Enterobacters

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 described provides an adequate description of plasmid frequency distributions and represents the observed frequencies better than the distribution predicted directly from the Poisson formula.

J Protozool, 1987 May, 34(2), 137 - 42
Growth of Paramecium tetraurelia in bacterized, monoxenic cultures; Enright WJ et al.; Wild type and mutant Paramecium tetraurelia were grown in monoxenic cultures by first growing Enterobacter aerogenes on a defined medium and then adding the Paramecium to the stationary phase bacterial culture . The bacterial growth was proportional to the concentration of the carbon source (citrate), and the Paramecium growth was dependent upon both the bacterial density and the starting density of Paramecium . The behavior, electrophysiological properties, ciliary lipid composition, and growth characteristics were similar to the commonly used bacterized medium (Cerophyl) except that 5-10 times greater Paramecium yields were reliably obtained.

South Med J, 1987 May, 80(5), 601 - 4
Enterobacter pneumonia; Karnad A et al.; Enterobacter species have not been well recognized as important lower respiratory tract pathogens . We describe 11 cases of Enterobacter pneumonia, seven diagnosed by transtracheal aspiration and four by simultaneous blood and sputum cultures . The infections were usually nosocomial, and were fatal in five patients . Our patients were old (mean age 65 +/- 12.3 years) with chronic obstructive pulmonary disease (COPD) as a common underlying disease . Enterobacter species are important pathogens causing nosocomial pneumonias, especially in elderly patients with COPD.

J Infect Dis, 1987 May, 155(5), 942 - 7
Emergence of resistance to ceftazidime during therapy for Enterobacter cloacae infections; Quinn JP et al.; The mechanism of resistance to ceftazidime in two clinical isolates of Enterobacter cloacae that emerged during therapy with broad-spectrum beta-lactam antibiotics was studied . Both isolates acquired broad resistance to advanced-spectrum beta-lactam drugs other than imipenem . Biotyping confirmed strain identity in both cases, and no new plasmids were detected in the resistant isolates . Both resistant isolates produced beta-lactamase constitutively . Slow but definite hydrolysis of ceftazidime was demonstrated by using purified beta-lactamase in a spectrophotometric assay . Further evidence that beta-lactamase is responsible for resistance in these organisms was provided by the demonstration that cefoxitin, a potent inducer of beta-lactamase, antagonized the activity of ceftazidime against these isolates . This antagonism could be prevented by inhibition of derepression of beta-lactamase with clindamycin . Clindamycin also prevented regrowth of ceftazidime-treated cells in time-kill studies and markedly reduced production of beta-lactamase in induced cultures at concentrations as low as 2 micrograms/ml.

J Pediatr Gastroenterol Nutr, 1987 May-Jun, 6(3), 430 - 8
Polymorphonuclear neutrophil leucocytes in childhood Crohn's disease: a morphological study; Lewis DC et al.; Light and electron microscopy was applied to surgical resections and endoscopic biopsies from the ileum and colon of 15 children with Crohn's disease in order to investigate the involvement of neutrophils in the disease process . Clear evidence was found of neutrophil infiltration of the lamina propria and epithelium, neutrophil migration into the gut lumen through epithelial breaks and intact epithelium, neutrophil phagocytosis of luminal and lamina propria bacteria, and the presence of intracellular neutrophils in enterocytes . Similar findings were seen in 5 of 6 children with ulcerative colitis and in a case of an E . coli colitis, but not in 8 controls . The observations demonstrate the involvement of neutrophils in Crohn's disease in childhood and suggest that the response is directed, in part, against luminal enterobacteria and enterocytes.

Mol Biol Evol, 1987 May, 4(3), 222 - 30
The rate of synonymous substitution in enterobacterial genes is inversely related to codon usage bias; Sharp PM et al.; Genes sequences from Escherichia coli, Salmonella typhimurium, and other members of the Enterobacteriaceae show a negative correlation between the degree of synonymous-codon usage bias and the rate of nucleotide substitution at synonymous sites . In particular, very highly expressed genes have very biased codon usage and accumulate synonymous substitutions very slowly . In contrast, there is little correlation between the degree of codon bias and the rate of protein evolution . It is concluded that both the rate of synonymous substitution and the degree of codon usage bias largely reflect the intensity of selection at the translational level . Because of the high variability among genes in rates of synonymous substitution, separate molecular clocks of synonymous substitution might be required for different genes.

Q J Med, 1987 May, 63(241), 427 - 40
An analysis of community and hospital-acquired bacteraemia in a large teaching hospital in the United Kingdom; Ispahani P et al.; A total of 875 episodes of bacteraemia and fungaemia were analysed in patients admitted to University Hospital, Nottingham, and three smaller hospitals over a four-year period . In 814 episodes (93 per cent) a single organism was isolated, most commonly Escherichia coli (27.4 per cent), other enterobacteria (14.4 per cent), Staphylococcus aureus (11.2 per cent), Streptococcus pneumoniae (9.0 per cent), or Haemophilus influenzae (6.4 per cent) . In 61 cases (7.0 per cent) bacteraemia was due to two or more species . In almost 60 per cent of cases, bacteraemia was considered to be community-acquired . The most common sources were the urinary (26.9 per cent), respiratory (14.6 per cent), gastrointestinal (11.6 per cent) and biliary (9.5 per cent) tracts, but in almost 10 per cent of cases the focus of infection was unknown . Polymicrobial bacteraemia was common when the biliary tract was the focus of infection . Shock was recorded in 19.5 per cent of cases, and was commoner in polymicrobial (42.9 per cent) than in monomicrobial (17.4 per cent) episodes . In monomicrobial episodes haemolytic streptococci were associated with the highest incidence of shock (30.0 per cent) . Mortality directly related to bacteraemia (19.5 per cent) was higher with Gram-positive (23.5 per cent) than with Gram-negative (15.8 per cent) organisms; in polymicrobial (31.1 per cent) than in monomicrobial episodes (18.7 per cent); and in those who had multiple episodes (34.7 per cent) than in those who had a single episode of bacteraemia (20.3 per cent) . Other factors influencing mortality included shock, failure to mount an adequate febrile response, leucopenia or granulocytopenia, and underlying disease . Mortality was markedly reduced by appropriate treatment; a single antimicrobial agent was as effective as combination therapy in bacteraemia caused by Gram-negative bacilli.

Plasmid, 1987 May, 17(3), 191 - 201
A new IncQ plasmid R89S: properties and genetic organization; Saano AK et al.; The new small (8.18 kb) streptomycin-resistant multicopy plasmid R89S of the Q group incompatibility is described . In contrast to other IncQ plasmids, replication of R89S is dependent on DNA polymerase 1 and proceeds in the absence of de novo protein synthesis . According to our data up to now, the host spectrum of the plasmid R89S is limited to Enterobacteriaceae . A genetic map of the plasmid R89S has been prepared through the construction of deletion and insertion derivatives . Phenotypic analysis of these derivatives has identified the location of genes encoding resistance to streptomycin, and the region essential for mobilization of R89S . The origin of vegetative replication has been located within a 0.7-kb fragment . Another region highly homologous to oriV of the plasmid RSF1010, but not functioning as an origin of replication, was localized . Two regions involved in the expression of incompatibility have also been identified . The data from the restriction analyses, DNA-DNA hybridization, and genetic experiments enable us to assume that the plasmid R89S is a naturally occurring recombinant between part of an IncQ plasmid and another narrow host range replicon of unknown incompatibility group.

Ann Inst Pasteur Microbiol, 1987 May-Jun, 138(3), 359 - 69
Resistance of attached Escherichia coli to acrylic acid and its significance for the survival of plasmid-bearing organisms in water; Hicks SJ et al.; As previously reported, free organisms of Escherichia coli are sensitive to damage and killing when exposed to acrylic acid in water . The effect of the agent was greatest in distilled water, but there was a marked effect in effluent and seawater also . The effect was temperature-dependent, with organisms exposed at 4 degrees C being much less affected than those exposed at 20 degrees C . The above sensitivity was for free organisms, but those attached to glass beads were resistant to acrylate . This resistance applied equally to attached plasmid-free and attached plasmid-bearing organisms, but is likely to be more significant for plasmid-bearing strains because some plasmids studied here stimulated bacterial attachment . The likely significance of the acrylate resistance of attached organisms for enterobacterial survival in the aquatic environment, e.g . in the vicinity of shellfish beds, is discussed.

Pathol Biol (Paris), 1987 May, 35(5), 613 - 5
{Comparison of the efficacy of cefotaxime alone and the combination cefazolin-tobramycin in the treatment of enterobacterial septicemia}; Arich C et al.; In a prospective, randomized study we compared cefotaxime (C) with tobramycin plus cefazolin (C + T) in the treatment of Enterobacterial septicemia . Twenty-five patients received C and twenty two C + T . There are 8 treatment failures, in C + T group, 3 in C group . We observed 5 adverse effects, 2 in the C group (1 reversible collapse and 1 Pseudomonas aeruginosa superinfection) and 3 in the C + T group (acute renal failures) . We conclude that C may be more effective and less toxic than cefazolin plus tobramycin for patients with Enterobacterial septicemia.

Pathol Biol (Paris), 1987 May, 35(5), 537 - 41
{Activity of ticarcillin combined with different concentrations of clavulanic acid on 137 Gram-negative bacilli resistant to ticarcillin}; Aubert G et al.; The MIC of ticarcillin exclusively or joined with 3 concentrations of clavulanic acid: (2, 4 and 8 mg/l) was determined by agar dilution in relation to 137 bacilli resistant to ticarcillin (MIC greater than or equal to 256 mg/l) detected between 1985 and 1986 in the Bellevue Hospital in Saint-Etienne . We could study 26 Escherichia coli, 30 Klebsiella, 28 Enterobacter, 36 Serratia and 17 Pseudomonas aeruginosa . The concentration of 2 mg/l of clavulanic acid allows to lower the MIC of ticarcillin over the very large majority of strains of Escherichia coli and Klebsiella resistant to ticarcillin . In those conditions, ticarcillin becomes more active than piperacillin over those species . The concentration of 4 and 8 mg/l of clavulanic acid doesn't bring any real advantage to those bacilli . Moreover the concentrations of 2, 4 and 8 mg/l slightly change the MIC of ticarcillin on the strains of Serratia, Enterobacter and Pseudomonas aeruginosa.

Pathol Biol (Paris), 1987 May, 35(5), 475 - 81
{Antibacterial activity of enoxacin in vitro and in urine}; Soussy CJ et al.; Minimal inhibitory concentrations (MIC) of enoxacin (ENO) were evaluated by agar dilution, in comparison with MIC of nalidixic acid (NAL), pipemidic acid (PIP), oxolinic acid (OXO), pefloxacin (PEF), norfloxacin (NOR), ofloxacin (OFL) and ciprofloxacin (CIP), for eleven Enterobacteriaceae reference strains chosen as a function of sensitivity and level of resistance to NAL . In the four strains susceptible to NAL, MIC of ENO (0.06 to 0.25 micrograms/ml) were similar to those for PEF and NOR, 2 to 4 times inferior to those for OXO, 16 to those for PIP and 32 to those for NAL; this ratio of activity was also seen in the majority of strains resistant to NAL . Measurement of MIC of ENO for 397 recent clinical isolates confirmed efficacy of this substance against Enterobacteriaceae and showed its activity against Pseudomonas aeruginosa (mode MIC: 0.5-1 micrograms/ml), and Gram positive cocci, essentially Staphylococcus aureus (mode MIC: 0.5-1) . Antibacterial activity in the urine was measured by the Heilman test in 5 male adults after two doses of 200 mg of ENO administered at 12 hours intervals, two doses of 400 mg of ENO and, in comparison two of 400 mg of PIP administered under the same conditions . Maximal inhibitory dilutions obtained with ENO reached (mean for 5 subjects): 1/64 to 1/128 after 200 mg and 1/128 to 1/512 after 400 mg for a sensitive Providencia strain (MIC ENO: 0.25); 1/32 to 1/128 and 1/64 to 1/256 for an E . coli strain of low level of resistance to NAL (MIC ENO: 2); activity was very low on a Serratia strain highly resistant to NAL (MIC ENO: 16).(ABSTRACT TRUNCATED AT 250 WORDS)

Pathol Biol (Paris), 1987 May, 35(5), 451 - 6
{Comparative antibacterial activity of a new monobactam, carumonam (RO 17-2301, AMA 1080) on hospital bacteria resistant to beta lactams}; Le Noc P et al.; In vitro activity of a new monobactam, carumonam (RO 17-2301, AMA 1080) was tested against 370 hospital bacterial isolates . Results were compared to aztreonam, cefotaxime, cefmenoxime, latamoxef, ceftazidime, ceftriaxone, pefloxacin against Enterobacteriaceae, to aztreonam, piperacillin, cefoperazone, cefsulodin, ceftazidime, imipenem and pefloxacin against P . aeruginosa . All Enterobacteriaceae strains produced cephalosporinases and all P . aeruginosa strains were ticarcillin resistant . MIC 90% of carumonam against Enterobacteriaceae strains was lower than 0.25 mg/l for P . mirabilis, P . vulgaris, P . stuartii, Salmonella sp., ranged from 0.25 to 0.5 mg/l for Klebsiella sp . and S . marcescens, from 1 to 2 mg/l for E . coli and P . morganii, and from 4 to 8 mg/l for C . freundii and E . cloacae . The rate of strains inhibited with 4 mg/l of carumonam was 95.3% . So carumonam was at the second place from eight tested products, after latamoxef (97.5% of susceptible strains) . Carumonam was active against second generation cephalosporins resistant strains when these strains were susceptible or intermediate to cefotaxime . Strains resistant to this compound escaped to its action . Its activity against A . calcoaceticus was weak (22.6% of strains inhibited by 4 mg/l), but was superior to that of cefsulodin against ticarcillin resistant P . aeruginosa strains (54.5 versus 16.1% of susceptible strains) . However carumonam was less active against this last species than ceftazidime or imipenem (92.6 and 91% of susceptible strains respectively).

Biull Eksp Biol Med, 1987 May, 103(5), 596 - 8
{Effect of SOS repair in enterobacteria on their interaction with the complement system}; Tets VV et al.; The interaction of E . coli (serovar 0124) and its rec A-mutants with serum complement resulting in the alternative pathway activation was studied . Bacteria VT1240 (original smooth strain), VT1241 (rough mutant) and VT 2240 (recA56 mutant) were shown to be complement-sensitive when treated with 1.5 X 10(8)--1.9 X 10(8) cells per ml of normal human serum, while the cells with SOS-activated system (recA441 mutant, strain VT3251) retained their viability . An alternative pathway of complement activation was minimal with E . coli VT1241, while VT3251 demonstrated intermediate activity . To decrease the level of complement components (AH50) and factor B (BH50) by 50%, 3.5 X 10(6)--4.5 X 10(6) cells of VT1240 and VT2240 strains were required . R-mutants and recA441 mutants caused a 50% reduction in AH50, when used in the amount of 6.4 X 10(7) and 2.6 X 10(7), respectively, the same degree of BH50 decrease was achieved with the amounts used equal to 1.1 X 10(8) and 4.3 X 10(6), respectively . C3 conversions caused by 4 X 10(8) cells in I ml of the normal human serum in the four strains tested accounted for 5-15%.

Diagn Microbiol Infect Dis, 1987 May, 7(1), 29 - 35
RO 23-6240 (AM-833), a new fluoroquinolone: in vitro antimicrobial activity and tentative disk diffusion interpretive criteria; Fuchs PC et al.; The susceptibility of over 7000 recent clinical bacterial isolates to RO 23-6240, a new trifluorinated quinolone, was determined at four medical centers . Over 99% of Enterobacteriaceae and 97% of staphylococci were inhibited by less than or equal to 2.0 micrograms/ml of RO 23-6240 . Only 71% of Pseudomonas spp . were inhibited by this concentration . Streptococci and enterococci were resistant to RO 23-6240 . Clinical isolates of Haemophilus spp., pathogenic Neisseria spp., and Branhamella catarrhalis were inhibited by less than or equal to 0.25 micrograms/ml of RO 23-6240 . This drug's antibacterial activity was comparable with that of enoxacin and norfloxacin, but was less than that of ciprofloxacin against most species . Using less than or equal to 2.0 micrograms/ml and greater than or equal to 8.0 micrograms/ml as the susceptible and resistant MIC breakpoints for RO 23-6240, the regression analysis-derived disk diffusion zone diameter breakpoints for the 5 micrograms disk are: Susceptible greater than or equal to 19 mm intermediate 16-18 mm, and resistant less than or equal to 15 mm.

J Infect Dis, 1987 May, 155(5), 936 - 41
Factors that influence the evolution of beta-lactam resistance in beta-lactamase-inducible strains of Enterobacter cloacae and Pseudomonas aeruginosa; Aronoff SC et al.; Induction ratios were determined for beta-lactamase-inducible strains of Enterobacter cloacae and Pseudomonas aeruginosa by using 10 beta-lactam agents . For E . cloacae, pre-incubation with ceftriaxone, cefoxitin, cefamandole, cefoperazone, or imipenem produced significantly larger amounts of beta-lactamase than did pre-incubation with moxalactam, clavulanate, ceftazidime, or aztreonam . For P . aeruginosa, imipenem was the best inducer, whereas ceftriaxone, piperacillin, cefoperazone, cefamandole, clavulanate, and aztreonam were poor beta-lactamase inducers . The rate of emergence of resistance by E . cloacae p99 and P . aeruginosa ATCC 27853 did not correlate with the induction ratio of the selecting agent; however, a strong correlation was noted between the mutation rate and the ratio of the MIC to the concentration of selecting antibiotic used . Emergence of resistance is related to the MIC of the antibiotic and the concentration of antibiotic used to select for resistance and is independent of the efficacy of the beta-lactam inducer . Resistant mutants arise through both beta-lactamase-dependent and -independent mechanisms.

Immun Infekt, 1987 May, 15(3), 103 - 9
{Sulbactam and clavulanic acid: studies of enzyme kinetics and synergism with ampicillin and mezlocillin}; Cullmann W et al.; Both inhibitors clavulanic acid and sulbactam exhibit high affinity (Ki-values less than 10(-6) mol/l) to the beta-lactamases of gram-negative bacteria with predominant penicillinase activity and lowered affinity to enzymes with cephalosporinase activity (above all clavulanic acid) . As compared to sulbactam there was a stronger synergism of clavulanic acid with ampicillin or mezlocillin in those isolates producing either a plasmid-mediated or a chromosomally-mediated penicillinase . In beta-lactamase-overproducing Klebsiella ssp . variants both inhibitors could protect neither ampicillin nor mezlocillin from breakdown-independent of the synergy observed in the corresponding wild-type strains . Moreover, there was a marked synergism between mezlocillin (but not ampicillin) and sulbactam in beta-lactamase-overproducing Enterobacter cloacae variants . There was no strong relation between the amount of enzyme produced and the resulting synergy between inhibitor and antibiotic among clinical isolates . These observations agree with the results obtained for routinely performed susceptibility testing of amoxycillin/clavulanic acid and ampicillin/sulbactam.

J Bacteriol, 1987 May, 169(5), 2281 - 3
Characterization of type 1 and mannose-resistant fimbriae of Erwinia spp; Korhonen TK et al.; Type 1 fimbriae from Erwinia carotovora subsp . carotovora and mannose-resistant fimbriae from Erwinia rhapontici were purified and characterized . The type 1 fimbrillin had an apparent molecular weight of 16,500; that of the mannose-resistant fimbrillin was 18,000 . The amino-terminal amino acid sequences of the two fimbrillins were related, but tryptic peptide maps showed significant differences between the proteins . No serological cross-reaction was found between the two fimbrial filaments, nor did they cross-react with type 1 or type 3 fimbriae purified from other enterobacterial species . Immunofluorescent staining of bacterial populations revealed that they were heterogeneous with respect to fimbriation.

Am J Med, 1987 Apr 27, 82(4A), 2 - 11
Overview of preclinical studies with ciprofloxacin; Sanders CC et al.; Ciprofloxacin is a new 6-fluoro-7-piperazino-4-quinolone that is highly active against a broad array of microbial pathogens . Minimal inhibitory concentrations (MICs) of ciprofloxacin are generally below 0.5 micrograms/ml for Hemophilus, Neisseria, and Enterobacteriaceae and are 1.0 microgram/ml or less for many non-fermentative gram-negative bacteria . Most staphylococci, including strains resistant to methicillin, are inhibited by 1.0 microgram/ml or less of ciprofloxacin, whereas streptococci are somewhat less susceptible . Obligate anaerobes are generally not susceptible to ciprofloxacin at concentrations below 1.0 microgram/ml . The antimicrobial potency of ciprofloxacin is twofold to fourfold greater than that of norfloxacin and is considerably greater than that of cephalosporins and aminoglycosides in tests with most gram-negative bacteria . Factors diminishing the in vitro activity of ciprofloxacin include acidic pH, high levels of magnesium ions, and an inoculum size of 10(7) colony-forming units/ml or greater . Ciprofloxacin is bactericidal at concentrations near its MIC for most bacteria . In vivo tests with experimentally induced infections in animals confirm the potency of ciprofloxacin . Doses required to protect 50 percent of animals from death are generally less than 2.0 mg/kg for gram-negative infections and range from 0.7 to 7.0 mg/kg for staphylococcal infections . The antimicrobial spectrum and potency of ciprofloxacin demonstrated in these preclinical studies make this quinolone a promising new antimicrobial agent.

Am J Med, 1987 Apr 27, 82(4A), 266 - 9
Randomized trial of ciprofloxacin compared with other antimicrobial therapy in the treatment of osteomyelitis; Greenberg RN et al.; Thirty adults (mean age, 52 years) were enrolled in a randomized, comparative trial of oral ciprofloxacin (750 mg twice daily) and other antimicrobial therapies . Etiologic agents included Enterobacteriaceae (18 isolates), Pseudomonas aeruginosa (16 isolates), and Staphylococcus aureus (four isolates) . Seven of 14 (50 percent) ciprofloxacin-treated infections are cured at up to 13 months follow-up and three infections appear improved . Treatment failure or relapse has occurred in four patients . Sixteen patients received other antimicrobial therapy and 11 patients (65 percent) remain without infection and have healed wounds, with follow-up from one to 13 months . One patient has had a relapse, while improvement is apparent in four patients . Complications that occurred in this group included drug-related neutropenia (two patients), diarrhea (two patients), drug allergy (one patient), and catheter-related staphylococcal cellulitis (one patient) . Oral ciprofloxacin therapy for chronic osteomyelitis caused by susceptible organisms appears to be as effective as other antimicrobial therapies.

