Chemotherapy, 1986, 32(1), 68 - 74 In vitro studies of the synergism of piperacillin and netilmicin against blood culture isolates; Arpi M et al.; The purpose of this study was to evaluate the in vitro synergism between piperacillin and netilmicin against microorganisms isolated from Danish patients with septicemia and to examine the influence of inactivation of piperacillin among these bacteria on the synergy results . A total of 132 stains was examined: Escherichia coli 20, indole-positive Proteus 17, Klebsiella pneumoniae 18, Enterobacter cloacae 20, Pseudomonas aeruginosa 20, Staphylococcus aureus 20, and coagulase-negative staphylococci 17 . Synergy testing was performed by checkerboard titration in microtiter trays . The ability of the strains to inactivate piperacillin was examined by the clover-leaf test . Synergism was found for 52% of the strains and partial synergism for 32% . Antagonism was not found . Of the piperacillin-resistant strains synergism could be demonstrated in 80% compared with 33% of the piperacillin-susceptible strains (p less than 0.001) . No significant correlation was seen between the results of the synergy test and the results of the susceptibility test to netilmicin . The frequency of piperacillin inactivation according to the clover-leaf test was significantly higher among the strains with synergism than among all the others (p less than 0.02) . The combination of piperacillin and netilmicin gave good results concerning the in vitro synergism . This synergism was probably sometimes caused by netilmicin disturbing the bacterial production of piperacillin-inactivating proteins. Antimicrob Agents Chemother, 1986 Jan, 29(1), 155 - 7 Antibacterial activity of Ro 17-2301 and other antimicrobial agents against cefotaxime-resistant aerobic gram-negative bacilli; Benson CA et al.; The in vitro activity of Ro 17-2301 was determined and compared with those of aztreonam, ceftazidime, amikacin, and piperacillin against 141 cefotaxime-resistant gram-negative bacilli . Ro 17-2301 was bactericidal, and its activity against the majority of these organisms was equal or superior to those of ceftazidime, aztreonam, and piperacillin . An inoculum effect of Ro 17-2301 and aztreonam for many Pseudomonas aeruginosa and Enterobacter spp . isolates was demonstrated. Scand J Infect Dis Suppl, 1986, 49, 146 - 53 Antibiotic use as an inducer of resistant urinary tract infections; Ball P; Urinary tract infection is second in frequency only to respiratory infection as an indication for antimicrobial chemotherapy . As a result, a significant proportion of both domiciliary and hospital patient populations are exposed to chemotherapy which, in turn, may act as a potent selection pressure for development of resistance mediated by intrinsic mechanisms or acquisition of R-plasmids or transposons . The widespread use of broad spectrum agents has encouraged the development of such resistance in enterobacteria, notably but not exclusively amongst the Klebsiella-Enterobacter-Serratia group, leading to the creation of patient reservoirs of multiply-antibiotic-resistant bacteria . Such situations occur frequently in urological units, amongst catheterised individuals receiving chemotherapy, and, via cross-infection, may rapidly spread to other units and other hospitals . The use of antibiotic combinations, such as co-trimoxazole, may not prevent such problems, which are however amenable to policies which restrict, either selectively or globally, antibiotic use . Such policies can be expected to control the spread of multiply-antibiotic-resistant infection. Can J Microbiol, 1986 Jan, 32(1), 66 - 9 Susceptibility of gram-negative bacteria to the synergistic bactericidal action of serum and polymyxin B nonapeptide; Viljanen P et al.; Polymyxin B nonapeptide was able to sensitize Escherichia coli strains and strains of Salmonella typhimurium, Klebsiella spp., Enterobacter cloacae, Pseudomonas aeruginosa, and Haemophilus influenzae to the bactericidal action of fresh normal human serum . The degree of sensitization varied significantly within the strains . Strains of Proteus mirabilis, Neisseria gonorrhoeae, and N . meningitidis remained resistant. Mol Biol (Mosk), 1986 Jan-Feb, 20(1), 92 - 101 {Similar organization of beta,beta'-subunit RNA-polymerase genes and adjacent ribosomal protein genes in Enterobacteriaceae and Pseudomonas putida}; Mekhedov SL et al.; The genes coding for the RNA-polymerase beta,beta'-subunits and adjacent ribosomal protein genes in Escherichia coli, Salmonella typhimurium, Shigella flexneri, Serratia marcescens, Proteus mirabilis and Pseudomonas putida are compared by the Southern hybridization procedure . In all the species studied close clustering of the genes rplKAJL and rpoBC is demonstrated . Preliminary physical maps for these genes in S . typhimurium, S . flexneri, S . marcescens and P . mirabilis are proposed . Rifampicin is shown to stimulate the beta,beta'-subunit synthesis in all the species studied, suggesting the existence of attenuators localized in front of the rpoBC genes . The similar arrangement of the genes rplKAJLrpoBC in a number of bacterial species is proposed to be due to common mechanisms of their coordinate expression. J Biochem (Tokyo), 1986 Jan, 99(1), 111 - 7 Regulation and properties of the glutamine synthetase purified from Photobacterium phosphoreum; Kimura K et al.; Glutamine synthetase from a marine enterobacterium, Photobacterium phosphoreum, was purified to homogeneity from cells grown in glycerol-yeast extract medium . The purified enzyme had a molecular weight of approximately 670,000 and a subunit size of 56,000, i.e . larger than that of the enzyme from E . coli . Regulation of the glutamine synthetase activity by adenylylation/deadenylylation was demonstrated on snake venom phosphodiesterase treatment . The state of adenylylation appeared to influence both the biosynthetic and gamma-glutamyltransferase activities of P . phosphoreum glutamine synthetase similar to in the case of the E . coli enzyme . The enzyme activity was controlled by adenylylation and possibly in combination with feedback inhibition by alanine, serine, and glycine, metabolites which are especially effective in inhibiting P . phosphoreum glutamine synthetase . When either Mn2+ or Mg2+ was added to the relaxed (divalent cation-free) enzyme, similar UV-difference spectra were obtained for the enzyme, indicating that the conformational states induced by these cations were also similar . The profile of these spectra varied from those published for E . coli, and three peaks were four 1 at 282.5, 288.5, and 298 nm. Mol Biol Evol, 1986 Jan, 3(1), 75 - 83 Molecular evolution of bacteriophages: evidence of selection against the recognition sites of host restriction enzymes; Sharp PM; Restriction enzymes produced by bacteria serve as a defense against invading bacteriophages, and so phages without other protection would be expected to undergo selection to eliminate recognition sites for these enzymes from their genomes . The observed frequencies of all restriction sites in the genomes of all completely sequenced DNA phages (T7, lambda, phi X174, G4, M13, f1, fd, and IKe) have been compared to expected frequencies derived from trinucleotide frequencies . Attention was focused on 6-base palindromes since they comprise the typical recognition sites for type II restriction enzymes . All of these coliphages, with the exception of lambda and G4, exhibit significant avoidance of the particular sequences that are enterobacterial restriction sites . As expected, the sequenced fraction of the genome of phi 29, a Bacillus subtilis phage, lacks Bacillus restriction sites . By contrast, the RNA phage MS2, several viruses that infect eukaryotes (EBV, adenovirus, papilloma, and SV40), and three mitochondrial genomes (human, mouse, and cow) were found not to lack restriction sites . Because the particular palindromes avoided correspond closely with the recognition sites for host enzymes and because other viruses and small genomes do not show this avoidance, it is concluded that the effect indeed results from natural selection. Eur J Immunol, 1986 Jan, 16(1), 87 - 91 Molecular requirement for interleukin 1 induction by lipopolysaccharide-stimulated human monocytes: involvement of the heptosyl-2-keto-3-deoxyoctulosonate region; Lebbar S et al.; Experiments were undertaken to localize in the lipopolysaccharide (LPS) the minimal structural determinants sufficient to initiate the signal leading to interleukin 1 (IL 1) secretion by human monocytes . Our results clearly demonstrated that this signal is triggered by structures present in the so-called inner-core region which chemically consists of 2-keto-3-deoxy-D-manno-octulosonic acid (KDO) and heptose in many LPS of gram-negative bacteria . Thus, the isolated polysaccharide region of Bordetella pertussis endotoxin as well as fragments derived therefrom containing the reducing KDO unit were able to induce similar levels of IL1 induction as the native LPS . Similarly, the trisaccharide alpha-D-manno-heptopyranosyl-(1-3)-alpha-D-manno-heptopyranosyl -(1-5)-3 -deoxy-D-manno-octulosonic acid (hep-hep-KDO), representative for the inner-core region of a large number of enterobacterial LPS, was a very potent IL 1 inducer . Neither KDO monosaccharide, nor the alpha-(2-4)-linked 3-deoxy-D-manno-octulosonic acid disaccharide isolated from Salmonella rough-form LPS promoted the signal indicating that the minimal structure of endotoxin able to induce IL 1 secretion resides in the hep (1-5)-KDO disaccharide. Nature, 1985 Dec 5-11, 318(6045), 478 - 80 Resistance to beta-lactam antibiotics by re-modelling the active site of an E . coli penicillin-binding protein; Hedge PJ et al.; The beta-lactam antibiotics kill bacteria by inhibiting a set of penicillin-binding proteins (PBPs) that catalyse the final stages of peptidoglycan synthesis . In some bacteria the development of intrinsic resistance to beta-lactam antibiotics by the reduction in the affinity of PBPs causes serious clinical problems . The introduction of beta-lactam antibiotics that are resistant to hydrolysis by beta-lactamases may also result in the emergence of intrinsic resistance among the Enterobacteriaceae . The clinical problems that would arise from the emergence of resistant PBPs in enterobacteria have led us to examine the ease with which Escherichia coli can gain resistance to beta-lactams by the production of altered PBPs . The development of resistant PBPs also provides an interesting example of enzyme evolution, since it requires a subtle re-modeling of the enzyme active centre so that it retains affinity for its peptide substrate but excludes the structurally analogous beta-lactam antibiotics . We show here that only four amino-acid substitutions need to be introduced into PBP 3 of E . coli to produce a strain possessing substantial levels of resistance to a wide variety of cephalosporins . We also show that transfer of the gene encoding the resistant PBP 3 from the chromosome to a plasmid could result in the spread of intrinsic resistance not only to other strains of E . coli but also to other enterobacterial species. Antimicrob Agents Chemother, 1985 Dec, 28(6), 834 - 6 In vitro activity of carumonam; Fass RJ et al.; The in vitro activities of carumonam and eight comparative antimicrobial agents were studied . MICs of carumonam were less than or equal to 0.5 microgram/ml for 91% of members of the family Enterobacteriaceae and less than or equal to 16 micrograms/ml for 88% of nonfermenters; gram-positive cocci and anaerobic bacteria were resistant . Combinations of carumonam with piperacillin, nafcillin, or clindamycin were usually indifferent, although synergy between carumonam and piperacillin was observed with 20 (13%) of 155 strains. Exp Mol Pathol, 1985 Dec, 43(3), 305 - 20 Morphometric changes of the lung induced by inhaled bacterial endotoxin; Lantz RC et al.; Due to the ubiquitous nature of airborne endotoxin, an understanding of pulmonary alterations which follow inhalation of environmentally realistic concentrations of purified bacteria derived lipopolysaccharide (LPS) is important . Using LPS derived from Enterobacter agglomerans, a bacterium found in cotton and cotton mill dust, aqueous aerosols (effective LPS concentration 4 micrograms/m3) were generated and used to expose either normal hamsters (N = 6) or those rendered endotoxin tolerant by pre-ip injection of 0.1 LD50 LPS . Control groups (normal--N = 6; tolerant--N = 6) received saline aerosol only . At 6 hr after 5-hr aerosol exposure, lungs of all animals were fixed, processed for light and transmission electron microscopy, and subject to qualitative and to multitiered morphometric analysis using standard point counting techniques . Qualitative evaluation of TEM micrographs from LPS aerosolized-nontolerant hamsters showed endothelial alteration (focal disruption, subendothelial space formation, and cytoplasmic blebbing) but volume and number of endothelial cells were not changed indicating only slight, focal endothelial damage . Quantitatively, septal capillary blood space in nontolerant, LPS aerosolized hamsters showed increased Vv of PMNs and platelets . These changes were not seen in tolerant induced-LPS aerosolized hamsters . Independent of tolerization treatment, LPS inhalation led to a decrease in fixed lung volume and an increase in numerical density of endothelial pinocytotic vesicles . It is concluded that the inhalation of realistic, environmental levels of bacterial endotoxin may induce significant changes in distal lung and may be important in the pathogenesis of byssinosis and adult respiratory distress syndrome. Zentralbl Bakteriol Mikrobiol Hyg {B}, 1985 Dec, 182(1), 95 - 101 {Oligodynamic action of 17 different metals on Bacillus subtilis, Enterobacteriaceae, Legionellaceae, Micrococcaceae and Pseudomonas aeruginosa}; Muller HE; The oligodynamic action of the pure metals aluminium, antimony, bismuth, cadmium, cobalt, copper, gold, iron, lead, manganese, mercury, nickel, platinum, silver, tin, titanium, and zinc on Bacillus subtilis (1 strain), Enterobacteriaceae (26 strains), Legionellaceae (13 strains), Micrococcaceae (6 strains), and Pseudomonas aeruginosa (4 strains) was investigated using an agar diffusion test . B . subtilis and Legionellaceae exhibited the highest susceptibility . The apathogenic micrococci and staphylococci were more susceptible to oligodynamic action of some metals than S . aureus . The group of gramnegative rods was the most resistant . The susceptibility of the different bacteria seems to be very different . Apart from the known oligodynamic action of some heavy metals the activity of antimony, cobalt, gold, and platinum should be mentioned. Chemioterapia, 1985 Dec, 4(6), 434 - 5 Ofloxacin: in-vitro activity against clinical isolates; Grima P; The in-vitro activity of ofloxacin, a new quinolone derivative, was evaluated in 273 bacterial strains isolated from urine . The results showed a remarkable activity against most Gram-negative bacteria and, in particular, against Enterobacter aerogenes, which is very difficult to eradicate even with third-generation cephalosporins. J Antimicrob Chemother, 1985 Dec, 16(6), 699 - 707 Resistance to beta-lactamase-stable cephalosporin antibiotics in strains of Enterobacteriaceae and Pseudomonas aeruginosa isolated from blood cultures; Towner KJ et al.; A total of 224 strains of Enterobacteriaceae and Pseudomonas aeruginosa isolated from blood cultures were screened for resistance to cefuroxime and cefotaxime . Seven of 200 strains of Enterobacteriaceae were resistant to either cefuroxime or cefotaxime, while five of 24 strains of Ps . aeruginosa were resistant to cefotaxime . A further 32 resistant variants were isolated by use of a single step selection procedure, without prior mutagenesis, from strains which were sensitive on initial screening . From the total of 44 resistant strains and variants isolated, 31 were found to produce elevated levels of chromosomal beta-lactamases . Of these 31, five strains of Proteus sp . produced significant amounts of beta-lactamase only when induced in the presence of cefuroxime or cefotaxime, while the remaining 26 strains also produced high levels of beta-lactamase in the absence of an inducer . Thirteen resistant strains and variants (9 Ps . aeruginosa, 3 P . mirabilis, 1 K . aerogenes) did not produce detectable levels of beta-lactamase in either the presence or absence of induction and presumably owed their resistance to another mechanism. Burns Incl Therm Inj, 1985 Dec, 12(2), 91 - 6 Antimicrobial cream susceptibility testing; Conly JM et al.; Utilizing a recently described rapid needle extrusion method for determining the sensitivities of burn wound isolates, we have compiled data on the resistance patterns of over 250 isolates from our burn unit . Major isolate groups were Staphylococcus aureus, Pseudomonas aeruginosa, various Enterobacteriaceae and Enterococci . Excellent correlation was exhibited between the inhibitory zone sizes and the minimal inhibitory concentration for 120 organisms tested . Utilizing the needle extrusion sensitivities to facilitate the selection of the burn creams, a significant reduction in the microbiologic flora of the burn wound was noted . The utilization of this technique in the selection of burn creams deserves controlled trials to assess whether changes in topical therapy might alter clinical outcome. J Trop Med Hyg, 1985 Dec, 88(6), 359 - 65 The changing bacteriology of recurrent pyogenic cholangitis in Hong Kong; Seto WH; When the results of bile cultures of RPC patients, admitted to Queen Mary Hospital in 1973-74 and 1979-80, were analysed together with data obtained from the publication of previous investigators, a change in the bacteriology of the disease was noted . The percentage of RPC patients was affected by E . coli was on the decline while, in contrast, a higher percentage of patients was affected by the other enterobacteriaceae (especially Klebsiella spp . and Proteus spp.) and the non-glucose fermenters . Similarly anaerobes and mixed aerobic cultures were more frequent in our series than in earlier ones . Improvement in anaerobic laboratory methods is postulated to be the most probable reason for the rising incidence of anaerobes, while changes in the use of antibiotics could be a major factor for some of the trends noted among the aerobes . Irrespective of the reason for the change in bacteriology, due consideration should be given to its therapeutic implications in the management of patients with recurrent pyogenic cholangitis. Pathol Biol (Paris), 1985 Dec, 33(10), 964 - 6 {Cross antigenicity between human arterial tissue and various germs}; Scebat L et al.; Cross antigenicity was demonstrated between human arterial tissue and enterobacteriaceae, some streptococcus strains or some viruses, using the indirect immunoenzymatic test . Absorption of antigerm antisera by the glycoproteins of either the human serum or aorta suggested that a glycoprotein or some fragment of it acted as a target-antigen or target-epitope for the investigated antibodies and that these antibodies might attack human arterial tissue. J Med Microbiol, 1985 Dec, 20(3), 291 - 8 Experimental oral candidal infection and carriage of oral bacteria in rats subjected to a carbohydrate-rich diet and tetracycline treatment; Hassan OE et al.; Oral candidal infection and the carriage of oral bacteria in rats has been studied in animals on a high carbohydrate diet and treated with tetracycline . Candidal infection was not significantly enhanced by carbohydrate alone but was promoted by tetracycline; carbohydrate plus tetracycline was no more effective than tetracycline alone . Carriage of lactobacilli was enhanced by carbohydrate but streptococcal carriage was depressed; there was no effect on the number of rats carrying enterobacteria . Administration of tetracycline reduced the carriage of all three groups of bacteria but the isolation rate for enterobacteria increased towards the end of the experiment, becoming nearly the same as at the start . The prevalence of C . albicans did not vary with these changes in bacterial populations. J Clin Microbiol, 1985 Dec, 22(6), 951 - 4 Large-scale clinical comparison of the lysis-centrifugation and radiometric systems for blood culture; Brannon P et al.; The Isolator 10 lysis-centrifugation blood culture system (E . I . du Pont de Nemours & Co., Inc., Wilmington, Del.) was compared with the BACTEC radiometric method (Johnston Laboratories, Inc., Towson, Md.) with 6B and 7D broth media for the recovery of bacteria and yeasts . From 11,000 blood cultures, 1,174 clinically significant organisms were isolated . The Isolator system recovered significantly more total organisms, members of the family Enterobacteriaceae, Staphylococcus spp., and yeasts . The BACTEC system recovered significantly more Pseudomonas spp., Streptococcus spp., and anaerobes . Of the Isolator colony counts, 87% measured less than 11 CFU/ml of blood . Organisms, on an average, were detected the same day from each of the two culture systems . Only 13 of the 975 BACTEC isolates (0.01%) were recovered by subculture of growth-index-negative bottles, and 12 of the 13 were detected in another broth blood culture taken within 24 h . Contaminants were recovered from 4.8% of the Isolator 10 and 2.3% of the BACTEC cultures. J Bacteriol, 1985 Dec, 164(3), 1057 - 63 Interspecific reconstitution of maltose transport and chemotaxis in Escherichia coli with maltose-binding protein from various enteric bacteria; Dahl MK et al.; In Escherichia coli, the periplasmic maltose-binding protein (MBP), the product of the malE gene, is the primary recognition component of the transport system for maltose and maltodextrins . It is also the maltose chemoreceptor, in which capacity it interacts with the signal transducer Tar (taxis to aspartate and some repellents) . In studies of the maltose system in other members of the family Enterobacteriaceae, we found that MBP is produced by Salmonella typhimurium, Klebsiella pneumoniae, Enterobacter aerogenes, and Serratia marcescens . MBP from all of these species cross-reacted with antibody against the E . coli protein and had a similar molecular weight (about 40,000) . The Shigella flexneri and Proteus mirabilis strains we examined did not synthesize MBP . The isoelectric points of MBP from different species varied from the acid extreme of E . coli (4.8) to the basic extreme of E . aerogenes (8.9) . All species with MBP transported maltose with high affinity, although the Vmax for K . pneumoniae was severalfold lower than that for the other species . Maltose chemotaxis was observed only in E . coli and E . aerogenes . In S . typhimurium LT2, Tar was completely inactive in maltose taxis, although it signaled normally in response to aspartate . MBP isolated from all five species could be used to reconstitute maltose transport and taxis in a delta malE strain of E . coli after permeabilization of the outer membrane with calcium. J Antimicrob Chemother, 1985 Dec, 16(6), 719 - 25 In-vitro activity of the combinations of ampicillin with mecillinam or with beta-lactamase inhibitors against strains resistant to ampicillin; Verbist L; The in-vitro activity of ampicillin, of mecillinam and of combinations of ampicillin with mecillinam, clavulanic acid or 6 beta-bromopenicillanic acid has been studied against 126 Enterobacteriaceae resistant to ampicillin . The combination of ampicillin with mecillinam showed synergy or addition in 60% of the combinations tested . Synergy was seen especially when the strains were resistant to mecillinam, indifference when they were susceptible to mecillinam . The combination of ampicillin with mecillinam was more active than the combination with clavulanic acid against Escherichia coli, Klebsiella and Enterobacter, but not against Proteus, Morganella and Providencia . The combination of ampicillin with clavulanic acid was more active than the combination with 6 beta-bromopenicillanic acid in E . coli, Klebsiella and Enterobacter strains. Jpn J Antibiot, 1985 Dec, 38(12), 3458 - 63 {Therapeutic efficacies of suppository of ceftizoxime against experimental infections in mice}; Obana Y et al.; In experimental infections in mice, the therapeutic efficacies of rectal administration of ceftizoxime (CZX) were compared with those of subcutaneous administration . The efficacies of rectal administration were equivalent to those of subcutaneous administration against intraperitoneal infections due to Streptococcus pneumoniae and Escherichia coli . Against Staphylococcus aureus, Streptococcus pyogenes, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Morganella morganii and Serratia marcescens, the efficacies of rectal administration were inferior to those of subcutaneous administration . Against urinary tract and respiratory tract infections, the efficacies of rectal administration were slightly inferior to those of subcutaneous administration . Serum concentrations of CZX for rectal administration were less than those of subcutaneous administration. J Clin Microbiol, 1985 Dec, 22(6), 1045 - 7 Cefotiam susceptibility testing criteria; Fuchs PC et al.; Interpretive zone size breakpoints for diffusion tests with 30-micrograms cefotiam disks are diameters of greater than or equal to 18 mm for susceptible and less than or equal to 14 mm for resistant strains . The standard control strains Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923 should both give zones 27 to 33 mm in diameter . Tests with 579 clinical isolates yielded an unacceptably high rate of very major discrepancies between disk tests and microdilution tests; such discrepancies were especially common among Enterobacter spp . Additional studies support the concept that standard microdilution tests and standard disk diffusion tests may fail to detect a potential for resistance among some microorganisms. Vestn Khir Im I I Grek, 1985 Dec, 135(12), 39 - 43 {Microflora in colonic cancer complicated by an inflammatory process}; Ganichkin AM et al.; The microbiological investigation was performed in 53 patients with carcinoma of the colon, 32 of them having inflammatory complications of the tumor . High incidence of the infected state of the tumor surface, infected regional lymph nodes and regional venous blood was noted especially by enterobacteria . The bacteria isolated were found to be highly resistant to most widely used antibiotics . For the antibiotics to have a bacteriostatic or bactericidal effect, they must be used in great doses which must be often higher than therapeutically admitted ones. Am J Med, 1985 Nov 29, 79(5B), 91 - 5 Timentin versus piperacillin in the therapy of serious urinary tract infections; File TM Jr et al.; In a comparative study, 47 patients received Timentin, a combination of ticarcillin plus clavulanic acid, or piperacillin to treat serious urinary tract infections . Thirty-nine infections in 38 patients were clinically evaluable (21 in the Timentin-treated group and 18 in the piperacillin-treated group) . These included pyelonephritis (10 in the Timentin-treated group and five in the piperacillin-treated group), bladder infections with sepsis (11 in the Timentin-treated group and 11 in the piperacillin-treated group) and bladder infections without fever (two in the piperacillin-treated group) . The addition of clavulanic acid to ticarcillin greatly enhanced the susceptibility of five of the 28 evaluable pathogens in the Timentin-treated group (two Escherichia coli isolates, two Staphylococcus aureus isolates, and one Klebsiella pneumoniae isolate) . The minimal inhibitory concentrations at which 50 and 90 percent of the bacterial growth was inhibited were 4 and 64 micrograms/ml, respectively, for Timentin, and 4 and 32 micrograms/ml, respectively, for piperacillin . All evaluable patients had a satisfactory symptomatic response at the end of the trial . Of 28 evaluable pathogens treated with Timentin, 18 were eradicated up through the one-week post-therapy evaluation period; of 27 evaluable pathogens treated with piperacillin, 18 were eradicated up through the same time period . Eradicated pathogens included E . coli (six of 13 in the Timentin-treated group and six of 11 in the piperacillin-treated group), other Enterobacteriaceae (three of three in the Timentin-treated group and eight of 10 in the piperacillin-treated group), Pseudomonas aeruginosa (two of four in the piperacillin-treated group), enterococcus (two of three in the Timentin-treated group and two of two in the