS) and Gram-Negative (GSC+) susceptibility cards (AMS, Vitek Systems Inc., Hazelwood, MO) . Interpretive category results (susceptible, moderately susceptible, resistant) obtained by this direct method (DAMS) were then compared with results obtained by conventional inoculation (i.e., using 18-hr subcultures) of both AMS cards (CAMS method) and broth microdilution panels (MIC method, Micro-Media Systems Inc., Potomac, MD) . Ninety-six Gram-positive cocci (951 antimicrobial agent--organism combinations) and 112 Gram-negative bacilli (1006 antimicrobial agent-organism combinations) were tested . When only very major (false susceptible DAMS results) and major (false resistant DAMS results) discrepancies were considered, 95% of the DAMS results for Gram-positive cocci agreed with CAMS results and 93% agreed with MIC results . Most discrepancies were observed when staphylococci were tested against oxacillin and when enterococci were tested against several antimicrobial agents . For Gram-negative bacilli, 94% of DAMS results agreed with CAMS results and 93% agreed with MIC results . Most discrepancies occurred when Enterobacter spp . and Serratia marcescens were tested against ampicillin and cefamandole . The DAMS method provides accurate and rapid preliminary susceptibility test results, usually within 6 to 7 hr of the time a positive blood culture is first detected. Rev Infect Dis, 1987 Sep-Oct, 9 Suppl 5, S527 - 36 Chemical structure and biologic activity of bacterial and synthetic lipid A; Rietschel ET et al.; The chemical structure of the lipid A component of enterobacterial lipopolysaccharide (LPS) is now known in some detail . For example, lipid A of Escherichia coli consists of a beta(1----6)-linked D-glucosamine disaccharide that carries four (R)-3-hydroxytetradecanoyl groups in positions 2, 3, 2', and 3' and two phosphoryl residues in positions 1 and 4' . The hydroxy fatty acids at positions 2' and 3' are acylated at their 3-hydroxyl groups by dodecanoic acid and tetradecanoic acid, respectively . The hydroxyl groups in positions 4 and 6' are free, the latter serving as the attachment site for the polysaccharide component in intact LPS . On the basis of this structure, E . coli-type lipid A and partial structures thereof have been chemically synthesized (group of T . Shiba, Osaka University, Osaka, Japan) and analyzed for endotoxic activity . In all in vivo and in vitro test systems employed (including lethal toxicity, pyrogenicity, local Shwartzman reactivity, B lymphocyte mitogenicity, macrophage activation, and serologic cross-reactivity with lipid A antiserum), synthetic lipid A has activity identical to that of E . coli lipid A . These findings support the structural proposal for lipid A and prove the previous hypothesis that the endotoxic principle is embedded in lipid A. J Med Microbiol, 1987 Sep, 24(2), 165 - 8 A morphological study of the action of equine anti-lipopolysaccharide plasma on gram-negative bacteria; Gaffin SL et al.; Three strains of gram-negative bacteria--one each of Escherichia coli, Klebsiella pneumoniae and Enterobacter sp.--were treated with anti-lipopolysaccharide hyperimmune equine plasma (anti-LPS) or non-immune control plasma and examined by scanning electronmicroscopy . Within a few minutes of treatment with anti-LPS, bacteria were agglutinated . Evidence of cell membrane destruction was observed shortly thereafter and total cell disintegration and disruption occurred within 1-2 h . In contrast, non-immune plasma had no effect on cell morphology . This confirms the findings in previous microbiological studies that specific antibodies in anti-LPS bind to lipopolysaccharide (LPS endotoxin), and thereby initiate the destruction of gram-negative bacteria. Mayo Clin Proc, 1987 Sep, 62(9), 821 - 34 Cephalosporin, carbapenem, and monobactam antibiotics; Thompson RL; Cephalosporin and related antibiotics are highly effective bactericidal agents of relatively low toxicity . The spectrum of activity varies with the drug but is usually broad . The first-generation cephalosporins, and especially cefazolin, are most active against sensitive staphylococci and streptococci . Most second-generation (except cefoxitin) and third-generation cephalosporins show substantial activity against Haemophilus influenzae . All cephalosporins (except cefsulodin) are active against Klebsiella, Escherichia coli, and Proteus mirabilis, whereas only the third-generation agents have pronounced activity against the other Enterobacteriaceae . Imipenem (a carbapenem) is active against essentially all pathogenic organisms, but aztreonam (a monobactam) is active against only aerobic gram-negative bacilli . Advantages associated with some of the new cephalosporins are once-daily administration and high cerebrospinal fluid levels . With the development of new cephalosporins, however, new toxicities have become apparent, and superinfections and induction of resistance have become greater problems . The cephalosporins are among the most expensive antibiotics in use today; thus, use of these expensive agents must be justified by lower toxicity, greater efficacy, or both in comparison with drugs of more reasonable cost. Mayo Clin Proc, 1987 Sep, 62(9), 806 - 20 The penicillins; Wright AJ et al.; The penicillin family of antibiotics is ever expanding and remains an important part of our antimicrobial armamentarium . These medications generally have bactericidal activity, excellent distribution throughout the body, low toxicity, and efficacy against infections due to susceptible organisms . The clinical introduction of aqueous penicillin G for treatment of streptococcal and staphylococcal infections was an important pharmacologic landmark . The emergence of penicillinase-producing staphylococci prompted the development of the penicillinase-resistant penicillins (methicillin, oxacillin, nafcillin, and others), in which the acyl side chain prevented disruption of the beta-lactamase ring . The aminopenicillins (ampicillin, amoxicillin, and others) were later developed because of the need for gram-negative antimicrobial activity . Their spectrum included Escherichia coli, Proteus mirabilis, Shigella, Salmonella, Listeria, and Haemophilus . The search for a penicillin with even further antimicrobial activity against the Enterobacteriaceae and Pseudomonas aeruginosa led to the development of the carboxypenicillins, ureidopenicillins, and piperazine penicillins . Recently, the combination of a beta-lactamase inhibitor (clavulanic acid or sulbactam) and an amino-penicillin or ticarcillin has resulted in further extension of their antibacterial spectra . The development of an ideal penicillin that is nonsensitizing, bioavailable, beta-lactamase-resistant, rapidly bactericidal, nontoxic, and inexpensive and that has high affinity to penicillin-binding proteins and no inoculum effect remains the goal. J Antimicrob Chemother, 1987 Sep, 20(3), 363 - 72 Comparative in-vitro activity of Ro 23-6240, a new trifluorinated quinolone; Verbist L; The in-vitro activity of Ro 23-6240, a new quinolone, was tested in comparison with that of other quinolones against 486 recent clinical isolates . Ro 23-6240 displayed the typical features of the new quinolones: highest activity against Gram-negative bacilli, MBCs close to the MICs, minimum inoculum effect and rapid killing . Against Gram-negative organisms (Enterobacteriaceae, non-fermenters, Haemophilus influenzae and gonococci) the activity of Ro 23-6240 was between that of ofloxacin and norfloxacin; against staphylococci its activity was between that of ciprofloxacin and ofloxacin, and against streptococci it was similar to that of norfloxacin. Immun Infekt, 1987 Sep, 15(5), 165 - 72 {Endocarditis caused by Haemophilus parainfluenzae and Neisseria gonorrhoeae}; Kern W et al.; Infective endocarditis due to gramnegative bacteria is rare . Overall, its relative frequency seems to be much lower than 10 percent . According to the extensive literature reviewed most often the causative microorganisms belong to the families of enterobacteriaceae and pseudomonads . Extremely rare, however, are cases where certain fastidious gramnegative bacteria such as hemophili, neisseria and others are the causative organisms . We report two cases of infective endocarditis due to Haemophilus parainfluenzae and to Neisseria gonorrhoeae . Despite their fastidious growth, both organisms could rapidly be isolated from venous blood cultures . Both were sensitive to ampicillin or penicillin respectively, and adequate antimicrobial therapy could early be initiated . As compared to reports in the literature both cases showed typical valve involvement and took a relatively typical course under medical treatment . The Haemophilus parainfluenzae endocarditis presented as a subacute illness following a tooth extraction and showed large vegetations on a prolapsed mitral valve . In contrast to the findings of others signs of slight renal involvement but no signs of major arterial embolization were noted . Medical treatment with ampicillin plus an aminoglycoside was effective as in most other reported cases . Vegetations were echocardiographically no longer seen after five weeks . The gonococcal endocarditis early led to destructive lesions of the aortic valve, significant regurgitation, vascular congestion and complicating pneumonia . Medical treatment alone was not effective despite the high susceptibility to antibiotics ot the strain isolated . As reported fur the majority of cases reviewed in the literature early valve replacement became necessary for a favourable outcome. J Bacteriol, 1987 Sep, 169(9), 3963 - 8 Purification and properties of pyridoxal-5'-phosphate-dependent histidine decarboxylases from Klebsiella planticola and Enterobacter aerogenes; Guirard BM et al.; Histidine decarboxylases from Klebsiella planticola and Enterobacter aerogenes were purified to homogeneity and compared with the histidine decarboxylase from Morganella morganii . All three enzymes required pyridoxal 5'-phosphate as a coenzyme, showed optimal activity at pH 6.5, decarboxylated only histidine among the amino acids derived from protein, and were tetramers or dimers of identical subunits . Amino-terminal sequences of the three enzymes showed up to 81% homology through residue 33, but the enzymes differed sufficiently in amino acid composition and sequence so that no cross-reaction occurred between the K . planticola or E . aerogenes enzymes and antibodies to the decarboxylase from M . morganii . All three enzymes were inhibited by carbonyl reagents; by amino-, carboxyl-, and some methyl-substituted histidines; and by alpha-fluoromethylhistidine . These decarboxylases, all from gram-negative organisms, differed greatly in subunit structure, biogenesis, and other properties from the pyruvoyl-dependent histidine decarboxylases from gram-positive organisms described previously. Arch Microbiol, 1987 Sep, 148(3), 187 - 92 Evolutionary relationship between Enterobacteriaceae: comparison of the ATP synthases (F1F0) of Escherichia coli and Klebsiella pneumoniae; Kauffer S et al.; The ATP synthase complex of Klebsiella pneumoniae (KF1F0) has been purified and characterized . SDS-gel electrophoresis of the purified F1F0 complexes revealed an identical subunit pattern for E . coli (EF1F0) and K . pneumoniae . Antibodies raised against EF1 complex and purified EF0 subunits recognized the