Infection, 1980, 8 Suppl 3, S 234 - 8 {Can chloramphenicol be combined with beta-lactam antibiotics? (author's transl)}; Braveny I et al.; The effect was studied of combinations of chloramphenicol with beta-lactam antibiotics, such as penicillin, ampicillin, cefotiam and cefotaxime, on 20 strains each of Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis . No antagonism was observed using the checkerboard titration method . In most cases no interaction could be established . An evaluation by the fractional inhibitory concentration index was discussed: only values above 2 were interpreted as antagonism . The minimal bactericidal concentrations of chloramphenicol were identical with the minimal inhibitory concentrations (MIC) - i . e . the antibiotic acted bactericidally on the species tested . Further investigations on the killing kinetics have shown that chloramphenicol in low concentrations can cause a delay in the bactericidal action of the antibiotic with which it is combined in the first few hours . At higher concentrations (more than double the MIC) the killing kinetics approximate those of the individual antibiotics . It is improbable that the minor delays in killing are of clinical significance . The combination is almost as effective as chloramphenicol. J Clin Microbiol, 1980 Jan, 11(1), 52 - 8 Rapid differentiation of the major causative agents of bacterial meningitis by use of frequency-pulsed electron capture gas-liquid chromatography: analysis of amines; Brooks JB et al.; The major causative agents of bacterial meningitis (Haemophilus influenzae serogroup B, Neisseria meningitidis serogroups B and C, Klebsiella pneumoniae, Steptococcus pneumoniae, and two types of Escherichia coli) were cultured in a chemically defined medium, and selected strains were further studied in Todd-Hewitt medium . After acidic extraction of the spent media with chloroform, a basic extraction was made with chloroform to obtain amines . A third extraction was performed on re-acidified Todd-Hewitt medium with ethyl ether to obtain hydroxyacids . The extracts were derivatized with heptafluorobutyric anhydride-ethanol to form electron-capturing derivatives, and the derivatives were analyzed on a frequency-pulsed electron capture gas-liquid chromatograph (FPEC-GLC) equipped with a PEP-2 computer . The data obtained from the study showed that amines were produced by these organisms that formed characteristic patterns . Different serotypes of K . pneumoniae and the two serogroups of N . meningitidis produced different types of FPEC-GLC profiles within serotypes . E . coli produced several hydroxy acids on Todd-Hewitt medium that made it unique among the organisms studied . The methods used are practical and the techniques have potential for use in clinical laboratories and hospitals as a valuable aid for the rapid identification of the major causative agents of bacterial meningitis. J Clin Microbiol, 1980 Jan, 11(1), 45 - 51 Rapid differentiation of the major causative agents of bacterial meningitis by use of frequency-pulsed electron capture gas-liquid chromatograph: analysis of acids; Brooks JB et al.; The major causative agents of bacterial meningitis, Haemophilus influenzae serogroup B, Neisseria meningitidis serogroups B and C, Klebsiella pneumoniae, Streptococcus pneumoniae, and two types of Escherichia coli, were cultured in a modified chemically defined Catlin medium and in a commercial version of the unmodified Catlin medium . The spent media were extracted under acidic conditions, and electron-capturing derivatives were prepared by derivatization with trichloroethanol or haptafluorobutyric anhydride . The derivatives were analyzed on a gas chromatograph equipped with a frequency-pulsed electron capture detector and a PEP-2 computer . The data obtained from the study show that these organisms can be easily distinguished from each other on the basis of metabolic products detected in either type of medium . Three different metabolic groups were detected within two serogroups of N . meningitidis . The methods are practical, and the new technique should offer clinical laboratories and hospitals a better method for rapid identification of this important group of pathogens. Infection, 1980, 8(4), 162 - 4 {Concentrations of mezlocillin in cerebrospinal fluid in vira meningitis (author's transl)}; Hoffmann HG et al.; The concentrations of mezlocillin in the cerebrospinal fluid were measured in ten patients with viral meningitis after a single infusion of 5 g lasting 30 minutes . One to two hours after infusion the CSF concentrations were between 0.1 mcg/ml and 1.6 mcg/ml, and thus exceeded the minimal inhibitory concentrations of Neisseria meningitidis and Diplococcus pneumoniae, the most common pathogens in bacterial meningitis in adults . The minimal inhibitory concentration of ampicillin-sensitive strains of Haemophilus influenzae was also attained . Further investigations must be carried out, in order to ascertain whether higher CSF concentrations are attained in bacterial meningitis. Acta Microbiol Pol, 1980, 29(2), 97 - 108 Bacteriophage N3 of Haemophilus influenzae . IV . Intracellular events during infection by Haemophilus influenzae phage and transfection by its DNA; Jablonska E et al.; Intracellular events following infection of competent Haemophilus influenzae cells by N3 phage or transfection by DNA from phage were examined . After infection by whole phage three forms of intracellular phage DNA were observed by sedimentation velocity analysis . These forms are probably twisted circles, open circles and linear duplexes . In transfection only about 15% of the phage DNA is efficiently taken up by the competent cells . After entry of phage DNA into wild-type cells in transfection the DNA is degraded at early times, but later some of the fragments are reassembled, resulting in molecules that sediment faster than the monomer length of phage DNA . These presumably concatamer forms are generated by recombination . In strain rec-1 the fast-sedimenting molecules do not appear and degradation of phage DNA is even more pronounced than in the wild-type cells . Since rec-1 is transfected with much lower efficiency than the wild-type our hypothesis is that both fragmentation and generation of fast-sedimenting phage DNA by recombination are required for efficient transfection . These results also show that although phage N3 codes for its own recombination system it cannot operate in the early stages of transfection and succesful transfection is entirely dependent upon the host recombination system. Acta Microbiol Pol, 1980, 29(2), 89 - 96 Bacteriophage N3 of Haemophilus influenzae . III . Characterization of bacteriophage N3 DNA; Jablonska E et al.; DNA extracted from phage N3 grown in Haemophilus influenzae strain JC9 was examined by velocity and equilibrium centrifugation, electron microscopy and thermal melting curves . This double stranded DNA, molecular weight 26X10(6) daltons, has continuous single strands at 13X10(6) daltons as shown by alkaline sucrose gradient centrifugation . The duplex form readily aggregates in neutral salt solutions at even moderate ionic strength . Aggregation may be due to N3 DNA having "sticky" ends . CsCl equilibrium centrifugation measurements and thermal melting curves indicate a G+C content of 43 mol %. Am J Vet Res, 1980 Jan, 41(1), 97 - 100 Relationship between protective activity and antigen structure of Haemophilus paragallinarum serotypes 1 and 2; Kume K et al.; The object in this investigation was to determine the relationship between protective activity and antigenic structure of Haemophilus paragallinarum, serotypes 1 and 2 . A close relationship exists in both serotypes between protective activity and colonial phenotypic form (iridescent and noniridescent) . Protective activities of both serotypes were related to a heat-labile, trypsin-sensitive (L) antigen of iridescent form that produced serotype-specific agglutinin to chickens . The chickens having the agglutinins were protected against challenge exposure with homologous strain, but not with heterologous strain . The chickens injected with unencapsulated organisms of noniridescent form that were derived from encapsulated organisms of iridescent form failed to produce both serotype-specific agglutinins and protection against challenge exposure with homologous strain . Most of the chickens injected with serotype 1 strain produced both hemagglutination-inhibition antibody and serotype 1-specific agglutinin, whereas those injected with serotype 2 produced serotype 2-specific agglutinin and protected against homologous challenge exposure . The protective activity was found in saline extract derived from encapsulated organisms of serotype 1, but was absent in those of serotype 2. Int Arch Allergy Appl Immunol, 1980, 61(3), 352 - 7 Mast cells as a possible source of Haemophilus influenzae-induced changes in plasma and lung histamine levels; Raaijmakers JA et al.; Histidine decarboxylase activity and histamine levels of peritoneal mast cells were enhanced 4 days after intraperitoneal Haemophilus influenzae vaccination of rats . Incubation of the cells with propranolol (3.4 x 10(-4) M) resulted in histamine release and an increased histidine decarboxylase activity . Histidine decarboxylase activity and histamine release were more increased in the presence of propranolol in mast cells obtained from H . influenzae-vaccinated rats . An increased mediator release is also suggested by the increase of the number of peritoneal eosinophils . These data might explain the earlier observed enhanced plasma and lung histamine levels in H . influenzae-vaccinated rats. Zhonghua Min Guo Wei Sheng Wu Xue Za Zhi, 1979 Dec, 12(4), 140 - 8 Serotypes and biotypes and antibiotic susceptibility of Haemophilus influenzae encountered in a clinical laboratory in Taiwan; Tsai WC et al.; Forty-four serologically and biochemically typable Haemophilus influenzae isolates from clinical specimens in Taiwan were subjected to analysis in their relationship with source of isolation and age distribution . It was found that all isolates from blood and cerebrospinal fluid were serotype b, biotype I, and all were in children less than 4 years of age . Serotypes b and e, biotypes I and III were encountered to have the highest incidence of infection caused by H . influenzae in this area . All H . influenzae isolates were further tested for susceptibility to several selected antibiotics . All strains of this organism were susceptible to erythromycin and chloramphenicol . All but two strains were susceptible to tetracycline, whereas more strains were resistant to carbenicillin, gentamycin, keflin, and penicillin . Thirty-four percent strains were found to be resistant to ampicillin and all were beta-lactamase producer . No direct correlation between ampicillin resistance and serotypes or biotypes was recognized. J Infect Dis, 1979 Dec, 140(6), 1009 - 12 Absence of increasing incidence of meningitis caused by Haemophilus influenza type b; Santosham M et al.; An epidemiologic survey of meningitis caused by Haemophilus influenzae type b in children aged zero to four years during an 11-year period (January 1965-December 1975) was conducted in the