Am J Med, 1987 Apr 27, 82(4A), 262 - 5
Clinical efficacy of ciprofloxacin therapy for gram-negative bacillary osteomyelitis; Hessen MT et al.; The efficacy and toxicity of ciprofloxacin, an orally administered fluoroquinolone, were evaluated in 24 infections in 23 patients with osteomyelitis caused by aerobic gram-negative bacilli . The diagnosis was confirmed by surgical findings and the results of bone biopsy and culture of bone or deep soft tissue . The aerobic gram-negative bacilli were Pseudomonas aeruginosa (15 isolates), Serratia marcescens (five isolates), Escherichia coli (three isolates), Enterobacter species (three isolates), Proteus mirabilis (one isolate), Pseudomonas fluorescens (one isolate), and Klebsiella pneumoniae (one isolate) . Minimal bactericidal concentrations (MBCs) were 1.56 micrograms/ml or less for all but one isolate . Nine infections were polymicrobial, involving aerobic gram-positive cocci or anaerobes in addition to aerobic gram-negative bacilli . Additional antibiotics to which the aerobic gram-negative bacilli were resistant were given when the additional organisms were resistant to ciprofloxacin . Patients received 750 mg of ciprofloxacin twice daily for a mean of 62 days . Peak serum levels of ciprofloxacin were at least threefold higher than the MBCs in 20 of 24 patients . Twenty of 22 infections in which a full course of therapy was completed were without evidence of active disease at one to 17 months posttreatment . A sternotomy wound infection relapsed after eight weeks of therapy with a newly resistant S . marcescens strain, and an infection of a compound fracture relapsed two months posttreatment with a still sensitive P . aeruginosa strain . Toxicity was minimal in most patients: eosinophilia (six patients), nausea (eight patients), mild elevation in transaminase levels (three patients), pruritus (one patient), diarrhea (two patients), thrush (two patients), rash (two patients), and mild leukopenia (one patient) . Two additional patients had severe side effects (vertigo in one and acute renal failure in another) that required discontinuation of ciprofloxacin therapy . Overall, ciprofloxacin is a promising agent for the oral treatment of gram-negative bacillary osteomyelitis.

Am J Med, 1987 Apr 27, 82(4A), 202 - 7
Efficacy and safety of oral ciprofloxacin in the treatment of serious respiratory infections; Fass RJ; Fifty-two patients with serious respiratory infections were treated with orally administered ciprofloxacin; 42 patients were evaluable for the efficacy analysis and all were evaluable for determining adverse reactions . Cures were achieved in 24 patients with infections (14 with bronchitis, 10 with pneumonia) caused by Hemophilus influenzae, Streptococcus pneumoniae, or Branhamella catarrhalis, and pathogens were rapidly eradicated from respiratory secretions . Seventeen patients had infections (seven bronchitis, 10 pneumonia) caused by Enterobacteriaceae or Pseudomonas aeruginosa; many of these patients were critically ill and were enrolled in the study because their pathogens were resistant to multiple drugs or because their infections had not responded to alternate antimicrobial therapy . All patients had favorable clinical responses, and members of the Enterobacteriaceae were rapidly eradicated from respiratory secretions . However, five of 12 strains of P . aeruginosa persisted during treatment; minimal inhibitory concentrations for these strains increased 4- to 16-fold as infections continued to resolve . One patient with Staphylococcus aureus infection also showed a response . Ciprofloxacin probably caused nausea, vomiting, or both in three of the 52 patients and possibly contributed to similar symptoms in another three patients (6 to 12 percent) . Other possible adverse reactions, including central nervous system symptoms, were also observed but were not clearly drug-related.

Am J Med, 1987 Apr 27, 82(4A), 44 - 54
Evaluation of ciprofloxacin's synergism with other agents by multiple in vitro methods; Moody JA et al.; The efficacies of ciprofloxacin, ceftizoxime, azlocillin, mezlocillin, and amikacin (minimal inhibitory concentration and minimal bactericidal concentration) against six Pseudomonas aeruginosa, six Enterobacteriaceae, and six group D streptococcal strains were evaluated using both agar and broth susceptibility methods, two inoculum sizes (5.7 log10 colony-forming units (cfu)/ml and 7.7 log10 cfu/ml), and aerobic and anaerobic incubation conditions . The results showed agreement between broth and agar methods of susceptibility determination; inoculum effects with beta-lactam antimicrobials; and decreased susceptibility to amikacin under anaerobiasis . Ciprofloxacin combined with azlocillin, ceftizoxime, or aminoglycosides in broth microdilution checkerboards against 100 gram-negative bacilli and gram-positive cocci demonstrated that ciprofloxacin combined with azlocillin or ceftizoxime was synergistic against at least 50 percent of P . aeruginosa and Serratia marcescens isolates and that ciprofloxacin combined with amikacin was synergistic against at least 50 percent of S . marcescens and Staphylococcus aureus isolates . Ciprofloxacin and azlocillin in combination were evaluated by microdilution checkerboard, agar dilution, and broth macrodilution time-kill methods at two inoculum sizes to assess antibacterial activity . Comparison between in vitro combination methods showed the following: the presence or absence of checkerboard synergism (as defined by the fractional inhibitory concentration index and the fractional bactericidal concentration index) with ciprofloxacin and azlocillin did not correlate with time-kill results; and good agreement between methods when comparing broth macrodilution time-kill (3 log10 cfu/ml or more decrease) with antimicrobial combinations at a single concentration in both agar and microdilution broth for ciprofloxacin and azlocillin . Rabbit studies using subcutaneous dialysis membrane chambers inoculated with six P . aeruginosa, six Enterobacteriaceae, and six group D streptococcal strains were performed using ciprofloxacin, azlocillin, ceftizoxime, and amikacin alone and in combination as therapy . In vitro testing of antibiotic combinations that provided the best prediction of in vivo outcome were combination antibacterial activity (3 log10 cfu/ml or more decrease) at 24 hours using either broth macrodilution time-kill or antimicrobial combinations at a single concentration in either agar or broth (microdilution) . For the most efficacious in vivo combination, ciprofloxacin plus azlocillin, there was in vitro correlation with in vivo outcome for 17 of 18 isolates.

Eur J Biochem, 1987 Apr 15, 164(2), 469 - 75
A comparative study on the phoE genes of three enterobacterial species . Implications for structure-function relationships in a pore-forming protein of the outer membrane; Van der Ley P et al.; The cloned phoE genes from Enterobacter cloacae and Klebsiella pneumoniae are normally expressed and regulated in Escherichia coli K-12, and their products are correctly assembled into the outer membrane . Differences between the three PhoE proteins were found with binding of two out of ten monoclonal antibodies directed against the cell-surface-exposed part and in pore characteristics, but not in phage receptor function . The DNA sequences of the E . cloacae and K . pneumoniae phoE genes were determined and used to predict the primary structures of the encoded proteins . In the upstream non-coding regions, which showed more variations among the three genes than the coding regions, conserved sequences were identified which might be involved in regulation of phoE gene expression . Comparison of the predicted PhoE primary structures revealed a high degree of homology, with 81% of the amino acid residues being identical in all three proteins . Four small variable regions were found where differences are the most pronounced, corresponding to regions which were previously predicted to be exposed at the cell surface . Implications of the sequence comparison for structure-function relationships in PhoE protein are discussed.

Lancet, 1987 Apr 11, 1(8537), 824 - 6
Periurethral enterobacterial carriage preceding urinary infection; Brumfitt W et al.; The periurethral enterobacterial flora was identified before infective episodes in 56 patients with recurrent urinary infection . There were 91 episodes of infection, with colonisation by aerobic gram-negative bacilli in 60 . In only 31 (34%) episodes were patients colonised with the infective strain . In 31 episodes there was no colonisation of the perineum and in 29 there was heterologous colonisation . In another group of 54 women investigated during an enterobacterial infection of the urine there was colonisation with the infecting organism in 55 (86%) of 64 episodes; in 2 there was no colonisation; and 7 (11%) were associated with a heterologous strain . Women who have recurrent urinary infections are susceptible to perineal and periurethral colonisation with gram-negative bacteria but the infection need not be with the colonising enterobacteria.

Pharmazie, 1987 Apr, 42(4), 248 - 50
Antimicrobial activity of benzylisoquinoline alkaloids; Villar A et al.; The antimicrobial in vitro activity of 14 benzylisoquinoline alkaloids was investigated by agar diffusion and agar dilution methods against several genera of microorganisms that included Streptococcus, Staphylococcus, Bacillus, Lysteria, Escherichia, Salmonella, Klebsiella, Pseudomonas, Enterobacter, Serratia, Shigella, Mycobacterium and Candida . Anolobine was the most active compound against grampositive bacteria with MIC90 between 12 and 50 mg/l; less active were anonaine, lysicamine and liriodenine . All the alkaloids of the noraporphine and oxoaporphine groups, with the exception of isopiline, showed activity against Mycobacterium phlei (MIC 6-25 mg/l) . Candida albicans ATCC26555 was inhibited by anonaine, nornantenine and xylopine (MIC 3-12 mg/l) . None of the alkaloids tested had a significant activity against gramnegative rods . The action against susceptible microorganisms was bactericidal.

Immunol Lett, 1987 Apr, 14(4), 303 - 6
Raised serum IgA to common cell envelope antigens supports enterobacterial inductive contribution to pathogenesis of secondary ankylosing spondylitis; van Bohemen CG et al.; Ankylosing spondylitis (AS) is closely associated with the histocompatibility antigen HLA-B27 . Pathogenesis of AS is thought to involve interactions between B27 and certain enterobacterial antigens . However, enterobacterial involvement is uncertain and contested by some . The present paper demonstrates raised serum IgA to a common enterobacterial heat modifiable major outer membrane protein (h-momp; Mr 35,000) in active AS (N = 25; IgA = 1485 +/- 20) compared with controls, who were hospital patients without known arthropathies or gastro-intestinal disease (N = 12; IgA = 548 +/- 59) . Serum IgG and IgM did not differ statistically . Raised serum IgA to h-momp might indicate enterobacterial antigenic stimulation from the gastro-intestinal tract and thus support an inductive contribution of enterobacterial antigens to the pathogenesis of secondary AS . It does not necessarily imply direct involvement in the pathogenesis of primary AS . H-momp appears to be a convenient tool for serological studies of AS and at present is likely to be more suitable than other bacterial antigens.

Infect Immun, 1987 Apr, 55(4), 899 - 908
Isolation and characterization of murine monoclonal antibodies specific for gram-negative bacterial lipopolysaccharide: association of cross-genus reactivity with lipid A specificity; Bogard WC Jr et al.; Somatic cell hybrids secreting monoclonal antibodies against the core-glycolipid portion of enterobacterial endotoxin were derived from mice immunized with Escherichia coli J5 or Salmonella minnesota R595 heat-killed organisms or lipopolysaccharide (LPS) . Eight antibodies were selected for their ability to cross-react with several members of a panel of gram-negative bacterial antigens in a radioimmunoassay . This panel represented five genera and two families of organisms: E . coli O111:B4, E . coli O55:B5, Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella minnesota, and Serratia marcescens . The binding sites for six of the antibodies were unequivocally localized within the lipid A moiety of the endotoxin molecule by using the radioimmunoassay on LPS and free lipid A . The anti-lipid A antibodies were further characterized for their ability to interact with LPS variants by using a sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunostaining procedure . The monoclonal antibodies bound almost exclusively to the low-molecular-weight species of LPS on the polyacrylamide gel . These components corresponded to LPS isolated from rough strains of organisms (strains which lack O-specific carbohydrate) . These results suggested that the cross-reactive component of antisera raised against rough mutants of gram-negative bacteria contain antibodies of lipid A specificity . Moreover, the determinant within the lipid A moiety of LPS may have been accessible to the monoclonal antibodies only in those endotoxin molecules on the outer membrane surface which lack the O-specific carbohydrate.

J Antimicrob Chemother, 1987 Apr, 19(4), 417 - 27
Properties of spontaneous Enterobacter cloacae mutants with temperature-conditional derepression of type I beta-lactamase synthesis; Curtis NA et al.; Spontaneous mutants, with temperature-conditional derepression of chromosomally-encoded Type I beta-lactamase synthesis, were derived from two independent clinical isolates of Enterobacter cloacae . At the permissive temperature (28 degrees C) the mutants' beta-lactamase activity was equivalent to that of their respective parents but at restrictive temperatures (above 40 degrees C) the activity increased many hundred-fold . The increased beta-lactamase expression correlated with reduced beta-lactam susceptibility . In temperature shift-up experiments, the initial rate of beta-lactamase synthesis closely paralleled that of the parent strains induced with cefoxitin . Maximal beta-lactamase activity in the mutants was attained after about 3 h growth at restrictive temperatures and was significantly higher than that of the cefoxitin-induced parents . However, the level was not as high as that observed in isogenic temperature-stable derepressed mutants, under the same conditions . All temperature-conditional mutants showed hyper-induction of beta-lactamase synthesis at permissive temperatures . Our findings are discussed in relation to a positive control model for regulation of Type I beta-lactamase synthesis in Ent . cloacae.

Environ Res, 1987 Apr, 42(2), 377 - 85
Induction of metallothionein synthesis in human peripheral blood leukocytes; Peavy DL et al.; Metallothionein (MT), a low molecular weight, metal-binding protein, has recently been shown to protect murine mononuclear phagocytic cells from the cytotoxic effects of bacterial lipopolysaccharides (LPS), the endotoxic component of Enterobacteriaceae . MT appears to function intracellularly as an antioxidant since autolysis results from lipid peroxidation initiated by free radicals of O2 . Since this activity is distinct from MT's capacity to specifically sequestrate heavy metals, we examined whether MT synthesis can be induced by direct membrane activation or through interaction with soluble leukocyte mediators . Normal human monocytes, polymorphonuclear neutrophils (PMN), and lymphocytes, isolated from heparinized whole blood, were incubated with and without LPS from Escherichia coli and Salmonella typhosa . MT in cell lysates was quantitated using a 203Hg-binding assay employing Sephadex G-10 "minicolumns." When incubated with monocytes, PMN, or lymphocytes, neither preparation of LPS (10-100 micrograms/ml) was capable of enhancing 203Hg-binding activity after 24 or 72 hr incubation . CdCl2 (2 micrograms/ml), however, increased binding activity in monocyte and lymphocyte cultures 4- and 15-fold, respectively . When monocytes and lymphocytes were cocultured with LPS, 203Hg-binding activity was not enhanced . Addition of human interleukin 1 (endogenous pyrogen) to these cultures had no significant effect . Leukocyte endogenous mediator (LEM), a product of LPS-activated PMN that possesses hypozincemic activity in vivo, did not induce MT synthesis . Collectively, these results demonstrate that leukocyte MT does not arise from direct LPS activation or from interaction with products secreted by LPS-activated cells . De novo synthesis of MT observed during endotoxemia and gram negative sepsis appears, therefore, to be induced by endogenously released corticosteroids.

Jpn J Antibiot, 1987 Apr, 40(4), 695 - 702
{Clinical study on effects of cefmetazole on severe infections accompanied by hematologic diseases}; Shirakami A et al.; Severe infections accompanied by hematopathy under granulocytopenic conditions were treated with cefmetazole (CMZ) . Subject diseases mainly consisted of acute leukemia, agranulocytosis and aplastic anemia; combined infections were septicemia, pneumonia, fever of an undetermined origin, etc . As for causative organisms found in cases that could be examined, Gram-negative bacilli such as Klebsiella pneumoniae, Klebsiella oxytoca, Pseudomonas aeruginosa and Enterobacter cloacae were isolated, as was Staphylococcus aureus . In general, 4 g of CMZ divided into 2 administrations was given per day through intravenous injection or intravenous drip infusion . On the basis of the judgement criteria for effectiveness established by Takaku et al., the efficacy rate in this study was found to be 68%, including 2 cases that showed excellent responses to treatment of infections caused by S . aureus . Cases that showed pyretolysis within 4 days had over 1,000/microliter of neutrophils, while cases with less than 1,000/microliter showed no pyretolysis . No hepatorenal dysfunctions related to the treatment with CMZ were seen as side effects except increases of transaminase in 1 case . These results indicate that CMZ is a useful drug for the treatment of infections accompanied by hematopathy under granulocytopenic condition.

Acta Pathol Microbiol Immunol Scand {B}, 1987 Apr, 95(2), 141 - 6
Comparative in vitro activities of pefloxacin, ofloxacin, enoxacin and ciprofloxacin against 256 clinical isolates; Arpi M et al.; The antibacterial activity of four new fluoroquinolone carboxylic acids, pefloxacin, ofloxacin, enoxacin and ciprofloxacin, against 256 clinical isolates was investigated by means of an agar dilution method . Generally, all quinolones tested had a high activity against Gram-negative bacteria . More than 90% of Enterobacteriaceae strains were inhibited by a quinolone concentration of 0.4 microgram/ml . Also strains usually resistant to conventional beta-lactam antibiotics, and sometimes to third-generation cephalosporins, like Enterobacter spp., Serratia spp, and Yersinia spp . were susceptible to the tested quinolones . Ciprofloxacin was 5 to 25-fold more potent on a weight basis against Enterobacteriaceae than the other quinolones . Neisseria meningitidis, Neisseria gonorrhoeae, and Haemophilus influenzae were extremely susceptible to the new quinolones . Ciprofloxacin was about 10 times more potent against Pseudomonas aeruginosa than the other quinolones, and was the only quinolone that was sufficiently active against all tested P . aeruginosa strains (MIC less than or equal to 0.4 microgram/ml) . The activity against Gram-positive bacteria was considerably lower . All the quinolones investigated had an acceptable activity against many of the methicillin-sensitive and methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci . The majority of the Streptococcus spp . tested was quinolone-resistant, and was Listeria monocytogenes . Generally, it was evident that ciprofloxacin was more potent on a weight basis than the other quinolones, but this difference was counterbalanced by a higher achievable serum concentration for ofloxacin . Some of the investigated fluoroquinolones might constitute valid therapeutical alternatives to beta-lactam antibodies and aminoglycosides in the treatment of serious bacterial infections.

Antibiot Med Biotekhnol, 1987 Apr, 32(4), 267 - 71
{Molecular-genetic structure and incompatibility of the nonconjugative enterobacterial R plasmids pKMR281 and pKMR285}; Viatkina GG et al.; Physical maps of Enterobacteriaceae nonconjugative plasmids pKMR281 (Sm, Su, molecular weight of 6 kb) and pKMR285 (Sm, Su Tc, molecular weight of 9 kb) were constructed for endonucleases EcoRI, PstI, EcoRV, SmaI, BglII, SalI and PvuII . The genes controlling production of aminoglycoside-3''-phosphotransferase and dihydropteroate synthetase of type II and the genetic tetracycline resistance determinant of class A were localized on the plasmids . Heteroduplex analysis of plasmids pKMR281 and pKMR285 showed that plasmid pKMR281 was completely homologous to plasmid pKMR285 . The site of plasmid pKMR285 nonhomology with respect to plasmid pKMR281 corresponded to the area containing the tetracycline resistance determinant . Plasmids pKMR281 and pKMR285 were compatible with the tester plasmids of 25 incompatibility groups of Enterobacteriaceae and probably constitute a new incompatibility group . It was shown that pKMR281 and pKMR285 type plasmids were widely distributed in clinical strains of E . coli and Shigella spp . isolated in the Krasnodar Region.

Vet Parasitol, 1987 Apr, 24(1-2), 129 - 38
Effects of infection with Enterobacteriaceae enteropathogens on subsequent infection with Ascaris suum in the laboratory mouse; Wade WF et al.; Prior to infection with Ascaris suum, ICR strain mice were inoculated with Salmonella typhisuis intraperitoneally or via gastric gavage . Similarly, Salmonella cholerae-suis var . kunzendorf, Salmonella typhimurium and enterotoxigenic Escherichia coli were administered to mice via gastric gavage 2 weeks prior to A . suum inoculation . Previous inoculation with S . typhisuis, via the intraperitoneal or gastric gavage routes and S . cholerae-suis var . kunzendorf decreased recovery of ascarid larvae from mice lungs . This effect appeared to be due to entrapment of migrating larvae by inflammatory reactions in the liver . This reaction was suspected to be due to non-specific resistance stimulated by the prior exposure to the bacterial pathogen . The number of A . suum larvae in the lungs of mice previously inoculated with S . typhimurium or enterotoxigenic E . coli (ETEC) was variable and in some cases greater in mice which had received the bacterial inoculation.

Eur J Clin Microbiol, 1987 Apr, 6(2), 167 - 9
In vitro activity of RO 15-8074 and RO 19-5247; Valle T et al.; The in vitro activity of RO 15-8074 (cefetamet) and RO 19-5247, new oral cephalosporins, was compared with that of amoxicillin, cephalexin, cefaclor, cefuroxime and erythromycin against 292 clinical isolates using the agar dilution method . Both RO 15-8074 and RO 19-5247 were very active against Proteus mirabilis, Neisseria gonorrhoeae, Haemophilus influenzae and Streptococcus pyogenes, but less active against Staphylococcus saprophyticus and Enterobacter cloacae . RO 19-5247 was more active than RO 15-8074 against Haemophilus influenzae and Streptococcus viridans.

Eur J Clin Microbiol, 1987 Apr, 6(2), 161 - 4
In vitro activity of the new 4-quinolone compound Ro 23-6240; Clarke AM et al.; The in vitro activity of the new 4-quinolone Ro 23-6240 was compared with that of pefloxacin, ciprofloxacin, norfloxacin, nalidixic acid and gentamicin against a total of 397 recent clinical isolates . An agar dilution procedure was used to determine MICs and two inocula (10(4) and 10(6) CFU) were used throughout . Ro 23-6240 inhibited most species of the Enterobacteriaceae, Haemophilus influenzae and Staphylococcus aureus (including methicillin-resistant strains) at less than or equal to 1 mg/l . Pseudomonas aeruginosa was somewhat more resistant (MIC 90 4 mg/l) and the Bacteroides fragilis group were considerably more resistant (MIC 90 32 mg/l) . Overall Ro 23-6240 was as active as pefloxacin but was two- to eight-fold less active than ciprofloxacin against most species tested.

Antimicrob Agents Chemother, 1987 Apr, 31(4), 667 - 70
More than one DNA sequence encodes the 2''-O-adenylyltransferase phenotype; Lee SC et al.; Biochemical and phenotypic assays indicate that three enterobacterial R plasmids isolated in a single hospital encode 2''-O-adenylyltransferase {ANT(2'')}, and an ANT(2'')-specific probe was developed from one plasmid . Southern hybridization revealed the three plasmids to be unrelated and, further, showed their ANT(2'')-encoding genes to be different.

Tijdschr Diergeneeskd, 1987 Mar 15, 112(6), 322 - 33
{The microbiological status of dry sausage in East Netherlands}; Hartog BJ et al.; Dry fermented sausage (dfs) was the food most suspected in a number of outbreaks of salmonellosis and staphylococcal enterotoxaemia . Data on formulation and processing showed that over 75 per cent of 76 producers still manufactured dfs in a traditional manner: fermentation and drying at ambient temperature for ten days on an average, green room facilities not present . 'Modern' processes were characterised by fermentation in green rooms at elevated temperatures, thus limiting production time to six days on an average . However, precautions to prevent luxurious growth of S . aureus under these conditions were not adopted to any appreciable extent . Consequently, high S . aureus levels (greater than 10(4) cfu/g) were detected precisely in dfs from five manufacturers using rapid processes . Colony counts of Enterobacteriaceae were low in dfs (81 per cent of 151 samples less than 10(3) cfu/g), associated with relatively low pH and aw levels and a high concentration of salt . However, Salmonella was detected in 16 (11%) of the samples, both from 'traditional' and 'modern' producers . Improvement of manufacturing practices in the manufacture of dfs should be stimulated to guarantee wholesome and safe products.