corresponding polypeptides of EF1F0 and KF1F0 in immunoblot analysis . Protease digestion of the individual subunits generated an identical cleavage pattern for subunits alpha, beta, gamma, epsilon, a, and c of both enzymes . Only for subunit delta different cleavage products were obtained . The isolated subunit c of both organisms showed only a slight deviation in the amino acid composition . These data suggest that extensive homologies exist in primary and secondary structure of both ATP synthase complexes reflecting a close phylogenetic relationship between the two enterobacteric tribes. Diagn Microbiol Infect Dis, 1987 Sep, 8(1), 19 - 24 Controlled evaluation of trypticase soy broth with and without gelatin and yeast extract in the detection of bacteremia and fungemia; Reimer LG et al.; The addition of gelatin to blood culture media has been suggested to prevent the inhibition of Neisseria meningitidis, Neisseria gonorrhoeae, Gardnerella vaginalis, and Peptostreptococcus anaerobius that is caused by sodium polyanetholsulfonate . To determine the effect of such supplementation on the overall yield of microorganisms, we compared the yield and speed of detection of clinically important microorganisms from 5422 paired 10-ml samples of blood cultured in Trypticase soy broth (TSB) containing 0.03% sodium polyanetholesulfonate (SPS) and TSB/SPS containing 1.2% gelatin and 1.0% yeast extract (mTSB) . The atmosphere of incubation (open venting unit) and ratio of blood to broth (1:5) were the same for both samples . Only cultures with adequate blood sample (greater than or equal to 80% of stated volume) were compared statistically . Addition of gelatin and yeast extract resulted in inhibited growth of Enterobacteriaceae (p less than 0.001), Pseudomonas aeruginosa (p less than 0.01), fungi (p less than 0.05), and the overall set of microorganisms encountered (p less than 0.001) . It delayed growth of Enterobacteriaceae (p less than 0.001) but reduced the time to recover staphylococci (p less than 0.02) . Of 12 isolates of species usually inhibited by SPS, seven grew only with the addition of gelatin and yeast extract, none grew only without supplementation, and five grew in both media . Although gelatin and yeast extract may improve the yield of some specific bacteria, the routine use of these additives cannot be recommended for all blood culture media. Arch Pathol Lab Med, 1987 Sep, 111(9), 879 - 81 Cryptosporidial and cytomegaloviral hepatitis and cholecystitis; Kahn DG et al.; We describe an immunosuppressed patient with enteric cryptosporidiosis who developed combined cryptosporidial and cytomegaloviral hepatitis and cholecystitis as well as Enterobacter cloacae cholecystitis . To our knowledge, the presence of Cryptosporidium in a liver biopsy specimen has not previously been reported. Biochemistry, 1987 Aug 25, 26(17), 5329 - 37 Cryoenzymology of beta-lactamases; Cartwright SJ et al.; The cryoenzymology of several different beta-lactamases has been investigated . Particular attention has been paid to the experimental pitfalls of the technique . These include such factors as false bursts at the start of the reaction, instability of the enzymes during turnover, and Km values so high that little of the enzyme is present as a complex . Many of the difficulties in cryoenzymology stem from the use of organic cryosolvents . A novel "salt" cryosolvent has been tested: ammonium acetate solutions can be used down to about -60 degrees C . The enzymes examined are readily soluble, and stable, in this solvent . Nevertheless, out of 17 beta-lactamase beta-lactam systems, only 4 proved suitable for detailed investigation . In two of these, the hydrolysis of nitrocefin or 7-(thienyl-2-acetamido)-3-{{2-{{4- (dimethylamino)phenyl}azo}pyridinio}-methyl}cephem-4-carboxylic acid (PADAC), by beta-lactamase I from Bacillus cereus, substrate was converted into product at a slow enough rate (at -60 or -55 degrees C, respectively) for it to be possible to do successive scans during the course of the reaction . The spectra were those of substrate and product, and no intermediate was detected . The results argue against the accumulation of intermediate acyl-enzyme . The hydrolysis of PADAC by the P99 beta-lactamase from Enterobacter cloacae again showed spectra characteristic of substrate and product, and there was, moreover, a break in the Arrhenius plot; it is possible that a conformational change is (at least partially) rate-determining . The hydrolysis of dinitrophenylpenicillin by the P99 beta-lactamase did show features suggesting the accumulation of acyl-enzyme.(ABSTRACT TRUNCATED AT 250 WORDS) Vet Rec, 1987 Aug 22, 121(8), 162 - 6 Efficacy of sulbactam-ampicillin in the treatment of neonatal calf diarrhoea; Grimshaw WT et al.; Sulbactam-ampicillin is a combination of sulbactam, a beta-lactamase inhibitor, and ampicillin, a broad spectrum beta-lactam antibiotic . The efficacy of sulbactam-ampicillin was evaluated in the treatment of neonatal calf diarrhoea under conditions where a major proportion of the calves were excreting enterobacteria which were resistant to beta-lactam antibiotics . In a series of six studies with a common experimental design, three treatments (sulbactam-ampicillin, ampicillin alone and untreated control) were compared in over 300 Friesian and Ayrshire calves aged between three and 10 days and of known immunological status as determined by their zinc sulphate turbidity values . A mortality rate of 26.4 per cent in the negative control calves was reduced to 14.0 per cent with ampicillin alone and 9.5 per cent with sulbactam-ampicillin . The probability of diarrhoea subsequent to initiation of treatment was reduced from 0.50 in the negative control calves to 0.44 with ampicillin alone and 0.35 with sulbactam-ampicillin . The differences in mortality and diarrhoea observed between the calves treated with sulbactam-ampicillin and the calves in each of the other treatment groups were statistically significant . The superior efficacy of sulbactam-ampicillin is explained by the inhibitory effect of sulbactam on the beta-lactamases produced by resistant bacteria, thus rendering them susceptible to the ampicillin in the combination. Lancet, 1987 Aug 8, 2(8554), 302 - 6 Transferable enzymatic resistance to third-generation cephalosporins during nosocomial outbreak of multiresistant Klebsiella pneumoniae; Brun-Buisson C et al.; Klebsiella pneumoniae strains that were resistant to third-generation cephalosporins and amikacin were recovered from 62 of 395 patients (15.7%) during 1986 . 25 isolates (40%) caused urinary tract infections . The outbreak involved three intensive care units (54 isolates), and spread from one unit to another and then to four wards (8 isolates) . K pneumoniae of various serotypes and strains of different Enterobacteriaceae demonstrating the same antibiotic resistance pattern were isolated, which suggests dissemination of an R-factor . The isolates had low-level resistance to third-generation cephalosporins (mode minimum inhibitory concentration of cefotaxime, 2 mg/l) but remained sensitive to cephamycins . Cefotaxime was effective in cases of uncomplicated urinary tract infection, but failed in major infections at other sites . 1-5 mg/l of the beta-lactamase inhibitors clavulanic acid or sulbactam restored normal activity to cefotaxime against the multiresistant strains . Resistance to third-generation cephalosporins was mediated by a new broad-spectrum enzyme of isoelectric point 6.3 . Resistance to beta-lactams and aminoglycosides was transferable to Escherichia coli . The emergence of transferable enzymatic resistance to newer beta-lactams in K pneumoniae strains indicates a major risk of spread of such resistance to otherwise sensitive strains. Antibiot Med Biotekhnol, 1987 Aug, 32(8), 597 - 602 {Bacterial antilysozyme activity and its regulation by antibiotics}; Bukharin OV et al.; The effect of subinhibitory doses of 25 antibiotics on the antilysozyme property of enterobacteria considered as a marker of their persistence was studied . This provided dividing the antibiotics into 3 groups: antibiotics increasing the bacterial capacity for lysozyme degradation, antibiotics indifferent with respect to this property and antibiotics decreasing it . Decreasing of the Salmonella antilysozyme activity by gentamicin under experimental conditions promoted suppression of the bacteria parasitism in Hep-2 cells . Clinical and laboratory studies on the effect of antibiotic therapy under the control of the time course of the antilysozyme property of the pathogen in patients with acute dysentery, pyelonephritis and inflammatory processes in the female genitalia showed that the use of the antibiotics increasing this property in the pathogen was not advisable which was confirmed by the absence of significant clinical improvement in the patients and necessity of prolonging the sanative period. Acta Pathol Microbiol Immunol Scand {B}, 1987 Aug, 95(4), 257 - 9 Evaluation of two vacuum bottle blood culture media--supplemented peptone broth and brain heart infusion broth; Sandven P et al.; A new blood culture medium (brain heart infusion broth) (BHI) from Terumo was compared with a commonly used blood culture medium, supplemented peptone broth (Becton Dickinson) (SPB) . Blood from patients with suspected bacteraemia was simultaneously cultured in the two media, approximately five ml of blood in each bottle . Both bottles were incubated aerobically at 37 degrees C for 7 days . A total of 3724 paired blood cultures (sets) were processed . Altogether 340 (9.1%) of the blood culture sets were positive . Of these, 233 were positive in both media, 51 in the SPB medium only and 56 in the BHI medium only . Despite the similar overall results, Streptococcus spp . and anaerobic bacteria were detected more frequently in the SPB bottles and Enterobacteriaceae more frequently in the BHI bottles. J Infect Dis, 1987 Aug, 156(2), 369 - 73 Development of beta-lactam-resistant Enterobacter cloacae in mice; Marchou B et al.; We compared the ability of four newer beta-lactam compounds to produce resistance in an experimental model of Enterobacter cloacae infection . Mice infected intraperitoneally developed resistance depending on antibiotic treatment and the dose given . Percentages of mice in which resistance was observed were as follows: 100% after ceftriaxone (50 mg/kg, two doses); 87% after ceftriaxone (50 mg/kg, one dose); 35% after ceftriaxone (500 mg/kg, one dose); and 21% after carumonam (25 mg/kg, two doses) . No resistance occurred after therapy with either BMY 28142 (25 mg/kg, two doses) or Sch 34343 (50 mg/kg, two doses) . Heterogeneous resistance to beta-lactams among the cells within a given Enterobacter population accounted for these differences . The minimal concentration inhibiting the growth of the preexisting resistant variants, together with the antibiotic concentrations obtained in the peritoneal fluid, were associated with further emergence of resistance in the mouse treated with this antibiotic. J Infect Dis, 1987 Aug, 156(2), 363 - 8 Patients' endogenous flora as the source of "nosocomial" Enterobacter in cardiac surgery; Flynn DM et al.; We prospectively studied Enterobacter colonization in cardiac surgery patients receiving cefazolin prophylaxis . Fifty-eight (67%) of 87 patients became colonized, 28 by the time of admission to a Cardiac