Baltimore, Maryland, metropolitan area to examine recent trends in the incidence of this disease . Cases of H . influenzae meningitis were identified at all 19 hospitals in the city and county of Baltimore and all 41 hospitals in the surrounding area . The population at risk (age, zero to four years) was estimated using yearly birth rates provided by the state of Maryland and U.S . Census information for 1960 and 1970 . Yearly age-adjusted incidence was calculated; in contrast to previous studies, there was no significant increase in the annual incidence (range, 12-27; mean, 19.3/100,000 population at risk) . Previous reports of recent increases in the incidence of meningitis caused by H . influenzae type b may be due to differences in study techniques. Ann Rheum Dis, 1979 Dec, 38(6), 561 - 2 Haemophilus influenzae tenosynovitis; Bansal S et al.; A case is reported of polytenosynovitis in a 31-year-old male during the course of a severe bacteraemic illness caused by Haemophilus influenzae type b . The clinical presentation was similar to tenosynovitis caused by bacterial or viral agents . As the management of the H . influenzae tenosynovitis would differ from that due to other causes, the addition of H . influenzae type b to a differential of tenosynovitis should be considered . Recognition and prompt treatment by appropriate antibiotics may be important to avoid suppurative complications affecting the tendons . As the pathophysiology of the tenosynovitis is not clear, careful bacteriological and immunological assessment must be obtained. Acta Pathol Microbiol Scand {B}, 1979 Dec, 87(6), 345 - 51 Precipitating antibodies against Haemophilus influenzae and Staphylococcus aureus in sputum and serum from patients with cystic fibrosis; Schiotz PO et al.; Serum and sputum sol phase from 23 patients with cystic fibrosis (CF) were examined for occurrence and titres of precipitins against Haemophilus influenzae and Staphylococcus aureus by means of crossed immunoelectrophoresis with intermediate gel . The patients had from four to nine H . influenzae precipitins in serum and in most cases fewer precipitins in sputum, but, on an average, there was no difference between the titres of the antibodies in serum and sputum . Most of the antibodies were cross-reactive with other species, notably those of the Haemophilus genus . S . aureus precipitins were generally found in higher numbers in serum than in sputum, but, on an average, the titre of the precipitins in sputum was higher than in serum . Three of the precipitins were detectable only in sputum and not in serum, and one of these is a S . aureus-specific precipitin . Most of the antibodies were cross-reactive with other species, and these antibodies were often present in sputum in much higher titres than in the corresponding sera . Antibodies against teichoic acid of the S . aureus cell wall could not be demonstrated in sputum, while they were present in 22 sera . The possible role of the local pulmonary humoral immune response in protective immunity and in the pathology of the lung disease in CF is discussed. J Clin Microbiol, 1979 Dec, 10(6), 926 - 7 Meningitis due to Haemophilus influenzae type e biotype 4; Shishido H et al.; Haemophilus influenzae type e biotype 4 was isolated from the cerebrospinal fluid of a 16-month-old child with meningitis . This is the first isolation, from a case of meningitis, of this organism that has been biotyped. Am Rev Respir Dis, 1979 Dec, 120(6), 1382 - 5 Antimicrobial resistance of Haemophilus species in patients with chronic bronchitis; Kauffman CA et al.; Haemophilus influenzae strains resistant to ampicillin have become an important cause of disease in pediatric patients . Because many adults with chronic bronchitis carry Haemophilus organisms in their tracheobronchial tree and because antimicrobial agents are used commonly in these patients, we assessed the prevalence of resistance to ampicillin and other antimicrobial agents in this population . We studied 150 Haemophilus isolates (73 H . influenzae, 69 H . parainfluenzae, 6 H . parahemolyticus, and 2 H . hemolyticus) obtained from 138 patients with chronic bronchitis from January 1978 through March 1979 . Ampicillin resistance due to production of beta-lactamase was found in 7 of the 150 isolates (4.7 %)-2 H . influenzae, 4 H . parainfluenzae and 1 H . parahemolyticus . Resistance to tetracycline was found in 9 strains (6 %), but all strains were susceptible to chloramphenicol. P N G Med J, 1979 Dec, 22(4), 72 - 5 Childhood pneumonia at Goroka Hospital; Shann F et al.; We have reviewed the clinical presentation of pneumonia to the Goroka paediatric ward . In comparison to survivors, children dying from pneumonia more often (p less than 0.05) had malnutrition (weight-for-age under 80%), anaemia (haemoglobin under 9g%), and a marked leucocytosis (total white cell count over 30,000 cells per c.m.m.) . Children dying from pneumonia had been ill for longer and had been given more antibiotics prior to admission . There was no significant difference between children dying from pneumonia and survivors in age distribution, pulse rate, incidence of cardiac failure or duration of stay in hospital . 70% of the children dying from pneumonia at Goroka Hospital are infants under 12 months of age . Pneumococcal vaccine gives a poor antibody response in infants, and overseas studies using lung aspiration suggest that Haemophilus influenzae and Staphylococcus aureus might be causative organisms as well as Streptococcus pneumoniae . A study to determine the aetiology of pneumonia in Highlands children is required to enable a rational choice of routine antibiotic therapy and to plan further research on vaccination against pneumonia. Infect Immun, 1979 Dec, 26(3), 827 - 31 Comparison of two antigen detection techniques in a primate model of Haemophilus influenzae type b infection; Scheifele DW et al.; Rapid diagnosis of Haemophilus influenzae type b meningitis is possible using immunological tests for capsular antigen (polyribophosphate, PRP), such as countercurrent immunoelectrophoresis (CIE) and latex particle agglutination (LPA) . We compared two tests in monkeys with evolving, serially quantitated H . influenzae type b bacteremia (n = 23) and meningitis (n = 21) . In vitro, the LPA test was sensitive to 0.5 ng of PRP/ml of saline, and the CIE test was sensitive to 1.0 ng/ml; in serum, however, CIE detected 5.0 ng of PRP/ml, whereas the sensitivity of LPA was unchanged . LPA detected PRP earlier in the course of bacteremia (mean, 12 h after onset; range, 4 to 36 h) than did CIE (mean, 45 h; range, 4 to 168 h) (P less than 0.01) . A positive LPA test required greater than or equal to 100 bacteria per ml of blood, whereas CIE required greater than or equal to 1,000/ml . PRP accumulated with continuing blood stream infection, aiding detection of low-grade bacteremia . LPA detected antigen in cerebrospinal fluid (CSF) earlier in the course of meningitis and at a lower bacteria density than did CIE . Both methods detected antigen reliably with greater than or equal to 1,000 bacteria per ml of CSF . A close correlation existed between CSF concentrations of capsular antigen and bacteria (r = 0.90, P less than 0.001) . We conclude that the LPA method permits earlier diagnosis of H . influenzae type b infection in part because of its greater sensitivity. Acta Pathol Microbiol Scand {B}, 1979 Dec, 87(6), 337 - 44 Cross-reactions between Haemophilus influenzae and nineteen other bacterial species; Schiotz PO et al.; Forty-one different antigens were demonstrated in an antigen preparation obtained by sonication of a Haemophilus influenzae (H . influenzae) type b strain, using crossed immunoelectrophoresis and antiserum obtained from rabbits . Antigens were characterized by absorption experiments with whole heat-killed bacteria, temperature resistance and protein and polysaccharide staining . Cross-reactions between H . influenzae type b and 19 other bacterial species were studied by various quantitative immunoelectrophoretic methods, using the reference system . A non-capsulated H . influenzae cross-reacted extensively (41 antigens) with H . influenzae type b and Haemophilus parainfluenzae, and Haemophilus haemolyticus showed considerable cross-reactivity with H . influenzae type b (26 and 32 antigens respectively), while antigens from eight other bacterial species cross-reacted to varying degrees with one to five H . influenzae antigens. Nature, 1979 Nov 8, 282(5735), 215 - 7 Competence for genetic transformation in pneumococcus depends on synthesis of a small set of proteins; Morrison DA et al.; In bacterial genetic transformation the uptake of DNA and its integration into the resident chromosome is dependent on a special cellular state, termed competence . In those species where appearance of competence has been studied, specific (but often poorly defined) growth conditions lead to a simultaneous development of competence in a substantial fraction of the cells in a culture . In Bacillus subtilis, and in Haemophilus species, competence appears in the stationary phase of growth or in certain other growth-limiting conditions . Streptococcus pneumoniae (pneumococcus) is perhaps unusual in that virtually all cells of a culture become competent, for a short period at a specific cell density during logarithmic growth, without perturbing the growth rate . The synchronous appearance of competence in pneumococcal cultures results from an autocatalytic effect of a small protein released by the cells that induces competence . The response to competence factor has been shown to require protein synthesis . We report here additional information on the nature of competence in pneumococcus: pulse-labelling studies show that for the brief period of competence protein synthesis is restricted to a few specific polypeptides. Antimicrob Agents Chemother, 1979 Nov, 16(5), 584 - 8 Pharmacokinetics of cefamandole and ampicillin in experimental meningitis; Beaty HN et al.; The penetration of cefamandole and ampicillin into the cerebrospinal fluid of rabbits with and without pneumococcal meningitis was evaluated . In normal animals, a mean maximum concentration of 0.22 +/- 0.13 microgram of cefamandole per ml was measured in the spinal fluid after a dose of 150 mg/kg given intramuscularly; with 25 and 50 mg/kg doses, no antibiotic was detected in the cerebrospinal fluid . With ampicillin, in intramuscular doses of 200 and 300 mg/kg, the mean maximum concentrations encountered in the cerebrospinal fluid were 1.59 +/- 0.4 and 1.47 +/- 0.44 microgram/ml, respectively . Penetration of cefamandole, and to a lesser extent ampicillin, was increased after 24 h of experimental meningitis . With cefamandole, the concentration of drug in the cerebrospinal fluid exceeded the usual inhibitory concentration for Haemophilus influenzae only with the 150 mg/kg dose . After 48 h of meningitis, there was a trend toward higher levels of antibiotic in the cerebrospinal fluid, but the difference between animals infected 24 versus 48 h was not statistically significant . In animals with meningitis, serum concentrations after 150 mg of cefamandole per kg and both ampicillin doses studied were 32 to 38% lower than the serum levels