Zh Mikrobiol Epidemiol Immunobiol, 1986 Nov, (11), 59 - 63 {Importance of the vibriocinogenic factor in the ecology of Vibrio cholerae}; Somova AG et al.; The relationship between 433 V . cholerae strains and 571 enterobacterial strains, isolated from different ecosystems, have been studied by the method of "delayed antagonism" . The direct correlation between the virulence of V . cholerae and the width of the spectra of their antagonistic activity towards indicator bacteria was detected . The expediency of studies on the role of the vibriocinogenic factor in the survival of V . cholerae in different ecological systems is substantiated. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1986 Nov, 262(4), 455 - 61 A sensitive method for demonstration of decarboxylase activities amongst Enterobacteriaceae without use of pH indicators; James AL et al.; Lysine decarboxylase and ornithine decarboxylase activities have been demonstrated in a range of Enterobacteriaceae and related taxa by methods not involving pH indicators . Detection of the diamines produced, cadaverine and putrescine, was achieved by use of reagents based on 5-nitrosalicylaldehyde in the presence of triethanolamine and nickel ions . The method has been shown to be a simple and sensitive means for demonstration of decarboxylase activities when organisms were grown in the presence of the appropriate amino acid . Formation of highly coloured insoluble metal chelates was indicative of enzymatic activity . Results correlated well with existing indicator methods while being superior to the latter with respect to interpretation. Rev Infect Dis, 1986 Nov-Dec, 8(6), 927 - 31 Wounds caused by corn-harvesting machines: an unusual source of infection due to gram-negative bacilli; Agger WA et al.; The infectious complications in 23 patients with mutilating wounds due to trauma during corn harvesting were compared with those in 41 patients with factory-related hand injuries of similar severity . Initial cultures revealed bacterial growth in 89% of the agricultural wounds and in 63% of the factory wounds . A mean of 3.8 initial bacterial species were isolated per corn-harvesting wound vs . 0.9 species per factory wound . Gram-negative rods were recovered from 81% of the agricultural wounds; the commonest of these organisms were Enterobacter species and Xanthomonas maltophilia . Only 7% of factory-wound cultures grew gram-negative rods . Osteomyelitis, all with gram-negative rods, developed in five (22%) of the patients with farm injuries but did not occur in patients with factory wounds . More gram-negative rods were recovered from environmental cultures of corn-harvesting machines and corn plants than from those of factory machinery. Ann Emerg Med, 1986 Nov, 15(11), 1324 - 9 The bacteriology of dog bite wounds on initial presentation; Ordog GJ; Four hundred twenty patients with open dog bite wounds on initial presentation to the emergency department had Gram stains, aerobic and anaerobic cultures, and antibiotic sensitivities of the bacterial isolates of each wound . Forty-eight percent of the wounds evidenced no bacterial growth . Staphylococcus epidermidis was the most common isolate (20.5%) . Multiple bacteria were isolated in 15.5% of patients . Fifty percent of clinically infected wounds showed multiple pathogenic organisms, on both culture and Gram stain . The predominant pathogenic bacteria in clinically infected wounds were, in order, Enterobacteria, Pseudomonas, Staphylococcus aureus, Bacillus subtilis, and beta-Streptococcus . Gram stains were useful in determining specific antibiotic therapy in only 6% of infected cases and in 2% of uninfected cases . Statistical differences appeared between initially clinically infected and uninfected dog bite wounds, in both the types of bacteria and frequency of occurrence . Clinical infections were treated effectively with cephradine in more than 95% of cases . Infected wounds growing multiple pathogenic bacteria and/or Gram stains that showed multiple bacterial types were covered by a cephalosporin or penicillinase-resistant penicillin . Six percent of isolates could require an aminoglycoside for treatment. Surgery, 1986 Nov, 100(5), 857 - 62 Enterobacter bacteremia in surgical patients; Burchard KW et al.; The records of 63 surgical patients with one or more positive blood cultures for Enterobacter organisms were reviewed to determine clinical, epidemiologic, and mortality risk factors . Enterobacter bacteremia occurred, on the average, on the twenty-third day of hospitalization, most frequently in male patients (47), after antibiotic therapy (48 patients), placement of central venous catheters (38 patients), gastrointestinal tract operations (36 patients), and respiratory failure (31 patients) . Portals of entry were most commonly sputum (25 patients), open skin wounds (16 patients), and central venous lines (12 patients) . Mortality risk (22 patients, 35%) was increased with Enterobacter bacteremia occurring after the fifteenth day of hospitalization (18 of 45 patients versus 4 of 28 patients, p less than 0.01), a preceding Enterobacter focus (13 of 22 patients versus 9 of 41 patients, p less than 0.05), preceding non-Enterobacter bacteremia (10 of 15 patients versus 12 of 48 patients, p less than 0.02), preceding total parenteral nutrition (11 of 21 patients versus 11 of 42 patients p less than 0.01), respiratory failure (19 of 36 patients versus 3 of 27 patients p less than 0.01), and renal failure (11 of 12 patients versus 11 of 51 patients p less than 0.01) . The mortality risk was not diminished by specific antibiotic therapy . Enterobacter is emerging as an important pathogen in surgical patients . Prolonged antibiotic administration, particularly that of cephalosporins, may promote Enterobacter colonization of the tracheobronchial tree and skin with subsequent invasion enhanced by respiratory failure, open skin wounds, or central venous catheters traversing the skin . Mortality risk is determined primarily by factors associated with critical illness rather than effects of Enterobacter organisms and their specific treatment.(ABSTRACT TRUNCATED AT 250 WORDS) J Clin Microbiol, 1986 Nov, 24(5), 741 - 3 Comparative evaluation of the new Titertek Enterobac Rapid Automated System (TTE-RAS) for identification of members of the family Enterobacteriaceae; Anzivino D et al.; The Titertek Enterobac Rapid Automated System (TTE-RAS; Flow Laboratories, SpA, Milan, Italy), a new semiautomated system for the identification of members of the family Enterobacteriaceae, was compared with the API 20E system (API System P.A., Montalieu Vercieu, France) by using 284 clinically isolated strains that were previously identified by conventional methods . Six strains from the American Type Culture Collection (Rockville, Md.) were included to evaluate the reproducibility of identification by both systems . Correct identifications at the species level were 93.7% with TTE-RAS and 96.1% with API 20E . Although some of the features of the TTE-RAS data base were not satisfactory, we consider this new miniaturized system to be a very valuable tool for the rapid identification of the most frequently isolated opportunistic bacteria. Am J Dis Child, 1986 Nov, 140(11), 1147 - 51 Aztreonam therapy for serious gram-negative infections in children; Stutman HR et al.; Fifty-nine children were enrolled in an open trial of aztreonam, a monocyclic beta-lactam, therapy for serious gram-negative infections . Thirty-six infections were microbiologically evaluable and received five or more days of therapy . Patients' ages ranged from 3 days to 12 years, and diagnoses included pyelonephritis or cystitis (20), deep soft tissue or joint infection (seven), septicemia (four), pneumonia (three), peritonitis, and epiglottitis . Causative bacteria included Escherichia coli and other Enterobacteriaceae, Pseudomonas aeruginosa, and Haemophilus influenzae . The standard regimen was 30 mg/kg every six or eight hours intravenously . All isolates were aztreonam-susceptible and were eradicated during therapy . Two patients had microbiologic relapses: a patient with Salmonella choleraesuis meningitis who was initially treated for only ten days and a patient with E coli pyelonephritis . Clinical cure was achieved in 31 of 36 children . Pharmacokinetic studies performed in six children demonstrated no difference in serum concentrations or pharmacokinetic variables between day 1 and day 7 of therapy . Although several patients had transient eosinophilia (eight), elevated levels of aminotransferase (seven), or thrombocytosis (ten), no clinically significant adverse effects were noted . In this initial, uncontrolled study, aztreonam was effective and safe in the treatment of a variety of serious gram-negative infections in children. J Gen Microbiol, 1986 Nov, 132 ( Pt 11), 3113 - 35 A revised probability matrix for the identification of gram-negative, aerobic, rod-shaped, fermentative bacteria; Holmes B et al.; The results of the identification of 933 strains of Gram-negative, aerobic, rod-shaped, fermentative bacteria (Enterobacteriaceae, Pasteurellaceae, Vibrionaceae) by a probabilistic method, in a computer, are given . The identification rate on the matrix was 89.2% . Many of the strains were atypical and had caused difficulty in identification in medical diagnostic laboratories . The results are given for each taxon by genus and species. J Gen Microbiol, 1986 Nov, 132 ( Pt 11), 3105 - 12 Characterization of Enterobacter cloacae and E . sakazakii by electrophoretic polymorphism of acid phosphatase, esterases, and glutamate, lactate and malate dehydrogenases; Goullet P et al.; Acid phosphatase, esterases, and glutamate, lactate and malate dehydrogenases of 34 strains of Enterobacter cloacae and 22 strains of Enterobacter sakazakii were analysed by horizontal polyacrylamide agarose gel electrophoresis and by isoelectrofocusing in thin-layer polyacrylamide gel . The two species could be separated on the basis of distinct electrophoretic patterns of all enzymes analysed . Glutamate dehydrogenase and acid phosphatase were detected exclusively in E . cloacae, whereas esterase bands were more intensively stained in E . sakazakii . For each species, two zymotypes could be distinguished, on the basis of electrophoretic mobilities of malate dehydrogenase and banding patterns of esterase for E . cloacae, and by both isoelectric point and electrophoretic mobilities of an esterase and of lactate and malate dehydrogenases for E . sakazakii . The high degree of enzyme polymorphism within the two species permitted precise identification of strains . The variations in electrophoretic patterns might therefore provide useful epidemiological markers. Antimicrob Agents Chemother, 1986 Nov, 30(5), 694 - 700 Contribution of two different mechanisms to erythromycin resistance in Escherichia coli; Arthur M et al.; Escherichia coli BM2570 was resistant to high levels of erythromycin by two different mechanisms . The two genes conferring resistance to erythromycin in BM2570 were carried by a 150-kilobase self-transferable plasmid, pIP1527, and were cloned separately in E . coli . A single polypeptide with an Mr of 27,000 was encoded by the gene erxA and conferred high-level resistance to macrolide, lincosamide, and streptogramin B-type antibiotics by a mechanism other than drug inactivation . This resistance phenotype, not previously reported for a clinical isolate of enterobacteria, was probably due to modification of the ribosomes . The gene ereB encoded an enzyme with an Mr of 51,000 which inactivated erythromycin and oleandomycin . The two different mechanisms specified by erxA and ereB contributed in more than an additive fashion to the high level of resistance to erythromycin conferred by plasmid pIP1527 to E . coli BM2570. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1986 Nov, 262(4), 483 - 91 Effects of anti-Bacteroides-antibodies on Escherichia coli and different Bacteroides species in vitro and vivo; Rodloff AC et al.; Bacteroides species are known to cause synergistic pathogenicity in mixed infections with Enterobacteriaceae . In vitro studies showed that anaerobes may compete with aerobes for opsonisation thus interfering with the phagocytosis and killing of the latter by leukocytes . The present study investigated the effect of anti-Bacteroides-antibodies on in vitro phagocytosis of E . coli and on experimental mixed infections . It was shown that in vitro, B . fragilis suppressed the phagocytosis of E . coli by leukocytes only moderately . The addition of specific antibodies to the phagocytosis mixture could enhance this effect . However, antibodies in the absence of B . fragilis were also active suggesting a nonspecific mechanism such as blockade of Fc receptors . Prophylactic treatment with the immunoglobulin preparations failed to protect mice from experimental infections with E . coli and Bacteroides species. J Antibiot (Tokyo), 1986 Nov, 39(11), 1584 - 91 Antibacterial activity of BMY-28142, a novel broad-spectrum cephalosporin; Tomatsu K et al.; BMY-28142, 7-{(Z)-2-(2-aminothiazol-4-yl)-2-methoxyiminoacetamido}-3- (1-methylpyrrolidinio)methyl-3-cephem-4-carboxylate, exhibited a well-balanced, extended-spectrum of antibacterial activity both in vitro and in vivo . Against Staphylococci and Streptococci, BMY-28142 was about four to ten times more active than ceftazidime and comparable to cefotaxime . Most Enterobacteriaceae were more susceptible to BMY-28142 than to ceftazidime, though strains of Pseudomonas aeruginosa were slightly more sensitive to ceftazidime . BMY-28142 showed potent activity against Gram-negative bacteria resistant to ceftazidime and/or cefotaxime . Bactericidal activity of BMY-28142 against 10 strains of P . aeruginosa was superior to that of ceftazidime . In bacterial infection models in mice, BMY-28142 was more effective than ceftazidime against three Gram-positive and three Gram-negative pathogens . The anti-pseudomonal in vivo activity of BMY-28142 was nearly comparable to that of ceftazidime . The blood levels and urinary excretion rates of BMY-28142 in mice were similar to those of ceftazidime. Medicine (Baltimore), 1986 Nov, 65(6), 399 - 414 The characterization of bacterial and nonbacterial prostatitis by prostatic