Surgery Intensive Care Unit . Enterobacter cloacae was four times more prevalent than Enterobacter aerogenes . We found increased Enterobacter colonization, after prophylaxis, in 45% of surgery patients . None of 25 control patients, who underwent coronary angioplasty and received no antibiotic prophylaxis, showed increased colonization (P = .001) . Both groups had similar baseline rates of Enterobacter carriage . Typing showed 50 distinct strains of E . cloacae and 11 of E . aerogenes; 25% of patients carried greater than or equal to 2 strains simultaneously . In the nine cases of horizontal transmission, source patients were intubated for greater than or equal to 5 days and had heavy throat carriage of Enterobacter . No environmental sources of transmission were found . Clinical Enterobacter infection developed in 12 patients; at least nine of these were infected with a strain that had been isolated by surveillance culture . We conclude that Enterobacter, part of the patients' endogenous flora, becomes an important pathogen when amplified by prophylactic antibiotics and is less often transmitted horizontally. Eur J Clin Microbiol, 1987 Aug, 6(4), 476 - 8 Evaluation of disk approximation and agar dilution induction tests for demonstration of in vitro antagonism of cefotaxime by cefoxitin in Enterobacter species; Chandler SW et al.; Cefoxitin-resistant clinical isolates of Enterobacter spp . demonstrated inducible beta-lactamase activity in 31 of 47 (65.9%) disk approximation tests and in 32 of 52 (63.5%) agar dilution induction tests . Agreement between the two results was only 72.3%, and 80.9% of the strains were positive in at least one induction test . Lack of valid interpretive criteria preclude their routine use in the clinical laboratory. Eur J Clin Microbiol, 1987 Aug, 6(4), 451 - 5 Ability of newer beta-lactam antibiotics to induce beta-lactamase production in Enterobacter cloacae; Then RL; The beta-lactamase inducing properties of various new beta-lactam antibiotics in two isogenic strains of Enterobacter cloacae were investigated . Beta-lactamase activity was measured two hours after addition of inducer to cells in the late logarithmic growth-phase . Beta-lactamase expression was highly dependent on the growth medium used, highest levels being obtained after induction with cefoxitin in Tryptic Soy broth, Mueller-Hinton broth and Nutrient broth . Upon induction the mutant 908 Ssi produced tenfold higher beta-lactamase levels than its parent wild type 908 Swi . Among the new antibiotics investigated, sulfoxides of several oxyimino-cephalosporins, HR 810, cefetamet, cefteram, carumonam and BRL 36650 were moderate or poor inducers . The penem FCE 22101 resembled imipenem in its strong inducing properties. Chemioterapia, 1987 Aug, 6(4), 251 - 5 Ciprofloxacin inhibition of cefoxitin betalactamase induction in an Enterobacter cloacae strain; Periti P et al.; The betalactamase activity of an Enterobacter cloacae strain was measured using subinhibitory concentrations of cefoxitin and ciprofloxacin respectively as enzyme inducer and induction inhibitor . Cultures of this strain were also exposed to different ceftriaxone concentrations either alone or in the presence of cefoxitin and/or ciprofloxacin . Ciprofloxacin at subinhibitory concentrations does not interfere with ceftriaxone's activity and is capable of neutralizing the antagonistic effect of cefoxitin on ceftriaxone . The enzyme assay and MS-2 System demonstrate ciprofloxacin's partial suppression of cefoxitin betalactamase induction in the E . cloacae strain tested. Antimicrob Agents Chemother, 1987 Aug, 31(8), 1188 - 93 Comparative in vitro activity of CGP 31608, a new penem antibiotic; Eliopoulos GM et al.; The in vitro activity of a new penem antimicrobial agent, CGP 31608, was compared with those of imipenem, SCH 34343, and several other antimicrobial agents against approximately 600 bacterial isolates . CGP 31608 was active against gram-positive organisms, including methicillin-susceptible Staphylococcus aureus (MIC for 90% of the isolates {MIC90}, 0.25 microgram/ml) and penicillin-susceptible streptococci (MIC90s, less than or equal to 2 micrograms/ml) . Penicillin-resistant streptococci (including enterococci) and methicillin-resistant S . aureus were more resistant to the penem . Activities of CGP 31608 against members of the family Enterobacteriaceae were remarkably uniform, with MIC90s of 8 to 16 micrograms/ml . CGP 31608 was at least as active as imipenem and ceftazidime and more active than piperacillin against Pseudomonas aeruginosa . Drug activity was not influenced by the presence of any of 10 plasmid-mediated beta-lactamases . Against strains of Serratia marcescens, Enterobacter cloacae, and P . aeruginosa with derepressible chromosomally mediated beta-lactamases, the presence of cefoxitin did not induce increased resistance to CGP 31608 . The new drug was also active against anaerobes (MIC90s, 0.25 to 8 micrograms/ml), Haemophilus influenzae (MIC90s, 0.5 to 1.0 micrograms/ml), and Legionella spp . (MIC90, 2 micrograms/ml) . CGP 31608 showed an antibacterial spectrum similar to those of imipenem and SCH 34343 (except that the latter is not active against P . aeruginosa) but was generally less potent than these drugs . However, CGP 31608 demonstrated more activity (MIC90) than imipenem against P . aeruginosa, Pseudomonas cepacia, and methicillin-resistant Staphylococcus epidermidis and S . aureus. Antimicrob Agents Chemother, 1987 Aug, 31(8), 1164 - 8 Leakage of beta-lactamase: a second mechanism for antibiotic potentiation by amdinocillin; Sanders CC et al.; Discrepancies were observed between results of different beta-lactamase induction tests with amdinocillin, which appeared to be a strong inducer in whole-cell assays but a weak inducer in assays with cell-free sonic extracts . Results of a nitrocephin-disk test with constitutive beta-lactamase producers indicated that the positive results obtained in whole-cell assays were due to drug-produced leakage of enzyme from the cell and not to induction . Imipenem was also found to cause leakage of beta-lactamase from a similar number of constitutive enzyme producers, while cefoxitin was much less likely to cause leakage . A split-dose regimen was employed to treat mice infected with a strain of Enterobacter cloacae which appeared to leak enzyme on exposure to amdinocillin . Results indicated that prior treatment with amdinocillin significantly enhanced (P less than 0.025) the efficacy of azlocillin, an enzyme-labile drug, but did not affect the efficacy of cefotaxime, a relatively enzyme-stable drug . Conversely, prior treatment with amdinocillin did not potentiate the efficacy of either azlocillin or cefotaxime in the treatment of mice infected with an Escherichia coli strain that was highly susceptible to all three drugs . Thus, it appears that amdinocillin may potentiate the activity of other beta-lactam drugs not only by binding to a complementary penicillin-binding protein but also by causing leakage of beta-lactamase from the cell . This effect may be related to its ability to bind to penicillin-binding protein 2 and subsequently produce changes in outer membrane permeability. J Clin Microbiol, 1987 Aug, 25(8), 1570 - 1 Cross susceptibility and absence of cross resistance to cefotetan and cefoxitin; Barry AL et al.; Tests with 2,713 bacterial isolates (members of the family Enterobacteriaceae and gram-positive cocci) from 14 laboratories compared cefoxitin MICs with cefotetan MICs . Strains that were susceptible to cefoxitin could be assumed to be susceptible to cefotetan . Over half of the cefoxitin-resistant isolates of the Enterobacteriaceae were susceptible to cefotetan. Zh Mikrobiol Epidemiol Immunobiol, 1987 Aug, (8), 19 - 23 {Biological properties of opportunistic microorganisms isolated from patients with acute intestinal diseases}; Polikarpov NA; The comparative study of the incidence of the pathogenicity markers (DNAase, RNAase, phosphatase and hemolytic activity) in shigellae and salmonellae, acknowledged as the causative agents of intestinal infections, and in opportunistic bacteria isolated from the feces of patients with acute intestinal diseases and healthy persons has been made . The study has revealed that DNAase and RNAase activity occurs most frequently in Shigella flexneri, in salmonellae and in opportunistic enterobacteria isolated from the intestinal contents of patients with acute intestinal diseases . In this respect they essentially differ from the same species of opportunistic enterobacteria isolated from healthy persons. Eur J Clin Microbiol, 1987 Aug, 6(4), 435 - 8 Clinical importance of inducible beta-lactamases in gram-negative bacteria; Sanders CC et al.; The clinical problems caused by inducible beta-lactamases in certain gram-negative bacteria are being recognized with increasing frequency . These problems include the rapid emergence of multiple beta-lactam resistance during therapy with many of the newer beta-lactam antibiotics . Such multiply resistant organisms are now spreading within the hospital and have become important nosocomial pathogens . This has been a particularly difficult problem for intensive care units, cystic fibrosis centers and burn units where there are clusters of patients who are highly susceptible to infections with organisms like Enterobacter spp., Serratia spp . and Pseudomonas aeruginosa, which possess inducible beta-lactamases . Only through an awareness of these problems, their cause, and restriction of the use of certain newer beta-lactam antibiotics can these problems be controlled. Eur J Clin Microbiol, 1987 Aug, 6(4), 420 - 2 Bacteria isolated from skin and soft tissue lesions; Kontiainen S et al.; The pathogens most often isolated from lesions in skin and soft tissues were Staphylococcus aureus and Streptococcus pyogenes . Cultures from venous leg ulcers, decubitus ulcers and infectious gangrene often yielded also Pseudomonas spp., enterobacteria and enterococci . Obligate anaerobes were frequently isolated especially from abscesses and decubitus ulcers . One third of the abscesses and half of the decubitus ulcers yielded obligate anaerobes. Drugs, 1987 Aug, 34(2), 188 - 221 Cefmenoxime . A review of its antibacterial activity, pharmacokinetic properties and therapeutic use; Campoli-Richards DM et al.; Cefmenoxime is an aminothiazolyl cephalosporin administered intravenously or intramuscularly . Like other 'third-generation' cephalosporins it is active in vitro against most common Gram-positive and Gram-negative pathogens, is a potent inhibitor of Enterobacteriaceae (including beta-lactamase-producing strains), and is resistant to hydrolysis by beta-lactamases . Cefmenoxime has a high rate of clinical efficacy in many types of infection and is at least equal in clinical and bacteriological efficacy to several other cephalosporins in urinary tract infections, respiratory tract infections, postoperative infections and gonorrhoea . Cefmenoxime, like latamoxef, cefoperazone and cefamandole, has an N-methyltetrazole side chain at the 3-position of the cephalosporin nucleus and thus possesses the potential for producing hypoprothrombinaemic bleeding and disulfiram-like reactions . However, these reactions have been reported very rarely and the antibacterial is generally well tolerated . It is likely that cefmenoxime will most closely resemble cefotaxime