achieved in normal rabbits after identical doses of antibiotic. Am J Vet Res, 1979 Nov, 40(11), 1564 - 7 Evaluation of different antigens in the complement-fixation test for diagnosis of Haemophilus pleuropneumoniae (parahaemolyticus) infections in swine; Gunnarsson A; The identification of new serotypes of Haemophilus pleuropneumoniae (parahaemolyticus) and the frequency of pleural adhesions due to contagious pleuropneumonia in many fattening swine herds have prompted the study of the complement-fixation (CF) test as a diagnostic tool for use in swine . Whole cell antigens, mixed antigens, autoclaved antigens, and phenol-water-extracted antigens derived from different serotypes were prepared and tested with immunized-swine sera by the CF test . Mixed antigen consisting of whole cells from all known serotypes was the best screening antigen for routine use . This antigen gave positive titers with all sera in which a positive reaction against the separate serotype antigen was registered . The most highly serotype-specific reactions were obtained with antigens prepared by phenol-water extractions of whole cells . When whole-cell antigens were used in the CF test, antibodies to superficial serotype-specific and common species-specific antigens could be detected. Jpn J Antibiot, 1979 Nov, 32(11), 1165 - 77 {Study of cefuroxime in pediatric field (author's transl)}; Iwai N et al.; 1 . Cefuroxime (CXM) was studied for absorption and excretion in 4 pediatric patients given one shot intravenous injection of 20 approximately 25 mg/kg . The following serum levels were determined: 24.5 approximately 38.0 micrograms/ml at 30 minutes (mean 33.3 +/- 6.1 micrograms/ml), 10.0 approximately 17.0 micrograms/ml at 1 hours (mean 13.9 +/- 3.3 micrograms/ml), 3.4 approximately 7.6 micrograms/ml at 2 hours (mean 5.2 +/- 1.9 micrograms/ml, 0.7 approximately 2.1 micrograms/ml at 4 hours (mean 1.3 +/- 0.6 micrograms/ml, 0.1 approximately 0.3 microgram/ml at 6 hours (mean 0.2 +/- 0.1 microgram microgram/ml) . Half-life (T 1/2) was 0.65 approximately 0.88 hour (mean 0.75 +/- 0.10 hour) . Urinary levels were 1,280 approximately 7,100 micrograms/ml at 0 approximately 2 hours, 96 approximately 3,400 micrograms/ml at 2 approximately 4 hours, 68 approximately 250 micrograms/ml at 4 approximately 6 hours . Urinary recovery rate at 0 approximately 6 hours was 54.1 approximately 74.4% (mean 61.8 +/- 9.4%) . 2 . From the study on spinal fluid concentration in pediatric patients with Haemophilus influenzae-induced meningitis, the dose of CXM 52.2 mg/kg was given to 1 pediatric case with this disease by one shot intravenous injection . Spinal fluid levels were presumed as 9.0 micrograms/ml at 30 minutes, 6.8 micrograms/ml at 1 hour, 3.8 micrograms/ml at 2 hours and 1.2 micrograms/ml at 4 hours . 3 . CXM was studied in 19 pediatric patients with bacterial infection for clinical efficacy, bacteriological effect and side effect . Clinical result was found good in 1 with purulent meningitis; excellent in 9 out of 15 with acute lobar pneumonia or acute bronchopneumonia, and good in remaining 6 cases; good in 2 with acute bronchitis; excellent in 1 with acute pyelonephritis . This represents efficacy ("excellent" plus "good") rate of 100% . Of 5 strains of H . influenzae presumed as causative organisms, 4 were disappeared and 1 was reduced . Two strains of Streptococcus pneumoniae and 1 strain of Escherichia coli were disappeared . No side effect was noted in terms of clinical symptom . Laboratory examination showed elevation of GOT and GPT in 1 case, but these elevated values returned to normal after the end of the CXM treatment. Pediatrics, 1979 Nov, 64(5), 627 - 31 Comparative pharmacokinetics of amoxicillin and ampicillin in infants and children; Ginsburg CM et al.; The pharmacokinetics of amoxicillin and ampicillin were studied in 24 infants and children . Mean peak serum concentrations of 5.4 micrograms/ml in fasting and 3.2 micrograms/ml in nonfasting patients were observed after 15 mg/kg amoxicillin doses . Area under the curve values and serum half-life values were similar in fasting and nonfasting patients . The pharmacokinetics of amoxicillin (15 mg/kg) were compared to those of ampicillin (25 mg/kg) . Peak serum concentrations, area under the curve values and half-life times were comparable for the two drugs . Amoxicillin (25 mg/kg) and ampicillin (25 mg/kg) were compared in cross-over fashion in 11 children . Serum concentrations of amoxicillin were consistently larger than those of ampicillin; the differences were of borderline significance at one and two hours and statistically significant at four and six hours after the dosage . The bioavailability of amoxicillin was twice that of ampicillin . Amoxicillin was detected in approximately half of the saliva samples studied . Although the salivary concentrations in many children exceeded the inhibitory level for most pneumococci and group A streptococci and for many non-beta lactamase-producing Haemophilus influenzae type b strains, the clinical relevance of these observations is unknown. Jpn J Antibiot, 1979 Nov, 32(11), 1132 - 6 {Clinical results of cefuroxime (CXM) therapy in pediatric infections (author's transl)}; Nakamura Y et al.; Cefuroxime, a new cephalosporin C antibiotic, was administered to 15 children with respiratory tract infection, urinary tract infection, or subcutaneous tumour . The following results were obtained . 1) CXM 30 approximately 100 mg/kg/day were used in treatment of respiratory tract infection . Eight of the eleven patients treated responded to the therapy . 2) CXM 45 approximately 75 mg/kg/day were given to 3 patients with urinary tract infection . Excellent results were obtained in all these cases . 3) One patient with subcutaneous tumour responded to CXM therapy . 4) Clinical isolates from the foci involved, i.e., Staphylococcus aureus (4 strains), Group A Streptococcus hemolyticus (1 strain), Streptococcus pneumoniae (1 strain), Haemophilus influenzae (1 strain), and Escherichia coli (3 strains) were all eliminated by CXM therapy except 2 unassessable strains . 5) No noteworthy side effect was noted. Infect Immun, 1979 Nov, 26(2), 415 - 21 Chemical composition and biological activities of a phenol-water extract from Haemophilus influenzae type a; Raichvarg D et al.; Ribonucleic acid was removed from a phenol-water extract of Haemophilus influenzae type a by streptomycin sulfate . This preparation was called purified preparation or PP . It contained neutral sugars (glucose, galactose, mannose, pentose), glucosamine, amino acids, and fatty acids . Heptose and 2-keto-3-deoxyoctonic acid were not present . The biological properties and immunogenicity were compared with the activities of lipopolysaccharide of Escherichia coli or Salmonella typhimurium . Higher doses were necessary to obtain lethality in mice and Sanarelli and Shwartzman reactions with our preparations than were necessary with lipopolysaccharide . The Limulus test and pyrogen assay in rabbits gave the same results with purified preparation and lipopolysaccharide, but pyrogenicity of purified preparation was not destroyed by NaOH treatment . Purified preparation was not as immunogenic at low doeses for rabbits as lipopolysaccharide . The results were different from those obtained with lipopolysaccharide but similar to those known from peptidoglycan studies . The contamination of purified preparation with peptidoglycan was negligible and cannot explain the biological activities of purified preparation . We suggest that the phenol-water extract from H . influenzae is not a classical endotoxin, but rather an endotoxin-like substance. Carbohydr Res, 1979 Nov, 76, 197 - 202 Structural studies of the capsular antigen of Haemophilus influenzae type c; Branefors-Helander P et al.; The structure of the capsular antigen from Haemophilus influenzae type c has been investigated, n.m.r . spectroscopy being the principal method used . It is concluded that the antigen is composed of repeating-units having the following structure: formula: (see text) . O-Acetyl groups are present in approximately 90% of the repeating-units. Clin Nucl Med, 1979 Nov, 4(11), 455 - 60 Scintigraphic findings of uncommon focal manifestations of Haemophilus influenzae septicemia; Sty JR et al.; Haemophilus influenzae septicemia is usually associated with a clinical focus of infection . The investigators describe early scintigraphic findings in some uncommon manifestations of H . influenzae septicemia. J Pediatr, 1979 Nov, 95(5 Pt 1), 690 - 5 Unsuspected bacteremia due to Haemophilus influenzae: outcome in children not initially admitted to hospital; Marshall R et al.; Children not initially admitted to the hospital accounted for 42 of 94 episodes of bacteremia due to Haemophilus influenzae . Antibiotics were prescribed for 22 of the 42 children who were initially sent home; at second visit, 17 were improved, including all 13 with pneumonia . No antibiotics were prescribed for 20 children; at second visit, 15 had persistent fever or new focal infection and five had resolution of symptoms . New diagnoses of focal infection were made at second visit in three of the 22 treated and in 11 of the 20 untreated children, including three who had a new diagnosis of meningitis (one treated with antibiotics initially; two not treated) . Cultures of blood positive for H . influenzae were obtained at second visit in ten children who were not treated initially; no child who was treated initially had a second positive culture . These findings indicate that although young children with bacteremia due to H . influenzae may be mildly ill at first visit, many are at risk for development of serious focal infection, including meningitis. Pathol Biol (Paris), 1979 Nov, 27(9), 543 - 8 {Epidemiologic features of pneumococcal meningitis in Africa . Clinical and serotypical aspects (author's transl)}; Mar ID et al.; Pneumococcal meningitis, because of their frequency and their severity, are regarded as an important problem of Public Health in Africa . In a great number of African countries, particularly Equatorial and Central Africa, the pneumococcus is the first agent of bacterial meningitis . The annual prevalence is estimated as about 14/100 000 persons . The case fatality rate (on 1 600 cases) is 49,5% ; the annual mortality reaches about 7/100 000 (28 000 annual deaths in Africa) . The babies and the old persons are more exposed to the risk, with an annual prevalence of 28,5/100 000 before five years old, and of 16,1/100 000 after sixty years old . The risk is small between five and forty five years old . The risk is very high in patients homozygous for sickle-cell disease . The spread of all detected serotypes, by descending frequency is : 1, 5, 6, 3, 23, 12, 2, 14, 9, 18, 19, 4, 8, 29, 40, others (Danish system of nomenclature) . The distribution according to age is indicated by the authors . A vaccine with only 8 serotypes (1, 5, 6, 3, 23, 12, 2, 14) could cover 80% of serotypes in Dakar . For the babies, addition to pneumococcal vaccine with polyribose phosphate of Haemophilus influenzae b, could be useful, because high prevalence of meningitis with this germ before five years old in Africa. Antimicrob Agents Chemother, 1979 Nov, 