piperacillin-treated group), staphylococcal species (four of five in the Timentin-treated group), and other organisms (three of four in the Timentin-treated group) . Resistance did not develop in any of the persisting pathogens . Adverse effects thought possibly to be related to the study drugs were minimal and included rash in one Timentin-treated patient and diarrhea in another. Am J Med, 1985 Nov 29, 79(5B), 62 - 6 Ticarcillin plus clavulanic acid in the treatment of patients with cancer; Fainstein V et al.; Since the combination of ticarcillin with clavulanic acid is active against many otherwise resistant organisms that commonly affect patients with cancer, a therapeutic trial with ticarcillin disodium plus clavulanate potassium for treating infections in cancer patients was conducted . A total of 127 evaluable patients were treated with this antibiotic . Of these, 63 percent were women with breast carcinoma, 28 percent were patients with leukemia, and the remainder were patients with sarcomas and lung cancer . The median duration of therapy was 7.7 days . There were 63 documented infections, with bacteriologic documentation in 39 episodes . Because of the high incidence of gram-positive infections and after the failure of ticarcillin plus clavulanate potassium in two of these episodes, vancomycin was added to the regimen . The overall response rate was 75 percent . In microbiologically proved infections, the response rate was 79 percent . Thirteen of 17 gram-negative infections responded (76 percent), including four of four episodes caused by Pseudomonas aeruginosa . The only failures in this group were two episodes with Klebsiella species, one episode with Escherichia coli, and one episode with Enterobacter species . Of the gram-positive infections treated without vancomycin, five of eight (63 percent) responded and only two episodes due to Staphylococcus aureus and one due to JK diphtheroid bacteria failed . All episodes treated with the combination of ticarcillin plus clavulanate potassium and vancomycin responded . Seven of eight (88 percent) polymicrobial infections and 73 percent of those infections without identified organisms responded as well . The overall response rates for septicemia, pneumonia, soft tissue infections, and urinary tract infections were 71, 50, 71, and 83 percent, respectively . Of five microbiologically proved superinfections, three were fungal, and one each was due to Klebsiella species and S . aureus . No toxicity was observed . For 12 organisms, the minimal inhibitory concentration was lower for ticarcillin plus clavulanate potassium than for ticarcillin alone; in six it was identical . Five organisms were resistant to both, and three that were resistant to ticarcillin were sensitive to ticarcillin plus clavulanate potassium . Ticarcillin plus clavulanate potassium is a safe drug with an expanded spectrum of activity . More therapeutic trials need to be conducted to better define its role in the therapy of serious infections in cancer patients. Am J Med, 1985 Nov 29, 79(5B), 136 - 40 Safety and efficacy of ticarcillin plus clavulanic acid in the treatment of infections of soft tissue, bone, and joint; Johnson CC et al.; The efficacy and safety of ticarcillin plus clavulanic acid in the treatment of patients with infections of soft tissue, bone, and joint were evaluated in this open study . Clinical diagnoses included osteomyelitis, soft tissue abscess or ulcer, cellulitis, bite wound, traumatic or postoperative cellulitis, necrotizing fasciitis, septic arthritis, septic bursitis, and septic thrombophlebitis . Trauma or underlying disease such as diabetes mellitus or vascular insufficiency was common (more than 50 percent) in the patient population . Clinical efficacy was evaluable in 66 patients who received 3 g of ticarcillin and 0.1 g of clavulanic acid every four or six hours for a mean of 23.4 days . A satisfactory clinical response was observed in 92 percent of the patients . Major pathogens isolated were Enterobacteriaceae, anaerobic cocci, Staphylococcus aureus, and beta-hemolytic Streptococcus . Of the 143 isolates recovered from 55 bacteriologically evaluable cases, 87 percent were eradicated by therapy . Overall, a satisfactory bacteriologic outcome occurred in 93 percent of the patients, and the pathogen(s) persisted in 7 percent . More than 98 percent of the isolates were susceptible to ticarcillin plus clavulanic acid in vitro . Emergence of resistance during therapy occurred with three strains of Pseudomonas aeruginosa . Adverse drug-related reactions required discontinuation of treatment in two patients, although other minor abnormal laboratory findings were common . These results indicate that ticarcillin plus clavulanic acid offers safe and effective therapy for infections of soft tissue, bone, and joint. Antimicrob Agents Chemother, 1985 Nov, 28(5), 601 - 6 Inoculum effect of beta-lactam antibiotics on Enterobacteriaceae; Eng RH et al.; Seven beta-lactam antibiotics were studied for both their antimicrobial activity and the degree to which they produced inoculum effect on Escherichia coli, Klebsiella pneumoniae, and Salmonella typhimurium . Aztreonam, cefoperazone, and ceftazidime were poorly bactericidal, caused marked bacterial filamentation, and exhibited a large inoculum effect on E . coli, K . pneumoniae, and S . typhimurium . Cefotaxime and ceftriaxone were more rapidly bactericidal, caused only a moderate amount of filamentous forms, and exhibited a modest inoculum effect, while cefoxitin and imipenem both were rapidly bactericidal and exhibited only a minimal-to-no-inoculum effect . The inoculum effect did not correlate with drug stability during incubation with the bacteria . Inoculum effect on these species of the family Enterobacteriaceae appears to be a manifestation of increase in optical density secondary to the development of filamentous bacterial forms with an increase in bacterial mass during exposure to antibiotics which are not rapidly bactericidal . These observations have a clear significance for the susceptibility testing of beta-lactam antibiotics when turbidity is used as a parameter to determine presence of bacterial growth. J Antibiot (Tokyo), 1985 Nov, 38(11), 1536 - 49 Studies on monocyclic beta-lactam antibiotics . II . Synthesis and antibacterial activity of 3-acylamino-2-azetidinone-1-oxysulfonic acids; Yoshida C et al.; The synthesis and in vitro antibacterial and beta-lactamase inhibitory activity of the 2-azetidinone-1-oxysulfonic acids having a substituent at C-4 position of the beta-lactam ring are described . The influence of C-4 substituents on the antibacterial activity was examined for the compounds having alpha-ureidoacetyl or alpha-oxyiminoacetyl group as acyl side chain at C-3 position . The antibacterial activity is correlated with the C-4 substituents and acyl side chain . Especially, 4(R)-methyl substituted derivatives exhibited excellent activity against Gram-negative bacteria and 4-dimethyl substituted derivatives exhibited strong activity against resistant Gram-negative bacteria except for Pseudomonas aeruginosa . 39 and 40 showed strong inhibitory activity against cephalosporinase of Enterobacter cloacae H-27. Am J Med, 1985 Nov, 79(5), 659 - 62 Liver abscess complicating Crohn's disease presenting as thoracic empyema . Case report and review of the literature; Valero V et al.; A 28-year-old man with a history of Crohn's disease presented with right pleuritic pain and dyspnea . Chest radiography showed a right pleural effusion . Thoracocentesis yielded purulent fluid that subsequently grew Enterobacter aerogenes . Computed axial tomography of the abdomen revealed right subphrenic abscess and right hepatic lobe abscess . Antibiotic therapy and surgical drainage resulted in complete recovery . A review of the English literature produced 18 cases of liver abscess complicating Crohn's disease . Details of 14 of these cases are summarized. Am J Cardiol, 1985 Nov 1, 56(12), 757 - 9 Infections in a coronary care unit; Schandorf WA et al.; All infections in patients in an active coronary care unit (CCU) over a 3-year period were analyzed to ascertain rates, outcomes, pathogens and sites of infections . Standard surveillance methods and definitions of the Center for Disease Control were used . A total of 236 infections were documented in 200 infected patients . Infection rates were 5 and 2% for total and CCU-acquired infections, respectively . CCU infections accounted for 11% of nosocomial infections that occurred within all critical care areas surveyed . Of all documented infections, 131 (56%) were community-acquired and 90 (38%) were acquired within the CCU . Lower respiratory and urinary tract infections were most frequently noted, with E . coli, S . aureus, and klebsiella-enterobacter-serratia most usually implicated . Mortality among patients with infections was 31%, compared with 8 to 12% in those who were not infected . Those with lower respiratory infections or primary bacteremias had a higher mortality rate than those with infections at other sites (p less than 0.001) . Infections are seen in close to 5% of CCU patients and may adversely affect the survival rate . The mortality rate in infected patients may be 3 times higher than that in the general CCU population . This study also provides data against which other similar institutions can gauge their CCU infection rates. J Clin Microbiol, 1985 Nov, 22(5), 793 - 8 Evaluation of the BIOGRAM antimicrobial susceptibility test system; D'Amato RF et al.; BIOGRAM is an antimicrobial susceptibility test system for the determination of MICs from the standard disk diffusion test zone diameters . The system was challenged with 511 recent clinical isolates of members of the family Enterobacteriaceae, nonfermentative gram-negative bacteria, staphylococci, and enterococci . Results were compared with those obtained with the broth microdilution method . Appropriate control organisms were included with each test series . A total of 10,085 organism-drug combinations were evaluated . BIOGRAM demonstrated an overall correlation of 95.9% with the reference broth microdilution method. Clin Pharmacol Ther, 1985 Nov, 38(5), 590 - 4 The pharmacokinetic and bactericidal characteristics of oral cefixime; Brittain DC et al.; The pharmacokinetics of cefixime (FK 027), a broad-spectrum cephalosporin, were assessed in 12 normal subjects after single oral doses of 50, 100, 200, and 400 mg . Mean peak serum concentrations were 1.02, 1.46, 2.63, and 3.85 micrograms/ml after the four respective doses . Respective mean serum levels at 12 hours were 0.16, 0.33, 0.72, and 1.13 micrograms/ml . Volumes of distribution averaged 0.1 L/kg body weight, and the elimination t1/2 was 3 hours for all doses . The AUC was 7.01, 11.4, 22.5, and 36.4 micrograms X hr/ml for the four doses, respectively . Serum clearance averaged 0.4 mg/min/kg and mean 24-hour urinary recovery was 21%, 19%, 20%, and 16% for the four respective doses . Serum bactericidal titers at 4 hours exceeded 1:16 for Streptococcus pneumoniae, S . pyogenes, Hemophilus influenzae, and Branhamella catarrhalis . Urine bactericidal titers exceeded 1:8 for Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae resistant to the available oral cephalosporins. Zh Mikrobiol Epidemiol Immunobiol, 1985 Nov, (11), 46 - 50 {Changes in the migration and adhesive activity of polymorphonuclear leukocytes as 1 of the characteristics of Gram-negative bacteria isolated from patients with suppurative lung destruction}; Lobashevskii AL et al.; The influence of Gram-negative bacteria on the migratory and adhesive activity of polymorphonuclear leukocytes (PMNL) in the peripheral blood of clinically normal donors has been studied by the specially developed method with the use of Boyden chambers . Pseudomonas and enterobacteria have been found to produce complex and various effects on the above-mentioned properties of PMNL . When incubated in fresh serum, Gram-negative bacteria are capable of enhancing the migratory activity of PMNL, this property being least pronounced in P . aeruginosa . The incubation of live bacteria from the authors' collection in the patients' sera or in sera obtained from normal donors and inactivated by heating induces no hemotaxis of PMNL, and P . aeruginosa strains even suppress it under such conditions . The isolated Gram-negative bacteria under study increase the number of highly adhesive PMNL in the population used in this investigation, but P . aeruginosa cultures do not produce such effect. Pathol Biol (Paris), 1985 Nov, 33(9), 906 - 10 {Evaluation of a new rapid antibiogram method, the Rapid-ATB system . Comparison with the agar dilution reference method and the standard antibiogram}; Le Noc P et al.; Results given by Rapid-ATB, a new automated system for the four hour susceptibility testing of bacteria were compared in this study to results given by agar dilution test and disc agar diffusion test . For 100 Enterobacteriaceae strains tested against ten antibiotics, overall agreement between agar dilution test and Rapid-ATB was 99.4% . 