and ceftizoxime in therapeutic profile and usefulness. J Antimicrob Chemother, 1987 Aug, 20(2), 255 - 9 Frequencies of variants resistant to different aminoglycosides in Pseudomonas aeruginosa; Nilsson L et al.; The MICs of aminoglycosides for Pseudomonas aeruginosa are higher than those for Enterobacteriaceae and the number of variants resistant to high concentrations of aminoglycosides is greater in P . aeruginosa than in Escherichia coli . However, when the frequencies of resistant variants at different multiples of the MIC were calculated, these frequencies were similar in P . aeruginosa and E . coli . When large inocula of strains of P . aeruginosa, which were classified as sensitive in conventional MIC determinations, were incubated with amikacin, gentamicin, netilmicin or tobramycin at the break-point concentrations between sensitivity and resistance, 82%, 90%, 90% and 15%, respectively, of the strains regrew . The corresponding percentages for Enterobacteriaceae were much lower . The clinical relevance of this pronounced regrowth of P . aeruginosa is discussed. J Clin Microbiol, 1987 Aug, 25(8), 1481 - 5 Sensititre autoreader for same-day breakpoint broth microdilution susceptibility testing of members of the family Enterobacteriaceae; Doern GV et al.; The Sensititre Autoreader system is an instrument-assisted broth microdilution susceptibility test procedure based on the detection of fluorogenic growth substrate metabolism by test bacteria with different concentrations of antimicrobial agents . In the current investigation, this system was assessed as a means for predicting the in vitro activity of 17 antimicrobial agents versus numerous species of the family Enterobacteriaceae and Pseudomonas aeruginosa by using a breakpoint broth microdilution test format . Same-day and overnight determinations of susceptibility were made with the Sensititre Autoreader system, and in both cases, the results were compared with those obtained with a manual overnight breakpoint broth microdilution susceptibility test . Among a total of 6,086 organism-antimicrobial agent comparisons with Enterobacteriaceae, concordance was noted between the results of the same-day Autoreader system and the manual overnight test in 94.4% of cases . The same-day Autoreader results with members of the Enterobacteriaceae other than Proteus spp . were determined after 4 h of incubation; with Proteus spp . the same-day Autoreader results were determined after 5 h of incubation . When the Enterobacteriaceae Autoreader results were determined after 18 h of incubation, concordance was noted in 97.2% of comparisons . Among a total of 1,377 organism-antimicrobial agent comparisons with P . aeruginosa after 18 h of incubation, agreement of results from the manual overnight test and the Autoreader system was achieved in 92.2% of cases. J Med Microbiol, 1987 Aug, 24(1), 21 - 8 Antigenic relationships among type-1 fimbriae of Enterobacteriaceae revealed by immuno-electronmicroscopy; Adegbola RA et al.; Antigenic relationships among type-1 fimbriae of 40 strains of Enterobacteriaceae representing 19 species and seven genera were determined by immuno-electronmicroscopy . Ten distinct antigenic groups were distinguished . Intra- and inter-generic relationships were observed although some antigenic groups were species-specific only . Antigenic relationships among type-1 fimbriae are more complex than have been reported hitherto. Hinyokika Kiyo, 1987 Aug, 33(8), 1316 - 8 {A study of prostatic tissue levels of cefbuperazone}; Izumi H et al.; The concentration of Cefbuperazone (CBPZ) were determined by bioassay in the serum and prostatic tissue of 36 patients with benign prostatic hypertrophy, who underwent transurethral resection . One gram of CBPZ was injected intravenously prior to surgery . Pharmacokinetic analysis was performed using the two or three compartment model theory . The maximum serum level of CBPZ was 82.2 micrograms/ml at 30 min after the start of CBPZ administration and biological half-life was 97.3 min . CBPZ concentration in prostatic tissue reached a maximum level of 26.3 micrograms/g at 50 min following CBPZ administration . The prostatic tissue level was 28-40% of the serum level . These results suggested that intravenous administration of CBPZ would be extremely effective against pathogenic bacteria, particularly Enterobacter, E . coli, Klebsiella, Serratia, Proteus and Bacteroides, judging from its prostatic concentration. J Antibiot (Tokyo), 1987 Jul, 40(7), 946 - 52 Chloropolysporins A, B and C, novel glycopeptide antibiotics from Faenia interjecta sp . nov . V . Comparative studies of the biological properties; Takatsu T et al.; Chloropolysporins A, B and C, as well as derivatives prepared from this group and alpha- and beta-avoparcins by enzymatic and mild acid hydrolysis, were active against Gram-positive bacteria including clinically isolated methicillin-resistant Staphylococci (MIC 0.39-6.25 micrograms/ml) and anaerobic enterobacteria (MIC 0.10-1.56 micrograms/ml) . Derhamnosyl and demannosyl derivatives from both groups of antibiotics showed stronger activities than the parent compounds . The MIC and MBC values against Staphylococci were similar and were not effected by the presence of serum . Moreover, chloropolysporin C exhibited very strong synergistic effects with various beta-lactam antibiotics against methicillin-resistant strains of Staphylococcus aureus . Some of these compounds also protected mice from experimental infection with S . aureus . Acute toxicities of chloropolysporin by intravenous administration ranged from 215-290 mg/kg in mice . Chloropolysporin B as well as other glycopeptide antibiotics, showed distinctive growth promoting activity in broiler chickens. J Clin Microbiol, 1987 Jul, 25(7), 1195 - 200 Collaborative clinical laboratory study of a broth-disk test for determination of bacterial susceptibility to beta-lactams in combination with amdinocillin; Isenberg HD et al.; Methodology for the performance of synergistic antibiotic susceptibility studies has not been standardized . We addressed this problem collaboratively with combinations of amdinocillin and select other beta-lactam antibiotics by using a simple broth-disk test compared with a microdilution approach . Each method used the same drugs singly and in combination . The broth-disk test evaluated each agent and the combinations at concentrations that reflected the breakpoints for each drug; the same ratios of beta-lactam to amdinocillin were used in doubling dilutions with the microdilution method . Initially, each participant studied the same 50 members of the family Enterobacteriaceae; each bacterium was studied on three occasions . Thereafter, 500 representatives of Enterobacteriaceae isolated recently from clinical specimens were studied . Designated strains served as controls . Reproducibility between the two approaches studied in phase 1 of the investigation indicated good agreement between the methods, ranging from 87 to 100% . Agreement between the microdilution and broth-disk tests for the 2,551 clinical isolates ranged from 86 to 95%, with slightly better correlations between combination results than with the single agents . The findings indicate that antibiotic disks used routinely in the clinical laboratory can be used in a simple elution test to determine susceptibility of organisms to beta-lactam antibiotics alone and in combination with amdinocillin. Surg Gynecol Obstet, 1987 Jul, 165(1), 29 - 32 Presumptive antibiotics for penetrating abdominal wounds; Posner MC et al.; The optimal antibiotic agent or agents for penetrating abdominal injuries remains undetermined . During the two year period ending April 1985, 150 consecutive patients undergoing celiotomy for penetrating abdominal trauma were prospectively randomized to receive either mezlocillin (4 grams every six hours) or clindamycin (600 milligrams every six hours) and gentamicin (loading dose of 2.0 milligrams per kilogram, then 1.5 milligrams per kilogram every eight hours) . Antibiotics were begun in the emergency department with duration of coverage based upon the injury pattern--colon, five days; other hollow visceral injury, two days, and all others, one day . Ten patients were excluded due to breach in protocol and other patients died within 48 hours of presentation . The two study groups, comprised of the remaining 130 patients, were comparable with respect to age, sex, injury mechanism, incidence of colonic injuries, intraoperative blood replacement and abdominal trauma index . Overall incidence of septic morbidity was similar among the groups; ten of the 61 patients receiving mezlocillin and nine of those receiving clindamycin and gentamicin had infection develop . There was no significant difference with respect to extensive abdominal infection (10 versus 3 per cent) . The pattern of postoperative infection and offending pathogens were similar in the study groups . Enterobacteriaceae, enterococcus and Bacteroides species were most frequently isolated . Infection was due to an organism resistant to the initial study regimen in one of the ten failures with mezlocillin and in two of the nine failures with clindamycin and gentamicin . Mezlocillin, a single agent broad spectrum penicillin, achieved comparable results with more expensive potentially toxic combination therapy for penetrating wounds. J Antimicrob Chemother, 1987 Jul, 20(1), 15 - 22 The effect of imipenem on strains of Enterobacteriaceae expressing Richmond & Sykes class I beta-lactamases; Ashby J et al.; Fourteen strains of Enterobacteriaceae producing Richmond & Sykes Class I beta-lactamase were studied . The ability of cefoxitin and imipenem to induce beta-lactamase production (reversible derepression) and to select stably derepressed mutants in these strains was assessed . beta-Lactamase induction by cefoxitin and imipenem was demonstrated by the disc diffusion technique in all strains . Cefoxitin selected stably derepressed mutants for all strains in broth cultures, but in an identical experiment imipenem did not . The susceptibility of each strain and its stably derepressed mutant (selected with cefoxitin) to a range of beta-lactam antibiotics was then ascertained . The stably derepressed mutants exhibited decreased susceptibility to all antibiotics tested except imipenem . The decrease in susceptibility varied between strains and between antibiotics but reached a maximum of a 256-fold decrease . The beta-lactamase activity of selected stably derepressed mutant strains showed at least a 600-fold increase in activity . Imipenem would therefore seem an appropriate choice for therapy of infections caused by this group of organisms, as it is active against derepressed mutants and unlikely to select any such strains during therapy. Jpn J Antibiot, 1987 Jul, 40(7), 1317 - 31 {Susceptibility of clinical isolates to aztreonam}; Asari S et al.; Aztreonam (AZT), which has a newly developed and synthetic structure belonging to the group of monobactams, possesses excellent antibacterial activity against a broad range of Gram-negative bacteria (including the beta-lactamase producing strains) . Antibacterial activities of AZT were examined and compared with those of 5 antibiotics (cefoperazone (CPZ), latamoxef (LMOX), cefotaxime (CTX), cefmetazole (CMZ) and cefsulodin (CFS) against 296 strains of clinical isolates . The evaluation of antibacterial activities was determined with the inhibition zone diameter obtained by the single disc method . The results can be summarized by three categories as follows: 1 . Susceptibility of clinical isolates to AZT and other antibiotics AZT and other 3rd-generation antibiotics (CPZ, LMOX, CTX) showed excellent antibacterial activities against most strains . Especially AZT was more active against Enterobacter cloacae and Serratia marcescens than reference drugs . Against Pseudomonas aeruginosa, the activity of AZT was similar to that of CFS . AZT showed as excellent activity against P . aeruginosa as CFS . 