Enterobacters

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, especially S . aureus, showed conspicuous increase of isolation between 1982 and 1983 . Furthermore, we discussed the detailed analysis of patient background to clinical bacterial isolates from UTI in respect of patient distribution by sex, types of infections, distributions by age in male and female, interrelations between the species of bacterial isolates and types of infection and antimicrobial chemotherapy.

J Antimicrob Chemother, 1985 Aug, 16(2), 183 - 8
Comparative activity of seven extended-spectrum cephalosporins against gram-negative bacilli from blood cultures; Norris SM et al.; One hundred sequential Gram-negative rod isolates from patients with hospital-acquired bloodstream infections were tested against seven new cephalosporins . Duplicate broth microdilution tests indicated superior activity for ceftazidime with 97% of strains susceptible to 16 mg/l . Less in-vitro activity was demonstrated cefotaxime (91% susceptible to 16 mg/l, P = 0.07), latamoxef (moxalactam) (90%, P = 0.04), cefoperazone (90%, P = 0.04), ceftriaxone (87%, P = 0.008), cefmenoxime (80%, P = 0.0001), and ceftizoxime (79%, P less than 0.0001) . With the exception of cefoperazone, the newer drugs had mean MICs of less than or equal to 0.6 mg/l against Enterobacteriaceae . Ceftazidime and cefoperazone had highest activities against Pseudomonas aeruginosa with MIC90S of 4 and 16 mg/l, respectively . A comparison of recently published data shows important geographic differences in MIC90 data for the new cephalosporins against specific species.

J Med Microbiol, 1985 Aug, 20(1), 63 - 8
Growth of bacteria in enteral feeding solutions; Anderton A; Solutions of Clinifeed ISO, Triosorbon, Vivonex Standard (full- and half-strength) and Vivonex HN were experimentally contaminated with two strains each of Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella aerogenes, Escherichia coli and Enterobacter cloacae at concentrations of 10(2)-10(3) organisms/ml . Samples were incubated at 4, 25 or 37 degrees C and viable counts were made at 0, 4, 8 and 24 h . No increase in numbers of any of the organisms was observed in any of the feeds during 24 h at 4 degrees C . All organisms multiplied rapidly in Clinifeed ISO and in Triosorbon at 25 and 37 degrees C . There was less rapid growth in half-strength Vivonex Standard at 25 degrees C, although at 37 degrees C all strains multiplied rapidly except for the two S . aureus strains, the growth of which was inhibited in half-strength Vivonex Standard at both 25 and 37 degrees C . In full-strength Vivonex Standard at 25 degrees C, only P . aeruginosa showed any increase in numbers during 24 h, whereas P . aeruginosa, K . aerogenes and E . cloacae all multiplied at 37 degrees C . None of the test organisms multiplied in full strength Vivonex HN at any of the temperatures studied . The results of the study show that bacteria survive and may multiply even in feeds with low pH and high osmolarity, and emphasise the importance of strict hygiene during the preparation and handling of all enteral feeds.

Arch Microbiol, 1985 Aug, 142(3), 289 - 94
Expression of Klebsiella pneumoniae nif genes in Proteus mirabilis; Postgate JR et al.; Self-transmissible plasmids carrying his and nif genes from Klebsiella pneumoniae have been introduced into three his mutants of Proteus mirabilis: strains 5006-1, WR19 and WR20 . Expression of his by the transconjugants was unequivocal, if slightly temperature-sensitive, but none was Nif+ when tested for acetylene reduction in anaerobic glucose medium using inocula from rich or glucose-minimal aerobic agar cultures . Succinate or pyruvate in place of glucose, low glucose, lower temperature or elevated Na2MoO4 did not allow nif expression and no nitrogenase MoFe-protein peptide was detected immunologically after exposure to conditions in which diazotrophic enterobacteria, normal or genetically constructed, derepress nif . One strain, P . mirabilis WR19, carrying the his nif Kmr plasmid pMF250 was examined in detail . The nif activator gene nifA was introduced on the plasmid pCK1 . Such derivatives remained Nif- when tested, after aerobic growth on rich agar media, with normal or low glucose, with succinate or with elevated Mo . However, pre-conditioning by aerobic growth on glucose-minimal agar led to subsequent anaerobic expression of nif in glucose medium from pMF250 in WR19 carrying pCK1 . NH+4 or proline could serve as N-source in the glucose-minimal agar . Maximum activity was about 5% of that of K . pneumoniae in our assay conditions . Material cross-reacting with anti-serum to the nitrogenase MoFe protein was formed . Nitrogenase activity was not 'switched off' by NH+4 . P . mirabilis WR19 (pCK1) showed NH+4-constitutive temperature-sensitive kanamycin resistance (a nif-related phenotype of this plasmid) in aerobic glucose minimal medium.(ABSTRACT TRUNCATED AT 250 WORDS)

J Clin Microbiol, 1985 Aug, 22(2), 292 - 5
Specimen volume versus yield in the BACTEC blood culture system; Plorde JJ et al.; During a 24-month period, 5,625 blood culture specimens were collected at the Seattle Veterans Administration Medical Center in 20-ml volumes and divided into separate 10-ml aliquots . The two aliquots were processed as duplicate sets (set 1, set 2) by the BACTEC system (Johnston Laboratories, Inc., Towson, Md.) . Specimens (5 ml) from each set were inoculated into aerobic (6B) and anaerobic (7C/7D) vials . A total of 434 significantly positive blood cultures were found . In 342 of these positive cultures, yielding 379 isolates (112 members of the family Enterobacteriaceae, 104 staphylococci, 87 streptococci, 27 anaerobes, 20 yeasts, 14 pseudomonads, and 15 miscellaneous organisms), there was adequate specimen volume to fill all four vials . The utilization of set 1 would have resulted only in the failure to detect 65 of 379 (17.2%) significant isolates, 52 of 342 (15.2%) positive cultures, and 20 of 198 (10.1%) bacteremic episodes . There were no significant differences in the recovery of individual species in sets 1 and 2 . Although the range of isolates recovered by the aerobic and anaerobic vials of each set differed, the percent yield of total isolates was similar, indicating total isolate yield was predominantly a function of specimen volume . The addition of set 2 most dramatically increased the recovery of Escherichia coli (30%), yeasts (33%), and anaerobes (42%).

J Bacteriol, 1985 Aug, 163(2), 756 - 62
Genetic location of genes encoding enterobacterial common antigen; Meier U et al.; A new rff mutation (rff-726) of Escherichia coli is described which affects the biosynthesis of the enterobacterial common antigen . This mutation was detected in an rfe-defective strain . A Tn10 insertion near the rfe locus was isolated to facilitate further mapping . Both mutations rfe and rff were mapped by transduction with bacteriophage P1, giving the gene order ilv rfe rff uvrD metE . The F' factor F14 was able to complement both mutations rfe and rff, whereas the F' factor F16 could complement the rfe but not the rff mutation . The rff mutation did not affect the biosynthesis of N-acetyl-D-mannosaminuronic acid, as the previously described rff mutations in Salmonella typhimurium do (H . C . Lew, H . Nikaido, and P . H . Makela, J . Bacteriol . 136:227-233, 1978), and also did not affect the biosynthesis of other enterobacterial common antigen components; however, the biosynthesis of the complete enterobacterial common antigen molecule was blocked.

Neurosurgery, 1985 Aug, 17(2), 327 - 8
Treatment of cerebrospinal fluid and syringosubarachnoid shunt infection with systemic and intrathecal antibiotics; Tomaszek DE et al.; We present a case of a patient with two preexisting Silastic syringosubarachnoid shunt catheters who developed Enterobacter meningitis . The infection was treated successfully with systemic and intrathecal antibiotics without removal of the catheters . With careful sequential clinical and laboratory monitoring, even this type of cerebrospinal fluid shunt infection can be eradicated without catheter removal and replacement.

J Med Microbiol, 1985 Aug, 20(1), 113 - 21
Antigenic relationships among type-3 fimbriae of Enterobacteriaceae revealed by immunoelectronmicroscopy; Old DC et al.; Antigenic relationships among type-3 fimbriae of 31 strains, representing 19 species and eight genera of Enterobacteriaceae, were investigated by immunoelectronmicroscopy in tests with 17 different type-3 fimbrial antisera . At least nine antigenically distinct groups among type-3 fimbriae were distinguished . The constituent membership of some groupings did not conform with current views on the taxonomy of Enterobacteriaceae.

J Immunol, 1985 Aug, 135(2), 1430 - 6
A heat-modifiable outer membrane protein carries an antigen specific for the species Yersinia enterocolitica and Yersinia pseudotuberculosis; Ogasawara M et al.; The outer membranes of gram-negative bacteria are considered to be of importance in host-bacteria interaction, in protective immunity, and occasionally in subclassification within a species . In this study, the outer membranes of several strains of Yersinia enterocolitica and Y . pseudotuberculosis were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) . It was found that the appearance of the major proteins depended on the temperature at which they were solubilized in SDS . A protein was identified with the use of two-dimensional gels and preparative SDS-PAGE, which was equivalent to the "heat-modifiable protein" (protein II) of other Enterobacteriaceae species . A monoclonal antibody, 4G1, was generated against an isolated preparation of this Y . enterocolitica protein . This antibody was tested with whole cell bacterial antigens of 46 individual bacterial strains . The reactive strains included only Y . enterocolitica and Y . pseudotuberculosis . In addition, the reactivity of the 4G1 monoclonal antibody preparation could be absorbed only with Y . enterocolitica and Y . pseudotuberculosis, and not with other strains of bacteria . The reactivity of this 4G1 monoclonal antibody was also tested by the Western Blot technique . Six individual strains were tested: a Y . enterocolitica serotype 0:3, a Y . enterocolitica serotype 0:9, an Escherichia coli, a Salmonella typhimurium, a Shigella flexneri, and a Klebsiella pneumoniae . The 4G1 antibody reacted with only the proteins of the two Y . enterocolitica strains . In conclusion, the equivalent of the heat-modifiable protein was present in Y . enterocolitica and Y . pseudotuberculosis . Moreover, this protein also carried a species-specific antigenic determinant.

Am J Med, 1985 Jul 15, 79(1A), 68 - 76
Identification and treatment of infections in multiply traumatized patients; Caplan ES et al.; Trauma is the leading cause of death among young adults, and infection is a leading complication in multiply traumatized patients . All antibiotic use and all infections among 1,009 patients admitted to the Maryland Institute for Emergency Medical Services Systems over a six-month period were reviewed . The vast majority of patients had sustained high-speed automobile trauma and had blunt injuries . All antibiotics were given by the infectious diseases consultants under predetermined protocols . During this time period, 175 infections and 76 bacteremias were identified . Thirty-three percent of the antibiotic use was for prophylaxis . Prophylactic antibiotics were used for open fractures, in which a cephalosporin was used; for abdominal trauma, in which an aminoglycoside and clindamycin or cefoxitin alone was used; and for penetrating open fractures of the oral cavity, in which penicillin was used . As therapy, the aminoglycosides were used in 25 percent, the cephalosporins in 21 percent, the penicillins in 39 percent, and other antibiotics in 15 percent of the cases . The organisms identified as causing infection were Staphylococcus aureus (25 percent), Escherichia coli (18 percent), Enterobacter species (17 percent), Pseudomonas species (12 percent), and Klebsiella species (11 percent) . The sites of infections were primary bacteremia (11 percent), vascular lines (21 percent), the central nervous system (3 percent), the lower respiratory tract (13 percent), the paranasal sinuses (6 percent), the urinary tract (19 percent), surgical wounds (11 percent), the abdomen (7 percent), and other sites (9 percent) . More than 82 percent of the infections that occurred were nosocomial in origin and were related to the various procedures used for monitoring and therapy in these critically ill patients . Infections of the abdominal cavity and the lower respiratory tract accounted for eight of the 10 infection-related deaths in these patients.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Jul, (7), 27 - 9
{Distribution of enterobacteria in man and small mammals}; Rechkin AI et al.; The species composition of the most common enterobacteria isolated from the intestine of 825 patients with intestinal dysbacteriosis and 292 small mammals of different species is compared.

J Bacteriol, 1985 Jul, 163(1), 106 - 10
Antigenic polymorphism of the LamB protein among members of the family Enterobacteriaceae; Bloch MA et al.; In this study we demonstrate that most members of the family Enterobacteriaceae possess a maltose-inducible outer membrane protein homologous to the LamB protein of Escherichia coli K-12 . These proteins react with polyclonal antibodies raised against the LamB protein of E . coli K-12 . We compared the antigenic structure of the LamB protein in members of the family Enterobacteriaceae with six monoclonal antibodies raised against the LamB protein of E . coli K-12 . Four of them reacted with epitopes located at the outer face of the membrane, and two reacted with epitopes located at the inner face of the membrane . A great degree of variability was observed for the external epitopes . Even in a single species, such as E . coli, an important polymorphism was present . In contrast, the internal epitopes were more conserved.

J Am Acad Dermatol, 1985 Jul, 13(1), 103 - 8
Activation of herpes simplex following dermabrasion . Report of a patient successfully treated with intravenous acyclovir and brief review of the literature; Silverman AK et al.; Herpes simplex labialis developed in a patient immediately following dermabrasion . The patient was hospitalized because the infection had spread rapidly over the dermabraded face and was complicated by secondary impetiginization . Herpesvirus hominis type I and Enterobacter aerogenes were isolated from cultures . Intravenous acyclovir and oral antibiotics were administered . On this regimen, new vesicle formation ceased in 36 hours . Complete resolution of the infection occurred within 6 days, with an excellent cosmetic result . Observation at 1 month confirmed no sequelae (in particular, scarring) . The "at risk" patient with a history of recurrent herpes labialis should be identified prospectively in an attempt to prevent possible reactivation; should this complication ensue, appropriate treatment should be immediately administered because a state of local immunocompromise exists . We believe our patient benefited greatly from vigorous treatment, with significant shortening of time to healing . Prophylaxis with oral acyclovir of "at risk" patients prior to dermabrasion is proposed.

Infect Immun, 1985 Jul, 49(1), 197 - 201
Chemical and immunochemical analyses of Bacteroides fragilis lipopolysaccharides; Weintraub A et al.; Lipopolysaccharides (LPSs) from 17 different Bacteroides fragilis strains were extracted in a two-step procedure . The first step was a hot phenol-water extraction of whole bacteria, resulting in a crude aqueous phase, which after lyophilization in a second step was extracted with a phenol-chloroform-light petroleum mixture . The resulting LPSs, which were essentially free from contaminating nucleic acid, proteins, and capsular polysaccharide, were investigated for their qualitative and quantitative sugar and fatty acid composition, immunochemical specificity by enzyme-linked immunosorbent inhibition assays, and particle weight by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . Of the 17 strains, 13 had LPSs which all contained L-rhamnose, D-glucose, D-galactose, and D-glucosamine in approximately the same ratio . Three of these LPSs also contained D-galactosamine . The fatty acid composition was also similar in that the same fatty acids, although in slightly varying proportions, were found in all LPSs . The 13 strains also showed the same specificity in inhibition studies by enzyme immunoassay with rabbit anti-LPS antisera and LPS antigen . The LPS particle weights were also very similar, in the range of what is found for LPSs from rough mutant strains of enterobacteria . Our results suggest that most strains of B . fragilis have similar, if not identical, LPSs with relatively short polysaccharide chains.

Med Trop (Mars), 1985 Jul-Sep, 45(3), 265 - 9
{Study of bacterial sensitivity in a Lambaréné hospital (Gabon)}; Burchard GD et al.; The authors present their findings about a research on bacterial resistance carried out in a Lambarene hospital . Enterobacteriaceae and Pseudomonas aeruginosa present a high level of resistance to ampicillin, carbenicillin and cefalexin . About 40 to 50% of the strains appear to be resistant to chloramphenicol and trimethoprim-sulfamethizole . The most recently imported cephalosporins are effective against Gram-negative germs . Gentamycin is also effective against Enterobacteriaceae, but uneffective against Pseudomonas aeruginosa . Frequency of multi-resistance is alarming . 1/3 of the Neisseria gonorrhoeae strains are resistant to penicillin.

J Antimicrob Chemother, 1985 Jul, 16 Suppl A, 91 - 100
Multiplicity of macrolide-lincosamide-streptogramin antibiotic resistance determinants; Courvalin P et al.; Bacteria can resist macrolide, lincosamide, and streptogramin (MLS) antibiotics enzymically by alteration of the target site or detoxification of the antibiotic . N6-dimethylation of adenine in 23 S ribosomal RNA confers resistance to M, L, and S B-type (MLSB) antibiotics . Investigation, by DNA annealing, of the relationship between the genes specifying this resistance mechanism from Streptococcus (groups A,B,D, and H, and pneumoniae), Staphylococcus aureus, Bacillus licheniformis, Bacteroides fragilis, Lactobacillus casei, and Streptomyces erythreus indicated substantial sequence diversity among the MLSB resistance (R) determinants . A minimum of four distinct classes of MLSB R determinants could be defined: classes A and B for the Gram-positive cocci (streptococci pmeumococci and staphylococci), class C for B . licheniformis, and class D for Bact . fragilis . These data do not support the hypothesis that the R determinants were acquired recently from a single common origin and suggest an easy exchange of genetic information among the Gram-positive cocci . The genetic classes do not correlate with differences in phenotypic expression or in regulation (inducibility or constitutivity) of resistance towards MLSB antibiotics . Inactivation of the drug confers resistance to M and/or L and/or S or SA or SB antibiotics and has been detected in strains of Streptococcus, Staph . aureus, Lactobacillus, C . perfringens, Streptomyces, and recently in the Gram-negative organism Escherichia coli . We have cloned and sequenced a DNA fragment conferring high level resistance (MIC greater than 2 g/l) to erythromycin by hydrolysis of the antibiotic . The distribution of this 'new' character in enterobacteria isolated from human faeces was studied by colony hybridization using an intragenic probe . The gene for the erythromycin esterase was detected in numerous strains of E . coli belonging to various biotypes, in Klebsiella pneumoniae, Enterobacter agglomerans, and in one 'coliform' . Moreover, our results indicated the existence of at least two classes of genes specifying resistance to erythromycin by inactivation of the antibiotic in enterobacteria.

Rev Infect Dis, 1985 Jul-Aug, 7 Suppl 3, S389 - 410
Antibacterial activity of imipenem: the first thienamycin antibiotic; Kropp H et al.; Imipenem (N-formimidoyl thienamycin) is the first representative of a new class of beta-lactam antibiotics--the carbapenems . Imipenem has an unusually broad spectrum, high potency, and no cross-resistance with other beta-lactam antibiotics . Susceptible gram-negative species include Pseudomonas aeruginosa, Serratia, and Enterobacter . Activity is high against Staphylococcus aureus, most group D streptococci, and Staphylococcus epidermidis but is variable against methicillin-resistant S . aureus . Imipenem is more active against Bacteroides than are other beta-lactam agents, chloramphenicol, metronidazole, and clindamycin . The minimal inhibitory concentrations (MICs) for 98% of 30,655 isolates--excluding those of the three resistant species (Pseudomonas maltophilia, Pseudomonas cepacia, and Streptococcus faecium)--were less than 8 micrograms/ml, the susceptibility breakpoint adopted for clinical trials . Imipenem is bactericidal (minimal bactericidal concentrations (MBCs} less than twice the MICs) . For P . aeruginosa, MBCs of imipenem are less influenced by high inoculum density rather than are MBCs of antipseudomonal penicillins and cephalosporins . Stability of imipenem to diverse classes of plasmid-mediated and chromosomal beta-lactamases accounts for its lack of cross-resistance with other beta-lactam antibiotics . Imipenem is also active against P . aeruginosa with non-lactamase-mediated resistance to classical beta-lactam agents . Efficacy of imipenem was shown in animal models, including septicemia in normal and neutropenic rodents and P . aeruginosa pneumonia . Imipenem also has a unique postantibiotic effect against P . aeruginosa in vivo.

Antimicrob Agents Chemother, 1985 Jul, 28(1), 133 - 7
Comparative in vitro evaluation of cefpimizole (U-63196E), a new antipseudomonal cephalosporin; LeFrock JL et al.; The activity of cefpimizole (formerly U-63196E) was compared with that of other broad-spectrum cephalosporins and penicillins . Overall, cefpimizole exhibited limited activity against gram-positive cocci and members of the family Enterobacteriaceae as compared with the other cephalosporins tested . The activity of cefpimizole against Pseudomonas aeruginosa was similar to that of cefoperazone and mezlocillin (90% MIC, 32 micrograms/ml) but poorer than that of ceftazidime (90% MIC, 8 micrograms/ml) . Cefpimizole appears to have no in vitro advantage over the cephalosporins with which it was compared.

Jpn J Antibiot, 1985 Jul, 38(7), 1739 - 49
{Study of clinical bacteriological efficacy in a cefmenoxime ototopical solution}; Deguchi K et al.; One percent cefmenoxime (CMX) ototopical solution was administered to 302 patients with purulent otitis media and acute diffuse external otitis in open study fashion, and to 216 patients with purulent otitis media in double blind condition . From among the total of 518 cases various bacteria were detected, except 22 of negative detection after incubation and 3 of impossible determination . The main bacteria detected from the above 493 cases were S . aureus (242 strains = 49.1%), P . aeruginosa (105 strains = 21.3%), S . epidermidis (67 strains = 13.6%), Proteus spp . (indole positive) (31 strains = 6.3%) and P . mirabilis (24 strains = 4.9%) as well as anaerobic bacteria (26 strains = 5.3%) . MIC of CMX against those bacteria detected was evaluated at 10(8) CFU/ml and 10(6) CFU/ml, respectively, up to the concentration of 800 micrograms/ml, with MIC of cefazolin (CEZ), chloramphenicol (CP) and fradiomycin (FRM) as the references . With respect to the antibacterial action of CMX against S . aureus, MIC50 of CMX was inferior to that of CEZ by 4-fold, but its MIC80 and MIC90 are almost equivalent to those of CEZ . These results were obtained because there existed relatively few CMX highly resistant strains, while more than 20% strains are said to resist cephem antibiotics . As far as MIC of CMX against P . aeruginosa was concerned, the MIC reached its peak with 100 micrograms/ml at the concentration of 10(8) CFU/ml and with 25 micrograms/ml at 10(6) CFU/ml, respectively, which indicated the real antibacterial value of CMX against P . aeruginosa . However, the strains which showed higher MIC of greater than 800 micrograms/ml were rather few, that is, only 8 out of 105 (7.6%) . Antibacterial action of CMX against Streptococcus (except Enterococcus), GNR from intestinal bacteria and anaerobic bacteria was favorable, and the stable and strong antibacterial action was shown against C . freundii, Enterobacter spp., S . marcescens and Proteus spp . (indole positive) which produce chromosome mediated beta-lactamase . On the other hand, the antibacterial action of CMX against GNF-GNR except P . aeruginosa was unfavorable for P . cepacia, P . putida and A . xylosoxidans, but relatively favorable for A . calcoaceticus . As a result of MIC evaluation of reference drugs, S . aureus was resistant to CEZ, and Proteus spp . (indole-positive) was resistant to CP, while FRM was highly resisted by almost all strains of bacteria . However, the resistance rate of S . aureus to CP was relatively low, that is, as low as 16.1%.(ABSTRACT TRUNCATED AT 400 WORDS)

Rev Infect Dis, 1985 Jul-Aug, 7 Suppl 3, S506 - 12
Imipenem/cilastatin therapy for serious bacterial infections; Nielsen DM et al.; Imipenem was administered intravenously with cilastatin to patients with suspected or documented significant infections . The mean peak serum level of imipenem 30 min after infusion of a 500 mg dose was 18.4 micrograms/ml, and the mean trough level (30 min before infusion) was 2.4 micrograms/ml . The organisms isolated before therapy included Enterobacteriaceae, Staphylococcus aureus, streptococci, Pseudomonas aeruginosa, and anaerobes . The response rate in 25 assessable patients was 96%, with 40% experiencing a complete cure and 56% improvement . Therapy failed in only one instance because an isolate of P . aeruginosa was mistakenly reported to be susceptible on disk testing . Toxicity in the 33 patients treated was generally minimal and included phlebitis, mild liver function abnormalities, eosinophilia, and thrombocytosis . The emergence of resistant organisms during therapy was very uncommon . Imipenem/cilastatin is a promising agent for the treatment of complicated infections.