6 major discordances concerning especially chloramphenicol were only detected in 1 000 realized susceptibility tests . Overall agreement between agar dilution test and disc agar diffusion test was 96.7% . Eighteen major discordances concerning alike chloramphenicol, but also doxycycline and nalidixic acid, and fifteen minor discordances were detected in this comparison . These results prove the high reliability of this new system which give results more precise than these of disc agar diffusion test. J Antimicrob Chemother, 1985 Nov, 16(5), 581 - 7 Interaction of gentamicin, dibekacin, netilmicin and amikacin with various penicillins, cephalosporins, minocycline and new fluoro-quinolones against Enterobacteriaceae and Pseudomonas aeruginosa; Van der Auwera P; Thirty strains of Enterobacteriaceae and ten strains of Pseudomonas aeruginosa were selected to study the in-vitro activity of various combinations containing aminoglycosides, by the checkerboard method . The following aminoglycosides: gentamicin, dibekacin, netilmicin and amikacin were used in combination with each of the following: ampicillin, ticarcillin, piperacillin, cefazolin, cefuroxime, ceftazidime, norfloxacin, enoxacin and minocycline . Synergy was not a constant feature of beta-lactam+aminoglycoside combinations . Discrepancies occurred with the same strain submitted to combinations containing different aminoglycosides . The combinations containing new quinolones+aminoglycosides were usually additive, although occasionally synergy occurred . The combination minocycline+aminoglycoside was usually additive but partial antagonism (FIC or FBC index: 1 X 5- less than 2) occurred in 10 to 40% of the strains depending on the aminoglycoside . The combinations of beta-lactams with dibekacin or netilmicin most frequently produced partial or full synergy against strains of Ps . aeruginosa susceptible to all four aminoglycosides tested. J Appl Bacteriol, 1985 Nov, 59(5), 451 - 7 Standardization of salt aggregation test for reproducible determination of cell-surface hydrophobicity with special reference to Staphylococcus species; Rozgonyi F et al.; The laboratory conditions for reproducible routine determination of staphylococcal cell-surface hydrophobicity by the salt aggregation test were standardized . Fresh bacterial suspensions standardized to 5 x 10(9) cfu/ml gave the most reproducible results with both Staphylococcus aureus and coagulase-negative staphylococci . For relatively hydrophobic strains a 5-min reading time was necessary to detect bacterial aggregation in ammonium sulphate solutions ranging from 0.1 M to 1.5 M, pH 6.8 . A x 10 hand lens facilitated reading aggregations . Overnight storage of bacterial suspensions at 20 degrees C reduced cell-surface hydrophobicity of all species, while storage at 4 degrees C reduced the hydrophobic nature of Staph . aureus strains . The hydrophobicity of coagulase-negative staphylococci rarely changed at 4 degrees C . A 10-fold dilution of fresh, standardized bacterial suspensions made it impossible to detect bacterial aggregation in ammonium sulphate solutions even with a hand lens . Under standardized conditions three types of staphylococcal cell aggregations were observed . The first looked like the slide agglutination for O antigens of Enterobacteriaceae, the second resembled H-agglutination, while the third had a filamentous appearance . These patterns indicated that more than one component might contribute to cell-surface hydrophobicity of both Staph . aureus and coagulase-negative staphylococci, or the same component might have different position on the cell surface. Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S778 - 82 Infections due to gram-negative bacteria: an overview; Neu HC; Infections caused by gram-negative bacteria have continued to be a major problem for hospitalized patients . Malignant necrotizing otitis due to Pseudomonas aeruginosa has been encountered with increasing frequency as the number of older diabetic patients has increased . Nosocomial sinusitis and bacteremia due to Escherichia coli, Klebsiella pneumoniae, Enterobacter species, or P . aeruginosa develop in hospitalized patients . Bacteremia due to E . coli, K . pneumoniae, or P . aeruginosa often follows instrumentation of the urinary, respiratory, or gastrointestinal tracts in the hospitalized patient . Mortality still is excessively high . Infections of skin structure, particularly decubitus ulcers in debilitated, bedridden patients, are due to a mixed gram-negative and anaerobic flora; frequently, P . aeruginosa and Enterobacteriaceae resistant to many older agents are the major pathogens . Similarly, osteomyelitis in patients who have undergone previous surgical procedures is caused by various multiply resistant Enterobacteriaceae and P . aeruginosa . In all of these situations, therapy has usually included an aminoglycoside . The availability of drugs such as aztreonam, which has activity directed at aerobic gram-negative bacilli, provides an alternative approach that has proved successful and can be evaluated in more detail in the coming years. Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S772 - 7 Summary of worldwide clinical trials of aztreonam in patients with urinary tract infections; Swabb EA et al.; Aztreonam was administered to a total of 681 patients with urinary tract infections due to susceptible gram-negative bacteria; 56 patients received a single 1-g intramuscular dose for acute uncomplicated cystitis, and 625 patients received multiple parenteral doses (usually a five-day course of 1 g two or three times daily) for a variety of urinary tract infections, including pyelonephritis, cystitis, prostatitis, and epididymitis . Microbiologic cure was achieved in 84% of patients in the single-dose study and in 85% of patients in the multiple-dose studies . In the latter studies the microbiologic cure rates for infections with Escherichia coli, the Klebsiella-Enterobacter-Serratia group, and Pseudomonas aeruginosa were 87%, 90%, and 76%, respectively . In a comparative study of aztreonam and cefamandole, the overall microbiologic cure rates were 89% and 80%, respectively . Of the 625 patients receiving multiple-dose therapy, 149 had urinary tract infections due to multiply drug-resistant bacteria; among these patients the microbiologic cure rate was 93% . Aztreonam constitutes effective therapy for urinary tract infections due to susceptible gram-negative bacilli. Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S767 - 71 Aztreonam therapy for complicated urinary tract infections caused by multidrug-resistant bacteria; Cox CE; Aztreonam was administered to 145 consecutive patients with complicated urinary tract infections caused by multidrug-resistant, aztreonam-sensitive bacteria . Multidrug resistance was defined by disk diffusion testing as resistance to aminopenicillins and to first- and second-generation cephalosporins, with or without resistance to aminoglycosides . The first 40 assessable patients received 1 g of aztreonam intravenously three times daily for a median period of eight days; the remaining 95 assessable patients received 0.5 g twice daily for a median period of nine days . Fifty-five patients were infected with Pseudomonas aeruginosa, 24 with Escherichia coli, 18 with Serratia marcescens, 13 with Morganella morganii, 12 with Providencia rettgeri, and 10 with Enterobacter species . Bacteriologic cure rates were 98% for the group given 3 g daily and 96% for that given 1 g daily . Minimal and transient adverse reactions occurred with both dosages. Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S690 - 5 Role of aerobic gram-negative bacilli in endometritis after cesarean section; Gibbs RS et al.; Endometritis is considered to be a polymicrobial infection, involving aerobes, anaerobes, and genital mycoplasmas . Aerobic gram-negative rods make up 7%-25% of all genital isolates, but findings from studies in which special collection techniques were used suggest that many of these may be contaminants from the lower genital tract . Bacteremia occurs in 4%-30% of patients with endometritis, and aerobic gram-negative rods account for approximately 25% of blood isolates . Both selected therapy studies and studies of intrauterine cultures collected at surgery from patients at risk for endometritis suggest the significant role of aerobic gram-negative rods . Among them Escherichia coli is the most common isolate in both genital and blood cultures . Klebsiella pneumoniae and Proteus mirabilis rank next, followed by Enterobacter species . Pseudomonas species account for fewer than 0.6% of genital isolates . Overall, aerobic gram-negative rods are causally involved in 10%-20% of cases of endometritis following cesarean section. Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S594 - 604 Aztreonam: antibacterial activity, beta-lactamase stability, and interpretive standards and quality control guidelines for disk-diffusion susceptibility tests; Barry AL et al.; In vitro activity of aztreonam was compared with that of ceftazidime, cefotaxime, cefoperazone, piperacillin, and ticarcillin against 656 representative bacterial pathogens . Aztreonam was not active against gram-positive cocci but was as active as the third-generation cephalosporins against the Enterobacteriaceae, Haemophilus influenzae, and Neisseria gonorrhoeae . Additional data for 5,262 gram-negative bacilli isolated in four separate medical centers documented the low incidence of resistance to aztreonam; 97.2% of 4,312 isolates of Enterobacteriaceae and 79% of 854 isolates of Pseudomonas aeruginosa were inhibited by less than or equal to 8.0 micrograms of aztreonam/ml . Additional studies confirmed the stability of aztreonam in the presence of seven different beta-lactamases . For disk-diffusion susceptibility tests, 30-micrograms disks are recommended, with interpretive breakpoints of less than or equal to 15 mm for resistance (MIC greater than or equal to 32 micrograms/ml), 16-21 mm for intermediate susceptibility (MIC, 16 micrograms/ml), and greater than or equal to 22 mm for susceptibility (MIC less than 8.0 micrograms/ml) . For quality control of tests with 30-micrograms disks, zone-size limits for Escherichia coli (ATCC 25922) should be 28-36 mm and those for P . aeruginosa (ATCC 27853) should be 23-29 mm. Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S572 - 8 Treatment of infections due to gram-negative bacilli: a perspective of past, present, and future; Young LS; Bacteremia due to gram-negative rods is a disease of the antimicrobial era . Mortality is critically related to the presence of underlying disease and to the appropriateness of therapy . During the last 15 years, survival has significantly improved for patients who have severe underlying disease and who are treated with aminoglycosides and beta-lactam agents possessing antipseudomonal activity . Newer broad-spectrum beta-lactam agents offer considerable therapeutic promise, but clinical results have been disappointing in serious infections caused by Enterobacter and Serratia species and a number of the "nonfermenting" bacilli, including Pseudomonas aeruginosa . A number of major problems exist in interpreting open or comparative clinical trials . Treatment of the critically ill patient with sepsis due to gram-negative bacteria will remain the definitive test of efficacy of any new broad-spectrum antimicrobial agent. Drugs, 1985 Nov, 30(5), 382 - 426 Cefotetan . A review of its antibacterial activity, pharmacokinetic properties and therapeutic use; Ward A et al.; Cefotetan is a new semisynthetic cephamycin antibiotic administered intravenously or intramuscularly . It has a broad spectrum of activity against Gram-negative aerobic and most clinically important Gram-positive and anaerobic bacteria, and is generally more active against Gram-negative bacteria than the 'first and second generation' agents . Cefotetan is particularly active against Enterobacteriaceae but has little activity against Pseudomonas aeruginosa . An extended plasma elimination half-life of about 3.5 hours, and relatively high achievable serum and tissue levels, enables cefotetan to be administered on a twice daily basis in the treatment of mild to severe infections . Cefotetan has shown good clinical efficacy in intra-abdominal, obstetric and gynaecological infections, postoperative wound infections, and infections in immunocompromised patients - all of which are often complicated due to their polymicrobial nature or by the presence of anaerobic pathogens . A satisfactory clinical response is achieved in over 90% of paediatric patients with acute otorhinolaryngological infections, whereas in the treatment of chronic disease, as with other agents, the efficacy is dramatically reduced . Like other cephalosporins, cefotetan is effective in treating patients with complicated urinary tract infections and lower respiratory tract infections . Its efficacy in urinary tract infections is at least as good as cefoxitin, although in this and some other clinical areas its activity relative to that of other cephamycins and cephalosporins remains to be assessed . Thus, with its convenient twice daily dosage schedule, cefotetan would appear to be a useful addition to a rapidly expanding group of antibacterial agents. Am J Dis Child, 1985 Nov, 139(11), 1086 - 9 Gentamicin vs cefotaxime for therapy of neonatal sepsis . Relationship to drug resistance; Bryan CS et al.; An outbreak of serious infections due to gentamicin-resistant Klebsiella pneumoniae occurred in a neonatal intensive care unit in which the combination of gentamicin sulfate and ampicillin sodium had been used for standard initial therapy for suspected sepsis for nearly 11 years . After institution of control measures that included the substitution of cefotaxime sodium for gentamicin in the standard regimen, the outbreak promptly subsided . Nevertheless, a second outbreak of serious infections due to cefotaxime-resistant Enterobacter cloacae began ten weeks later . Sequential stool cultures from patients in the unit confirmed the disappearance of gentamicin-resistant K pneumoniae and the emergence of cefotaxime-resistant E cloacae after the change in antibiotic policy . These observations suggest that routine use of newer cephalosporins for therapy of suspected sepsis may lead to the emergence of drug-resistant microorganisms more rapidly than has occurred with the aminoglycosides. J Antimicrob Chemother, 1985 Nov, 16(5), 539 - 47 In-vitro antibacterial activity of AMA-1080; Matsuda K et al.; The in-vitro antibacterial activity of AMA-1080 against both Gram-positive and Gram-negative clinical isolates was studied in comparison with that of aztreonam, cefotaxime, ceftazidime and cefoperazone . AMA-1080 showed a potent antibacterial activity against Gram-negative bacteria, particularly, the strains of Enterobacteriaceae . In addition, AMA-1080 inhibited the strains of genus Pseudomonas at the low concentrations . However, AMA-1080 showed less active against Gram-positive bacteria . It was found that AMA-1080 was highly resistant to hydrolysis by both chromosomal and plasmid-mediated beta-lactamases. J Antibiot (Tokyo), 1985 Nov, 38(11), 1555 - 63 Interactions of formylamino- and methoxy-substituted beta-lactam antibiotics with beta-lactamases; Okonogi K et al.; Cephem and nocardicin-type monocyclic beta-lactam antibiotics with a formylamino substituent were highly resistant to hydrolysis by both penicillinases and cephalosporinases . Among antibiotics with a methoxy substituent, an N-sulfonated monocyclic beta-lactam antibiotic, sulfazecin was resistant to beta-lactamases, but cephem antibiotics were sensitive to the cephalosporinase of Enterobacter cloacae . The resistance of the antibiotics to the beta-lactamases depended primarily on the presence of the substituent, but affinity for the beta-lactamases was affected not only by the substituent but also by the presence of other side chains . Formylamino compounds and sulfazecin were as good inducers of beta-lactamases as semisynthetic 7-methoxycephalosporins, but naturally occurring 7-methoxycephalosporins were poor inducers . The inducer activities of the antibiotics were not necessarily related to their beta-lactamase stabilities . The stabilities of the compounds to the beta-lactamases were well reflected in their antibacterial activities against beta-lactamase producing bacteria. Am J Clin Pathol, 1985 Nov, 84(5), 643 - 8 Reliability of cefaclor, cefazolin, cefamandole, and cephalothin disks to predict susceptibility of Enterobacteriaceae, Staphylococcus species, and Haemophilus influenzae; Barry AL et al.; Interpretive zone-size standards currently used for cephalothin and cefamandole disk tests also may be applied to tests with disks containing 30 micrograms of cefaclor or cefazolin . Against 627 representative isolates, susceptibility to cefaclor and cefazolin could be predicted by testing cephalothin . However, cefazolin is more active than cephalothin against isolates of Escherichia coli with a TEM beta-lactamase plasmid . The expanded spectrum of cefamandole continues to necessitate separate testing . Against methicillin-resistant staphylococci, cefaclor disks were more reliable than cephalothin or cefamandole, but false-susceptible results were seen with all four disks . For testing Haemophilus influenzae, the cefazolin disks were not reliable; cephalothin or cefaclor disks could predict susceptibility to either drug. Diagn Microbiol Infect Dis, 1985 Nov, 3(6), 525 - 33 The comparative in vitro susceptibility of cefazolin-resistant organisms to six cephalosporins, four penicillins, and three aminoglycosides; Chan EL et al.; One thousand thirty-seven cefazolin-resistant, gram-negative clinical isolates including members of the family Enterobacteriaceae, pseudomonads, and other nonfermenters were tested against a variety of newer antimicrobial agents by microdilution . Most of the Enterobacteriaceae were resistant to the second-generation cephalosporins, but highly susceptible to the third-generation agents and the broad-spectrum penicillins, 90% of the strains being inhibited at attainable serum concentrations . Cefoperazone and the penicillins had good activity against the Pseudomonas species, but the aminoglycosides remained the most active agents against all the gram-negative bacilli tested except Pseudomonas maltophilia. Antimicrob Agents Chemother, 1985 Nov, 28(5), 663 - 6 Comprehensive evaluation of ciprofloxacin-aminoglycoside combinations against Enterobacteriaceae and Pseudomonas aeruginosa strains; Haller I; The in vitro activities of antibiotic combinations containing ciprofloxacin and either gentamicin, sisomicin, netilmicin, amikacin, or tobramycin were evaluated by checkerboard assay (agar dilution method) . A total of 220 strains of Enterobacteriaceae and Pseudomonas aeruginosa (11 species, 20 strains each) were tested . Synergistic or antagonistic effects were observed in less than 1% of the tests performed; they appeared to represent method-dependent fluctuations rather than true antibiotic interactions . No significant differences among the five aminoglycosides tested were seen . Time-kill experiments performed with three representative strains of Escherichia coli and Serratia marcescens showed additive combination effects with respect to the kill rates and inhibition of bacterial regrowth . Exposure of Serratia strains to either ciprofloxacin or gentamicin before the addition of the second drug had little influence on the combination effects observed . No antagonistic drug interactions were seen in vivo when combination therapy with ciprofloxacin and gentamicin was evaluated in a model of E . coli thigh muscle infection in neutropenic mice . Comparable therapeutic effects were obtained, regardless of whether the two compounds were administered simultaneously or sequentially at 1- or 2-h intervals. Zh Mikrobiol Epidemiol Immunobiol, 1985 Nov, (11), 33 - 7 {Vi antigen and microbial adhesion factors . The detection of adhesins in commercial Vi antigen preparations}; Kravtsov EG et al.; Enterobacterial Vi-antigen inhibit the Escherichia coli-induced agglutination of red blood cells of guinea pigs and other animals, which indicates that Vi-antigen contains the admixture of adhesion associated with type I pili . The amount of adhesion contained in Vi-antigen can be determined from the degree to which its hemagglutination-inhibiting effect is manifested. Infect Immun, 1985 Nov, 50(2), 459 - 66 Monoclonal antibodies to enterobacterial common antigen and to Escherichia coli lipopolysaccharide outer core: demonstration of an antigenic determinant shared by enterobacterial common antigen and E . coli K5 capsular polysaccharide; Peters H et al.; We established hybridoma cell lines producing monoclonal antibodies against enterobacterial common antigen (ECA) and a substructure of the outer core of different Escherichia coli lipopolysaccharides (LPSs) . Anti-ECA antibodies 865 and 898 reacted with ECA in extracts of heated E . coli and with ECA-bound R1 and R4 core-containing LPS preparations, as well as with a purified sample of ECA from Salmonella montevideo . Antibody 865, but not antibody 898, cross-reacted with K5 capsular polysaccharide, suggesting that 4-linked alpha-N-acetylglucosamine is part of an antigenic determinant shared by both K5 polysaccharide and ECA . Anti-LPS antibody 786 recognized an outer core structure common to E . coli K-12, B, R2, and R4 core type LPS, but not to R1 and R3 core type LPS . Its most probable target is the trisaccharide sequence Hexp(1----2)-alpha-D -Glcp(1----3) alpha-D-Glcp----(Hepp) (where Hex is hexose, p is phosphate, Glc is glucose, and Hep is heptose), the first glucose being the immunodominant moiety . These monoclonal antibodies may be used not only for the detection of ECA, K5, and LPS core structures but also for analysis of the molecular forms resolved on polyacrylamide gels (banding patterns) of both ECA and LPS, independently of one another. J Immunol, 1985 Nov, 135(5), 3468 - 72 Induction of germ-line anti-alpha 1-3 dextran antibody responses in mice by members of the Enterobacteriaceae family; Kearney JF et al.; A large panel of enteric organisms was screened for agglutination with a panel of lambda monoclonal antibodies of different heavy chain isotypes specific for alpha 1-3 dextran (DEX) . Two strains were initially isolated that were bound by most of the anti-DEX antibodies . One organism, Enterobacter cloacae strain MK7, which was characterized in detail, induced a typical lambda anti-DEX response in Igh-Ca mice that had a fine idiotope profile comparable with that induced by purified B1355S dextran containing alpha 1-3 glucosidic linkages (alpha 1-3-DEX) . The determinant on the bacterial surface was shown by binding inhibition with nigerotriose to contain alpha 1-3 linkages . Hyperimmunization with these organisms of normal, athymic (nu/nu), or germ-free mice induced large amounts of IgM antibodies but very little IgG . This is the first description of an organism isolated from the normal gut flora of mice that can be shown directly to be bound by alpha 1-3-DEX antibodies and to induce the typical germ-line response of the DEX family of antibodies. J Mol Biol, 1985 Oct 5, 185(3), 501 - 7 Evolution of the lipoprotein gene in the enterobacteriaceae . Cloning and DNA sequence of the lpp gene from Proteus mirabilis; Ching G et al.; We cloned the lipoprotein gene from Proteus mirabilis and determined its DNA sequence . Comparison with the lpp genes from Escherichia coli, Serratia marcescens, Erwinia amylovora and Morganella morganii revealed several unique features of the evolution of the lpp gene in the Enterobacteriaceae and enabled us to establish phylogenetic relationships between these bacteria. Nature, 1985 Oct 3-9, 317(6036), 458 - 60 DNA sequence at the end of IS1 required for transposition; Gamas P et al.; The insertion sequence IS1 belongs to a class of bacterial transposable genetic elements that can form compound transposons in which two copies of IS1 flank an otherwise non-transposable segment of DNA . IS1 differs from other known elements of this class (such as IS10, IS50 and IS903) in several respects . It is one of the smallest known insertion elements, exhibits a relatively complex array of open reading frames, is present in the chromosomes of various Enterobacteria, in some cases in many copies, and its insertion can result in the duplication of either 8 or 9 base pairs (bp) in the target DNA . Furthermore, although, like other members of the compound class, it seems to undergo direct transposition, IS1 also promotes replicon fusion (co-integrate formation) at a relatively high frequency . Like all other elements studied to date, the integrity of the extremities of IS1 are essential for efficient transposition . We have constructed a test system to determine the minimal DNA sequences at the extremities of IS1 required for transposition . Sequential deletions of the end sequences reveal that 21-25 bp of an isolated extremity are sufficient for transposition . A specific sequence 13-23 bp from the ends, defining the edge of the minimal sequence, is implicated as an essential site . The sites, symmetrically arrayed at both ends of IS1, correspond to the apparent consensus sequence of the known binding sites for the Escherichia coli DNA-binding protein (called integration host factor or IHF) which is required for the site-specific recombination that leads to integration of bacteriophage lambda into the bacterial genome . The sites at the ends of IS1 may thus bind a host protein, such as JHF or a related protein, that is involved in regulating the transposition apparatus. Antibiot Med Biotekhnol, 1985 Oct, 30(10), 776 - 80 {Experimental study of the antibacterial activity and chemotherapeutic effectiveness of amikacin sulfate}; Lobuseva AN et al.; In vitro antibacterial activity of amikacin against 250 strains of various microorganisms was studied . It was shown that the antibiotic had a broad antibacterial spectrum and was active against gentamicin and sisomicin resistant strains of Enterobacteriaceae and Pseudomonas . By the antibacterial spectrum amikacin was close to kanamycin . Still it differed from kanamycin by activity against P . aeruginosa . By the specific activity gentamicin and sisomicin were superior to amikacin . However, since amikacin was active against gentamicin resistant strains of various microorganisms it was considered advisable to use it as a reserve antibiotic in treatment of infections caused by such strains . High in vivo efficacy of amikacin was shown in experimental sepsis of albino mice due to staphylococci and gramnegative bacteria sensitive to the aminoglycosides and P . aeruginosa strains resistant to gentamicin and sisomicin. Zh Mikrobiol Epidemiol Immunobiol, 1985 Oct, (10), 15 - 9 {Biological properties of opportunistic enterobacteria isolated from the blood of patients}; Polikarpov NA et al.; The comparative study of the signs of pathogenicity in enterobacteria (119 strains) isolated from the blood of 145 patients with the clinical symptoms of sepsis and from the feces of healthy persons (560 strains from 220 persons) has demonstrated that the same species of opportunistic microorganisms may essentially differ in the formation of DNase, RNase, as well as in their capacity for the positive reaction with Congo red . The possibility of using the above-mentioned signs of pathogenicity for diagnostic purposes as additional signs for the differentiation of virulent cultures of opportunistic enterobacteria from avirulent ones is suggested. Appl Environ Microbiol, 1985 Oct, 50(4), 1052 - 7 Fermentative and oxidative transformation of ferulate by a facultatively anaerobic bacterium isolated from sewage sludge; Grbic-Galic D; A facultatively anaerobic, gram-negative, non-sporeforming, motile rod-shaped bacterium was isolated from methanogenic consortia degrading 3-methoxy-4-hydroxycinnamate (ferulate) . Consortia were originally enriched from a laboratory anaerobic digester fed sewage sludge . In the absence of exogenous electron acceptors and with the addition of 0.1% yeast extract, the isolated bacterium transformed ferulate under strictly anaerobic conditions (N2-CO2 gas phase) . Ferulate (1.55 mM) was demethoxylated and dehydroxylated with subsequent reduction of the side chain, resulting in production of phenylpropinate and phenylacetate . Under aerobic conditions, the substrate was completely degraded, with transient appearance of caffeate as the first aromatic intermediate and beta-ketoadipate as an aliphatic intermediate . The pure culture has been tentatively assigned to the genus Enterobacter with the type strain DG-6 (ATCC 35929) . Tentative pathways for both fermentative and oxidative degradation of ferulate are now proposed. Microbiologica, 1985 Oct, 8(4), 399 - 403 A rapid multistrips tests for determination of the enzyme profile in enterobacteria; Giammanco G et al.; A simple test for the detection of bacterial enzymes has been developed using paper strip impregnated with different chromogenic substrates . The test was applied to 145 strains belonging to various species of the family Enterobacteriaceae . Positive reactions were revealed after four hours of incubation at 35 degrees C by the formation of a yellow colour indicating released nitrophenol or nitranilide where a loopful of bacteria had been placed . The results of the multistrips test were in agreement with those obtained by previously described methods for the detection of beta-galactosidase, beta-xylosidase, beta-glucuronidase, gamma-glutamyltransferase, and phenylalanine ammonialyase . The suitability of the test for rapid determination of the enzyme profile in enterobacteria is discussed. Microbiologica, 