Am J Dis Child, 1987 Mar, 141(3), 267 - 70
Infections in a pediatric intensive care unit; Brown RB et al.; All infections occurring in a busy pediatric intensive care unit (PICU) from 1982 to 1984 were characterized by site, bacteriology, acquisition status, and outcome . Standard Centers for Disease Control criteria were employed . Nine hundred sixty-five patients were admitted to the PICU . Mortality was 3.4% . Two hundred twenty-one infections occurred in 180 patients . Infection rates were 23% and 6% for total and PICU-acquired infections, respectively . Infections of the central nervous system (n = 56), lower respiratory tract (n = 53), and genitourinary tract (n = 46) made up 70% of all infections . Haemophilus influenzae (n = 39) was the most commonly isolated pathogen . Staphylococcus aureus (20%) and Klebsiella-Enterobacter-Serratia (18.3%) were most commonly noted in PICU-acquired infections . Twenty infected patients (11.1%) died in the PICU . Lower respiratory tract infections (20.5%) were associated with the highest mortality . Both PICU-acquired and community-acquired infections were associated with similar mortalities . Infected patients in a PICU have a mortality approximately 300% higher than that seen in the overall PICU population . The data presented document the importance of infection and provide information against which similar units can gauge their infection status for quality-assurance purposes.

Infection, 1987 Mar-Apr, 15(2), 142 - 5
{Lipoid A antibody titer in the human}; Marget W; Lipid A is the toxic component of endotoxin in gram-negative bacteria . Antibodies to lipid A are not usually found in healthy persons (or only at a low titer) without a corresponding history of infection . Even gram-negative septicemia is found to be accompanied by only low titers . A completely different situation is seen in patients with chronic or recurrent infections due to Enterobacteriaceae and other gram-negative bacteria . Here it is notable that the antibody titer varies with the type of disorder (e.g . cystitis and pyelonephritis) . A severe wound infection, e.g . due to Pseudomonas aeruginosa, also leads to measurable lipid A antibody titers . Varying antibody titers can be observed in cystic fibrosis, Crohn's disease, and severe surgical infections . One can conclude that a significantly elevated antibody titer develops during an extensive tissue involvement of long duration and indeed is caused by tissue inhibition by endotoxin . Based on clinical experience, it can be assumed that lipid A antibodies present in the body have a protective effect in septic shock.

Antimicrob Agents Chemother, 1987 Mar, 31(3), 404 - 9
Distribution of erythromycin esterase and rRNA methylase genes in members of the family Enterobacteriaceae highly resistant to erythromycin; Arthur M et al.; The distribution of nucleotide sequences related to ereA, ereB, and ermAM was studied by colony hybridization in 112 strains of members of the family Enterobacteriaceae that are highly resistant to erythromycin . The ereA and ereB genes encoding erythromycin esterases type I and II, respectively, were detected in strains inactivating the 14-membered macrolides erythromycin and oleandomycin . Because all 52 strains resisting these antibiotics by inactivation were detected by ereA (n = 23), ereB (n = 23), or both probes (n = 6), only two classes of genes accounted for this resistance phenotype . The ermAM gene encoding a streptococcal rRNA methylase was detected in 21 strains of Escherichia coli and two strains of Klebsiella spp . Determination of the MICs of macrolide, lincosamide, and streptogramin (MLS) antibiotics demonstrated a correlation between hybridization with ermAM and the so-called MLS resistance phenotype . The presence of 11 strains coresistant to MLS antibiotics that did not hybridize to the ermAM probe suggests that, as in gram-positive organisms, MLS resistance in members of the family Enterobacteriaceae involves more than one class of rRNA methylase . Numerous strains (n = 18) were found to produce both an erythromycin esterase type II and an rRNA methylase . Physical linkage between ereB and ermAM may be responsible for the codissemination of the genes . Despite their exogenous origin, ereB and ermAM are already disseminated in various genera of the Enterobacteriaceae.

Antibiot Med Biotekhnol, 1987 Mar, 32(3), 206 - 10
{Changes in the microflora of the large intestine in rats administered cephalexin and erythromycin orally}; Lapchinskaia AV et al.; The effect of long-term use of cephalexin and erythromycin (for 17 days) on large intestine microflora was studied on rats . It was found that intragastric administration of cephalexin in a dose of 800 mg/kg and erythromycin in a dose of 400 mg/kg was followed by changes in the quantitative and qualitative composition of the large intestine aerobic and anaerobic microflora . However, it did not induce production of beta-aspartyl glycine which is a biochemical indicator of deep changes in intestinal microflora . The long-term use of the above antibiotics resulted in increased levels and persistence of intestine colonization with facultative pathogenic enterobacteria and staphylococci resistant to the chemotherapeutic agents.

Diagn Microbiol Infect Dis, 1987 Mar, 6(3), 193 - 8
Antimicrobial activity of Ro 19-5247 (T-2525), a new oral cephalosporin, tested against 7,745 recent clinical isolates; Jones RN et al.; The susceptibility testing of 7,745 recent clinical isolates from four medical centers showed Ro 19-5247 to be eight- to greater than 64-fold more active than cephalexin against the Enterobacteriaceae . Ro 19-5247 was comparable with cephalexin in anti-staphylococcal activity (MIC50, 4.0 micrograms/ml) and fourfold more active than cefixime . None of the oral cephalosporins were effective (MIC50, greater than 32 micrograms/ml) against enterococci, Pseudomonas aeruginosa and P . maltophilia . beta-lactamase hydrolysis experiments failed to demonstrate significant Ro 19-5247 inactivation by ten commonly encountered chromosomal- or plasmid-mediated enzymes (P99, K1, K14, TEM, CARB, OXA).

Rev Infect Dis, 1987 Mar-Apr, 9 Suppl 2, S195 - 210
Recurrent urinary tract infections in female patients: an overview of management and treatment; Stamey TA; Several major factors have contributed to the current availability of highly successful techniques for the management of recurrent urinary tract infection (UTI) in female patients . Since UTI cannot be diagnosed by symptoms alone, greater accuracy in diagnostic techniques that establish whether bacteria in the voided urine are present in the bladder urine is the most important factor . Second, the recognition that almost all recurrent UTIs are reinfections is crucial . Third, it has been observed that bacteriuria in female patients is preceded by colonization of the introital mucosa of the vagina and urethra with Enterobacteriaceae from the rectal flora; it is at these sites that oral antimicrobial agents can determine the character of subsequent reinfections of the urinary tract . A fourth factor is the development of highly effective prophylactic regimens, including trimethoprim-sulfamethoxazole, nitrofurantoin, cinoxacin, and cephalexin . In addition, the management of patients with UTI has improved because correctable causes of bacterial persistence are now well recognized and there is an improved understanding of the kinds of patients at increased risk . Finally, new antimicrobial agents with more favorable pharmacokinetic properties have become available.

Am J Clin Pathol, 1987 Mar, 87(3), 396 - 8
Clinical comparison of the Roche Septi-Chek and Dupont Isolator blood culture systems; Buck GE et al.; A study was conducted to compare the recovery of clinical isolates by the DuPont Isolator and Roche Septi-Chek blood culture systems . A total of 5,262 blood culture specimens were processed by the two systems . Of these, 358 cultures contained significant isolates: 219 were positive in both systems, 68 were recovered only by Isolator, 71 were recovered by Septi-Chek only (not statistically significant) . Of the isolates recovered in both systems, 159 were positive the same day, 55 were recovered first by Isolator, and 5 were recovered first by Septi-Chek . In cases where Isolator recovered organisms first, the average difference in time was one to two days . Regarding particular groups of organisms, there was no difference between the systems in recovery of Enterobacteriaceae, anaerobes, yeast, and gram-positive bacteria, except for Streptococcus pneumoniae . Septi-Chek recovered S . pneumoniae significantly more often . These results suggest that these two systems are essentially comparable, except with S . pneumoniae, although the Isolator frequently provided results more rapidly.

Antimicrob Agents Chemother, 1987 Mar, 31(3), 458 - 60
Comparison of difloxacin, enoxacin, and cefoperazone for treatment of experimental Enterobacter aerogenes endocarditis; Boscia JA et al.; This study compared difloxacin administered orally, enoxacin administered orally, and cefoperazone administered intramuscularly for the treatment of experimental Enterobacter aerogenes endocarditis . Difloxacin significantly reduced bacterial counts of vegetations, as compared with enoxacin and cefoperazone . Enoxacin and cefoperazone did not differ significantly . This study demonstrated that difloxacin was significantly more effective than enoxacin and cefoperazone for the treatment of E . aerogenes endocarditis in rabbits.

J Korean Med Sci, 1987 Mar, 2(1), 35 - 42
Antimicrobial susceptibility of bacteria isolated in 1985--with special reference to prevalence of methicillin-resistant staphylococcus aureus and activities of cefazolin, cefotaxime and piperacillin; Lee SY et al.; Antimicrobial susceptibility of nine species and one group of bacteria isolated from patients at the hospitals of Seoul National University, Severance, Hanyang University, and Kyungpuk University were tested by agar dilution method . S . aureus was most susceptible to cefazolin, methicillin and cotrimoxazole, and enterococci to ampicillin . Isolates of Enterobacteriaceae were most frequently susceptible to aminoglycosides and cefotaxime . Cefazolin susceptibility was markedly different from species to species . Aminoglycosides and piperacillin were more active than others against P . aeruginosa, and amikachin against A . anitratus . A large proportion of strains of several different species were conditionally susceptible to either tetracycline, ampicillin, cefazolin or cotrimoxazole suggesting the usefulness of these drugs for treatment of urinary tract infection . Activity of cefotaxime was highest against E . coli, and K . pneumoniae, while lowest against A . anitratus and P . aeruginosa . Decrease in the proportion of susceptible isolate was noted in E . coli and K . pneumoniae to cefazolin, K . pneumoniae, E . cloacae and S . marcescens to cotrimoxazole, and P . aeruginosa to tobramycin and gentamicin.

Ann Inst Pasteur Microbiol, 1987 Mar-Apr, 138(2), 201 - 12
{Comparative immunological study of glyceraldehydephosphate dehydrogenase in Enterobacteriaceae: contribution of an anti-glyceraldehydephosphate dehydrogenase antiserum of Enterobacter intermedium}; Trinel PA et al.; A comparative immunological study of glyceraldehyde-3-phosphate dehydrogenase among Enterobacteriaceae was carried out with an antiserum against Enterobacter intermedium G-3-PDH . Results of immunodiffusion experiments and microcomplement fixation studies showed E . intermedium to be a homogeneous species . The genera Enterobacter and Escherichia were found to be quite heterogeneous.

J Bacteriol, 1987 Mar, 169(3), 1325 - 7
Characterization of suppressible mutations in the viomycin phosphotransferase gene of the Streptomyces enteric plasmid pVE138; Paradiso MJ et al.; The viomycin phosphotransferase gene (vph) is expressed and confers resistance to viomycin in both Streptomyces spp . and members of the family Enterobacteriaceae . We report the isolation of UGA (opal) and UAG (amber) mutations in the vph gene of shuttle plasmid pVE138 . We found that the five UGA mutations in vph resulted in a temperature-sensitive phenotype in Salmonella typhimurium . Su- strains are Vior at 28 degrees C and Vios at 37 degrees C, whereas Su+UGA strains are Vior at both 28 and 37 degrees C . The single amber mutation isolated was not temperature sensitive and resulted in the expected Vios phenotype in Su- strains and Vior in Su+UAG strains.

J Bacteriol, 1987 Mar, 169(3), 1223 - 31
Hexuronate catabolism in Erwinia chrysanthemi; Hugouvieux-Cotte-Pattat N et al.; In the phytopathogenic enterobacterium Erwinia chrysanthemi, the catabolism of hexuronates is linked to the degradation of pectic polymers . We isolated Mu lac insertions in each gene of the hexuronate pathway and used genetic fusions with lacZ (the beta-galactosidase gene of Escherichia coli) to study the regulation of this pathway . Three independent regulatory genes (exuR, uxuR, and kdgR) were found . Galacturonate and glucuronate were converted into 2-keto-3-deoxygluconate (KDG) by separate three-step pathways encoded by the uxaC, uxaB, and uxaA genes and the uxaC, uxuB, and uxuA genes, respectively . The two aldohexuronates entered the cell by a specific transport system, encoded by exuT . Wild-type strain 3937 was unable to use glucuronate as a carbon source since glucuronate was unable to induce the exuT expression . Mutants able to use glucuronate possessed an inactivated exuR gene . The product of the regulatory gene exuR negatively controlled the expression of exuT, uxaC, uxaB, and uxaA, which was inducible in the presence of galacturonate . The two genes specifically involved in glucuronate catabolism, uxuA and uxuB, formed two independent transcriptional units regulated separately, uxuB expression was not inducible, whereas uxuA expression was induced in the presence of glucuronate and controlled by the uxuR product . KDG, the common end product of both pathways, is cleaved by the kdgK and kdgA gene products . KDG enters the cell by a specific transport system, encoded by kdgT . The regulatory gene kdgR controlled the expression of kdgT, kdgK, and kdgA and partially that of the pel genes encoding pectate-lyases . The real inducer of pectate-lyase synthesis, originating from catabolism of galacturonate or glucuronate, appeared to be KDG . The genes of E . chrysanthemi affecting hexuronate catabolism are separated into six independent transcriptional units exuT, uxaCBA, uxuA, uxuB, kdgK, and kdgA, but only three gene clusters were localized on the genetic map: exuT-uxaCBA, uxuA-uxuB-kdgK, and kdgA-exuR.

J Bacteriol, 1987 Mar, 169(3), 1071 - 9
An unusual genetic link between vitamin B6 biosynthesis and tRNA pseudouridine modification in Escherichia coli K-12; Arps PJ et al.; We characterized several unusual phenotypes caused by stable insertion mutations in a gene that is located upstream in the same operon from hisT, which encodes the tRNA modification enzyme pseudouridine synthase I . Mutants containing kanamycin resistance (Kmr) cassettes in this upstream gene, which we temporarily designated usg-2, failed to grow on minimal plus glucose medium at 37 and 42 degrees C . However, usg-2::Kmr mutants did form oddly translucent, mucoid colonies at 30 degrees C or below . Microscopic examination revealed that cells from these translucent colonies were spherical and seemed to divide equatorially . Addition of D-alanine restored the shape of the mutant cells to rods and allowed the mutants to grow slowly at 37 degrees C and above . By contrast, addition of the common L-amino acids prevented growth of the usg-2::Kmr mutants, even at 30 degrees C . Furthermore, prolonged incubation of usg-2::Kmr mutants at 37 and 42 degrees C led to the appearance of several classes of temperature-resistant pseudorevertants . Other compounds also supported growth of usg-2::Kmr mutants at 37 and 42 degrees C, including glycolaldehyde and the B6 vitamers pyridoxine and pyridoxal . This observation suggested that usg-2 was pdxB, which had been mapped near hisT . Complementation experiments confirmed that usg-2 is indeed pdxB, and inspection of the pyridoxine biosynthetic pathway suggests explanations for the unusual phenotypes of pdxB::Kmr mutants . Finally, Southern hybridization experiments showed that pdxB and hisT are closely associated in several enterobacterial species . We consider reasons for grouping pdxB and hisT together in the same complex operon and speculate that these two genes play roles in the global regulation of amino acid metabolism.

J Hosp Infect, 1987 Mar, 9(2), 143 - 50
Outbreak of colonization of neonates with Enterobacter sakazakii; Arseni A et al.; An outbreak of colonization of 11 neonates with Enterobacter sakazakii occurred in a neonatal intensive care unit from the 10 September to 17 October 1984 . During this period Ent . sakazakii was isolated from throat and rectal swabs and tracheal aspirates, but not from blood, of the neonates . The duration of colonization ranged from 2 to 8 weeks . The isolates were resistant to amikacin and to tobramycin, but sensitive to gentamicin . Four of the 11 colonized neonates had clinical signs of severe sepsis and one of meningitis and four died in spite of intensive chemotherapy . The source and the mode of spread of Ent . sakazakii remained unknown as it was not found on the hands of staff or in the inanimate environment of the unit . Ent . sakazakii may be implicated in severe infections in neonates and should be included when screening clinical specimens.

Microbiol Sci, 1987 Mar, 4(3), 87 - 90
PQQ-linked enzymes in enteric bacteria; Neijssel OM; Klebsiella aerogenes possesses a PQQ-linked glucose dehydrogenase . Other members of the Enterobacteriaceae, such as Escherichia coli, Salmonella typhimurium or Serratia marcescens are seemingly unable to synthesize PQQ, but are able to synthesize the glucose dehydrogenase apoenzyme . The physiological significance of this enzyme is discussed.

Stain Technol, 1987 Mar, 62(2), 67 - 71
Use of tannic acid for the ultrastructural visualization of periplasm in gram-negative bacteria; Bal AK et al.; Tannic acid mordanting reveals the periplasm, the area between the outer membrane and the inner membrane of gram-negative bacteria, Rhizobium sp., Escherichia coli and Enterobacter aerogenes, as an electron-dense layer continuous with the inner leaflet of the outer membrane . The method involves 18 hr of tannic acid treatment after fixation in aldehyde prior to osmium tetroxide postfixation, followed by conventional electron microscopy.

Arch Dis Child, 1987 Feb, 62(2), 148 - 51
Outbreak of cephalosporin resistant Enterobacter cloacae infection in a neonatal intensive care unit; Modi N et al.; Enterobacter cloacae resistant to third generation cephalosporins emerged rapidly during an outbreak of serious infections due to this organism in a neonatal intensive care unit where ampicillin and gentamicin were used as first line antibiotic treatment . Organisms resistant to cephalosporins were isolated from 12 infants, six of whom developed systemic infection . Two infants died . Isolates of E . cloacae from four of five infants treated with cefotaxime showed a loss of sensitivity to this antibiotic during treatment, but in the three infants who survived sensitive organisms were again isolated after treatment had stopped . Stopping treatment with the cephalosporins, closure of the unit to new admissions, and strict cohorting of colonised infants resulted in a prompt end to the outbreak . This outbreak suggests that the routine use of third generation cephalosporins for suspected sepsis may be inappropriate in the presence of a large reservoir of organisms with the potential for rapidly developing resistance . Routine bacteriological surveillance, however, might permit their use on a rotational basis.

J Clin Microbiol, 1987 Feb, 25(2), 377 - 82
Qualitative and quantitative determination of enterobacterial common antigen (ECA) with monoclonal antibodies: expression of ECA by two Actinobacillus species; Bottger EC et al.; The presence and quantity of the enterobacterial common antigen (ECA) in several species belonging to the family Enterobacteriaceae as well as to other gram-negative families were determined by a solid-phase enzyme-linked immunosorbent assay system and Western blotting by using mouse monoclonal antibodies specific for ECA . Except for Erwinia chrysanthemi, previously known to be an exception, all species known or presumed to belong to Enterobacteriaceae produced ECA (89 of 90 species) . Most species not belonging to Enterobacteriaceae did not produce ECA (25 of 28 species), with one already known (Plesiomonas shigelloides) and two hitherto unknown (Actinobacillus equuli and Actinobacillus suis) exceptions . Interestingly, all strains of P . shigelloides produced ECA, regardless of the presence of the Shigella sonnei cross-reacting O antigen . Quantitation of the amount of ECA in members of the family Enterobacteriaceae revealed a remarkable heterogeneity among genera and species as well as within one species . We conclude that the rapid, sensitive, and reliable determination of ECA is a useful aid in taxonomic classification and may help to characterize the relatedness of the family Enterobacteriaceae to other families . However, a quantitative analysis of ECA appears to be without value for these purposes.

Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi, 1987 Feb, 20(1), 9 - 14
Detection of acetoin by head-space gas-liquid chromatography for rapid identification of bacteremia caused by Klebsielleae; Ho SW et al.; Head-space gas-liquid chromatographic (HS-GLC) detection of acetoin in 223 blood cultures of gram-negative bacilli was compared with results obtained from the conventional identification method . Seventy-three out of 76 cultures of Klebsielleae, including Klebsiella pneumoniae, Klebsiella oxtytoca, Enterobacter cloacae, Enterobacter agglomerans and Serratia marcescens, were identified by the acetoin detection method with HS-GLC . One hundred and forty-six out of 147 blood cultures of other gram-negative aerobic and anaerobic bacilli did not produce acetoin . The findings indicate that the HS-GLC technique is a useful method with high sensitivity and specificity for identification of bacteremia caused by Klebsielleae.

Antimicrob Agents Chemother, 1987 Feb, 31(2), 151 - 5
Treatment of bone, joint, and soft-tissue infections with oral ciprofloxacin; Greenberg RN et al.; We treated 52 patients with orally administered ciprofloxacin . In this study of 34 men and 18 women who completed therapy and who could be evaluated, there were 29 patients with nonhematogenous osteomyelitis, 20 patients with skin or soft-tissue infections, and 3 patients with joint infections . During the study, 92 isolates of pathogenic facultative aerobic bacteria, including 37 members of the family Enterobacteriaceae, 30 Staphylococcus aureus isolates, and 21 Pseudomonas aeruginosa isolates, were recovered, and 88 (96%) of the isolates were found to be susceptible to ciprofloxacin . Of the 29 patients with osteomyelitis, 14 have not experienced relapse after a follow-up of at least 1 year . Overall, 61% of infections were resolved, as judged by both clinical and microbiological criteria, during therapy . One patient developed Streptococcus salivarius sepsis during ciprofloxacin therapy, and one patient developed a rash which required discontinuation of ciprofloxacin . Otherwise, there were no serious reactions or complications.

Zh Mikrobiol Epidemiol Immunobiol, 1987 Feb, (2), 7 - 12
{Search for propionic acid bacteria in the human intestine}; Vorob'eva LI et al.; The possibility of detecting propionic acid-producing bacteria in the intestine of healthy humans with a view to obtaining a strain which is physiologically most suitable for therapeutic purposes has been studied . The selective conditions for the isolation of propionic acid-producing bacteria from the large intestine have been experimentally established . Analysis of 70 puncture biopsy specimens of parietal mucus and luminal contents from different sections of the intestine has not shown the presence of the representatives of propionic acid-producing bacteria . The strains isolated under the conditions selective for such bacteria have been found to belong to the family Enterobacteriaceae . These strains have proved capable of synthesizing vitamin B12, but the synthesis of propionic acid has not been observed.