2 . Susceptibility of strains isolated from different clinical materials and different clinics AZT showed the highest antibacterial activity against the clinical isolates from sputum, pharynx, urine, pus, bile, puncture fluid, blood and others . AZT exhibited the most potent activity against isolates in the 7 clinics we tested . 3 . Susceptibility of strains isolated from inpatients and outpatients AZT demonstrated the highest antibacterial activity (the rate of susceptibility: 87.0%) against strains obtained from inpatients (except for P . aeruginosa) . The activity of AZT (81.4%) against P . aeruginosa was as active as that of CFS (81.4%), and it was the highest in all drugs . Antibacterial activity of these antibiotics against bacteria was rated as follows: AZT greater than LMOX greater than CPZ greater than CTX greater than CMZ AZT showed the highest antibacterial activity (100%) against strains isolated in all the materials and at all the clinics tested of outpatients . Antibacterial activity of these antibiotics against isolates from outpatients was rated as follows: AZT greater than CPZ greater than LMOX greater than CTX greater than CMZ. Ann Inst Pasteur Microbiol, 1987 Jul-Aug, 138(4), 439 - 48 Trimethoprim resistance in urinary bacteria isolated from patients attending general practitioners; Amyes SG; The incidence of trimethoprim resistance amongst enterobacterial strains responsible for significant bacteriuria in patients attending general practitioners in Edinburgh was 11.4% . Two-thirds of these resistant strains were highly resistant to trimethoprim . Trimethoprim resistance was more prevalent in bacteria isolated from men and from elderly patients . Less than half of the highly resistant strians possessed trimethoprim resistance plasmids; however, amongst those that did, one plasmid predominated . This plasmid was identical with the most successful trimethoprim resistance plasmid in hospital enterobacterial isolates at that time. Zh Mikrobiol Epidemiol Immunobiol, 1987 Jul, (7), 53 - 6 {Content and properties of the antibodies to the outer membrane Re-glycolipid of enterobacteria in mothers and newborn infants}; Galdavadze MA et al.; Antibodies to Re-glycolipid of the outer membrane of enterobacteria have been detected in higher titers in the blood and milk of mothers and in the umbilical blood of newborns than in the blood of nonpregnant women . Re-antibodies in the umbilical blood are mainly resistant to 2-mercaptoethanol and possess higher protective activity with respect to Escherichia coli than Re-antibodies in the venous blood of mothers. Zh Mikrobiol Epidemiol Immunobiol, 1987 Jul, (7), 3 - 6 {Hemagglutinating and adhesive capacities of Klebsiella and Enterobacter strains}; Bondarenko VM et al.; The authors analyze the data of studies on the hemagglutinating and adhesive capacity of 290 cultures, including 118 K . pneumoniae strains and 64 E . cloacae strains isolated from sick children, as well as 59 K . pneumoniae strains and 49 E . cloacae strains isolated from healthy children . The hemagglutinating properties of the strains were determined in the hemagglutination test with fresh, formalin- and tannin-treated red blood cells, the adhesive properties were studied by light microscopy . Among K . pneumoniae and E . cloacae strains isolated in acute intestinal infections, mannose-sensitive hemagglutination and pronounced adhesive activity were prevalent in most cases . Poorly adhesive and nonadhesive strains were characteristic of K . pneumoniae and E . cloacae cultures isolated from healthy children . The strains isolated from sick and healthy children differed only by the prevalence of adhesive cultures. Infection, 1987 Jul-Aug, 15(4), 241 - 4 The influence of flucloxacillin and amoxicillin with clavulanic acid on the aerobic flora of the alimentary tract; Vlaspolder F et al.; In a randomized study, 42 patients undergoing extensive maxillo-facial surgery (correction of the position of the mandible or maxilla by using autologous bone transplants) received prophylactically ten-day courses of either flucloxacillin or amoxicillin with clavulanic acid . Patients were comparable with regard to age and type of surgery . During the prophylactic treatment the effect of antibiotics used on the microbial flora of the alimentary tract was studied . Patients receiving flucloxacillin showed increased numbers of Klebsiella spp . isolated from the faeces (59% of the patients versus 19% of the patients receiving amoxicillin with clavulanic acid) . Patients receiving amoxicillin with clavulanic acid showed higher colonization rates of oropharynx with Enterobacteriaceae than patients receiving flucloxacillin (ten patients versus five patients) . 60% of those strains isolated from patients receiving amoxicillin with clavulanic acid were resistant to this combination, as compared to 20% of gram-negative bacilli isolated from patients receiving flucloxacillin . In 50% of patients receiving amoxicillin with clavulanic acid, colonization of the gut with yeast occurred, as compared to 18% of patients receiving flucloxacillin . Only one infection leading to a partial loss of the graft was seen in the group of patients receiving flucloxacillin. Antimicrob Agents Chemother, 1987 Jul, 31(7), 1069 - 74 Interaction of (2,3)-methylenepenams with penicillin-binding proteins; Georgopapadakou NH et al.; A series of (2,3)-methylenepenams were examined with respect to binding to essential penicillin-binding proteins (PBPs) in Escherichia coli and Staphylococcus aureus . The compounds were also examined with respect to their interaction with Streptomyces strain R61 DD-carboxypeptidase . The alpha isomer of (2,3)-methylene penicillin G bound to PBP 3 of E . coli and other enterobacteria at 0.1 to 10 micrograms/ml . The beta isomer bound to PBP 3 at 100 micrograms/ml . Either isomer bound to PBPs 1b and 2 of E . coli only at 100 micrograms/ml . The alpha, but not the beta, isomer also bound to PBP 2 of S . aureus at 0.1 micrograms/ml . Binding studies with radiolabeled compounds indicated the binding to be covalent and revealed no additional binding proteins . (2,3)-Methylenepenams active against E . coli bound to PBP 3 and induced filamentation . The compounds also inhibited Streptomyces strain R61 DD-carboxypeptidase with apparent 50% inhibitory concentrations as low as 10(-7) M . The two (2,3)-methylene penicillin G isomers bound to the enzyme covalently, most likely at the same site as penicillin G since partial proteolysis after binding radiolabeled compounds produced similar peptide patterns . The bound beta isomer was released with a half-time similar to that of penicillin G (70 min at 30 degrees C), while the alpha isomer was released with a longer half-time (13 h at 30 degrees C) . With either isomer, the major release product was phenylacetylglycine, suggesting C-5-C-6 cleavage. Drug Intell Clin Pharm, 1987 Jul-Aug, 21(7-8), 568 - 74 Ciprofloxacin; Terp DK et al.; Ciprofloxacin is a new fluorinated quinolone antibiotic with high activity against a wide spectrum of gram-positive and gram-negative bacteria, including methicillin-resistant Staphylococcus aureus, Enterobacteriaceae, and Pseudomonas aeruginosa . Clinical trials using the oral preparation of ciprofloxacin have demonstrated its effectiveness in a wide variety of infections . In addition, extensive clinical trials with the intravenous preparation are underway . In vitro and in vivo studies with ciprofloxacin have reported the incidence of resistant organisms to be very low . In addition, the incidence of ciprofloxacin-related side effects throughout its clinical trials has been minimal . Most reports of side effects have been related to the gastrointestinal tract, such as nausea or vomiting . The incidence of adverse experiences in worldwide clinical trials has been reported to be approximately 6.4 percent. Mol Biol Evol, 1987 Jul, 4(4), 426 - 44 Codon contexts in enterobacterial and coliphage genes; Gouy M; This investigation of the codon context of enterobacteria, plasmid, and phage protein genes was based on a search for correlations between the presence of one base type at codon position III and the presence of another base type at some other position in adjacent codons . Enterobacterial genes were compared with eukaryotic sequences for codon context effects . In enterobacterial genes, base usage at codon position III is correlated with the third position of the upstream adjacent codon and with all three positions of the downstream codon . Plasmid genes are free of context biases . Phage genes are heterogeneous: MS2 codons have no biased context, whereas lambda genes partly follow the trends of the host bacterium, and T7 genes have biased codon contexts that differ from those of the host . It has been reported that two successive third-codon positions tend to be occupied by two purines or two pyrimidines in Escherichia coli genes of low expression level . Here, the extent to which highly expressed protein genes can modulate base usage at two successive codon positions III, given the constraints on codon usage and protein sequence that act on them, was quantified . This demonstrates that the above-mentioned favored patterns are not a characteristic of weakly expressed genes but occur in all genes in which codon context can vary appreciably . The correlation between successive third-codon positions is a distinct feature of enterobacteria and of some phages, one that may result from adaptation of gene structure to translational efficiency . Conversely, codon context in yeast and human genes is biased--but for reasons unrelated to translation. Pathology, 1987 Jul, 19(3), 274 - 6 Susceptibility of gentamicin sensitive and resistant gram negative bacilli to ceftazidime; Bremner DA; The in-vitro activity of ceftazidime was compared with other third-generation cephalosporins and gentamicin against 409 isolates . Ceftazidime was the most active agent against Enterobacter sp., Proteus mirabilis, Serratia sp., Proteus sp . and Pseudomonas aeruginosa . It was less active against Escherichia coli and Klebsiella than moxalactam and cefotaxime but more active than cefoperazone . Against gentamicin resistant E . coli, Klebsiella, Enterobacter and P . aeruginosa, ceftazidime was more active than moxalactam, cefotaxime or cefoperazone but was as active as moxalactam against gentamicin-resistant Proteus sp . and more active than cefotaxime and cefoperazone. Zh Mikrobiol Epidemiol Immunobiol, 1987 Jul, (7), 16 - 20 {Etiological structure of pneumonias in children and adults}; Baizhomartov MS et al.; The bacteriological study of sputa, nasopharyngeal smears and bronchial washings taken from pneumonia patients has shown that the leading etiological agent was Streptococcus pneumoniae isolated in the diagnostic