Rev Infect Dis, 1985 Jul-Aug, 7 Suppl 3, S380 - 8
Current needs in chemotherapy for bacterial and fungal infections; Young LS; Failure of therapy for microbial infections may be related to a number of factors, a major one being drug resistance . Although much progress has been made during the past decade, agents are still needed for improved treatment of infections in which clinical success rates remain unsatisfactory . Problem pathogens include enteric bacteria such as Serratia species, Enterobacter species, and a number of nonfermenting gram-negative bacilli, including Pseudomonas species . Gram-positive organisms that continue to pose a significant therapeutic problem are the coagulase-positive and coagulase-negative staphylococci and enterococci . Atypical mycobacterial species offer major therapeutic challenges . No important broad-spectrum antifungal agents of low toxicity have been developed during the past two decades . Any new antibacterial or antifungal agent should be potent, safe, and well tolerated and should possess pharmacokinetic advantages that will lead to more simplified dosing; low cost would be an additional important advantage.

J Antimicrob Chemother, 1985 Jul, 16(1), 31 - 42
Effect of beta-lactamase induction on susceptibility to cephalosporins in Enterobacter cloacae and Serratia marcescens; Okonogi K et al.; For Enterobacter cloacae GN5797 and Serratia marcescens 72-2, which produce inducible beta-lactamases and respond antagonistically to many combinations of cephalosporins, the changes in beta-lactamase activity and sensitivity to cephalosporins were examined during semi-continuous cultivation in which the concentration of inducers was decreased by two-fold dilution of the culture every 30 min starting from 1 h after the addition of inducers . The levels of beta-lactamase, which peaked at 0.5-2 h after induction, decreased concomitantly with the disappearance of the inducers in the culture, and returned to the uninduced levels by 6 h . The ability of cefoxitin and cefmetazole to induce beta-lactamases was more potent than that of cefazolin and cefotiam . The sensitivity to some cephalosporins, judged by the MIC and bactericidal effect, was slightly decreased at an early stage of induction, and reverted to the uninduced levels within several hours after the inducers were depleted.

Antimicrob Agents Chemother, 1985 Jul, 28(1), 113 - 7
Transferable plasmid-linked chloramphenicol acetyltransferase conferring high-level resistance in Bacteroides uniformis; Martinez-Suarez JV et al.; Bacteroides uniformis RYC3373 resistant to 64 micrograms of chloramphenicol per ml was isolated from a peritoneal pelvic abscess of a patient not previously treated with this drug . Chloramphenicol resistance was transferable at low frequency to a suitable Bacteroides fragilis recipient . The acquisition of resistance was linked to the presence of a 39.5-kilobase plasmid (pRYC3373), which was subsequently transferred to a secondary recipient . The transfer of Cm resistance occurred by a conjugation-like process . Donor and transconjugant strains produced chloramphenicol acetyltransferase constitutively . The Km for chloramphenicol was 40 microM, and its inactivation by 5-5'-dithiobis(2-nitrobenzoic acid) suggested its similarity to the type II enterobacterial enzymes encoded by different conjugative plasmids and also to a previously described enzyme of B . fragilis F47 and F48 . The specific activity and the resistance level in pRYC3373-bearing strains were more than 10-fold higher than in the case of the enzyme from B . fragilis strains F47 and F48 . The genetic basis of chloramphenicol acetyltransferase synthesis in Bacteroides spp . had not been previously established.

Drug Intell Clin Pharm, 1985 Jul-Aug, 19(7-8), 509 - 13
Ceftazidime review; Yost RL et al.; The chemistry, in vitro activity, adverse effects, and clinical indications for the new third-generation cephalosporin, ceftazidime, are reviewed . Ceftazidime appears to have a unique place among the third-generation agents in the treatment of some infectious processes caused by Pseudomonas aeruginosa . It does not demonstrate superiority to other third-generation drugs against Enterobacteriaceae, aerobic gram-positive cocci, or anaerobes . It is eliminated renally and is similar to ceftizoxime, cefoperazone, and moxalactam in half-life . Ceftazidime shares the safety profile of most of the cephalosporins, and has not been shown to have an effect on prothrombin or produce the disulfuram reaction seen with moxalactam and cefoperazone . Specific indications for its use are discussed.

Br J Ophthalmol, 1985 Jul, 69(7), 542 - 4
Enterobacter cloacae ulceration in a failed corneal graft: a case report; Gross ND et al.; A 70-year-old female developed a bacterial ulcer in a previously rejected corneal graft . Cultures identified the pathogen as Enterobacter cloacae . Intensive topical antibiotic therapy arrested the progress of the ulcer, and the epithelial defect healed in one week; there was no resultant stromal thinning . Factors which may have predisposed the cornea to ulceration by this organism of relatively low virulence include chronic oedema following graft rejection, topical corticosteroid therapy, and tear insufficiency.

Ann Intern Med, 1985 Jul, 103(1), 70 - 8
Cefamandole and cefoxitin; Sanders CV et al.; Cefamandole and cefoxitin, introduced only 7 years ago, are now the most commonly prescribed parenteral antibiotics in the United States . These drugs are similar to the first-generation cephalosporins in toxicity, but their in-vitro spectrum of activity is greater . Their serum half-lives are longer than those of cephalothin and cephapirin but shorter than that of cefazolin . Although cefamandole has been recommended in empiric therapy for patients with community-acquired pneumonia and as a prophylactic agent for patients having various surgical procedures, other regimens are less expensive and just as effective . Cefamandole should not be used to treat intra-abdominal, enterobacter, or ampicillin-resistant Haemophilus influenzae infections . Cefoxitin is effective in the treatment and prevention of mixed aerobic-anaerobic skin and soft-tissue, intra-abdominal, gynecologic, and penicillinase-producing, spectinomycin-resistant Neisseria gonorrhoeae infections . Cefoxitin represents a greater advance than cefamandole in our continuing search for safe and more effective antimicrobial agents.

J Antibiot (Tokyo), 1985 Jul, 38(7), 912 - 9
Cefpirome (HR 810): lack of selection of beta-lactamase overproducing variants; Cullmann W et al.; With respect to the selection of beta-lactam-resistant variants marked discrepancies between the recently developed cephalosporin HR 810 and other recently developed cephalosporins could be observed: beta-lactam resistant subpopulations did not emerge during a 16-hour culture in the presence of the 20-fold minimal inhibitory concentration in a clinical Enterobacter cloacae isolate (2240/81) in contrast to cefoperazone, cefotaxime, ceftriaxone and ceftazidime . Breakdown of the antibacterial agents during the 16-hour period as evaluated by monitoring their levels in the medium was not responsible for selection of beta-lactam-resistant subpopulations . The study of affinity of various cephalosporins to the chromosomally mediated beta-lactamase of E . cloacae strain 2240/81 revealed low affinity of HR 810 to the enzyme (Ki amounted 4.4 X 10(-3)M) . It is suggested that the low affinity of this new agent to the E . cloacae enzyme plays a major role in the lack of selection of resistant subpopulations.

Rev Infect Dis, 1985 Jul-Aug, 7 Suppl 3, S426 - 31
Influence of imipenem on the serum resistance of enterobacteriaceae; Wiemer CW et al.; Following growth in a subinhibitory concentration of imipenem and additional incubation in a 20% dilution of normal human serum (NHS) for 90 minutes, five of 12 serum-resistant strains of enterobacteriaceae showed a decrease in colony-forming units of two or more logs of growth compared with the control . Two strains (of Escherichia coli and Enterobacter aerogenes) showed this phenomenon even with incubation in 5% NHS . Treatment with imipenem did not change the serum resistance of the other seven strains (two strains each of Enterobacter cloacae, Klebsiella pneumonia, and Serratia marcescens, and one strain of Proteus morganii) . The phenomenon of induced serum susceptibility is dose dependent and reversible . Other beta-lactam antibiotics either caused only a slight decrease of resistance (cefsulodin, cefoxitin, cefuroxime, cefodizime-HR221) or did not influence the serum resistance at all (cefotaxime, mecillinam) . Killing of the induced serum-sensitive strains appeared to be antibody dependent.

J Antimicrob Chemother, 1985 Jul, 16(1), 43 - 8
The in-vitro activity of EN 272, a quinolone-7-carboxylic acid, in comparison with other quinolones; Neu HC; The in-vitro activity of EN 272, a quinolone-7-carboxylic acid was determined and compared with that of enoxacin, ofloxacin, norfloxacin, ampicillin, cephalexin and trimethoprim . EN 272 inhibited the majority of the Enterobacteriaceae at concentrations of less than or equal to 1.6 mg/l . EN 272 was four- to 32-fold less active than the other new quinolones, but it inhibited organisms resistant to nalidixic acid, ampicillin and cephalexin . EN 272 had poor activity against Pseudomonas aeruginosa and streptococcal species, but it did inhibit most staphylococci at less than or equal to 6.3 mg/l . EN 272 was less active at pH 5.5 and in urine as are other quinolones.

Antimicrob Agents Chemother, 1985 Jul, 28(1), 69 - 73
Comparison of three DNA hybridization methods for detection of the aminoglycoside 2"-O-adenylyltransferase gene in clinical bacterial isolates; Gootz TD et al.; Two rapid DNA hybridization methods in which whole-cell lysates fixed to nitrocellulose were used were compared with Southern hybridization of purified plasmid or chromosomal DNA for the ability to identify the 2"-O-adenylyltransferase {ANT(2")} gene in 42 enzymatically defined isolates of gram-negative bacilli . A DNA restriction fragment isolated from an ANT(2") gene cloned into pBR322 and radiolabeled with 32P was used as the probe in all three procedures . Under conditions of high stringency, agreement was obtained between the Southern hybridization method and detection of the ANT(2") enzyme by the phosphocellulose paper binding assay or resistance phenotype in 39 of the 42 strains tested . By using these characterized strains, colony hybridization was shown to be unsatisfactory as a rapid technique for detecting the ANT(2") gene, due to the high number of false-positive and -negative signals obtained . Compared with Southern hybridization, however, spot hybridization (SPH) proved highly reliable for detecting the ANT(2") gene in both members of Enterobacteriaceae and Pseudomonas aeruginosa harboring R factors ranging in size from 23 to 150 kilobases . The relatively low copy number of the 150-kilobase plasmids decreased the sensitivity of SPH, necessitating a minimum cell density of 5 X 10(6) cells per spot . SPH proved to be a very useful method for rapidly screening large numbers of clinical isolates for this resistance determinant.

Appl Environ Microbiol, 1985 Jul, 50(1), 1 - 9
pULB113, an RP4::mini-Mu plasmid, mediates chromosomal mobilization and R-prime formation in Erwinia amylovora, Erwinia chrysanthemi, and subspecies of Erwinia carotovora; Chatterjee AK et al.; The RP4::mini-Mu plasmid pULB113, transferred from Escherichia coli strain MXR, was stable and transfer proficient in Erwinia amylovora strain EA303, E . carotovora subsp . atroseptica strain ECA12, E . carotovora subsp . carotovora strain ECC193, and E . chrysanthemi strain EC183 . The plasmid mobilized an array of Erwinia sp . chromosomal markers (E . amylovora: his+,ilv+,rbs+,ser+,thr+;E . chrysanthemi:arg+,his+,ilv+,leu+; E . carotovora subsp . atroseptica: arg+,gua+,leu+,lys+,pur+,trp+; E . carotovora subsp . carotovora: arg+,gua+,leu+,lys+,out+{export of enzymes},pur+,trp+), suggesting random interactions of the plasmid with the chromosomes . In E . carotovora subsp . carotovora, pULB113-mediated two-factor crosses revealed linkage between three auxotrophic markers and the out loci . The export of pectate lyase, polygalacturonase, and cellulase and the maceration of potato tuber tissue occurred with Out+, but not Out-, strains of E . carotovora subsp . carotovora, indicating the importance of enzyme export in plant tissue maceration . Erwinia sp . donors harboring pULB113 complemented mutations in various biosynthetic and catabolic genes (arg, gal, his, leu, met, pro, pur, thy) in Escherichia coli recA strains . Escherichia coli transconjugants harbored pULB113 primes as indicated by the cotransfer of Erwinia genes and pULB113 markers and a change in plasmid mass . Moreover, the PstI and SmaI cleavage patterns of selected pULB113 primes were different from those of pULB113 . pULB113 primes carried DNA insertions ranging from 3 to about 160 kilobases . These findings indicate that pULB113 is useful for in vivo gene cloning and genetic analysis of various enterobacterial phytopathogens.

Gan No Rinsho, 1985 Jul, 31(9 Suppl), 1203 - 10
{Infectious complications of lung cancer and its management}; Oizumi K; Analysis of clinical features of infectious complications of lung cancer was carried out to obtain the informations necessary for the efficient management . Infectious complications developed in 114 patients out of 188 patient of primary lung cancer who were admitted to the institute during the period of two years from 1982 to 1983 . From the results of the analysis it was revealed that anticancer chemotherapy was extensively restricted by coexistent infectious complications . Therefore, complete and partial responses in the patients associated with infections was significantly (p less than 0.05) lower than that in the patients without infection . Survival rate at the point of one year after the admission was also lower with significance (p less than 0.05) in the patients with infections than that in the patients without infections . Main and direct cause of the infection was bronchial obstruction . Therefore, the incidence of the infectious complication was the highest in the patients with squamous cell carcinoma . Of defence mechanism against infection, cellular immunity seemed to play the more important role as compared with that of humoral immunity . And it was shown that decrease in number of lymphocytes was most closely related to the development of serious or terminal infections . Causative organisms in most of the pulmonary infections were opportunistic Gram-negative bacilli . Recently, the incidence of the infections due to E . colioand K . pneumoniae decreased and that due to Enterobacteriaceae except for these two species increased . Therapeutic efficacy rate of antimicrobial agents including cephems of the 3rd generation remained as low as 50% or so . However, the cure rate of the triple regimen consisted of beta-lactam, aminoglycoside and tetracycline was revealed to be satisfactorily high.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1985 Jul, 259(4), 538 - 47
Protective characteristics of the antigen common to Pseudomonas and Vibrio and significance of bacterial endotoxins in protection against selected bacterial infections; Sourek J; The protective effect of different vaccines against the killing activity of Pseudomonas aeruginosa and Vibrio parahaemolyticus for mice was studied . Cross experiments confirmed the high protective effect of the Pseudomonas common antigen (original endotoxin protein) contained in Pseudomonas vaccine, which, together with other soluble components, substantial afforded protection of mice against vibrios and thus confirmed the antigenic relationship between Pseudomonas and Vibrio . Satisfactory results were also obtained by vaccination with selected bacterial endotoxin lipopolysaccharides derived from some members of the Enterobacteriaceae family, which in some cases afforded 70-90% and in others only a 20-50% protection against Pseudomonas and Vibrio infection . The protective effect was reduced by up to 2/3 was obtained with vaccines subjected to alkaline hydrolysis . A single dose of Propionibacterium parvum cells not followed by specific vaccination afforded up to 50% protection against challenge with P . aeruginosa or V . parahaemolyticus . Special characteristics of the vaccines studied and their protective effects in relation to some immunological aspects of nonspecific resistance are discussed.

Am J Med, 1985 Jun 7, 78(6A), 154 - 64
Gram-negative bacillary infections . Pathogenic and pathophysiologic correlates; Duma RJ; Gram-negative bacillary infections continue to be extremely important . Escherichia coli is the single most frequently encountered pathogen, followed by organisms belonging to the tribe Klebsiella-Enterobacter-Serratia and Proteus-Providencia . Pseudomonas aeruginosa, although it receives considerable (perhaps excessive) attention, is found relatively less frequently, occurring principally in the hospitalized patient who is immunocompromised . Many factors, both host and microbial, are responsible for invasiveness, virulence, and pathogenicity of gram-negative bacilli, but their relative roles, importance, and the pathophysiologic reactions they trigger are yet to be precisely defined . Certain aspects of many (but certainly not all) of the pathogenic correlates considered important in gram-negative bacillary infections, such as microbial flora, local barriers, surface and serum antibodies, complement, cell-mediated immunity, slime production, capsules, pili, endotoxin, cell wall components, extracellular products, and inoculum size are discussed herein . Points at which preventive or therapeutic strategies might be developed are offered . The benefits of antibiotics in managing susceptible gram-negative bacillary infections appear to be plateauing . If further advances are to be made in the therapy of these infections, new approaches to rapidly identifying the responsible etiologic agent and a better understanding of the factors responsible for invasiveness, virulence, and pathogenicity are needed.

Am J Med, 1985 Jun 7, 78(6A), 140 - 4
Role of imipenem/cilastatin in the treatment of soft tissue infections; Marier RL; Imipenem/cilastatin was given to 243 evaluable patients with moderately severe to severe soft tissue infections . Cultures prior to therapy yielded Staphylococcus aureus (108 isolates), group D and non-group D enterococci (49), group A streptococci (42), other aerobic gram-positive cocci (72), Pseudomonas aeruginosa (54), Escherichia coli (32), Proteus mirabilis (31), Enterobacter (21), Klebsiella (20), other aerobic gram-negative rods (58), Bacteroides fragilis group (16), and other anaerobes (65) . Overall, 95 percent (230 of 243) of the patients treated had clinical cure (137 of 243) or improvement (93 of 243) . Of the 506 strains of etiologic bacterial pathogens isolated from these patients and tested against imipenem, 498 (98 percent) were susceptible to the antibiotic . Many were resistant to both older and newer penicillins and cephalosporins . Serial cultures of infection sites revealed that 426 of 498 (86 percent) of pre-therapy bacterial isolates were eradicated by imipenem/cilastatin therapy . Eight of 498 etiologic pathogens (1.6 percent) acquired resistance to imipenem (seven P . aeruginosa and one enterococcus) . Such resistance acquisition was associated with clinical failure in two patients . Imipenem/cilastatin appears to be a highly effective, relatively safe therapy of soft tissue infections caused by a wide variety of gram-positive and gram-negative aerobes and anaerobes, both polymicrobial and monomicrobial in nature . Imipenem/cilastatin should be considered particularly when infection by the more antibiotic-resistant of these bacteria is suspected or proved.

Am J Med, 1985 Jun 7, 78(6A), 3 - 21
Carbapenems, a new class of beta-lactam antibiotics . Discovery and development of imipenem/cilastatin; Birnbaum J et al.; The discovery of Streptomyces cattleya and its antibiotic product, thienamycin, has ushered in a new era of beta-lactam agents, the carbapenems . Numerous carbapenems were subsequently discovered; however, none had the potency, broad-spectrum activity, and lack of cross-resistance exhibited by thienamycin . Chemical instability encountered with thienamycin was overcome by the N-formimidoyl derivative, imipenem . Imipenem is distinguished from other beta-lactams by its outstanding activity against gram-positive organisms as well as against Enterobacteriaceae, Pseudomonas aeruginosa, and Bacteroides . However, development was hindered by extensive renal metabolism of imipenem, resulting in low urinary concentrations of antibiotic . A renal dipeptidase, dehydropeptidase-I, was responsible for hydrolyzing imipenem and other carbapenems . To counter its action, a specific inhibitor, cilastatin, was developed . Coadministered with imipenem in a one-to-one ratio, cilastatin provides prolonged, reversible blockade of imipenem metabolism, dramatically improving urinary recoveries to therapeutically significant levels . Cilastatin also contributes to the safety of imipenem, since its coadministration prevents proximal tubular necrosis which has been observed in sensitive animals receiving imipenem alone in high doses . Thus, the combination imipenem and cilastatin overcame the pharmaceutical and metabolic challenges presented by thienamycin, and allowed for the evaluation in humans of the outstanding antimicrobial activity of this new class of beta-lactam antibiotics.

Am J Med, 1985 Jun 7, 78(6A), 117 - 21
Efficacy of imipenem/cilastatin in endocarditis; Dickinson G et al.; Imipenem, a potent new beta-lactam antibiotic, which is bactericidal against most pathogenic bacteria, and cilastatin, a dehydropeptidase inhibitor combined with imipenem to prevent the metabolism of imipenem in the kidney, were evaluated in the treatment of bacterial endocarditis . Seventeen patients, including 14 who used intravenous drugs, were treated with imipenem/cilastatin in a dose of 500 mg each infused over 30 minutes every six hours . The mean duration of treatment was 29 days with a range of 21 to 56 days . Causative bacteria were Staphylococcus aureus in 10 patients, S . aureus plus group B Streptococcus in one, viridans group Streptococcus in two, Neisseria subflava, Eikenella corrodens, and group G Streptococcus in one patient, and Staphylococcus epidermidis, Hemophilus aphrophilus, and Enterobacter aerogenes in one patient each . The minimal bactericidal concentration of imipenem against 16 of 18 isolates tested was 0.04 micrograms/ml, 1 microgram/ml against H . aphrophilus, and 0.4 micrograms/ml against E . aerogenes . The site of infection was the right side of the heart in 11 patients, the left side in five, and both sides in one . The mean number of days to defervescence was 9.7 . All patients were cured, and none required cardiac surgery . Adverse effects were few and interrupted treatment occurred in only one patient who had acute dyspnea during an infusion on Day 26 of therapy . Imipenem/cilastatin appears to be a relatively safe and highly effective treatment of staphylococcal endocarditis in intravenous drug users; too few patients with endocarditis caused by other bacteria were treated to allow a firm statement about efficacy in non-staphylococcal endocarditis.

Quad Sclavo Diagn, 1985 Jun, 21(2), 214 - 24
{Rapid identification of Enterobacteriaceae: evaluation of 3 commercial systems}; Sala A et al.; We have compared three rapid systems for the identification of Enterobacteriaceae: MS-2, Rapid 20E, Micro-ID . These methods allows to identifications of bacteria within 4-5 hours . We have chosen API 20E as reference system; because it is normally used in the clinical microbiology laboratories . We have noted good agreement of concordance for MS-2, Micro-ID and Rapid 20E towards API 20E, respectively 95, 90, 84% . We have, moreover, analysed significative difference about three systems biochemical tests in comparison with the same of API 20E.