Mol Gen Mikrobiol Virusol, 1987 Feb, (2), 27 - 30
{The nature of typhimuricin--a substance produced by Salmonella typhimurium LT2 and relation of its synthesis to the cryptic plasmid}; Khmel' IA et al.; The effect of typhimuricin on Escherichia coli K12 cells and the properties of this substance produced by Salmonella typhimurium LT2 have been studied . The obtained data permit one to conclude that typhimuricin is similar to the aminoacid L-valine or the chemical very similar to it in properties . The synthesis of typhimuricin is not controlled by the cryptic plasmid present in Salmonella typhimurium LT2 cells . The experiments aimed at isolation of enterobacterial strains producing low molecular mass antibiotics--microcines have been done . It was found that the capability to produce macrocines is not widespread among the isolates of enterobacteria.

J Appl Bacteriol, 1987 Feb, 62(2), 97 - 104
Fate of salmonellas and competing flora in meat sample enrichments in buffered peptone water and in Muller-Kauffmann's tetrathionate medium; Beckers HJ et al.; Studies have been carried out in which growth patterns of a Salmonella sp . and competing micro-organisms, especially other Enterobacteriaceae, were followed during pre-enrichment in buffered peptone water (BPw) and subsequent selective enrichment in tetrathionate broth (TBB) . Pre-enrichment cultures were inoculated with minced meat and three reference samples containing nalidixic acid-resistant salmonellas . Irrespective of their initial numbers in BPw, Enterobacteriaceae increased to 10(8)/ml or more . During incubation in TBB at 43 degrees C, numbers of lactose-positive Enterobacteriaceae decreased in most enrichments which resulted in a positive salmonella isolation, but remained constant in the majority of those that did not . Levels of lactose-negative Enterobacteriaceae did not decrease in most salmonella-positive tests, but did so in half of the salmonella-negative ones . In the salmonella-positive tests the numbers of salmonellas had increased to 10(3)-10(7)/ml in BPw and after transfer to TBB slowly reached 10(4)/ml or more . In all cases the numbers of salmonellas exceeded those of the competing flora on brilliant green agar (BGA) . In the salmonella-negative tests the numbers of salmonellas had increased less in BPw and decreased in most of the TBB enrichments . In none of these negative tests did the numbers of salmonellas exceed those of the competing flora on BGA . Escherichia coli dominated in most of the salmonella-negative tests . The results suggest more influence of lactose-positive than lactose-negative Enterobacteriaceae on the detection of salmonellas . The effect of competing microorganisms seems to depend not only upon their initial numbers, but also upon the types that can interact with salmonellas during selective enrichment.

Antimicrob Agents Chemother, 1987 Feb, 31(2), 274 - 80
Antibacterial activity and mechanism of action of 3'-azido-3'-deoxythymidine (BW A509U); Elwell LP et al.; The thymidine analog 3'-azido-3'-deoxythymidine (BW A509U; azidothymidine {AZT}) had potent bactericidal activity against many members of the family Enterobacteriaceae, including strains of Escherichia coli, Salmonella typhimurium, Klebsiella pneumoniae, Shigella flexneri, and Enterobacter aerogenes . AZT also had bactericidal activity against Vibrio cholerae and the fish pathogen Vibrio anguillarum . AZT had no activity against Pseudomonas aeruginosa, gram-positive bacteria, anaerobic bacteria, Mycobacterium tuberculosis, nontuberculosis mycobacteria, or most fungal pathogens . Several lines of evidence indicated that AZT must be activated to the nucleotide level to inhibit cellular metabolism: AZT was a substrate for E . coli thymidine kinase; spontaneously arising AZT-resistant mutants of E . coli ML-30 and S . typhimurium were deficient in thymidine kinase; and intact E . coli ML-30 cells converted {3H}AZT to its mono-, di-, and triphosphate metabolites . Of the phosphorylated metabolites, AZT-5'-triphosphate was the most potent inhibitor of replicative DNA synthesis in toluene-permeabilized E . coli pol A mutant cells . AZT-treated E . coli cultures grown in minimal medium contained highly elongated cells consistent with the inhibition of DNA synthesis . AZT-triphosphate was a specific DNA chain terminator in the in vitro DNA polymerization reaction catalyzed by the Klenow fragment of E . coli DNA polymerase I . Thus, DNA chain termination may explain the lethal properties of this compound against susceptible microorganisms.

Am J Obstet Gynecol, 1987 Feb, 156(2), 495 - 503
A review of the role of beta-lactamase-producing bacteria in obstetric-gynecologic infections; Eschenbach DA; beta-Lactam antibiotics are the most commonly used antibiotics in obstetrics and gynecology . However, they are susceptible to inactivation when attacked by beta-lactamase, an enzyme produced by many bacterial species . During the past three decades, numerous penicillins and cephalosporins have been made with a stable beta-lactam ring that resists enzyme attack . More recently enzyme inhibitors have been discovered that inactivate beta-lactamase . The combination of an enzyme inhibitor with a beta-lactam antibiotic, such as ampicillin, restores the antimicrobial activity of the beta-lactam against formerly resistant strains of staphylococci, Haemophilus influenzae, Enterobacteriaceae, and Bacteroides fragilis.

Am J Obstet Gynecol, 1987 Feb, 156(2), 491 - 5
Microbiology of the female genital tract; Gibbs RS; Patients who contract genital tract infections are predominantly young, are otherwise healthy, and generally respond well to treatment for bacterial infections . These infections are most commonly polymicrobial in etiology, with several noteworthy exceptions . Often there is an inciting event such as childbirth, surgical intervention, pregnancy termination or intrauterine contraceptive device insertion . With treatment, prognosis for cure is excellent; however, sequelae such as recurrent infections, infertility, or ectopic pregnancy can be serious . Bacteria encountered in the female genital tract can be divided into aerobic and anaerobic organisms . Among the aerobic gram-positive organisms, several varieties of streptococci such as Group B streptococci and enterococci occur frequently . Staphylococcus aureus is an infrequent but important pathogen . Among the aerobic gram-negative organisms, the most common is Escherichia coli . Klebsiella sp . and Proteus sp . occur in about 5% of genital tract infections . Species that are more resistant to antibiotics, such as Pseudomonas aeruginosa and Enterobacter sp., occur in approximately 1% or 2% of these cases and are more likely to appear in patients who have previously received antibiotic therapy or who have been hospitalized for some time . Among the anaerobic organisms, the most common gram-positive isolates are Peptostreptococci and Peptococci . Clostridia sp . occurs less frequently . Among the anaerobic gram-negative organisms, the Bacteroides sp . most frequently encountered are Bacteroides bivius and Bacteroides disiens . Bacteroides fragilis is still a common problem but appears to be less predominant . Other organisms encountered are Chlamydia trachomatis, the genital mycoplasmas, yeasts, protozoa, and viruses.

J Clin Microbiol, 1987 Feb, 25(2), 312 - 5
Effect of agitation and frequent subculturing on recovery of aerobic and facultative pathogens by Roche Septi-Chek and BACTEC blood culture systems; Kim MJ et al.; The positivity rate and time to recovery of pathogens were compared in Roche Septi-Chek (RSC-TSB) and BACTEC radiometric systems on 3,539 paired blood cultures . Both systems were steadily agitated, with frequent subculturing or processing of the RSC-TSB agar slides and BACTEC bottles, respectively, during the first 24 h of incubation . The RSC-TSB system recovered 249 pathogens (7.0% positivity rate), compared with 234 (6.6% positivity rate) isolates recovered from BACTEC . For the most common isolates, Staphylococcus aureus and the Enterobacteriaceae, the median time to detection was 15.8 h for BACTEC and 18.6 h for the RSC-TSB system . No statistically significant difference was observed in recovery of organisms from the two systems, except for S . aureus (P less than 0.05) . In the RSC-TSB system, 42% of S . aureus, 58% of the Enterobacteriaceae, and 45% of Pseudomonas aeruginosa isolates had sufficient growth on the agar slant to allow performance of rapid standardized identification and susceptibility studies . In comparison with other studies using static incubation, it appears that agitation and frequent subculturing of the RSC-TSB system during the first 24 h of incubation decreased the time to detection for the majority of significant blood culture isolates.

Infect Immun, 1987 Feb, 55(2), 472 - 6
Aromatic alpha-glycosides of mannose are powerful inhibitors of the adherence of type 1 fimbriated Escherichia coli to yeast and intestinal epithelial cells; Firon N et al.; Adherence of bacteria via their surface lectins to host epithelial cells is considered an important initial event in bacterial pathogenesis . Mannose-specific (type 1) fimbriae are among the most commonly found lectins in enterobacteria . We studied the effect of aromatic alpha-glycosides of mannose on the agglutination of mannan-containing yeasts by different strains of Escherichia coli and on the adherence of the bacteria to guinea pig ileal epithelial cells . In both systems these compounds were considerably more effective inhibitors than methyl alpha-mannoside, with 4-methylumbelliferyl alpha-mannoside and p-nitro-o-chlorophenyl alpha-mannoside being the strongest inhibitors . Both compounds were approximately 400-times stronger inhibitors of yeast agglutination by E . coli O128 than was methyl alpha-mannoside and 1,000- and 470-fold stronger, respectively, than was methyl alpha-mannoside in inhibiting the adherence of the bacteria to ileal epithelial cells . 4-Methylumbelliferyl alpha-mannoside was 540 to 1,000 times more effective in inhibiting yeast agglutination by four additional strains of mannose-specific E . coli . It was also more efficient than methyl alpha-mannoside in removing adherent E . coli O128 from ileal epithelial cells . Our results provide further evidence that type 1 fimbriae of E . coli possess a hydrophobic region next to the mannose-binding site . The results suggest that 4-methylumbelliferyl alpha-mannoside and p-nitro-o-chlorophenyl alpha-mannoside are good candidates for the design of therapeutic agents that may prevent adherence in vivo and infection by E . coli strains that express type 1 fimbriae.

Zh Mikrobiol Epidemiol Immunobiol, 1987 Feb, (2), 63 - 7
{Pseudomonas aeruginosa and Proteus antigenemia and antibody formation in mono- and mixed infections in patients with suppurative inflammatory diseases}; Bulava GV et al.; P . aeruginosa and Proteus antigenemia and antibody production have been studied in 335 patients with purulent inflammatory diseases . The study has revealed that in the association of P . aeruginosa and Proteus with staphylococci and representatives of the family Enterobacteriaceae the level of antigenemia is considerably lower than in monoinfections or in the association of these microorganisms with streptococci . In mixed infections humoral immune response develops later than in cases of monoinfection . An important role of ecological and physiological relationships between microorganisms in the course of purulent processes and in their influence on the host has been confirmed . The use of the enzyme immunoassay in the clinical practice has made it possible to determine the etiological role of P . aeruginosa and Proteus in the development of suppurative-inflammatory diseases, to select adequate immunotherapy, including the use of anti-P . aeruginosa and anti-Proteus plasmas, and to evaluate the effectiveness of treatment.

Acta Pathol Microbiol Immunol Scand {B}, 1987 Feb, 95(1), 29 - 32
In vitro activity of amifloxacin (WIN 49,375) compared with those of ciprofloxacin and ofloxacin; Digranes A; The in vitro activity of the novel fluoroquinolone derivative, amifloxacin (WIN 49,375), was compared with the activities of ciprofloxacin and ofloxacin . A total of 500 clinical isolates of Gram-negative and Gram-positive bacteria were included, and the minimal inhibitory concentration (MIC) was determined by an agar dilution method . All drugs were highly active against Enterobacteriaceae, but ciprofloxacin showed the highest activity on a weight-for-weight basis (MIC 90% less than or equal to 0.03 mg/l) . Ciprofloxacin was the most active agent against Pseudomonas isolates; all isolates being inhibited by 0.25 mg/l or less . The staphylococcal isolates were inhibited by ciprofloxacin and ofloxacin at relatively low concentrations (MIC 100% = 1 mg/l), whereas amifloxacin showed moderate activity against the majority of these isolates . Ciprofloxacin was highly active against enterococci, ofloxacin was moderately active, and amifloxacin was inactive . All Neisseria gonorrhoeae isolates were susceptible to the lowest concentrations of the agents that were employed in the study (0.03 mg/l).

J Exp Med, 1987 Feb 1, 165(2), 471 - 82
The DNA sequence of the structural gene of gonococcal protein III and the flanking region containing a repetitive sequence . Homology of protein III with enterobacterial OmpA proteins; Gotschlich EC et al.; The insert of a lambda gt11 clone expressing gonococcal protein III was sequenced . The deduced amino acid sequence showed a coding frame of 236 amino acids with a typical 22-amino-acid signal peptide, followed by the known NH2-terminal sequence of PIII . The mature protein has a molecular weight of 23,298 . It was found that PIII had extensive and very striking homology to the carboxy-terminal portion of enterobacterial OmpA proteins . The homology encompasses the OmpA domain that is believed to be located in the periplasmic space . If the disposition of PIII across the OM is analogous, then the surface-exposed domain consists of less than 40 amino acids . These include a potential 15-amino-acid disulfide loop, a feature not found in OmpA proteins . Hybridization studies with the sequenced insert indicated that it contained a repetitive sequence that occurred at least 20 times in the genome . By additional hybridization studies the area containing the repetitive sequence was narrowed to a region of 43 bp . This region contained an exact copy of the consensus sequence of a 26-bp repetitive sequence recently described . An analogous sequence recurs in an inverted orientation 53 bp downstream.

Antimicrob Agents Chemother, 1987 Feb, 31(2), 295 - 9
Molecular genetic analysis of cephalosporinase production and its role in beta-lactam resistance in clinical isolates of Enterobacter cloacae; Nicolas MH et al.; Two strains of Enterobacter cloacae were isolated from a patient before (strain MHN1) and during (strain MHN2) treatment with moxalactam and gentamicin . Strain MHN1 exhibited inducible ampC cephalosporinase production . In contrast, strain MHN2 expressed the enzyme constitutively at a 3,000-fold higher level . With the Escherichia coli ampC gene as a hybridization probe it was shown that the genomic arrangement of the ampC region was the same in both strains . To gain more insight into regulatory phenomena, the ampC genes were cloned, and their expression was studied in E . coli K-12 . The ampC gene from MHN1 behaved normally and conferred inducible beta-lactam resistance . A regulatory region of at least 800 base pairs involved in controlling repression-induction was located immediately upstream of ampC . Surprisingly, when present in E . coli the ampC gene from MHN2 no longer overproduced the cephalosporinase, and inducible expression was observed . This indicates that in MHN2 stable cephalosporinase overproduction is controlled by another factor which is not linked to the ampC gene.

Microbiologia, 1987 Feb, 3(1), 51 - 4
{APH(3')-II phosphotransferase determination using protein transfer (western blotting)}; Rivera MJ et al.; The APH(3')-II aminoglycoside-phosphotransferase has been studied by protein blotting . This technique allowed the detection of the enzyme in the crude extracts from clinical isolates of Enterobacteriaceae, and the molecular weight determination of the APH(3')-II . The obtained molecular weight of 25,000 is coincident with the previously reported value determined by a different method . These results demonstrate that this technique is useful for the study of aminoglycoside-modifying enzymes.

Minerva Med, 1987 Jan 31, 78(2), 71 - 7
{Comparative study of the in vitro activity of 5 new antibiotics on strains isolated from urinary infections}; Salvo S et al.; In vitro activity of Cefotaxime, Ceftriaxone, Ceftazidime, Piperacillin and Netilmicin against 189 urinary isolates of Enterobacteriaceae, Pseudomonas and Enterococcus has been evaluated . To assess the minimal inhibitory concentrations (MIC), the broth dilution method and the Sensititre system were employed . No considerable differences were found between the two methods . Cefotaxime showed the highest activity against Enterobacteriaceae, the great majority of the isolates being susceptible to 1 microgram/ml or less . Piperacillin showed good activity against Enterococci . Ceftazidime resulted the most active against Pseudomonas.

Eur J Biochem, 1987 Jan 2, 162(1), 75 - 81
Chemical characterization of enterobacterial common antigen isolated from Plesiomonas shigelloides ATCC 14029; Basu S et al.; Serologically characterized samples of enterobacterial common antigen (ECA) from Plesiomonas shigelloides, Salmonella montevideo and Shigella sonnei were investigated by chemical methods including methylation and NMR techniques . All showed the same sugar composition and contained a lipid moiety with palmitic acid as main fatty acid and with a phosphodiester group . Additional enzymatic studies, reported in the preceding paper, provided evidence that the lipid moiety is an L-glycerophosphatidyl residue attached via a phosphodiester linkage to C-1 of GlcNAc as the reducing end of the ECA sugar chain . ECA of P . shigelloides showed the best-resolved 13C-NMR spectra, especially after the removal of non-stoichiometric O-acetyl groups at C-6 of GlcNAc of the ECA repeating unit and of the lipid moiety by mild acid hydrolysis (0.01 M HCl, 100 degrees C, 10 min) . Subsequent 13C-NMR studies were therefore carried out with the mild-acid-treated ECA of P . shigelloides which allowed a tentative assignment of all resonances of the ECA repeating unit . 13C-NMR spectra of Salmonella and Shigella ECA were essentially the same as those obtained with Plesiomonas ECA . The same trisaccharide repeating unit was encountered as demonstrated previously in the cyclic form of ECA isolated from S . sonnei by Dell et al . {Carbohydr . Res . 133, 95-104 (1984)} . Methylation analysis, however, afforded small amounts of terminal GlcNAc thus proving, in combination with the demonstration of the attached lipid moiety, an acyclic nature of ECA from P . shigelloides and from the two enterobacterial species . The question of whether the cyclic form co-exists in S . sonnei phase I and possibly in other enterobacterial species or, whether it had been formed during extraction as an artifact, has not yet been answered . The way in which ECA was isolated in our studies would preclude the presence of a non-amphiphilic (cyclic) polysaccharide . The finding that the sugar chain of ECA is attached to an L-glycerophosphatidyl residue is in full corroboration with serological, enzymatic and gel electrophoretic studies shown in the preceding paper and with the character of ECA as a surface antigen being anchored by hydrophobic interactions in the outer membrane of Enterobacteriaceae and P . shigelloides.

Eur J Biochem, 1987 Jan 2, 162(1), 69 - 74
Comparison of enterobacterial common antigen from different species by serological techniques; Kuhn HM et al.; Enterobacterial common antigen (ECA) was isolated from a number of selected species (including Salmonella montevideo, Shigella sonnei and Plesiomonas shigelloides) using the extraction method described by Mannel and Mayer {Eur . J . Biochem . 86, 361-370 (1978)} . ECA of all these species behaved identically in enzyme-linked immunosorption assay (ELISA) and in its inhibition using monoclonal anti-ECA antibodies . Immunoblotting showed a ladder-like pattern of at least 20 bands for all preparations tested . ECA modified at its lipid moiety (e.g . by phospholipases A2 and D or by mild acid hydrolysis) lost its coating capacity leaving, however, the serological reactivity as detected by inhibition assays intact . In contrast, reduction of the carboxylic groups of 2-acetamido-2-deoxy-D-mannopyranosyluronic acid destroyed the serological reactivity . Deacylated ECA was also not detectable in immunoblotting . Chemical reacylation restored the reactivity of deacylated ECA in ELISA and in immunoblot and thus proved the essential function of fatty acids for the physicochemical properties of the molecule . 2-Acetamido-2-deoxy-D-glucopyranose was identified as the reducing end of the ECA sugar chain after splitting off the lipid moiety by phospholipase D.

Diagn Microbiol Infect Dis, 1987 Jan, 6(1), 81 - 3
Bactericidal activities of ten different fluoroquinolones against selected Enterobacteriaceae; Barry AL et al.; Ten fluoroquinolone compounds and two other 4-quinolones were tested in a microdilution system . Minimal inhibitory concentrations and minimal bactericidal concentrations were determined with 1 X 10(7) and 5 X 10(5) colony forming units per milliliter . All 12 compounds were bactericidal . Continued inhibition by drug carried over in the subcultured samples was documented and that represents a potential source of technical error that needs to be controlled when determining minimal bactericidal concentrations for these extremely potent drugs.

Diagn Microbiol Infect Dis, 1987 Jan, 6(1), 77 - 9
Resistance to ten different fluoroquinolone antibiotics following in vitro exposures to nalidixic acid; Barry AL et al.; Ten different fluoroquinolone antibiotics were tested against selected Enterobacteriaceae . Against nalidixic acid-resistant clinical isolates, minimal inhibitory concentrations for all 10 drugs were eightfold to 32-fold greater than those against comparable nalidixic acid-susceptible strains . When the latter strains were serially exposed to increasing concentrations of nalidixic acid, susceptibility to all 10 fluoroquinolones decreased as resistance to nalidixic acid and cinoxacin was acquired in vitro.

J Clin Microbiol, 1987 Jan, 25(1), 138 - 41
Passive hemagglutination test for enteric fever; Petchclai B et al.; A passive hemagglutination (PHA) test for serodiagnosis of enteric fever was developed by sensitizing glutaraldehyde-preserved erythrocytes with lipopolysaccharide from Salmonella serogroups A, B, C, and D singly or simultaneously . The lipopolysaccharide-sensitized erythrocytes were tested with sera from 200 blood donors, 100 patients whose hemoculture was positive for Salmonella species, and 10 patients septicemic for other members of the family Enterobacteriaceae . The PHA test was positive in 90% of 28 acute-phase serum samples from patients with enteric fever from one hospital and in 93% of 72 acute-phase serum samples from another hospital . It was also positive in 100 and 60% of early- and late-convalescent-phase sera, respectively . The PHA test was negative in all patients septicemic for other members of the Enterobacteriaceae . Absorption of sera from patients with enteric fever with lipopolysaccharide from other members of the Enterobacteriaceae did not reduce PHA titers, indicating the specificity of the PHA test . Simultaneous sensitization with lipopolysaccharide from Salmonella serogroups A, B, C, and D was useful as a screening test in a limited trial with 28 acute-phase sera, 10 early-convalescent-phase sera, and 17 late-convalescent-phase sera . The PHA test is indeed a simple, sensitive, specific, and rapid test supplementing hemoculture in laboratory diagnosis of enteric fever.

Microbiol Immunol, 1987, 31(8), 717 - 25
Chemical properties of lipopolysaccharide-like substance (LLS) extracted from Leptospira interrogans serovar canicola strain Moulton; Shimizu T et al.; The aqueous layer was isolated from Leptospira interrogans serovar canicola strain Moulton by the hot phenol-water method . After ultracentrifugation, the precipitate was designated as lipopolysaccharide-like substance (LLS) fraction and the chemical composition was compared with that of bacterial LPS . The LLS fraction consists of 35.2% carbohydrate, 3.8% amino sugar, 36.4% lipid, 15.2% protein, and 0.3% phosphorus . Neutral sugars were detected as rhamnose, arabinose, xylose, 4-O-methylmannose, mannose, galactose, and a small amount of erythrose, fucose and glucose by gas-liquid chromatography (GLC), but 2-keto-3-deoxyoctonic acid was not detected in the LLS by thiobarbituric acid test and high voltage paper electrophoresis . Fatty acids detected by GLC were decanoic acid (C10: 0), dodecanoic acid (C12: 0), dodecenoic acid (C12: 1), tridecenoic acid (C13: 1), tetradecanoic acid (C14: 0), hexadecanoic acid (C16: 0), hexadecenoic acid (C16: 1), and octadecenoic acid (C18: 1) . With SDS-polyacrylamide gel electrophoresis, bacterial LPS showed many orderly bands, while the banding pattern of the leptospiral LLS was very simple . These findings demonstrate that the physicochemical properties and chemical composition of LLS fraction from Leptospira are different from those of LPS extracted from gram-negative bacteria such as Enterobacteriaceae, and suggesting that Leptospira has no typical LPS.