titre (10(7) bacteria per ml) in 78.1% of the cases . Staphylococcus aureus, Haemophilus influenzae, enterobacteria and yeast-like fungi have been found to play an insignificant role in the etiology of acute pneumonia (2.5 +/- +/- 0.9%) . The results of the serological diagnosis by means of the complement fixation test have revealed that, alongside S . pneumoniae, the following infective agents are of etiological importance in cases of acute pneumonia: respiratory viruses (more than 50%), Mycoplasma pneumonia (10%), Chlamydia psittaci (6.4%) and Legionella pneumophila (3.8%) . The study has first revealed that, under the conditions of Alma-Ata, serotypes 19, 23, 8 and 4 prevail among circulating pneumococci . This study has also shown that the use of M . pneumoniae antibody erythrocyte diagnosticum enhances the detection rate of mycoplasma infections in pneumonia patients. J Hosp Infect, 1987 Jul, 10(1), 17 - 27 Serotypes and biochemical profiles of British hospital strains of Enterobacter cloacae in relation to site of infection and antibiotic susceptibility; Gaston MA et al.; Comparisons were made between the O-serotype, API 20E profile, site of isolation and antimicrobial resistance of clinical isolates of Enterobacter cloacae . Correlations were found between autoagglutinable strains and urinary-tract infection, and API 20E profile 3305573 and strains isolated from blood . The proportion of strains sensitive to amikacin, gentamicin, cefotaxime, cefuroxime and trimethoprim were 100%, 93%, 91%, 83% and 89%, respectively . No individual resistances or patterns of resistance were associated with O-serotype or biochemical profile . Strains isolated from urinary-tract infections were the most resistant, 40% being resistant to five or more antimicrobials compared to 18%, 12% and 4% for strains from blood, wounds and sputum, respectively . There were no readily identifiable phenotypes within E . cloacae that possessed unique characteristics that could contribute to infections in hospitals. J Hosp Infect, 1987 Jul, 10(1), 10 - 6 A hospital outbreak caused by a chlorhexidine and antibiotic-resistant Proteus mirabilis; Dance DA et al.; An outbreak of urinary-tract infection involving a strain of Proteus mirabilis resistant to gentamicin and several other antibiotics affected 90 patients in Southampton between July 1980 and May 1985 . The outbreak strain was also resistant to chlorhexidine and this, in combination with the antibiogram and Dienes' test, permitted differentiation from other P . mirabilis strains . The outbreak had features in common with other Enterobacteriaceae outbreaks, although certain aspects of the population involved have made it particularly difficult to control . The outbreak commenced shortly after the introduction of a catheter care policy which involved the use of chlorhexidine, and although the majority of the cases were colonized before this policy was enforced, chlorhexidine had been used extensively for other procedures within the district . Preliminary evidence suggests that there is no genetic linkage between the chlorhexidine and multiple antibiotic resistance. Infect Immun, 1987 Jul, 55(7), 1600 - 6 Antigenic analysis of Serratia marcescens fimbriae with monoclonal antibodies; Jingushi S et al.; Monoclonal antibodies (MAbs) were raised against the purified fimbriae of Serratia marcescens US46, a strain expressing three morphologically distinct fimbriae . The widths of these fimbriae were 7, 4.5, and 3 nm, respectively . Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the purified fimbriae showed three bands with molecular weights of 21,000, 20,000, and 19,000, respectively . This strain had mannose-resistant (MR) hemagglutinating activity and was agglutinated by yeast cells . Therefore, strain US46 appeared to have both MR and mannose-sensitive fimbriae . In the immunoblot analysis, all MAbs reacted with the 20,000-molecular-weight subunit when given a choice of three differently sized subunits . Immunoelectron microscopy showed these MAbs attached to the MR fimbriae with the largest width (7 nm) . The antigenic cross-reactivity of fimbriae was examined by an MAb-mediated agglutination test . All MR strains of S . marcescens and some mannose-sensitive strains were agglutinated by the MAbs . The serological homogeneity of MR fimbriae was confirmed by a spot test, using the crude purified fimbriae from several MR strains of S . marcescens . In other gram-negative rods, clinical isolates of Klebsiella spp . with hemagglutinating activity were agglutinated, but clinical isolates of Escherichia coli and Enterobacter spp . were not. Mol Microbiol, 1987 Jul, 1(1), 45 - 52 Cloning and nucleotide sequence of the thrB gene from the cyanobacterium Calothrix PCC 7601; Parsot C et al.; The cyanobacterium Calothrix PCC 7601 thrB gene, encoding homoserine kinase (EC 2.7.1.39), was cloned via complementation of an Escherichia coli threonine auxotroph, and its nucleotide sequence was determined . The comparison of the homoserine kinase amino acid sequences from Calothrix PCC 7601, E . coli K12 and Bacillus subtilis 168 indicates a closer relationship between cyanobacteria and bacillaceae than between cyanobacteria and enterobacteriaceae . Sequence analysis of the 5' and 3' flanking regions of the Calothrix thrB gene revealed the existence of a 169-codon-long open reading frame downstream from thrB: this sequence may be the second gene of a Calothrix thr operon . Two types of tandemly repeated sequences, sharing similarities with other prokaryotic transcriptional regulatory elements, were detected in the region upstream from the thrB gene. Antimicrob Agents Chemother, 1987 Jul, 31(7), 1027 - 32 Characterization of a staphylococcal trimethoprim resistance gene and its product; Coughter JP et al.; Resistance to trimethoprim (Tp) is mediated by a plasmid-encoded gene in staphylococci . The gene is responsible for high-level resistance (MIC, greater than 1,000 micrograms/ml) in both its native host and when cloned on high-copy-number vectors in Escherichia coli . Analysis of subclones of the staphylococcal Tp gene on E . coli expression vectors and estimation of the size of full and truncated proteins produced in E . coli minicells generated an approximate size limit of 505 base pairs for the gene and 18,500 daltons for the gene product . Crude extracts of E . coli containing the cloned gene had dihydrofolate reductase (DHFR) specific activity that was more than 100 times greater than that of control cells and more than 1,000 times more resistant to trimethoprim inhibition . The amount of trimethoprim required for a 50% reduction in the specific activity of staphylococcal DHFR differed from those of cells containing DHFR types I, II, or III, enzymes mediating Tp in members of the family Enterobacteriaceae . In addition, the size of the monomeric staphylococcal DHFR protein was larger than that of any of the gram-negative DHFRs both compared with published sequence data and as observed by direct comparison on polyacrylamide gels . Finally, there was no homology between a DNA fragment containing the cloned staphylococcal gene and DNA encoding any of the gram-negative DHFRs . Thus, the staphylococcal Tp gene codes for a single protein with DHFR activity that appears to be unrelated to DHFR genes that mediate Tp in members of the Enterobacteriaceae. Microb Pathog, 1987 Jul, 3(1), 31 - 44 The effects of O-antigen character and enterobacterial common antigen content on the in vivo persistence of aromatic-dependent Salmonella sp . live-vaccine strains; Nnalue NA et al.; Aromatic-dependent (aro) derivatives of Salmonella choleraesuis like aro S . typhimurium are non-virulent but, unlike them, are ineffective as live vaccines in mice, given i.p . An aro derivative of S . choleraesuis did not persist in the liver and spleen (RES) of mice after i.p . inoculation whereas a similar derivative of S . typhimurium persisted . S . choleraesuis (O group C1; O-6,7) and S . typhimurium {O group B; O-(1),4(5),12} differ in O antigen of LPS, determined by chromosomal locus, rfb . Three pairs of nearly-isogenic aro derivatives, one member O-6,7 and the other O-(1),4,(5),12, were constructed in two lines of S . typhimurium by replacement of their B-rfb genes with the C1-rfb genes of S . choleraesuis . In tests for persistence after mixed or separate i.p . inoculation of equal doses into BALB/c mice the O-(1),4,(5),12 member of each pair was recovered as CFU in the RES at ca . 100-fold greater number than the O-6,7 member at 24 hours post-inoculation and subsequently . O-6,7 derivatives of S . typhimurium constructed as described above by a simple replacement of group B with group C-rfb locus synthesise only trace (tr) amounts of enterobacterial common antigen (ECA) . An ECA+ (able to make normal levels of ECA) derivative of one aro, O-6,7 S . typhimurium strain was constructed by replacement of its B-rfe locus with the C-rfe locus of S . choleraesuis . Tested by mixed inoculation i.p . this strain persisted in the RES in numbers 10-fold greater than its O-6,7 ECAtr but 5-10-fold lesser than its O-(1),4,(5),12 cousins . Thus both O-specificity and ECA contribute to the survival of salmonella species in mice as determined by in vivo persistence of non-multiplying aro derivatives. Clin Allergy, 1987 Jul, 17(4), 341 - 53 Non-IgE-dependent bacteria-induced histamine release from human lung and tonsillar mast cells; Church MK et al.; A wide spectrum of formalin-killed bacteria have been tested for their ability to release histamine from human dispersed lung and tonsillar mast cells . Escherichia coli, Enterobacter cloacae, Staphylococcus epidermidis, Proteus vulgaris, Klebsiella oxytoca and K . pneumoniae were the most effective histamine releasers . Further studies on tonsillar mast cells showed that E . coli-induced histamine release differed from IgE-dependent release with respect to its kinetics, temperature and pH profiles and its sensitivity to calcium deprivation and metabolic inhibitors . A lectin-mediated mechanism may operate, but other non-immunological mechanisms might also be involved in the release . Escherichia coli and anti-IgE did not synergize in inducing histamine release . The production of PGD2 and the failure to detect lactate dehydrogenase following incubation of mast cells with E . coli suggests that histamine release is not due to cytotoxicity. Am J Med, 1987 Jun 26, 82(6B), 70 - 4 Norfloxacin in the treatment of urinary tract infections in men with and without identifiable urologic complications; Corrado ML et al.; A retrospective analysis of data from the treatment of 95 men with nonbacteremic urinary tract infections (UTIs) (clean-catch urinary bacterial count greater than or equal to 10(5) colony-forming units/ml) who received norfloxacin (400 mg orally twice daily) was performed . Treatment duration ranged from a required minimum of seven days to a maximum of 30 days . If an underlying anatomic or functional condition existed that might decrease the likelihood of a favorable medical response and/or require prolonged treatment, the patient's UTI was considered "complicated." In addition to eight patients with polymicrobic UTIs (usually involving enterococci or Pseudomonas aeruginosa), 48 men (i.e., 51 percent of the total population) had an identifiable complication . Complications included benign prostatic hypertrophy in 13 