immunoglobulins; Shortliffe LM et al.; Although inflammatory diseases of most human secretory surfaces are difficult to investigate clinically, the secretory immune system of the human prostate may be studied relatively easily because prostatic fluid may be obtained from the gland by digital massage . We studied inflammatory conditions of the prostate to establish whether we could use the humoral immune response to differentiate these conditions . Using a sensitive solid-phase radioimmunoassay, we measured total IgA and IgG, and IgA and IgG antibodies to Enterobacteriaceae in the serum and prostatic fluid of men with and without prostatic inflammation . These studies show that levels of IgA and IgG in the prostatic fluid of men with bacterial prostatitis are higher than those in men without histories of urinary or prostatic infections . In men with bacterial prostatitis, prostatic antibodies to Enterobacteriaceae were elevated 12 to 18 months after curative treatment and indefinitely after ineffective treatment; anti-Enterobacteriaceal IgG levels returned to normal after infection only with cure . Total IgA and IgG in the prostatic fluid of men with nonbacterial prostatitis--men who have signs of prostatic inflammation without evidence of old or ongoing bacterial infection--are also higher than levels found in uninfected individuals . Although this finding supports an inflammatory etiology for the symptoms seen in nonbacterial prostatitis, no significant IgA or IgG Enterobacteriaceal antibody titers were detected in these patients . This excludes a remote Enterobacteriaceal infection as a cause of nonbacterial prostatitis . These observations confirm that the prostate gland is a distinct part of the male secretory immune system. Diagn Microbiol Infect Dis, 1986 Nov, 5(4), 345 - 9 In vitro activity of carumonam (RO 17-2301), BMY-28142, aztreonam, and ceftazidime against 7,620 consecutive clinical bacterial isolates; Fuchs PC et al.; For 45-60 days four geographically separate clinical laboratories tested routine clinical bacterial isolates for susceptibility to carumonam, aztreonam, BMY-28142, and ceftazidime by the broth microdilution method . All four drugs were highly active against Enterobacteriaceae, inhibiting greater than 96% of the 4887 strains tested at less than or equal to 8.0 microgram/ml . The minimal inhibitory concentration at which 50% of the isolates were inhibited for each drug was less than or equal to 0.125 micrograms/ml . Ceftazidime was the most active against nonenteric gram-negative bacilli (86% inhibited at less than or equal to 8.0 micrograms/ml), followed by BMY 28142 (82%), carumonam (75%), and aztreonam (68%) . The two monobactams exhibited no activity against gram-positive cocci at the concentrations tested, whereas BMY-28142 had excellent activity against nonenterococcal streptococci and good activity against staphylococci. Urol Clin North Am, 1986 Nov, 13(4), 673 - 83 Urinary tract infections in women; Fowler JE Jr; Bacteriuria in the adult female is properly classified according to the pathogenesis and frequency of the infectious process . The vast majority of infections are reinfections that are characterized by sequential infections caused by different organisms . Reinfections result from inoculation of bladder urine in the sterile urinary system by enterobacteria from the vaginal flora and may be occasional or frequent . Susceptibility to frequent reinfections is due to enhanced colonization of the vaginal mucosa by enterobacteria . Persistent infections are characterized by sequential infections caused by the same organism . These infections, which are always frequent, usually result from the continued inoculation of urine by an infected focus within the urinary system . Because of the expense of health care, the efficacy of antimicrobial therapy for reinfections, and the infrequency of serious morbidity associated with reinfections, the rationale for traditional components of patient management has been questioned . An analysis of diagnostic and treatment options and recommendations for the management of bacteriuric women seen by the urologist has been presented. J Med Microbiol, 1986 Nov, 22(3), 225 - 9 Effects of Bacteroides asaccharolyticus cells and B . fragilis surface components on serum opsonisation and phagocytosis; Jones GR et al.; The effect of Bacteroides asaccharolyticus on the opsonisation and phagocytosis of gram-positive and gram-negative bacteria by human polymorphonuclear leukocytes (PMNL) was investigated . Uptake of most isolates of staphylococci, streptococci and clostridia by PMNL after opsonisation with serum treated with B . asaccharolyticus was largely unimpaired . The same treatment of serum before opsonisation of isolates of Pseudomonas, Enterobacter, Klebsiella and Gardnerella resulted in the uptake by PMNL varying with individual isolates; a large reduction occurred with some and none with others . Treatment of serum with B . fragilis lipopolysaccharide before opsonisation of Proteus mirabilis produced a marked reduction in uptake, whereas treatment with B . fragilis capsular polysaccharide had little effect. Antimicrob Agents Chemother, 1986 Nov, 30(5), 684 - 8 Multiply resistant mutants of Enterobacter cloacae selected by beta-lactam antibiotics; Then RL et al.; Mutants of Enterobacter cloacae, selected in vitro with ceftriaxone, ceftazidime, carumonam, or aztreonam, fell into several distinct classes . Three mutants highly resistant to nearly all beta-lactam antibiotics were stably derepressed for beta-lactamase production . Although no other changes could be detected, virulence in a mouse septicemia model was decreased in two of these mutants . One mutant, 908-Ssi, showed selectively decreased susceptibility to ampicillin and cefotetan . A change in beta-lactamase expression was thought to be responsible for this . Alterations in the production of two outer membrane proteins with molecular sizes of 36.5 and 39 kilodaltons were responsible for multiple antibiotic resistance in two mutants, both of which acquired a low level of resistance to beta-lactam antibiotics . Whereas one of the mutants, AMA-R, simultaneously acquired resistance to chloramphenicol and trimethoprim, the other, AZT-R, became hypersusceptible to these and other hydrophobic agents . Both strains had drastically reduced virulence in mice. J Infect Dis, 1986 Nov, 154(5), 792 - 800 Type I beta-lactamases of gram-negative bacteria: interactions with beta-lactam antibiotics; Sanders CC et al.; The interaction of type I beta-lactamases with diverse beta-lactam compounds representing cephalosporins, cephamycins, penicillins, penams, penems, carbapenems, monobactams, and clavams was examined by using various Enterobacteriaceae and Pseudomonas aeruginosa as sources of the enzymes . The ability of a given drug to reversibly induce beta-lactamase was unrelated to its ability to select mutants stably derepressed for beta-lactamase production . Imipenem was one of the most-potent enzyme inducers, yet it did not select derepressed mutants . Many of the newer cephalosporins were poor enzyme inducers but readily selected derepressed mutants . Resistance to hydrolysis did not predict a drug's inhibitory activity against derepressed mutants . The activity of the penems, penams, and carbapenems was least affected by derepression of beta-lactamase, whereas the activity of anionic cephalosporins and aztreonam was most affected. Immun Infekt, 1986 Nov, 14(6), 232 - 5 {Selection of resistant variants by broad spectrum beta-lactam antibiotics: to what extent is there cross resistance between imipenem and other beta-lactam antibiotics?}; Kahan F et al.; Resistant variants can be selected in the presence of most of the recently developed beta-lactam antibiotics thus resulting in cross resistance between penicillin-, cephalosporin- and monocyclic derivatives except for imipenem . Among the Enterobacteriaceae-resistant so-called beta-lactamase-overproducing variants can be selected in some species in the presence of various broad-spectrum beta-lactams except for imipenem . However, imipenem-resistant variants can be selected from clinical Pseudomonas aeruginosa isolates in a frequency comparable to those obtained for other beta-lactams . Imipenem resistance in Pseudomonas aeruginosa is presently understood to be independent of either enzymatic degradation or an alteration of the penicillin-binding proteins; moreover, it has to be attributed to characteristic changes of the outer membrane proteins, thus explaining imipenem resistance due to impaired penetration . Consequently, resistance to imipenem in Pseudomonas aeruginosa has to be considered independent of resistance to other beta-lactams. Am J Clin Pathol, 1986 Nov, 86(5), 608 - 18 The anti-microbial activity, beta-lactamase stability, and disk diffusion susceptibility testing of carumonam (RO 17-2301, AMA-1080), a new monobactam; Jones RN et al.; Carumonam, a new monobactam, was found to have an anti-microbial spectrum similar to aztreonam . Its spectrum includes Enterobacteriaceae, Haemophilus influenzae, pathogenic Neisseria species, Pseudomonas aeruginosa, and some streptococci . Staphylococcus species, enterococci, and many other nonenteric gram-negative bacilli were not inhibited . Enterobacteriaceae resistant to cefoperazone (minimum inhibitory concentrations {MICs} greater than or equal to 32 mg/L) were more likely inhibited by carumonam (52% at less than or equal to 8.0 mg/L) than aztreonam (39%) or ceftazidime (35%) . Dilution test methods on agar or in Mueller-Hinton broth produced similar results . Carumonam minimum bactericidal concentrations were usually the same or one dilution above the MIC . Carumonam and aztreonam were very stable to most chromosomal (P99, K1, K14) and plasmid-mediated beta-lactamases (TEM, OXA, PSE) . The Klebsiella oxytoca enzymes hydrolyzed aztreonam at rates greater than or equal to fivefold higher than carumonam but at a rate less than 1% that of cephaloridine . The aztreonam MICs for these Klebsiella stains were greater than or equal to 32 mg/L, but the hydrolysis rates do not fully explain the high-grade resistance to aztreonam . In vitro susceptibility tests with 30-micrograms carumonam disks were found to be very predictive . Similar regression statistics were observed for aztreonam and cefotaxime . Recommendations for carumonam susceptibility testing are susceptible greater than or equal to 21 mm (less than or equal to 8.0 mg/L) and resistant less than or equal to 14 mm (greater than or equal to 32 mg/L) . Cross-resistance analysis favors the independent testing of carumonam or aztreonam against gram-negative species other than Enterobacteriaceae and P . aeruginosa. Rev Infect Dis, 1986 Nov-Dec, 8 Suppl 5, S579 - 82 Efficacy of sulbactam plus ampicillin in gynecologic infections; Giamarellou H et al.; The efficacy of sulbactam plus ampicillin in the treatment of various gynecologic infections was evaluated in 24 women (median age, 35 years) . Ten women had pelvic cellulitis plus vaginal cuff abscess; six, pyeloperitonitis; three, vaginal cuff abscess; three, surgical wound sepsis; one, tubo-ovarian abscess; and one, endometritis . Surgical procedures preceding infection included abdominal hysterectomy, ovarian cyst removal, ectopic pregnancy, correction of cystocele, and uterine dilatation and curettage . Twenty patients received 1 g of sulbactam plus 1 g of ampicillin per dose; four received 0.5 g of sulbactam plus 1 g of ampicillin per dose . The combination was given iv every 6 hr for three to four days and then im every 8 hr for three to five days (mean treatment duration, seven days) . Pus cultures yielded Enterobacteriaceae (21 cases), enterococci (two), Bacteroides fragilis (12), other Bacteroides species (five), Peptococcus species (nine), Peptostreptococcus species (seven), and other anaerobes (five) . Six infections were purely anaerobic; 18 were mixed . All but two infections were cured by both clinical and bacteriologic criteria, with no adverse reactions . Parenteral sulbactam/ampicillin seems safe and effective in the treatment of gynecologic infections of moderate severity. Rev Infect Dis, 1986 Nov-Dec, 8 Suppl 5, S569 - 75 A randomized, double-blind comparison of sulbactam/ampicillin and clindamycin for the treatment of aerobic and aerobic-anaerobic infections; Reinhardt JF et al.; In a randomized, prospective, double-blind trial, sulbactam/ampicillin was compared with clindamycin in terms of efficacy and safety for the treatment of bacterial infections . Both sulbactam/ampicillin and clindamycin were given with gentamicin when this course was indicated by clinical or laboratory findings . In five patients the site of infection was pleuropulmonary; in 14, bone; in 11, skin and soft tissue; and in one, intraabdominal . The commonest anaerobes isolated were anaerobic cocci and Bacteroides species; the commonest aerobic and facultative bacteria were Enterobacteriaceae, Pseudomonas aeruginosa, and various gram-positive cocci . All of six assessable patients given sulbactam/ampicillin alone had satisfactory clinical responses, as did seven of nine patients given sulbactam/ampicillin plus gentamicin, all of six patients given clindamycin alone, and six of nine patients given clindamycin plus gentamicin . Pathogens were totally or partially eradicated in four of five, eight of nine, four of five, and three of nine assessable patients given these same regimens . Adverse reactions and laboratory abnormalities were relatively uncommon . Overall, sulbactam/ampicillin was as effective as clindamycin in the treatment of aerobic or mixed aerobic-anaerobic infections; however, the concomitant use of gentamicin was frequently required with both regimens. Antibiot Med Biotekhnol, 1986 Nov, 31(11), 863 - 6 {Resistance to antibiotics and sulfanilamides of enterobacteria isolated in Ulyanovsk Province}; Vos'mirko VL; The data on resistance to 10 antibiotics and sulfanilamides of 178 coprocultures of Enterobacteriaceae isolated from patients in the Ulyanovsk Region are presented . It is indicated that 93.8 per cent of the isolates were resistant to the antibiotics . The majority of the cultures were resistant to ampicillin, tetracycline and streptomycin and sensitive to gentamicin, polymyxin, trimetoprim, rifampicin and nalidixic acid . 