J Antimicrob Chemother, 1985 Jun, 15(6), 723 - 8
Inability of gentamicin and fosfomycin to eliminate intracellular Enterobacteriaceae; Kihlstrom E et al.; The ability of gentamicin and fosfomycin to kill Salmonella typhimurium and Escherichia coli in a HeLa cell culture system was investigated . Antibiotic activity against extracellular, cell membrane-attached and intracellular bacteria were determined . Both gentamicin and fosfomycin had the same low ability to kill intracellular bacteria . The efficacy of fosfomycin against extracellular bacteria was also low, whereas gentamicin rapidly killed such bacteria . These observations show that intracellular enterobacteria are protected from the bactericidal activity of gentamicin and fosfomycin.

J Antimicrob Chemother, 1985 Jun, 15(6), 695 - 700
Determination of molecular hydrogen in investigations of the susceptibility of Enterobacteriaceae to ampicillin; Hornsten EG et al.; One hundred and five enterobacterial isolates from urinary tract infections were examined for ampicillin-susceptibility by measurement of molecular hydrogen production with a palladium metal oxide semi-conductor (Pd-MOS sensor) . Eighty-one per cent of hydrogen producing strains could be placed in the same susceptibility groups as recorded by disc-diffusion tests . However, it was harder to separate susceptible from intermediate types than to determine resistance . In all but five strains the hydrogen production allowed determination of viability within 5 h.

Arch Intern Med, 1985 Jun, 145(6), 1024 - 7
Enterobacter bacteremia . An analysis of 50 episodes; Bouza E et al.; During a six-year period, 147 patients had Enterobacter bacteremia (3.8% of the episodes of bacteremia), with an incidence of 1.25 per 1,000 admitted patients . We chose a random group of 50 cases for analysis . The disease was community acquired in 24% of the cases and nosocomially acquired in the remaining 76% . The bacteremia was unimicrobial in 70% and part of a polymicrobial bacteremia in 30% . The species most commonly causing bacteremia was Enterobacter cloacae . Portals of entry, in decreasing order of frequency, were unknown, surgical wound, respiratory tract, and urinary tract . The most common clinical finding was fever (92%) . Shock occurred in 30% of the patients, and only two patients had evidence of disseminated intravascular coagulation . Of the Enterobacter isolates, 12% were resistant to gentamicin . Overall mortality was 42%; factors associated with a poor prognosis were inadequacy of antimicrobial chemotherapy, septic shock, type of underlying disease, clinical condition, and requirement of intensive care.

South Med J, 1985 Jun, 78(6), 704 - 7
Brain abscess: recent experience at a community hospital; Harris LF et al.; Brain abscess is a formidable diagnostic and therapeutic problem with mortality ranging from 35% to 65% . It may occur at any age, and there is a male:female ratio of 2:1 . Brain abscess arises from a contiguous focus of infection, direct implantation due to trauma, or hematogenous spread from a remote site . The commonest organisms isolated from brain abscess include streptococci, Staphylococcus aureus, Bacteroides species, and Enterobacteriaceae . Brain abscess frequently produces headache, vomiting, focal neurologic signs, and depressed level of consciousness . Fever and leukocytosis often are absent . Diagnosis is suggested by computerized tomography, but most cases require surgical confirmation . Optimal management consists of intensive antibiotic therapy . Aggressive surgical treatment is required in cases not responding to antimicrobial therapy . Long-term neurologic deficit occurs in up to 60% of cases.

Crit Care Med, 1985 Jun, 13(6), 472 - 6
A comparison of infections in different ICUs within the same hospital; Brown RB et al.; Infections identified between 1981 and 1983 in a hospital's medical/surgical, pediatric, neonatal, coronary care, and cardiac surgery ICUs were compared . Among 14,360 admissions, 1840 infections occurred in 1360 patients . Total infection rates ranged from 1.0% (cardiac surgery ICU) to 23.5% (medical/surgical ICU) . Rates of ICU-acquired infection ranged from 0.8% (cardiac surgery ICU) to 11.2% (medical/surgical ICU), indicating that only about half of infections in the latter unit were acquired from within . Primary bacteremias comprised 14.5% of neonatal ICU infections, a rate 500% higher than in other ICUs . Meningitis and genitourinary infections were more common in pediatric and coronary care ICUs . Candida and Pseudomonas species and Klebsiella-Enterobacter-Serratia were most common in the medical/surgical ICU . Survival rate of infected patients was over 87% in pediatric and neonatal ICUs, compared with only 55.4% in the medical/surgical ICU . These differences in types and rates of infection have an important bearing on infection-control activities in the ICU, and also provide a yardstick against which similar institutions can gauge their ICU infection status.

Clin Pediatr (Phila), 1985 Jun, 24(6), 338 - 41
Intestinal flora in the second week of life in hospitalized preterm infants fed stored frozen breast milk or a proprietary formula; Stevenson DK et al.; Twenty infants fed stored frozen breast milk or a proprietary formula only had both aerobic and anaerobic cultures performed at a chronologic age of 8 to 14 days . Nine out of 10 stools from the infants fed stored frozen breast milk contained Enterobacteriaceae and one stool was sterile . One contained a Pseudomonas species; one contained anaerobic gram-positive rods; one contained anaerobic gram-negative rods; and four contained anaerobic gram-positive cocci . No anaerobes were found in six stools . Six stools had aerobic gram-positive cocci, none of which was hemolytic . Nine out of 10 stools from infants fed a proprietary formula had Enterobacteriaceae . Six stools had anaerobic gram-positive rods, three had anaerobic gram-negative rods, and four had gram-positive cocci . Four stools had no anaerobic bacteria . All 10 stools had nonhemolytic aerobic gram-positive cocci . Enterobacteriaceae were predominant in the stools of the infants fed either stored frozen breast milk or a proprietary formula, and the colony counts of aerobic bacteria were similar in both groups . This pattern of intestinal flora in hospitalized preterm infants in the second week of life is very different from that of normal term infants and may contribute to their increased incidence of systemic and localized infections . The use of stored frozen breast milk for the purpose of suppressing coliform and other potentially pathogenic organisms may not be effective in hospitalized preterm infants who have been treated previously with broad-spectrum, parenteral antibiotics.

Pathol Biol (Paris), 1985 Jun, 33(5 Pt 2), 623 - 7
{Plasmid resistance to antiseptics . Demonstration of methods}; Van Cuyck-Gandre H et al.; Susceptibility to chlorhexidine, benzalkonium chloride and mercury chloride was studied for 70 Gram negative strains (56 Enterobacteriaceae and 14 Pseudomonas aeruginosa) recovered from humans or animals . Minimal inhibitory concentration (MIC) was determined on solid agar (replica plating) and in a liquid medium (laser nephelometry) . For resistant strains, plasmidic mediation was looked for using conjugation . Isolation of lysates by the miniprep analytic method and physicochemical characterization of plasmids by agar electrophoresis were carried out using conjugative strains . MICs obtained using the two methods differed by one dilution at the most . Both methods yielded reproducible results . Regardless of the origin of strains, a resistant population was identified only for mercury chloride . This resistance was plasmid-mediated and transferred singly or associated with resistance to other antibiotics.

Pathol Biol (Paris), 1985 Jun, 33(5 Pt 2), 591 - 5
{Clinical evaluation of a ticarcillin-clavulanic acid combination in severe infections in adults}; Lacut JY et al.; Timentin (ticarcillin (TCR) + clavulanic acid (AC)) was given for severe bacterial infections to sixteen hospitalized patients (10 male and 6 female; 16 to 75 years of age; normal renal function in 12) . Infections included 8 septicemias (of which 4 were secondary to pyelonephritis), 6 pyelonephritis (in addition to the four above-mentioned cases), and 3 suppurated cellulitis of the lower limbs (with septicemia in one case) . The following bacteria were recovered: 10 Escherichia coli, 1 Pseudomonas aeruginosa, 1 Enterobacter cloacae, 1 Providencia stuartii, 1 Salmonella typhi, 1 Klebsiella pneumoniae, and 1 Staphylococcus aureus . The sixteen strains were all susceptible to timentin (MICs determined by agar dilution: TCR + AC 4 mg/l: 0.5-16 mg/l; TCR + AC 8 mg/l: 0.2-16 mg/l) . Thirteen strains were susceptible to TCR (MIC less than or equal to 16 mg/l), and three (1 E . coli, 1 K . pneumoniae, and 1 S . aureus) were resistant to TCR (MIC greater than or equal to 256 mg/l) . 14 patients received timentin alone, while two were also given dibekacin . Timentin was given in one-hour IV infusions in a dosage of 9.6 g/24 h (3.2 g X 3) in 10 patients and 6.4 g/24 h (3.2 g X 2) in 6 . Duration of therapy was 14 to 16 days in half of cases (range 5 to 21 days) . At termination of the infusion, serum concentrations of ticarcillin and clavulanic acid (determined in ten patients) were greater than 50 mg/l and 3-7.4 mg/l respectively, and serum bactericidal activity (evaluated in ten cases) was consistently less than 1/2.(ABSTRACT TRUNCATED AT 250 WORDS)

Pathol Biol (Paris), 1985 Jun, 33(5 Pt 2), 581 - 5
{Computerized analysis of activity profiles of beta-lactams}; Pitton JS et al.; This study was designed to compare the in vitro activities of recent cephalosporins and other beta-lactams . One of our objectives was to determine whether the microbiologist could use a single cephalosporin for routine antibiotic sensitivity testing . All the strains studied were recovered from outpatients . Sensitivity and/or resistance were evaluated by MIC determination, according to a program developed in our laboratory, using a personal computer . Using special programs, patterns of activities of beta-lactams were determined quantitatively and graphically for each bacterial strain tested . For most strains ceftriaxone, and to a lesser extent moxalactam and cefoperazone, exhibited greater antibacterial activity than the other beta-lactams, except against group D streptococci . For Enterobacteriaceae, cefadroxil is satisfactory in screening for in vitro activity of cephalosporins.

J Antibiot (Tokyo), 1985 Jun, 38(6), 721 - 39
Preparation and structure-activity relationships of some 6 alpha-substituted penicillins; Burton G et al.; The influence on the antibacterial activity of introducing a 6 alpha-methoxy group into carbenicillin, and various 6 alpha-substituents into sulbenicillin and piperacillin was examined . Further variations of the side chain aryl group were examined in the 6 alpha-methoxy substituted series . This led to the identification of disodium 6 beta-(D,L-2-carboxy-2-thien-3-ylacetamido)-6 alpha-methoxypenicillanate (5b) as a beta-lactamase stable derivative with useful activity against Enterobacteriaceae, and disodium 6 beta-{D-2-(4-aminophenyl)-2-sulfoacetamido}-6 alpha-methoxypenicillanate (6e) with slightly lower activity against the Enterobacteriaceae but more active against Pseudomonas aeruginosa.

J Pediatr, 1985 Jun, 106(6), 1023 - 9
Urinary tract infections in childhood: an update; Ogra PL et al.; Although controversies remain regarding the definition, diagnosis, and management of urinary tract infections, such infections can pose a major risk to a child's well-being . Bacteriuria or recurrent urinary tract infections often pose difficult management problems . Symptomatic and asymptomatic bacteriuria during infancy are generally characterized by a benign outcome . In some children repeated episodes and, possibly, renal scarring result . The prognosis in young boys may be guarded if neonatal bacteriuria, with or without symptoms, occurs in the presence of anatomic defects . Although a variety of pathogens have been identified as causing urinary tract infections, Enterobacteriaceae are usually the cause of initial uncomplicated lower tract infections . Accepted therapy for such infections is reviewed, as are the combination therapies used for hospitalized patients with upper tract infections . An investigation of piperacillin, a new, extended-spectrum acylaminopenicillin, raises the hope that it may provide effective monotherapy for upper tract infections . The criteria for selecting patients who require radiologic evaluation in the management of urinary tract infections are reviewed.

Pathol Biol (Paris), 1985 Jun, 33(5 Pt 2), 517 - 20
{Antibiotic sensitivity testing on the automatic MS-2 . Use of antibiotic discs from 3 different sources}; Blin C et al.; The MS-2 automate for antibiotic susceptibility testing was experimented under conditions different from those recommended by the manufacturer, namely using antibiotic discs from different firms . Susceptibility of eight Enterobacteriaceae strains recovered from urine to nine antibiotics borne by discs from three different firms was tested . Results obtained with the different brands of discs were dissonant in less than 7% of cases (major and minor disagreements compounded) . Major discrepancies ranged from 2.8 to 4.2% according to the origin of discs . The reproducibility study found consistent results in 87.5% of cases, and satisfactory results (i.e . minor discrepancies excluded) in 93.5% of cases.

Pathol Biol (Paris), 1985 Jun, 33(5 Pt 2), 466 - 8
{In vitro study of the synergistic effect of cefotiam- aminoglycoside combinations on strains of low susceptibility to this cephalosporin}; Husson MO et al.; Antibacterial activity of cefotiam associated with gentamicin, tobramycin, netilmicin, or amikacin against Enterobacteriaceae strains either moderately susceptible (MIC = 4 to 32 micrograms/ml, 14 strains) or resistant (MIC = 64 to 512 micrograms/ml, 22 strains) to cefotiam was studied using the checkerboard method . High rates of synergic associations (FIC index less than or equal to 0.5) were found, with variations according to the aminoglycoside: 65% for tobramycin and netilmicin, 76% for amikacin, and 81% for gentamicin . Activity of cefotiam is increased by the synergic effect of these associations: of the 36 strains tested, 83, 78 and 76% became susceptible to cefotiam (MIC less than or equal to 4 micrograms/ml) associated with tobramycin, netilmicin or gentamicin, and amikacin respectively.

Pediatrie, 1985 Jun, 40(4), 291 - 9
{Treatment of purulent meningitis in the child using Cefotaxime}; Borderon JC et al.; Cefotaxime has a good meningeal diffusion and is effective at low concentrations on many bacteria, especially ampicillin resistant Enterobacteriaceae and Hemophilus influenzae . We have therefore used cefotaxime (150 mg/kg/24 h, continuous infusions lasting 30 minutes q . 6 h.) in meningitis due to gram negative bacilli . Twenty eight infants and children have been treated within 4 years . The 13 Hemophilus influenzae meningitis (including 2 beta-lactamase producers) have been cured without immediate sequelae . The duration of treatment could be reduced from 3 weeks to 2 weeks . The 7 infants with Enterobacteria meningitis (6 E . coli and 1 Serratia) have been cured of their infection with a 21 to 28 days treatment . The C.S.F . was sterile 2-3 days after treatment except a case of E . coli persisting during 7 days in C.S.F . contrasting with a normal ventricular fluid . A case of relapse with E . coli remaining sensitive was cured with a new course of the same treatment . Five meningitis complicated with hydrocephalus needed external drainage: the fluid was sterile 1 day after treatment in 4 of them . Two superinfections of ventriculo-peritoneal shunt due to Enterobacteriaceae have been cured . To obtain a good result, the need for a careful drug monitoring must be emphasized.

J Appl Biochem, 1985 Jun, 7(3), 161 - 79
Sulfite, an elective agent in the microbiological and chemical changes occurring in uncooked comminuted meat products; Banks JG et al.; The literature dealing with sulfite preservation of meat products is reviewed . Discussion is centered on three aspects: (i) the elective action of sulfite, whereby its presence in meat products encourages the development of an association of Gram-positive bacteria (Brochothrix thermosphacta and homofermentative lactobacilli) and yeasts . Unsulfited products tend to be dominated by Pseudomonas fragi at chill, and Enterobacteriaceae at ambient temperatures; (ii) the diminution of the preservative potential of a meat product, which is associated with the binding of sulfite by acetaldehyde-producing yeasts; and (iii) the sparing action that sulfite has on the carbohydrates contained in the meat or included as an ingredient.

Jpn J Antibiot, 1985 Jun, 38(6), 1587 - 602
{Distribution and changes in the susceptibility of bacteria isolated from clinical samples . II}; Deguchi K et al.; In vitro activity of antimicrobial agents such as ABPC, SBPC, MPC, CEZ, CTM, CMZ, CTX, CMX, CZX, LMOX, CPZ, CFS and GM against major clinical isolates, S . aureus, S . pyogenes, E . coli, K . pneumoniae, P . mirabilis, C . freundii, Enterobacter spp., S . marcescens, P . vulgaris and P . aeruginosa, was examined . In this paper, we will report the susceptibility of S . aureus, S . pyogenes, E . coli, K . pneumoniae and P . mirabilis during a three-year period, 1981 to approximately 1983 . CEZ- and GM-resistant S . aureus has markedly increased and occupied 24% and 18%, respectively, in 1983 . CMZ and CFS have showed potent activity against CEZ-resistant S . aureus . It seems that the abuse of third generation-cephems and new oral cephalosporins is closely related with the increase of cephems-resistant S . aureus . The penicillin- and cephem-resistant strains of S . pyogenes could not be found in our study . Quite a few strains of E . coli, K . pneumoniae and P . mirabilis are resistant to penicillins, and also there is no appreciable change in susceptibility . Some strains of E . coli, K . pneumoniae and P . mirabilis showed low susceptibility to CPZ, but all strains showed high susceptibility and no change in susceptibility to third generations, and these strains showed no tendency to decrease in susceptibility to GM.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Jun, (6), 20 - 3
{Determination of the structural integrity of DNA from pathogenic enterobacteria}; Tets VV et al.; Among the enterobacterial strains under study, more organisms in the stationary phase of growth have been found to have nicks in their DNA than those in the exponential phase . Bacteria less sensitive to ultraviolet irradiation have the least number of nicks in each phase of growth . The number of nicks in different strains belonging to the serovar is sufficiently stable . Virulent and avirulent forms show no difference in this characteristic.

J Antimicrob Chemother, 1985 Jun, 15 Suppl C, 85 - 97
In-vitro activity of Sch 34343 against Gram-negative bacteria producing characterized beta-lactamases; Dornbusch K et al.; The activity of Sch 34343 against 13 strains producing large amounts of characterized beta-lactamases was compared with that of imipenem, latamoxef (moxalactam), aztreonam and other third-generation cephalosporins . Sch 34343, like imipenem, was active against all strains, including many resistant to all other beta-lactams . MICs of Sch 34343 determined for 16 different inocula were rarely increased even at very high inocula . Sch 34343 was rapidly bactericidal against Escherichia coli TEM-2, Enterobacter agglomerans (with an induced beta-lactamase) and two strains of Bacteroides fragilis with highly active cephalosporinases . Like cefoxitin, Sch 34343 was only slowly inactivated by concentrated crude penicillinases which inactivated cefotaxime within 1 h . Sch 34343 was even more stable to cephalosporinases than was cefoxitin . Stability of the antibiotics to the different beta-lactamases was also determined by pre-incubating them with dilutions of the beta-lactamases before determination of MICs against E . coli 25922 . Very large amounts of all enzymes were required to increase the MICs significantly for Sch 34343 and imipenem . These results indicate the good stability of Sch 34343 to beta-lactamases.

J Antimicrob Chemother, 1985 Jun, 15(6), 743 - 9
Ceftazidime in serious hospital-acquired infections; Hoogkamp-Korstanje JA et al.; Thirty-four patients, most of them immunocompromised, with severe hospital-acquired infections, including septicaemia, respiratory tract and complicated urinary tract infections were treated with ceftazidime 1-2 g intravenously 8-hourly . Twenty-six patients were cured or improved (76%) . The most common pathogens were Enterobacteriaceae and Pseudomonas aeruginosa; Gram-positive organisms were isolated from nine patients . Failure were observed in eight patients (24%), four of them had infections caused by resistant organisms, one had infection with Ps . aeruginosa which became resistant during therapy . Superinfection occurred in 11 patients (32%) . Mean peak serum levels after 1 g intravenously were 86.2 +/- 30.3 mg/l; after 2 g intravenously 151.6 +/- 52.2 mg/l . The half-life of serum elimination was 1.8-1.9 h, 2 h in patients with liver function disorders and 3 h in patients with renal impairment . Side effects were mild . Ceftazidime is useful in treating Gram-negative infections, but the gaps in its spectrum, the high rate of superinfection and emergence of resistance are matters of concern.

J Infect Dis, 1985 Jun, 151(6), 995 - 1004
Cross-reactive immunoprotective antibodies to Escherichia coli O111 rough mutant J5; Sakulramrung R et al.; The potential immunoprotective role of antiserum to an Escherichia coli J5 mutant derived from E . coli O111:B4 was demonstrated in an experimental mouse model . Overwhelming bacterial inocula masked the effects of cross-reactive immunoprotection due to antiserum to strain J5 . Enhanced bacterial clearance was observed in mice receiving antiserum to strain J5 in sublethal infections but not from lethal doses . Incorporation of hemoglobin with the bacterial inocula decreased the 50% lethal dose of challenge organisms, allowing the demonstration of protective activity of antiserum to strain J5 in lethal infection . Pretreatment of mice with antiserum to strain J5 did not protect against lethal doses of endotoxin . The protective factor was demonstrated by exhaustive adsorption experiments to be an antibody specific for strain J5 lipopolysaccharide . The protective activity of antiserum to strain J5 was abolished only after adsorption with strain J5 lipopolysaccharide but not with Salmonella typhimurium mutants with or without enterobacterial common antigen.

J Antimicrob Chemother, 1985 Jun, 15 Suppl C, 99 - 109
In-vitro evaluation of Sch 34343: antimicrobial activity, beta-lactamase stability and inhibition; Jones RN et al.; Sch 34343 was compared with representative parenteral beta-lactams including monobactams (aztreonam), 1-oxa-beta-lactams (latamoxef), carbapenems (imipenem) and cephalosporins (cefamandole, cefoperazone, cefotaxime, cefsulodin and ceftazidime) . Sch 34343 was active against the Enterobacteriaceae (MIC50 range, 0.12-4.0 mg/l) and the facultative Gram-positive cocci (MIC50 range, 0.03-4.0 mg/l), and was comparable to the third-generation cephalosporins and imipenem . Pseudomonas aeruginosa and other Pseudomonas spp . were not susceptible to Sch 34343 . Haemophilus influenzae and Neisseria spp . were all susceptible to less than or equal to 2.0 mg/l of Sch 34343 . Methicillin-resistant staphylococci (MIC90, 32 mg/l) appear to be insusceptible to Sch 34343 . Sch 34343 inhibited the majority of cefotaxime- and gentamicin-resistant bacteria (MICs less than or equal to 8.0 mg/l) . The new penem was stable to hydrolysis by 11 beta-lactamase preparations (both plasmid- and chromosomally-mediated types) . Sch 34343 inhibited beta-lactamases as did other newer cephalosporins.

J Antimicrob Chemother, 1985 Jun, 15 Suppl C, 73 - 83
Sch 34343, in-vitro antibacterial activity and beta-lactamase stability; Stobberingh EE et al.; The in-vitro activity of Sch 34343, a derivative of Sch 29482, was assessed and compared with that of other beta-lactam antibiotics . Nearly all Enterobacteriaceae, including ampicillin-resistant strains (MIC greater than or equal to 256 mg/l) were inhibited at concentrations ranging from 0.125-8 mg/l . The geometric mean MIC values varied from 0.25 mg/l to 2.4 mg/l for Klebsiella and Serratia spp., respectively . Sch 34343 did not inhibit Pseudomonas aeruginosa . The antibacterial activity was minimally altered by changes of medium or inoculum size . The results suggest high stability against plasmid- and chromosomally-mediated beta-lactamases . However, crude extracts of four Pseudomonas strains did hydrolyse Sch 34343 . In addition to the high antibacterial activity and the beta-lactamase stability, Sch 34343 markedly inhibited most plasmid- and chromosomally-mediated beta-lactamases, with the exception of PSE-1 and PSE-4.