patients; prostatic cancer in four; urethral stricture in four; quadriplegia/paraplegia with indwelling urinary catheter in four; prostatism in three; and other conditions commonly recognized as altering the response to antibiotic treatment . Among the 95 patients treated, 76 (80 percent) were considered to have had a cure and five (5 percent) showed improvement . Fourteen patients (15 percent) failed to show a response to treatment . Of the 48 patients with UTI and defined complications, 36 (75 percent) had a cure, three (6 percent) showed improvement, and therapy failed in nine (19 percent) . Ninety-seven percent (105 of 108) of the pretreatment bacterial isolates were susceptible to norfloxacin . In addition to the three resistant organisms that were present prior to therapy, three organisms (two P . aeruginosa and one Enterobacter) persisted and acquired resistance during therapy . Five adverse clinical experiences and six adverse laboratory experiences were noted . Only one of the former (mild heartburn) was thought to be drug related, and no adverse experience was considered serious or required discontinuation of treatment . Gastrointestinal tolerability of oral norfloxacin was good. Am J Med, 1987 Jun 26, 82(6B), 59 - 64 Oral norfloxacin versus parenteral treatment of nosocomial urinary tract infection; Cox CE et al.; In a multiclinic, randomized trial, oral norfloxacin, a fluoroquinolone antibacterial, was compared with several standard parenteral regimens for the treatment of nonbacteremic, hospital-acquired urinary tract infections . Parenteral antibiotic agents included aminoglycosides alone; aminoglycosides in combination with either broad-spectrum penicillins or first-generation cephalosporins; or cefotaxime alone . Ninety-two percent of bacterial isolates were multiresistant gram-negative rods including Pseudomonas aeruginosa (31 percent), Escherichia coli (17 percent), Klebsiella/Enterobacter species (14 percent), and Serratia species (11 percent) . In the first evaluable 94 patients, norfloxacin was comparable to the parenteral agents in eliminating infecting bacteria from the urine . Similarly, combined bacterial eradication and clinical cure or improvement occurred in 96 percent (76 percent with cures, 20 percent with improvement) of those treated with norfloxacin and 88 percent (67 percent with cures, 21 percent with improvement) of those treated with parenteral agents . A negative outcome (i.e., failure, superinfection, or reinfection) occurred in two (4 percent) norfloxacin-treated patients versus six (12 percent) parenterally treated patients . Adverse effects were few, infrequently drug related, and rarely serious (one with norfloxacin versus two with parenteral agents) . Additionally, drug, preparation, and administration costs were substantially less with oral norfloxacin compared with the parenteral agents . The data suggest, therefore, that oral norfloxacin can be substituted for commonly used parenteral antibiotic regimens, without any compromise in efficacy, in the treatment of nonbacteremic patients with multiresistant, nosocomial urinary tract infections. Biochemistry, 1987 Jun 16, 26(12), 3385 - 95 Kinetics and mechanism of the serine beta-lactamase catalyzed hydrolysis of depsipeptides; Govardhan CP et al.; Steady-state kinetic parameters have been determined for the hydrolysis of a series of acyclic depsipeptides (ester analogues of acyl-D-alanyl-D-alanine peptides) catalyzed by representative class C (Enterobacter cloacae P99) and class A (Bacillus cereus I, TEM-2, and Staphylococcus aureus PC1) beta-lactamases . The best of these substrates, and the one most used in this work, was m-{{(phenylacetyl)-glycyl}oxy}benzoic acid, whose rates of cleavage could be followed spectrophotometrically . The P99 enzyme also catalyzed the methanolysis of these substrates in aqueous methanol solutions . Quantitative evaluation of the effects of methanol on the kinetics of the competing hydrolysis and methanolysis reactions, and on the product distribution, supports a reaction mechanism involving an acyl-enzyme intermediate whose formation is rate-determining under conditions of substrate saturation . Consideration of the variation of these kinetic parameters with the structure of the depsipeptides and comparison with the analogous parameters for bicyclic beta-lactam substrates suggest that a variety of substrate binding modes exist on this enzyme . The class A enzymes, B . cereus beta-lactamase I and the TEM-2 beta-lactamase, catalyze depsipeptide and benzylpenicillin hydrolyses but not methanolysis . The acyl-enzyme derived from both types of substrate is thus shielded from external nucleophiles; the shielding is therefore not an effect, direct or indirect, of the thiazolidinyl group in the penicilloyl-enzyme . The class A beta-lactamase of the PC1 plasmid of S . aureus is distinctly different from the above two representatives of that class, in that it does catalyze methanolysis of depsipeptides (but not of benzylpenicillin) . The methanolysis kinetics suggest that deacylation is rate-determining at saturation, a conclusion supported by the demonstration of an intermediate during the hydrolysis of m-{{(phenylacetyl)glycyl}oxy}benzoate, subsequent to leaving-group departure . The beta-lactamases have thus been shown to catalyze the hydrolysis of specific depsipeptides with comparable facility to that demonstrated by D-alanyl-D-alanine carboxypeptidase/transpeptidases . The former enzymes, however, differ in being unable to cleave the analogous peptides. Arch Fr Pediatr, 1987 Jun-Jul, 44(6), 419 - 22 {Bacteriological study of acute otitis media in children . Therapeutic consequences}; Megraud F et al.; One hundred children presenting with acute otitis media underwent a bacteriological study of otitis exudate over a 18 month period . The bacteria found were as follows: Streptococcus pneumoniae (24), Haemophilus influenzae (19), Staphylococcus aureus (12), Streptococcus pyogenes (7), Branhamella catarrhalis (3), and 18 Gram negative bacilli (including 7 Pseudomonas aeruginosa and 11 enterobacteriaceae) . One pathogenic bacterium was isolated in 56 cases, 2 or more in 12 cases and none in 32 cases . In the age categories 0-1 year (47 cases) and 1-3 years (31 cases), S . pneumoniae and H . influenzae were the main organisms found, followed by S . pyogenes in children older than 3 years (22 cases) . With respect to the antibiotics used for treating otitis, 5/22 S . pneumoniae and 4/17 H . influenzae were erythromycin resistant (9/17 had an intermediate susceptibility) and 7/19 H . influenzae and 1/17 S . pneumoniae were cotrimoxazole resistant . None of the S . pneumoniae and 2/19 H . influenzae were ampicillin resistant . These 2 H . influenzae and 2/3 B . catarrhalis were beta-lactamase producers . They were sensitive to the combination of amoxicillin with clavulanic acid. Antimicrob Agents Chemother, 1987 Jun, 31(6), 899 - 902 Penetration of ciprofloxacin into cerebrospinal fluid of patients with bacterial meningitis; Wolff M et al.; We evaluated the diffusion of ciprofloxacin into the cerebrospinal fluid (CSF) in 23 patients with bacterial meningitis or ventriculitis undergoing treatment with other antibiotics . Three successive ciprofloxacin doses of 200 mg were administered intravenously at 12-h intervals, first between days 2 and 4 and again between days 10 and 20 after the admission . Concentrations of ciprofloxacin in plasma and CSF obtained at 60, 120, 240, and 480 min after the third infusion were determined by high-performance liquid chromatography . In addition, serial samples were obtained from ventricular fluid in four patients . The concentrations of ciprofloxacin in CSF ranged from 0.35 to 0.56 micrograms/ml . These concentrations were equal to or higher than the MICs for most of the enterobacteria. J Trauma, 1987 Jun, 27(6), 626 - 38 Concurrent oral surgery and orthopaedic treatment in the multiply injured patient: is there an increased incidence of orthopaedic sepsis? Foster RJ, Collins FJ, Bach AW. Fifty-five patients requiring oral surgery and orthopaedic care were studied prospectively and compared to a control group . Six patients received no antibiotics and one developed an orthopaedic operative site infection due to a mouth organism . Seventeen patients had concurrent surgery and perioperative antibiotic usage and no infections occurred . Twenty-six patients required multiple operations and courses of antibiotic treatment and five developed infections . Enterobacter infections were common and emerge because they are resistant to first-generation cephalosporins . Treatment by a perioperative first-generation cephalosporin is recommended, followed by throat cultures and treatment by antibiotics specific for cultured organisms for patients requiring subsequent operations. Int J Clin Pharmacol Ther Toxicol, 1987 Jun, 25(6), 306 - 9 Critical risk/benefit analysis of pefloxacine use in children under 15 years--the problem of arthralgias; Chevais M et al.; Pefloxacine belongs to a group of new quinolone antibiotics with more general indications than the urinary quinolones marketed about twenty years ago . The contraindication of the quinolones in children under 15 years of age limits their usage exclusively to adults . In this paper, the adverse arthralgic effects of these quinolones, which have largely motivated the contraindication, have been analyzed from an experimental, clinical and pathophysiological point of view . It is concluded that the pediatric benefits associated with the marked antibacterial activity of pefloxacine, particularly in pseudomonas and enterobacteriae infections, should be balanced against the risks associated with arthralgia whenever the condition of the patient is grave and decisions vital to a favorable prognosis for the sick child are necessary. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1987 Jun, 265(1-2), 169 - 75 Transmissible drug resistance among Shigellae and other enterobacteriaceae isolated from diarrhoeic human beings in Ibadan, Nigeria; Adetosoye AI et al.; Antibiotic resistance patterns and the distribution of R-factors among Shigella, Salmonella and Escherichia coli isolated from diarrhoeic human beings were studied . Nine multiple antibiotic resistance patterns among which PNS TCK was the most common were observed . All the Shigella, Salmonella and eighteen Escherichia coli isolates transferred part of their r determinants respectively to E . coli K12 . It is thought that enforcement of the law regulating the sales and judicious use of antibiotic in Human and Veterinary Medicines would reduce the incidence of multiple drug resistance in Nigeria. Pathol Biol (Paris), 1987 Jun, 35(5 Pt 2), 829 - 34 {Epidemiology, clinical aspects and treatment of nosocomial septicemias}; Lacut JY et al.; One hundred one nosocomial septicemias (NS) were studied among 461 cases of septicemias (22%) collected by French Septicemia Expert System Group during 1985 . The mean-age of the patients was 58 +/- 23 years while it was 56 +/- 23 years in the 360 community acquired septicemias (CAS) . The source of septicemia was found more frequently in NS than in CAS (79/101 versus 223/360; p less than 0.002): mainly urinary tract and intravenous therapy in NS, urinary tract, gastrointestinal and biliary origin in CAS . Invasive procedures (except surgical procedures) were more frequent in NS than in CAS (13/101 vs 14/360; p less than 0.0001) . Underlying diseases were more often associated with NS than with CAS (96/101 vs 276/360; p less than 0.0001) . Many pathogens were involved in these NS but the frequency of S . aureus meti-S and meti-R, S . epidermidis, Enterobacter, Klebsiella, Serratia, Proteus indol + and Pseudomonas carbeni-R was significantly greater in NS than in CAS . There was no significant difference between NS and CAS for septic localizations, respiratory distress syndrome and septic shock . Two antibiotics (and possibly 3 antibiotics for polymicrobial septicemias) were more often used in NS than in CAS (61/101 vs 135/360; p = 0.002) . If the duration of hospitalization was not significantly greater in NS than in CAS (26 +/- 29 days vs 23 +/- 33 days), the overall mortality was significantly more important (25.6% vs 14.9%; p less than 0.05). Pathol Biol (Paris), 1987 Jun, 35(5 Pt 2), 819 - 24 {Fatal septicemias: factors of mortality . Analysis of 72 fatal cases in the series of 462 case reports collected by the Septicemia Expert System group in 1985}; Beytout J et al.; During the year 1985, 462 cases of septicemia were collected by SES group; 417 observations could be exploited . 