16(5), 635 - 7 Ineffectiveness of erythromycin for treatment of Haemophilus vaginalis-associated vaginitis: possible relationship to acidity of vaginal secretions; Durfee MA et al.; To assess the efficacy of oral erythromycin in the treatment of nonspecific vaginitis (NSV), conducted a nonrandom, unblinded pilot study among 17 women with symptoms and signs of NSV . At the completion of treatment, 10 of 13 patients had persistent symptoms, 9 of 13 had persistent abnormal discharge, and 11 of 13 had persistently positive cultures for Haemophilus vaginalis . Ten patients with persistent or relapsing NSV and four who did not complete erythromycin treatment were retreated with oral metronidazole, and 14 of 14 showed clinical improvement and eradication of H . vaginalis . The susceptibility of 27 clinical isolates of H . vaginalis to erythromycin was determined at pH 5.5, 6.0, 6.5, and 7.0 . The minimal inhibitory concentration of erythromycin for H . vaginalis was approximately 10-fold higher at pH 5.5 than at pH 7.0 . Erythromycin is not effective for the treatment of H . vaginalis-associated NSV; this may be partly attributable to the reduced activity of this drug in acidic vaginal secretions. Blood, 1979 Nov, 54(5), 1171 - 5 Use and efficacy of pneumococcal vaccine in patients with Hodgkin disease; Levine AM et al.; Fulminant bacterial sepsis has been described in patients with Hodgkin disease who have undergone splenectomy for staging purposes . The organisms commonly associated with sepsis in this setting include Streptococcus pneumoniae and Haemophilus influenzae . Polyvalent pneumococcal vaccine (Merck) has recently been licensed and has been suggested for use in patients with Hodgkin disease who are at risk for postsplenectomy sepsis . We administered 14-valent pneumococcal vaccine to 24 patients with Hodgkin disease and 24 normal controls, and measured antibody response to 13 antigens at time of immunization and at 3 wk and 3 mo following immunization . Our results indicate that patients who have been previously treated for Hodgkin disease, with chemotherapy, radiotherapy, or both, have severe impairment of antibody response . Untreated patients, however, respond in a manner similar to normal controls. Nord Vet Med, 1979 Oct, 31(10), 401 - 6 Haemophilus parahaemolyticus serotypes . Serological response; Nielsen R; Serotypes 1,2,4 and 5 of Haemophilus parahaemolyticus were inoculated into, respectively, 4,4,2 and 5 pigs . Serum samples were tested for circulating antibodies by the modified complement fixation test (CF test) . When individual serotypes were used as antigen, titers were found only to the serotype which had been used for inoculation . Using antigen in which the serotypes were pooled, antibodies were demonstrated in sera from all the pigs . The CF titers obtained with the pooled antigen were equivalent to those found with each serotype separately . When the CF test was used for serological examination of field sera there was full agreement between the results obtained with the pooled antigen and those obtained with serotype 2 antigen alone . No cross reactions were found with the pooled antigen in herds that were sero-positive to Haemophilus parasuis, strain 4800 . The experiment has shown that there is no serological cross reaction between serotypes 1, 2, 4 and 5 when they are used as antigen in the CF test . Also, the results imply that with a pool of the different serotypes of Haemophilus paralyticus as antigen similar results may be obtained as with the single serotype 2 antigen. J Infect Dis, 1979 Oct, 140(4), 453 - 64 Diagnosis of bacterial meningitis by gas-liquid chromatography . II . Analysis of spinal fluid; LaForce FM et al.; The feasibility of gas-liquid chromatographic analysis of spinal fluid from dogs with experimental meningitis and from patients with meningitis was evaluated . Normal canine and human spinal fluid contained consistent levels of palmitic and stearic acids, glucose, and trace amounts of glycerol . Pneumococcal meningitis in dogs and humans was characterized by a complex fatty-acid pattern in spinal fluid similar to that seen in pneumococcal cells . Spinal fluid from dogs with Haemophilus influenzae meningitis yielded several saturated fatty acids as well as rhamnose, xylose, and glucosamine; four of five spinal fluid specimens from patients with H . influenzae meningitis gave similar results . Fatty-acid profiles of spinal fluid from dogs with staphylococcal meningitis were complex, with branched-chain and straight-chain fatty acids . Spinal fluid specimens from Neisseria meningitidis-infected dogs yielded 16- and 18-carbon fatty acids and sialic acid . Gas-liquid chromatographic analysis of spinal fluid proved valuable as a tool for identifying bacterial infections and differentiating between common spinal fluid pathogens. Arch Dis Child, 1979 Oct, 54(10), 792 - 3 Lumbar punctures, meningitis, and persisting pleocytosis; Connolly KD; A retrospective survey of children with haemophilus and pneumococcal meningitis was carried out to assess the significance of persistent CSF pleocytosis and the need for repeat lumbar punctures after adequate treatment . Persistent pleocytosis was noted in 9 of 27 patients with haemophilus meningitis; this tended to be present in those with higher initial CSF white blood counts and lower initial CSF glucose contents . No sequelae were noted in those with persistent pleocytosis . Repeat lumbar punctures were not of clinical benefit and tended to result in longer treatment which was not warranted. Nord Vet Med, 1979 Oct, 31(10), 407 - 13 Haemophilus parahaemolyticus serotypes . Pathogenicity and cross immunity; Nielsen R; Pigs inoculated intranasally with Haemophilus parahaemolyticus, serotype 2, resisted challenge 3 weeks later with serotypes 2, 4 and 5 without showing clinical symptoms . The pigs were sacrificed 2 days after challenge, and post mortem examination showed a chronic pleuropneumonia from which only serotype 2 was re-isolated . Pigs inoculated intranasally with H . parahaemolyticus, serotype 2, showed no clinical symptoms when challenged 3 weeks later with serotype 1 . Post mortem examination revealed a chronic pleuropneumonia with areas of necrosis from which H . parahaemolyticus, serotype 2, was re-isolated, but also small areas of a more acute fibrinous pneumonia from which serotype 1 was re-isolated . The control pig inoculated with only serotype 1 showed a severe acute fibrinous pleuropneumonia . The results indicate that a considerable cross immunity exists between the various serotypes of H . parahaemolyticus. J Infect Dis, 1979 Oct, 140(4), 471 - 8 Meningitis caused by Haemophilus influenzae in infant rats: protective immunity and antibody priming by gastrointestinal colonization with Escherichia coli; Moxon ER et al.; Infant rats aged five to seven days were fed Escherichia coli O75:K100:H5, E . coli O13:K92:H4, or saline and five weeks later were inoculated with Haemophilus influenzae type b . The incidence of bacteremia and meningitis was significantly less (P less than 0.05) for rats fed E . coli that possessed K100 capsular antigen (cross-reactive with type b capsular antigen) than for rats fed E . coli K92 or saline . Antibody to capsular antigen was not detectable in sera obtained from rats prior to challenge with H . influenzae type b, but five days after challenge, antibody levels were significantly higher (P less than 0.001) in rats colonized with E . coli K100 than in controls . These results, together with data from passive-immunization studies, suggested that the protection against infection with H . influenzae type b was due to priming or serum anticapsular antibody, although a protective role for cell-mediated immunity and/or secretory antibody could not be ruled out . E . coli K100 primed rats vaccinated with purified H . influenzae type b antigen for a significantly increased, although transient, anticapsular antibody response. J Infect Dis, 1979 Oct, 140(4), 443 - 52 Diagnosis of bacterial meningitis by gas-liquid chromatography . I . Chemotyping studies of Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus, and Escherichia coli; Brice JL et al.; With the use of gas-liquid chromatographic techniques, the chemical characteristics of Streptococcus pneumoniae type 3, Escherichia coli, group B Neisseria meningitidis, Haemophilus influenzae type b, and Staphylococcus aureus, organisms that commonly cause bacterial meningitis, were identified . The combination of lipid, carbohydrate, and lipopolysaccharide components provided discriminating markers for chemotyping these bacteria . E . coli had a high content of 17- and 19-carbon cyclopropane fatty acids, whereas none of the other organisms tested revealed any cyclic acids, apart from a possible trace amount in S . pneumoniae . The content of isomethyl branching fatty acids clearly distinguished S . pneumoniae and S . aureus . N . meningitidis and H . influenzae were somewhat similar in their overall fatty acid compositions, but the presence of galactose without rhamnose in extracts of N . meningitidis readily distinguished N . meningitidis from H . influenzae . Only extracts from E . coli contained mannose; erythrose was an exclusive marker in extracts of S . pneumoniae . These data suggest that these differences in chemotype might be useful in developing a gas-liquid chromatographic assay of spinal fluid for the rapid laboratory diagnosis of bacterial meningitis. Antimicrob Agents Chemother, 1979 Oct, 16(4), 510 - 3 Effect of inoculum size on the susceptibility of Haemophilus influenzae b to beta-lactam antibiotics; Syriopoulou VP et al.; The current prevalence of ampicillin-resistant Haemophilus influenzae b meningitis requires accurate knowledge of susceptibility to alternative antibiotics . One variable affecting susceptibility is inoculum size . We studied the susceptibility of 200 clinical isolates of H . influenzae b to ampicillin, carbenicillin, and cefamandole at inocula of 10(5) and 10(7) CFU by two techniques . Fifty ampicillin-susceptible and fifty ampicillin-resistant strains were tested for susceptibility to ampicillin by broth dilution while 100 of each were tested by agar dilution . An inoculum effect was found, being greatest with the ampicillin-resistant strains . The range of minimal inhibitory concentrations for the resistant strains was 25 to 800 microgram of ampicillin per ml at an inoculum of 10(5) and 2,000 to less than 6,000 microgram of ampicillin at 10(7); 1.0 to 150 microgram of carbenicillin per ml at 10(5) and 6.2 to 2,000 microgram of carbenicillin per ml at 10(7); 0.4 to 2.0 microgram of cefamandole at 10(5) and 1.0 to 125 microgram/ml at 10(7) . Because of this inoculum effect, we would not recommend the use of carbenicillin or cefamandole for therapy of ampicillin-resistant H . influenzae meningitis. J Clin Microbiol, 1979 Oct, 10(4), 404 - 8 Serological grouping of meningococci and encapsulated Haemophilus influenzae strains by latex agglutination; Leinonen M et al.; The latex agglutination method, utilizing antibody-coated latex particles, was adapted for serogrouping of Neisseria meningitidis and serotyping of encapsulated Haemophilus influenzae strains from agar plates . It was