Chemioterapia, 1985 Jun, 4(3), 204 - 8
Ceftriaxone against gram-negative and gram-positive bacteria: bactericidal and post-antibiotic effect; Ravizzola G et al.; The effect of ceftriaxone against Gram-negative and Gram-positive strains of different clinical isolates has been compared to that of other cephalosporins such as cefuroxime, cefoxitin and cefotaxime . Cefotaxime and ceftriaxone have a notably higher activity against Enterobacteriaceae than cefuroxime and cefoxitin . If ceftriaxone activity is compared to cefotaxime activity, it may be seen that the former shows a stronger action against Pseudomonas, Proteus rettgeri, Enterobacter and Serratia . Against Staphylococcus aureus and enterococci the four antibiotics show a low level of activity . The effect of a microorganism's temporary contact with ceftriaxone was tested by a method whereby the antibiotic was removed with an ion-exchanging resin . Ceftriaxone shows rapid bactericidal activity against sensitive bacteria and if it is used at concentrations slightly higher than MIC, as in vivo against bacteria of average sensibility, we notice a 10-18 h bacteriostatic effect during which a prevalence of filamentous shapes of gram-negative bacteria is observed.

Proc Natl Acad Sci U S A, 1985 Jun, 82(12), 4172 - 6
Differences in mutagenic and recombinational DNA repair in enterobacteria; Sedgwick SG et al.; The incidence of recombinational DNA repair and inducible mutagenic DNA repair has been examined in Escherichia coli and 11 related species of enterobacteria . Recombinational repair was found to be a common feature of the DNA repair repertoire of at least 6 genera of enterobacteria . This conclusion is based on observations of (i) damage-induced synthesis of RecA-like proteins, (ii) nucleotide hybridization between E . coli recA sequences and some chromosomal DNAs, and (iii) recA-negative complementation by plasmids showing SOS-inducible expression of truncated E . coli recA genes . The mechanism of DNA damage-induced gene expression is therefore sufficiently conserved to allow non-E . coli regulatory elements to govern expression of these cloned truncated E . coli recA genes . In contrast, the process of mutagenic repair, which uses umuC+ umuD+ gene products in E . coli, appeared less widespread . Little ultraviolet light-induced mutagenesis to rifampicin resistance was detected outside the genus Escherichia, and even within the genus induced mutagenesis was detected in only 3 out of 6 species . Nucleotide hybridization showed that sequences like the E . coli umuCD+ gene are not found in these poorly mutable organisms . Evolutionary questions raised by the sporadic incidence of inducible mutagenic repair are discussed.

Infect Control, 1985 Jun, 6(6), 237 - 9
70% alcohol disinfection of transducer heads: experimental trials; Talbot GH et al.; We investigated the feasibility of transducer head disinfection with 70% alcohol wipes . In the initial trial, nine gas-sterilized transducers were inoculated with an estimated 5 X 10(6) organisms of a clinical isolate of Enterobacter cloacae, mimicking a contaminated fluid couple . A sterile disposable transducer dome was attached to each transducer . The units were allowed to sit for 24 hours at room temperature; the domes were then removed . Three transducer heads were cultured prior to disinfection to ensure that viable organisms remained . Each transducer head was wiped clean with a single alcohol wipe, allowed to dry, and then cultured . All nine cultures showed growth of E . cloacae . A second series of trials with 54 transducers employed an identical protocol, except that each transducer head received not one, but two, applications of alcohol . In addition to E . cloacae (26 runs), Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were employed in nine, nine and ten runs, respectively . Cultures of 53 of 54 transducer heads showed no growth; the single positive culture was attributed to an error in technique . These preliminary results suggest that the double-alcohol-wipe technique may be an easy, cost-effective, alternative or supplemental method of transducer head disinfection . However, we do not advocate routine implementation of this technique in patient care settings until clinical trials confirm its safety and efficacy.

Mol Gen Mikrobiol Virusol, 1985 Jun, (6), 24 - 8
{Comparative study of non-conjugative R-plasmids from enterobacteria and Pseudomonas aeruginosa}; Anisimova LA et al.; Nonconjugative R-plasmids pBS76 and pBS94 (Sm Su), pBS95 and pBS96 (Sm Su Ap) isolated from clinical strains of Pseudomonas aeruginosa and plasmids pKMR281-pKMN284 (Sm Su), pKMR285-pKMR286 (Sm Su Tc) isolated from clinical strains of enterobacteria have been studied . Restriction maps of these plasmids are presented in the paper with some of plasmid genes for antibiotic resistance localized on them . The resistance determinants of plasmids pBS95 and pBS96 are shown to be included in transposon Tn3612 analogous to Tn3 . Plasmids pBS76, pBS94-96 are of the wide host range and belong to incompatibility group P4 (IncQ) . Plasmids pKMR281-pKMR286 are mutually incompatible and share the conspicuous DNA homology . They are inherited only by enterobacteria and are compatible with IncQ plasmids but in contrast to them are mobilized by RP4 plasmid with lower frequency.

Antimicrob Agents Chemother, 1985 Jun, 27(6), 933 - 7
Plasmid-borne or chromosomally mediated resistance by Tn7 is the most common response to ubiquitous use of trimethoprim; Steen R et al.; The folic acid analog trimethoprim has been in clinical use for more than 10 years . The use of it in Sweden has doubled in the last 6 to 7 years, and from the distribution statistics it can be calculated that during 1 year 4 to 5% of the population in Sweden are given this drug . The bacterial resistance mechanisms to be found in response to such a selection pressure were investigated in a relatively isolated population in northern Sweden (the county of Jamtland), in which one centrally located bacteriological laboratory serves the area . Trimethoprim-resistant strains were collected during an 8-month period from consecutive specimens of bacteria from the urinary tracts of patients . Among the highly resistant strains of enteric bacteria, trimethoprim resistance mediated by transposon-borne dihydrofolate reductase of type I was found to dominate . The corresponding Tn7-like transposon was found to be localized both on the chromosome of isolated Escherichia coli strains and also on a 50-kilobase IncI transferable plasmid which was found in several different serotypes of E . coli . In two enterobacterial strains, resistance to more than 10(3) micrograms of trimethoprim per ml was furthermore found to be caused by a ca . 80-fold increase in the formation of chromosomal dihydrofolate reductase.

J Bacteriol, 1985 Jun, 162(3), 1317 - 9
Restriction endonuclease analysis of the ilvGEDA operon of members of the family Enterobacteriaceae; Driver RP et al.; Four of the genes required for the biosynthesis of isoleucine and valine form the ilvGEDA operon in Escherichia coli K-12 and Salmonella typhimurium . The structural relationship of these genes was examined in eight other members of the family Enterobacteriaceae by genomic Southern blot hybridization . These genes are contiguous in all the strains examined, and specific restriction sites appear to be highly conserved, indicating the possible functional importance of the DNA sequences of which they are part.

Int J Zoonoses, 1985 Jun, 12(2), 147 - 9
Secondary infections in dracunculiasis: bacteria and morbidity; Adeyeba OA; In the course of a study to determine the nature and type of secondary bacterial infection in dracunculiasis . The most common organisms cultured from lesions were Escherichia coli, Enterobacter and Staphylococcus aureus . E . coli and Enterobacter which were found to carry high morbidity were sensitive to Gentamycin, Claforan and Septrin.

J Hosp Infect, 1985 Jun, 6(2), 147 - 53
Evidence for the dispersion and evolution of R-plasmids from Serratia marcescens in a hospital; Mendoza MC et al.; Incompatibility tests were used to study the types, evolution and dispersion of R-plasmids from Serratia marcescens in a hospital over the period 1975-82 . R-plasmids belonged to incompatibility groups IncM, IncC, IncP or were unclassified, or compatible with all the plasmids tested . In 1982, IncM plasmids, including varieties codifying different resistance patterns, predominated . The oldest members of the IncM group codified fewer R determinants and were of smaller size than the more recent ones . Plasmids of IncM and IncC are dispersed among other genera of Enterobacteriaceae.

Biochem J, 1985 May 15, 228(1), 241 - 8
The beta-lactamase of Enterobacter cloacae P99 . Chemical properties, N-terminal sequence and interaction with 6 beta-halogenopenicillanates; Joris B et al.; The beta-lactamase of Enterobacter cloacae P99 consists of one polypeptide chain of Mr 39000 devoid of disulphide bridges and free thiol groups . It contains an unusually high proportion of tyrosine and tryptophan . The N-terminal sequence exhibits overlaps with the tryptic peptide obtained after labelling the active site with 6 beta-iodopenicillanate . The active-site serine residue is at position 64 . The homology with the chromosomal beta-lactamase of Escherichia coli K 12 (ampC gene) is lower within the 25 residues of the N-terminal portion than around the active-site serine residue . The P99 beta-lactamase is inactivated by 6 beta-bromo- and 6 beta-iodo-penicillanate, with a second-order rate constant of 110-140M-1 X s-1 at 30 degrees C and pH 7.0, a value that is much lower than that observed with class-A beta-lactamases.

Toxicol Appl Pharmacol, 1985 May, 78(3), 377 - 85
Influence of dietary carrageenans on microbial biotransformation activities in the cecum of rodents and on gastrointestinal immune status in the rat; Mallett AK et al.; Rats, mice, and hamsters were fed iota-carrageenan incorporated in a fiber-free, purified diet for 30 days, and the activities of a number of cecal microbial enzymes were determined in vitro . Carrageenan treatment produced cecal enlargement in all species, yet significantly decreased the concentration of bacteria per gram of cecal content . Azoreductase, beta-glucosidase, beta-glucuronidase, nitrate reductase, and nitroreductase activities per gram of cecal content were significantly decreased in the rat, although less consistent effects were found in these enzymes in the mouse and hamster . beta-Glucuronidase and nitrate reductase functions were increased per gram of cecal contents in the hamster . The total activity per cecum of certain of these enzymes was modified by the concomitant cecal enlargement, yet total nitroreductase activity was significantly decreased in all three rodent species . iota-Carrageenan significantly decreased the concentration of enterobacteria, staphylococci, streptococci, lactobacilli, facultative anaerobes, and the total microscopic count in the rat cecum, but did not exert any effect on bacterial viability in vitro . Although having no effect on biliary IgA antibody concentration, iota- and kappa- carrageenan when present at 50 g/kg diet increased the agglutination response of the IgA specific for the hindgut microflora.

Diabetes Care, 1985 May-Jun, 8(3), 244 - 9
Bacteremia in diabetic patients: comparison of incidence and mortality with nondiabetic patients; Bryan CS et al.; We determined the incidence of bacteremia and associated mortality in diabetic and nondiabetic patients in the four major hospitals of one metropolitan area over the 5-yr period 1977-1981 . Mortality rates, based on episodes of bacteremia, were similar in diabetic and nondiabetic patients in most instances . Diabetic patients experienced lower mortality rates from Enterobacteriaceae bacteremia compared with nondiabetic patients; this finding was explained by a greater tendency for diabetic patients to have Escherichia coli bacteremia due to community-acquired urinary tract infection . However, the incidence of bacteremia due to all microorganisms was increased twofold in diabetic patients and the incidence of Enterobacteriaceae bacteremia was increased threefold . Because of their increased incidence of bacteremia, diabetic patients in this population were nearly twice as likely to die as a result of bacteremia compared with nondiabetic patients . Thus, the frequent occurrence of bacteremia among patients with diabetes mellitus represents a significant problem.

J Clin Microbiol, 1985 May, 21(5), 815 - 8
Clinical comparison of an agar slide blood culture bottle with tryptic soy broth and a conventional blood culture bottle with supplemented peptone broth; Weinstein MP et al.; The Roche Septi-Chek biphasic blood culture system with tryptic soy broth was compared with a conventional blood culture bottle with supplemented peptone broth in 6,956 paired blood cultures from adult patients . Both systems were inoculated with equal volumes of blood (5 ml) and incubated aerobically (vented) for 2 weeks . More clinically important bacteria and fungi, including Staphylococcus aureus, S . epidermidis, Escherichia coli and other Enterobacteriaceae, Pseudomonas aeruginosa, and Candida albicans and C . tropicalis were recovered from the biphasic system (P less than 0.001) . In contrast, more clinically important anaerobic bacteria (P less than 0.001) and Gardnerella vaginalis (P less than 0.05) were recovered in conventional supplemented peptone broth . Staphylococci (P less than 0.01), Enterobacteriaceae other than E . coli (P less than 0.05), and fungi (P less than 0.001) were detected 1 or more days earlier in the biphasic system, whereas streptococci (P less than 0.001) were detected earlier in the conventional bottle . The overall superiority of the agar slide blood culture system compared with conventional blood culture bottles was confirmed by this evaluation . For optimal detection of anaerobic bacteremia, however, the agar slide bottle should be paired with an anaerobic bottle.

Am J Clin Pathol, 1985 May, 83(5), 655 - 7
Isolation of Klebsiella ozaenae from a corneal abscess; Janda WM et al.; In this report, a case of bacterial keratitis caused by Klebsiella ozaenae is presented . The patient was an otherwise healthy 65-year-old woman with a history of chronic ocular inflammation and a corneal transplant two years prior to the appearance of the corneal ulcer . K . ozaenae is uncommon as a cause of keratitis and is recognized as a cause of atrophic rhinitis and as an opportunistic pathogen in patients with various underlying diseases . The organism was not identified with the computer-assisted API 20E for identification of the Enterobacteriaceae, and conventional methods were required to demonstrate its unique properties . The clinical spectrum of disease, the characteristics of the organism, and its susceptibility to antimicrobial agents are discussed.

J Bacteriol, 1985 May, 162(2), 504 - 9
Comparative studies of lipopolysaccharide and exopolysaccharide from a virulent strain of Pseudomonas solanacearum and from three avirulent mutants; Drigues P et al.; The composition of the Pseudomonas solanacearum lipolysaccharide (LPS) was found to be similar to that described for the LPS of enterobacteria . The lipid A contained fatty acids and glucosamine in a molar ratio of 5:2 . The LPS fraction contained 2-keto-3-deoxyoctulosonic acid, L-glycero-D-mannoheptose, hexoses (glucose, rhamnose, and glucosamine), and a pentose (xylose) . The LPSs from the wild-type strain (GMI1000), from the spontaneous rough mutant (GMI2000), and from their respective acridine orange-resistant (Acrr) mutants (GMI1178 and GMI2179) contained the same component sugars in their polysaccharide moieties, but the relative amounts of each sugar varied greatly . Spontaneous mutation to the rough type was characterized by a decrease in the ratio of rhamnose to glucose, whereas a reverse effect was seen for the acridine orange resistance mutation from the parent strains (GMI1000 and GMI2000) to the respective mutant strains (GMI1178 and GMI2179) . The exopolysaccharide (EPS) from GMI1000 was found to be composed of two fractions: a heteropolysaccharide (galactosamine, glucose, and rhamnose) excluded from Sephadex G-50 and an additional glucan with a lower molecular weight . Strains GMI1000 and GMI1178 produced comparable amounts of EPS, GMI2179 synthesized less EPS, and GMI2000 produced no detectable EPS . High-pressure liquid chromatography and 13C nuclear magnetic resonance analyses revealed some differences between these EPSs . The glucan fraction seemed to be the major component of the EPS from GMI2179, whereas GMI1000 and GMI1178 EPSs contained both fractions and appeared to differ in the structures of their heteropolysaccharide fractions . Viscosity measurements confirmed differences between whole EPSs produced by the three strains.

Infect Immun, 1985 May, 48(2), 573 - 5
Chemical characterization of Chlamydia trachomatis lipopolysaccharide; Nurminen M et al.; The group-specific antigen of Chlamydia trachomatis serotype L2 was chemically analyzed . It is composed of typical lipopolysaccharide (LPS) components, i.e., D-glucosamine, long-chain 3-hydroxy fatty acids, 2-keto-3-deoxyoctonic acid, and phosphate in a molar ratio of approximately 2:5:3:2.6, respectively, resembling enterobacterial LPS of the Re chemotype . For the first time, 3-hydroxydocosanoic acid (3-OH C22:0) was found as an LPS constituent.

Pathol Biol (Paris), 1985 May, 33(5), 404 - 7
{Comparative in vitro activity of 2 monobactams (RO 172301 (AMA 1080)and aztreonam), ceftazidime and cefotaxime on Gram-negative bacilli}; Thabaut A et al.; In vitro activities of two monobactams (RO 172301 and aztreonam), ceftazidime and cefotaxime against 739 bacterial strains belonging to different species of Gram negative aero-anaerobic bacilli were studied comparatively . Strains were studied according to their resistance phenotype to beta-lactams . Minimal inhibitory concentrations (MIC) of the four antibiotics were determined using the agar dilution method . RO 172301 and aztreonam exhibited a similar activity against P . aeruginosa with a MIC around 2 mg/l for 50% of strains and around 4 mg/l for 90% of strains . As compared to the two monobactams, ceftazidime was more active and cefotaxime less active (one halving dilution either way) . Activity of antibiotics was not dependent upon the mechanism of resistance to beta-lactams, except for strains producing a constitutive cephalosporinase . Against Enterobacteriaceae, RO 172301 proved slightly more active than aztreonam and cefotaxime; ceftazidime was the least active drug . Only 12 of the 739 strains tested (1.6%) had a MIC for RO 172301 above 32 mg/l . The percentage of resistant strains was 2.4% for aztreonam and ceftazidime and 8.8% for cefotaxime.

Ann Inst Pasteur Microbiol, 1985 May-Jun, 136A(3), 281 - 8
{Homologies between integral proteins of the inner membrane of binding protein transport systems in enterobacteria}; Dassa E et al.; Binding protein-dependent transport systems from Enterobacteriaceae comprise a periplasmic binding protein and three proteins associated with the inner membrane . Of these, two appear to be integral membrane proteins . We describe here a sequence which is highly conserved between these two proteins in the case of the system for maltose transport in Escherichia coli . This sequence is also present in all of the known integral membrane proteins from binding protein-dependent transport systems . It is remarkable that this sequence is located at a constant distance of approximatively 90 residues from the COOH-terminal ends of these proteins . Some implications of these observations are discussed.

Pathol Biol (Paris), 1985 May, 33(5), 399 - 403
{In vitro antibacterial activity of cefodizime (HR 221) on 323 hospital strains of Gram negative bacilli . Comparison with cefotiam, cefoperazone, cefotetan and cefotaxime}; Le Noc P et al.; In vitro activity of a new cephalosporin, cefodizime, was investigated by comparison with cefotiam, cefoperazone, cefotetan and cefotaxime . 291 Enterobacteriaceae strains belonging to 6 cephalosporin-resistance phenotypes and 32 strains of oxidative Gram negative bacilli were tested . With modal MICs of 0.25 to 4 mg/l, cefodizime is active on most phenotypes of resistance to first or second generation cephalosporins demonstrated in vitro in Enterobacteriaceae, including strains resistant to cefamandole and intermediate to cefoxitin . Cefodizime fails to inhibit strains resistant to third generation cephalosporins (E . cloacae, C . freundii, P . stuartii), except for those strains of S . marcescens belonging to this phenotype whose modal MIC is 4 mg/l . 85% of all tested Enterobacteriaceae are inhibited by 4 mg/l and 91% by 8 mg/l . Cefodizime exhibits little activity against A . calcoaceticus and P . aeruginosa . Comparison of activities of the five cephalosporins against Enterobacteriaceae shows that cefodizime out-strips cefotiam, cefoperazone and cefotetan as a result of its broader spectrum of activity against tested species . Cefotaxime, on the contrary, proves superior to cefodizime and is still the most potent drug against . A . calcoaceticus whereas cefoperazone has the greatest effectiveness against P . aeruginosa.

Pathol Biol (Paris), 1985 May, 33(5), 350 - 3
{Rapid ATB . A new system of antibiotic testing in 4 hours . Description and parameters of variation}; Gayral JP et al.; Rapid ATB is a new automated system which performs antibiotic sensitivity testing of Enterobacteriaceae in four hours . It is composed of strips containing dehydrated antibiotics and a medium which ensures rapid bacterial growth, and of the equipment required for standardization of the inoculum, reading of results and interpretation . Strains are classified as susceptible or resistant according to the value of the growth index (IC) which is the ratio of growth in the presence of the antibiotic to growth of a control inoculum . Use of this system requires standardization . The main factors to control are state of the culture used to prepare the inoculum, standardization of the inoculum, incubation temperature (35 to 37 degrees C), and duration of incubation (4 to 5 hours) . Variations of these factors usually induce significantly delayed growth . Under well standardized conditions, results are highly reproducible, as proved by testing ten strains ten times each by three investigators.

J Bacteriol, 1985 May, 162(2), 494 - 503
Biosynthesis of enterobacterial common antigen; Rick PD et al.; Cultures of Salmonella typhimurium pulse-labeled with N-acetyl-D-{3H}glucosamine ({3H}GlcNAc) incorporated isotope into a GlcNAc-linked lipid that was tentatively identified as GlcNAc-pyrophosphorylundecaprenol . The incorporation of {3H}GlcNAc into this compound was abolished when cells were pulse-labeled in the presence of the antibiotic tunicamycin . Tunicamycin also abolished the in vivo synthesis of the haptenic form of enterobacterial common antigen (ECA) in S . typhimurium as determined by the passive hemagglutination test . These data indicated that the synthesis of the GlcNAc-linked lipid is related to ECA synthesis . Support for this conclusion was provided by the following observations . Cultures of Escherichia coli and S . typhimurium incorporated {3H}GlcNAc into cell envelope components that migrated as a homologous series of polymers when analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . The {3H}GlcNAc-labeled polymers were not detected in mutants of E . coli and S . typhimurium defective in ECA synthesis due to lesions in either the rfe or rff gene clusters . These polymers were identified as ECA based on Western blot analyses employing anti-ECA monoclonal antibody . The incorporation of {3H}GlcNAc into ECA polymers was abolished by tunicamycin when the drug was added to cultures to give a minimum concentration of 3 micrograms/ml . In addition, pulse-chase experiments provided evidence for a precursor-product relationship between the GlcNAc-linked lipid and ECA . These results strongly suggest that the GlcNAc-linked lipid is involved in the biosynthesis of ECA in a manner analogous to the role of carrier lipid in the biosynthesis of O-antigen and peptidoglycan.

Mutat Res, 1985 May, 145(3), 103 - 6
Interspecies regulation of the SOS response by the E . coli lexA+ gene; Sedgwick SG et al.; A plasmid-encoded E . coli lexA+ gene was introduced into 6 species of Enterobacteria . Ultraviolet light-sensitization occurred in all species except P . rettgeri, and 4 organisms showed reduced inducibility of RecA-like proteins . The mechanism of lexA+ control of the SOS response therefore appears common to several species.