73 patients died (17.3%) . The statistical analysis of epidemiological and clinical data argued to factors correlated with high mortality rate: a shock, an acute respiratory distress syndrome, a pulmonary portal of entry lead to a high mortality rate . The fatal outcome increased with the age of the patients . A documented immunodeficiency (granulopenia, cytotoxic chemotherapy...), a previous broncho-pulmonary, neurologic or cardiovascular disease were factors of risk . The pulmonary or cutaneous localisations occurring within a septicemic phase were significantly related to death . Among fatal cases of bacteremia, 25% were Staphylococci, 25% Enterobacteria, 20% Pneumococci, 7% Pseudomonas . Pseudomonas, then Pneumococcus, then Staphylococcus bacteremias looks to have a worse prognosis . The more serious cases were prescribed several antibiotics, significantly much more than the mild cases . These results are compared with the results of former series; the main prognosis factors of actual septicemia are elicited in here. Pathol Biol (Paris), 1987 Jun, 35(5 Pt 2), 727 - 9 {Diffusion of ceftriaxone in the renal parenchyma}; Freney J et al.; Diffusion of ceftriaxone in renal parenchyma after IV injection (2 g) was studied in six patients with normal renal function, undergoing nephrectomy . Cortex and medulla of the kidney were studied . Blood samples, tissular fragments and urine were studied for drug concentration using HPLC and microbiologic assay 1, 12 and 24 h after injection . Both methods led to similar results . No difference in drug concentration was found between cortex and medulla . Tissular concentration of ceftriaxone remain higher than MIC for most Enterobacteriaceae strains until 24 h. J Clin Invest, 1987 Jun, 79(6), 1756 - 63 Administration in vivo of recombinant interleukin 2 protects mice against septic death; Weyand C et al.; Administration in vivo of recombinant interleukin 2 (rIL-2) to mice induces a polyclonal IgM response . When co-administered with a specific antigen, rIL-2 can enhance concentrations of murine IgM antibodies specific for the antigen by fivefold within 7 d of initial treatment . IgM antibodies that are induced after injection of rIL-2 include antibodies specific for J5, a cell wall core lipopolysaccharide (LPS) antigen that is shared by the different members of the Enterobactericeae family . We report here that mice pretreated with rIL-2 or immunized with J5 antigen 7 d before bacterial challenge were protected from septic death that is caused by intraperitoneal challenges with Escherichia coli . Optimal protection was provided by a combined J5 antigen and rIL-2 treatment . Acquisition of the rIL-2 and J5 antigen-induced protection against lethal bacterial infection coincided temporally with maximal serum IgM titers that also contained IgM antibodies specific for the J5 antigen . In passive immunization experiments, the affinity-purified IgM fraction in sera of rIL-2-treated animals was identified as necessary and sufficient for protection . The IgM-depleted serum had no protective effect . The nonspecific augmentation of host-defense mechanisms without the induction of endotoxin manifestations makes rIL-2 a potential candidate to any alternative LPS-containing vaccines for the prevention of bacterial infections by gram-negative organisms since the core LPS antigen is shared among gram-negative bacteria. J Biol Chem, 1987 May 25, 262(15), 7142 - 50 Biosynthesis of enterobacterial common antigen in Escherichia coli . In vitro synthesis of lipid-linked intermediates; Barr K et al.; An in vitro system was developed to study the biosynthesis of enterobacterial common antigen (ECA) . Membranes of Escherichia coli were found to possess an enzyme activity that catalyzes the transfer of UDP-N-acetyl-acetylglucosamine-1-phosphate from UDP-N-acetyl-glucosamine (UDP-GlcNAc) to an endogenous lipid acceptor according to the reaction UDP-GlcNAc + P-lipid----GlcNAc-PP-lipid + UMP . The lipid-linked product was tentatively identified as GlcNAc-pyrophosphorylundecaprenol (lipid I) based on a comparison of its chemical and chromatographic properties with those of authentic GlcNAc-pyrophosphorylundecaprenol . The enzyme was dependent on the presence of Mg2+ for activity, and the reaction catalyzed by the enzyme was totally inhibited by the antibiotic tunicamycin in both the forward and reverse directions . Incubation of membranes with both UDP-N-acetylmannosaminuronic acid (UDP-ManNAcA) and UDP-GlcNAc resulted in the conversion of lipid I to a more polar compound, lipid II . The synthesis of lipid II was dependent on prior synthesis of lipid I . Characterization of the saccharide moiety of lipid II resulted in the identification of this compound as ManNAcA-GlcNAc-pyrophosphorylundecaprenol. Infect Control, 1987 May, 8(5), 204 - 9 Effect of water temperature on bacterial killing in laundry; Smith JA et al.; The increasing cost of energy directed our attention to testing the feasibility of low temperature washing . Hospital laundries use formulated chemicals at high temperature wash waters of 66 degrees C . Wash water effluents and fabric bacterial counts of heavily soiled linen were correlated with alkalinity and temperature measurements to investigate the bacterial killing action of hot and cold wash formulas . Terry towels were found to be contaminated with 10(7) to 10(9) organisms per 100 cm2 at the beginning of the washing process . The most common gram-negative rods found were Klebsiella, Enterobacter and Serratia species . Staphylococci were the predominant gram-positives . Both cold and hot water washing including the bleach cycle reduced bacterial counts in fabric by 3 log10 . Similarly wash water cfu/mL mL declined 3 to 4 log10 . A further 0.5 to 1.0 log10 reduction was effected in the 93.3 degrees C drying cycle . Low temperature wash formulas were comparable to high temperature laundry with respect to bacterial counts and species . Cold water formulas at 31.1 degrees C offer an alternative method to reduce energy consumption and maintain bacteriological and esthetic linen quality. Klin Monatsbl Augenheilkd, 1987 May, 190(5), 445 - 6 {The pathogen spectrum in neonatal dacryocystitis}; Huber-Spitzy V et al.; The most common cause of congenital dacryostenosis is the persistence of Hasner's membrane, which in more than 90% of cases perforates during the first 4 to 6 weeks . If no perforation occurs, the tears gather in the lacrimal duct and lacrimal sac until the system is full and an inflammation starts . Formerly, dacryocystitis neonatorum was caused mainly by gram-positive cocci, in particular Streptococcus Pneumoniae; the primary cause now, in consequence of the abuse of antibiotics, are the gram-negative enterobacteriaceae . The most common agent still is Staphylococcus, which is becoming more and more resistant to gentamycin (26.5%) . During the past 3 years 64 infants have been examined at the Second Eye Clinic of Vienna University . Smears were taken from the purulent discharge and tested in the usual microbiological way . The study shows the importance of exact diagnosis and specific therapy. Appl Environ Microbiol, 1987 May, 53(5), 1178 - 80 Attachment as a factor in the protection of Enterobacter cloacae from chlorination; Herson DS et al.; Enterobacter cloacae attached to drinking water distribution particles was subjected to chlorination . Attachment resulted in the protection of these organisms from disinfection . This effect was found to be dependent upon both the level of chlorine in the system and attachment time . The results obtained in this study indicate that attached organisms may play an important role in coliform outbreaks. Antibiot Med Biotekhnol, 1987 May, 32(5), 383 - 5 {Comparative evaluation of the results of antibiotic sensitivity testing using automated microbiological systems and the disk diffusion method}; Bekbergenov BM et al.; A total of 1120 comparative estimations of antibiotic sensitivity of clinical gram positive and gram negative bacteria isolated from patients with surgical and urological infections were performed . The data for comparison were obtained with the use of microbiological systems MIC-2000 and MS-2 and the disk diffusion method . A high percentage of coincidence for both gram negative and gram positive organisms was observed . The frequency of total coincidence was higher for Enterobacteriaceae . The results of disk diffusion estimations more frequently coincided with the results obtained with the use of apparatus MIC-2000 as compared to the results provided by MS-2 . The choice of the nutrient medium markedly influenced the coincidence level of the results obtained with the apparatus and control methods. J Med Microbiol, 1987 May, 23(3), 255 - 60 A simple statistical approach that represents the frequency distribution of plasmids in clinical isolates of the enterobacteria; Platt DJ; The frequency distribution of plasmids in a representative collection of Escherichia coli and other enterobacteria was compared with the frequencies predicted by the Poisson distribution . The distribution of E . coli plasmids did not differ significantly (p greater than 0.2) whereas the difference between observed and predicted distributions of plasmids in combined populations of other enterobacteria was significant (p less than 0.001) . Previous studies had suggested that plasmid-free strains contributed disproportionately to the overall frequency distribution . Therefore, plasmid-free strains were excluded and the frequency distribution of plasmids in plasmid-containing strains compared with frequencies predicted by a modified Poisson distribution conditional upon n not equal to 0 . The results obtained showed that the frequency distribution of plasmids in E . coli and in other enterobacteria did not differ significantly from the predicted distribution (p less than 0.2 and p greater than 0.6 respectively) . The frequency distribution of plasmids in previously published studies was compared with predicted frequencies by means of the Poisson distribution and the modified Poisson distribution conditional upon n not equal to 0 . The results indicate that the modified Poisson distribution de