found to give more clear-cut results than conventional slide agglutination . A 100% agreement with the antiserum agar method was found for all strains isolated from blood or cerebrospinal fluid . Many meningococcal strains from nasopharyngeal carriers are autoagglutinable, but some of these gave a positive reaction with the group B latex reagent, although they were negative by the antiserum agar method . The latex agglutination method has several advantages over others: the lack of autoagglutination, easy performance, easy interpretation, and very low consumption of antisera. J Clin Pathol, 1979 Oct, 32(10), 1058 - 60 Significance of the detection of beta-galactosidase and of beta-xylosidase in the taxonomic study of the genus Haemophilus; Hansen W et al.; A total of 314 strains of Haemophilus, isolated from clinical samples, were studied for the production of beta-galactosidase and beta-xylosidase . None of the H . influenzae strains studied (9 beta-lactamase positive strains and 129 beta-lactamase negative strains) possessed these enzymes . Both enzymes were almost constantly observed among strains of H . paraphrophilus (10 strains studied) and of H . paraphrohaemolyticus (9 strains studied) . Among the other species (H . parainfluenzae, 55 strains; H . haemolyticus, 5 strains; H . parahaemolyticus, 97 strains), beta-galactosidase was present in about 30% of the strains studied whereas beta-xylosidase was detected occasionally (3% of the strains studied) . Detection of these two enzymes could be a valuable test for the taxonomic study of the genus Haemophilus . However, the type of substrate used for the detection of beta-xylosidase is important: use of the para-nitro-phenyl-beta-xylopyranoside yielded more positive results than the use of its ortho-isomer. Br J Dis Chest, 1979 Oct, 73(4), 373 - 81 In vivo and in vitro reactions to antigens of Haemophilus influenzae in bronchial obstruction; Clarke CW; The frequency of precipitating antibody to heat-labile (H(1--2) and heat-stable (HCW and HCF) antigens of Haemophilus influenzae was determined in patients with asthma, chronic bronchitis, cystic fibrosis and bronchiectasis and compared with that in a control group . This showed that the immune response of asthmatic patients to heat-stable antigens was different from that to the heat-labile antigens . Exposure to antigens of H . influenzae is common in all the disease groups . Skin test reactions having the time course and macroscopic appearance of Type I (immediate) and Type III (late) were obtained after prick and intracutaneous skin testing with HCW antigen in varying concentrations in a group of patients with asthma, chronic bronchitis or cystic fibrosis and in a control group . It is suggested that IgE and short-term sensitizing IgG antibodies may be responsible for the immediate reactions while activation of the alternative pathway of complement by endotoxin contained in HCW could be responsible for the late reactions . HCW antigens were shown to release histamine from non-sensitized human leucocytes; HCW and HCF antigens were shown to release histamine from non-sensitized human lung . None of the antigens tested had an effect on beta-receptors in tracheal preparations . It is proposed that these reactions may contribute to the pathogenicity of H . influenzae in the lower respiratory tract. Am J Vet Res, 1979 Oct, 40(10), 1450 - 3 Antigenic structure and relationship between serotypes 1 and 2 of Haemophilus paragallinarum; Sawata A et al.; Antigenic structure and relationship between serotypes 1 and 2 of Haemophilus paragallinarum were analyzed by the rapid plate agglutination and cross-absorption tests . Encapsulated strain forming iridescent colony type of both serotypes 1 and 2 had at least three antigens: heat-labile and trypsin-sensitive (L), heat-labile and trypsin-resistant (HL), and heat-stable and trypsin-resistant (HS) . The L was a major antigen located in a surface and divided serologically into three parts: L1, L2, and L3 . The L1 was specifici to serotype 1, the L2 was specific to serotype 2, and the L3 was a common antigen shared by serotypes 1 and 2 . The HL and HS were common antigens between serotypes . By trypsinization or heating at 121 C, L antigen lost its agglutinability and agglutinin-producing ability . Nonencapsulated organisms forming noniridescent colony type lacked the L antigen . These results suggested that antigenic structure of H paragallinarum serotypes 1 was L1, L3, HL and HS, while serotype 2 was L2, L3, HL, and HS. J Clin Pathol, 1979 Oct, 32(10), 1061 - 5 An evaluation of 12 methods for the demonstration of penicillinase; Lucas TJ; Twelve methods for the demonstration of bacterial penicillinase production by strains of Haemophilus influenzae and Staphylococcus aureus are compared, and their suitability for routine clinical laboratory use is evaluated . The acidometric agar plate method is recommended. Zh Mikrobiol Epidemiol Immunobiol, 1979 Oct, (10), 108 - 12 {Culture and morphological characteristics of Haemophilus influenzae and pneumococcus in bronchial infection}; Luneva OK et al.; In the cultures obtained by inoculating sputum samples faken from patients with bronchial infection into solid agar medium prepared on Hottinger's hydrolysate with fresh rabbit blood added Haemophilus influenzae produced colonies varying in their from (dome-shaped, conical, trapeziform), as well as in the morphology of the organisms . Pneumococci produced mainly flat colonies surrounded by the zone of alpha hemolysis . Along-side with isolated H . influenzae and pneumococcal colonies, symbiotic colonies could be observed . In these colonies pneumococci were diffused among H . influenzae. Infect Immun, 1979 Oct, 26(1), 254 - 61 Immunoglobulin A1 protease production by Haemophilus influenzae and Streptococcus pneumoniae; Male CJ; Bacterial strains of Haemophilus species and Streptococcus pneumoniae were examined for synthesis of the enzyme immunoglobulin A1 (IgA1) protease . Of 36 H . influenzae strains examined, 35 produced IgA1 protease; strains included all six capsular types, unencapsulated variants of types b and d, and untypable H . influenzae . Eight Haemophilus strains (non-H . influenzae) were studied, and two produced IgA1 protease . All 10 strains of S . pneumoniae produced IgA1 protease; these strains included 9 different capsular polysaccharide types and 1 untypable strain . Both IgA1 proteases cleaved myeloma IgA1 and secretory IgA but not myeloma IgA2, IgM, or IgG as determined by immunoelectrophoresis . Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that both enzymes cleaved IgA1 myeloma sera, but not IgA2, into two fragments . The apparent molecular weight of the cleaved fragments was dependent both on the apparent molecular weight of the cleaved fragments was dependent both on the specific IgA1 protease assayed and the specific IgA1 substrate utilized . It is postulated that both carbohydrate variation between the IgA1 substrates studied and the ability of S . pneumoniae glycosidases to cleave carbohydrates from glycoprotein offer an explanation for the different fragment sizes observed. Infect Immun, 1979 Oct, 26(1), 178 - 82 Bacterial adherence to pharyngeal cells in smokers, nonsmokers, and chronic bronchitics; Fainstein V et al.; Selective adherence to host mucosal surfaces is probably a requirement for colonization and infection by bacteria . Since pharyngeal colonization may be an important determinant in the pathogenesis of pneumonia, we studied the adherence of 10 different bacteria to pharyngeal cells obtained from nonsmokers, smokers, and chronic bronchitics . Various patterns of adherence among the different groups of subjects were found . Young healthy smokers had increased adherence of Streptococcus pneumoniae type I and, to a lesser extent, S . pneumoniae type III and Staphylococcus aureus when compared with nonsmokers . Middle-aged smokers with a long history of chronic bronchitis had significantly increased adherence only of untypable Haemophilus influenzae when compared with age-matched nonsmokers . The acquisition of pneumococcal pneumonia by smokers and the role of nontypable Haemophilus species in chronic bronchitis may be determined, in part, by bacterial adherence to pharyngeal cells. Am J Med Sci, 1979 Sep-Oct, 278(2), 173 - 6 Ampicillin resistant Haemophilus parainfluenzae endocarditis; Smith PW et al.; A case of Haemophilus parainfluenzae bacterial endocarditis is described . This is the first reported case of endocarditis caused by ampicillin resistant H parainfluenzae . Resistance was not mediated by a beta lactamase . Ampicillin therapy had not controlled the infection, but a four-week course of chloramphenicol was curative . Several general therapeutic points are discussed. Pediatrics, 1979 Sep, 64(3), 292 - 5 Fatal Haemophilus influenzae endocarditis diagnosed by echocardiography in an infant; Laird WP et al.; A 1-year-old boy was admitted to the hospital with Haemophilus influenzae meningitis . On the second hospital day a heart murmur heard on admission seemed louder . No signs of congestive heart failure were present . An echocardiogram demonstrated a persistent echo-dense mass behind the anterior leaflet of the mitral valve . A presumptive diagnosis of endocarditis was made . After ten days of antibiotic treatment the child was considerably improved . Treatment was continued for endocarditis . Over the next several days the infant's condition deteriorated . On the 16th hospital day he died . Autopsy examination showed a large vegetation attached to the posterior mitral valve leaflet . Bacterial endocarditis caused by H influenzae is uncommon at any age and rare in children . Echocardiography provided a definitive diagnosis early in the hospital course of this patient. Arch Intern Med, 1979 Sep, 139(9), 985 - 8 Adult bacteremic Haemophilus parainfluenzae infections . Seven reports of cases and a review of the literature; Oill PA et al.; Seven cases of adult Haemophilus parainfluenzae infections diagnosed by positive blood cultures are compared with cases previously reported in the English literature . Three patients had pneumonia, while the others had epiglottitis with meningitis, pharyngitis, arthritis, and endocarditis, respectively . Nonendocarditic manifestations of adult H parainfluenzae infection were reported in four other cases . In addition to the diseases of our patients, H parainfluenzae also has been isolated from cerebral abscesses . Patients did well with antibiotic therapy and there were no deaths . Patients did well with antibiotic therapy and there were no deaths . Report of antibiotic sensitivity testing of 50 strains disclosed 6% of isolates resistant to ampicillin sodium, with all sensitive to chloramphenicol . If the antibiotic sensitivity of the organism is unknown, then chloramphenicol therapy should be instituted until adequate susceptibility studies have been performed . If the organism is sensitive to ampicillin, then this is the drug of choice. Mol Gen Genet, 1979 Sep, 175(2), 175 - 9 A hex mutant of Haemophilus influenzae; Bagci H et al.; A mutant of Haemophilus influenzae which does not discriminate between low efficiency (LE) and high efficiency (HE) markers has been isolated . The mutant does not differ wild type in its sensitivity to ultraviolet radiation, methyl methanesulfonate (MMS) mitomycin C, and nitrous acid . Spontaneous mutation frequencies for three loci studied are 10- to 30-fold higher in the mutant than in the wild type strain . Low- and high-efficiency transforming markers are equally UV-resistant when assayed on this mutant . This mutant is thus similar to the hex mutant of Streptococcus pneumoniae. J Clin Pathol, 1979 Sep, 32(9), 956 - 9 Use and interpretation of Schlichter's test on Haemophilus influenzae: relation of in vitro to in vivo results for cefamandole; Yourassowsky E et al.; When Haemophilus influenzae infections are treated by an antibiotic acting on the bacterial wall, the adequacy of antimicrobial therapy can be assessed by Schlichter's test . This test may be carried out using Mueller Hinton broth (or Mueller Hinton broth with 50% pooled serum and a supplement of Ca++ and Mg++) supplemented with Fildes' enrichment and an inoculum adjusted to the 0.5 McFarland turbidity standard diluted 200x . However, correct reading of end points can be obtained only by phase contrast microscopic examination, which allows the establishment of good correlation between the in vitro and in vivo findings . In patients with lung infections successfully treated with cefamandole, the presence of spheroplasts in samples derived from Schlichter's tests correlates well with clinical improvement and eradication of the pathogenic organism checked by transtracheal aspiration. Pediatrics, 1979 Sep, 64(3), 287 - 91 Nasopharyngeal carriage of antibiotic-resistant Haemophilus influenzae in healthy children; Lerman SJ et al.; We selected 16 schools representing a broad socioeconomic cross-section of metropolitan Omaha and obtained nasopharyngeal cultures for Haemophilus influenzae from 1,084 healthy 4- to 7-year-old children . We found that 34.2% of the children carried nontypable strains and 2.0% carried type b strains . Carriage rates were not influenced by recent illness, family size, or number of people sharing a bedroom . The prevalence of ampicillin-resistant H influenzae in the sample population was 0.9% for nontypable strains and 0.4% for type b strains; it was not significantly different in the group of children who had recently used beta-lactam antibiotics . One child carried a nontypable strain which was resistant to both chloramphenicol and tetracycline, the first chloramphenicol-resistant H influenzae detected in Omaha . A survey of healthy children may be a useful method for projecting a community's risk of disease caused by ampicillin-resistant H influenzae . Among the nasopharyngeal isolates from healthy children, 2.7% of nontypable strains and 18.2% of type b strains were resistant to ampicillin (P less than .01) . During the same five-month period in Omaha, clinical failure in the treatment of otitis media with ampicillin was uncommon and four (20.0%) of 20 cases of H influenzae type b bacteremia and meningitis were caused by ampicillin-resistant organisms. Pediatrics, 1979 Sep, 64(3), 283 - 6 Report of 65 cases of Haemophilus influenzae b pneumonia; Ginsburg CM et al.; During a 14-year period there were 65 cases of pneumonia caused by Haemophilus influenzae b; 83% were children less than 2 years of age and 80% of illness occurred in winter and spring . The roentgenographic picture was consolidative pneumonia in 75% and pleural effusions were present in 75% of all cases . Ten patients had associated meningitis and three had purulent pericarditis . Otitis media was diagnosed in 43% and H influenzae b was isolated from eight middle ear aspirates . Three patients (5%) died . Recommendations for diagnosis and treatment are made. J Biochem (Tokyo), 1979 Sep, 86(3), 711 - 7 The use of Haemophilus gallinarum DNA-relaxing enzyme to investigate the relationship between the number of superhelical turns and the molecular weight in a negatively twisted DNA; Shishido K; Covalently closed-circular, superhelical DNAs, including viral DNAs, bacterial plasmid DNAs, and bacteriophage replicative-form DNA, were treated with a small amount of Haemophilus gallinarum DNA-relaxing enzyme to generate incompletely relaxed DNA molecules . Each sample consisted of a set of closed-circular DNA molecules differing by one turn in their number of superhelical turns . The DNA samples were analyzed by agarose gel electrophoresis under conditions such that the electrophoretic mobility was a function of the number of turns . The numbers of superhelical turns (at 37 degrees C in 20 mM Tris-HCl (pH 7.5)-5 mM MgCl2) in the DNAs of pSC101 (5.8 megadaltons), Colicin E1 (4.2 megadaltons), pMR4 (4.0 megadaltons; recombinant between pBR322 and lambda DNA fragment), phi X174 replicative-form (RF) I, Simian virus 40 (SV40), and polyoma virus (3.4--3.6 megadaltons each), and lambda dv021 (2.05 megadaltons) were estimated to be 36, 27, 23--24, 20--21, 20--21, 20--21, and 11--13, respectively . It appears that the number of superhelical turns is mainly a function of the molecular weight of the DNA, at least in the substrates tested here. J Bacteriol, 1979 Sep, 139(3), 1021 - 7 Haemophilus influenzae periplasmic protein which binds deoxyribonucleic acid: properties and possible participation in genetic transformation; Sutrina SL et al.; A protein which binds to either single-stranded or double-stranded deoxyribonucleic acid (DNA) but not to ribonucleic acid has been isolated by osmotic shock treatment of growing cells . This periplasmic protein differs from the principal intracellular binding protein in its greater thermolability and by the absence of salt-induced cooperativity in its interaction with single-stranded DNA . Certain mutant strains of Haemophilus influenzae defective in the DNA suptake steps of genetic transformation were found to be deficient in periplasmic DNA-binding protein, suggesting that this protein participates in the uptake of DNA in transformation. J Antimicrob Chemother, 1979 Sep, 5(5), 601 - 7 A pharmacological and in vitro comparison of three oral cephalosporins; Wise R et al.; The pharmacology of cephradine, cephalexin and a new oral cephalosporin, cefaclor, has been compared in six volunteers . Cefaclor was absorbed rapidly and was cleared from the serum more rapidly than the other two agents . This was probably partially due to its instability in serum at body temperature, which was investigated . Against a wide range of common pathogens cefaclor was the more active oral cephalosporin . In particular the activity against Neisseria gonorrhoeae and Haemophilus influenzae was of interest. JAMA, 1979 Aug 24-31, 242(8), 721 - 6 Bacterial tracheitis; Jones R et al.; During a 14-month period, eight infants and children were observed with an acute, infectious, upper airway obstructive disease with features common to both croup and epiglottitis . We have termed this distinct entity "bacterial tracheitis." All patients failed to respond to treatment for croup, including racemic epinephrine delivered by intermittent positive-pressure breathing . Direct laryngoscopy consistently revealed a normal epiglottis and aryepiglottic folds but marked subglottic mucosal edema . Tracheal suctioning yielded copius mucopus below the subglottic swelling . Gram stain of this material corroborated subsequent cultures: Staphylococcus aureus, six; group A Streptococcus, one; and Haemophilus influenzae (not typed), one . All patients required periodic tracheal suctioning for relief of upper airway obstruction . Six patients required endotracheal intubation; one required a tracheostomy . Bacterial tracheitis should be considered in the differential diagnosis of a young child with a croup-like illness that is refractory to conventional therapy. Aust Vet J, 1979 Aug, 55(8), 389 - 90 An outbreak of porcine pleuropneumonia due to Haemophilus parahaemolyticus; Cameron RD et al.; An outbreak of porcine pleuropneumonia in an intensive piggery in south-eastern Queensland is described . Haemophilus parahaemolyticus was isolated from weaner piglets at post-mortem examination . The disease began in weaners and later occurred in suckling piglets 3 weeks of age . It was associated with poor ventilation, hygiene and overcrowding . Treatment and control measures included intramuscular lincomycin hydrochloride (10 mg/Kg body weight), creep feed medication with oxytetracycline (500 g/tonne) and disinfection and improvement of housing . These appeared to be successful. Appl Environ Microbiol, 1979 Aug, 38(2), 248 - 57 Comparison of antibodies in marine fish from clean and polluted waters of the New York Bight: relative levels against 36 bacteria; Robohm RA et al.; Fish from polluted waters are subject to increased prevalence of disease . Because they respond to bacterial pathogens by producing serum antibodies, it was possible to construct a seasonal serological record in three fish species from clean and polluted waters of the New York Bight . Antibody levels were determined by testing sera for agglutinating activity against 36 strains of bacteria . Evaluation of 5,100 antibody titrations showed the following . During warm months, summer flounder (Paralichthys dentatus) from the polluted area had significantly higher antibody levels and antibody to a greater diversity of bacteria than fish from the unpolluted area . Weakfish (Cynoscion regalis) from the same polluted area shared with summer flounder raised titers to many bacteria . The greatest proportion of raised titers was against Vibrio species, although prominent titers were also seen against Aeromonas salmonicida and Haemophilus piscium, bacteria usually associated with diseases in freshwater but not marine fish . Differences between polluted and clean waters were not as evident in winter flounder (Pseudopleuronectes americanus) during cold months . This could be due, in part, to reduced antibody production at colder temperatures . The data illustrate the usefulness of the serum antibody record in identifying environmental exposure to bacteria in marine fish and indicate that the polluted New York Bight apex has increased levels and diversity of bacteria during warm months. Carbohydr Res, 1979 Aug, 73, 59 - 65 Mass-spectral studies of isomeric D-ribofuranosylribitol disaccharides from the capsular polysaccharides of Haemophilus influenzae type b and Escherichia coli K 100; Fraser BA et al.; Two isomeric-D-ribofuranosylribitols, derived from capsular polysaccharides of Haemophilus influenzae type b and Escherichia coli K 100, were methylated or acetylated, and the products analyzed by gas-liquid chromatography-mass spectrometry . The marked difference in the mass spectra of the methyl ethers of these disaccharides allowed clear distinction between 1- and 2-O-D-ribofuranosylribitol was characteristic for this disaccharide; its isomer, the (1 leads to 2)-linked species, has a base peak at m/e 57 . The difference in the base peaks is attributable to fragmentation of the methylated ribitol, as both spectra display common ions characteristic of the methylated D-ribofuranosyl group . For the acetylated disaccharides, the mass spectra displayed common ions characteristic of the acetylated D-ribofuranosyl group . However, no ions similar to those found