Antimicrob Agents Chemother, 1985 May, 27(5), 821 - 7
In vitro and in vivo antibacterial activities of carumonam (AMA-1080), a new N-sulfonated monocyclic beta-lactam antibiotic; Imada A et al.; The in vitro and in vivo antibacterial activities of carumonam (AMA-1080), a synthetic sulfazecin derivative, were compared with those of aztreonam, cefoperazone, ceftazidime, and cefsulodin . Carumonam was highly active in vitro against members of the family Enterobacteriaceae, Pseudomonas aeruginosa, and Haemophilus influenzae and weakly active against Streptococcus pneumoniae, but it was not active against Staphylococcus aureus . The MICs of carumonam for 90% of 1,156 clinical Enterobacteriaceae isolates were between 0.013 and 25 micrograms/ml, which were the lowest MICs of the antibiotics tested . The MIC of carumonam for 90% of Klebsiella oxytoca was 0.2 micrograms/ml, whereas that of aztreonam was 50 micrograms/ml . The superiority of carumonam to aztreonam and the reference cephalosporins was also demonstrated by their activities against Klebsiella pneumoniae and Enterobacter cloacae . The MIC of carumonam for 90% of P . aeruginosa was 12.5 micrograms/ml, which was comparable to the MICs of aztreonam and ceftazidime . Carumonam showed a high affinity for the penicillin-binding protein 3 of gram-negative bacteria, but not for the penicillin-binding proteins of S . aureus and Bacteroides fragilis . Carumonam was resistant to hydrolysis by 12 plasmid-mediated beta-lactamases and 7 chromosomal beta-lactamases . It was more stable than aztreonam to hydrolysis by the beta-lactamase of K . oxytoca; this stability is related to the superiority of the in vitro and in vivo activities of carumonam to those of aztreonam against this species . In general, the protective activities (50% effective dose) of carumonam and reference antibiotics in mice with experimental intraperitoneal infections correlated with the in vitro activities (MIC); carumonam showed excellent protective activity against most aerobic gram-negative bacteria.

Antimicrob Agents Chemother, 1985 May, 27(5), 708 - 11
Enoxacin compared with cefoperazone for the treatment of experimental Enterobacter aerogenes endocarditis; Boscia JA et al.; This study compared enoxacin administered orally with cefoperazone administered intramuscularly for the treatment of Enterobacter aerogenes endocarditis in rabbits . The MICs and MBCs of both enoxacin and cefoperazone for an inoculum of 10(5) CFU/ml of the E . aerogenes strain used were 0.8 micrograms/ml, respectively . With an inoculum of 10(8) organisms per ml, enoxacin at 2 and 5 micrograms/ml and cefoperazone at 60 and 155 micrograms/ml were effective in reducing titers of E . aerogenes in broth . E . aerogenes endocarditis in rabbits was treated with enoxacin (100 or 25 mg/kg orally every 6 h) or cefoperazone (60 mg/kg intramuscularly every 6 h) for 5 or 10 days . Enoxacin at 100 and 25 mg/kg significantly reduced bacterial titers of vegetations compared with those of untreated controls . Enoxacin at 100 mg/kg was significantly more effective than enoxacin at 25 mg/kg and cefoperazone . Enoxacin at 25 mg/kg and cefoperazone did not differ significantly . Cefoperazone and controls did not differ significantly . In uninfected rabbits single doses of cefoperazone achieved much higher concentrations in serum than single doses of enoxacin (25 and 100 mg/kg) . The half-lives of enoxacin at 25 and 100 mg/kg were approximately three times longer than that of cefoperazone.

Diagn Microbiol Infect Dis, 1985 May, 3(3), 213 - 21
Evaluation of in vitro antibacterial activity of enoxacin: comparison with other orally absorbed antimicrobial agents, proposed disk diffusion test interpretive criteria, and quality control limits; Fuchs PC et al.; The antibacterial activity of enoxacin was assessed by a standard microdilution susceptibility test method against 6,096 consecutive clinical isolates at four clinical laboratories and compared with that of norfloxacin and cefaclor . Its activity was comparable to that of norfloxacin; both inhibited over 90% of Enterobacteriaceae at 0.5 micrograms/ml . Resistance to enoxacin {minimum inhibitory concentration (MIC) greater than 4 micrograms/ml} was observed in only 18 of 4,076 Enterobacteriaceae (0.5%, 36 of 650 nonfermentative gram-negative bacilli (5.5%), and 6 of 836 staphylococci (0.7%) . Relatively poor activity was observed against streptococci . An additional 618 selected clinical isolates were tested with enoxacin and were compared with nine other orally absorbed antimicrobial agents . The greatest activity was observed with enoxacin, norfloxacin, and cotrimoxazole, but some difference were noted with individual species . Results of enoxacin disk diffusion susceptibility testing of 487 isolates were correlated with the MICs, analyzed, and interpretive criteria were determined . With MIC breakpoints of: susceptible = less than or equal to 2.0 micrograms/ml, intermediate = 4.0 micrograms/ml, and resistant = greater than 4.0 micrograms/ml, the corresponding preliminary disk diffusion zone diameter breakpoints for the 10-micrograms enoxacin disk are: susceptible greater than or equal to 18 mm, intermediate 15-17 mm, and resistant less than or equal to 14 mm . Quality control zone diameter limits were determined for three standard QC organisms.

Pathol Biol (Paris), 1985 May, 33(5), 341 - 9
{Influence of technical factors in the determination of minimal inhibitory concentration by microdilution}; Forey F et al.; Minimal inhibitory concentrations (MICs) of a new quinolone, norfloxacin, as determined by agar dilution are greater than those found using a liquid dilution micromethod . We report herein an analysis of the various parameters possibly involved in this discrepancy: Mueller-Hinton and BioMerieux, glass or plastic, small or large inoculum, and comparative volumes in which the inoculum (IN) and antibiotic (AB) are presented (1 ml IN + 1 ml AB or 1.5 microliter IN + 50 microliter AB or 50 microliter IN + 50 microliter AB) . Volume of the inoculum suspension had a bearing on the results obtained with all three reference strains tested . Norfloxacin MICs for S . aureus 7625 and P . aeruginosa 76110 increased commensurately with the ratio of inoculum volume to antibiotic volume, and vice versa . In contrast, no significant variation was found for E . coli 7624 . To evaluate the frequency of this effect, we tested 40 antibiotics on the reference strains, and several antibiotics on savage strains (16 Enterobacteriaceae, 40 Staphylococcus, 12 Pseudomonas and 17 P . aeruginosa) . The significance of inoculum and antibiotic volumes was corroborated for some antibiotics . Results most consistent with the reference method were obtained with 50 microliter inoculum and 50 microliter antibiotic solution.

Antibiot Med Biotekhnol, 1985 May, 30(5), 348 - 51
{Characteristics of R plasmids expressed by dysenteric bacteria}; Shishkina ZV et al.; One hundred and eighty-six clinical strains of Enterobacteriaceae isolated in the Krasnodar region and Krasnodar in 1982 from patients with acute intestinal diseases were studied . 137 strains of Shigella were investigated in detail . It was shown that S . flexneri, S . sonnei, S . boydii and S . dysenteriae accounted for 77, 15, 5 and 2 per cent, respectively . 78.1 per cent of the wild Shigella strains were resistant to antibiotics and in 43.9 per cent of the strains this property was controlled by conjugative R plasmids . 11 variants of the antibiotic resistance spectra were revealed . However, strains of SmTcApCm, SmTc and SmTcAp phenotypes were the most frequent . Among the resistant strains 80.3 per cent were resistant to tetracycline, 75.7 per cent to streptomycin, 50.4 per cent to ampicillin, 31.7 per cent to chloramphenicol, 1.8 per cent to trimethoprim, and 0.9 per cent to kanamycin . The investigation showed that the strains isolated in one region usually had similar phenotypes of antibiotic resistance . The frequency of the plasmid transfer varied from 10(-1) to 10(-7) . However, the majority of the plasmids were transferred at a frequency of 10(-4)-10(-5) . Only one of the investigated plasmids had a capacity for transmitting fd phage sensitivity to the host cells . 33 plasmids belong to the fi+ type and the others belong to the fi- type . The majority of the plasmids have molecular weights of 46 to 50 mD.

J Infect Dis, 1985 May, 151(5), 783 - 9
Trimethoprim resistance in multiple genera of Enterobacteriaceae at a U.S . hospital: spread of the type II dihydrofolate reductase gene by a single plasmid; Mayer KH et al.; The percentage of clinical isolates of several species of Enterobacteriaceae, particularly Escherichia coli and Klebsiella pneumoniae, resistant to trimethoprim (TMPR) has increased gradually at the Brigham and Women's Hospital (Boston) in recent years . Thirty-seven of 42 TMPR isolates from six species of gram-negative bacilli conjugally transferred TMP resistance to K12 E . coli . beta-Lactam resistance cotransferred from 21 of the 37 donors, and sulfamethoxazole (SMZ) resistance cotransferred from five of the 37 donors . Plasmids that encoded TMP resistance either alone or with SMZ resistance had a molecular size of approximately 52.5 kilobases, with identical restriction endonuclease-generated "fingerprints." Plasmids encoding beta-lactam-mediated resistance (beta R) were approximately four kilobases larger and had fragment patterns that were identical for all of the TMPR/beta R plasmids tested and had many restriction endonuclease-generated bands in common with TMPR plasmids . Radiolabeled dihydrofolate reductase (DHFR) probes identified the type II DHFR as the determinant of TMP resistance . In contrast with reports from Europe, TMP resistance in multiple species of Enterobacteriaceae was found to be spread in one hospital by a single, stable conjugative plasmid that has a wide host range and encodes the type II DHFR gene.

Antimicrob Agents Chemother, 1985 May, 27(5), 791 - 7
Structure and mode of action of microcin 7, an antibacterial peptide produced by Escherichia coli; Garcia-Bustos JF et al.; Microcin 7 is a small peptide produced and excreted to the culture medium by stationary-phase Escherichia coli cells harboring the pMccC7 plasmid (formerly named pRYC7) . This peptide inhibited the growth of the enterobacteria phylogenetically closer to E . coli, apparently by blocking protein biosynthesis . The molecule was degraded with trypsin, and the resulting fragments were purified and sequenced . The results show that microcin 7 is a linear heptapeptide blocked at both ends.

J Bacteriol, 1985 May, 162(2), 799 - 803
Frequency among Enterobacteriaceae of the DNA sequences encoding type 1 pili; Buchanan K et al.; Type 1 pili, characterized by mannose-inhibitable agglutination of fowl or guinea pig erythrocytes, have been found throughout the family Enterobacteriaceae . A radiolabeled probe was prepared from a restriction endonuclease-digested fragment of the Escherichia coli pil operon and used to detect homologous DNA sequences in 236 bacteria representing 11 genera of Enterobacteriaceae . Only isolates identified as E . coli or Shigella spp . exhibited homology . In contrast, mannose-sensitive hemagglutination was observed in nine genera . Probe DNA did not hybridize to plasmid DNA, indicating a chromosomal location for the pil operon . Analysis of restriction nuclease-digested whole-cell DNA from 60 E . coli and two Shigella sp . isolates indicated that internal sequences were conserved in most strains, but that changes in flanking sequences in the chromosome were common.

Infect Immun, 1985 May, 48(2), 569 - 72
Antigenic properties of Chlamydia trachomatis lipopolysaccharide; Brade L et al.; The antigenic properties of the lipopolysaccharide (LPS) of Chlamydia trachomatis L2 were investigated . By means of passive hemolysis, passive hemolysis inhibition, and absorption experiments, it was shown that antiserum raised against chlamydial elementary bodies contained at least two different antibody specificities which reacted with different antigenic determinants of chlamydial LPS . One of these antibodies cross-reacted with enterobacterial Re LPS, recognizing a structure which is shared by both LPSs, whereas the reactivity of the second antibody was restricted to chlamydial LPS . The former antibody could be absorbed with Salmonella minnesota Re LPS, whereas the latter was not affected by this absorption . Therefore, chlamydial LPS possesses two distinct antigenic determinants, one of which is C . trachomatis specific, the other of which is responsible for the cross-reactivity with enterobacterial Re-type LPS . Both antigenic determinants were destroyed during mild acid-catalyzed hydrolysis . It was further shown that free chlamydial lipid A exhibits antigenicity that cross-reacts with free enterobacterial lipid A . This antigenicity, however, as in enterobacterial LPS, is present in a cryptic form, i.e., it is unmasked only after acid hydrolysis of LPS.

Infect Immun, 1985 May, 48(2), 275 - 9
Construction and comparison of recombinant plasmids encoding type 1 fimbriae of members of the family Enterobacteriaceae; Clegg S et al.; The genes encoding type 1 fimbriae of Salmonella typhimurium, Enterobacter cloacae, and Serratia marcescens were cloned in Escherichia coli . All transformants possessing recombinant plasmids were shown to be fimbriate and demonstrated mannose-sensitive hemagglutinating activity . A comparison of the physical maps of these plasmids revealed little similarity among them, although plasmids encoding type 1 fimbriae of Escherichia coli and Klebsiella pneumoniae appeared similar with respect to restriction enzyme sites . The fimbrial gene cluster ranged in size from 5.5 to 9.0 kilobase pairs as determined by transposon mutagenesis . Plasmid-containing E . coli strains were shown to produce species-specific fimbrial antigens with little or no cross-reactivity between genera . Therefore, it was presumed that each plasmid contained the gene encoding the fimbrial subunit . Complementation was not detected between nonfimbriate insertion mutants of different species but was seen with mutants of the same species.

Immunobiology, 1985 May, 169(4), 372 - 88
Antigenic and immunogenic characteristics of subcellular fractions and whole cells of a rough E . coli 0111 (J5) mutant; Sakulramrung R et al.; Little information is available on the antigenic and immunogenic properties of an E . coli rough mutant: J5 derived from E . coli 0111:B4, and the relationship of J5 to other cross-reacting antigens of Enterobacteriaceae . Subcellular fractions of J5 and various antigen preparations were tested against antisera to Enterobacterial Common Antigen (ECA-Kunin) and to the Re mutant of S . minnesota (R595) . ECA-Kunin was demonstrated in all subcellular fractions of the J5 mutant by means of indirect hemagglutination and by hemagglutination inhibition tests . This common antigen was separable from J5 LPS by ethanol fractionation and by phenol-chloroform-petroleum ether extraction . Treatment with alkali destroyed the hemagglutinating reactivity of ECA-Kunin and revealed the complex nature of J5 surface antigens; an alkalinized 20p30 fraction (containing cell wall components) contained both specific J5 antigen and an antigen which cross-reacted with S . minnesota and S . typhimurium . This antigen was shown by absorption studies to be a new common antigen other than Re LPS or ECA-Kunin . Studies of J5 LPS by ELISA demonstrated that there was a shared cross-reactive immunodeterminant between the glycolipids of J5 and Re . Accordingly, heat-killed J5 preparations were complex vaccines which were able to elicit an antibody response with at least two specificities: ECA-Kunin and the specific J5 antigen.

Presse Med, 1985 Apr 6, 14(14), 777 - 80
{Gram-negative bacteria in a medical resuscitation unit . Distribution of species and antibiotic sensitivity}; Riou B et al.; The distribution of Gram-negative bacilli species and their susceptibility to various antibiotics were surveyed over a 18-month period in an intensive care unit . Gram-negative bacilli were isolated from blood cultures (65), urine cultures (191), respiratory tract samples (176) or miscellaneous samples (69) . The bacilli most frequently isolated from blood cultures were enterobacteriaceae (95%), including Escherichia coli (46%), Proteus (22%) and Klebsiella pneumoniae (12%) . Pseudomonas aeruginosa was predominant in respiratory tract samples, and Serratia marcescens was more frequently isolated from urine cultures than from other samples . Antibiotic susceptibility testing was performed using a standard disc diffusion method . In view of the susceptibility of blood isolates to the second-generation cephalosporins we consider that these are preferable to third-generation cephalosporins for first-line antibiotic therapy of septicaemia due to Gram-negative bacilli, except for hospital-acquired infections . More than 50% of the bacilli were resistant to ampicillin; ticarcillin and mezlocillin were not very active against Klebsiella . Nalidixic acid was very active on urine isolates and therefore seems to be a good first-line antibacterial for lower urinary tract infections.

Eur J Clin Microbiol, 1985 Apr, 4(2), 119 - 22
Evaluation of the Cobasbact automated antimicrobial susceptibility testing system; Dupuis G; The Cobasbact is an automated system for use in the microbiological laboratory which is capable of performing antimicrobial susceptibility tests within five hours . The performance of the Cobasbact system was evaluated using 2000 non-fastidious, facultative and aerobic clinical bacterial isolates . The standard Kirby-Bauer disk diffusion test served as reference method . For gram-positive isolates, the rate of overall full and essential agreement between Cobasbact and reference antibiograms was 90% and 95.5% respectively, for Enterobacteriaceae 91% and 95.5% and for Pseudomonas spp . 90% and 96% . Reproducibility studies yielded an essential agreement rate of 98% . On the basis of this preliminary evaluation it would seem that the Cobasbact system can rapidly produce reasonably accurate and reproducible results of antimicrobial susceptibility tests for gram-positive cocci, Enterobacteriaceae and Pseudomonas spp.

J Appl Bacteriol, 1985 Apr, 58(4), 391 - 400
The cytotoxic and photodynamic inactivation of micro-organisms by Rose Bengal; Banks JG et al.; Rose Bengal was cytotoxic to the following bacteria at the concentrations given in parentheses (highest concentrations of dye in mol/l at which growth occurred on nutrient medium): Brochothrix thermosphacta and Deinococcus radiodurans (1 X 10(-6) or less); Streptococcus, Micrococcus, Staphylococcus, Bacillus, Arthrobacter and Kurthia spp . (1 X 10(-5)-1 X 10(-4}, and Pseudomonas spp . and Enterobacteriaceae (5 X 10(-3)-1 X 10(-2) or greater) . These organisms were killed rapidly when suspended in illuminated (170 microE/m2/s) solutions of Rose Bengal (1 X 10(-4) mol/l) providing oxygen was present . Singlet oxygen was identified as the lethal agent, because the rate of killing was increased by dissolving the dye in deuterium oxide while the organism were protected against photoinactivation by L-histidine or crocetin . Yeasts from chilled foods were killed in illuminated solutions of Rose Bengal but a light intensity of 315 microE/m2/s was needed for a death rate comparable with that of bacteria . The yeasts present in a range of chilled meat and dairy products failed to form colonies on Rose Bengal (5 X 10(-5) mol/l) media exposed continuously to modest illumination (55-80 microE/m2/s).

J Med Microbiol, 1985 Apr, 19(2), 269 - 72
Effect of microwave energy on the metabolism of Enterobacteriaceae; Spencer RC et al.; The effect of microwave irradiation on the metabolism of 94 strains of Enterobacteriaceae was studied . Sixteen substrates were used and the results obtained with microwave irradiation were compared with those given by conventional biochemical tests . There was good correlation between the methods but not sufficient to enable accurate identification of unknown species . However, microwave irradiation considerably increased the enzymatic activity of bacterial suspensions and the results obtained could form the basis for a rapid method of microbial identification.

J Bacteriol, 1985 Apr, 162(1), 248 - 55
Lactose metabolism in Erwinia chrysanthemi; Hugouvieux-Cotte-Pattat N et al.; Wild-type strains of the phytopathogenic enterobacterium Erwinia chrysanthemi are unable to use lactose as a carbon source for growth although they possess a beta-galactosidase activity . Lactose-fermenting derivatives from some wild types, however, can be obtained spontaneously at a frequency of about 5 X 10(-7) . All Lac+ derivatives isolated had acquired a constitutive lactose transport system and most contained an inducible beta-galactosidase . The transport system, product of the lmrT gene, mediates uptake of lactose in the Lac+ derivatives and also appears to be able to mediate uptake of melibiose, raffinose, and galactose . Two genes encoding beta-galactosidase enzymes were detected in E . chrysanthemi strains . That mainly expressed in the wild-type strains was the lacZ product . The other, the lacB product, is very weakly expressed in these strains . These enzymes showed different affinities for the substrates o-nitrophenyl-beta-D-galactopyranoside and lactose and for the inhibitors isopropyl-beta-D-thiogalactopyranoside and galactose . The lmrT and lacZ genes of E . chrysanthemi, together with the lacI gene coding for the regulatory protein controlling lacZ expression, were cloned by using an RP4::miniMu vector . When these plasmids were transferred into Lac- Escherichia coli strains, their expression was similar to that in E . chrysanthemi . The cloning of the lmrT gene alone suggested that the lacZ or lacB gene is not linked to the lmrT gene on the E . chrysanthemi chromosome . One Lac+ E . chrysanthemi derivative showed a constitutive synthesis of the beta-galactosidase encoded by the lacB gene . This mutation was dominant toward the lacI lacZ cloned genes . Besides these mutations affecting the regulation of the lmrT or lacB gene, the isolation of structural mutants unable to grow on lactose was achieved by mutagenic treatment . These mutants showed no expression of the lactose transport system, the lmrT mutants, or the mainly expressed beta-galactosidase, lacZ mutants . The lacZ mutants retained a very low beta-galactosidase level, due to the lacB product, but this level was low enough to permit use of the lacZ mutants for the construction of gene fusions with the Escherichia coli lac genes.

Chemioterapia, 1985 Apr, 4(2), 166 - 9
In vitro antibacterial activity of ceftizoxime against gram-negative strains; Debbia E et al.; The in vitro activity of ceftizoxime against 200 clinical isolates of Enterobacteria and Pseudomonas, was compared with those of other beta-lactam antibiotics such as: cefotaxime, cefoperazone, cefuroxime, and the aminoglycosides gentamicin and amikacin . Ceftizoxime inhibited Escherichia coli and Klebsiella pneumoniae with doses from two to four fold lower than cefotaxime . Ceftizoxime and cefotaxime were more active than cefuroxime and cefoperazone against Enterobacter spp., and Proteus morganii . Ninety percent of the Serratia spp . were inhibited at 0.2 microgram/ml of ceftizoxime whereas the other cephalosporins needed doses up to thirty-two fold higher . The rest of the Proteus spp . were inhibited 90% with 0.8 or 3.2 micrograms/ml of ceftizoxime; on the contrary, to inhibit the same percentage of these bacteria, doses two to sixteen fold higher than cefotaxime or other cephalosporins were needed . Ceftizoxime was less active than amikacin against multiresistant Pseudomonas spp . Strains isolated from urine were generally more resistant to antibiotics than those encountered in other clinical material.