43 combinations of the antibiotic resistance types were revealed . 92.7 per cent of the isolates were resistant to the sulfanilamides. J Hosp Infect, 1986 Nov, 8(3), 300 - 4 A study of some factors associated with wound infection; Abussaud MJ et al.; Five hundred and four surgical patients were studied at Princess Basma Hospital, North Jordan, during the period April 1984-January 1985 . The overall postoperative wound infection rate was 3.6% . In clean surgery 1.1% of wounds were infected and in potentially contaminated and contaminated surgery the infection rate was 3.3% and 18.5% respectively . Major organisms isolated from infected wounds were Staphylococcus aureus (55.5%), Escherichia coli (16.6%), Proteus vulgaris (11.1%), Pseudomonas aeruginosa, Enterobacter aerogenes and Aeromonas hydrophilia, each with 5.6% . Use of a wound drain, duration of operation and carriage of Staph . aureus by the patient were associated with a higher frequency of wound infection. J Hosp Infect, 1986 Nov, 8(3), 268 - 74 The use of alcoholic paper wipes for routine hand cleansing: results of trials in two hospitals; Jones MV et al.; The use of alcoholic paper hand wipes by nursing staff was assessed in two trials . No significant changes in total viable counts from finger imprint samples were observed when wipes were used, but some decrease in samples positive for Enterobacteriaceae and Staphylococcus aureus was recorded . The wipes were found to be pleasant and convenient to use . It is concluded that wipes are an acceptable alternative to soap and water for routine hand cleansing. Infection, 1986 Nov-Dec, 14(6), 289 - 93 Induction of an atypical interferon by bacteroides fragilis and Escherichia coli in experimental infections and in leukocyte cultures; Blanchard DK et al.; Previous reports have shown that Bacteroides fragilis may enhance the pathogenicity of coinfecting enterobacteriaceae by interfering with the host's immune response . With the present study, we have investigated the possible role of interferons (IFN) in mediating these effects . Mice injected with B . fragilis developed moderate serum levels of IFN that appeared just prior to alterations of the animals' immunity described earlier . The IFN was neutralized by treatment with anti-IFN-alpha/beta-antibodies or hydrochloric acid; hence it displayed the same "atypical" characteristics as IFN found in patients with immuno-compromising diseases such as AIDS, systemic lupus erythematosus or rheumatoid arthritis . Escherichia coli displayed the same induction patterns as B . fragilis, while gram-positive bacteria induced "regular" IFN alpha/beta and gamma . Spleen cells, peritoneal macrophages, or liver leukocytes taken from B . fragilis or E . coli-injected animals 6 h post infection were refractory to IFN induction by E . coli lipopolysaccharide in vitro; cells from mice infected with gram-positive organisms showed normal or enhanced responsiveness. J Bacteriol, 1986 Nov, 168(2), 715 - 21 Biosynthesis of enterobacterial common antigen requires dTDPglucose pyrophosphorylase determined by a Salmonella typhimurium rfb gene and a Salmonella montevideo rfe gene; Lew HC et al.; In group C1 salmonellae, rfe and rff genes linked to the ilv locus specify the synthesis of a glycolipid called the enterobacterial common antigen . In contrast, in group B salmonellae the synthesis requires in addition some of the genes in the rfb cluster, the main genetic determinant of the O side chains of lipopolysaccharide . In an effort to define the biochemical functions of these rfb genes, we looked in Salmonella typhimurium LT2 (group B) for rfb mutants in which the synthesis of both enterobacterial common antigen and the O side chains would be blocked in a manner suppressible by the wild-type rfe cluster of S . montevideo, of group C1 . We found one mutant with these characteristics . This rfb mutation affected the activity of dTDPglucose pyrophosphorylase (glucose-1-phosphate thymidylyltransferase, EC 2.7.7.24) . Whereas the rfe cluster of S . montevideo contained a gene producing this enzyme activity, there was no evidence for the presence of such a gene in the rfe cluster of group B strains . These results also showed that the synthesis of dTDP-glucose is necessary for the biosynthesis of enterobacterial common antigen; this conclusion fits with the recent demonstration of 4-acetamido-4,6-dideoxy-D-galactose as a component of enterobacterial common antigen (Lugowski et al., Carbohydr . Res . 118:173-181, 1983), because the biosynthesis of the donor of this sugar, dTDP-4-acetamido-4,6-dideoxy-D-galactose, requires dTDPglucose pyrophosphorylase. Presse Med, 1986 Oct 18, 15(36), 1813 - 8 {Failure of new beta-lactam antibiotics in the treatment of severe Enterobacter cloacae infections}; Perronne C et al.; In 12 patients infected with an Enterobacter cloacae (E . cl.) initially susceptible to the 3rd generation cephalosporins, we observed the emergence in vivo of variants resistant to most of the new beta-lactam antibiotics (carboxy-penicillins, ureido-penicillins, 3rd generation cephalosporins and aztreonam) . These variants remained susceptible to mecillinam and imipenem . The variant emerged under treatment with cefotaxime in 3 cases, with moxalactam in 3 cases, with aztreonam, carbenicillin, and ticarcillin in 1 case each and without treatment in 1 case . An aminoglycoside was combined with the beta-lactam antibiotic in 6 cases . Therapeutic failure was attributed to emergence of the resistant variant in 6 out of 12 cases (with an aminoglycoside in 3 cases, with the beta-lactam antibiotic alone in 3 cases) . These case reports underline the importance of bacteriological monitoring of patients infected with E . cl . treated with a beta-lactam antibiotic . The susceptibility to beta-lactam antibiotics of the E . cl . strains isolated during treatment should be systematically retested. J Immunol, 1986 Oct 15, 137(8), 2676 - 81 A synthetic analogue of Escherichia coli lipoprotein, tripalmitoyl pentapeptide, constitutes a potent immune adjuvant; Lex A et al.; Lipoprotein from the outer membrane of Escherichia coli and other Enterobacteriaceae constitutes a potent B lymphocyte mitogen and polyclonal activator in various species . Tripalmitoyl pentapeptide (S-(2,3-bis-(palmitoyloxy)-(2RS)-propyl)-N-palmitoyl-(R)-cysteinyl -(S)-seryl-(S)-seryl-(S)-asparaginyl-(S)-alanine) is a synthetic analogue of the N-terminal part of lipoprotein and has, in all assays tested, a biologic activity similar to native lipoprotein . It also exhibits a strong adjuvant activity in vitro: In the presence of 3.3 to 33.3 micrograms/ml of tripalmitoyl pentapeptide, the stimulation of the primary antibody response toward underivatized sheep red blood cells (SRBC) and toward trinitrophenylated (TNP-) SRBC was markedly enhanced, as measured by a direct hemolytic plaque assay . At optimal mitogen- and antigen-doses, plaque formation was increased up to 100-fold, and at suboptimal doses (0.03 to 0.3 microgram/ml) a 10- to 60-fold increase of plaque numbers was achieved . In the presence of tripalmitoyl pentapeptide, the antigen-specific IgM response was increased about sevenfold and the IgG response was augmented about 10-fold, as measured by ELISA . Similarly, in the secondary in vitro response to TNP-SRBC, a 7 to 10-fold enhancement of the antibody titer was obtained in the presence of the adjuvant . The application of tripalmitoyl pentapeptide and antigen had to occur concurrently in order to achieve a strong adjuvant effect . Addition of tripalmitoyl pentapeptide to the cell cultures 1 day after or 1 day before antigen application had no significant positive effect, and in several instances a decrease in antibody production was found . Thus, tripalmitoyl pentapeptide, a well-characterized synthetic product available in major amounts, constitutes a potent immune adjuvant for potential animal and clinical use. Presse Med, 1986 Oct 11, 15(34), 1715 - 8 {Severe infections associated with chronic lymphoid leukemia . 159 infectious episodes in 60 patients}; Travade P et al.; This retrospective hospital study concerns 159 infectious episodes observed in 60 patients with chronic lymphoid leukaemia (CLL) staged A, B or C on first admission . The most frequent site of infection was pulmonary (33%), followed by ENT and stomatological infections (15%), septicaemia (9%), urinary and genital tracts infections (9%), herpes virus infections (9%), skin and soft tissue purulent sepsis (8%), digestive tract (3%) and meningeal (1%) infections and isolated fever (8%) . Seventy nine bacteria were isolated, including 35 Gram-positive cocci (Staphylococcus spp . 12, Streptococcus spp . 13, D . pneumoniae 5, Enterococcus spp . 5), 43 Gram-negative bacilli (Enterobacteriaceae 36, Pseudomonas spp . 5, Haemophilus influenzae 2) and 1 M . tuberculosis . The other documented infections were: candidiasis 11, viral infections 19 (including 17 of the herpes group) and 2 parasitoses (1 pneumocystosis, 1 toxoplasmosis) . Sixteen patients died of toxic -infectious shock (9 cases, including 1 meningitis) or pneumonia (7 cases, including one chicken-pox) . Stage C leukaemia and granulopenia (less than 1 X 10(9) PN/l) were associated with significantly more frequent and severe infections. Jpn J Antibiot, 1986 Oct, 39(10), 2795 - 802 {Clinical investigation of the biliary excretion of cefoperazone in obstructive jaundice}; Matsumoto T et al.; In the present study, we investigated the biliary excretion of cefoperazone (CPZ) in patients with complete obstruction in the lower bile duct governing PTC drainage, i.e., patients with completely blocked enterohepatic circulation . The blockage was observed to cause a delay in the excretion of CPZ due to hepatic dysfunction and the half-life of CPZ levels in serum was as long as 4.9 hours on the average . This is approximately the same as the half-life of 4.8 hours in hepatic dysfunction reported by Belaieff . Biliary concentration of CPZ reached their peak levels within the first 2 to 6 hours . The time to peak in cases with hepatic dysfunction was similar to that reported by observed in patients without hepatic dysfunction Yura et al . In our cases, however, peak biliary concentrations of CPZ were observed to be between 28 to 954 micrograms/ml with a mean of 320.5 micrograms/ml . These peak levels were lower than those reported by several investigators, but sufficiently effective concentrations seem to have been achieved in the bile even in jaundice because MIC80 values of CPZ are reported to be 6 to 10 micrograms/ml against E . coli, Klebsiella, and Enterobacter and 50 micrograms/ml against the most resistant Serratia . As mentioned above, the lowest peak biliary concentration was found to be 28 micrograms/ml and peak levels reached at least 50 micrograms/ml in 8 out of the 10 patients . Urinary concentrations of CPZ reached their peak levels within the first 30 minutes to 2 hours and CPZ urinary recovery ratio in 24 hours was 24.2 to 93.1% with a mean of 64.1%.(ABSTRACT TRUNCATED AT 250 WORDS) J Antimicrob Chemother, 1986 Oct, 18 Suppl C, 159 - 64 Impact of orally administered antimicrobial agents on human oropharyngeal and colonic microflora; Nord CE et al.; Phenoxymethylpenicillin, bacampicillin, clindamycin, erythromycin and doxycycline were given orally to 46 subjects for seven days . The numbers of aerobic and anaerobic bacteria in the oropharyngeal and colonic microflora were determined as were the concentrations of antimicrobial agents in saliva and faeces . Clindamycin, erythromycin and doxycycline were detected both in saliva and faeces . Phenoxymethylpenicillin, bacampicillin and doxycycline caused only minor changes in the microflora, while pronounced suppression of anaerobic bacteria was noticed when clindamycin was administered . Erythromycin decreased the aerobic bacteria in the oropharynx and both aerobic and anaerobic bacteria in the colon . New colonizing clostridia, enterobacteria and fungi were found both in the oropharynx and in the colon when erythromycin and clindamycin were administered. Antibiot Med Biotekhnol, 1986 Oct, 31(10), 760 - 4 {Antibacterial activity of dioxidine under aero- and anaerobic conditions}; Bol'shakov LV; The activity of dioxidine under the conditions of aerobiosis was studied with respect to 23 bacterial species (443 strains) . High activity of dioxidine against enterobacteria and its less pronounced activity against P . aeruginosa, Staphylococcus and Enterococcus were shown . It was found for the first time that dioxidine was active against H . alvei, M . lacunata, M . nonliquefaciens, A . anitratus, A . lwoffii and P . maltophilia . Comparative activity of dioxidine under the conditions of aerobiosis and anaerobiosis against 21 bacterial species (101 strains) was investigated . It was demonstrated that under the conditions of anaerobiosis the activity of dioxidine increased 4-128 times . The coefficient of the increase in the antimicrobial activity of dioxidine depended on the species and strain of the bacteria and mainly on the initial level of the drug sensitivity . Thus, with respect to the strains having the MIC of 125 to 1000 micrograms/ml or higher under the conditions of aerobiosis the antibacterial activity of dioxidine increased 16-128 times . However, with respect to the highly sensitive strains (MIC of dioxidine under the conditions of aerobiosis was equal to 4-8 mg/ml) the antimicrobial activity of the drug increased only insignificantly i.e . 