Pediatrie, 1987, 42(4), 309 - 14
{Urinary tract infections in children . Status in a pediatric hospital and sensitivity of bacterial strains to amoxycillin-clavulanic acid combination}; Cochat N et al.; Three hundred bacterial strains from positive urine cultures were isolated over a 10 months period in paediatric hospitalized and out-patients . In addition to commonly used antibiotics, each strain was tested for amoxycillin-clavulanic acid (Augmentin, Beecham) susceptibility . This antibiotic, which is a potent inhibitor of bacterial beta lactamases, may be of interest in the treatment of urinary tract infections because of its pharmacokinetics and activity . The antibacterial activity of amoxycillin and Augmentin against Enterobacteriaceae with special reference to Escherichia coli was compared . The resistance phenotype of Enterobacteriaceae to amoxycillin, carbenicillin and cephalothin allows to anticipate the nature of the beta-lactamase produced by a particular strain, and infer the activity of Augmentin . The overall activity of Augmentin should be interpreted taking into account the resistance phenotypes . In our study, Augmentin was active against 90% of E . coli strains, almost all Proteus mirabilis and vulgaris strains but 9 out of 24 Klebsiella strains were resistant . Augmentin had no activity against nosocomial Enterobacteriaceae, nor against Pseudomonas aeruginosa . On the other hand, its activity was of interest against penicillinase producing Staphylococcus . Our results confirm the interest of Augmentin as a preferential treatment of urinary tract infections in children.

Med Microbiol Immunol (Berl), 1987, 176(5), 257 - 71
A direct enzyme-linked immunosorbent assay (ELISA) for antibodies to enterobacterial Re core glycolipid and lipid A . Results in healthy subjects and in patients infected by gram-negative bacteria; Nys M et al.; We have developed an ELISA for IgM and IgG antibodies to the core glycolipid (CGL) of the Re mutant Salmonella minnesota R 595, and to lipid A . Anti-CGL antibodies have been detected in sera from 37% of healthy blood donors, whereas anti-lipid A activities were found in 13% of individuals only . The anti-CGL and anti-lipid A activities were examined in patients in a surgical intensive care unit, selected on the basis of a definite risk of infectious complications due to Gram-negative bacteria . Of the patients who developed such infections, the rate of favourable outcome was significantly higher in patients with either stable positive or increasing anti-CGL activities than in patients found to be negative . Our results provide clear evidence that anti-CGL antibodies contribute to host defence against various Gram-negative bacteria.

Microbios, 1987, 51(207), 89 - 96
Intracellular bioaccumulation of zinc by an Enterobacter species; Kasan HC et al.; Bacterial strains tolerant to the presence of 100 mg/l zinc ions were isolated from a water reclamation system . Each of the organisms were screened for their ability to accumulate zinc at the above mentioned concentration . The organism capable of maximum zinc accumulation was identified as an Enterobacter species and intracellular zinc deposition by this micro-organism was determined using energy dispersive X-ray analysis, transmission electron microscopy and a metal-staining technique at the light microscopy level . Further studies revealed that growth and glucose utilization by this isolate were inhibited in the presence of zinc, compared to a control culture grown in the absence of zinc.

Intensive Care Med, 1987, 13(5), 352 - 4
Co-infection or early superinfection of pneumococcal pneumonia; Riou B et al.; Two cases of co-infection or very early superinfection of pneumococcal pneumonia with Staphylococcus aureus in one case, and Enterobacter cloacae in the other, are reported . The two patients were not fully immunocompetent, had leukopenia and a mild intravascular coagulation, and were bacteremic . Mixed infection probably accounted for the lethal outcome because initial antibiotherapy was only directed against Streptococcus pneumoniae . Accurate bacteriologic methods are required to delineate contaminating and infecting pathogens when another bacteria is found in initial bronchial samples of patients with pneumococcal pneumonia, and the antibiotherapy might be directed against the two pathogens until quantitative bacteriologic results would be available, especially in old and debilitated patients . The incidence of mixed infection in pneumococcal pneumonia seems low.

Infection, 1987 Jan-Feb, 15(1), 32 - 4
The elimination of gentamicin-resistant gram-negative bacteria in a newborn intensive care unit; Raz R et al.; The aminoglycosides play a central role in the treatment of infectious diseases caused by gram-negative bacteria . During the period of January to June 1984, 45 clinical specimens collected in our neonatal intensive care unit grew Enterobacter cloacae; 41 of them were gentamicin resistant . One neonate developed septicemia . The routine antibiotic protocol was then changed from gentamicin-ampicillin to amikacin-ampicillin for a period of six months . During this period the resistance to gentamicin declined to a minimum . Only eight of 122 specimens proved to harbor gram-negative organisms resistant to gentamicin . The gentamicin-resistant E . cloacae vanished . No isolate was resistant to amikacin . The gentamicin-ampicillin regimen was then reintroduced.

Rev Med Interne, 1987 Jan-Feb, 8(1), 109 - 14
{Comparison of fosfomycin-penicillin M and penicillin M-gentamycin . Apropos of 35 severe infections caused by methicillin-sensitive Staphylococcus aureus}; Baron D et al.; Two combined antibiotic treatments were compared in 35 cases of methicillin-sensitive Staph . aureus infection . Eighteen patients (including 17 with septicaemia) received penicillin M (methicillin or oxacillin) and gentamicin daily for a mean period of 11 days . Clinical and bacteriological cure was obtained in 14 cases; 2 of these 14 patients developed superinfection with gentamicin-resistant enterobacteria, 1 relapsed and 2 had renal impairment . Seventeen patients (including 15 with septicaemia) were given fosfomycin and penicillin M for a mean period of 17 days . Clinical and bacteriological cure was obtained in 16 patients; the patient with clinical and bacteriological failure died . There was no superinfection or relapse; 3 patients had hypokalaemia and 1 had renal damage caused by methicillin . The clinical and bacteriological results, therefore, were in favour of the fosfomycin-methicillin combination, but the only statistically significant difference between the two groups concerned the complications.

Drugs Exp Clin Res, 1987, 13(3), 171 - 3
Temocillin in the treatment of pyelonephritis in children; Verboven M et al.; Temocillin is a beta-lactamase-stable penicillin with a selective . Gram-negative spectrum of activity and a long half-life . Previous studies in adult patients have demonstrated its efficacy and safety in the treatment of Gram-negative infections . The aim of the study was to evaluate the clinical and bacteriological efficacy and safety of temocillin in children with complicated urinary tract infections . Twenty-two children, aged 3 months to 13 years (mean 5.8 years) were treated with temocillin i.v . at a dose of 25 mg/kg 12 hourly for a mean period of 5.9 days (range 3-12 days) . Acute pyelonephritis was diagnosed in 21 patients (one case associated with septicaemia); one patient presented recurrent bacteriuria due to a multiresistant pathogen . Some 20/22 children presented an underlying condition complicating the urinary tract infection (UTl) . The causative pathogens, isolated from the urine, were: E . coli (17), Proteus mirabilis (3), Enterobacter cloacae (1), enterococcus (1) . The enterococcus and one Proteus mirabilis were found to be resistant to temocillin . Clinical improvement was obtained after 24-36 h in all children with temocillin-sensitive organisms . Bacteriological cure was obtained in all patients with temocillin-sensitive organisms . The two patients with temocillin-resistant pathogens were treated with another antibiotic . Follow-up treatment was given per os during +/- 2 weeks . No adverse reactions or abnormal laboratory values were noted . In the authors' limited experience temocillin proved to be effective and safe in the treatment of pyelonephritis often due to ampicillin-resistant strains in children.

Drugs Exp Clin Res, 1987, 13(3), 149 - 53
Comparative in vitro evaluation of BMY-28142, a new broad-spectrum cephalosporin, versus other beta-lactams against multiresistant gram-negative isolates; Giamarellou H et al.; The in vitro activity of the new parenteral cephalosporin BMY-28142 was compared with that of cephalothin, cefoxitin, cefotaxime, ceftriaxone, moxalactam, aztreonam and ceftazidime, against a total of 374 recent multiresistant Gram-negative microorganisms of nosocomial origin . Against all species of Enterobacteriaceae resistant to the first- and second-generation cephalosporins, BMY-28142 had superior inhibitory activity than the newer beta-lactams tested, with intrinsic activity against E . coli and Pr . mirabilis slightly less than that of cefotaxime and ceftriaxone . BMY-28142 differed from the other beta-lactams mainly in being at least 16-fold more active against E . cloacae, while BMY-28142 and ceftazidime showed comparable activity against Ps . aeruginosa strains . Against strains of Ps . aeruginosa resistant to both BMY-28142 and amikacin, the combination of the two antibiotics proved to be synergistic in vitro.

Scand J Infect Dis, 1987, 19(3), 331 - 7
A prospective randomised comparison of cefotaxime vs . netilmicin vs . cefotaxime plus netilmicin in the treatment of hospitalised patients with serious sepsis; Sage R et al.; 93 patients were enrolled into a prospective randomised study to determine the efficacy and safety of netilmicin, cefotaxime or their combination in the treatment of sepsis caused by susceptible strains of Enterobacteriaceae or staphylococci . 83 patients were evaluable for safety, 74 for clinical efficacy and 63 for microbiological response including 36 patients (57%) with positive blood cultures . There were significantly more clinical failures with cefotaxime than with netilmicin even when urinary tract sepsis was excluded . Microbiological failures occurred more frequently in the cefotaxime arm and were associated with Klebsiella and Enterobacter spp . Four cefotaxime failures were subsequently successfully treated with netilmicin . More mixed infections were however enrolled by chance into the cefotaxime arm . The statistical difference between netilmicin and cefotaxime is not significant if mixed infections are excluded . There was no difference in efficacy between the netilmicin and combination groups although superinfection was seen in the latter group . The incidence of nephrotoxicity was greater in the netilmicin group but not significantly so . Only one minor case of ototoxicity was detected in the 41 patients receiving netilmicin who had serial audiograms . The results suggest that netilmicin is a more effective agent than cefotaxime for treating life-threatening infections with susceptible Enterobacteriaceae or staphylococci particularly with infections in non-urinary tract sites . If dosage of netilmicin is closely monitored by measuring serum concentrations, toxicity is minimal.

Infection, 1987, 15 Suppl 2, S85 - 8
{Lipoid A antibody titer in humans}; Marget W; Lipid A is the toxic component of endotoxin in gram-negative bacteria . Antibodies to lipid A are not usually found in healthy persons (or only at a low titer) without a corresponding history of infection . Even gram-negative septicemia is found to be accompanied by only low titers . A completely different situation is seen in patients with chronic or recurrent infections due to Enterobacteriaceae and other gram-negative bacteria . Here it is notable that the antibody titer varies with the type of disorder (e . g . cystitis and pyelonephritis) . A severe would infection, e . g . due to Pseudomonas aeruginosa, also leads to measurable lipid A antibody titers . Varying antibody titers can be observed in cystic fibrosis, Crohn's disease, and severe surgical infections . One can conclude that a significantly elevated antibody titer develops during an extensive tissue involvement of long duration and indeed is caused by tissue inhibition by endotoxin . Based on clinical experience, it can be assumed that lipid A antibodies present in the body have a protective effect in septic shock.

Ann Inst Pasteur Microbiol, 1987 Jan-Feb, 138(1), 3 - 13
Diversity of the phosphoenolpyruvate/glucose phosphotransferase system in the Enterobacteriaceae; Bouvet OM et al.; The presence of the phosphoenolpyruvate glucose phosphotransferase entry routes was studied in 97 genospecies of Enterobacteriaceae . Phosphoenolpyruvate(PEP)-dependent phosphorylation of alpha-methyl-D-glucoside and 2-deoxyglucose was evidenced in 72 species (group I organisms), suggesting the presence of both the IIGlc (formerly II-BGlc/IIIGlc) and IIMan (formerly II-B/II-AMan) entry routes . Erwinia amylovora, Budvicia aquatica and all species of Leminorella and Proteus (as defined by DNA relatedness studies) showed little or no PEP phosphorylation of 2-deoxyglucose, suggesting the absence of the IIMan entry route (group II organisms) . Morganella morganii, Tatumella ptyseos and all species of Xenorhabdus and Providencia (as defined by DNA relatedness studies) showed little or no PEP phosphorylation of alpha-methyl-D-glucoside, suggesting the absence of the IIGlc entry route (group III organisms).

Int J Clin Pharmacol Res, 1987, 7(1), 73 - 6
Cefotaxime therapy of lower respiratory tract infections in intensive-care patients; Rondanelli R et al.; Cefotaxime is one of two third-generation cephalosporins (the other being ceftriaxone) that undergo significant metabolism and is the only third-generation cephalosporin for which an active metabolite has been identified . Cefotaxime was administered intravenously in doses of 6 g per day to 20 patients with serious infections of the lower respiratory tract due to organisms susceptible to cefotaxime (isolates of Enterobacteriaceae and of Pseudomonas aeruginosa) . It was administered with gentamicin in some high-risk patients . Cefotaxime resulted in mean peak concentrations of 32 mu/ml (cv% = 53) and of 29.5 micrograms/ml (cv% = 65) respectively after the first and after the last dose of a regimen of 2 g every 8 hours . The half-life value averaged 1.8 h and 6.4 h for cefotaxime and its desacetyl metabolite respectively . The average value of the metabolite at the end of short infusion was 11.5 micrograms/ml (cv% = 31) after the initial dose and 15.5 micrograms/ml (cv% = 37) after the last administered dose . Overall results were 75% patients cured or improved; 83% of the patients with nosocomial pulmonary infections due to Enterobacteriaceae were cured; 50% of the patients with Pseudomonas aeruginosa infections were cured and 25% improved despite the pathogen not being eradicated . No serious toxicity was observed.

Clin Ther, 1987, 9(2), 193 - 200
Worldwide study of cefoperazone susceptibility; Gibbs DL; In vitro susceptibility to cefoperazone of more than one million clinical aerobic bacterial isolates was evaluated in 369 hospitals in Japan, the United States, Canada, France, Austria, and Hungary . Standard versions of the disk diffusion method were used according to interpretive criteria approved in the respective countries, and comparisons were made among the countries and among various body sites . Susceptibility of organisms varied little within most species among the countries . Minor differences in methodology and in interpretive criteria may explain some of the variations observed among countries and hospitals . The susceptibility of key pathogens to cefoperazone among countries ranged from 91% to 98% for Escherichia coli, 73% to 91% for Pseudomonas aeruginosa, 90% to 95% for Klebsiella pneumoniae, 73% to 92% for Enterobacter cloacae, 74% to 92% for Staphylococcus aureus, and 91% to 97% for Proteus mirabilis . Susceptibility of isolates from the urinary tract did not vary markedly from that in other body sites.

Biochem Int, 1987 Jan, 14(1), 153 - 60
Biosynthesis of thiamin . Different biosynthetic routes of the thiazole moiety of thiamin in aerobic organisms and anaerobic organisms; Tazuya K et al.; The nitrogen atom of glycine was incorporated into the thiazole moiety of thiamin in the aerobic microorganisms Bacillus subtilis, Pseudomonas putida, Saccharomyces cerevisiae, Mucor racemosus, Neurospora crassa, and Emericella nidulans . It was not incorporated in the case of the facultative anaerobic microorganisms Escherichia coli and Enterobacter aerogenes, which, however, did incorporate the nitrogen atom of tyrosine . These results show that aerobic microorganisms and facultative anaerobic microorganisms have different biosynthetic pathways for the thiazole moiety of thiamin.

Antimicrob Agents Chemother, 1987 Jan, 31(1), 60 - 6
Novel type of plasmid-borne resistance to trimethoprim; Sundstrom L et al.; A novel trait for transferable resistance to high concentrations of trimethoprim was found to dominate among enterobacteria collected from different parts of Sri Lanka . Drug resistance was a result of the production of dihydrofolate reductase with a decreased sensitivity to antifolates . By characterization of the partially purified enzyme and by restriction enzyme digestion analysis, the newly found gene was shown to be distinct from the earlier known plasmid-borne resistance genes which express dihydrofolate reductases of types I, II, and III . Cloning of fragments containing the resistance gene and further restriction enzyme digestion analysis showed that this gene was inserted very close to a sulfonamide resistance gene . Evolution of trimethoprim resistance in Sri Lanka thus seems to have taken a different route from that taken in the industrialized world, where transposon Tn7 seems to dominate . The close combination of the new trimethoprim resistance gene with sulfonamide resistance on the plasmids studied would effect an efficient spread of these genes, since trimethoprim has most often been used in combination with a sulfonamide.

Vopr Pitan, 1987 Jan-Feb, (1), 64 - 5
{Isolation of enterobacteria from food products}; Sudakova RN et al.; The results of the investigation of 98124 samples of food products for pathogenic and opportunistic bacteria are presented . Among them there were 39711 meat, 4441 fish, 51240 milk and 2732 vegetable and fruit samples . Pathogenic bacteria were isolated in 2.93% samples, opportunistic bacteria in 5.6% . The opportunistic bacteria isolated from food products possessed multiple drug resistance which was determined by R-plasmids in 65.6% . The authors claim that the criteria should be elaborated for the estimation of epidemic hazard values of the opportunistic bacteria content in food products.

Drugs Exp Clin Res, 1987, 13(2), 79 - 84
Effects of changes in pH, medium and inoculum size on the in vitro activity of different quinolone and fluoroquinolone antibiotics against urinary pathogens; Gesu GP et al.; The antibacterial activity of quinolones and fluoroquinolones was evaluated against several strains of enterobacteria growing in Mueller-Hinton broth and in urine at different pH . The data obtained in alkaline urine and in Mueller-Hinton broth indicate that the MIC values of the fluoroquinolones are about 16-32 times inferior to those found in urine at pH 6 . On the other hand, the activity of nalidixic acid and more particularly that of cinoxacin in urine appears to be optimum at this lower pH, showing MIC values only 2-4 times higher than those obtained in Mueller-Hinton media . Although the fluoroquinolones appear to have the highest degree of activity, a better MBC/MIC ratio was observed for cinoxacin and for nalidixic and oxolinic acids.

Ann Biol Clin (Paris), 1987, 45(1), 74 - 7
{Identification of gram-negative aerobic and non-fastidious aero-anaerobic bacilli using the ATB 32 GN system}; Croize J et al.; ATB 32 GN was tested with 279 gram negative non fastidious rods = 188 Enterobacteriaceae and 91 non-enterobacteriaceae . This micro-method included 32 carbon substrate's assimilation tests, read and interpreted automatically after incubation for one or two days at 30 degrees C . 93.5 p . cent of all bacteria are correctly identified (92.5 p . cent of Enterobacteriaceae and 95.6 p . cent of non enteric rods) . 2.6 p . cent are misidentified and 3.9 p . cent are unidentified . The results these strains are analysed . This novel system of identification was possible utilised in a medical analysis laboratory.

J Hyg Epidemiol Microbiol Immunol, 1987, 31(1), 91 - 8
Normalizing effect of immunoglobulins in the treatment of endogenous infection and intestinal dysbacteriosis in irradiated mice; Klemparskaya NN et al.; It has been demonstrated in experiments on 2160 CBA mice and mice of mixed breed, irradiated by LD90/30, that therapeutical administration (subcutaneous or intraperitoneal) of immunoglobulins - homologous (polyglobulin, IgG, IgM) or heterologous - polyglobulin, IgG (from human, equine, canine blood) repeated three times, i.e., 2, 24 and 48 hours after irradiation, not only induces longer survival, but also shows a normalizing effect on the commonly developing dysbacteriosis and increased amount of intestinal microflora and, in addition, leads to suppression of postirradiation endogenous infection . Enterobacteria, enterococci, staphylococci, yeasts, disappear from the small intestine or their quantity decreases substantially in treated irradiated mice in contrast to untreated irradiated mice . In the large intestine, the amount of these organisms decreases considerably while the content of lactobacteria increases; no microbes can be found in the internal organs and in blood (or their content is small) . Other conditions being equal, homologous immunoglobulins are more efficient in comparison with heterologous, this applying also to preparations containing normal antibodies to tissues.

Scand J Infect Dis, 1987, 19(1), 131 - 5
The penetration of ceftazidime into the inflamed rabbit eye; Walstad RA et al.; Acute endophthalmitis was unilaterally induced in 8 rabbits by intravitreal injection of 5 micrograms Escherichia coli endotoxin . A reproducible increase in aqueous humour polymorphonuclear neutrophils and total protein content was observed after 24 h (mean +/- SD: 2400 +/- 274 X 10(6)/l and 3.7 +/- 0.4 g/l, respectively) . In the opposite eye only minor changes occurred, making it suitable as a paired control . The intraocular penetration of ceftazidime was then studied in 30 rabbits after i.v . injection of 50 mg/kg body weight . The mean penetration into aqueous humour of the eyes with and without endophthalmitis was 64 and 10%, respectively . In the vitreous body the corresponding penetration was 5 and 1% . The concentration of ceftazidime achieved in the intraocular structures was sufficient to inhibit the growth of pathogens, i.e . Enterobacteriaceae, commonly responsible for intraocular infections.

J Clin Microbiol, 1987 Jan, 25(1), 61 - 6
Cobas-Bact system for identification of members of the family Enterobacteriaceae in 4 h 20 min; Wenger A et al.; The Cobas-Bact (Roche Diagnostics, Basel, Switzerland) new rotor for the identification (ID) in 4 h 20 min of 33 members of the family Enterobacteriaceae to genus and species level was evaluated by testing 444 strains of which 398 belonged to common species and 46 belonged to rare species of Enterobacteriaceae . Each strain was identified by the API 20E system (Analytab Products, Plainview, N.Y.), and additional discriminating tests were set up if necessary . Only first-choice ID were considered in this study and were classified either as high-confidence ID (normalized likelihood, greater than or equal to 80%) or as low-confidence ID (normalized likelihood, less than 80%) requiring additional tests for confirmation . The data were analyzed by two versions of Cobas-Bact software . With the first version of the software (SW8446), the overall accuracy of Cobas-Bact was 95.5% (424 correct ID of 444) . When restricted to high-confidence ID it rose to 99.4% (350 of 352) for the common species and 96.9% (31 of 32) for the rare species . Only three strains of the high-confidence group were misidentified . Sixty ID were considered unacceptable because of their low confidence . Using the first software version (SW8446) they represented 12% (46 of 398) of the common species (17 typical strains, 10 Shigella species, 10 inactive Escherichia coli strains, and 9 rare biotypes) and 30% (14 of 46) of the rare species . The same data analyzed by the new version (SW8524) of the Cobas-Bact software resulted in an overall accuracy of 93.9% (417 correct ID) . The number of high-confidence ID rose to 401, of which 392 (97.7%) were accurate . The decrease in low-confidence ID (43 versus 60) was mainly due to the Shigella species . In conclusion the accuracy of Cobas-Bact identification system was very good when restricted to high-confidence ID . The Cobas-Bact performance for rare species ID was poorer, but the small number of strains tested does not allow definitive conclusions.