Drugs, 1985 Apr, 29(4), 281 - 329
Ceftizoxime . A review of its antibacterial activity, pharmacokinetic properties and therapeutic use; Richards DM et al.; Ceftizoxime is a 'third generation' cephalosporin administered intravenously or intramuscularly . Like other third generation cephalosporins it has a wide spectrum of in vitro activity against Gram-positive and Gram-negative bacteria, is particularly active against Enterobacteriaceae (including beta-lactamase-positive strains), and is resistant to hydrolysis by beta-lactamases . However, the third generation cephalosporins are less active than earlier cephalosporins against staphylococci and so could not be considered the drugs of choice . Like many currently available third generation cephalosporins, ceftizoxime has limited activity against Pseudomonas aeruginosa, and thus cannot be recommended as sole treatment of known or suspected non-urinary tract pseudomonal infections . Similarly, although favourable clinical results have been obtained in patients treated with ceftizoxime for infections caused by mixed aerobic/anaerobic organisms (such as intra-abdominal, and obstetric and gynaecological infections), the relatively low in vitro activity of ceftizoxime (in common with most other third generation cephalosporins) against Bacteroides fragilis and enterococci may restrict its usage in situations where these organisms are the suspected or proven pathogens . Ceftizoxime appears to be similar in efficacy to several other cephalosporins in lower respiratory tract infections in elderly and/or debilitated patients, and in chronic and/or complicated urinary tract infections, 2 clinical situations in which third generation cephalosporins may have a major role . Ceftizoxime is also effective clinically and bacteriologically in skin, soft tissue, bone and joint infections, septicaemia/bacteraemia, meningitis and neonatal infections . However, a few large, well designed clinical comparisons of efficacy with aminoglycosides are needed before ceftizoxime can be recommended as an alternative in patients in whom potential aminoglycoside toxicity is a concern . Single intramuscular doses of ceftizoxime appear similar in efficacy to aqueous procaine penicillin G in gonorrhoeae due to nonpenicillinase-producing Neisseria gonorrhoea, and ceftizoxime is also highly effective against penicillinase-producing strains . Although only a few infections have been treated to date, ceftizoxime may be useful in the treatment of gonorrhoea in places where penicillinase-producing strains are common . Thus, ceftizoxime appears to be an effective addition to the growing number of third generation cephalosporins . However, further studies are needed to confirm its relative efficacy compared with other new cephalosporins, in particular cefotaxime.(ABSTRACT TRUNCATED AT 400 WORDS)

J Clin Microbiol, 1985 Apr, 21(4), 542 - 5
Comparison of the API rapid E four-hour system with the API 20E overnight system for the identification of routine clinical isolates of the family Enterobacteriaceae; Overman TL et al.; Four hundred forty-one clinical isolates of the family Enterobacteriaceae were identified in parallel by using the API Rapid E 4-h and the API 20E overnight procedures (Analytab Products, Plainview, N.Y.) . The results obtained by using the API Rapid E were compared with those obtained by using the API 20E . Discrepancies were resolved by using standard biochemicals . The API 20E identified 98.9% (436 of 441) of the isolates without the use of additional biochemicals and was found to be correct in each case of a discrepancy among the 436 isolates . The API Rapid E gave the same identification as the API 20E for 94.0% (410 of 436) of the isolates, misidentified 3.0% (13 of 436), and gave a correct but low-selectivity answer for the remaining 3.0% (13 of 436) . The API Rapid E is a suitable alternative for the rapid identification of the Enterobacteriaceae.

Invest Ophthalmol Vis Sci, 1985 Apr, 26(4), 591 - 4
Experimental guinea pig ocular infection by Salmonella typhimurium; Belfort R Jr et al.; The clinical, microbiologic, and cytologic features of the guinea pig model of keratoconjunctivitis with enterobacteria, Salmonella typhimurium were elucidated . Guinea pig eyes were instilled with S . typhimurium and the eyes were studied by biomicroscopy, culture, cytology, pathology, and electron microscopy . All animals developed moderate to severe conjunctivitis that was present in 18% of the animals on day 1 . It became more intense, appearing in all of the eyes on day 10 and disappeared before day 30 . The cultures for S . typhimurium were almost all positive on days 1 and 2, declined steadily to 10% on day 10, and were negative after that . A coarse, epithelial punctate keratitis was present in more than 90% of the infected eyes at some time during the experiment . The keratitis had a biphasic clinical course . The first peak correlated with the maximum culture results, but during the second peak only 10% of the cultures were positive . Electron microscopy of the cornea showed the S . typhimurium at the epithelial surface within surface epithelial cells during the early phases of infection . The later phase keratitis, with negative culture results, resembles the keratitis of Reiter's syndrome.

J Appl Biochem, 1985 Apr, 7(2), 93 - 7
Properties of Sepharose-bound beta-lactamase from Enterobacter cloacae; Pastorino AM et al.; beta-Lactamase from Enterobacter cloacae P99 was immobilized onto Sepharose by the cyanogen bromide activation method and the properties of the Sepharose-bound enzyme were compared with those of soluble and cell-bound enzyme . The immobilized beta-lactamase showed enhanced stability to storage at 4 degrees C (approximately 1 year) in respect to the free enzyme in solution (few days) . The optimum pH for activity is similar for both Sepharose- and cell-bound beta-lactamase and extends over a broader pH range (pH 6-9) than the soluble enzyme (pH 8-9) . Immobilization leads also to significant enhancement of thermal stability . Effective enzyme inhibition by flucloxacillin occurs with both soluble and Sepharose-bound beta-lactamase, whereas the cell-bound enzyme is much less (10(-5) times) inhibited . These results indicate that immobilized beta-lactamase could be usefully employed as a tool for investigating the properties of newly designed beta-lactamase inhibitors.

J Antimicrob Chemother, 1985 Apr, 15(4), 449 - 56
The antimicrobial activity of cefpirome, a new cephalosporin; Wise R et al.; The activity of the extended spectrum cephalosporin cefpirome (HR 810) was compared with that of other beta-lactams and gentamicin . A total of 524 clinical isolates and strains known to be resistant to certain agents were studied . Against the Enterobacteriaceae, Haemophilus influenzae and Neisseria spp . cefpirome was highly active (MIC90 less than or equal to 0.5 mg/l), generally being as active or slightly more active than ceftazidime and cefotaxime, and 8 to 32 times more active than cefuroxime . Against Pseudomonas aeruginosa cefpirome (MIC90 8 mg/l) was four-fold less active than ceftazidime . Staphylococcus aureus was susceptible to cefpirome (MIC90 2 mg/l) and cefpirome was the only cephalosporin tested with significant activity against Lancefield Group D streptococci . Bacteroides spp . (with the exception of Bact . ureolyticus) were resistant to cefpirome . The compound was bactericidal to all the susceptible strains studied with the exception of Lancefield Group D streptococci . The major target site for cefpirome was PBP 3 and the protein binding was low.

Antimicrob Agents Chemother, 1985 Apr, 27(4), 555 - 60
Resistance caused by decreased penetration of beta-lactam antibiotics into Enterobacter cloacae; Bush K et al.; Strains of Enterobacter cloacae were selected on the basis of resistance to aztreonam, ceftazidime, moxalactam, or imipenem . All strains produced the same E2 beta-lactamase, with an isoelectric point greater than 9.5 and with high hydrolytic activity in the presence of cephaloridine . Resistance to beta-lactams could not be correlated with the amount of beta-lactamase present in the various strains . beta-Lactamase activity was induced strongly by moxalactam and imipenem in the wild-type and moxalactam-resistant strains, with beta-lactamase representing as much as 4% of the total cellular protein after induction (2 X 10(5) molecules per cell) . Ceftazidime and aztreonam were poor inducers . None of the antibiotics studied was readily hydrolyzed by the E2 beta-lactamase; aztreonam and moxalactam inhibited the enzyme with apparent Ki values of 1.2 and 100 nM, respectively . Aztreonam, which bound covalently to the E2 beta-lactamase with a half-life of 2.3 h at 25 degrees C, was used to measure penetrability of beta-lactam into the periplasmic space of the resistant E . cloacae strains . In all of the E2-producing organisms studied, a significant permeability barrier existed . A maximum concentration of 0.02 microgram of aztreonam per ml should have saturated the periplasmic beta-lactamase in the highest enzyme producers studied . However, fully active beta-lactamase was observed in the periplasm of cells exposed to aztreonam at concentrations at least 1,000-fold higher than that theoretically necessary to inhibit the total enzyme within the cell . Thus, the major cause for resistance to beta-lactam antibiotics in these E . cloacae strains was lack of penetration across the outer membrane.

Antimicrob Agents Chemother, 1985 Apr, 27(4), 455 - 9
Role of beta-lactamases and outer membrane proteins in multiple beta-lactam resistance of Enterobacter cloacae; Werner V et al.; The chromosomal beta-lactamase and outer membrane proteins of Enterobacter cloacae were examined to determine their relative contributions to multiple antibiotic resistance in this organism . Mutants altered in beta-lactamase expression, whether derived in the laboratory or recovered from patients treated with one of the new beta-lactam antibiotics, were found to have no detectable alterations in outer membrane proteins . Derepression of beta-lactamase in these mutants was associated with high-level resistance to multiple beta-lactam antibiotics, while loss of inducible beta-lactamase (i.e., production of basal enzyme levels only) was associated with acquisition of susceptibility to many beta-lactam antibiotics, including cephalothin . In contrast, alteration in outer membrane proteins was associated with only moderate-level resistance to beta-lactam antibiotics . However, this included resistance to such drugs as amdinocillin and Sch 34343, which were unaffected by derepression of beta-lactamase . Resistance to chloramphenicol and tetracycline also accompanied changes in outer membrane proteins . Although the outer membrane proteins of various strains of E . cloacae were similar, there did appear to be some major strain-to-strain variations . Thus, it appears that alterations in both beta-lactamase and outer membrane proteins can affect the susceptibility of E . cloacae to many antibiotics . However, alterations in beta-lactamase alone are sufficient to produce high-level multiple beta-lactam resistance in this organism.

Antimicrob Agents Chemother, 1985 Apr, 27(4), 515 - 9
In vitro activity of BMY-28142 in comparison with those of other beta-lactam antimicrobial agents; Tsuji A et al.; The in vitro susceptibility of 406 clinical isolates to BMY-28142, a new semisynthetic cephem, was evaluated and compared with cefpimizole, HR 810, ceftazidime, cefotaxime, moxalactam, and cefoperazone in a broth microdilution assay . On a weight basis, the activity of BMY-28142 against Escherichia coli, Proteus species, and Klebsiella-Enterobacter-Serratia was superior to the other cephems . Against gentamicin-susceptible and -resistant Pseudomonas aeruginosa, BMY-28142 was more active than the other cephems, except ceftazidime and HR 810 . A total of 74% of gram-negative and 56% of gram-positive isolates resistant to third-generation cephalosporins were susceptible to less than or equal to 8 micrograms of BMY-28142 per ml . Finally, for 83% of tested isolates, the bactericidal concentration of BMY-28142 was within one dilution of the inhibitory concentration.

Chemioterapia, 1985 Apr, 4(2), 192 - 6
Cross resistance of quinolone derivatives in gram-negative bacteria; Barba D et al.; A total of 127 Gram-negative bacteria resistant to nalidixic acid were isolated from as many patients affected by urinary tract infections and hospitalized in the first Clinic of Infectious Diseases, University of Naples . Enterobacteria were identified by Enterotube system (Roche) and API 20 system (Ayerst) . Non-fermentative bacteria were identified by OXI/FERM system (Roche) . The following bacteria were collected: Escherichia coli 50, Proteus spp . 35, Enterobacter agglomerans 12, Serratia sp . 5, Pseudomonas aeruginosa 25 . The in vitro antibacterial activity of nalidixic acid and three other quinoline derivatives (pipemidic acid, oxolinic acid and ciprofloxacin) were studied by determining the MICs by a miniaturized dilution broth method . The MICs were compared to evaluate the eventual cross resistance to the drugs under examination within each bacterial species . The results showed that 23% of bacteria were resistant to nalidixic acid, pipemidic acid and oxolinic acid; 49.6% to nalidixic and pipemidic acid and 0.7% to nalidixic acid and oxolinic acid . On the other hand none of the bacteria were resistant to ciprofloxacin . The last showed very low MICs against all the bacteria under examination, including Pseudomonas and Serratia . The high antibacterial activity of ciprofloxacin even against bacteria highly resistant to the other quinolines could be due to a greater affinity of the target sites or to the better permeability of resistant strains to the newer drug or because it is unaffected until now by mutations of genes responsible for cross resistance.

J Clin Microbiol, 1985 Apr, 21(4), 626 - 9
Controlled evaluation of Trypticase soy broth in agar slide and conventional blood culture systems; Weinstein MP et al.; A commercially available biphasic blood culture system that utilizes an attachable agar slide paddle and Trypticase soy broth (BBL Microbiology Systems, Cockeysville, Md.) was compared with a conventional Trypticase soy broth blood culture bottle in 6,867 paired blood cultures from adult patients . Both systems were inoculated with equal volumes of blood (5 ml) and incubated aerobically (vented) for 2 weeks . More clinically important bacteria and fungi, including Staphylococcus epidermidis, streptococci, Escherichia coli, Klebsiella spp., other Enterobacteriaceae, and Pseudomonas aeruginosa, were recovered from the biphasic system (P less than 0.001) . In contrast, more anaerobic bacteria of importance were recovered in the conventional bottle (P less than 0.01) . Staphylococci (P less than 0.001), gram-negative facultative and aerobic bacteria (P less than 0.001), and fungi (P less than 0.001) were detected 1 or more days earlier in the biphasic system, whereas pneumococci (P less than 0.05) were detected earlier in the conventional bottle . Of 603 clinically important microorganisms that grew in the biphasic system, 601 (99.7%) were detected by day 7 of incubation, but only 403 of 490 microorganisms (82.2%) were detected by day 7 in the conventional bottle . Overall, the biphasic system was superior to the conventional bottle . For optimal detection of anaerobic bacteremia, however, the biphasic system should be used in conjunction with a complementary anaerobic conventional bottle.

Wien Klin Wochenschr, 1985 Mar 29, 97(7), 334 - 9
{Resistance of blood culture isolates in vitro to 4 aminoglycoside antibiotics in Austria--1982/83}; Mittermayer H et al.; Over the period September 1982 to February 1983 268 blood culture isolates were consecutively collected in 4 microbiological laboratories in Austria (Linz, Vienna, Graz, Feldkirch) and 251 of these strains (streptococci excluded) were tested for resistance to Gentamicin (G), Tobramycin (T), Netilmicin (N) and Amikacin (A) using a microtitre broth dilution method . This investigation was part of an international study . Of the bacterial strains examined 57% were staphylococci (34% Staphylococcus aureus) and 43% gram-negative rods (18% E . coli, 17% other enterobacteriaceae and 5% Pseudomonas aeruginosa etc.) . 25% of all strains tested were resistant to Gentamicin (MIC greater than 4 mg/l), 27% to Tobramycin (MIC greater than 4 mg/l), 6% to Netilmicin (MIC greater than 4 mg/ml) and 5% to Amikacin (MIC greater than 8 mg/l) . The resistance rate of staphylococci was markedly greater towards Gentamicin (35%) and Tobramycin (39%) than Netilmicin (4%) and Amikacin (6%) . The respective percentages of resistant gram-negative rods were considerably smaller, except in the case of Netilmicin (G 13%, T 11%, N 8%, A 4%) . Regional differences were observed between Linz and Vienna in the resistance of staphylococci to Gentamicin (24% versus 49%) and Tobramycin (33% versus 53%) . On a weight basis Netilmicin was the most active substance in combating nearly all groups of bacteria . Also in strains sensitive to the other aminoglycosides the MIC values of Netilmicin were considerably lower than for the other substances . A noteworthy feature in comparison with the results of other countries participating in this international study was the distinctly higher incidence of staphylococci among the blood culture isolates and the considerably higher percentage of aminoglycoside-resistant strains in Austria . Analysis of the data suggests that the high resistance rates among staphylococci are a consequence of selection by frequently used antibiotics . Hence, it appears essential to observe the development of aminoglycoside resistance in Austria closely and to recommend that these substances, of extreme value in the treatment of severe infections, should be used solely for the most stringent indications.

Presse Med, 1985 Mar 23, 14(12), 673 - 6
{Enterobacter cloacae and E . aerogenes septicemia: emergence of resistant variants (derepressed cephalosporinase) during treatment with third-generation cephalosporins}; Nauciel C et al.; From three patients hospitalised in intensive care units with Enterobacter septicaemia (two cases with E . cloacae, and one with E . aerogenes), cefotaxime therapy, alone or in combination with an aminoglycoside, selected variants (R) with increased resistance to beta-lactam antibiotics . The cross-resistance extended to all the beta-lactam antibiotics tested, penicillins and cephalosporins, including third-generation cephalosporins . The crude extracts of uninduced cultures of R variants showed high beta-lactamase activity and of the cephalosporinase type . These variants were selected in vitro with a frequency of 10(-6) to 10(-7) and may result from a mutation involving the regulation of Enterobacter cephalosporinases, usually inducible . Data from the literature indicated that this new type of resistance is actually emerging and observed not only in Enterobacter sp . The problem of emergence of R variants exhibiting cross-resistance to beta-lactam antibiotics should be considered when third-generation cephalosporins are used.

Quad Sclavo Diagn, 1985 Mar, 21(1), 56 - 61
{Evaluation of a semiautomatic system (ABAC-ABACTOR III) for the identification of Enterobacteriaceae}; Nani E et al.; ABAC-ABACTOR II system has been compared with two conventional methods (Enterotube II and MS-2) for the identification of Enterobacteriaceae . Our findings demonstrate the validity and the reproducibility of the identification obtained with this system.

J Antibiot (Tokyo), 1985 Mar, 38(3), 372 - 9
Semisynthetic penicillins and cephalosporins containing the substituted 6-vinyl-1,2-dihydro-2-oxo- and 1,4-dihydro-4-oxo-3-pyridinecarboxylic acid side chains . Synthesis and structure-activity relationships; DeJohn D et al.; A series of penicillins and cephalosporins containing the substituted 6-vinyl-1,2-dihydro-2-oxo- and 1,4-dihydro-4-oxo-3-pyridinecarboxylic acid side chains has been prepared and compared to piperacillin and cefoperazone . The compounds show good activity when tested in vitro against an array of Gram-negative bacteria . In vitro activity was also demonstrated against several species of Gram-positive bacteria . Two compounds, 14 and 21, show good in vivo activity when tested against Klebsiella pneumoniae, Enterobacter cloacae, and two strains of Pseudomonas aeruginosa.

J Clin Microbiol, 1985 Mar, 21(3), 447 - 8
Evaluation of the Micro-ID system for the identification of Yersinia pestis; Harrison DN et al.; One hundred isolates of Yersinia pestis identified by conventional means were tested by the Micro-ID system to assess its reliability for distinguishing Y . pestis from other members of the family Enterobacteriaceae . The Micro-ID system gave Y . pestis as a choice for the identification of 89 of these cultures, although not always as the first choice . Most nitrate-negative strains of Y . pestis keyed out with Yersinia pseudotuberculosis as first choice and Y . pestis as second or fourth choice.

J Clin Microbiol, 1985 Mar, 21(3), 431 - 7
DNA probe specific for Legionella pneumophila; Grimont PA et al.; A procedure for preparing a DNA probe to be used in the specific detection of Legionella pneumophila by dot or colony hybridization has been devised . When total DNA from L . pneumophila was used as a radioactive probe, cross-hybridization occurred with DNA from many other species belonging to various families (including Legionellaceae, Enterobacteriaceae, Pseudomonadaceae, and Vibrionaceae) . Cross-hybridizing restriction fragments in L . pneumophila ATCC 33152 DNA were identified on Southern blots . When unlabeled DNA from strain ATCC 33152 was cleaved by endonuclease BamHI, the DNA fragments cross-hybridizing with the labeled DNA from all of the other species and genera tested (or with Escherichia coli 16 + 23 S RNA) had a size of 21.4 and 16.2 kilobase pairs (major bands) and 28.0, 12.8, and 10.1 kilobase pairs (minor bands) . BamHI restriction fragments of L . pneumophila DNA deprived of the cross-hybridizing fragments were pooled and used as a probe for the detection of L . pneumophila . This probe proved to be specific for L . pneumophila in colony and dot hybridization . It can potentially be used for the detection of L . pneumophila in clinical and water samples . The procedure described can be readily applied to the preparation of probes specific for phylogenetically isolated bacterial species other than L . pneumophila.

Diagn Microbiol Infect Dis, 1985 Mar, 3(2), 143 - 7
Differentiation of Pseudomonas aeruginosa and Enterobacteriaceae in direct smears based on measurements by scanning electron microscopy; Bartlett RC et al.; We believe that experienced observers can often distinguish between Enterobacteriaceae and Pseudomonas aeruginosa, by differences in dimensions in Gram-stained direct smears . Many microbiologists question whether this should be attempted because of overlap in dimensions . We have found that culture results confirm our observations about 80% of the time and that such reporting is helpful in diagnosis and treatment . We decided to try to verify the differences in dimensions objectively . Because of the limitations of making measurements by light microscopy, exudate from clinical specimens and from experimental mouse infections were examined by scanning electron microscopy . Discriminant function analysis was applied to the dimensions of length and width, and this showed that 83% of the organisms in both groups could be correctly classified on the basis of the dimensions . This supports our premise that experienced observers should be able to differentiate between these organisms in Gram-stained direct smears, using light microscopy with sufficient confidence to provide clinically useful information.

J Infect, 1985 Mar, 10(2), 126 - 42
Bacteraemia at the University Hospital of the West Indies--a report of 222 cases; Macfarlane DE et al.; A total of 222 cases of septicaemia was recorded at the University Hospital of the West Indies between June 1982 and June 1983 . This gave an overall incidence of 16.1 per 1000 admissions . The 233 bacterial strains isolated comprised 100 Gram-positive and 133 Gram-negative organisms with Klebsiella pneumoniae, Streptococcus pneumoniae and Staphylococcus aureus being the most frequent . Highest rates of septicaemia were recorded in patients less than 1 year and over 50 years of age . Septicaemia caused by Gram-positive organisms was predominantly a disease of children whereas that caused by Gram-negative organisms arose more often in neonates and in patients over 50 years of age . A predisposing factor was noted in 104 patients of whom 42 had neoplastic disease . The most frequently identified initial sites of infection were the respiratory tract, the gastro-intestinal tract and the meninges . Most blood stream infections were community-acquired, three quarters of all septicaemic patients being admitted to the departments of medicine or paediatrics . There were 11 cases of polymicrobial septicaemia caused predominantly by Gram-negative organisms in patients with underlying disease . Appropriate antimicrobial drugs were administered to 57% of septicaemic patients whereas 17% received superfluous antimicrobial therapy . In those patients who received inappropriate antimicrobial therapy there was a marked increase in mortality . Forty of 61 deaths were attributed to septicaemia . Mortality from septicaemia caused by Gram-negative organisms was 21% compared with 13% for that caused by Gram-positive organisms . The organisms associated with the highest case fatality rates were Escherichia coli, 53%; Enterobacter sp., 27%; and beta-haemolytic streptococci 24% . There were no deaths from septicaemia caused by Haemophilus influenzae, Salmonella sp . or Serratia sp . The highest mortality rates were associated with neoplastic disease, diabetes, polymicrobial septicaemia, urinary tract infections and old age.

Drug Intell Clin Pharm, 1985 Mar, 19(3), 171 - 5
Aztreonam--an overview; Hopefl AW; Aztreonam is the first synthetic monobactam to undergo clinical studies in the U.S . Aztreonam has excellent activity against P . aeruginosa and Enterobacteriaceae, but poor activity against anaerobic and gram-positive organisms . Aztreonam has poor oral bioavailability, but can be given intramuscularly or intravenously in doses of 1-2 g q6-12h . Clinical trials of aztreonam have shown it to be effective in infections of urine, lung, skin, blood, bones and joints, and abdomen with an adverse reaction profile similar to beta-lactams . Aztreonam may be an alternate to aminoglycoside therapy, with the advantage of not being nephrotoxic.