4-8 times . The results of the study indicated that the use of dioxidine as a reserve drug in treating pyoinflammatory infections such as phlegmon, abscesses, etc., developing at lowered concentrations of oxygen in the tissues was promising. Am J Reprod Immunol Microbiol, 1986 Oct, 12(2), 55 - 7 Short-term failure of IUD removal to alter bacterial flora in a patient with chronic anaerobic endometritis; Monif GR; PIP: A case study is reported of a 34-year-old para 4-0-1-4 with cytological and clinical evidence of IUD-associated anerobic endometritis . The purpose of this report is to use quantitative and qualitative microbiology in conjunction with sophisticated anerobiology in analyzing the impact of IUD removal on the deep endocervical flora of a patient with IUD-related chronic polymicrobial anerobic endometritis (CAE) . Approximately 6 years and 7 months before the examination, the patient had a Dalkon Shield inserted following the birth of her 4th child . About 6 months prior to referral to the Shands Teaching Hospital, the patient began experiencing menstrual irregularities . A routine Papanicolaou smear performed 5 months later revealed pseudomycelial clumps of bacteria that stained positive with a silver stain amidst an intense inflammatory background . On the basis of the cytological findings and the history of menstrual irregularities, the diagnosis of CAE was made and the patient was referred for evaluation and IUD removal . In retrospect, it was learned that the patient had been having a malodorous intermenstrual discharge for an unspecified period of time . The patient was microbiologically sampled on the 20th day of the ensuing cycle and 1 week later . Because of persistence of the anerobic endocervical flora, a single 2-g dose of metronidazole was administered . The patient was re-examined at 9 days and 7 weeks post therapy . Table 1 lists the qualitative bacteriological data, aerobic and anerobic, of the pre- and postremoval cultures . Papanicolaou smears made directly from the IUD demonstrated the presence of Gram-positive filamentous bacteria morphologically consistent with "Actinomyces israelii." With the exception of an interchange among the Enterobacteriaceae, a quantitative reduction of the alpha streptococci and the elimination of the Gram-negative nonfermenting bacilli, there were no significant changes in the aerobic flora prior to IUD removal and 28 days later . Besides the post-IUD removal culture and premetronidazole culture 7 days later, the alpha streptococci were further reduced below threshold quantities following metronidazole administration . Following IUD removal, the "Propionibacterium" species and "Actinomyces israelii" were eliminated . The 6 other anerobic bacteria -- "Peptococcus" species, "Peptostreptococcus" species, Gram-positive nonsporeforming bacilli, "Bacteroides fragilis," "Bacteriodes melaninogenicus," and "Fuscobacterium" species -- persisted . No significant quantitative changes occurred . The only change in the post-IUD removal and premetronidazole culture was greater than 3 log increase in the peptococci present . Following the administration of metronidazole, the anerobic flora was eradicated . Acta Pathol Microbiol Immunol Scand {B}, 1986 Oct, 94(5), 365 - 7 Two isolations of enteric group 69 from human clinical specimens; Sogaard P et al.; Enteric Group 69 has previously only been isolated from beef muscle . Two cases of isolations from human clinical specimens are reported on here: One from a throat swab and one from an abscess . In both cases, only EG 69 was cultured . This group has biochemical reactions similar to Enterobacter cloacae and Enterobacter sakazakii . EG 69 produces yellow pigment as E . sakazakii but only the former ferments sorbitol and dulcitol . EG 69 utilizes malonate and usually ferments sucrose slowly (3-4 days) . EG 69 is distinguished from E . Cloacae by production of yellow pigment, fermentation of dulcitol and usually late fermentation of sucrose . EG 69 was found resistant to ampicillin and carbenicillin and susceptible to cephalothin . The pathogenic potential for man is still questionable, but EG 69 is shown to occur in human clinical specimens. J Antimicrob Chemother, 1986 Oct, 18 Suppl C, 43 - 50 Induction of chromosomal beta-lactamase expression in enterobacteria; Lindberg F et al.; Enterobacteria and Pseudomonas express evolutionarily related chromosomally encoded beta-lactamases . These enzymes have a high affinity for modern cephalosporins, and beta-lactamase overproduction is the most important factor in the development of resistance against such drugs . In some species the beta-lactamase is produced constitutively at a low level, and mutations to high expression occur only infrequently . In other species beta-lactamase synthesis can be induced by beta-lactams, and mutation to constitutive overexpression of the enzyme is a frequent event . We discuss the current knowledge concerning the genetic basis of the two different modes of beta-lactamase regulation, as well as the mechanisms through which a high level of beta-lactamase synthesis is reached. J Antimicrob Chemother, 1986 Oct, 18 Suppl C, 215 - 21 Epidemiology of trimethoprim resistance; Amyes SG; Trimethoprim resistance in the Enterobacteriaceae has been dominated by the spread of two genes encoding different dihydrofolate reductases (types IA and II) . The original carriage of these genes was by transferable bacterial plasmids . Now, however, one of these genes is often found to be located on the bacterial chromosome . Two new plasmid-mediated dihydrofolate reductases have been identified . One of these enzymes (type IV) confers a low degree of insusceptibility but is inducible, to give levels 600 times higher than the bacterial host enzyme . The technique used to demonstrate the plasmids that carry the gene for this enzyme suggests that they would not be identified by the plasmid transfer methods in current use. Helv Paediatr Acta, 1986 Oct, 41(4), 311 - 5 Bacterial meningitis in infants two to six weeks old; Benderly A et al.; We reviewed our experience with bacterial meningitis in older neonates (2 to 6 weeks of age) during a five-year period . Seventeen patients with bacterial meningitis were diagnosed and treated . Bacteria recovered from the cerebral spinal fluid (CSF) included pneumococci (29%), E . coli and meningococci (23% each), group B streptococci (12%), Enterobacter and H . influenzae (6% each) . There were no cases of Listeria monocytogenes . The mean duration of symptoms before admission was 3.1 days . The mortality rate was high (30%), and 36% of the patients had significant neurologic residua . Our study shows that this specific age group is different from newborns or older infants . Therefore, the initial selection of antibiotics for the treatment of meningitis in this age group should include antibiotics that are effective across this spectrum of potential pathogens. Antimicrob Agents Chemother, 1986 Oct, 30(4), 611 - 3 In vitro activity of DQ-2556, a new cephalosporin; Fujimoto T et al.; The in vitro antibacterial activity of DQ-2556, a new semisynthetic cephalosporin, was compared with that of ceftazidime and cefotaxime . The activity of DQ-2556 against members of the family Enterobacteriaceae was roughly comparable to that of cefotaxime . Against Pseudomonas aeruginosa, DQ-2556 was slightly less active than ceftazidime . DQ-2556 was more active than the reference cephalosporins against staphylococci . Haemophilus influenzae and Neisseria gonorrhoeae were also highly susceptible to DQ-2556. Pathol Biol (Paris), 1986 Oct, 34(8), 908 - 12 {Interactions of ceftriaxone with beta-lactamases including those which hydrolyze cefotaxime}; Labia R et al.; As it occurs with most of 3rd generation cephalosporins, ceftriaxone has few, if any, interactions with penicillinase-type beta-lactamases, such as TEM-1, TEM-2 or PIT-2 . These poor interactions are characterized by an extremely low hydrolysis, associated to a poor affinity of these compounds for the penicillinases . Conversely, ceftriaxone, as cefotaxime, shows a high affinity for chromosomally-mediated cephalosporinases (indole-positive Proteus, Enterobacter, Pseudomonas...), which is characterized by Ki values ranging from about 0.05 to 1 microM . Within these beta-lactamases, the hydrolysis of ceftriaxone, as that of cefotaxime, is always low, but significant . Then few beta-lactamases are able to hydrolyze more efficiently cefotaxime, as cefuroxime, such as those produced by P vulgaris and K oxytoca . Within these enzymes, ceftriaxone is also hydrolyzed, in a way quite similar to that of cefotaxime. J Bacteriol, 1986 Oct, 168(1), 348 - 56 Immunocytochemical localization of enterobacterial common antigen in Escherichia coli and Yersinia enterocolitica cells; Acker G et al.; Enterobacterial common antigen (ECA) was localized on Lowicryl K4M sections and on ultrathin cryosections by using either a mouse monoclonal antibody or an absorbed rabbit polyclonal immune serum with the corresponding gold-labeled secondary antibodies . Comparable results were obtained with both monoclonal antibody and polyclonal immune serum . Controls with two ECA-negative mutants revealed the ECA specificity of both labeling systems . On Lowicryl K4M sections, good labeling of the outer membrane and of membrane-associated areas in the cytoplasm was obtained . Unexpectedly, however, the ribosome-containing areas of the cytoplasm also showed significant labeling . On ultrathin cryosections, labeling of the cytoplasmic areas was much weaker, although the density of label in the outer membrane was comparable to that obtained with the Lowicryl K4M sections . With the techniques used, it cannot be completely excluded that the appearance of ECA in the cytoplasm is due to displacement of ECA-reactive sites during the preparation procedure. Pathology, 1986 Oct, 18(4), 379 - 81 The effect of casein derivatives on glycine enhancement of beta-lactamase production in Enterobacter cloacae ATCC.13047; Gatus BJ et al.; Our earlier work showed that glycine enhancement of class I beta-lactamase production in Enterobacter cloacae ATCC.13047 was greater on Isosensitest Agar than on other laboratory media . In the present study it was demonstrated that Casein Hydrolysate was the constituent of Isosensitest Agar which was necessary for glycine enhancement of beta-lactamase production . Also, a comparison of the effect of casein and casein derivatives on glycine enhancement of beta-lactamase production showed that acid hydrolysis of casein was a prerequisite for glycine enhancement of beta-lactamase production . Enterobacter cloacae ATCC.13047 failed to grow on a medium containing casein, and glycine enhancement of beta-lactamase production did not occur on a medium containing tryptic hydrolysate of casein . The effect on beta-lactamase production of variations in the concentrations of both Casein Hydrolysate and glycine was examined by titration of both components in a chequerboard fashion . Beta-lactamase production was influenced by the concentrations of both Casein Hydrolysate and glycine . This inter-relationship indicated that there was a balance between the concentrations of Casein Hydrolysate and glycine and that alterations in this balance modified beta-lactamase production . The significance of the observations is discussed in relation to the factors which influence glycine enhancement of beta-lactamase production in Enterobacter cloacae ATCC.13047. J Antimicrob Chemother, 1986 Oct, 18 Suppl B, 31 - 8 Genetic and biochemical basis of resistance of Enterobacteriaceae to beta-lactam antibiotics; Wiedemann B; Resistance to beta-lactam drugs is usually determined by genes mediating the production of beta-lactamases . These genes can be located on resistance plasmids or on the chromosome . Resistance to drugs which have been available for many years is mostly transposable . Although the origin of these genes is not known, it is possible to draw a hypothetical flow diagram of the evolution of resistance genes in general . The mechanism of resistance although mediated in Gram-negative bacteria mostly by beta-lactamases cannot be simply described as the hydrolytic function of the enzyme . It is a complex interaction involving the affinity of the drug for the target and the lactamase, the amount of drug in the periplasmic space, the amount of enzyme and the number of lethal target sites . Usually one of these factors is predominant. Antimicrob Agents Chemother, 1986 Oct, 30(4), 559 - 64 Antigenic relationships among penicillin-binding proteins 1 from members of the families Pasteurellaceae and Enterobacteriaceae; Schryvers AB et al.; Penicillin-binding proteins (PBPs) from Haemophilus influenzae RD purified by a combination of affinity chromatography, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and electroelution were used to immunize rabbits to obtain specific antisera . Antisera directed against PBP 1 (1b) of H . influenzae cross-reacted with representative organisms of the family Pasteurellaceae and with many members of the family Enterobacteriaceae but not with other gram-negative organisms . Immunization with purified PBP 3 of H . influenzae produced antisera that reacted with PBP 1 (1b) of H . influenzae and showed the same cross-reactive pattern with other species as the anti-PBP 1 antiserum . A 24,000-molecular-weight polypeptide of H . influenzae, not radiolabeled by {35S}penicillin, reacted with antisera against purified PBPs 1 (1a, 1b), 2, and 3 . The results suggest that antigenic epitopes are shared among similar PBPs from related species and even among different PBPs within the same species. Eur J Clin Microbiol, 1986 Oct, 5(5), 502 - 6 Effect of changing selection pressures on trimethoprim resistance in Enterobacteriaceae; Towner KJ et al.; The incidence of trimethoprim resistance was correlated with changes in prescription behaviour in the Nottingham area from 1978-1985 . The prevalence of trimethoprim resistance among Enterobacteriaceae isolated from patients with urinary tract infection rose from 5% to 15% of total strains examined . Strains resistant to trimethoprim but susceptible to sulfamethoxazole appeared from 1980 onward and represented 35% of the total trimethoprim-resistant strains examined in 1985 . Co-trimoxazole (trimethoprim + sulfamethoxazole) has been generally available for prescription in the United Kingdom since 1969, whereas trimethoprim alone was released in October 1979 . By 1983, prescriptions in the form of trimethoprim alone accounted for approximately 50% (in hospitals) and 15% (in the community) of total trimethoprim usage in the Nottingham area . Although the introduction of trimethoprim alone seems to have had only a minor effect on overall resistance levels, it has greatly increased the proportion of trimethoprim-resistant strains which are susceptible to sulfamethoxazole . This was particularly evident in strains of Proteus spp., in which 52% of the total trimethoprim-resistant strains were sulfamethoxazole-susceptible in 