1985 Oct, 8(4), 395 - 7 A simple chromogenic test for rapid screening of Proteus and Providencia bacteria; Giammanco G et al.; A rapid test for detection of p-nitrophenylalanine ammonia-lyase is described . The test is performed by suspending a loopful of bacteria in 0.5 ml of a buffered 1 mM solution of p-nitro-DL-phenylalanine (PNPA) . The enzymatic activity is revealed by the formation of a yellow colour after 2 hours of incubation at 35 degrees C . Out of 285 strains of different enterobacteria species positive results were shown only by 75 Proteus and Providence strains . Thus, the PNPA test can be useful for rapid screening of these enterobacteria. Pathology, 1985 Oct, 17(4), 636 - 9 The in vitro activity of the newer beta-lactam antibiotics against 124 strains of gram-negative bacilli; Dixson S et al.; The MIC values of 99 isolates of Enterobacteriaceae to 11 of the newer beta-lactam antibiotics, and 25 isolates of Pseudomonas aeruginosa to 9 of these drugs were compared with representatives of the established beta-lactam antibiotics and gentamicin . The MIC values for the newer agents were significantly lower in comparison with the older reference compounds . The potential clinical use of these newer antibiotics is discussed. J Gen Microbiol, 1985 Oct, 131 ( Pt 10), 2673 - 86 Colicin E2 production and release by Escherichia coli K12 and other Enterobacteriaceae; Pugsley AP et al.; Previous work has shown that Escherichia coli K12 ColE2+ cells undergo a form of partial lysis and exhibit increases in lysophosphatidylethanolamine (lysoPE) and free fatty acid content due to activation of phospholipase A when induced to produce and release colicin E2 . The increase in lysoPE content was assumed to be essential for efficient colicin release . These same characteristics are also presented by some natural ColE2+ isolates, and by other representatives of the Enterobacteriaceae after transformation with derivatives of a ColE2 plasmid . However, Salmonella typhimurium strains carrying ColE2 plasmids released colicin without partial lysis and without increasing their lysoPE content . A previously undetected minor phospholipid, which appeared in these and other strains only when they were induced to produce colicin, may be an important factor in colicin release . In ColE2+ E . coli K12, production of this new lipid was dependent on phospholipase A activation following expression of the ColE2 lysis gene . Some other ColE2+ strains did not respond to induction of colicin production in the same way as ColE2+ E . coli K12 . These strains were less sensitive to inducer (mitomycin C) or unable to produce increased amounts of colicin in response to induction, or unable to degrade colicin once it was released . In general, the results suggest that colicin release occurs by the same or similar processes in the various strains tested, and support the continued use of E . coli K12 as the model strain for studying the mechanisms of colicin release. J Antimicrob Chemother, 1985 Oct, 16(4), 457 - 61 In-vitro activity of the monobactam Ro 17-2301 against clinical isolates of Enterobacteriaceae and Pseudomonas aeruginosa; Bremner DA; Ro 17-2301 is a monobactam antibiotic . Its in-vitro activity was compared with those of aztreonam, ampicillin, cefuroxime, ceftriaxone, ceftazidime, and gentamicin . Ro 17-2301 had qualitatively similar activity to aztreonam and activity superior to that all the other antibiotics against the Enterobacteriaceae, but against Pseudomonas aeruginosa ceftazidime had equal or marginally better activity. Can J Microbiol, 1985 Oct, 31(10), 926 - 9 Measuring the spermosphere colonizing capacity (spermosphere competence) of bacterial inoculants; Kloepper JW et al.; Spermosphere establishment by bacteria which were coated onto seeds was studied using soybean seeds treated with four bacterial strains at levels of log10 1 to 4 colony-forming units (cfu) per seed planted in a field soil mix, and incubated 48 h . Each strain at every inoculum level developed spermosphere population densities of log10 4 to 8 cfu/seed, demonstrating an average multiplication of log10 3 cfu/seed . An alternative method was developed to differentially rank bacteria for spermosphere colonizing capacity, based upon incorporation of bacteria into a soil and monitoring the resulting spermosphere population densities around noninoculated seeds after 4 days at 14 degrees C . Fifty-seven bacterial strains which were isolated from soybean roots or from water samples, including Pseudomonas putida, P . putida biovar B, P . fluorescens, Serratia liquefaciens, Enterobacter aerogenes, and Bacillus spp . were tested in the spermosphere colonization assay . Average spermosphere population densities for the 57 strains ranged from 0 to log10 7.0 cfu/seed . Strains of a given taxon demonstrated marked diversity with ranges from 0 to log10 6.0 cfu/seed for Bacillus spp . and from log10 1.4 to 7.0 cfu/seed for Pseudomonas putida . The relative ranking of representative strains was consistent in repeating experiments . The potential usefulness of the assay for efforts to develop competitive bacterial inoculants for crop seeds is discussed. Arq Gastroenterol, 1985 Oct-Dec, 22(4), 162 - 5 Emergence of sulfamethoxazole-trimethoprim resistant Shigella flexneri in Northeastern Brazil; Tiemens KM et al.; In contrast to prior experience in this setting, three of four Shigella flexneri strains recently isolated from patients in Northeastern Brazil with acute inflammatory diarrhea were found to be resistant to sulfamethoxazole, trimethoprim and the combination in vitro . We performed mating studies to determine if the resistance was transferable, and then isolated and characterized plasmid DNA from the resistant Shigella isolates, other resistant Enterobacteriaceae isolated simultaneously from the stools of these individuals, and transconjugant strains . Each of the resistant Shigella strains contained a large plasmid . These plasmids were of different molecular weights ranging from 30 to 50 Mdal in size . Two of these plasmids were transferred with sulfamethoxazole-trimethoprim resistance to E . coli K-12 recipient strains . These findings of transferable resistance to sulfamethoxazole-trimethoprim associated with plasmids in Shigella and in other Enterobacteriaceae raises concerns about the potential limitations of this widely used antimicrobial combination. Zh Mikrobiol Epidemiol Immunobiol, 1985 Oct, (10), 60 - 3 {Effect of normal and immune IgG, IgM and IgA on the intestinal microflora of mice with experimental dysbacteriosis}; Glad'ko IA et al.; Human IgG, IgM and IgA produce a pronounced protective effect, preventing enterobacteria from penetration into the mucous membrane of the proximal section of the small intestine of mice in antibiotic-induced dysbacteriosis . Normal mouse IgG and IgM, in contrast to IgA, are effective against mucosal enterobacteria of the small intestine . Immune mouse IgG, IgM and IgA show greater activity in protecting the mucous membrane than normal immunoglobulins of these classes. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1985 Oct, 260(2), 260 - 72 Investigations on the bactericidal activity of fosfomycin using the membrane filter-agar dilution method and the time-kill technique; Haag R et al.; Minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) for a 99% and a 99.9% kill can be reproducibly determined for fosfomycin by the agar dilution procedure when placing the inoculum on top of membrane filters . In 88.7% (85%) of 80 bacterial strains (Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus) examined we found a 99% (99.9%) kill at concentrations higher than the respective MIC by up to one dilution step . For 5% (10%), the bactericidal concentrations were more than two steps higher . Both the MIC and the MBC were influenced by the culture medium . The influence of the medium on fosfomycin activity was also shown by the time-kill curves . In nutrient broth, Mueller-Hinton broth, Iso-Sensitest broth and human plasma water (with and without glucose-6-phosphate) we found different killing rates, different killing maxima and different times of regrowth of the cultures . The bactericidal activity of fosfomycin against Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 25923, and Pseudomonas aeruginosa ATCC 27853 was more pronounced in plasma water, nutrient broth, and Mueller-Hinton broth than in Iso-Sensitest broth. Eur J Clin Microbiol, 1985 Oct, 4(5), 498 - 501 Evaluation of the Micro-ID, the API 20E and the Rapid 20E for same-day identification of Enterobacteriaceae; Appelbaum PC et al.; In a comparative study of three methods for same-day identification, the Rapid 20E identified 91.8% of 328 clinically isolated Enterobacteriaceae correctly to species level, 0.3% to genus level, 4.0% as part of a spectrum of identifications, and 4.0% incorrectly . Corresponding data for Micro-ID were 86.6%, 3.7%, 5.8%, 4.0%, and for same-day API 20E values were 72.6%, 7.3%, 13.4%, and 6.7% . Both Rapid 20E and Micro-ID provide accurate identification within four hours; same-day five-hour API 20E was less satisfactory. J Clin Pathol, 1985 Oct, 38(10), 1132 - 8 Four hour identification of Enterobacteriaceae with the API Rapid 20E and Micro-ID systems; Holmes B et al.; One hundred strains of Enterobacteriaceae were examined in parallel with the API Rapid 20E and Micro-ID commercial four hour identification systems . With the API Rapid 20E system 78% of the strains were correctly identified, 15% were not identified, and 7% were misidentified . The respective figures with the Micro-ID system were 74%, 11%, and 15%. EMBO J, 1985 Oct, 4(10), 2469 - 74 pH-dependent membrane fusion is promoted by various colicins; Pattus F et al.; The ability of colicin A, a bacteriocin produced by some Enterobacteriaceae, to fuse phospholipid vesicles at acidic pH, was demonstrated by electron microscopy and resonance energy transfer . The fusion depends on protein concentration and on the nature of the phospholipids . Vesicles, prepared from Escherichia coli phospholipids, fused one or more rounds at pH 4.5 upon addition of stoichiometric amounts of colicin A . Fusion was not only induced by pore-forming colicins (E1, K) but also by colicins that contain nuclease activities (E2, E3) . By recombinant DNA technology it is shown that the first glycine-rich 70 NH2-terminal amino acids and, most probably, the extreme COOH-terminal end of colicin A are involved in the fusion activity of the protein . The physiological relevance of this property of colicins is discussed. J Antimicrob Chemother, 1985 Oct, 16(4), 485 - 90 In-vitro activity of pefloxacin compared with six other quinolones; Ligtvoet EE et al.; The in-vitro antimicrobial activity of pefloxacin was compared with that of three of the newer fluorated quinoline derivates: ciprofloxacin, norfloxacin and enoxacin, as well as with those of the earlier analogues: nalidixic acid, pipemidic acid and cinoxacin, against almost 750 recent patient isolates of medically important bacteria . MIC90S of pefloxacin were less than or equal to 2 mg/l for Enterobacteriaceae, less than or equal to 8 mg/l for Pseudomonas aeruginosa, less than or equal to 4 mg/l for other nonfermenters and 0.5 mg/l for Staphylococci . Most streptococcal strains were resistant to pefloxacin . Of all the fluorated quinolones, ciprofloxacin was overall the most active compound . The older non-fluorated quinolone analogues had activity against the Enterobacteriaceae only at levels achievable in urine. J Antimicrob Chemother, 1985 Oct, 16(4), 463 - 8 In-vitro activity of BMY 28142, a new aminothiazolyl cephalosporin; Steele JC Jr et al.; The in-vitro activity of BMY 28142, a new alpha-methoxyimino aminothiazolyl cephalosporin, was determined by microdilution broth techniques . The agent demonstrated excellent activity against recent clinical Enterobacteriaceae isolates with a 90% minimum inhibitory concentration (MIC90) of 0.25 mg/l or less for all but one species tested . BMY 28142 inhibited all Pseudomonas aeruginosa strains tested (MIC90 = 8.0 mg/l) as well as most other non-fermentative bacteria studied . Methicillin-susceptible Staphylococcus aureus were susceptible to BMY 28142 with MIC90 = 4.0 mg/l, while methicillin-resistant strains were generally resistant (MIC range 8- greater than 32 mg/l). J Bacteriol, 1985 Oct, 164(1), 51 - 6 Marker-exchange mutagenesis of a pectate lyase isozyme gene in Erwinia chrysanthemi; Roeder DL et al.; The phytopathogenic enterobacterium Erwinia chrysanthemi contains pel genes encoding several different isozymes of the plant-tissue-disintegrating enzyme pectate lyase (PL) . The pelC gene, encoding an isozyme with an approximate isoelectric point of 8.0, was mutagenized by a three-step procedure involving (i) insertional inactivation of the cloned gene by ligation of a kan-containing BamHI fragment from pUC4K with a partial Sau3A digest of E . chrysanthemi pelC DNA in pBR322; (ii) mobilization of the pBR322 derivative from Escherichia coli to E . chrysanthemi by the helper plasmids R64drd11 and pLVC9; and (iii) exchange recombination of the pelC::kan mutation into the E . chrysanthemi chromosome by selection for kanamycin resistance in transconjugants cultured in phosphate-limited medium (which renders pBR322 unstable) . The resulting E . chrysanthemi mutant was Kanr Amps, lacked pBR322 sequences, and was deficient in only one of the four major PL isozymes, PLc, as determined by activity-stained isoelectric-focusing polyacrylamide gels . The rates of PL induction and cell growth in a medium containing polygalacturonic acid as the sole carbon source were not significantly reduced in the mutant . No difference was detected in the ability of the mutant to macerate potato tuber tissue . The evidence suggests that this isozyme is not necessary for soft-rot pathogenesis. Infect Immun, 1985 Oct, 50(1), 338 - 40 Complementation analyses of recombinant plasmids encoding type 1 fimbriae of members of the family Enterobacteriaceae; Clegg S et al.; Insertion mutants of recombinant plasmids encoding type 1 fimbriae of four genera of enteric bacteria were used to detect genetic complementation . After transformation by pairs of plasmids, double transformants were screened for their ability to express