Eur J Biochem, 1985 Mar 1, 147(2), 401 - 7
Monoclonal antibodies directed against the cell-surface-exposed part of PhoE pore protein of the Escherichia coli K-12 outer membrane; van der Ley P et al.; Six monoclonal antibodies directed against the trimeric form of outer-membrane pore protein PhoE of Escherichia coli K-12 were isolated and characterized . All six antibodies bind to PhoE protein in intact cells and as isolated trimers, but not to dodecyl-sulphate-denatured monomers . Cross-reaction with the related pore proteins OmpF protein and OmpC protein was not observed . A hybrid pore protein in which the amino-terminal 74 amino acids of PhoE protein have been replaced by the corresponding part of OmpF protein is able to bind the six monoclonal antibodies . Five of the antibodies bind to the PhoE proteins of thirteen different Enterobacteriaceae when expressed in E . coli K-12, whereas the other antibody recognizes PhoE protein from nine of these strains . Four monoclonal antibodies are able to block adsorption of the PhoE-protein-specific phage TC45 to its receptor on whole cells . None of the antibodies has any effect on the uptake rate of the antibiotic cefsulodin through PhoE protein pores . Five antibodies are able to direct the complement-mediated killing of PhoE-protein-carrying cells . It is concluded that the six monoclonal antibodies recognize at least three distinct cell-surface-exposed epitopes whose specificity is determined by the carboxy-terminal 256 amino acids of PhoE protein.

Antimicrob Agents Chemother, 1985 Mar, 27(3), 393 - 8
Role of beta-lactam hydrolysis in the mechanism of resistance of a beta-lactamase-constitutive Enterobacter cloacae strain to expanded-spectrum beta-lactams; Vu H et al.; Enterobacter cloacae strains producing chromosomally mediated beta-lactamase constitutively show high degrees of resistance to most of the third-generation beta-lactams . It has been proposed that this resistance is due to the nonhydrolytic binding or trapping of beta-lactams by the enzyme . We found that the outer membrane of E . cloacae strain 55M indeed had permeability to cefazolin about 14-fold lower than that of Escherichia coli, and that the number of beta-lactamase molecules produced by this constitutive mutant was exceptionally large (2 X 10(5) per cell) . These conditions are expected to produce a low degree of resistance, but could not explain the high resistance level of the mutant . We showed that the beta-lactamase of this strain hydrolyzed third-generation beta-lactams at measurable rates . Although the V max for these compounds was less than 0.01% of that for cefazolin, the enzyme could hydrolyze them at rates comparable to the rate for cefazolin when the substrate concentration was near 0.1 microM, a concentration thought to be physiologically relevant for the inhibition of cell growth, because of the exceptionally high affinity of the enzyme to many third-generation compounds . Calculations based on kinetic parameters of the enzyme, outer membrane permeability, and affinity toward penicillin-binding proteins succeeded in predicting the MICs for several third-generation beta-lactams . The data suggest that hydrolysis may be more important than nonhydrolytic binding for the expression of the resistant phenotype, and that studies on the susceptibility of beta-lactams to beta-lactamases should be carried out at physiologically relevant, very low concentrations of the drug, rather than the customary very high concentrations, such as 100 microM.

Diagn Microbiol Infect Dis, 1985 Mar, 3(2), 93 - 104
Imipenem (N-formimidoyl thienamycin): in vitro antimicrobial activity and beta-lactamase stability; Barry AL et al.; In vitro studies with imipenem (N-formimidoyl thienamycin or MK0787) were performed with 8481 clinical isolates in three separate medical centers . More extensive comparative studies were also performed with 605 representative isolates, comparing imipenem to six other beta-lactams . Although the newer beta-lactams were often more active against susceptible species, imipenem demonstrated the broadest spectrum of antibacterial activity, with MIC 90s less than or equal to 4.0 micrograms/ml for all species tested except Pseudomonas maltophilia and P . cepacia . Imipenem was very active against all streptococci and staphylococci, in contrast to the third-generation cephalosporins . There was no evidence of cross-resistance between imipenem and the cephalosporins or penicillins . Resistance to hydrolysis by seven beta-lactamase preparations was documented for imipenem, cefotaxime, and moxalactam . Like many other beta-lactams, imipenem inhibited the Type I beta-lactamase produced by Enterobacter cloacae . Other beta-lactamases from gram-negative bacilli were also inhibited by high concentrations of imipenem.

Infect Control, 1985 Mar, 6(3), 115 - 9
Enterobacter mediastinitis following cardiac surgery; Palmer DL et al.; Eight cases of sternal/mediastinal infection due to Enterobacter species were seen in postoperative cardiac patients during 1980 to 1981 . The attack rate was 14.5% (8/55), compared to 3.7% (2/54) for an identical period in 1979 to 1980 (p less than 0.05) . Cases varied in severity from fulminant, acute bacteremic infections (one death) to less severe wound infection . Late complications or recurrences were not seen . There was a hospital-wide increase, relative to all other gram-negative bacillary isolates, in Enterobacter laboratory isolations, but no increased rate of infection in any other specific surgical condition . No personnel, materials, or techniques were associated with the outbreak, and all but two environmental cultures were negative . Case-control analysis suggested that surgical complications and prophylactic cephalosporins were associated with infection . Prospectively, an additional 85 cardiac surgery patients had increased Enterobacter skin/wound colonization following perioperative prophylaxis with cephalosporin antibiotics . After introduction of barrier isolation and restriction of contacts no further mediastinitis occurred in 100 subsequent cardiac surgery patients . This study indicates that Enterobacter may be major pathogens causing post-cardiac-surgery infection not prevented by cephalosporin prophylaxis.

J Antimicrob Chemother, 1985 Mar, 15(3), 305 - 10
HR 810 and BMY-28142, two new cephalosporins with broad-spectrum activity: an in-vitro comparison with other beta-lactam antibiotics; Clarke AM et al.; The in-vitro activity of the new parenteral cephalosporins, HR 810 (HR) and BMY-28142 (BMY), was compared with that of other beta-lactam antibiotics, including cefotaxime, against a total of 315 recent clinical isolates and characterized beta-lactamase producers . An agar dilution procedure was used to determine MICs and two inocula (10(4) and 10(6) cfu) were used throughout . Against all species of the Enterobacteriaceae tested, both HR and BMY were as active as, or slightly more active than, cefotaxime . HR differed from cefotaxime mainly in being eight-fold more active against Pseudomonas aeruginosa and two-fold more active against Staphylococcus aureus . BMY was also eight-fold more active than cefotaxime against Ps . aeruginosa but was two-fold less active than the latter against Staph . aureus . Both new compounds had good activity against Haemophilus influenzae, including the beta-lactamase producing strains of that species, and both had poor activity against the Bacteroides fragilis group (MIC90 greater than 128 mg/l).

Antimicrob Agents Chemother, 1985 Mar, 27(3), 422 - 3
Norfloxacin versus trimethoprim-sulfamethoxazole in the therapy of uncomplicated, community-acquired urinary tract infections; Goldstein EJ et al.; In a prospective, randomized trial, norfloxacin (400 mg perorally, twice a day) was compared with trimethoprim-sulfamethoxazole (160-800 mg perorally, twice a day) in 45 patients with uncomplicated urinary tract infections . Escherichia coli was the most common isolate . Infections due to Enterobacter spp., Proteus mirabilis, Pseudomonas spp., and Staphylococcus spp . were also treated . Norfloxacin was equivalent in effectiveness and safety to trimethoprim-sulfamethoxazole, with a cure rate of 91% at the 5- to 9-day posttherapy visit and 88% at the 4- to 6-week posttherapy visit . It was well tolerated and had a low incidence of side effects.

J Infect Dis, 1985 Mar, 151(3), 501 - 7
Cross-resistance to nalidixic acid, trimethoprim, and chloramphenicol associated with alterations in outer membrane proteins of Klebsiella, Enterobacter, and Serratia; Gutmann L et al.; We studied in vitro mutants of Klebsiella, Enterobacter, and Serratia cross-resistant to nalidixic acid, trimethoprim, and chloramphenicol that were similar to mutants found in vivo . The sole mechanism for this type of resistance appeared to be a reduction in permeability of the cell envelope . The mutants had significantly lower rates of uptake of glucose and chloramphenicol, but binding of chloramphenicol to ribosomes was normal . In addition, the amounts of dihydrofolate reductase were similar in both wild-type and cross-resistant mutants of Klebsiella . Examination of the bacterial outer membrane revealed that the amount of at least one major protein, with a molecular size of approximately 40 kilodaltons, was decreased in the mutants . Therefore the resistance seemed likely to be due to the reduction in quantity of these outer membrane proteins, possibly porins, in the mutant bacteria.

J Bacteriol, 1985 Mar, 161(3), 913 - 20
Molecular cloning in Escherichia coli of Erwinia chrysanthemi genes encoding multiple forms of pectate lyase; Collmer A et al.; The phytopathogenic enterobacterium Erwinia chrysanthemi excretes multiple isozymes of the plant tissue-disintegrating enzyme, pectate lyase (PL) . Genes encoding PL were cloned from E . chrysanthemi CUCPB 1237 into Escherichia coli HB101 by inserting Sau3A-generated DNA fragments into the BamHI site of pBR322 and then screening recombinant transformants for the ability to sink into pectate semisolid agar . Restriction mapping of the cloned DNA in eight pectolytic transformants revealed overlapping portions of a 9.8-kilobase region of the E . chrysanthemi genome . Deletion derivatives of these plasmids were used to localize the pectolytic genotype to a 2.5-kilobase region of the cloned DNA . PL gene expression in E . coli was independent of vector promoters, repressed by glucose, and not induced by galacturonan . PL accumulated largely in the periplasmic space of E . coli . An activity stain used in conjunction with ultrathin-layer isoelectric focusing resolved the PL in E . chrysanthemi culture supernatants and shock fluids of E . coli clones into multiple forms . One isozyme with an apparent pI of 7.8 was produced at a far higher level in E . coli and was common to all of the pectolytic clones . Activity staining of renatured PL in sodium dodecyl sulfate-polyacrylamide gels revealed that this isozyme comigrated with the corresponding isozyme produced by E . chrysanthemi . The PL isozyme profiles produced by different clones and deletion derivative subclones suggest that the cloned region contains at least two PL isozyme structural genes . Pectolytic E . coli clones possessed a limited ability to macerate potato tuber tissues.

J Hosp Infect, 1985 Mar, 6(1), 46 - 59
Dissemination of gentamicin-resistant plasmids among strains of Enterobacteriaceae; Takahashi S et al.; The frequency of gentamicin-resistance among strains of many species of Enterobacteriaceae isolated from in-patients in our hospital has increased considerably since 1979 . To clarify the reason for this increase, we tried to detect R-plasmids conferring gentamicin-resistance in all of the isolates in 1981 and found that most of them had conjugative R-plasmids . For epidemiological purposes we classified these into types I to X and 'others' by the following criteria: the nature of the resistances conferred; their incompatibility group; their molecular weight and the pattern of the DNA fragments after digestion with restriction endonucleasis . In the urology department, type-I plasmids conferring resistance to gentamicin, kanamycin, tobramycin and amikacin, and type-II plasmids conferring resistance to gentamicin, kanamycin and tobramycin were detected in the isolates belonging respectively to six species and twelve biotypes, and four species and six biotypes . In the second surgery ward, isolates belonging to six species and twelve biotypes were found to have type-III plasmids conferring resistance to gentamicin, kanamycin, tobramycin and chloramphenicol . Our investigation shows that not only antibiotic-resistant strains but also R-plasmids may be disseminated in hospitals.

J Bacteriol, 1985 Mar, 161(3), 1002 - 9
Cell-bound and secreted proteases of Serratia marcescens; Schmitz G et al.; Exoprotease of Serratia marcescens ATCC 25419 is exceptional among members of the family Enterobacteriaceae in that it is secreted in large amounts by viable cells into the culture medium . Labeling of cells with radioactive amino acids revealed no intracellular protein that could be precipitated with antibodies raised against purified exoproteases . With substances known to interfere with the excretion of some proteins--tosyl-L-lysine chloromethyl ketone, phenethyl alcohol, procaine, and sodium azide--and with rifampin, an intracellular form (apparent molecular weight, 52,000) larger than the major exoform (molecular weight, 51,000) was identified . Moreover, the 52,000-molecular-weight form was the main protein in immunoprecipitates of a cysteine-auxotrophic mutant starved for cysteine . Beside the major exoform, protease I, two additional exoproteases, termed II and III, appeared in the medium of stationary cultures . They were precipitated by antibodies against protease I, were identical in the Ouchterlony double-diffusion assay, and exhibited only a small difference, if any at all, in the peptide pattern after partial hydrolysis with protease V8 of Staphylococcus aureus . The amino- and carboxy-terminal amino acid sequences of protease I and II were determined and found to be identical, NH2-Ala-Ala-Thr-Gly-Gly-Tyr-Asp-Ala-Val-Asp and Phe-Ile-Val-COOH, respectively . The microheterogeneity of the isolated exoforms revealed by anion-exchange chromatography and sodium dodecyl sulfate-polyacrylamide gel electrophoresis was also observed in samples pulse-labeled with radioactive amino acids . It remains to be determined whether the different protease forms are the result of processing (modification) reactions or whether they constitute isoenzymes encoded by very similar genes.

Am J Med, 1985 Feb 8, 78(2A), 77 - 80
Current state of infectious diseases--potential areas of directed therapy with aztreonam; Neu HC; Gram-negative bacillary organisms have continued to be a major source of hospital infections . Beta-lactamase-producing species have rendered many older beta-lactam antibiotics impotent . Aztreonam is a monocyclic beta-lactam antibiotic that inhibits aerobic gram-negative bacilli, including beta-lactamase-producing species . The agent has been used in the treatment of infections due to Enterobacteriaceae and Pseudomonas aeruginosa . Potential areas of use of aztreonam are as sole therapy for urinary tract infections, gram-negative pneumonias, and bone and joint infections . It can be used in combination with other antibiotics as empiric therapy of respiratory, intra-abdominal, skin structure, and gynecologic infections . Aztreonam offers a new approach to the use of beta-lactam antibiotics.

Am J Med, 1985 Feb 8, 78(2A), 34 - 41
Treatment with aztreonam or tobramycin in critical care patients with nosocomial gram-negative pneumonia; Schentag JJ et al.; During the course of one year, 47 critical care patients with gram-negative bacillary pneumonia at Millard Fillmore Hospital were randomly assigned to aztreonam or tobramycin therapy (two to one) . Of these, 40 were fully evaluable for microbiologic and clinical response . All evaluable patients had gram-negative organisms in tracheal aspirate culture specimens and confirmed susceptibility of the organism to both study drugs . There was no difference between the two groups with respect to the percentage of patients who received concurrent antibiotics for gram-positive organisms . More than 60 percent of the patients received mechanical ventilation . Essentially, all had new lung infiltrates as shown by chest radiography, leukocytosis, recent onset of fever, and increased volume of purulent secretions . Half had multilobar pulmonary infiltrates . Their mean age was 73 years, with none under age 50 . Most had chronic obstructive pulmonary disease, congestive heart failure, or both . By the prognostic nutritional index criteria, over 70 percent were nutritionally deficient at entry . The majority of infections were caused by Pseudomonas, Enterobacter, Klebsiella, and Escherichia coli . Aztreonam eradicated 92 percent of the causative gram-negative organisms, compared with 57 percent for tobramycin (p less than 0.05) . Aztreonam produced a favorable clinical response (cure or improvement) in 93 percent of patients, compared with 50 percent for tobramycin (p less than 0.05) . There were no differences in the minor adverse effects observed in the two treatment groups . Overall, aztreonam was superior to tobramycin for treatment of pneumonia due to susceptible gram-negative bacteria in these critical care patients.

Antimicrob Agents Chemother, 1985 Feb, 27(2), 246 - 51
Efficacy and safety of aztreonam-clindamycin versus tobramycin-clindamycin in the treatment of lower respiratory tract infections caused by aerobic gram-negative bacilli; Rodriguez JR et al.; A total of 80 patients were randomized to receive either aztreonam or tobramycin for the treatment of lower respiratory tract infections caused by gram-negative bacilli; all these patients received clindamycin concomitantly . A total of 53 patients were randomized to receive aztreonam-clindamycin; of these, 46 were clinically evaluable and 39 were bacteriologically evaluable . Of the 46 clinically evaluable patients, 41 were considered cured, 3 failed to be cured, and 2 died during the study period of unrelated causes . Of the 39 bacteriologically evaluable patients, 36 were considered cured, and 3 failed to be cured . There were 26 clinically evaluable patients in the group randomized to receive tobramycin-clindamycin . Of them, 22 patients were considered cured, 3 failed to be cured, and 1 died of unrelated causes during the study period . There were 18 bacteriologically evaluable patients in the tobramycin-clindamycin group; 17 were cured, and 1 failed to be cured . The most common pathogens isolated from the patients were Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa . All of the isolated organisms were susceptible to both tested antibiotics, except for a strain of Pseudomonas cepacia resistant to both tested antimicrobial agents and a strain of Enterobacter aerogenes and one of P . aeruginosa that were resistant to aztreonam . Very few adverse reactions related to the antibiotics were seen . These effects, when present, were transient and comparable in both studied groups, except for renal-function tests, which were altered in 7.7% of the patients randomized to receive tobramycin-clindamycin and in none of the patients randomized to receive aztreonam-clindamycin . Aztreonam-clindamycin is safe and effective for the treatment of lower respiratory tract infections caused by aerobic gram-negative bacilli when the organisms are susceptible.

Am J Med, 1985 Feb, 78(2), 251 - 61
Use of aztreonam in the treatment of serious infections due to multiresistant gram-negative organisms, including Pseudomonas aeruginosa; Scully BE et al.; Aztreonam is a novel antimicrobial agent belonging to the monobactam class of antibiotics . It inhibits both beta-lactamase-producing and non-beta-lactamase-producing aerobic gram-negative bacilli, but it has no activity against gram-positive species or against anaerobic species . The efficacy of aztreonam in the treatment of infection in 76 patients and its safety in 87 patients was evaluated . The majority (91 percent) of patients had significant underlying disease, and 47 percent were critically ill . Aztreonam produced an overall clinical response of 86 percent, with 10 of 11 cases of bacteremia cured, including four due to Pseudomonas aeruginosa, seven of eight cases of pneumonia, and seven of nine episodes of osteomyelitis . Infections due to bacteria resistant to ampicillin, carbenicillin, cefazolin, cefamandole, cefoxitin, and gentamicin were cured . Although 15 of 18 patients with exacerbations of pulmonary infection due to P . aeruginosa showed clinical improvement, bacteriologic cure was not achieved, as has been noted with other drugs . Similarly, patients with major underlying structural abnormalities of the urinary tract showed early relapses of bacteriuria . Aztreonam combined with antistaphylococcal, antistreptococcal, or antianaerobic agents provided an alternative to aminoglycoside use in these non-neutropenic patients . Administration of 1 or 2 g every eight hours yield serum bactericidal levels well in excess of 1:8 against all Enterobacteriaceae and some P . aeruginosa strains . There was a low incidence of adverse side effects, none serious . Overall, aztreonam is a useful alternative to the drugs available for use in hospital-acquired gram-negative infections and provides a chance for more directed therapy.

Zh Mikrobiol Epidemiol Immunobiol, 1985 Feb, (2), 54 - 7
{Effect of human immunoglobulins on mouse intestinal microflora in dysbacteriosis}; Glad'ko IA et al.; Human immunoglobulins, injected into mice subcutaneously after their irradiation or at the beginning of antibiotic therapy, protected the mucous membrane of the proximal section of the small intestine from the penetration of enterobacteria . The formation of the protective barrier was observed when immunoglobulin preparations with the titer of antibodies to Escherichia coli O14 between 1:16 and 1:256 was used . The preliminary exhaustion of immunoglobulin preparations with E . coli strain O14 led to the complete loss of their protective properties.

Chemioterapia, 1985 Feb, 4(1), 43 - 6
Epidemiological study of Enterobacter cloacae resistant to 3rd generation cephalosporins: a preliminary report; Giamarellou H et al.; In 1983 an increase in the resistance rate of cefotaxime against Enterobacter cloacae strains was observed in "Laikos General" hospital, that reached 59.3% in the 2nd half of the same year . All strains resistant to cefotaxime were found resistant to cefamandole, moxalactam and ceftriaxone while 61.8% were also resistant to amikacin . Urine represented the main source of isolation, particularly from the catheterized patient of the Renal Transplantation Unit in whom cefuroxime was mostly over used . Multiresistant strains were virulent since 5 patients died of septicemia . Mechanisms of resistance to cefotaxime are speculated upon because resistance work-up has not yet been completed . SHV, was exclusively isolated in the limited number of strains which have been studied up to now.

Chemioterapia, 1985 Feb, 4(1), 110 - 2
Occurrence of cefotaxime-resistant Enterobacter during therapy of cardiac surgery patients; Weinstein RA; During 1981-1984, nine patients were treated with second or third generation cephalosporins for deep post-operative wound, respiratory, and blood infections with Enterobacter . In at least 50-60% of cases, therapy failed due to emergence of broad-spectrum cephalosporin resistance . Laboratory testing of two strains that became resistant showed that they were more likely to develop high level resistant mutants, which had greater ability to bind cefotaxime . Although these surgery patients represent an extreme case, spread of their resistant strains to other patients in hospital could lead to wide-spread nosocomial resistance.

J Clin Microbiol, 1985 Feb, 21(2), 234 - 9
Leminorella, a new genus of Enterobacteriaceae: identification of Leminorella grimontii sp . nov . and Leminorella richardii sp . nov . found in clinical specimens; Hickman-Brenner FW et al.; Leminorella is proposed as a new genus for the group of Enterobacteriaceae formerly known as Enteric Group 57 . Strains of Leminorella gave positive tests for H2S production, acid production from L-arabinose and D-xylose, and tyrosine clearing; they were negative for indole production, Voges-Proskauer, urea hydrolysis, phenylalanine deaminase, motility, gelatin liquefaction, lysine and ornithine decarboxylases, arginine dihydrolase, growth in KCN, and acid production from adonitol, D-arabitol, cellobiose, erythritol, D-galactose, myo-inositol, lactose, maltose, D-mannitol, D-mannose, melibiose, alpha-CH3-glucoside, raffinose, L-rhamnose, salicin, D-sorbitol, sucrose, and trehalose . By DNA hybridization, strains of Leminorella were only 3 to 16% related to other Enterobacteriaceae and were divided into three groups . Leminorella grimontii is proposed as the type species for the genus and strain CDC 1944-81, ATCC 33999, is designated as the type strain . There were four strains of L . grimontii from stool specimens and two from urine specimens . L . richardii is proposed as the name for the second species (type strain, CDC 0978-82, ATCC 33998) . All four L . richardii strains were from stool specimens . L . grimontii can be distinguished from L . richardii because it produces gas from glucose (100%) and acid from dulcitol (83%) and is methyl red positive (100%) . One strain, CDC 3346-72, was more related to L . grimontii by DNA hybridization than to L . richardii, but the lower relatedness to both of these species indicated that it may be a third species . Biochemically it could not be distinguished from L . grimontii . All Leminorella strains were resistant (no zone of inhibition) to ampicillin, carbenicillin, and cephalothin . Some of the Leminorella strains were sent to us for Salmonella serotyping, and two reacted weakly in Salmonella antisera . The clinical significance of Leminorella is unknown.