for the methylated ribitol allowed ready differentiation between the two acetates . Instead, their spectra displayed similar ions, differing somewhat in relative abundance; the M-1 ion, m/e 577, was obtained for both . Comparison of the relative abundance of m/e 139, 259, and 303 in the spectra of the two acetates did allow distinction between them. J Gen Microbiol, 1979 Aug, 113(2), 409 - 11 Simplified media for the growth of Haemophilus influenzae from clinical and normal flora sources; Klein RD et al.; The nutritional requirements of 43 strains of Haemophilus influenzae isolated from clinical and normal flora sources were investigated . Two defined minimal media were developed by modifying the medium of Herriott et al . (1970):74% of the strains could grow on the minimal media and Herriott's medium; the remaining strains could not grow on any of these media. J Clin Microbiol, 1979 Aug, 10(2), 168 - 74 Biotypes of Haemophilus encountered in clinical laboratories; Oberhofer TR et al.; The biochemical characteristics of 464 strains of Haemophilus influenzae and 83 strains of Haemophilus parainfluenzae isolated over an 18-month period are described . Of 22 characteristics obtained, only 6 were necessary to biochemically identify and biotype the isolates . The key substrates or tests were urease, ornithine, indole, o-nitrophenyl-beta-D-galactopyranoside, sucrose, and xylose . Five biotypes of H . influenzae and four of H . parainfluenzae were commonly recognized . Some strains were encountered which could not be accommodated in the recognized taxa but which constituted separate biotypes of the two species, H . influenzae biotype I was recovered principally from blood, cerebrospinal fluid, and upper respiratory secretion, and biotypes II and III were recovered from eye and sputum cultures . Biotype I was recovered primarily from children less than 1 year of age, whereas biotypes II and III were from persons 1 to 5 years old and from those over 20 years of age . Multiple isolates recovered from the same patient were almost always of the same biotype . Strains of H . parainfluenzae were isolated primarily from sputum, with others being isolated from body sources such as dental abscesses, gastric aspirates, and peritoneal fluid . An inverse relationship was noticed between hemolysis and mannose fermentation among H . parainfluenzae biotype III strains, whereas the relationship was absent among the other biotypes. Mutat Res, 1979 Aug, 62(1), 1 - 6 Action spectrum for lethality of near-UV light on Haemophilus influenzae and lack of mutation; Cabrera-Juarez E et al.; Mutation and inactivation of H . influenzae have been measured following irradiation at various near-UV wavelengths . Inactivation takes place most readily at 334 nm (but is unaffected by absence of excision or postreplication repair), and decreases markedly at longer wavelengths . No induced mutations to resistance to novobiocin or streptomycin or to ability to utilize protoporphyrin instead of hemin were detected at any of the wavelengths used . There were also no detectable induced mutations in an excision-defective strain after 334-nm irradiation . These results are in contrast to the in vitro mutation of purified transforming DNA we previously observed. J Bacteriol, 1979 Aug, 139(2), 520 - 9 Plasmid transfer in Haemophilus influenzae; Stuy JH; Twenty-nine strains of Haemophilus influenzae highly resistant to ampicillin, chloramphenicol, or tetracycline were examined for the presence of plasmids . Agarose gel electrophoresis of ethanol-precipitated cell extracts revealed large plasmids in 11 strains, of which 7 were conjugative . Plasmid transfer by conjugation between isogenic strains was quite efficient, but transfer between different serotypes was nearly always much more inefficient . Type I or II restriction enzymes do not appear to be barriers to this transfer . Encapsulated cells can be both efficient donors and recipients . Small plasmids were seen in three strains, but only two of the three are resistance factors (RSF0885, pUB703) . Thus, in 17 isolates antibiotic resistance genes are believed to be located in the bacterial chromosome . Most of these resistances could be transferred by genetic transformation into the widely used Rd strain . In some cases transfer of chromosomal resistance into conjugative plasmids was observed in both rec+ and rec host cells . Since transfer by conjugation seems to be the more efficient process, it is puzzling that in the majority of the 29 isolates studied resistance genes appeared to be in the chromosome. N Engl J Med, 1979 Jul 19, 301(3), 122 - 6 Haemophilus influenzae meningitis . A national study of secondary spread in household contacts; Ward JI et al.; To determine the risk of severe Haemophilus influenzae illness among household contacts of patients with H . influenzae meningitis, we studied prospective data obtained in 19 states from January 1, 1977, to June 30, 1978 . H . influenzae meningitis was reported in 1403 patients, and 1147 (82 per cent) of the exposed families were investigated for the occurrence of H . influenzae disease within 30 days after its onset in the index patient . During this interval, nine of 1687 household contacts (0.5 per cent) under the age of six years had systemic disease confirmed to be caused by H . influenzae Type b . The risk in children less than one year of age was 6 per cent, and the risk in those less than four years of age was 2.1 per cent . None of 2624 contacts above the age of five was affected . In the 30 days after onset of meningitis, the risk of this infection alone, aside from other types of serious H . influenzae disease, is 585 times greater in household contacts than the age-adjusted risk in the general population . The risk of H . influenzae disease in household contacts under six years of age is similar to the risk of secondary meningococcal disease in all household contacts--indicating a need for effective antimicrobial prophylaxis. J Antibiot (Tokyo), 1979 Jul, 32(7), 718 - 26 Bactericidal activity of cefadroxil, cephalexin, and cephradine in an in vitro pharmacokinetic model; Leitner F et al.; Cefadroxil (Duricef, Mead Johnson and Company), resembles cephalexin and cephradine in spectrum of antibacterial activity but differs in human pharmacokinetic properties . Whether the latter are likely to affect activity in vivo was assessed by determining bactericidal activity against clinical isolates under conditions simulating the variation of drug concentration in the blood stream after an oral dose of 500 mg to adults . In this kinetic model, cefadroxil was more active than cephalexin or cephradine against Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Proteus mirabilis, Haemophilus influenzae and one of two strains of Escherichia coli . The other strain of E . coli was virtually unaffected by the cephalosporins . S . pyogenes was equally susceptible to all three cephalosporins . Analysis of the results suggest that the pharmocokinetic properties of an antibiotic affect its activity in the blood stream, provided the susceptibility of the infecting organism is concentration-dependent within the range of drug concentration occurring in serum. Am J Hosp Pharm, 1979 Jul, 36(7), 893 - 906 Drug therapy reviews: trimethoprim-sulfamethoxazole; Gleckman R et al.; The mechanism of action, antimicrobial spectrum, pharmacokinetic properties, drug interactions, adverse reactions and therapeutic uses of trimethoprim-sulfamethoxazole, a combination enzyme-specific inhibitor of bacterial folate synthesis, are reviewed . Trimethoprim-sulfamethoxazole currently is approved by the FDA for the therapy of established recurrent bacterial urinary tract infections, pneumocystosis, otitis media in children and shigellosis . Claimed advantages of the drug are synergistic activity, bactericidal activity and ability to decrease the rate of emergence of resistance to the individual components . Trimethoprim-sulfamethoxazole is the drug of choice for treatment of pneumocystosis and an acceptable oral therapy for recurrent urinary tract infections caused by susceptible bacteria . In children with otitis media, it is used as an alternative to ampicillin and amoxicillin and is preferred when these patients are penicillin-sensitive or when the infection is caused by beta-lactamase-producing Haemophilus influenzae . Hematologic reactions (anemia, thrombocytopenia, granulocytopenia, agranulocytosis) to trimethoprim-sulfamethoxazole occur rarely . Gastrointestinal intolerance and skin eruptions are the most prevalent adverse reactions . Most untoward reactions to trimethoprim-sulfamethoxazole develop within two weeks of onset of therapy, and their incidence compares favorably with that of standard agents administered for the same indications. J Clin Pathol, 1979 Jul, 32(7), 728 - 31 Effect of tobacco and nicotine on growth of Haemophilus influenzae in vitro; Roberts D et al.; Two nutritionally poor bacteriological media, prepared from phosphate-buffered saline and from bronchial secretions, support the growth of Haemophilus influenzae only poorly . The presence of tobacco or pure nicotine in these media stimulates the growth of the organism, and the component(s) responsible appear(s) to be volatile. Arch Otolaryngol, 1979 Jul, 105(7), 386 - 90 Bacteria in chronic maxillary sinusitis; Karma P et al.; Sixty-one chronically inflamed maxillary sinuses produced 131 bacterial strains from mucosal pieces that were taken during a Caldwell-Luc operation and cultured aerobically and anaerobically . Sinus secretions showed only 62 and nasal secretions 106 bacterial strains . Fourteen mucosal strains, including 11 Haemophilus influenzae, grew heavily . None of 24 mucosal anaerobes showed heavy growth . Of 52 antral mucosae with culturable bacteria, 37 disclosed mixed and 15 pure growth . The bacteriological characteristics of the diseased sinus and the nose did not correlate . The duration or extent of the disease, the macroscopic appearance of the diseased sinus, or the presence or absence of allergy were unrelated to bacteriological findings, except that H influenzae was concentrated in purulent sinuses . Intraoperative culture of antral mucosa seems to give the most reliable picture of the bacteriological condition in chronic maxillary sinusitis. Biochim Biophys Acta, 1979 Jun 20, 563(1), 261 - 5 Purification and characterization of DNA-relaxing enzyme from Haemophilus gallinarium; Shishido K et al.; A DNA-relaxing enzyme capable of concerted nicking and closing of DNA backbone bonds has been purified from Haemophilus gallinarum by two chromatographic steps and gel filtration . The enzyme efficiently catalyzes the removal of superhelical turns from a negatively twisted DNA and requires Mg2+ for this activity . Slight removal of superhelical turns from a positively twisted DNA generated by binding of ethidium bromide is found, but only at high enzyme concentrations . The DNA-relaxing activity is inhibited markedly with heat-denatured DNA, whereas native DNA and RNA have almost no affect on this activity. Am J Dis Child, 1979 Jun, 133(6), 617 - 8 Prosthetic valve endocarditis due to Haemophilus parainfluenzae biotype II; Blair DC et al.; Haemophilus parainfluenzae