type 1 fimbriae . Complementation was observed between genes derived from the same genus but was absent with chimeric molecules carrying genetic information from two different genera . The results indicate that diffusible gene products of the fim cluster are necessary for phenotypic expression of type 1 fimbriae. Minerva Med, 1985 Sep 22, 76(36), 1619 - 21 {In vitro activity of netilmicin compared to the activity of other antibiotics against strains of urinary enterobacteria}; Vanni M et al.; The in vitro susceptibility of 50 Gram-negative bacterial strains isolated from the urine was tested . Excluding Amikacin, Netilmicin was found to be the most effective antibiotic against the isolated bacterial complex. Ann Inst Pasteur Microbiol, 1985 Sep-Oct, 136B(2), 151 - 68 Separation of Escherichia adecarboxylata from the "Erwinia herbicola-Enterobacter agglomerans" complex and from the other Enterobacteriaceae by nucleic acid and protein electrophoretic techniques; Izard D et al.; The species Escherichia adecarboxylata was examined for DNA relatedness to the "Erwinia herbicola-Enterobacter agglomerans" complex and to other members of the family Enterobacteriaceae . DNA-DNA hybridizations (nitrocellulose filter method) showed that strains received as E . adecarboxylata were highly related to each other (73-100% homology) . Three strains of E . agglomerans and one strain of E . herbicola showed, respectively, 77, 96, 97 and 92% relatedness with the labelled DNA of E . adecarboxylata . Two groups (E2 and E3) of "atypical coliforms" previously described by Gavini et al . (1983) showed high reassociation values (76-79% and 80-89%, respectively) with E . adecarboxylata . Most of these strains produced similar or nearly identical protein electrophoregrams . All these strains were therefore classified in E . adecarboxylata . This taxon yielded hybridization values lower than 53% with the previously described phenetic or genetic groups belonging to or related to the "herbicola-agglomerans" complex and values lower than 64% with 56 other species of the Enterobacteriaceae . It was concluded that E . adecarboxylata is a species different from E . agglomerans and the other species of the family Enterobacteriaceae . A new definition of the species E . adecarboxylata is presented. Antimicrob Agents Chemother, 1985 Sep, 28(3), 413 - 8 Molecular analysis of multiple-resistance plasmids transferred from gram-negative bacteria isolated in a urological unit; Griffin HG et al.; Forty-one isolates of multiply resistant gram-negative bacteria causing infection in a urological unit of a Dublin hospital were collected during a 6-month period . Twenty-one isolates transferred multiple resistance to an Escherichia coli K-12 recipient in liquid matings . Serratia marcescens, Proteus morganii, Proteus vulgaris, and E . coli isolates harbored similar 120-megadalton IncC plasmids, whereas Enterobacter cloacae strains transferred a 160-megadalton plasmid of a different Inc group . Southern hybridization experiments were performed with purified fragments cloned from one IncC plasmid as probes . They were hybridized to plasmid sequences in total cellular DNA extracts, showing that the IncC plasmids were very closely related . This suggests that the same plasmid has transferred to different bacterial species in the hospital environment. Zh Mikrobiol Epidemiol Immunobiol, 1985 Sep, (9), 17 - 20 {Etiology of intestinal Enterobacteriaceae infections in young children}; Zinin-Bermes NN et al.; Enterobacteria, potentially capable of causing infections, were isolated from the feces of 88.7% of young children in the intestinal department of an infectious disease hospital . Opportunistic bacteria were considered to be the causative agents of infections only in cases of their high concentration in the material under test . In about a half of the cases the etiological role of the suspected microorganisms was confirmed by the detection of antibodies in low titers . The presence of maternal antibodies did not interfere with diagnostic procedures . The detection of antibodies to autocultures, even in a single case, is of diagnostic importance in the examination of young children . Autoserologically confirmed mixed infection was found to take a more prolonged course than autoserologically confirmed monoinfection. Trop Geogr Med, 1985 Sep, 37(3), 245 - 9 A preliminary survey of aerobic bacteria in breast milk of mothers from the low-income group in Nigeria; Afolabi OA et al.; The aerobic bacteria colonizing breast milk of the low-income group in Nigeria were quantified to assess its suitability for use in milk banks . In parallel, the nutritional and health status of donating mothers and their infants were assessed by physicians . The aerobic bacteria contained in the specimens included Streptococcus salivarius, Bacillus cereus, Klebsiella pneumoniae, Enterobacter aerogenes, Streptococcus pneumoniae, Streptococcus pyogenes, Pseudomonas aeruginosa and Staphylococcus epidermides . In general, the microbial load found in these milk samples is lower than levels considered dangerous . An analysis of the results showed that 50% of the mother's milk is contaminated, 17% of which was infected with primary pathogens . There was no correlation between demographic data, nutritional or health status of either mother or infant and microbial load in mother's milk . Milk obtained from this socio-economic group, is therefore, considered safe for use in milk banks. Infection, 1985 Sep-Oct, 13(5), 211 - 5 Influence of gastrostomy on the colonization of the stomach: impact on neonatal septicaemia; Kraeft H et al.; Quantitative bacterial counts were carried out on 161 gastric aspirates of 65 neonates with gastrostomy . In comparison to 101 controls--cultures of premature infants without gastrostomy--Enterobacteriaceae, enterococci, Pseudomonas and Candida were found far more frequently (p less than 0.01) . The colonization of the stomach was influenced by the duration of gastrostomy and by the pH of the gastric juice but not by systemic antibiotic therapy or the kind of food . Six newborns with gastrostomy developed septicaemia caused by the same organisms as we had found in elevated numbers in their gastric aspirates . The influence of non-absorbable antibiotics was studied prospectively in 72 gastric aspirates and 48 stool specimens . There was no highly significant difference between infants who had been treated with these antibiotics and those who had not. J Clin Pathol, 1985 Sep, 38(9), 1055 - 8 Effect of temperature on antimicrobial susceptibilities of Pseudomonas maltophilia; Wheat PF et al.; After a case of peritonitis caused by Pseudomonas maltophilia had occurred 20 strains of the organism were investigated and the minimum inhibitory concentrations of a variety of antibiotics determined at 30 degrees C and 37 degrees C . There was a significant difference in susceptibility between 30 degrees C (most resistant) and 37 degrees C (most susceptible) for aminoglycosides and polymyxin B . No difference was seen with the other agents or in strains of Ps aeruginosa and Enterobacteriaceae tested under similar conditions . The possible mechanisms of this phenomenon are discussed below. Pathol Biol (Paris), 1985 Sep, 33(7), 758 - 63 {Effect of ceftazidime on enterobacteria and Pseudomonas producers of beta-lactamases}; Chabbert YA et al.; The activity of cephalotin, cefoxitin, cefamandole, cefoperazone, cefotaxime, latamoxef, thienamycin, azthreonam, cefsulodine and ceftazidime against beta-lactamase producing strains of Enterobacteriaceae and Pseudomonas was compared by determination of 99% inhibitory concentrations . The isogenic strains studied differed by a single genetic event: mutation, gene amplification, acquisition of a high or low copy-number plasmid or of a transposon and were representative of the major known mechanisms of resistance toward beta-lactams . The results obtained indicate an overall excellent activity of ceftazidime, in particular against Pseudomonas. J Clin Microbiol, 1985 Sep, 22(3), 355 - 60 Accuracy and reproducibility of the AutoMicrobic System Gram-Negative General Susceptibility-Plus Card for testing selected challenge organisms; Nadler HL et al.; A total of 180 selected strains of gram-negative bacilli were tested for susceptibility to nine antibiotics by the prototype General Susceptibility Card and reference broth microdilution MIC method, and 112 of 180 were tested by the modified Gram-Negative General Susceptibility-Plus Card (Vitek Systems, Inc., Hazelwood, Mo.) . When category calls--susceptible, intermediate, and resistant for the prototype card and very susceptible, moderately susceptible, and resistant for the modified card--were identical or compatible (very susceptible by one method and moderately susceptible by the other), the methods were considered in qualitative or categorical agreement . The overall categorical agreement improved from 83% for the prototype card to 91.5% for the modified card, and the frequency of major and very major disagreements was reduced from 7.5 to 1%, respectively . Overall agreement between the modified card and reference method for both category calls and MICs (+/- 2 dilutions) was 90% . Of the results, 67% were identical, 22% were more susceptible with the modified card, and 11% were more resistant . Reproducibility of identical or compatible category calls and MICs obtained from three trials was 94.5% . The poorest accuracy and reproducibility were observed when testing Pseudomonas aeruginosa . The study suggests that the modified card can rapidly and efficiently perform susceptibility tests with an acceptable level of accuracy and reproducibility provided that the system is appropriately used for testing strains of the family Enterobacteriaceae with preset criteria for excluding organism-antibiotic combinations . The evaluation also indicates dramatic improvement in the technical performance of the modified card compared with its earlier prototype. Ann Inst Pasteur Microbiol, 1985 Sep-Oct, 136B(2), 249 - 52 {A medium for rapid and economic identification of Escherichia coli lactose+ colonies: brilliant green-bile-lactose-tryptophan broth}; Richard C; Among 17 lactose-fermenting species of Enterobacteriaceae (735 strains studied), only Escherichia coli could grow at 44 degrees C in brilliant green/ bile/lactose/L-tryptophan broth (BLBVB-T) with production of gas and indole . When the inoculum was from a lactose+ colony developed on selective or differential agar media commonly used in enteric bacteriology, detection of gas and indole in BLBVB-T after 8 to 18 h incubation at 44 degrees C allowed good identification of E . coli . The use of a single-test medium for the identification of lactose+ E . coli saves time and money. Appl Environ Microbiol, 1985 Sep, 50(3), 670 - 5 Rapid detection of salmonellae by immunoassays with titanous hydroxide as the solid phase; Ibrahim GF et al.; Radioimmunometric and enzyme-immunometric assays were developed for the detection of salmonellae in pure and mixed cultures as well as in 59 food samples . The performances of titanous hydroxide suspension and microtiter plates as the solid phase for the immobilization of microorganisms were compared in these immunoassays . Detection of populations of salmonella cells in pure culture, diluted with saline, was 4- to 10-fold more sensitive with the microtiter plates . However, with mixed culture of salmonella and other enterobacterial species, the detection sensitivity with titanous hydroxide was 100- to 160-fold more sensitive than with microtiter plates . Good correlation existed between results of a standard cultural method for the detection of salmonellae in foods and those obtained from radioimmunometric and enzyme-immunometric assays utilizing titanous hydroxide . However, a high incidence of false-positive and false-negative results with food samples occurred with the enzyme-immunometric assay utilizing microtiter plates . The results provided strong evidence for the merits of substituting titanous hydroxide for microtiter plates as the solid phase for the immobilization of salmonellae for their detection by immunoassays . The immunoassays were rapid and enabled the analysis of a large number of selective enrichment cultures of food samples for salmonellae within 8 h. J Gen Microbiol, 1985 Sep, 131 ( Pt 9), 2281 - 4 Inhibition of conjugal transfer of R plasmids by nitrofurans; Michel-Briand Y et al.; Nifurzide is a nitrofuran with antibacterial activity . As nitrofurans have been reported to interact with DNA, we tested the ability of nifurzide to inhibit plasmid transfer . Inhibition of plasmid transfer between Escherichia coli strains was obtained for ten plasmids belonging to nine incompatibility groups . The same effect was observed when plasmid RP4 was harboured in six different members of the Enterobacteriaceae . Inhibition depended on the reduction of the -NO2 group of nifurzide and was obtained with four other nitrofuran derivatives. Infection, 1985 Sep-Oct, 13(5), 207 - 10 Urinary tract infection in renal transplant patients; Prat V et al.; The incidence of urinary tract infections (UTI) in 299 renal graft transplantations (281 patients) was analyzed . UTI episodes were demonstrated in 185 grafts (62%), most frequently in the first month after transplantation . The infectious episodes were mostly recurrent . Persistent infection, detected in 11% of grafts, was associated with urologic complications in almost all cases . No significant correlation between the primary renal disease and the UTI rate was found, and there was no significant correlation between UTI and sex . In grafts with recurrent infectious episodes, vesicoureteral reflux was more common . No significant difference was observed in the residual bladder volume, irrespective of whether infection was present or not . The urine was infected by a number of hospital strains, particularly Klebsiella, Enterobacter and indole-positive Proteus strains . An overwhelming majority of UTI episodes (96%) were asymptomatic . Antibody-coated bacteria in urinary sediment were present in only 19% of infectious episodes . Clinically severe courses were observed in infections associated with urologic complications (especially urinary fistulae); these were difficult to treat