1985. Acta Pathol Microbiol Immunol Scand {B}, 1986 Oct, 94(5), 351 - 6 Population analysis of susceptibility to ciprofloxacin and nalidixic acid in Staphylococcus, Pseudomonas aeruginosa, and Enterobacteriaceae; Sogaard P et al.; Susceptibility to ciprofloxacin (Cfl) and nalidixic acid (Nal) was tested in vitro by means of the population analysis technique against six strains of Staphylococcus, one strain of Pseudomonas aeruginosa, and seven strains from five genera of Enterobacteriaceae . All strains of Staphylococcus were uniformly resistant to Nal as was the Pseudomonas aeruginosa strain, all bacteria being resistant to 250- less than 500 micrograms/ml . The Enterobacteriaceae were heterogeneous as regards susceptibility to Nal . With some strains minority populations of highly-resistant bacteria could be detected with frequencies of about 10(-6.3) . The MIC for Cfl for the staphylococci varied between 0.25 and 0.50 microgram/ml . There were no differences in MIC of penicillinase-producing and penicillin-susceptible strains, either in Staphylococcus aureus or in Staphylococcus epidermidis . The MIC for Cfl in the enterobacteria varied between 0.004 and 0.03 microgram/ml . The MIC for Cfl in the Pseudomonas aeruginosa was 0.25 microgram/ml . MIC for Cfl increased in all strains when the parental strains were compared to bacteria selected from the plates with the highest concentration permitting growth, indicating heterogeneity against Cfl . But while the MIC of the selected enterobacteria were lower than one fourth of the level obtainable in serum, the MIC of the selected staphylococci and Pseudomonas aeruginosa were either exceeding the level obtainable in serum or were only a little lower than this level . While Cfl thus seems to be a promising antimicrobial agent in the treatment of infections caused by enterobacteria, the suitability for infections caused by staphylococci and Pseudomonas aeruginosa should be further explored. J Med Chem, 1986 Oct, 29(10), 2060 - 8 Chloroalanyl antibiotic peptides: antagonism of their antimicrobial effects by L-alanine and L-alanyl peptides in gram-negative bacteria; Cheung KS et al.; A large number of structurally diverse di- and tripeptides containing the alanine racemase inactivator beta-chloro-L-alanine (beta-Cl-LAla) have been synthesized, and their antibacterial properties in vitro have been evaluated . The dipeptides 1, 3-6, and 8-17 and the tripeptide 20 are all broad-spectrum antibacterial agents with considerable potency against both Gram-positive and Gram-negative species, but none of these peptides improves dramatically on the antibiotic efficacy of the previously described beta-Cl-LAla-beta-Cl-LAla, 9 (Cheung, K . S.; Wasserman, S . A.; Dudek, E.; Lerner, S . A.; Johnston, M . J . Med . Chem . 1983, 26, 1733) . Gram-negative microorganisms, such as Escherichia coli, Hemophilus influenzae, Shigella flexneri, and Enterobacter species are consistently resistant to any haloalanyl peptide containing an alanyl residue, such as the dipeptide LAla-beta-Cl-LAla (2) and the tripeptides LMet-LAla-beta-Cl-LAla (7), LAla-LAla-beta-Cl-LAla (18), and LVal-LAla-beta-Cl-LAla (19) . Correspondingly, these same organisms are protected from the bactericidal effects of 9 by supplementation of the growth medium with LAla or LAla-LAla . Escherichia coli JSR-O exposed to 9, but protected from lysis by sucrose stabilization, has only about 10% the normal level of intracellular alanine racemase activity . But when these cells are cultured in the presence of 9 with LAla supplementation, or in the presence of 2 with no supplementation, the alanine racemase levels are only about 20-30% below control values . These findings suggest that the resistance of Gram-negative species to chloroalanyl peptides containing alanyl units arises from the ability of LAla to protect the targeted racemase from inactivation by beta-Cl-LAla in vivo, an event which otherwise leads to cell death and lysis . Inactivation of alanine racemase in Gram-positive organisms appears not to be the cellular event that confers sensitivity of these species to a haloalanyl peptide. J Hyg (Lond), 1986 Oct, 97(2), 205 - 10 Restriction enzyme fingerprinting of enterobacterial plasmids: a simple strategy with wide application; Platt DJ et al.; Restriction enzyme fingerprints were generated from purified plasmid DNA from 324 clinical isolates that belonged to 7 enterobacterial genera and 88 single plasmids in Escherichia coli K 12 according to the following strategy . Purified plasmid DNA was digested with PstI . The number of fragments detected in a 0.8 agarose gel was used to determine which 2 of 6 restriction enzymes including PstI was most likely to provide a fingerprint comprising sufficient fragments to ensure specificity but sufficiently few to allow easy visual assessment and minimize coincidental matching . When PstI produced greater than 20 fragments, EcoRI and HindIII were used; when PstI generated less than 6 fragments Bsp 1286 and AvaII were used and SmaI was employed when between 6 and 20 fragments were obtained from PstI digests . Using a minimum of 12 fragments from a combination of 2 enzymes as the criterion for characterizing a strain/plasmid, satisfactory 2-enzyme fingerprints were obtained from 87% of the strains and plasmids studied using PstI and no more than two additional enzymes per strain . Of the remaining 54 strains, 51 harboured only small plasmids (less than 10 kb) and 3 produced satisfactory fingerprints when digested with a fourth enzyme. Microbiologica, 1986 Oct, 9(4), 431 - 42 Comparative study of some biological activities of porins extracted from various microorganisms; Tufano MA et al.; The outer membrane of Gram-negative bacteria contains some major proteins, called porins, with particular chemical and physical characteristics which reflect some specialized functions peculiar to the outer membrane . In recent years the biological properties of Salmonella typhimurium SH5014 porins have been the focus of our experimental studies . The aim of the present research was to make a comparative investigation of the biological activities of porins extracted from other microorganisms classified in the Enterobacteriaceae, together with a taxonomically different one, Eikenella corrodens frequently isolated from gum pockets of patients with periodontal disease . Porins from E . coli K12, Proteus mirabilis and Eikenella corrodens were extracted, purified and separated from LPS by means of phenol extraction . The purity of preparation was checked by sodium dodecyl sulphate polyacrylamide gel electrophoresis in slabs . We studied the interactions of these proteins with some cellular and humoral systems within the host . Mouse peritoneal macrophages in the presence of these proteins show morphological and functional modifications, depending upon the type of porins and the concentrations used . The ability of porins to interact with the complement system was investigated in vitro . A pool of sera from 20 blood donors served as a source of human complement . The results obtained with porins of various sources were shown comparatively. Microbiologica, 1986 Oct, 9(4), 423 - 30 Fluorescence polarization immunoassay to determine aminoglycoside modifying enzymes activity; Pagani L et al.; The possible use of polarized-immunofluorescence to evaluate aminoglycoside-modifying enzyme activities has been investigated . The TDX instrument was used to determine the residual quantity of aminoglycoside following inactivation during the assay procedure . Through the spectrum of the modified aminoglycoside antibiotics the enzymes encoded on eleven R-factors from clinical isolates of Enterobacteriaceae have been identified. J Bacteriol, 1986 Oct, 168(1), 221 - 7 Purification and characterization of fimbriae from Salmonella enteritidis; Feutrier J et al.; A human isolate of Salmonella enteritidis which displayed strong pellicle formation during static broth culture and mannose-sensitive hemagglutination produced fimbriae which were morphologically indistinguishable from type 1 fimbriae of members of the family Enterobacteriaceae . Fimbrin was purified to homogeneity, and the apparent molecular weight (Mr, 14,400) was markedly lower than that reported for the type 1 fimbrin of Salmonella typhimurium (Mr, 22,100) . This fimbrin contained 40% hydrophobic amino acids and lacked cysteine . The sequence of the N-terminal 64 amino acids was determined, and sequence alignment revealed that although the 18 N-terminal residues of the S . enteritidis molecule shared considerable homology with Escherichia coli and S . typhimurium type 1 fimbrins, the S . enteritidis fimbrin lacked a 6- to 9-residue terminal sequence present in the other type 1 fimbrins and, after residue 18, shared little homology with the E . coli sequence . Antibodies raised to the purified S . enteritidis fimbrin bound to surface-exposed conformational epitopes on the native fimbriae and displayed pronounced serospecificity . These antibodies were used in the isolation of a nonfimbriated Tn10 insertion mutant which was unable to hemagglutinate. Microb Pathog, 1986 Oct, 1(5), 475 - 81 Antibody responses to Escherichia coli J5 lipopolysaccharide and to Salmonella porin in patients with bacteremia; Brauner A et al.; This study was undertaken in order to evaluate whether patients with bacteremia respond with antibodies directed towards two outer membrane components of Gram-negative bacteria . The antibody responses to the core of the lipopolysaccharide molecule (LPS) of the rough E . coli J5 mutant and to a purified outer membrane protein (porin) from Salmonella were studied in bacteremic patients . Two or three serum samples were consecutively collected from 77 patients having 82 episodes of bacteremia altogether, of these 50 were caused by bacteria of the genus Enterobacteriaceae . As controls, sera from 82 age and sex matched patients and 100 healthy blood donors were analysed . The antibody titers were assessed by enzyme-linked immunosorbent assays (ELISA) . None of the patients with bacteremia responded with an increase in antibody level to the E . coli J5 rough LPS . This finding indicates that the core portion of the E . coli J5 LPS contains no antigenic epitopes immunologically cross-reactive with Gram-negative bacteria causing bacteremia . By contrast, 13 patients showed significant titer increases to the porin preparation derived from Salmonella . Twelve of these patients had bacteremia caused by Gram-negative organisms belonging to Enterobacteriaceae . One patient had bacteremia with Bacteroides fragilis but also suffered from a severe peritonitis with growth of both E . coli and Klebsiella . It is suggested that the measurement of antibody response to porin may be of value for differential serological diagnosis in patients with bacteremia, to distinguish between Enterobacteriaceae and other organisms. Zh Mikrobiol Epidemiol Immunobiol, 1986 Oct, (10), 12 - 5 {Taxonomy and systematics of pathogenic microorganisms}; Bondarenko VM; The modern state of the problem of the systematics of microorganisms is analyzed and the data on the taxonomy of bacteria belonging to the family Enterobacteriaceae are presented . The importance of studies on the taxonomy of microorganisms is emphasized . These studies play a vital role in the development of diagnostic preparations and techniques for the identification of infective agents, as well as in the realization of epidemiological surveillance . Much attention is given to the works of Soviet microbiologists, discussing such problems as the unification of the classification scheme of dysentery bacteria, the intraspecific taxonomy of Francisella tularensis, the systematic position of Allomonas and the antigenic scheme of Hafnia, included into Bergey's Determinative Bacteriology, edition IX (1984). Antimicrob Agents Chemother, 1986 Sep, 30(3), 505 - 7 Aztreonam concentrations in human tissues obtained during thoracic and gynecologic surgery; Beam TR Jr et al.; The concentrations of aztreonam in human tissues obtained during surgery were measured after a single 2-g intravenous dose . The average concentration in the skeletal muscle, atrial appendage, lung, sternum, pericardial fluid, endometrium, myometrium, fallopian tube, and ovary varied from 3 to 33 micrograms/g (or microgram/ml) . These concentrations significantly exceed the MIC for 90% of strains for most members of the family Enterobacteriaceae. J Antimicrob Chemother, 1986 Sep, 18(3), 317 - 24 Selective growth of resistant variants during incubation of Enterobacteriaceae with four aminoglycosides; Nilsson L et al.; The selective growth of resistant variants, present at low frequencies, varied with different strains of Enterobacteriaceae and different aminoglycosides . This phenomenon was more pronounced during incubation with amikacin than with gentamicin, netilmicin and tobramycin . Selective growth of the resistant variants resulted in an inoculum effect and an increase in MIC with longer incubation . In-vitro evaluation of this phenomenon may be justified when choosing an aminoglycoside for therapy. Diagn Microbiol Infect Dis, 1986 Sep, 5(3), 185 - 96 Clinical importance of polymicrobial bacteremia; Weinstein MP et al.; Ninety-one episodes of polymicrobial bacteremia and fungemia were compared with 407 unimicrobial episodes to assess differences in the microbiological, epidemiological, and clinical features of the two syndromes . Enterobacteriaceae, nongroup A streptococci, anaerobic bacteria, and pseudomonads were disproportionately common in polymicrobial bacteremia . Polymicrobial episodes were significantly more likely to be hospital-acquired, to emanate from bowel or multiple foci, and to occur in patients with nonhematologic malignancies or multiple underlying diseases . Deaths directly related to sepsis were twofold higher in polymicrobial versus unimicrobial bacteremia . Factors associated with increased mortality in polymicrobial sepsis included age greater than 40 yr; absent or diminished febrile response to sepsis; absolute granulocytopenia; inadequate antimicrobial therapy for all microorganisms isolated; and a primary focus of infection in the bowel, the respiratory tract, an abscess, or an occult site . The occurrence and type of polymicrobial