J Clin Microbiol, 1987 Jan, 25(1), 26 - 30
Identification with monoclonal antibodies of hemolysin produced by clinical isolates of Escherichia coli; Hugo F et al.; Murine monoclonal antibodies were generated against the 107,000-dalton hemolysin encoded by the hemolytic determinant from Escherichia coli LE 2001, and colony blotting was used to assay for production of the hemolysin by 35 hemolytic strains of E . coli and other hemolytic members of the family Enterobacteriaceae of clinical origin . All hemolytic E . coli strains gave positive reactions with two monoclonal antibodies . In contrast, none of the hemolytic, non-E . coli isolates yielded positive colony blots . In addition, Western blotting showed that the hemolysins produced by all clinical E . coli isolates had a similar molecular weight of about 107,000 . Discrete antigenic variation may occur in the molecule, since a third monoclonal antibody did not react with the hemolysin from a number of wild-type E . coli strains . Western blot analysis was used to assess the presence of immunoglobulin G (IgG), IgA, and IgM antibodies to E . coli hemolysin in human sera . All 20 of the tested sera from healthy adults contained antibodies to the toxin, with various constellations among the antibody classes . In contrast, sera from five of eight infants aged 8 to 36 months contained no antihemolysin antibodies . We conclude that the 107,000-dalton hemolysin of E . coli is a widespread immunogen that is produced by most or all hemolytic E . coli strains in the human host.

J Bacteriol, 1987 Jan, 169(1), 61 - 5
Flagellar variation in Serratia marcescens is associated with color variation; Paruchuri DK et al.; The pigmented enterobacterium Serratia marcescens, an opportunistic pathogen, shows a striking variation of its red color . Different strains differ greatly both in color and in the frequency with which they produce color variants . Within a strain, the variations occur at constant rates and are reversible . During an investigation of this phenomenon we observed that variation of a 39-kilodalton protein in S . marcescens 274 is closely associated with color variation . Using antibodies to this protein we identified it as being a component of the bacterial flagella . Variation of surface proteins often provides an organism with alternate offense-defense strategies for survival in a challenging environment . The pigment, in association with flagella, may provide such a function for S . marcescens.

Drugs Exp Clin Res, 1987, 13(3), 155 - 9
Comparative activity of ceftizoxime against aminoglycoside-resistant aerobic gram-negative bacilli; Gomez-Lus R et al.; The in vitro activity of ceftizoxime was compared with that of other beta-lactam antibiotics against 331 aminoglycoside (AG)-resistant clinical isolates . Two hundred and six AG-resistant, beta-lactamase producing, R-plasmid harbouring Enterobacteriaceae strains had MICs ranging from 0.0125 to 0.063 mg/l . AG-resistant Escherichia coli (36 strains) and Klebsiella pneumoniae (19) had MIC 90 values of 8 mg/l . Proteus rettgeri and P . vulgaris as well as Morganella morganii, resistant to several AGs, had MICs ranging from 0.5 to 4 mg/ml . Against all six isolates of AG-resistant Salmonella enteritidis the MIC90 was 0.5 mg/l . Twenty-seven strains of Serratia marcescens, most of which were resistant to beta-lactam and AG antibiotics, had MICs ranging from 0.5 to 8 mg/l . The AG-resistant strains of Enterobacteriaceae producing several AG-modifying enzymes (AAC(3); AAC(2'); AAC(6'); APH(3')) showed MICs ranging from 0.6 to 4 mg/l . Against 10 AG-resistant strains of Pseudomonas aeruginosa producing AAC(3), AAC(6') and APH(3') enzymes, the MICs ranged from 16 to 64 mg/l . In conclusion, ceftizoxime was equally or more active than cefotaxime, cefoperazone, ceftazidime and moxalactam against AG-resistant E . coli, Klebsiella, Morganella, Proteus, Serratia, Salmonella and R-plasmid harbouring Enterobacteriaceae . Ceftizoxime was less active than cefotaxime, moxalactam and ceftazidime against P . aeruginosa.

Scand J Infect Dis, 1987, 19(3), 361 - 7
Trimethoprim used for selective decontamination of the digestive tract in rats: possible route of excretion; Toorop-Bouma AG et al.; Selective elimination of Enterobacteriaceae species from the digestive tract of rats has been accomplished by oral treatment with trimethoprim (235 mg/kg body weight/day) within 6 days . In the present study it was investigated whether this elimination was mainly due to antimicrobial activity of trimethoprim excreted with the gastrointestinal mucus or mainly by non-absorbed trimethoprim in the lumen contents . By means of whole gut irrigation (WGI) the lumen contents were washed out, followed by mucosa-associated flora . The concentration of the mucosa-associated Enterobacteriaceae remained at least 10(1)/ml as measured in the last samples of rectal effluent during WGI in untreated rats . During trimethoprim treatment, however, the amount of mucosa-associated Enterobacteriaceae had decreased significantly more (p less than 0.05) compared with the Enterobacteriaceae present in the lumen contents of the gastrointestinal tract (photospectrometrically measured by the color of the rectal effluent) . No difference was observed in the concentration of mucosa-associated enterococci in the rectal effluent of trimethoprim treated and untreated rats . It is concluded that orally administered trimethoprim may be predominantly active against Enterobacteriaceae associated with the mucous blanket.

Chemotherapy, 1987, 33(1), 40 - 51
Selection frequency of resistant variants by various beta-lactam antibiotics in clinical Enterobacter cloacae isolates; Buscher KH et al.; The frequency of selection of resistant variants by 10 different broad-spectrum beta-lactam derivatives was evaluated for 10 clinical Enterobacter cloacae isolates . With respect to most penams or cephems, resistant variants could be selected up to 8- or 32-fold the MIC, respectively . However, with cefpirome as the selecting agent resistant variants were obtained only at twice the MIC, whereas resistant variants were barely detectable with temocillin and not detectable in any case with imipenem . The variants exhibited cross-resistance between penams and cephems including aztreonam, but not to temocillin and imipenem regardless of the beta-lactamase amount produced . Enzyme production of the variants ranged from 0.2 U to 19.0 U beta-lactamase/mg protein of the cell-free supernatants . Moreover, analysis of the outer membrane protein composition did not reveal marked alterations between wild strains and the corresponding variants . It is evident that 'overproduction of the chromosomal beta-lactamase' cannot explain entirely phenotypic resistance to broad-spectrum beta-lactam compounds, but a lack of porin production, i.e., major outer membrane proteins, cannot provide an explanation for the above findings.

Antimicrob Agents Chemother, 1987 Jan, 31(1), 102 - 3
In vitro evaluation of S-25930 and S-25932, two new quinolones, against aerobic gram-negative isolates from cancer patients; Rolston KV et al.; The in vitro activity of S-25930 and S-25932, two new 4-quinolones, against 450 aerobic gram-negative organisms isolated from cancer patients was evaluated and compared with the activity of ciprofloxacin, enoxacin, difloxacin (A-56619), and A-56620 . Both agents inhibited most members of the family Enterobacteriaceae at concentrations of less than or equal to 2.0 micrograms/ml, but their activity against Pseudomonas aeruginosa was inferior to that of other quinolones . Although considerably less active than ciprofloxacin and A-56620, S-25930 was frequently two- to eightfold more active than S-25932 and was comparable to difloxacin and enoxacin against most isolates.

Bull Soc Pathol Exot Filiales, 1987, 80(5), 756 - 60
{Isolation of Kluyvera ascorbata from Madagascan lemurs, healthy carriers of this unusual enterobacterium}; Richard C et al.; Six strains of Kluyvera ascorbata--an unusual species in the family Enterobacteriaceae--were isolated from six healthy lemurs, located in Tananarive's zoological garden . Their bacteriological characters are reported and compared with those of Levinea and Escherichia coli . Their occurrence and significance in animals are discussed.

Drugs Exp Clin Res, 1987, 13(12), 727 - 9
First microbiological approach to dactimicin, a novel aminoglycoside antibiotic; Stefani S et al.; Dactimicin (ST 900) is the first aminoglycoside antibiotic of Dactylosporangium origin . This drug shows resistance to many enzymes that destroy aminoglycosides . In this first approach, the authors have pointed out the activity of dactimicin against Gram-negative rods, particularly Klebsiella, Enterobacter, Serratia and Gram-positive bacteria, especially methicillin susceptible and resistant staphylococci . Dactimicin showed remarkable antibacterial activity against all strains tested; however this activity was strongly influenced by the inoculum size . The bactericidal activity of dactimicin towards some Gram-positive and Gram-negative bacteria was also evaluated.

Microbiol Immunol, 1987, 31(11), 1107 - 11
Characterization and mobilization of nonconjugative plasmids encoding resistance to streptomycin and sulfanilamide; Araki Y et al.; Most of nonconjugative streptomycin (Sm)- and sulfanilamide (Su)- resistance of clinical isolates belonging to various species of Enterobacteriaceae and Pseudomonas were encoded by an Inc Q plasmid, molecular size of which was 5.5 Md . The SmSu plasmids were efficiently mobilized by Inc P plasmids between E . coli strains . Inc I group and Inc F group plasmids could mobilize the Inc Q plasmids at lower efficiencies . The Inc Q plasmid was also mobilized to various species of Enterobacteriaceae at high frequencies without accompanying the conjugative Inc P plasmid; as a result, most of the SmSu-resistant transconjugants were nontransferable . The above results may explain the wide distribution of nonconjugative SmSu strains among clinical isolates.

Drugs Exp Clin Res, 1987, 13(10), 641 - 6
Intestinal microflora changes induced by ciprofloxacin and treatment of portal-systemic encephalopathy (PSE); Esposito S et al.; The modifications of colon microflora in 14 patients under oral ciprofloxacin therapy for intercurrent UTIs or RTIs, at the dose of 250 mg b.i.d . or 500 mg o.d . were examined . All patients were affected by liver cirrhosis . A marked decrease in enterobacteria with both doses was noticed in the first few days, with a complete disappearance from days 3-6 of therapy and a return to normal within 2 weeks after interruption of treatment . Gram-positive and Gram-negative aerobic and anaerobic flora were not affected significantly . As a consequence of these results, the treatment of six patients affected by PSE (grade 2-3) was studied, testing the colon microflora changes, the presence of circulating endotoxins and blood ammonium levels before, during and after 12 days of therapy . A marked reduction or suppression of enterobacteria was observed, and a prompt normalization of blood ammonium levels, the disappearance of circulating endotoxins and a clear clinical improvement in 5 out of 6 patients.

Ann Rech Vet, 1987, 18(3), 249 - 54
Comparison between the influence of carbadox and that of traditional antibiotics on the resistance of enterobacteria in pigs; Spanoghe P et al.; Whatever the product used as a food additive, ("traditional" antibiotic or carbadox) it is likely to increase the proportion of enterobacteria resistant to it . This phenomenon is commonly seen with chloramphenicol, neomycin and ampicillin, whether used as feed additives or therapeutic agents . The use of carbadox also selects strains which are resistant to it, but this increase is much lower than those given by the traditional antibiotics and tends to be reversed when the drug is withdrawn . All the products select coding plasmids for multiple resistances . Resistance to carbadox is most often transferable to the strains of E coli C600 and 14R525; but the Salmonella which were tested proved to be very bad recipients of carbadox resistance.

Ann Biol Clin (Paris), 1987, 45(5), 558 - 61
{Role of invasive candidiasis in hospital pathology}; Minozzi C et al.; The frequency, mode of occurrence, diagnostic criteria and main features of systemic and visceral candidiasis have been evaluated in a retrospective study of all cases managed in St Louis Hospital, Paris, during the {June 1, 1985-May 31, 1986} period . During this one year period 23 patients suffered from systemic or visceral candidiasis and Candida spp . accounted for 9.6% of all positive blood cultures, fourth in number after Enterobacteriaceae, Staphylococcus and Pseudomonas . Abnormal underlying condition was present in all patients, mainly haematologic malignancies, serious abdominal surgery and AIDS . In patients with haematologic malignancies C . tropicalis was the main species involved in contrast with surgical patients in whom the dominant responsible species was C . albicans . No Candida oesophagus was common . Therapeutic regimens included amphotericin B in all patients with systemic disease . We conclude that in an institution mainly oriented toward management of cancer and surgical patients, systemic and visceral candidiasis are common and represent a serious problem.

Scand J Infect Dis, 1987, 19(5), 577 - 9
Enterobacter meningitis--treatment complicated by emergence of mutants resistant to cefotaxime; Ralph ED et al.; A case of Enterobacter cloacae meningitis in a postoperative patient is reported . A slow response to cefotaxime necessitated the use of gentamicin and trimethoprim-sulfamethoxazole for cure . Two types of resistance in the strain of E . cloacae isolated to cefotaxime were demonstrated: an inducible beta-lactamase that likely was the cause of the poor response to cefotaxime and a constitutive beta-lactamase in a mutant strain detected by a disc susceptibility test.

Childs Nerv Syst, 1987, 3(6), 371 - 4
Ultrasound-guided brain abscess aspiration in neonates; Theophilo F et al.; Four cases of brain abscess in neonates are described, diagnosed by ultrasonography and CT . All abscesses were confirmed surgically . One patient was operated on 5 weeks after diagnosis because of initial parental refusal . The etiology in all cases was meningitis superimposed on an hypoxic-ischemic insult . Two cases had a single abscess while the other two had multiple lesions . All cases were operated on with intraoperative ultrasound examination through the fontanelle . The case with delayed aspiration showed complete evolution from localized cerebritis to complete capsule formation with mass effect . One abscess was sterile, and in the others grew Klebsiella pneumoniae and Enterobacter aerogenes . The microorganism initially isolated from the lumbar CSF was also found in the abscess . Even after sterilization of the lumbar CSF, all abscesses were still present . Ultrasound examination and CT are compared.

Drugs, 1987, 34 Suppl 2, 64 - 88
Mechanisms of resistance to cephalosporin antibiotics; Livermore DM; Cephalosporins, like other beta-lactams, bind to the bacterial penicillin-binding proteins (PBPs) . These correspond to the D-ala-D-ala trans-, carboxy- and endo-peptidases responsible for catalysing the cross-linking of newly formed peptidoglycan . Resistance arises when the PBPs-and particularly the transpeptidases-are modified, or when they are protected by beta-lactamases or 'permeability barriers' . Target-mediated cephalosporin resistance can involve either reduced affinity of an existing PBP component, or the acquisition of a supplementary beta-lactam-insensitive PBP . beta-lactamases are produced widely by bacteria and may be determined by chromosomal or plasmid DNA . The chromosomal beta-lactamases are species-specific, but can be classified into a few broad groups . The plasmid-mediated enzymes cross interspecific and intergeneric boundaries . The level of beta-lactamase-mediated resistance relates to the amount of enzyme produced with or without induction; to the location of the enzyme (extracellular for Gram-positive organisms and periplasmic in Gram-negative ones); and to the kinetics of the enzyme's activity . In Gram-positive organisms the PBPs are located on the outer aspect of the cytoplasmic membrane and so shielding by permeability barriers is minimal . In Gram-negative cells, however, the PBPs are protected by the outer membrane, which most beta-lactams cross by diffusion through aqueous pores composed of 'porin' proteins . In enterobacteria, a clear correlation exists between porin quantity and cephalosporin resistance, suggesting that the outer membrane is the sole barrier to drug entry . Such relationships are less clear for Pseudomonas aeruginosa, where the cell may contain additional barriers between the outer membrane and the PBPs . Although elevated cephalosporin resistance often is attributed to a single factor (PBP-modification, beta-lactamase action or impermeability) an organism's response to a drug often reflects the interplay of several factors . Mathematical models can be proposed to describe this interplay.

Drugs, 1987, 34 Suppl 2, 216 - 39
Cephalosporins in surgery . Prophylaxis and therapy; McEniry DW et al.; Prophylactic antibiotics in surgery are intended to prevent morbidity and mortality, as well as to reduce the duration and cost of hospitalisation . The indications for prophylaxis, and its effectiveness, should be evaluated with these criteria in mind . The basis for antibiotic prophylaxis in surgery is either provision of an effective concentration of antibiotic in the tissue site at the time of potential contamination, or (primarily in the case of colorectal surgery) to reduce the inoculum of potentially contaminating bacteria . Cephalosporins are the antibiotics most widely used for prophylaxis in surgery, and have clearly been shown to reduce postoperative morbidity in vaginal hysterectomy, resection of head and neck cancers, vascular grafting, total joint replacement, repair of hip fractures, and high risk gastroduodenal surgery . They are probably also useful in cardiac surgery, abdominal hysterectomy, caesarean section, and colorectal surgery . For orthopaedic, cardiac, gynaecological, and gastroduodenal procedures it is important to select an antibiotic with proven clinical activity against Gram-positive organisms . For head and neck surgery, the spectrum of activity should also include oral anaerobes and Enterobacteriaceae . For biliary surgery an antibiotic effective against both Gram-positive and Gram-negative organisms may offer at least theoretical advantages, while for appendicectomy a cephamycin represents the most appropriate choice . In colorectal procedures, activity against B . fragilis is the major consideration in selecting an antibiotic for systemic prophylaxis . When intra-abdominal sepsis occurs following surgery, a potentially wide range of bacteria may be implicated, but in practice such infections are due to a small number of species, with B . fragilis most commonly implicated . The most useful cephalosporins in this setting are those active against both aerobic Gram-negative bacteria and anaerobes, especially B . fragilis . In practice, an aminoglycoside is often administered concomitantly . Importantly, prompt surgical treatment is the cornerstone of management of abdominal sepsis, and empirical antibiotic therapy should be adjusted as needed when culture and sensitivity tests become available.

Drugs, 1987, 34 Suppl 2, 135 - 53
Cephalosporins in the treatment of meningitis; Neu HC; The synthesis of new cephalosporin antibiotics has provided agents which can effectively be used to treat most of the different forms of meningitis . None of the first generation cephalosporins can be considered acceptable as agents to treat meningitis . Cefuroxime can be used to treat meningitis due to Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis in children . Agents such as cefotaxime and ceftriaxone are appropriate for neonatal meningitis due to Escherichia coli and group B streptococci, but not Listeria monocytogenes . Cefotaxime, ceftriaxone, ceftizoxime and ceftazidime have all proved effective as therapy of meningitis in children and adults when the pathogens are pneumococci, H . influenzae or N . meningitidis, but they have not been shown to yield an improved mortality or lower morbidity in spite of much greater cerebrospinal fluid (CSF) bactericidal titres . Cefotaxime, ceftizoxime, ceftriaxone and ceftazidime have been effective as therapy of meningitis due to E . coli, K . pneumoniae and Proteus species, but failures have occurred with all of the cephalosporins when used to treat meningitis due to Enterobacter spp . and Serratia marcescens . Only ceftazidime yields adequate CSF concentrations to treat meningitis due to Pseudomonas aeruginosa . Overall, the cephalosporins can now be considered a major component of the therapy of acute bacterial meningitis irrespective of the age group to be treated.

Clin Ther, 1987, 10 Suppl A, 36 - 49
Treatment and long-term follow-up of foot infections in patients with diabetes or ischemia: a randomized, prospective, double-blind comparison of cefoxitin and ceftizoxime; Hughes CE et al.; The efficacy and safety of ceftizoxime and cefoxitin were compared in a randomized, double-blind study of therapy for lower extremity infections in patients with diabetes mellitus or peripheral vascular disease . Overall clinical responses were satisfactory in 82% (23/28) of patients treated with ceftizoxime and in 68% (17/25) of patients treated with cefoxitin . The difference was not statistically significant . Ceftizoxime had superior in vitro activity against Enterobacteriaceae, especially Enterobacter cloacae, whereas cefoxitin had better activity against the Bacteroides fragilis group . Relapses of infection were common in both groups during long-term follow-up; only about one third of patients in either group maintained satisfactory outcomes after one year . More than half of the patients in both groups responded to one or more courses of medical therapy and avoided major amputations for one year following entry into the study.

Trans R Soc Trop Med Hyg, 1987, 81(3), 504 - 7
The genetics of bacterial trimethoprim resistance in tropical areas; Amyes SG et al.; Resistance to trimethoprim in Gram-negative bacteria is largely manifested by two trimethoprim resistant dihydrofolate reductases (types I and II) encoded by genes originally located on resistance plasmids . Although trimethoprim resistance increased markedly after the clinical introduction of trimethoprim in the West, its spread has slowed and, in Edinburgh at least, has actually been declining . This reduction has been accompanied by the migration of a transposon, encoding the type I plasmid resistance gene, into the bacterial chromosome . In tropical areas, the incidence of trimethoprim resistance is very much higher . In Tanzania, it has spilled over into other bacteria outside the Enterobacteriaceae, but it was in India where the major problem existed . The majority (64%) of the Indian Enterobacteriaceae studied were resistant to the drug and most of the resistance genes were located on very large plasmids which also conferred resistance to many other antibacterial drugs . Some Indian plasmids carried a new trimethoprim resistance gene which is not detectable by conventional sensitivity tests and may be spreading unnoticed elsewhere . The proportion of trimethoprim resistance has been related to the volume of antibacterial drugs used.

Pharmacotherapy, 1987, 7(4), 92 - 110
Norfloxacin: clinical pharmacology and clinical use; Rowen RC et al.; Norfloxacin, a nalidixic acid analog, is the first of the fluorinated quinolinecarboxylic acids to be marketed in the United States . It demonstrates potent antibacterial activity against aerobic, gram-negative bacteria including the Enterobacteriaceae, gentamicin-resistant Pseudomonas aeruginosa, and penicillin-resistant Neisseria gonorrhoeae . Norfloxacin exhibits good activity against methicillin-resistant and -sensitive Staphylococcus aureus, but less activity against most other aerobic, gram-positive organisms . Anaerobic bacteria are resistant to the drug . Resistance to norfloxacin is not plasmid mediated, but is secondary to bacterial mutation, and occurs less frequently than nalidixic acid resistance . Its pharmacokinetic properties after a 400-mg oral dose consist of a peak serum concentration of 1.3-1.58 micrograms/ml, an elimination half-life of 3-7 hours, and good penetration into kidney and prostatic tissues . Renal excretion is the major route of elimination . Norfloxacin is highly effective in the treatment of uncomplicated and complicated urinary tract infections, and gonococcal urethritis . Adverse effects are generally well tolerated and usually do not require discontinuation of therapy.