J Antibiot (Tokyo), 1985 Feb, 38(2), 133 - 8
Chlorocardicin, a monocyclic beta-lactam from a Streptomyces sp . I . Discovery, production and biological activities; Nisbet LJ et al.; Chlorocardicin is a new monocyclic beta-lactam produced by a Streptomyces sp . It is structurally related to nocardicin A but differs in having a m-chloro substituent on the p-hydroxyphenylglycine unit . The biological activity of chlorocardicin was similar to nocardicin A but the former showed less antagonism in complex media . Moderate in vitro activity was observed against Enterobacteriaceae and Pseudomonas aeruginosa . Chlorocardicin showed low activity against Staphylococcus aureus whereas nocardicin A was inactive . Both compounds were shown to be strongly potentiated by antibiotics that inhibit peptidoglycan biosynthesis and were antagonized by selected L- and D-amino acids.

Biochimie, 1985 Feb, 67(2), 253 - 7
Genetic transformation of the phytopathogenic bacteria, Erwinia chrysanthemi; Reverchon S et al.; Erwinia chrysanthemi is an enterobacterium whose phytopathogenicity is due to its pectinolytic and cellulolytic activities . The CaCl2 mediated transformation procedure was successfully applied to two E . chrysanthemi wild type strains . The highest efficiency of transformation of E . chrysanthemi with pBR322 was found using 0.1 M CaCl2, 0.1 M MgCl2 treated cells and a heat pulse at 30 degrees C for 6 min . This yielded about 600 transformants per microgram of pBR322 DNA and 2.3 X 10(-6) per viable cell . Plasmid stability after twenty generations was lower than in E . coli: only 40-60% of the cells retained the plasmid in the absence of selective pressure . Based on this result, cloning in E . chrysanthemi with pBR322 vectors should therefore be possible, making it a potential host for cloning any gene for biomedical or industrial purposes.

Antimicrob Agents Chemother, 1985 Feb, 27(2), 207 - 16
Comparison of a new cephalosporin, BMY 28142, with other broad-spectrum beta-lactam antibiotics; Kessler RE et al.; BMY 28142, a new broad-spectrum semisynthetic cephalosporin, was evaluated in vitro and in vivo in comparison with ceftazidime, cefotaxime, moxalactam, and cefoperazone . The activity of BMY 28142 compared favorably with the activities of the other compounds against both Pseudomonas aeruginosa and Staphylococcus aureus and was somewhat greater against members of the family Enterobacteriaceae . The influence of inoculum size on MICs of BMY 28142 was small for most of the isolates tested, except Enterobacter species . With Enterobacter strains, a marked inoculum effect was found with all of the compounds, and the effect was more pronounced in broth than agar . Still, MICs of BMY 28142 in broth did not exceed 16 micrograms/ml . Of 37 Enterobacteriaceae strains resistant to one or more of the comparison beta-lactams, none were resistant, at a low inoculum size (10(4) CFU), to BMY 28142, compared with 3 for moxalactam, 18 for ceftazidime, 23 for cefotaxime, and 34 for cefoperazone; at an inoculum size of 10(6) CFU, the number of resistant strains was 12, 17, 25, 34, and 37, respectively . Binding to human serum proteins approximated 19% . Recovery of 73% of the drug in mouse urine indicated good bioavailability . The in vitro profile was sustained in vivo by the results obtained with experimental infections in mice . BMY 28142 was as effective as ceftazidime against systemic infection with P . aeruginosa and as effective as cefotaxime against systemic infection with S . aureus . Overall, infections with 18 of 20 strains representing nine genera were responsive to BMY 28142 at doses equivalent to or lower than those of the most effective of the comparison compounds.

Drugs, 1985 Feb, 29(2), 105 - 61
Ceftazidime . A review of its antibacterial activity, pharmacokinetic properties and therapeutic use; Richards DM et al.; Ceftazidime is a new 'third generation' cephalosporin administered intravenously or intramuscularly . Similarly to other third generation cephalosporins it has a broad spectrum of in vitro activity against Gram-positive and Gram-negative aerobic bacteria, is particularly active against Enterobacteriaceae (including beta-lactamase-positive strains) and is resistant to hydrolysis by most beta-lactamases . Importantly, in vitro ceftazidime is presently the most active cephalosporin available against Pseudomonas aeruginosa, but it is less active against Staphylococcus aureus than first and second generation cephalosporins . Only larger comparative trials are likely to discern any statistically significant differences in clinical efficacy which may exist between ceftazidime and other antibiotics, but ceftazidime appears to be similar in efficacy to 'standard' comparative drugs in lower respiratory tract infections and complicated and/or chronic urinary tract infections among debilitated or hospitalised patients . Thus, in patients having Gram-negative infections at these sites and in whom the potential toxicity of the aminoglycosides is a concern, ceftazidime may be a valuable alternative in that it apparently lacks serious side effects and does not require routine drug plasma concentration monitoring . In fibrocystic patients having acute respiratory tract infections, ceftazidime is highly effective at both reducing symptoms of infection and temporarily reducing the sputum counts of Pseudomonas species . However, in these patients resistance to ceftazidime may develop, as seen with other beta-lactam antibiotics . In the treatment of fever of unknown origin or documented infections in immunocompromised adults and children, ceftazidime appears to be similar in efficacy to various 2- or 3-drug combinations . Nevertheless, the coadministration of an antibiotic having greater efficacy against Gram-positive bacteria should be considered in immunocompromised patients . Results from a small number of comparative trials suggest that ceftazidime may be as effective as the aminoglycosides in intra-abdominal, obstetric and gynaecological, and skin and soft tissue infections . However, further clinical experience, particularly a few well designed comparative studies, is needed to clarify the comparative efficacy in these conditions as well as in septicaemia/bacteraemia, meningitis, and bone and joint infections.

J Med Microbiol, 1985 Feb, 19(1), 61 - 7
Contribution of the traT gene to serum resistance among clinical isolates of enterobacteriaceae; Kanukollu U et al.; Antimicrobial resistance plasmids containing the traT gene confer resistance to serum bactericidal activity upon some laboratory strains of Escherichia coli . We have examined the DNA of Enterobacteriaceae from human extraintestinal infections to determine the frequency of traT-like genes . DNA sequences homologous with traT were found among 58% of Escherichieae but among none of the Klebsielleae or Proteeae tested and were found as frequently among serum-sensitive E . coli as among serum-resistant strains . Sequences related to traT were always associated with large plasmids . The potential contribution of traT-containing plasmids to serum resistance of clinical isolates is discussed.

Chemioterapia, 1985 Feb, 4(1), 83 - 9
Ways to overcome cephalosporinase-mediated beta-lactam resistance in Enterobacter cloacae; Then RL et al.; Beta-lactam antibiotics which affect mainly PBP 3 and are poor substrates for the cephalosporinase of Enterobacter cloacae, but tightly bind to it, are not active against cephalosporinase-overproducing variants of this organism . Attempts have been made to greatly reduce the affinity for the beta-lactamase in order to prevent both binding and hydrolysis . 3-Quaternary ammonium cephalosporins and some cephalosporin (S)-sulfoxides were seen to fit this requirement . Suitable substitution of the monocyclic beta-lactam nucleus also resulted in compounds with lower affinity than aztreonam . Temocillin, differing from ticarcillin by the 6-methoxy group, also has a lower affinity for the cephalosporinase . All compounds discussed retain the highest affinity for PBP 3 and are active against cephalosporinase-overproducing E . cloacae in contrast to compounds with high affinity for the cephalosporinase.

Chemioterapia, 1985 Feb, 4(1), 78 - 82
In vitro selection of beta-lactam resistance by exposure to second, third, and fourth generation cephalosporins; Murray PR; The frequency in which in vitro resistance to beta-lactam antibiotics can be selected by prior exposure to a second, third, or fourth generation cephalosporin was examined . A total of 91 isolates of Enterobacteriaceae or Pseudomonas were tested against cefamandole, cefotaxime, moxalactam, cefoperazone, ceftazidime, ceftizoxime, ceftriaxone, or HR 810 . Resistance was most commonly observed in members of the genera Enterobacter, Serratia, and Pseudomonas . Resistance developed after exposure to all 8 test antibiotics and stable resistance was maintained in 31% of the originally selected isolates . Cross-resistance was frequently seen, although stable resistance to the fourth generation cephalosporin, HR 810, was not observed in any isolate.

Antimicrob Agents Chemother, 1985 Feb, 27(2), 265 - 9
In vitro studies of BMY-28142, a new broad-spectrum cephalosporin; Bodey GP et al.; BMY-28142 was compared with other broad-spectrum antibiotics against gram-positive cocci and gram-negative bacilli . BMY-28142 was highly active against all gram-negative bacilli and especially against Enterobacter cloacae, Serratia marcescens, and Morganella morganii . Its in vitro activity suggests that BMY-28142 should prove to be useful for the treatment of gram-negative bacillary infections.

Eur J Clin Microbiol, 1985 Feb, 4(1), 55 - 8
In vitro activity of enoxacin compared with norfloxacin and amikacin; van der Auwera P et al.; The in vitro activity of enoxacin was tested against 1000 clinical isolates of gram-positive and gram-negative microorganisms and compared with that of norfloxacin and amikacin . The MIC90 of enoxacin was 1 mg/l for Enterobacteriaceae, 2.6 mg/l for Pseudomonas aeruginosa and 6.2 mg/l or Staphylococcus aureus . The inoculum effect was minimal . The MICs and MBCs for Pseudomonas aeruginosa strains were significantly affected by the addition of calcium and magnesium ions . Synergy was occasionally observed between enoxacin and the antibiotics tested; antagonism was rare.

J Appl Bacteriol, 1985 Feb, 58(2), 123 - 9
The scope and limitations of four methods for the rapid identification of Enterobacteriaceae in foods; Villagarcia N; Four methods for the identification of Enterobacteriaceae in cooked frozen meat have been appraised . Although these methods could be modified to improve efficiency they could be clearly classified into two categories: (i) those that allow identification to genus level and which often cannot discriminate between two genera without the help of additional reactions; (ii) those that allow identification to species level and which only occasionally require additional reactions to differentiate one species from another . A different evaluation criterion was followed for each of these categories . In the first, as methods lead to final identification by means of data furnished by the manufacturer or via a number code which does not indicate probability, reactions were compared with those obtained by classical methods . In the second group, every number code admits three possibilities and indicates a probable biotype for each, thus reducing the risk of faulty interpretation on the part of the operator while also compensating for deficiencies of certain reactions . Evaluation was therefore based on the percentage of correctly identified cases per species . Efficiencies of the main biochemical reactions are also discussed.

J Med Microbiol, 1985 Feb, 19(1), 35 - 43
Fimbrial and non-fimbrial haemagglutinins in Enterobacter aerogenes; Adegbola RA et al.; Ten strains of Enterobacter aerogenes were examined for their ability to produce haemagglutinins and fimbriae . Nine strains formed a mannose-sensitive (MS) haemagglutinin associated with thin (4 nm) non-channelled fimbriae . These thin fimbriae of E . aerogenes were antigenically different from the thin fimbriae of other fimbriate strains of Enterobacter and Klebsiella and probably represent a new kind of fimbria not previously described in Enterobacteriaceae . Eight of these same nine strains also formed a non-fimbrial mannose-resistant, proteus-like (MR/P) haemagglutinin . The formation of thin fimbriae associated with MS haemagglutinin and of non-fimbrial MR/P haemagglutinin are properties not associated with other strains of Enterobacter and Klebsiella . E . aerogenes strain NCIB11460 was unusual among the strains examined in this series in that it alone produced mannose-resistant, Klebsiella-like (MR/K) haemagglutinin and type-3 fimbriae which, as judged by immunoelectronmicroscopy, were antigenically like those of type-3 fimbriate Klebsiella strains . The identifying characters of this exceptional strain of E . aerogenes are discussed in detail . All ten strains also produced thick fimbriae which by immunoelectronmicroscopy behaved like the type-1 fimbriae of Klebsiella strains . However, correlation between their presence and the production of MS haemagglutinin in E . aerogenes was not established . The findings are discussed in the light of the present difficult taxonomic status of E . aerogenes within the tribe Klebsielleae.

Dtsch Med Wochenschr, 1985 Jan 11, 110(2), 43 - 7
{Infections caused by intravascular catheters}; Staszewski S et al.; Microbiological investigations showed a positive culture in 430 out of 1540 venous catheters and shunts for dialysis . In 21 cases, a mixed culture with two different specific organisms was present . Of the total of 451 isolated organisms, 362 were gram-positive cocci and only 56 gram-negative bacillaceae . Staphylococcus epidermidis was by far the most frequent pathogen (n = 228), staphylococcus aureus in second place (n = 94) . Among the gram-negative organisms, germs of the Klebsiella-Enterobacter group and Pseudomonas aeruginosa dominated . Staphylococcus aureus represented 31% of all germs isolated from Scribner shunts and Brescia fistulas . On the other hand the causative organism could be isolated in only 18% of the infected venous catheters . Staphylococcus aureus was the most frequent pathogen in septicemia due to catheters; in 16 out of 24 patients this microorganism was found in both cultures drawn from the blood and from the catheter . In 16 cases, a venous catheter led to septicemia, a shunt for chronical dialysis in 2 cases only . The frequency of infections caused by catheters can be significantly lowered by prudent care of the site of insertion, sterile handling and short indwelling time.

Prostate, 1985, 6(4), 445 - 8
Chronic prostatitis: comments on infectious etiologies and antimicrobial treatment; Greenberg RN et al.; Twenty-three males with the clinical diagnosis of chronic prostatitis were evaluated for a bacterial etiology by the Stamey and Meares method . In addition, 16 patients, regardless of culture results, were placed on either cefadroxil or oral carbenicillin antimicrobial therapy . Culture results identified only four (17%) of 23 patients with bacterial prostatitis: coagulase-negative Staphylococcus (2), Enterobacter agglomerans (1), and Haemophilus parainfluenzae, and coagulase-negative Staphylococcus (1) . Four of seven patients who received oral carbenicillin and three of nine patients who received cefadroxil reported symptomatic relief . This study did not identify a common etiology for chronic prostatitis or a consistently effective antimicrobial treatment . Rather, we observed that the etiologic agent in most cases of chronic prostatitis (83%) could not be identified by routine bacteriologic culture . Future research efforts in chronic prostatitis must address not only treatment regimens but expand the search for etiologic agents.

Vox Sang, 1985, 49(4), 267 - 76
In vitro and in vivo activities of different immunoglobulin G preparations from the rabbit against Enterobacteriaceae; Trautmann M et al.; Specific rabbit IgG, prepared against three enterobacterial strains, was modified according to procedures used for the production of human IgG preparations suitable for intravenous infusion . The resulting products were examined for their in vitro opsonic and in vivo protective activity against the respective bacterial strains . A sulfonated IgG preparation (S-sIgG) and the enzymatically derived fragments F(ab')2 and Fab/Fc were opsonic in vitro and provided in vivo protection against lethal enterobacterial infection in mice . Protection by Fab fragments varied in the different in vivo models.

Infection, 1985, 13 Suppl 1, S68 - 72
Cefotaxime in the treatment of meningitis; Cherubin CE et al.; Information on 62 bacteriologically confirmed cases of bacterial meningitis treated with cefotaxime in this country was obtained retrospectively from infectious disease consultants . This series of cases differed markedly from the world cumulative case data so far presented . One of the two most common organisms treated was the pneumococcus (allergy to penicillin or misdiagnosis of the Gram stain were the major reasons given) . Unanticipated bacteriologic successes were noted in two cases of staphylococcal meningitis secondary to parameningeal foci . The bacteriologic cure rate and survival rate were about 85% . Failure of monotherapy was seen in one case of pseudomonas meningitis, as well as in three of five cases of enterobacter meningitis . In addition, two cases of Escherichia coli meningitis which had inexplicably failed on moxalactam were cured with cefotaxime . Thus, overall not all gram-negative species and not all isolates of any particular species which cause meningitis can be successfully treated by cephalosporins . Data obtained during the investigative trials do not appear to be entirely predicative of what occurred during the free clinical use of an antibiotic . There is a need for the post-investigatory follow-up and surveillance of all newly introduced therapeutic agents.

Chemotherapy, 1985, 31(5), 336 - 45
Cefotaxime aminoglycoside interactions; Pierce MA et al.; Minimum inhibitory concentrations and minimum bactericidal concentrations were determined for cefotaxime, gentamicin, tobramycin and amikacin and for the combination of cefotaxime and each of the aminoglycosides in vitro against 200 strains of Enterobacteriaceae . 91% were susceptible to cefotaxime, 93.5% were susceptible to gentamicin, 89.5% were susceptible to amikacin and 68% were susceptible to tobramycin . There were 95 strains which could be evaluated for synergistic killing by the antimicrobial combinations . Synergism was shown against 78% of strains by cefotaxime and amikacin, against 71% by cefotaxime and tobramycin and against 64% by cefotaxime and gentamicin . In 19 of 22 instances where a bacterial strain was resistant to both cefotaxime and the aminoglycoside, synergistic killing with clinically achievable levels of both antimicrobial agents was demonstrated . There was no significant decrease in concentration of any of the three aminoglycosides after incubation with cefotaxime at 37 degrees C for 0, 4 or 24 h.

Antonie Van Leeuwenhoek, 1985, 51(2), 203 - 18
Plasmid-determined cloacin DF13-susceptibility in Enterobacter cloacae and Klebsiella edwardsii; identification of the cloacin DF13/aerobactin outer membrane receptor proteins; Krone WJ et al.; Both Enterobacter cloacae H478 and Klebsiella edwardsii S15 were shown to harbour a relatively large conjugative plasmid that coded for cloacin DF13-susceptibility and the production and uptake of a hydroxamate iron chelator, most probably aerobactin . Protein-blotting experiments with antiserum raised against the purified cloacin DF13/aerobactin receptor protein from Escherichia coli (Co1V-K30) revealed that the corresponding outer membrane receptor proteins of Ent . cloacae H478 and K . edwardsii S15 had apparent mol wts of 85 000 and 76 000, respectively . E . coli transconjugants harbouring either the plasmid from Ent . cloacae H478 or K . edwardsii S15 expressed a cloacin DF13/aerobactin outer membrane receptor protein with a mol wt of 74 000 . The receptor protein encoded by the Ent . cloacae and K . edwardsii plasmids were immunologically more related to each other than to the pCo1V-K30-encoded receptor protein.

Trans R Soc Trop Med Hyg, 1985, 79(3), 322 - 7
Post-infective malabsorption in the temperate zone; Montgomery RD et al.; A series of 37 adults normally resident in Britain have been investigated for persistent bowel symptoms following acute enteritis . 26 had intestinal malabsorption, of whom 12 had been travelling in the Mediterranean area, whereas 10 developed their illness at home . Mild jejunal mucosal abnormalities were found in cases with and without malabsorption, and the intraepithelial lymphocyte count correlated more closely with the degree of malabsorption than did the histological grading . Over 80% of severe cases were folate deficient . Enterobacteria were cultured from the jejunal fluid in 30% of cases . Our observations confirm that post-infective malabsorption occurs sporadically in adults in the temperate zone and is occasionally severe . The condition involves small bowel contamination with enterobacteria, and it differs from acute tropical sprue only in its greater tendency to spontaneous recovery.

Drugs, 1985, 29 Suppl 5, 172 - 4
The treatment of complicated and uncomplicated urinary tract infections with temocillin; Kosmidis J; Temocillin was given to 33 patients with urinary tract infection as a once daily dosage regimen of 500mg intramuscularly or Ig intravenously for 7 to 10 days . The lower dose produced a clinical cure in 83% of patients with uncomplicated infection but was ineffective in complicated cases, whereas the higher dose cured 100% of uncomplicated and 70% of complicated cases and there were no side effects or toxicity . In vitro studies with 120 consecutive clinical isolates of Enterobacteriaceae gave an MIC90 of 8 mg/L for Escherichia coli, although some resistant strains were found in other species.

Vutr Boles, 1985, 24(3), 47 - 50
{Causative agents of urologic infections and their sensitivity to the most frequently used antibiotics and chemotherapeutic agents (data from the Clinic for the Therapy of Internal Diseases and Clinical Pharmacology for 1984)}; Belovezhdov N et al.; The causative agents of uroinfections were studied among the patients at the Clinic of therapy of internal diseases and clinical pharmacology during 1984 . Significant bacteriuria was established in 279 out of 485 patients, with 1475 urine inoculations performed, 14 with mixed flora . The highest is the share of E . coli--50,5 per cent, followed by Proteus--25,7 per cent . No essential change was established in the microbiological spectrum of the causative agents of uroinfections as compared with that from 1961-1970 . Good susceptibility was established to ampicillin but only of Enterococcus, to chloramphenicol of E . coli, Klebsiella, Enterobacter . The susceptibility of all microorganisms to gentamycin and nalidixic acid was very good . The susceptibility to doxycycline was poor . The treatment is recommended only after precise microbiological study.

What is Food Microbiology?, What Is Salmonella?, What Is Nitrification?, What Is Genome?, What Is Amino Acid?, s, Microorganisms, i, Bacterium, n, Bacteriology, r, Microbe, e, Microbiology, c, Salmonella, o, Biodegradation, c, Antibiotics, e, Fermentations, i, Microbial, e, Bacteria, c, Microorganisms, i, Bacteriophage, c, Bactericidal, c, Microbial, i, Pseudomonas aeruginosa, a, Escherichia coli, c, Denitrificans, n, Microbial, s, Salmonella, n, Microorganisms, a, Bacteriophage, c, Bacillus, e, Escherichia coli, e, Escherichia coli, i, Gram negative

Scientific Publications - Work Done by Microbiology Reader Bioscreen C
Agricultural Microbiology Anaerobic Microbiology Antimicrobial Susceptibility Artificial Atmosphere Bioassay of Antibiotics Biofilm Microbiology Bioreactor Technology Biotechnology Cell Biology Clinical Microbiology Environmental Microbiology Experiments with Yeast	Fermentation Food Microbiology Functional Genomics Gene Technology Growth Media Development Growth Rate and Lag Time Industrial Microbiology Medical/Pharmaceutical Field Microbiological Assay Microbiological Research Microbiology of Cosmetics go to a specific theme...	Military Microbiology Molecular Microbiology Mutagenicity and Genotoxicity Oral Microbiology Patents Postantibiotic Studies Soil Microbiology Spore Microbiology Veterinary Microbiology Waste/Wastewater Treatment Water Microbiology Wine Microbiology

� 2005 Transgalactic Ltd (manufacturer of Bioscreen C software) | Privacy Statement | P.O. Box 1393, 00101 Helsinki, Finland, phone: +358 9 85172920, fax: +358 9 8749481, e-mail: microbiology@bionewsonline.com

Last modified: May 25, 2005