bacteremia can suggest a source of sepsis as well as additional diagnostic and therapeutic maneuvers. Infect Immun, 1986 Sep, 53(3), 460 - 3 Pasteurellosis in laboratory rabbits: characterization of lipopolysaccharides of Pasteurella multocida by polyacrylamide gel electrophoresis, immunoblot techniques, and enzyme-linked immunosorbent assay; Manning PJ et al.; The lipopolysaccharides (LPSs) of five isolates of Pasteurella multocida from rabbits were characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, immunoblots, and enzyme-linked immunosorbent assay . Silver-stained sodium dodecyl sulfate-polyacrylamide gel electrophoresis profiles of purified unaggregated LPSs resembled those of semirough strains of gram-negative enterobacteria and consisted of one or two bands that migrated within an interval just ahead or slightly behind the migration of the Ra chemotype of "Salmonella minnesota," which has a molecular size of 4.3 kilodaltons . Polyclonal rabbit antisera to P . multocida whole cells used in Western blots and enzyme-linked immunosorbent assays of unabsorbed and LPS-absorbed antisera revealed that the LPS of these isolates of P . multocida contained at least two types of antigens: a nonserospecific antigen and a serospecific antigen . The LPSs of four isolates each had a different serospecific antigen . The nonserospecific antigen was expressed in two isolates and was the only demonstrable LPS antigen in one other isolate. Rev Infect Dis, 1986 Sep-Oct, 8(5), 693 - 704 Plasmids as epidemiologic markers in nosocomial gram-negative bacilli: experience at a university and review of the literature; John JF Jr et al.; Bacterial plasmids have become valuable markers for the comparison of strains of nosocomial gram-negative bacilli . The importance of plasmids in nosocomial infections is primarily due to their transferable antibiotic resistance genes (R plasmids), but other plasmid-mediated traits may eventually serve as potential markers . Stable cryptic plasmids have also served to relate outbreak strains, particularly nonfermenting strains of gram-negative bacteria . Klebsiella pneumoniae and Serratia marcescens have been the major plasmid-containing species in outbreaks involving single or multiple species . Outbreaks of single species with common plasmid patterns have included the Enterobacteriaceae, Pseudomonas aeruginosa, Pseudomonas cepacia, Ewingella americana, and Legionella pneumophila . Intrageneric spread of the same or similar R plasmids has nearly always occurred within the Enterobacteriaceae in large medical centers or Veterans Administration hospitals . High-risk nurseries and burn units have been conspicuous foci for R plasmid evolution . Hospital epidemiologists and clinical microbiologists will likely have an ever-increasing need to determine the plasmid content of gram-negative bacilli producing endemic and epidemic nosocomial infections. Pathol Biol (Paris), 1986 Sep, 34(7), 859 - 62 {Diffusion of ceftriaxone in human bone tissue}; Soudry B et al.; Ceftriaxone diffusion into spongious and cortical bone after single 2 g dose by intravenous injection was studied in 40 patients undergoing total hip replacement . Serum and tissue assays were performed by HPLC and microbiological method 2, 4, 12 and 24 hours after administration . Both methods produced similar results . Antibiotic levels (HPLC) were 19.3 +/- 7.3; 16.9 +/- 9.2; 11.2 +/- 4.7 and 5.6 +/- 2.7 micrograms/g in spongious bone at hours 2, 4, 12 and 24, and 6.5 +/- 1.6; 3.1 +/- 0.7; 3.3 +/- 1.1 and 2.2 +/- 0.4 micrograms/g in cortical bone at the same times . The tissue/serum ratios were 14% for spongious bone and 5% for cortical bone after 2 hours . At hour 24 these ratios were 21% and 8% in spongious and cortical bone respectively . These tissue levels remain higher than ceftriaxone MIC for most Enterobacteriaceae strains until hour 24. J Antimicrob Chemother, 1986 Sep, 18(3), 415 - 20 Comparison of a slow-release trimethoprim with co-trimoxazole: efficacy and selection of resistance in the Enterobacteriaceae; Menon R et al.; One hundred and fifty one patients with symptoms of urinary tract infection were treated randomly in a double blind study with a slow release form of trimethoprim or with co-trimoxazole . Similar cure rates were seen . There was no difference between the proportions of patients in the two groups who acquired trimethoprim-resistant Enterobacteriaceae . Further clinical trials with slow release trimethoprim should be performed. J Antimicrob Chemother, 1986 Sep, 18(3), 345 - 50 In-vitro evaluation of carumonam (Ro 17-2301); Stobberingh EE et al.; The in-vitro antibacterial activity of carumonam (Ro 17-2301) was assessed and compared with those of aztreonam and other beta-lactam antibiotics . Carumonam was highly active against the Enterobacteriaceae and Pseudomonas strains resistant to ampicillin (MIC greater than or equal to 256 mg/l) and carbenicillin (MIC greater than or equal to 64 mg/l), respectively . The MICs of carumonam for 90% of the strains ranged between 0.25 mg/l for Klebsiella spp . to 32 mg/l for Pseudomonas spp . The antibacterial activity was minimally altered by changes of medium or inoculum size . Carumonam was resistant to hydrolysis by the plasmid-mediated and chromosomal beta-lactamases tested . Also in the microbiological assay no inactivation was observed . Carumonam was an effective inhibitor of the SHV enzyme and the chromosomal beta-lactamases tested . Against the other plasmid-mediated enzymes carumonam was not an effective inhibitor. Biochem J, 1986 Sep 1, 238(2), 613 - 6 Isolation and characterization of the M.EaeI modification methylase; Jacobs D et al.; The modification enzyme (M.EaeI) corresponding to the restriction endonuclease EaeI was partially purified from Enterobacter aerogenes PW201 . The M.EaeI enzyme methylates the innermost cytosine residue in each strand of the family of related sequences that constitute the EaeI recognition site to give: 5'-Y-G-G-5mC-C-R-3' where 5mC is 5-methylcytosine . M.EaeI protects these sites against cleavage by HaeIII, and protects overlapping 5'-C-C-G-G-3' sites against cleavage by both HpaII and MspI. Jpn J Antibiot, 1986 Sep, 39(9), 2344 - 54 {A clinical bacteriological efficacy study on a fosfomycin otic solution}; Deguchi K et al.; Fosfomycin (FOM) otic solution was administered to 587 patients with suppurative otitis media infections including 190 patients in the dose-establishment test, 126 patients in the open clinical trial and 271 patients in the double blind test . Various bacteria were detected in the 549 cases in which bacteriological investigation was possible . Main bacteria detected from the above cases were S . aureus (261 strains, 47.5%), P . aeruginosa (93 strains, 16.9%), coagulase negative Staphylococci (CNS) (89 strains, 16.2%), Providencia spp . (35 strains, 6.4%) and Proteus spp . (28 strains, 5.1%) . Twenty-seven strains of anaerobic bacteria (4.9%) were also detected . The MIC of FOM, and the reference drug, chloramphenicol (CP), fradiomycin (FRM), cefmenoxime (CMX) and cephalexin (CEX), were determined up to a concentration of 800 micrograms/ml with inoculum sizes of 10(6) and 10(8) CFU/ml . About 30% of S . aureus was multi-drug resistant, including methicillin and cephems, but FOM showed excellent antibacterial activity against it . The FOM had superior antibacterial activity against P . aeruginosa to CP, FRM and CMX, and was also active against other bacteria . The antibacterial activity of FOM was inferior to other drugs against CNS, Enterobacter spp., P . putida and P . cepacia . The detection rate of these bacteria, however, was low and since their role as causative organisms is not well defined, the inferior activity of FOM has no effect on the bacteriological evaluation of FOM . Since the concentration in the tympanic cavity about 1 hour after the administration of 3% FOM solution was estimated to be 2,000 to 3,000 micrograms/ml, it could be presumed that bacteria inhibited by 800 micrograms/ml of FOM at an inoculum size of 10(8) CFU/ml would be eradicable . The low ototoxicity of FOM is likely due to its characteristic as an inhibitor of bacterial cell wall synthesis . From these results, 3% FOM otic solution may be considered as a remarkably useful topical preparation for the treatment of suppurative otitis media. J Antimicrob Chemother, 1986 Sep, 18(3), 421 - 4 An ultra-rapid method for the study of antibiotic resistance plasmids; Bennett PM et al.; A rapid method of isolating plasmid DNA has been developed from that of Birnboim & Doly (1979) . This method allows large numbers of strains to be examined, and can be employed to isolate DNA from members of the Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus, (including methicillin-resistant strains) and coagulase-negative staphylococci . Plasmids of widely differing sizes are amenable to isolation by this technique, which yields DNA of sufficient purity to allow restriction endonuclease and homoduplex analysis. J Antimicrob Chemother, 1986 Sep, 18(3), 351 - 8 In-vitro activity of BRL-36650, a novel beta-lactamase-stable penicillin, against multiply resistant gram-negative organisms; Verbist L; The in-vitro activity of BRL-36650, a novel beta-lactamase-stable penicillin was tested in comparison with that of cefotaxime, ceftazidime, aztreonam and imipenem against 559 multiply resistant Gram-negative organisms, some of which were also resistant to third generation cephalosporins . BRL-36650 and imipenem were the most active antibiotics . Against 342 Enterobacteriaceae the MICs90 were: imipenem 2 mg/l, BRL-36650 4 mg/l, aztreonam 8 mg/l and cefotaxime 32 mg/l . Against 122 Pseudomonas aeruginosa the MICs90 were: BRL-36650 4 mg/l, imipenem 8 mg/l, aztreonam and ceftazidime 64 mg/l. J Gen Microbiol, 1986 Sep, 132 ( Pt 9), 2491 - 6 A multi-resistance plasmid isolated from commensal Neisseria species is closely related to the enterobacterial plasmid RSF1010; Rotger R et al.; pFM739, an R plasmid from Neisseria sicca that encodes penicillin, streptomycin and sulphonamide resistance, and the enterobacterial IncQ(P-4) plasmid RSF1010, which encodes streptomycin and sulphonamide resistance, were incompatible, and were mobilized by the same conjugative plasmids . Restriction mapping confirmed a high degree of similarity between both R plasmids; pFM739 carried DNA fragments corresponding to the known replication and resistance regions of RSF1010 . pFM739 also carried an extra segment with the same restriction map as that described for the beta-lactamase-coding region of transposon Tn3 . It is suggested that the R plasmids isolated from commensal Neisseria sp . could have resulted from transposition of a Tn3-like genetic element to an RSF1010-like plasmid, and that they contain deletion derivatives of transposon Tn3. Rev Infect Dis, 1986 Sep-Oct, 8(5), 725 - 37 The changing pattern of trimethoprim resistance in Paris, with a review of worldwide experience; Goldstein FW et al.; From 1972 to 1984, all Enterobacteriaceae isolated from clinical specimens at St . Joseph Hospital in Paris were tested for susceptibility to trimethoprim . During this period, resistance to trimethoprim increased from 17.9% to 25.5%; the increase was due mainly to strains with high-level resistance . Genetic studies, including transferability, incompatibility grouping, determination of the molecular mass of plasmids, and hybridization with dihydrofolate reductase I and II genes, were performed with randomly selected strains, and the results were compared with those of similar studies in other countries . The most striking phenomenon in trimethoprim-resistant strains was the presence of various resistance mechanisms and of different plasmids, transposons, and genetic determinants. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1986 Aug, 262(2), 195 - 202 Sensitive reagents for detection of indole production by bacteria; James AL et al.; A number of substituted 4-aminobenzaldehydes were compared with more commonly employed reagents for the detection of indole-producing organisms among the Enterobacteriaceae . Factors such as rate of colour intensity and stability were compared in tests with reference organisms and clinical isolates, and with appropriate concentrations of pure indolic standards . 