J Reprod Fertil Suppl, 1987, 35, 33 - 8
Evaluation of cellulose acetate/nitrate filters for the study of stallion sperm motility; Strzemienski PJ et al.; Stallion semen was diluted in a Hepes-supplemented buffer (CM) (10(6) spermatozoa/ml) and placed in the upper well of a Sykes-Moore chemotaxis chamber . Chambers were incubated in a humidified atmosphere (5% CO2 in air) at 37 degrees C for 1 and 2 h and spermatozoa were allowed to swim through filters with a mean pore size of 3,5 or 8 micron . Spermatozoa entered filters of all three pore sizes . Distance travelled was greater for each increase in pore size (P less than 0.01) but did not differ (P greater than 0.05) between 1 and 2h of incubation . Extended semen from stallions of different fertility was analysed for the minimal concentration of spermatozoa needed to enter filters with a 3 micron pore size . Sperm progression into the filter reflected the motility of the ejaculate . Assuming that sperm motility is a good indicator of fertility, this method may be useful for estimating the fertility of a stallion . Progression of spermatozoa into filters with a pore size of 3 micron was hampered by supernatants from overnight cultures of Streptococcus zooepidemicus and Enterobacter aerogenes . Motility decreased after 2h of incubation in supernatant from S . zooepidemicus diluted 1:5 and E . aerogenes supernatant diluted 1:5 and 1:10 in culture medium . In contrast, the bacterial supernatants were chemokinetic to horse neutrophils and did not affect their viability.

J Hyg Epidemiol Microbiol Immunol, 1987, 31(3), 287 - 92
Using SIB and API kits to identify and biotype enterobacteria of different origin; Kulinich LI et al.; A collection of 26 Enterobacteriaceae reference strains provided by Reference Centres in Moscow (USSR) and Copenhagen (Denmark) as well as a collection of 660 freshly isolated cultures of Gram-negative bacteria of different origin were investigated using SIB indicator systems manufactured at the Gorky Institute of Epidemiology and Microbiology (USSR) and API-20E, Rapid-20E and API-10S kits (API, France) with the aim of species determination . In analyzing freshly isolated cultures, API-20E, API-10S and SIB-B kits proved to be of approximately equal efficiency, whereas the Rapid-20E system enabled species identification in no more than 78% of the tested cultures . In a model biotyping of 284 E . coli cultures of different origin, SIB-B and API-20E kits in combination with the Analytical Profile Index enabled sufficiently rapid and standard identification of Enterobacteriaceae biovars.

Ann Biol Clin (Paris), 1987, 45(4), 419 - 22
{TTE-RAS (Titertek-Enterobac-Ras), a new micromethod for the semi-automatic identification of Enterobacteriaceae within 5 hours}; Barth JG et al.; Titertek-Enterobac-Ras (TTE-RAS), a new semi-automated system for the identification of the Enterobacteriaceae-within five hours, has been evaluated and compared with conventional methods . This note presents the results upon 655 strains, mainly Enterobacteriaceae TTE-RAS provided correct identification for about 92 p . cent and 97 p . cent of Enterobacteriaceae respectively before and after carrying out supplementary tests according to manufacturer's instruction . TTE-RAS gave 97 p . cent specific results for Salmonella . On the other hand, the system correctly identified Aeromonas hydrophila, but not the Gram negative strict aerobic bacteria.

Infection, 1987, 15 Suppl 4, S173 - 8
{Ceftazidime versus cefotaxime in the therapy of severe infections in intensive care patients}; Muller E et al.; In a randomized controlled, clinical study the efficacy of ceftazidime at a dosage of 2 g b . i . d . was compared to that of cefotaxime at a dosage of 2 g t . i . d . or more in the treatment of pneumonia or peritonitis in intensive care patients . 61 of 67 assessable cases were evaluable . In the ceftazidime group ten out of 11 patients with pneumonia and 17 out of 20 with peritonitis showed a clinical success . In the cefotaxime group 15 out of 19 patients with pneumonia and eight out of 11 with peritonitis were clinically cured or improved . With ceftazidime an overall success was achieved in 87% of the patients (27 out of 31) and with cefotaxime in 77% of the patients (23 out of 30) . Two patients in the cefotaxime group developed a reinfection . Five of the patients treated with cefotaxime and four of those treated with ceftazidime were therapeutical failures . Escherichia coli, Pseudomonas, Klebsiella, Enterobacter and Proteus species as well as Staphylococcus aureus and enterococci were the most frequent organisms isolated prior to therapy . Following ceftazidime therapy 30 of the 32 gram-negative species were eliminated, whereas in the cefotaxime group the number of gram-negative species isolated was reduced from 28 to ten . Gram-positive species isolated in ten cases prior to therapy, were still present in seven cases after ceftazidime therapy and the number of gram-positive organisms was reduced from 19 to ten following treatment with cefotaxime . In one patient therapy with ceftazidime was stopped due to urticaria . Reversible leukopenia was observed in a patient treated with ceftazidime and a cholestatic reaction in a patient treated with cefotaxime . In both groups a slight elevation of transaminases was seen.

Infection, 1987, 15 Suppl 4, S158 - 67
{A comparative review of combination therapy: 2 beta-lactams versus beta-lactam plus aminoglycoside}; Dejace P et al.; We have reviewed the available literature on the controlled use of combinations of beta-lactams in the treatment of fever in neutropenic patients, as compared to that of combinations of beta-lactams and aminoglycosides . We compared overall responses, responses in septicemia and various other infections, according to different pathogens and degree of neutropenia, and we evaluated toxicity . Overall, these results showed that response rates with combinations of two beta-lactams are similar to those obtained with combinations of a beta-lactam and an aminoglycoside for infections in immunocompromised patients with serious underlying diseases . They also suggest that the emergence of resistance of pathogens to beta-lactams has often been coped by the use of newer drugs in infections caused by Enterobacteriaceae, but much less effectively in the case of Pseudomonas aeruginosa infections . There are still other important theoretical reasons for preferring an aminoglycoside-containing combination for empiric therapy in febrile neutropenic patients, and our overall conclusion is that a large-scale study comparing beta-lactam combinations to the traditional beta-lactam plus aminoglycoside regimens is mandatory.

Contrib Microbiol Immunol, 1987, 9, 254 - 8
Yersiniae and iron . A study in host-parasite relationships; Robins-Browne RM et al.; Most enterobacteria obtain the iron they require for growth by producing low-molecular-weight high-affinity iron ligands known as siderophores . These substances chelate and solubilize iron making it available to bacteria . The pathogenic Yersiniae produce no detectable siderophores; thus, they proliferate poorly or not at all under conditions of iron limitation . Most systemic infections with Yersinia enterocolitica occur in patients who are overloaded with iron . This may be due to the presence of excess iron in the tissues of such patients, but the adverse effects of excess iron on immune responsiveness may also be partly responsible . Many patients with iron overload receive treatment with desferrioxamine B, a bacterial siderophore which promotes growth of Y . enterocolitica in vitro and in vivo . Thus, desferrioxamine B may add to the risk of systemic yersiniosis developing in patients with siderosis . Some strains of Yersinia frederiksenii, Yersinia intermedia and Yersinia kristensenii produce the hydroxamate siderophore aerobactin, but, paradoxically, they appear to be unable to proliferate in tissues.

Gene, 1987, 52(1), 31 - 40
Evolution of the enterobacterial sulA gene: a component of the SOS system encoding an inhibitor of cell division; Freudl R et al.; The LexA-regulated sulA (sfiA) gene of Escherichia coli encodes an unstable protein which inhibits cell division . By determining the nucleotide sequences of the corresponding genes from the related bacteria Salmonella typhimurium, Enterobacter aerogenes and Serratia marcescens it was found that the regulatory region and the LexA binding site (SOS box) have been better conserved during evolution than the coding sequence . The N terminus of the SulA protein {amino acid (aa) residues 1-30} has diverged extensively during the evolution of Enterobacteriaceae, whereas the central region (aa residues 31-149) has been well conserved . At the C terminus a sequence showing some homology to the N protein of phage lambda was detected that may represent a recognition site for the Lon protease, which is known to degrade both polypeptides . When expressed in E . coli, the foreign sulA genes did not block cell division suggesting that their products are inactive . This may indicate that the N terminus of the SulA protein is involved in recognizing the cell division apparatus.

Antonie Van Leeuwenhoek, 1987, 53(6), 455 - 9
Gonococcal protein III . Purification and chemical characterization of the protein, and the DNA sequence of the structural gene; Gotschlich EC et al.; We have purified protein III (PIII) from several strains of gonococcus by extractions with Zwittergent 3,14 followed by cation exchange chromatography and gel filtration . The pI of 8.6 determined by isoelectric focusing was in keeping with the high content of basic amino acids found . PIII from two strains had identical N-terminal sequence . In contrast to PIII in vivo, purified PIII was highly susceptible to proteolysis . Rabbit antibodies raised with purified antigen reacted with PIII of all strains tested as well as meningococcal protein 4 . Furthermore, intact gonococci or meningococci could absorb 80% of antibodies raised by immunization with the purified PIII . The structural gene of PIII was cloned and the DNA sequenced . The predicted primary structure is strongly homologous to the OmpA proteins of Enterobacteria.

Antonie Van Leeuwenhoek, 1987, 53(4), 273 - 7
Esculinase (beta-glucosidase) for the rapid estimation of activity in bacteria utilizing a hydrolyzable substrate, p-nitrophenyl-beta-D-glucopyranoside; Trepeta RW et al.; The ability of bacteria to hydrolyse esculin is an important phenotypic characteristic for their identification . The presence of 'esculinase' is especially useful in identifying genera of the Enterobacteriaceae and in separating Bacteroides, Listeria, and group D streptococci from other pathogens . Three methods have been used to measure esculin hydrolysis . Each of these methods suffered from limitations . A new procedure employing the hydrolysable substrate p-nitrophenyl-beta-D-glucopyranoside was developed . This method required only 15 min incubation at either room temperature or 35 degrees C, may be used either qualitatively or quantitatively, and is inexpensive . The sensitivity and specificity of this method was found to be equivalent to that of the standard methodology.

Chemotherapy, 1987, 33(3), 197 - 203
In vitro evaluation of Ro 23-6240, a new fluorinated 4-quinolone; Stobberingh EE et al.; The in vitro antibacterial activity of Ro 23-6240 was assessed and compared with those of ciprofloxacin and beta-lactam antibiotics including several oral compounds against members of the family Enterobacteriaceae (n = 130) and Pseudomonas spp . (n = 31) . In general, Ro 23-6240 was 2 dilution steps less active than ciprofloxacin . For the Pseudomonas spp . the MICs for 90% inhibition were 2 and 0.5 mg/1 for Ro 23-6240 and ciprofloxacin, respectively . For the other species tested, the MIC90 values for Ro 23-6240 ranged from 0.031 to 1 mg/1 and for ciprofloxacin from 0.016 to 0.25 mg/1 . Spontaneous Ro 23-6240-resistant mutants were only isolated from Enterobacter cloacae with a frequency similar to that of ciprofloxacin (4.8 X 10(-8) and 2.4 X 10(-8), respectively) . No resistant mutants were isolated from Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae and Pseudomonas aeruginosa at concentrations of 4 and 8 times the MIC of Ro 23-6240 or ciprofloxacin (frequency less than 10(-9).

Chemotherapy, 1987, 33(3), 183 - 8
Synergy of imipenem--a novel carbapenem, and rifampin and ciprofloxacin against Pseudomonas aeruginosa, Serratia marcescens and Enterobacter species; Chin NX et al.; Although imipenem inhibits most bacteria at very low concentrations, some Pseudomonas aeruginosa, Serratia marcescens and Enterobacter species are resistant or become resistant after exposure . At concentrations of rifampin equivalent to those attainable in man after daily oral ingestion of 600 mg, synergy of imipenem and rifampin was found for 52% of 62 P . aeruginosa and an additive effect for 37% . Against 30 S . marcescens synergy of imipenem and rifampin was not found, but an additive effect was noted for 47% of the isolates . With 32 Enterobacter isolates 35% were synergically inhibited, and an additive effect was found against 38% of the strains . Imipenem and ciprofloxacin were synergistic for 8% of P . aeruginosa and 22% of Enterobacter . Eighty-seven percent of P . aeruginosa isolates with imipenem MIC greater than or equal to 4 micrograms/ml were synergistically inhibited by the combination of imipenem-rifampin . Imipenem MIC and MBC were lowered to 1-2 micrograms/ml and to 2-4 micrograms/ml for rifampin . MIC of imipenem and ciprofloxacin were 0.5-2 and 0.05-0.1 micrograms/ml, respectively . When a triple combination of imipenem-rifampin-ciprofloxacin was studied, 62% of P . aeruginosa, 32% of Enterobacter spp . and 47% of S . marcescens were synergistically inhibited.

J Antimicrob Chemother, 1987 Jan, 19(1), 45 - 8
In-vitro antimicrobial activity of enoxacin in combination with eight other antibiotics against Pseudomonas aeruginosa, Enterobacteriaceae and Staphylococcus aureus; Baltch AL et al.; Susceptibilities of 28 strains of Pseudomonas aeruginosa, 32 strains of Enterobacteriaceae and 24 strains of Staphylococcus aureus were tested against combinations of enoxacin with either cefsulodin, piperacillin, or amikacin, enoxacin with either aztreonam, latamoxef or amikacin, and enoxacin with either oxacillin, clindamycin or vancomycin, respectively . Synergy was detected by the agar dilution technique and was defined as a four-fold decrease in the inhibitory concentration of both drugs (sigma FIC less than or equal to 0.5) . Against Ps . aeruginosa, synergy occurred in 28.5% of the strains for enoxacin plus cefsulodin, 17.6% for enoxacin plus piperacillin, and 3.7% for enoxacin plus amikacin . Against the Enterobacteriaceae, synergy was detected with enoxacin plus aztreonam, latamoxef or amikacin in 9.3%, 3.1% and 0% of strains, respectively . Against Staph . aureus, no synergy was demonstrable with enoxacin plus oxacillin, clindamycin or vancomycin . No antagonism was detected for any combination tested . Selected strains demonstrating synergy by the agar dilution method for enoxacin plus cefsulodin or piperacillin failed to show synergy in kinetic studies.

Scand J Infect Dis, 1987, 19(1), 105 - 12
In vitro activity of ampicillin alone and in combination with different concentrations of 6 beta-bromopenicillanic acid, clavulanic acid and mecillinam; Stobberingh EE et al.; The antibacterial activity of ampicillin against Enterobacteriaceae strongly increased when combined with 6 beta-bromopenicillanic acid (BPA) or clavulanic acid (CA) . In vitro, the combination ampicillin: BPA in the ratio 1:1 proved to be the most effective one . The antibacterial activity of mecillinam against Enterobacteriaceae was strongly potentiated by the addition of ampicillin . The combination mecillinam:ampicillin in the ratio 4:5 showed an antibacterial activity comparable to that of new beta-lactam compounds such as cefotaxime and ceftazidime.

Folia Haematol Int Mag Klin Morphol Blutforsch, 1987, 114(2), 220 - 33
Pericarditis in the course of acute leukemia; Nowicka J et al.; Among 140 patients with acute leukemia (AL) diagnosed according to FAB criteria, pericarditis was diagnosed clinically in 5 of them . They were 2 women and 3 men with different types of AL (L2-in one, M2-in one, M3-in one and M4-in two persons) . It occurred in one patient at the onset of the disease and was associated with hyperuricemia, in another one--in complete remission, in the third--during partial remission, and in remaining two patients--during induction therapy . In all patients pericarditis was manifested by fever up to 38-40 degrees C, tachycardia and pericardial friction, in 3-heart silhouettes were enlarged . The ECG revealed mainly depression of ST segments . In 1 case only ECG pattern was typical of pericarditis . Clinically the symptoms of right ventricle failure predominated in 3 and of septic shock--in 2 patients . The etiologic factors were: Pseudomonas aeruginosa 2 X, Enterobacter cloacae 1 X, tuberculosis infection 1 X and hyperuricemia and Enterobacter sepsis 1 X . Pericarditis was favourably influenced by treatment with antibiotics, cardiaca and diuretics in 4 patients . One patient died of a sepsis . In no case the patient's death was attributable to pericarditis . The results of postmortem examinations in 79 cases of AL has revealed three additional cases of pericarditis due to tuberculosis infection, Staphylococcus aureus sepsis and aspergillosis.

Plasmid, 1987 Jan, 17(1), 46 - 53
Plasmid-determined bleomycin resistance in Staphylococcus aureus; Semon D et al.; A 1580-bp fragment of Staphylococcus aureus plasmid pUB110 encoding resistance to the DNA synthesis inhibitor bleomycin has been cloned and sequenced . A DNA sequence containing an open reading frame of 405 bp was subcloned into several expression vectors and bleomycin resistance was expressed at high level in Escherichia coli under the control of lambda PL promoter . On induction, a ca . 14,000-Da protein was detected by gel electrophoresis . The bleomycin resistance determinant of the gram-positive plasmid pUB110 was compared to that of the enterobacterial transposon Tn5; limited regions of close relatedness could be identified.

J Immunol Methods, 1986 Dec 24, 95(2), 187 - 94
Characterization and diagnostic application of a lipopolysaccharide core oligosaccharide-protein conjugate; Lugowski C et al.; Shigella sonnei phase II core oligosaccharide (OSPhII) was linked covalently with protein (bovine serum albumin or tetanus toxoid) to obtain a conjugate (OSPhII-protein) of good immunogenicity in rabbits . Anti-OSPhII-protein conjugate sera contained high levels of immunoglobulin G antibodies against the complete core region of Sh . sonnei lipopolysaccharide . The antigenic relationships between lipopolysaccharides of R1, R3 and R4 core types using anti-OSPhII-protein sera were studied . These antisera may be used for the rapid determination of core types in unknown enterobacterial strains.

EMBO J, 1986 Dec 20, 5(13), 3709 - 14
Inducible cephalosporinase production in clinical isolates of Enterobacter cloacae is controlled by a regulatory gene that has been deleted from Escherichia coli; Honore N et al.; Cephalosporin hyper-resistant Enterobacter cloacae strains are isolated with increasing frequency from hospital infections . Resistance is principally due to the chromosomal ampC gene encoding a cephalosporinase . In contrast to Escherichia coli which expresses ampC constitutively from a promoter located in the upstream frdD gene, E . cloacae displays inducible ampC expression . By cloning the ampC gene it was shown that a linked genetic locus, ampR, mediated the induction by beta-lactams . In the absence of the antibiotic the 30,500 dalton AmpR protein represses ampC expression . The ampR gene shows a highly compact arrangement and is situated between the divergently expressed ampC gene and the frd operon from which it is separated by a bifunctional transcription terminator . The promoters for ampR and ampC substantially overlap and mRNA analyses showed that on induction transcription from the ampC promoter increased greatly whereas that from ampR did not . Two regions of sequence homology flank the ampR gene and it is proposed that a homologous recombination event between these in an ancestral enteric bacterium may have led to the deletion of ampR from the E . coli genome.

Presse Med, 1986 Dec 20, 15(46), 2353 - 7
{Treatment of infectious outbreaks in neutropenic patients with a piperacillin and amikacin combination}; Calvo F et al.; Two hundred and fifty patients (mean age 39 years) were involved in a multicentric pilot trial aimed at evaluating the effectiveness of a piperacillin (P) + amikacin (A) combination in severe neutropenic patients (less than 500 PNN/microliters) . In patients who failed to improve under this combination vancomycin (V) was added . Two hundred and thirty-five patients were assessable for response to P + A . The infection was microbiologically undocumented in 148 of them (63%) and documented in 87 (37%) . Response rates were 64% and 53% respectively, rising to 73% in both groups after addition of vancomycin . Thirty p . 100 of the patients had bacteremia . The most frequently encountered pathogens were staphylococci, enterobacteria, streptococci and Pseudomonas aeruginosa . Sixty-six p . 100 of gram-negative and staphylococcal infections responded to the P + A combination, while the response rate of staphylococcal infections was 23% . Fifty-seven p . 100 of staphylococci resistant to P + A were controlled by P + A + V . Fifteen (6.4%) patients died of infection, 5 of them of fungal infection . Toxicity was mild, with 3% renal toxicity . The P + A combination is effective as first line therapy in febrile neutropenic patients . These results and epidemiological data suggest that this combination plus vancomycin would be a suitable second line therapy for patients who did not improve.

Presse Med, 1986 Dec 20, 15(46), 2339 - 41
{Piperacillin in the newborn infant . A clinical and pharmacologic study}; Kacet N et al.; The study involved 70 neonates born at 27 to 48 weeks of pregnancy (mean: 34.2 weeks) and weighing between 840 and 4350 g (mean: 1860 g) . In every case piperacillin was combined with an aminoglycoside . The infants were treated for materno-foetal infection (14), post-partum infection (19), enterocolitis (18, surgical in 9 cases) and other post-operative infections (19) . The antibiotic combination was given prophylactically in 2 cases . Fifty micro-organisms were isolated in 39 patients: 24 from blood (hemoculture), 2 from CSF, 24 from multiple peripheral samples . There were 13 Gram-positive organisms (Streptococcus B, D, A, Listeria spp.) and 37 Gram-negative organisms (E . coli 14, Klebsiella spp . 10, Enterobacter spp . 6) . Clinical and bacteriological cure was obtained in 67 patients . Three failures were recorded, with resistance to treatment of Klebsiella pneumoniae and emergence (at hemoculture) of Klebsiella oxytoca under treatment in one patient and of Enterobacter cloacae in another patient . A pharmacokinetic study was performed in 47 neonates . Piperacillin (75 mg/kg per dose) was given twice a day until the 8th day post-partum and three times a day subsequently . The antibiotic was administered either by 30-min infusions or by intravenous or intramuscular injections; 124 serum level measurements were carried out at peak and/or residual level . In 44 infants with normal renal and hepatic function the mean residual level was 23 micrograms/ml (range: 7-100 micrograms/ml) and the mean peak level was 119 micrograms/ml (range: 47-278 micrograms/ml) . No local or systemic side-effect was noted, and there was no evidence of toxicity.

Presse Med, 1986 Dec 20, 15(46), 2313 - 6
{In vitro comparative study of piperacillin-aminoglycosides combinations against Enterococci and Enterobacteriaceae}; Chanal M et al.; The hundred and ninety-two combinations were tested against 17 strains chosen from the results of MIC determination (disc method): 5 enterococci exhibiting low level resistance (r) or high level resistance (R) to streptomycin (S) and gentamicin (G): 2 strains Sr Gr, 2 strains SR Gr and 1 strain Sr GR; 12 enterobacteria chosen for their resistance phenotypes to beta-lactams and aminoglycosides and because they are the most frequent clinical isolates: 2 strains Amos Tics Ctns (group 1), 4 strains AmoR Tics CtnR (gr . II), 4 strains AmoR TicR Ctns (gr . III) and 2 strains AmoR TicR CtnR (gr . IV) . MIC and MBC were assessed for the 17 strains (Mueller Hinton broth) . Combinations were carried out by a checkerboard micromethod . FBC index was calculated for each combination . Against enterococci the 50 combinations were: piperacillin versus ampicillin + aminoglycosides (streptomycin, tobramycin, amikacin, gentamicin, netilmicin) . Against enterobacteria piperacillin was combined with different aminoglycosides depending on their resistance phenotypes . These combinations were compared with ticarcillin or mezlocillin or cefotaxime + aminoglycosides (total number 142) . The species studied produced different results: with the enterococci Gr synergistic effects (FBC = 0.62-0.75) were rare; additive and indifferent effects were predominant . With the GR strain some antagonistic effects were observed . With the enterobacteria, in groups I and II synergistic effects were frequent and almost equivalent regardless of the beta-lactam chosen . In groups III and IV (TicR) piperacillin MICs were greater than or equal to 128 mg/l and mezlocillin MICs greater than 512 mg/l; the synergistic effects were significant (FBC from 0.25 to 0.62) . beta-lactam + amikacin or netilmicin, and especially piperacillin + amikacin, were found to have the most frequent synergistic effects upon the strains tested . Mezlocillin combinations cannot be used clinically; the use of piperacillin combinations requires further discussion . On the other hand, cefotaxime + aminoglycosides combinations are active against those TicR strains.