and were often a source of sepsis and a risk factor in graft loss. Clin Pharm, 1985 Sep-Oct, 4(5), 516 - 26 Aztreonam, a new monobactam antimicrobial; Guay DR et al.; The chemistry, in vitro activity, pharmacokinetics, adverse reactions, and clinical use of the monobactam antimicrobial aztreonam are reviewed . Aztreonam, an investigational agent nearing approval in the United States and Canada, is the first in a class of monobactam antimicrobials to be evaluated extensively in vitro and in vivo . It has a narrow spectrum of activity, encompassing only aerobic gram-negative microorganisms including Pseudomonas aeruginosa and most multiply resistant Enterobacteriaceae . Aztreonam has no useful activity against gram-positive or anaerobic microorganisms . In preliminary studies, aztreonam achieved high tissue concentrations and was usually well tolerated . Approximately 65-75% of an administered dose is excreted unchanged into the urine, and the elimination half-life is 1.6-2.2 hours in subjects with normal renal function . Dosage should be adjusted in patients with renal impairment . Aztreonam was shown equivalent to gentamicin and cefamandole for treating serious urinary-tract infections and produced cure rates greater than 85% in gonococcal, lower respiratory tract, orthopedic, serious urinary tract, acute uncomplicated lower urinary-tract, gynecologic, and intraabdominal infections . Development of resistance during therapy may be less likely with aztreonam than with other new cephalosporins . Aztreonam will probably have an important role in antimicrobial therapy, but much further study is necessary to assess clinical efficacy and toxicity . The clinical importance of aztreonam's superior activity under anaerobic conditions compared with aminoglycosides and the theoretical reduced alteration in GI colonization resistance must be assessed in controlled trials . Evaluation of aztreonam versus ceftazidime, the carbapenems, and the carboxyquinolones is needed, and the likelihood of gram-positive superinfection, especially with enterococci, must be further assessed. Pediatr Infect Dis, 1985 Sep-Oct, 4(5), 499 - 502 Cefotaxime therapy of neonatal gram-negative bacillary meningitis; Naqvi SH et al.; Seven neonates were treated with cefotaxime during eight episodes of Gram-negative bacillary meningitis and sepsis . The causative organisms were Escherichia coli in six cases and Klebsiella pneumoniae and Enterobacter sakazakii in one each . After identification of the pathogen cefotaxime was used alone in six instances . Two patients with brain abscesses received adjunctive therapy with another antibiotic . The sterility of cerebrospinal fluid was documented after a mean of 3.3 days of therapy . Mean cerebrospinal fluid bactericidal titer was 1:64 . All patients recovered with good neurologic outcome . Cefotaxime in a dosage of 150 mg/kg/day divided every 6 hours intravenously seems safe and effective therapy for neonatal Gram-negative bacillary meningitis. J Immunol, 1985 Sep, 135(3), 1900 - 5 Synthetic lipopeptide analogs of bacterial lipoprotein are potent polyclonal activators for murine B lymphocytes; Bessler WG et al.; The lipoprotein from the outer membrane of Escherichia coli and other Enterobacteriaceae is a potent polyclonal activator for B lymphocytes . To determine the molecular structure responsible for the biologic activity of lipoprotein, a well-defined series of analogs of its N-terminal part was synthesized: S-(2,3-bis(palmitoyloxy)-(2-RS)-propyl)-N-palmitoyl-(R)-cysteine, -cysteine methyl ester, -cysteinyl-serine, -cysteinyl-seryl-serine, -cysteinyl-seryl-seryl-asparagine, and -cysteinyl-seryl-seryl-asparaginyl-alanine . All compounds were tested for mitogenic activity toward spleen cells from BALB/c, LPS-non-responder C3H/HeJ, and congenitally athymic C3H/Tif/Bom/nu/nu mice, measuring the incorporation of {3H}thymidine into DNA . Lymphocyte activation was confirmed by determination of the incorporation of {3H}uridine into RNA and {3H}leucine into protein . The synthetic lipopeptides were also investigated for their ability to stimulate B lymphocytes into immunoglobulin secretion, as shown by a hemolytic plaque assay . Throughout our studies, the compounds carrying two to five amino acids exhibited strong stimulation activity toward B lymphocytes comparable to native lipoprotein . In contrast, products containing only one amino acid, cysteine or cysteine methyl ester, were only marginally active, indicating that to obtain full biologic activity the presence of the hydrophilic dipeptide structure is necessary . All compounds exhibited only a marginal effect on thymocytes . Thus, a series of defined synthetic fragments of a bacterial outer membrane component exhibits a pronounced mitogenic and polyclonally stimulating activity towards B lymphocytes . The substances will be valuable tools for more detailed investigations on the molecular mechanisms of B cell activation. Antibiot Med Biotekhnol, 1985 Sep, 30(9), 676 - 81 {Genetic control and the mechanism of the spread of gentamycin resistance among Enterobacteriaceae strains in a hospital}; Belokrysenko SS; Strains of K . pneumoniae belonging to serowars K10, K3, K16 and K62 and two strains of E . coli with multiple drug resistance including newly detected resistance to gentamicin were isolated in succession within the 2-year period of microbiological survey of a hospital department for premature infants . Resistance to gentamicin in the first isolate of K . pneumoniae was due to the non-conjugated plasmid pP12140 with a molecular weight of 15 MD . This plasmid also controlled resistance to streptomycin and sulfanilamides and was physically independent of the other large (about 80 MD) conjugative R plasmid controlling resistance to kanamycin, tetracycline, chloramphenicol and ampicillin . In the strains of K . pneumoniae and E . coli isolated within the following 2 years the marker of gentamicin resistance was included into large (80-120 MD) conjugative R plasmids controlling 6-7 resistance types . DNA of such plasmids was used for transformation of the recipient strain C600 of E . coli . In addition to the transformants with the acquired R plasmids possessing all the resistance markers there were isolated transformants carrying plasmids with the molecular weight of 15 MD controlling resistance to gentamicin, streptomycin and sulfanilamides and capable of self-replication . Analysis of the plasmids with the help of endonucleases EcoR1 and Pst1 revealed complete identity of plasmid pP12140 and similar plasmids of the transformants isolated with the use of DNA of the plasmids of the other K . pneumoniae strains . Marked relation with the plasmids of the transformants isolated with the use of the plasmid DNA of E . coli was also revealed.(ABSTRACT TRUNCATED AT 250 WORDS) Quad Sclavo Diagn, 1985 Sep, 21(3), 294 - 305 {Evaluation of various methods of preserving samples for the study of intestinal microflora}; Babudieri S et al.; Intestinal microflora changes in ten adult and healthy subjects after storage of specimen with different modalities, temperatures and times were evaluated quantitatively and qualitatively . Aerobic components (Enterobacteriaceae, Enterococcus, Staphylococcus and Bacillus spp.) did not show considerable variations of concentration in all maintenance conditions . Anaerobic components showed different capacity of survival for every researched genus: Clostridia and Lactobacilli, even kept frozen for one month in glycerol broth at -70 degrees C, maintained a stable viable count; Bacteroides, Fusobacteria, Veillonellae and Peptostreptococci were found stable after one week, while after one month showed a loss of concentration superior to 4 Log; Eubacteria were found remarkably reduced after seven days and completely lost after one month. J Hosp Infect, 1985 Sep, 6(3), 245 - 51 Stored urine as a reservoir of gentamicin-resistant bacteria and as a site of conjugative R-plasmid transfer; Nagano Y et al.; For some years we have observed the dissemination of gentamicin-resistant strains of Enterobacteriaceae in our hospital and we have reported the spread of antibiotic resistance by plasmid transfer . Stored urine was suspected to be a reservoir for gentamicin-resistant enterobacteria and to be a means of dissemination of gentamicin resistance amongst different species . We now report an epidemiological analysis based on biotyping of isolates and R-plasmid typing, and show that dissemination of bacterial strains and R-plasmids was not associated with disposable urine reservoirs, but dissemination of strains and plasmids was observed when non-disposable urine bottles were used in the wards. Int J Zoonoses, 1985 Sep, 12(3), 219 - 27 Serological cross-reactions between Brucella abortus and Yersinia enterocolitica 0:9; Mittal KR et al.; Yersinia enterocolitica (Ye) 0:9 is an organism of great significance in veterinary medicine largely as a result of its cross-reaction with Brucella abortus (Ba) . Boty Ye 0:9 and Ba possess somatic antigens in common; as a result of which animals exposed to Ye 0:9 have an immune response which is distinguishable only with difficulty from that induced by Ba . Cattle were exposed to Ye 0:9 by the oral or intramammary routes . Oral exposure failed to generate significant serologic response . In contrast, intramammary inoculation produced a marked response . Serum antibodies provoked in this manner reacted strongly with Ba . The anti-Brucella response provoked by inoculation of Yersinia was sufficient to render milk and serum Brucella-seropositive as measured by the standard milk ring and serum agglutination tests . While both Ba and Ye 0:9 have 9 antigens in common, they differ significantly with respect to motility . Thus Ba is always non motile while Ye is motile when grown at room temperature . The presence of Yersinia H agglutinins in serum were shown to be evidence of previous exposure to Ye . The H agglutinins were not generated by Brucella infection . A rapid H agglutination test was shown to provide this differentiation without interference from cross-reacting O antigens . Results of Ba O and Ye O and OH antigens used in the agglutination test were found useful to differentiate antibodies against Ba from those induced by Ye 0:9 in cattle sera . The existence of enterobacterial common antigen (ECA) in Ye and its absence in Ba were utilized in an attempt to provide a method to distinguish Brucella infections from those with cross-reacting Yersinia.(ABSTRACT TRUNCATED AT 250 WORDS) Am J Med, 1985 Aug 9, 79(2A), 89 - 95 Ceftazidime in the treatment of nosocomial sepsis; Young LS; Ceftazidime has broad antibacterial activity against many gram-positive and most clinically significant nosocomial gram-negative bacillary pathogens . Many studies have been undertaken both in this country and in western Europe to determine the clinical effectiveness of ceftazidime in seriously ill patients . Differentiating between nosocomial and community-acquired infections is difficult in many reports, but high cure rates, usually exceeding 80 percent, have been reported for documented gram-negative bacillary infections . In non-neutropenic patients, response rates have also been in a comparable range . Particularly impressive have been the high cure rates in Pseudomonas aeruginosa bacteremia complicating burns and other gram-negative bacteremias in patients with underlying diseases . In comparative studies carried out in seriously ill or neutropenic patients, the results with ceftazidime have not significantly differed from those obtained with regimens that included beta-lactam agents paired with aminoglycosides . Some problem areas persist in these studies: the interpretation of comparative studies in which a large number of cases were eliminated because of "unevaluability," superinfections due to gram-positive organisms that may require or necessitate addition of agents like vancomycin, and the emergence of resistance as seen in three groups of organisms--Pseudomonas, Serratia, and Enterobacter species . Nonetheless, summary data from cases treated in the United States indicate cure and/or improvement in 100 percent of 14 cases of Serratia bacteremia, 83 percent of 12 cases of Enterobacter sepsis, 82 percent of 22 cases of Staphylococcus aureus bacteremia, and 85 percent in 27 cases of P . aeruginosa bacteremia . Only 11 of 86 cases of bacteremia due to the organisms just cited were judged unevaluable . Three of the four failures in the treatment of Pseudomonas bacteremia occurred in neutropenic patients . More definitive information on the relative efficacy of ceftazidime in controlled trials, particularly in granulocytopenic patients, may result from more careful analysis of survivorship using methods that do not eliminate "unevaluable cases." Techniques for this type of analysis have already been implemented in some studies. Jpn J Antibiot, 1985 Aug, 38(8), 2230 - 41 {Comparative studies of antimicrobial agents against causative organisms isolated from urinary tract infections (1983) . II . Background of patients}; Kosakai N et al.; We have been collected the causative isolates from patients with urinary tract infections (UTI) from the 8 institutions in Japan during 1980-1983 . All strains isolated from UTI and recognized as etiologically responsible in each institution were sent to Bacteriology Laboratory of Juntendo University Hospital, Tokyo and the species of these strains were reidentified . We classified the UTI into 3 categories, simple, complicated without catheter and complicated with catheter . Of all strains isolated as etiologically responsible from cases of simple UTI, 65.3% were E . coli and 9.6%, Klebsiella spp . in 1983: these species accounted for about 75% of all isolates . Most frequently isolated from patients without catheter were E . coli 27.6% in 1983, followed in order by Pseudomonas spp . (20.9%), Gram-positive bacteria (16.7%), Serratia spp . (8.8%), Klebsiella spp . (8.0%) and Proteus spp . (7.1%) . In complicated UTI with catheter, Pseudomonas spp . were most frequently isolated (25.6%), followed in order by Gram-positive bacteria (22.9%), Serratia spp . (15.0%), Proteus spp . (12.4%), Enterobacter spp . (6.0%) and Klebsiella spp . (6.0%) . A remarkable difference, that is, Gram-positive bacteria, e