2-Methoxy 4-dimethylaminobenzaldehyde and 4-N pyrrolidylbenzaldehyde produced immediate and intense red to purple colourations when used in the indole test both in liquid media and on multipoint inoculated plates . Both reagents were considered to be superior to the traditional Ehrlich's reagent and also to 4-dimethylaminocinnamaldehyde which is often used as an alternative. Acta Anaesthesiol Scand, 1986 Aug, 30(6), 477 - 9 Effect of chlorhexidine 0.5% on the hand bacterial flora; Sia RL et al.; The effects of cleaning the dorsal hand with chlorhexidine 0.5% in spirit was evaluated by bacteriological study in 45 adult patients . In the absence of cleaning it was found that the prevalent microorganisms were Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus viridans and Enterobacteriaceae . Cleaning the hand with chlorhexidine 0.5% eliminated all bacteria except S . epidermidis and S . aureus . In both instances, the culture results showed that the microorganisms were present in very low growth density. J Appl Bacteriol, 1986 Aug, 61(2), 117 - 23 Bacterial sources of putrescine and cadaverine in chill stored vacuum-packaged beef; Dainty RH et al.; Of the meat strains of streptobacteria, leuconostocs, Enterobacteriaceae and Brochothrix thermosphacta tested, only Hafnia alvei and Serratia liquefaciens showed diamine-producing potential during growth in pure culture on beef stored in vacuum packs at 1 degree C . Both organisms produced cadaverine at concentrations similar to those reported previously in naturally contaminated beef stored under the same conditions . Putrescine concentrations produced by the two organisms, however, were an order of magnitude lower . During the growth on beef of either H . alvei or S . liquefaciens in mixed culture with arginine-utilizing strains of streptobacteria, putrescine as well as cadaverine concentrations were similar to those detected in naturally contaminated samples. Zh Mikrobiol Epidemiol Immunobiol, 1986 Aug, (8), 5 - 10 {Etiology of acute pneumonia occurring against a background of influenza and other acute respiratory viral infections}; Vishniakova LA et al.; The etiology of acute pneumonia (AP) was studied in 229 patients who had the disease simultaneously with influenza (106 patients), other viral and mycoplasmal infections (48 patients), and without concomitant acute viral infections (75 patients) . The use of the quantitative microbiological method and the indirect immunofluorescence test with autostrains or Streptococcus pneumoniae strains of serotypes 2, 3, and 6, prevailing in Leningrad in patients with acute inflammatory diseases of the lungs, made it possible to find out the pneumococcal etiology of AP in 95% of patients irrespective of the presence of acute respiratory viral infections . The etiological role of opportunistic bacteria was revealed in 13 AP patients (5.7%); in 2 of them the causative agent of AP was Staphylococcus aureus and in 11, various species of Gram-negative enterobacteria . The latter were the cause of complications in 8 cases of pneumococcal pneumonia. Eur J Clin Microbiol, 1986 Aug, 5(4), 411 - 5 Cross-resistance of nalidixic acid resistant Enterobacteriaceae to new quinolones and other antimicrobials; Piddock LJ et al.; One hundred urine isolates Enterobacteriaceae screened for resistance to 30 micrograms nalidixic acid by disc diffusion test were examined by MIC determination for in vitro susceptibility to nalidixic acid, ciprofloxacin, enoxacin, gentamicin, nitrofurantoin, trimethoprim, cephalexin and ceftazidime . Those resistant to nalidixic acid and also gentamicin or a cephalosporin were further examined to determine the mechanism of resistance . Compared to the total urine isolates of Enterobacteriaceae from the same time period, this population as a whole was less susceptible to all antimicrobials tested except gentamicin . Strains that exhibited multiple resistance had the conventional mechanisms of resistance to those antimicrobials . No multiply resistant strains had a permeability barrier due to outer membrane protein alterations causing cross-resistance to chemically unrelated classes of antimicrobials. Am Ind Hyg Assoc J, 1986 Aug, 47(8), 437 - 42 Mesophilic microorganisms and endotoxin levels on developing cotton plants; DeLucca AJ 2nd et al.; Healthy cotton leaf, bract, fiber and soil were collected twice each week during growing season . These samples were studied to determine the epiphytic total and gram-negative bacterial (GNB) populations and endotoxin levels from seedling development to harvest . Since bract is a significant trash component of raw cotton, a study of the epiphytic bract fungi was performed also . Bract and soil had the highest total bacterial count (TBC) until senescence, when the bract count increased significantly over that of the soil . Leaf TBC was usually third while fiber had the least TBC . Leaf senescence did not result in an increase in TBC as with bract . GNB counts paralleled, but were approximately 10-fold lower than that of the TBC . Enterobacter agglomerans was the most predominant bacterium on leaf and bract . Gram-positive rods were the most common bacteria on fiber with E . agglomerans second . Gram-positive rods were by far the predominant species in soil . Senescence affected the population levels of the various genera on leaf and bract . Endotoxin varied greatly for all sample types . Soil usually gave the highest amounts, followed by bract, fiber leaf surface . Statistical analysis showed some minor correlations between the presence of certain bacteria with other bacteria . No correlations were found between weather data and bacterial types present or endotoxin levels . The epiphytic fungal population on bract was studied through the growing season . Though different genera appeared, the predominant genus throughout the study was Cladosporium. Acta Pathol Microbiol Immunol Scand {B}, 1986 Aug, 94(4), 205 - 13 Clinical strains of Enterobacter agglomerans (synonyms: Erwinia herbicola, Erwinia milletiae) identified by DNA-DNA-hybridization; Lind E et al.; Using DNA-DNA-hybridization it could be shown that 52 of 86 clinical isolates of Enterobacter agglomerans were closely related to each other, to the type strain of the species and also to the type strains of Erwinia herbicola and Erwinia milletiae . Most of the strains investigated were of the biogroups 1 and G1 of Ewing & Fife . All strains of the genetically defined group belonged to these two biogroups; none of these isolates fermented dulcitol, and with few exceptions they were also cellobiose, lactose and sorbitol negative. Br J Obstet Gynaecol, 1986 Aug, 93(8), 869 - 80 Clinical and microbiological investigation of women with acute salpingitis and their consorts; Kinghorn GR et al.; To determine the microbiological causes of pelvic inflammatory disease, 43 women with acute salpingitis (AS) and 160 controls were studied . Amongst AS women there were significantly higher endocervical isolation rates of Neisseria gonorrhoeae (54% vs 6%), Chlamydia trachomatis (40% vs 13%), Mycoplasma hominis (60% vs 19%), enterobacteria (26% vs 11%) and anaerobic bacteria (58% vs 29%) . A polymicrobial pathogenic endocervical flora was present in both gonococcal and non-gonococcal AS . Laparoscopic sampling of the fallopian tubes rarely provided useful microbiological data but did reveal the inaccuracy of clinical diagnosis of AS . Thirty-four male consorts of AS women were investigated; 20 had gonorrhoea and 27 had non-gonococcal urethritis (NGU) . A high proportion of infected men had asymptomatic gonorrhoea (35%) and/or asymptomatic NGU (56%) . These findings had implications for the management of AS. Antimicrob Agents Chemother, 1986 Aug, 30(2), 220 - 4 Novel plasmid-mediated beta-lactamase in members of the family Enterobacteriaceae from Ohio; Shlaes DM et al.; Epidemiologic studies of plasmid-mediated resistance at the Cleveland Veterans Administration Medical Center revealed that related plasmids had disseminated among members of the family Enterobacteriaceae . We studied the beta-lactamases encoded by these plasmids in Escherichia coli C600 transformants or transconjugants . Substrate and inhibition profiles of the enzymes determined by two of these plasmids suggested an activity resembling TEM-1; however, isoelectric focusing revealed a pI of 7.0 . These two plasmids were originally found in a Serratia marcescens (pDS076) and an Enterobacter cloacae (pDS075) strain isolated from the same sink in the medical intensive care unit and later, in an Enterobacter cloacae (pDS142 identical to pDS076) isolate colonizing a patient in the same unit . The plasmids also carried the aminoglycoside resistance determinant, 2"-aminoglycoside nucleotidyl transferase . A 2-kilobase AvaI restriction endonuclease digestion fragment of pSD075 known to carry the beta-lactamase determinant was used as a molecular probe . This probe did not recognize sequences of any plasmid-mediated beta-lactamase tested including the recently described determinants ROB-1, TLE-1, and OXA-4-7 . A TEM-1 probe derived from the 0.7-kilobase PstI-EcoRI fragment of pBR322 failed to recognize the new beta-lactamase gene . Four additional Enterobacter cloacae and two Enterobacter aerogenes strains isolated in Columbus, Ohio, have been shown to produce a pI 7.0 beta-lactamase and to carry plasmids recognized by the 2-kilobase probe . These data suggest dissemination of a novel plasmid-mediated beta-lactamase among members of the family Enterobacteriaceae in Ohio and demonstrate the development and utility of a molecular probe for the new determinant . We suggest that the novel beta-lactamase be named OHIO-1. Acta Pathol Microbiol Immunol Scand {B}, 1986 Aug, 94(4), 251 - 6 The beta-lactamase stability and in vitro activity of cefotetan; a comparison with 8 other beta-lactam antibiotics and gentamicin; Friis H et al.; The antibacterial activity of cefotetan, 8 other beta-lactam antibiotics and gentamicin, was tested in vitro on 288 recently isolated bacteria . The activity of cefotetan was generally higher than the 2.generation cephalosporin cefuroxime and lower than the 3.generation cephalosporins tested . In addition, cefotetan was shown to have some antibacterial activity against anaerobic bacteria . Cefotetan is a cephamycin and was found resistant to all 14 plasmid-mediated and 2 chromosomally-mediated beta-lactamases . With its beta-lactamase resistance and antibacterial activity, cefotetan seems to be a "second-generation-like" cephalosporin, almost with 3.generation cephalosporin antibacterial activity against Enterobacteriaceae. Antimicrob Agents Chemother, 1986 Aug, 30(2), 330 - 2 In vitro activity of Ro 23-6240, a new difluoroquinolone derivative, compared with that of other antimicrobial agents; Manek N et al.; Ro 23-6240 is a new difluorinated quinolone antimicrobial agent . Its in vitro activity against a wide range of bacteria was compared with those of other quinolones and beta-lactams . Generally, members of the family Enterobacteriaceae were inhibited by low concentrations of Ro 23-6240 (MIC90 {MIC for 90% of isolates tested}, less than or equal to 1 microgram/ml) . Ninety percent of Staphylococcus aureus (including methicillin-resistant strains) and Neisseria gonorrhoeae isolates were inhibited by 0.5 microgram/ml . Pseudomonas aeruginosa (MIC90, 2 micrograms/ml) and Bacteroides fragilis (MIC90, 4 micrograms/ml) showed intermediate susceptibility, and Streptococcus pneumoniae (MIC90, 8 micrograms/ml) was less susceptible . Strains resistant to nalidixic acid were less susceptible to all the quinolones tested . The protein binding of Ro 23-6240 (5 micrograms/ml) was 27%. Antimicrob Agents Chemother, 1986 Aug, 30(2), 310 - 4 Aztreonam in the treatment of severe urinary tract infections in pediatric patients; Rusconi F et al.; Aztreonam was administered to 30 patients, ages 0.03 to 15.4 years, with severe and in 21 cases complicated urinary tract infections caused by members of the family Enterobacteriaceae and Pseudomonas aeruginosa which were resistant to ampicillin and susceptible to the study drug in vitro . A mean dose of 47.7 mg/kg was given intramuscularly every 12 h to 26 patients . In four patients with renal insufficiency, the dose was reduced according to pharmacokinetic data . Permanent urine sterilization and clinical cure were achieved in 22 patients, 13 of whom had urological malformations . In two patients with P . aeruginosa and Proteus mirabilis infections, the treatment failed . Another patient had an Escherichia coli reinfection 21 days after the end of therapy . Four patients with various urological abnormalities had gram-positive superinfections, and two patients had gram-negative superinfections during and at the end of therapy: all six had indwelling ureteric splints or pyelostomy as predisposing conditions . No adverse clinical effects were observed . Some transient and slight or moderate alterations were observed at the end of treatment: eosinophilia (nine cases), elevation of hepatic enzymes (eight cases), prolongation of prothrombin time (three cases), and neutropenia (one case) . A pharmacokinetic study was performed in six patients with normal renal function and in seven patients with various degrees of renal insufficiency . The elimination half-life of the drug was inversely correlated with the glomerular filtration rate . At the dosage used, aztreonam proved effective for severe urinary tract infections caused by members of the family Enterobacteriaceae in pediatric patients. Antimicrob Agents Chemother, 1986 Aug, 30(2), 281 - 9 Diversity of determinants encoding carbenicillin, gentamicin, and tobramycin resistance in nosocomial Pseudomonas aeruginosa; Mucha DK et al.; Plasmid pFMH1010, an 89-megadalton R plasmid, is endemic among members of the family Enterobacteriaceae at Hines Veterans Administration Hospital, Hines, Ill . It encodes resistance to nine antibiotics, including resistance to carbenicillin (Cb), gentamicin (Gm), and tobramycin (Tm) . Pseudomonas aeruginosa strains resistant to carbenicillin, gentamicin, and tobramycin were isolated from five patients at Hines Veterans Administration Hospital from whom Serratia marcescens strains harboring pFMH1010 were also obtained . The P . aeruginosa strains were investigated to determine whether their Cb, Gm, and Tm characteristics derived from pFMH1010 . One of the isolates, Ps559, was shown by Southern hybridization to contain approximately 76% of pFMH1010 . Several lines of evidence suggested that the pFMH1010 sequences in Ps559 are integrated in the chromosome . Southern hybridization also demonstrated that the beta-lactam resistance of pFMH1010 is most probably due to the presence of sequences homologous with Tn3 and that these sequences are retained in Ps559 . In two other Pseudomonas isolates, resistance to carbenicillin, gentamicin, tobramycin, and kanamycin was encoded by R plasmids unrelated to pFMH1010 . In the last two isolates, resistance to gentamicin and tobramycin and several other antibiotics appeared to be chromosomally encoded, and it was rescuable from one of these strains by RP4-mediated mobilization. J Gen Microbiol, 1986 Aug, 132 ( Pt 8), 2243 - 7 The transfer of genes encoding production of mannose-resistant haemagglutinating fimbriae from uropathogenic enterobacteria; Hales BA et al.; Two hundred and thirty-seven bacterial strains, isolated from patients with urinary tract infections, were examined for the presence of plasmid-determined fimbrial adhesins . Ninety-nine strains were capable of producing mannose-resistant haemagglutination . Seventeen of these strains possessed transferable resistance plasmids and 11 of these were also able to transfer the mannose-resistant haemagglutination gene, suggesting that it was carried on the R plasmid or had been mobilized by it. Carbohydr Res, 1986 Aug 1, 150, 63 - 90 {Synthesis of trisaccharide determinants of enterobacterial common antigens}; Paulsen H et al.; In the presence of silver silicate, the reaction of 3,4,6-tri-O-acetyl-2-azido-2-deoxy-alpha-D-mannopyranosyl bromide with 1,6-anhydro-2-azido-3-O-benzyl-2-deoxy-beta-D-glucopyranose gave beta-glycosidically linked 1,6-anhydro-2-azido-3-O-benzyl-2-deoxy-4-O-(3,4,6- tri-O-acetyl-2-azido-2-deoxy-beta-D-mannopyranosyl)-beta-D- glucopyranose . After deacetylation and catalytic oxidation with oxygen and platinum, 1,6-anhydro-2-azido-4-O-{(2-azido-2-deoxy-beta-D-mannopyranosyl) uronic acid}-3-O-benzyl-2-deoxy-beta-D-glucopyranose was obtained . A series of intermediate steps led to the glycosyl donor 6-O-acetyl-2-azido-3-O-benzyl-4-O-{benzyl (3,4-di-O-acetyl-2-azido-2-deoxy-beta-D-mannopyranosyl)uronate}-2-deoxy- alpha, beta-glucopyranosyl chloride which was coupled with 8-methoxycarbonyloctyl 4-azido-2-O-benzyl-4,6-dideoxy-alpha-D-galactopyranoside to give 8-methoxycarbonyloctyl O-{benzyl (3,4-di-O-acetyl-2-azido-2-deoxy-beta-D-mannopyranosyl)uronate}- (1----4)-O-(6-O-acetyl-2-azido-3-O-benzyl-2-deoxy-alpha-D-glucopyranosyl )-(1----3)-4-azido-2-O-benzyl-4,6-dideoxy-alpha-D-galactopyranoside . Deblocking gave the spacer-linked repeating unit of the enterobacterial common antigen, beta-D-ManpNAcA-(1----4)-alpha-D-GlcpNAc-(1----3)-alpha- D-Fucp4NACO(CH2)8CO2CH3. Biochem J, 1986 Jul 15, 237(2), 511 - 7 The association behaviour of beta-lactamases . Sedimentation equilibrium studies in ammonium sulphate solutions; Braswell EH et al.; The beta-lactamases (EC 3.5.2.6) from TEM plasmid RP4, Bacillus licheniformis 749/C and Enterobacter cloacae P99 were studied in solution over a wide concentration range by equilibrium sedimentation . Though crystal symmetries indicate that all three enzymes are potentially dimeric in their crystal forms, in 50 mM-sodium cacodylate at pH 6.5 the enzymes show only a small tendency to associate, indicated by a weight-average Mr (Mw) at 3% (w/v) concentration about 9% greater than that of the monomer . Although the mode of association could not be determined, this extent of association corresponded to a dimerization constant of about 2 X 10(2) M-1 . In 2.1 M-(NH4)2SO4 the B . licheniformis enzyme shows some association at concentrations over 1%, displaying an Mw value at 7% concentration about 60% more than the monomer . Under the same conditions Mw for the Entero . P99 enzyme is about 60% greater than the monomer near the solubility limit of about 2% . However, the Mw for the TEM enzyme is over twice that of the monomer at its solubility limit (3%) in 1.7 M-(NH4)2SO4 . Fitting the sedimentation data of the TEM enzyme in 1.7 M-(NH4)2SO4 with a dimerization model and an indefinite-isodesmic-association model yielded equilibrium constants of 1.5 X 10(4) and 3.3 X 10(2) M-1 respectively, with the indefinite-isodesmic model giving the better fit . Fitting the data for the other two enzymes yielded values of 1.4 X 10(3) and 1.7 X 10(2) M-1 respectively for the Entero . P99 enzyme and 4.5 X 10(2) and 45 M-1 respectively for the B . licheniformis enzyme . It could not be determined which model was the better fit for these two enzymes . Since none of the beta-lactamases studied here showed strong evidence of the terminal aggregate being a dimer, we conclude that crystalline dimers, if they exist, will not be tightly associated or physiologically significant. Carbohydr Res, 1986 Jul 1, 149(2), 279 - 91 Methylation analysis of the heptose/3-deoxy-D-manno-2-octulosonic acid region (inner core) of the lipopolysaccharide from Salmonella minnesota rough mutants; Tacken A et al.; A modified methylation analysis is described which allows the elucidation of the structure of the inner core region {heptose/3-deoxy-D-manno-2-octulosonic acid (KDO)} of enterobacterial lipopolysaccharides (LPS) of Salmonella minnesota rough mutants (Re, strain R595; and Rd2P-, strain R4) . Methylation, carboxyl-reduction, remethylation, hydrolysis, carbonyl-reduction, and acetylation of the Re-mutant LPS yielded the 2,6-di-O-acetyl and 2,4,6-tri-O-acetyl derivatives of partially methylated 3-deoxyoctitol in equimolar amounts, indicating the presence of a terminal and a 4-linked pyranosidic KDO residue . For Rd2P- LPS, the hydrolysis step involved 0.1M trifluoroacetic acid at 100 degrees for 1 h which cleaved ketosidic linkages, and the final products included the foregoing acetyl derivatives in the molar ratio of 1:02 and a partially methylated and acetylated 3-deoxyoctitol derivative which was substituted at O-5 by a methylated heptopyranosyl residue . Trideuteriomethylation of the latter product followed by methanolysis and acetylation gave 5-O-acetyl-3-deoxy-1,7,8-tri-O-methyl-2,4,6-tri-O-trideuteriomethyl++ +-D- glycero-D-talo/galacto-octitol and 1,5-di-O-acetyl-2,3,4,6,7-penta-O-methyl-L-glycero-D-manno-heptitol++ + . These results prove the presence of a (2----4)-linked KDO disaccharide in Re LPS and show that the core region of Rd2P- LPS contains a terminal alpha-L-glycero-D-manno-heptopyranosyl group and a non-substituted, a 4-O-, and a 4,5-di-O-substituted pyranosidic KDO residue in the molar ratios 1:1:0.2:1. Antimicrob Agents Chemother, 1986 Jul, 30(1), 143 - 6 Factors influencing the in vitro activity of two new aryl-fluoroquinolone antimicrobial agents, difloxacin (A-56619) and A-56620; Hirschhorn L et al.; The in vitro activity of difloxacin (A-56619) and A-56620, two new aryl-difluoroquinolones, was decreased by magnesium at 9 mM and in assay at pH 5.5 or in urine . Resistance was seen with members of the family Enterobacteriaceae, Pseudomonas aeruginosa, and Staphylococcus aureus repeatedly exposed to subinhibitory concentrations of the compounds . The frequency of resistance was similar to that found for other new quinolones. J Clin Pathol, 1986 Jul, 39(7), 798 - 802 Constructing a database for low cost identification of gram negative rods in clinical laboratories; Clayton P et al.; A database was constructed for the routine identification of Enterobacteriaceae and Gram negative rods growing aerobically on MacConkey agar . The test methods were based primarily on multipoint inoculation technology . The final database was constructed from the laboratory results of 4989 clinical isolates and 66 reference strains and was extensively analysed and evaluated . The proposed scheme is rapid, reliable, and cheap. Can J Surg, 1986 Jul, 29(4), 247 - 50 Microbiologic features and treatment of persistent peritonitis in patients in the intensive care unit; Rotstein OD et al.; The charts of 25 patients who died in the intensive care unit of persistent peritonitis after abdominal operations were reviewed to determine the microbial flora and the efficacy of antibiotic treatment . All patients had undergone two or more surgical procedures for abdominal sepsis and 23 had at least three-system organ failure . The most common organisms cultured were: Staphylococcus epidermidis, 24 cultures from 16 patients, Candida albicans, 19 cultures from 10 patients, Pseudomonas aeruginosa, 16 cultures from 12 patients, Enterobacter, 16 cultures from 8 patients and enterococcus, 14 cultures from 8 patients . The classic isolates, Escherichia coli (11 cultures from six patients) and Bacteroides fragilis (4 cultures from three patients) were found infrequently . To determine the adequacy of antimicrobial therapy for this "new" flora, we examined the ability of appropriate agents to eradicate the micro-organism upon subsequent culture . Candida sp . were eradicated in 54% (6 of 11) of the assessable cases, while enterococcus and S . epidermidis were cleared in only 25% and 28% respectively . The spectrum of intra-abdominal organisms cultured from critically ill surgical patients in the intensive care unit differs from that seen in those with acute peritonitis . Despite administration of appropriate antimicrobial agents, these organisms tend to persist, probably reflecting impaired host defences with multiple-system organ failure rather than antimicrobial failure. Am Surg, 1986 Jul, 52(7), 391 - 4 Endotracheal aminoglycosides in gram negative pneumonia . A preliminary report; Sorensen VJ et al.; Five postoperative patients with respiratory failure and gram negative pneumonia unresponsive to systemic antimicrobials were treated with endotracheally instilled aminoglycosides . Sputum cultures in four patients grew Pseudomonas aeruginosa and, in the fifth, Enterobacter cloacae . The five patients had been treated systemically for an average of 13 days (range 9 to 19 days) without improvement prior to endotracheal antibiotic administration . The gram negative organisms disappeared from the sputum cultures in all patients within an average of 4 days (range 2 to 8 days) following initiation of endotracheal antibiotics . All five patients had continued clinical improvement manifest by improved chest radiographs, improved oxygenation, and absence of the offending organisms from sputum cultures . None of the patients died from their gram negative pneumonia . This success coupled with data from other investigators suggests that endotracheal antibiotics should be considered in life-threatening gram negative pneumonias that are unresponsive to conventional systemic antimicrobials. J Bacteriol, 1986 Jul, 167(1), 285 - 90 In vivo formation of hybrid aspartate transcarbamoylases from native subunits of divergent members of the family Enterobacteriaceae; Foltermann KF et al.; The genes encoding the catalytic (pyrB) and regulatory (pyrI) polypeptides of aspartate transcarbamoylase (ATCase, EC 2.1.3.2) from several members of the family Enterobacteriaceae appear to be organized as bicistronic operons . The pyrBI gene regions from several enteric sources were cloned into selected plasmid vectors and expressed in Escherichia coli . Subsequently, the catalytic cistrons were subcloned and expressed independently from the regulatory cistrons from several of these sources . The regulatory cistron of E . coli was cloned separately and expressed from lac promoter-operator vectors . By utilizing plasmids from different incompatibility groups, it was possible to express catalytic and regulatory cistrons from different bacterial sources in the same cell . In all cases examined, the regulatory and catalytic polypeptides spontaneously assembled to form stable functional hybrid holoenzymes . This hybrid enzyme formation indicates that the r:c domains of interaction, as well as the dodecameric architecture, are conserved within the Enterobacteriaceae . The catalytic subunits of the hybrid ATCases originated from native enzymes possessing varied responses to allosteric effectors (CTP inhibition, CTP activation, or very slight responses; and ATP activation or no ATP response) . However, each of the hybrid ATCases formed with regulatory subunits from E . coli demonstrated ATP activation and CTP inhibition, which suggests that the allosteric control characteristics are determined by the regulatory subunits. Infect Control, 1986 Jul, 7(7), 362 - 4 Dissemination of a plasmid determining multiple antibiotic resistance between two Veterans Administration Medical Centers; Shlaes DM et al.; The endemic R-plasmids mediating resistance to gentamicin and multiple other antibiotics among many species of Enterobacteriaceae from the Minneapolis and Cleveland Veterans Administration Medical Centers were compared by restriction endonuclease digestion profiling and by phenotype expressed in sensitive E . coli recipients . Southern hybridizations were also performed . Our data indicate that these plasmids demonstrate some microheterogeneity, but are very closely related . Both are self-transferable and mediate resistance to ampicillin, carbenicillin, chloramphenicol, gentamicin, tobramycin, neomycin and kanamycin . These results suggest the dissemination of a conjugal R-plasmid or of Enterobacteriaceae bearing the plasmid between two midwestern Veterans Administration Medical Centers . The most likely mechanism of transmission may be the frequent transfer of patients between midwestern Veterans Administration Medical Centers. Pharmacotherapy, 1986 Jul-Aug, 6(4), 138 - 52 Aztreonam; Childs SJ et al.; Aztreonam is a new, totally synthetic beta-lactamase agent--the first monobactam . It is highly resistant to hydrolytic inactivation caused by plasmid-mediated (except PSE-2 enzyme found in some Pseudomonas species) or chromosomally mediated beta-lactamases (except for K1 produced by rare strains of Klebsiella oxytoca) . Accordingly, aztreonam remains active against many pathogens that are resistant to other beta-lactam antibiotics . The drug exhibits directed antibacterial activity against gram-negative organisms and is effective as monotherapy against most Enterobacteriaceae and Hemophilus and Neisseria species, including beta-lactamase-producing strains; it is not active against anaerobes or gram-positive organisms . Before culture results are known, it may be necessary to administer the agent empirically in combination with other antibiotics . Aztreonam is rapidly distributed to most body tissues and fluids when administered parenterally . Its serum half-life is 1.7 hours, suggesting a dosing interval of 6-8 hours for severe or life-threatening infections and 8-12 hours for moderately severe infections and urinary tract infections . It is primarily eliminated unchanged in the urine and in much lesser amounts as a microbiologically inactive metabolite; slight biliary excretion may occur . Aztreonam is well-tolerated, lacking any serious adverse hematologic, otic, or renal system effects . Its lack of effect on anaerobes helps to maintain resistance against colonization . Particularly in light of its safety and unique properties, aztreonam promises to be a useful alternative to aminoglycoside therapy. Antimicrob Agents Chemother, 1986 Jul, 30(1), 90 - 5 Double-blind, prospective, multicenter trial comparing ceftazidime with moxalactam in the treatment of serious gram-negative infections; Joshi M et al.; Ceftazidime is a new antimicrobial agent possessing excellent in vitro activity against most members of the family Enterobacteriaceae and against Pseudomonas aeruginosa . We conducted a double-blind, prospective, multicenter trial to compare ceftazidime with moxalactam in the treatment of serious gram-negative infections . The overall favorable response rates for the two regimens were similar (93 of 106 {88%} and 84 of 97 {86%}, respectively) . Among these, the response rates of the 56 gram-negative bacteremias and the 23 P . aeruginosa infections were comparable . Both groups had similar incidences of subsequent infections with P . aeruginosa, enterococci, and yeasts . A total of 13% of the patients