Presse Med, 1986 Dec 20, 15(46), 2303 - 8
{Enzymologic aspect of piperacillin combinations}; Labia R et al.; Like all penicillins, piperacillin exhibits some susceptibility to beta-lactamases of the penicillinase type, including those produced by Staphylococcus aureus and the TEM, OXA and CARB enzymes isolated from Gram-negative bacilli . Piperacillin is very slightly hydrolyzed by cephalosporinases, which makes it similar to 3rd generation cephalosporins . When tested with Enterobacter cloacae GN 5797 and Pseudomonas aeruginosa NTC 8303, two strains which produce inducible cephalosporinases, piperacillin had moderate inductive activity compared to cefoxitin, a potent inducer . Induction was very low with Enterobacter, but the drug was slightly more sensitive to Pseudomonas . Inhibition of this type of beta-lactamase synthesis was very strong when piperacillin was combined with amikacin and weaker when it was combined with pefloxacin . The piperacillin-amikacin combination prevented the development of piperacillin-resistant mutants of Enterobacter and Pseudomonas and, probably, of all Gram-negative bacilli . In our tests, the piperacillin-pefloxacin combination was of interest only against Enterobacter, and probably against all enterobacteria, since Pseudomonas mutants that resist pefloxacin are fairly easily obtained in vitro.

Presse Med, 1986 Dec 20, 15(46), 2297 - 302
{Bactericidal effect of piperacillin alone and combined}; Drugeon HB et al.; The bactericidal activity of piperacillin was evaluated by the kill rate kinetics method . Piperacillin compared with amoxicillin, amdinocillin, mezlocillin, cefotaxime, ceftazidime and latamoxef . Against E . coli, piperacillin and antibiotics electively bound to penicillin-binding protein (PBP) 3 had the same, mainly time-dependent, bactericidal activity . Antibiotics bound to PBP 1 and 2 mainly have a dose-dependent activity . The bactericidal activity of piperacillin against E . coli was enhanced when the drug was combined with amoxicillin and amdinocillin; in contrast, the kill rate remained unmodified when piperacillin was combined with latamoxef . When the piperacillin-amikacin combination was tested against Pseudomonas aeruginosa, Enterobacter cloacae, Escherichia coli and Serratia marcescens, early synergism (5th hour), was weak, but after 24 hours piperacillin reduced the regrowth observed with the aminoglycoside, and synergism was much more pronounced irrespective of the species investigated.

Presse Med, 1986 Dec 20, 15(46), 2282 - 9
{Mechanisms of action of beta-lactam antibiotics and mechanisms of non-enzymatic resistance}; Williamson R et al.; The mode of action of beta-lactam antibiotics, and the non-enzymatic resistance mechanisms to their activity, are intimately linked to the structure and biosynthesis of the bacterial cell wall . The bacteriostatic effect of beta-lactam antibiotics is related to their various interactions and concomitant inhibition of essential enzymes (transpeptidases, carboxypeptidases) involved in the terminal stages of peptidoglycan biosynthesis . These cytoplasmic membrane-associated target enzymes bind the antibiotics covalently, and hence are known as penicillin-binding proteins (PBPs) . The bactericidal effect of these antibiotics is due to a second step following on from the inhibition of cell division and growth, in which the activation of an autolytic system causes cell death . Resistance to beta-lactam antibiotics in Gram-positive bacteria, in the absence of a beta-lactamase, is due to various modifications of the PBPs . Such mechanisms are often found in enterococci, pneumococcus, ans staphylococci . With Gram-negative bacteria such modifications of PBPs are only a rare basis for resistance . The presence of an outer membrane brings another factor into the activity of beta-lactam antibiotics, which is the facility with the antibiotics can diffuse through specialised proteins termed porins . It is generally a modification of the amounts of these proteins, or some other components of the outer membrane, which causes the non-enzymatic mechanism of resistance, particularly in species such as Klebsiella, Enterobacter, Serratia and Pseudomonas.

Zh Mikrobiol Epidemiol Immunobiol, 1986 Dec, (12), 38 - 43
{Characteristics of microbial associations represented by the Enterobacteriaceae family isolated from the feces of healthy children and children with salmonellosis}; Dombrovskii AM et al.; Associations formed by microorganisms of the family Enterobacteriaceae in feces have been studied using the principles of ecological investigation . The study has revealed that the associations isolated from children with salmonellosis sharply differ from those isolated from healthy children in the number of species and in the variety of their combinations, as well as in changes in the proportion of different species, observed in multiple investigations.

Zh Mikrobiol Epidemiol Immunobiol, 1986 Dec, (12), 31 - 4
{Detection of enterotoxigenic enterobacteria with adhesion antigens in acute intestinal diseases}; Mnatsakanov ST; As revealed in this study, 56.8 +/- 4.3% of children under 1 year, suffering from acute intestinal diseases of unknown (i.e . not determined by common bacteriological methods) etiology, show the presence of enterobacteria capable of the combined synthesis of enterotoxins and adhesion antigens . No such cultures are isolated from healthy children . In cases of diarrhea of domestic animals (piglets and calves), frequent isolation of enterobacteria characterized by both, toxigenicity and capacity for producing adhesion antigens (50.6 +/- 4.8% and 42.9 +/- 4.8% respectively), is noted.

Antimicrob Agents Chemother, 1986 Dec, 30(6), 945 - 7
Epidemiology of intestinal colonization by members of the family Enterobacteriaceae resistant to cefotaxime in a hematology-oncology unit; Prevot MH et al.; Intestinal colonization by members of the family Enterobacteriaceae resistant to cefotaxime was surveyed for 3 years in a hematology-oncology unit . Of 416 patients, 66 (15.9%) were colonized, each with a different strain . The incidence of intestinal carriage was not correlated with cefotaxime consumption in the ward but was strongly associated with individual exposure to cefotaxime.

Pediatrics, 1986 Dec, 78(6), 1090 - 6
Osteoarticular infections in children with sickle cell disease; Syrogiannopoulos GA et al.; Thirteen children with sickle cell disease were identified as having 14 episodes of osteoarticular infection in a review of 27 years' experience . There were eight episodes of osteomyelitis or osteoarthritis and six of suppurative arthritis alone . The etiologic agents in osteomyelitis or osteoarthritis were Salmonella sp in four cases, Escherichia coli in one, Enterobacter aerogenes in one, Staphylococcus aureus in one, and Haemophilus influenzae type b in one . Five of the cases with infection limited to the joint were caused by Streptococcus pneumoniae; the sixth was caused by H influenzae type b . Fever (greater than or equal to 38.3 degrees C) was present in all children and the temperature was in excess of 39 degrees C in 62% . The mean duration of pain before admission was 4.5 days . The initial total white blood cell count ranged from 5,200 to 29,700/microL (mean 19,436/microL) and the total band neutrophil count ranged from 0 to 5,103/microL (mean 1,660/microL) . The ESR was greater than 20 mm/h in eight of the ten patients who were tested . Management consisted of antibiotic therapy in all . Needle aspiration was performed in two patients with osteomyelitis and in three with suppurative arthritis . Incision and drainage was performed in two cases of osteomyelitis and in four with suppurative arthritis . The outcome was satisfactory in all except one patient who had several complications as a consequence of femoral neck osteomyelitis . Recurrence was reported in only one patient.

Quad Sclavo Diagn, 1986 Dec, 22(4), 369 - 87
{Urinary tract infections: observations on 19,021 patients hospitalized in Sassari Province}; Muresu E et al.; We report the results of a study carried out upon samples of urine from 19,021 patients in various departments of medical school in Sassari and in the hospitals of Alghero and Ozieri . The 34.7% of samples examined proved to be positive . Among these we isolated Escherichia coli (32%), Proteus spp . (24%), Staphylococcus (12%), Klebsiella-Enterobacter-Serratia (KES) spp . (9%), Pseudomonas spp . (5%) . We found microbic associations in 11% of cases . We also studied the sensitivity of microorganisms to various chemoantibiotics, and the efficacy of therapy on 964 patients . In the various checks made, the results point out a persisting positivity (53%) . E . coli strains show a major sensitivity to the various antibiotics (aminoglycosides, quinolones, cephalosporins, etc.); Proteus spp . and KES are less sensitive; Pseudomonas spp . strains are very resistant and respond mainly to norfloxacin and ceftazidime.

Am J Clin Pathol, 1986 Dec, 86(6), 761 - 4
Use of the RIM Escherichia coli Kit for rapid identification of Escherichia coli; Varga FJ et al.; The Rapid Identification Method (RIM) Escherichia coli Kit (Austin Biologicals Laboratories Inc., Austin, TX) was evaluated as a means to rapidly differentiate at reduced cost clinical isolates of Escherichia coli from other members of the Enterobacteriaceae . A group of 408 gram-negative rods that were isolated on primary isolation plates were tested with the use of both the kit and complete bacterial identification . The RIM E . coli Kit identified 92.5% (272 of 294) of the E . coli isolates . Only 1 of 114 non-E . coli isolates was misidentified as E . coli (positive predictive value equal to 99.6) . Although the RIM E . coli Kit was sufficiently rapid (less than one hour), any supply cost savings would depend upon the proportion of true E . coli in the group of organisms tested . Savings derived from the lower cost of using the RIM E . coli Kit would be reduced by the extra cost of screening non-E . coli isolates, which would then have to be completely identified.

J Clin Microbiol, 1986 Dec, 24(6), 922 - 8
Dip slide culture of intraoperative peritoneal irrigation fluid for prediction of septic complication in elective colorectal surgery; Claesson BE et al.; A controlled prospective study of a simplified technique, the dip slide culture method, for assessment of bacterial concentration in peritoneal irrigation fluid at the end of an elective colorectal operation is presented . The prediction of postoperative surgical infection based on intraoperative culture was compared between this method and a standard streak-plate technique in 190 patients . One gram of metronidazole was given intravenously as prophylaxis on induction of anesthesia and 12 h postoperatively . Intraoperative growth of members of the family Enterobacteriaceae or Staphylococcus aureus was strongly correlated to infection (P less than 0.001) . By using this finding as a single criterion for the prediction of sepsis, sensitivity and specificity for the dip slide method were 70.8 and 94.3%, respectively, compared with 79.2 and 94.6%, respectively, for the streak-plate method . Of the 24 infections, 20 (83.3%) were correctly predicted when a combination of the two methods was used . An increasing number of Enterobacteriaceae or S . aureus in the dip slide culture resulted in a steady rise in the rate of infections from 5.7% at 0 CFU to 57% at greater than or equal to 80 CFU compared with 4.1% at 0 CFU/ml and 45.4% at greater than or equal to 800 CFU/ml with the streak-plate method . The differences were statistically significant at the greater than or equal to 5 CFU level with regard to wound infection (P less than 0.001) and deep surgical infection (P less than 0.01) . It is concluded that the dip slide is a simple, rapid, and reliable method for the routine assessment of bacterial contamination in colorectal operations.

J Antimicrob Chemother, 1986 Dec, 18 Suppl E, 1 - 8
Beta-lactamase stability of imipenem; Labia R et al.; The beta-lactamase stability and interactions of imipenem were analysed in comparison with those of cefazolin, cefuroxime, cefoxitin, cefotaxime, ceftazidime, mezlocillin, piperacillin and penicillin G for a set of representative beta-lactamases . These enzymes included penicillinases such as those obtained from Staphylococcus aureus, Escherichia coli and other Enterobacteriaceae (TEM-1 and similar enzymes) (group A); cephalosporinases produced by Esch . coli (Amp C type), Serratia liquefaciens, Enterobacter cloacae, Pseudomonas aeruginosa (group B); and beta-lactamases produced by Klebsiella spp., Proteus vulgaris and Bacteroides fragilis and with a high hydrolytic activity for the newer cephalosporins (group C) . Enzymes of group A were demonstrated to be highly active against penicillins and also against the early cephalosporins; enzymes of group B showed hydrolytic activity for all other tested compounds, including the newer cephalosporins and cephamycins, but not imipenem, whereas enzymes of group C were highly active against the new cephalosporins but not against cephamycins and imipenem . In conclusion, imipenem shows a moderate affinity for all these enzymes but no detectable hydrolysis.

Antimicrob Agents Chemother, 1986 Dec, 30(6), 961 - 3
Antimicrobial activity of Ro 15-8074, active metabolite of a new oral cephalosporin (Ro 15-8075), against 7,775 recent clinical isolates; Jones RN et al.; Susceptibility testing of 7,775 recent clinical isolates from four medical centers showed Ro 15-8074 to be 2-to greater than 8-fold more active than either cefaclor or cefuroxime against the Enterobacteriaceae . Ro 15-8074 MICs for 50% of the strains tested were greater than or equal to 32 micrograms/ml for Staphylococcus spp., enterococci, Pseudomonas aeruginosa, and Pseudomonas maltophilia . beta-Lactamase hydrolysis experiments failed to demonstrate significant Ro 15-8074 inactivation by commonly encountered chromosomal or plasmid-mediated enzymes (P99, K1, K14, TEM, and CARB).

J Antimicrob Chemother, 1986 Dec, 18 Suppl E, 167 - 73
Severe gram-negative infections in neutropenic children cured by imipenem/cilastatin in combination with an aminoglycoside; Baruchel A et al.; Nine severe Gram-negative septicaemias in neutropenic (less than 500 neutrophils/mm3) children with neoplastic diseases were treated with imipenem/cilastatin (75 mg/kg/day) in combination with an aminoglycoside . The bacterial strains (Pseudomonas aeruginosa 7, P . putida 1, Enterobacter cloacae 1) were resistant to penicillins and cephalosporins, or were isolated during treatment with a broad-spectrum penicillin to which the bacterial strain was sensitive in vitro . The mean duration of neutropenia was 18.5 (3-51) days and duration of treatment 20 (8-51) days . Pyrexia was controlled in 2.8 (1-10) days and eradication of the pathogen from blood in one day . No clinical and biological adverse reaction was observed . These results show imipenem/cilastatin to be an effective treatment of infections in severely immunocompromised patients.

Scand J Dent Res, 1986 Dec, 94(6), 515 - 20
Biological activity of lipopolysaccharides from oral Selenomonas; Hofstad T et al.; Lipopolysaccharides (LPSs) were extracted by phenol-water from three oral strains of Selenomonas . The preparations were tested for the ability to induce a blastogenic response in cultures of spleen cells from normal and nude BALB/c mice, to activate guinea pig complement and the clotting enzyme system of Limulus polyphemus amoebocytes, and to kill Actinomycin-D treated mice . The capacity of the three LPSs was comparable to that of enterobacterial LPS.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1986 Dec, 183(1), 1 - 22
{Hygiene of meat production and processing}; Reuter G; Meat becomes unavoidably contaminated already at slaughtering . During storage and processing this contamination is increasing in a considerable degree . Cooling immediately and continuously enables a psychrotrophic saprophytic microflora to propagate . This will provoke characteristic spoilage after a longer period of storage or at interruption of the cooling chain . A limitation of total counts from the early beginning of meat processing increases stability of meat considerably . Potential pathogenic or toxinogenic microorganisms may occur, too . Their origin has to be seen at the living animals and at the meat handlers . These microorganisms may not be allowed a competitive growth within a comprehensive psychrotrophic microflora normally . On the other hand they may get hygienic importance as resistant parts to processing steps or as recontaminants after elimination of accompanying microflora . A good manufacturing practice must be directed by limiting growth criteria for microflora components . These are lower limits of growth temperature, water activity, pH-value or anaerobic condition after packing . A good manufacturing practice may be achieved considering the HACCP-concept: Meat and meat products must be defined as risk carriers according to animal and product specialties . The numerous microflora habitats have to be known very well . Generally the risk factors and especially the critical control points in each production area have to be explained . An effective control during process stages and/or of the final products must be applied . The determination of the total count or of the count of Enterobacteriaceae as indicator organisms may be suitable at the microbiological process control . Index microorganisms may be used at special final products . The practice of processing meat and meat products may be optimized considerably . The most important aspects concerning the questions mentioned before are listed in this paper.

Am Rev Respir Dis, 1986 Dec, 134(6), 1158 - 62
Effects of endotoxin and tannin isolated from cotton bracts on the airway epithelium; Cloutier MM et al.; The effects of increasing concentrations of tannin isolated from cotton bracts and endotoxin prepared from Enterobacter agglomerans on the electrophysiologic and ion transport properties of the canine tracheal epithelium mounted in Ussing chambers were examined . Results were compared with those obtained using cotton bracts extract (CBE) . Tannin concentrations in the isolated tannin and in the cotton bracts were analyzed spectrophotometrically . When added to the mucosal bathing solution, tannin produced a significant decrease in transepithelial potential difference and short-circuit current (lsc) with a maximal response at 25 microliter . The decrease in lsc was accounted for entirely by a decrease in net chloride secretion . The effects were reversible and specific for the mucosal bathing solution . In contrast to CBE, tannin had no effect on mannitol flux, suggesting no effect on the paracellular pathway . Endotoxin at a concentration of 10 micrograms/ml had no effect on the electrophysiologic properties of the canine trachea . We conclude that tannin in CBE is responsible for the decrease in lsc observed with aqueous extracts of CBE but is not responsible for the changes in the paracellular pathway . We also conclude that endotoxin alone has no effect on the airway epithelium.

J Antimicrob Chemother, 1986 Dec, 18(6), 667 - 74
Elimination of plasmids from Enterobacteriaceae by 4-quinolone derivatives; Michel-Briand Y et al.; Twelve 4-quinolones (cinoxacin, ciprofloxacin, enoxacin, flumequin, nalidixic acid, norfloxacin, oxolinic acid, pefloxacin, pipemidic acid, rosoxacin, and piromidic and beta-hydroxypiromidic acids) and novobiocin, were used at subinhibitory concentrations to eliminate from Escherichia coli 11 antibiotic resistance plasmids belonging to different incompatibility groups . The 12 4-quinolones were also tested for their ability to cure virulence plasmids from five species of Enterobacteriaceae . All quinolones eliminated three antibiotic resistance plasmids (R446b, R386, S-a) and one virulence plasmid (pWR105), but at a low rate . Optimal curing of antibiotic resistance plasmids was obtained in human urine . Two virulence plasmids (pWR24 and pWR110) were eliminated only by flumequin and pefloxacin . Novobiocin eliminated three antibiotic resistance plasmids (R446b, R386, pIP24) . The variable and low level of plasmid loss may be explained by the induction of the recA system . In addition, the inability to eliminate certain plasmids could be due to their presence in high numbers per cell.

J Clin Microbiol, 1986 Dec, 24(6), 1004 - 12
Centers for Disease Control performance evaluation program in bacteriology: 1980 to 1985 review; Griffin CW 3rd et al.; This report presents a summary and analysis of data from the Centers for Disease Control performance evaluation program in bacteriology for the 6-year period 1980 to 1985 . During this period, the number of laboratories enrolled in the program ranged from about 750 to 1,000 . Identification results reported by participating laboratories for representative species of six major groups of bacteria were placed into five response categories that were based on the level and accuracy of the identifications . Data on the performance of participants with bacterial groups and performance with selected species within each major group were analyzed . Overall, participants experienced the least difficulty in identifying species or serogroups of members of the gram-positive and gram-negative cocci . Participants encountered greater difficulties with anaerobes, gram-positive bacilli, and miscellaneous gram-negative bacteria . Identification of members of the family Enterobacteriaceae was of moderate difficulty . Problems in identifying certain bacterial species were probably related to a number of factors such as the characteristics of the species, its frequency of occurrence, the state of technology available for identification, and the state of proficiency and quality control in individual laboratories at the time of testing . Examples are given of improvements over time in the identification of certain bacterial species . Laboratories participating in an external proficiency testing program should take full advantage of the benefits of participation by instituting measures to correct testing deficiencies identified by the program.

J Appl Bacteriol, 1986 Dec, 61(6), 563 - 8
Differences in adhesiveness among type 1 fimbriate strains of Enterobacteriaceae revealed by an in vitro HEp2 cell adhesion model; Old DC et al.; Ten type 1 fimbriate strains of Enterobacteriaceae were examined in an in vitro adhesion assay with HEp2 epithelial cells . The range of HEp2 cell adhesiveness, which was characteristic for each strain, was affected by motility, type 1 fimbriation and production of mannose sensitive haemagglutinin . Nevertheless, not all type 1 fimbriate strains adhered well in this model . The findings are discussed with regard to the possibility that different type 1 fimbriate enterobacteria, though all are mannose sensitive, recognize different mannose-containing receptors present or available on the surfaces of the HEp2 cells.

Biochem J, 1986 Nov 15, 240(1), 215 - 9
Carboxy groups as essential residues in beta-lactamases; Little C et al.; Beta-lactamases are divided into classes A, B and C on the basis of their amino acid sequences . Beta-Lactamases were incubated at pH 4.0 with the carboxy-group reagent 1-(3-dimethylaminopropyl)-3-ethylcarbodi-imide plus a coloured nucleophile and the extents of inactivation and nucleophile incorporation were monitored . Two class A enzymes (from Bacillus cereus and Bacillus licheniformis) and two class C enzymes (from Enterobacter cloacae P99 and Pseudomonas aeruginosa) were examined . All four enzymes were inactivated, with total inactivation corresponding to the incorporation of approx . 2-3 mol of nucleophile/mol of enzyme . In the case of beta-lactamase I from Bacillus cereus, some 53% of the incorporated nucleophile was located on glutamic acid-168 in the amino acid sequence.

J Antimicrob Chemother, 1986 Nov, 18 Suppl D, 153 - 7
Treatment of skin and soft tissue infections with oral ciprofloxacin; Fass RJ; Thirty adult patients with severe skin and soft tissue infections (four with contiguous osteomyelitis) caused by a variety of bacterial pathogens were treated with oral ciprofloxacin . Favourable clinical responses were observed in 23 (92%) of the 25 evaluable cases . All Enterobacteriaceae and anaerobic bacteria were eradicated during treatment . Enterococci, Staphylococcus aureus, and Pseudomonas aeruginosa were usually eradicated but occasional strains persisted during treatment . Strains that persisted during treatment were associated with therapeutic failure in two cases, one with contiguous osteomyelitis and one with vascular gangrene . The only significant adverse reaction observed was nausea and/or vomiting in five of the 30 patients.

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