endocarditis is characterized by great variation in the acuteness of presentation, difficulty in isolation of the pathogen, a 50% to 60% incidence of major arterial emboli, and variability of response to therapy . Prosthetic valve endocarditis (PVE) due to H parainfluenzae biotype II occurred in a 14-year-old girl with congenital heart disease and a Starr-Edwards mitral valve prosthesis . Management was complicated by a prolonged culture-negative period (eight days), intermittent bacteremia (only five of 15 positive blood cultures), an embolus to the right femoral artery, progressive congestive heart failure, and urgent prosthestic valve replacement . Cure was achieved with 44 days of ampicillin sodium-gentamicin sulfate therapy monitored by serum bactericidal titers. Am J Dis Child, 1979 Jun, 133(6), 603 - 5 Acute Haemophilus pneumonia in childhood; Jacobs NM et al.; In our hospital Haemophilus influenzae type B seems to be a common cause of acute childhood pneumonia . In the past five years, 34 children with acute Haemophilus pneumonia were identified . Although these children generally had an uncomplicated segmental pneumonia associated with a bacteremia, 13 of the children had pneumonia with a pleural effusion . These children with Haemophilus pneumonia represented 18% of the children hospitalized with systemic Haemophilus disease and almost a third of those hospitalized with acute bacterial pneumonia from whom the causal agent was isolated. Jpn J Antibiot, 1979 Jun, 32(6), 668 - 74 {Sensitivity of frequent-occurring isolates in outpatients to routinely-used antibiotics (author's transl)}; Deguchi K; The susceptibility of microorganisms (Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, E . coli, Klebsiella pneumoniae, Salmonella spp . and Haemophilus influenzae) frequently occurring in outpatients (treated by practitioners) to six kinds of antibiotics {ampicillin (ABPC), cefazolin (CEZ), erythromycin (EM), minocycline (MNC), gentamicin (GM) and thiamphenicol (TP)} was determined by the standard method established by the Japan Society of Chemotherapy . 1) There were few multiple-antibiotic-resistant urine isolates from patients with a simple urinary tract infection, whereas urine isolates from patients with a complicated urinary tract infection contained many multiple-antibiotic resistant organisms . 2) Isolates from patients with a respiratory tract infection (sputum and tonsillar secretions isolates) and isolates from patients with acute purulent otitis media (purulent discharge isolates) contained few multiple-antibiotic-resistant organisms except for EM-resistant Streptococcus pyogenes . 3) Superficial pus isolates contained many multiple-antibiotic-resistant organisms, while bile isolates were relatively free from multiple-antibiotic resistant organisms . 4) When the results of the previous8,9) and present investigations were compared with the reports of other Japanese investigators1,5,6), suggestive evidence was provided that organisms resistant to macrolides and chloramphenicol showed a tendency to decrease, whereas organisms resistant to penicillins, cephalosporins and aminoglycoside antibiotics were on the increase. J Clin Microbiol, 1979 Jun, 9(6), 729 - 30 Comparison of two media for isolation of haemophilus vaginalis; Smith RF; Starch agar and V agar were comparable in the isolation of Haemophilus vaginalis from vaginal discharge specimens . Each medium had certain advantages over the other, which are described. J Clin Pathol, 1979 Jun, 32(6), 538 - 41 Haemophilus influenzae type b antigenuria in children; Kaldor J et al.; Detection of Haemophilus influenzae type b (HIb) antigenuria by latex agglutination has been shown to be sensitive, specific, and rapid . In children, antigenuria persisted for a mean duration of 10 days and a maximum of 18 days . Antigenuria was demonstrated in 25 of 30 patients with HIb infection but not in 62 with other types of infection . In five children, antigenuria confirmed the diagnosis in the absence of bacteriological confirmation . In five other children, antigenuria was not found, but in this group the antigen was detected in another body fluid or HIb was recovered. J Pediatr, 1979 Jun, 94(6), 983 - 7 Treatment of ampicillin-resistant Haemophilus influenzae in soft tissue infections with high doses of ampicillin; Murphy D et al.; Six soft tissue infections (three epiglottitis, one cellulitis, one pneumonia, and one arthritis) with ampicillin-resistant Haemophilus influenzae were treated initially with high doses of ampicillin (200 to 400 mg/kg/day intravenously) alone and had good clinical responses . All had documented bacteremia with H . influenzae . One child was treated only with ampicillin; treatment in the remainder was changed to oral therapy with other antibiotics to facilitate discharge . There was no recurrence of disease . Disc diffusion studies done on clinical isolates of both resistant and sensitive organisms indicate a break point at which the resistant organism shows progressive sensitivity to increasingly higher concentrations of ampicillin. Arch Intern Med, 1979 Jun, 139(6), 712 - 3 Acute bilateral suppurative parotitis due to Haemophilus influenzae . Report of two cases; Fainstein V et al.; Acute bilateral suppurative parotitis developed in two patients with documented cirrhosis of the liver while they were in the hospital . Gram's stain and culture of purulent material obtained from the orifice of Stensen's duct disclosed Haemophilus influenzae as the sole isolate . Both patients were treated successfully with local care and antibiotics . To our knowledge, with one possible exception, infection of the parotid gland due to this organism has not been described previously. Am J Dis Child, 1979 Jun, 133(6), 606 - 8 Endophthalmitis associated with Haemophilus influenzae type b bacteremia and meningitis; Sastry RV et al.; The unusual occurrence of endophthalmitis associated with Haemophilus influenzae type b bacteremia and meningitis was confirmed in three young children during a five-year period . In contrast to bacterial endophthalmitis attributed to other microorganisms, these three infections resolved completely within a few days with conventional antimicrobial therapy . Endophthalmitis is but one of the apparently increasing number of unsuual complications that may be observed as a result of H influenzae type b bacteremia. J Clin Pathol, 1979 Jun, 32(6), 556 - 9 A simple biological method for detecting streptococcal nicotinamide adenine dinucleotide glycohydrolase; Green NE; A biological method for detecting streptococcal nicotinamide adenine dinucleotide glycohydrolase (NADG) is presented, based on its ability to inhibit the growth of Haemophilus parainfluenzae . Three hundred clinical isolates of beta-haemolytic streptococci were tested . All isolates producing NADG belonged to Lancefield's group A, C, or G. Pediatrics, 1979 Jun, 63(6), 915 - 9 The microbiology of serous and mucoid otitis media; Giebink GS et al.; One hundred forty-four serous and mucoid effusions were cultured for aerobic bacteria, Mycoplasma pneumoniae, and virus . Thirty percent of all effusions yielded an unequivocally positive culture for aerobic bacteria . Although serous effusions were culture positive as often as mucoid effusions, Haemophilus influenzae was isolated predominantly from serous effusions and Staphylococcus epidermidis predominantly from mucoid samples . Only one of 73 effusions yielded a viral isolate (Herpesvirus hominis) . None of 33 effusions yielded M pneumoniae, and only one of 17 effusions yielded an anaerobe (Propionibacterium) . These findings suggest that aerobic bacteria may play a role in the pathogensis of serous and mucoid otitis media. N Z Med J, 1979 May 23, 89(636), 384 - 6 Isolation of Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus at Auckland Hospital; Garner JG; Actinobacillus actinomycetemcomitans and Haemophilus aphrophilus were each isolated three times at Auckland Hospital, over a one year period . Relevant clinical particulars of the major cases are given, and problems of isolation, identity and treatment discussed. JAMA, 1979 May 18, 241(20), 2170 - 3 The nasopharyngeal culture in acute otitis media . A reappraisal of its usefulness; Schwartz R et al.; Simultaneous cultures of the nasopharynx and middle ear exudate (obtained by tympanocentesis) were obtained from 225 children (mean age, 34 months; median age, 41 months) with suppurative otitis media . A 72% prediction rate for middle ear pathogens was obtained by examining the nasopharyngeal cultures after the strict observance of two essential prerequisites: (1) the nasopharyngeal culture was immediately plated on appropriate solid agar and (2) a semiquantitative method for bacterial enumeration was employed in the reading of the nasopharyngeal culture plates . The technique was most valuable where 2+ (greater than 25% up to 50% of total number of colonies was a single pathogen) or greater of a single pathogen was recovered from the nasopharynx . In only one instance, the semiquantitative nasopharyngeal culture incorrectly predicted the middle ear pathogen if one was recovered . Quantitative nasopharyngeal cultures were particularly useful in predicting the presence of ampicillin-resistant Haemophilus influenzae and group A streptococci as causative agents in otitis media. J Clin Invest, 1979 May, 63(5), 828 - 35 Amine content of vaginal fluid from untreated and treated patients with nonspecific vaginitis; Chen KC et al.; We examined the vaginal washings from patients with nonspecific vaginitis (NSV) to seek biochemical markers and possible explanations for the signs and symptoms of this syndrome . Seven amines were identified including methylamine, isobutylamine, putrescine, cadaverine, histamine, tyramine, and phenethylamine . These amines may contribute to the symptoms of NSV and may contribute to the elevated pH of the vaginal discharge . They may also be partly responsible for the "fishy" odor that is characteristic of vaginal discharges from these patients . Among the seven amines, putrescine and cadaverine were the most abundant and were present in all vaginal discharges from each of ten patients before treatment . These amines are produced in vitro during growth of mixed vaginal bacteria in chemically defined medium, presumably by decarboxylation of the corresponding amino acids . We hypothesize the anaerobic vaginal organisms, previously shown to be quantitatively increased in NSV, are responsible for the amine production, because metronidazole inhibited the production of amines by vaginal bacteria in vitro, and Haemophilus vaginalis did not produce amines . H . vaginalis did release high concentrations of pyruvic acid and of amino acids during growth in peptone-starch-dextrose medium, whereas, other vaginal flora consumed both pyruvic acid and amino acids in the same medium during growth . These findings suggest that a symbiotic relationship may exist between H . vaginalis and other vaginal flora in patients with NSV. J Clin Microbiol, 1979 May, 9(5), 570 - 4 Methods for serotyping nasopharyngeal isolates of Haemophilus influenzae: slide agglutination, Quellung reaction, countercurrent immunoelectrophoresis, latex agglutination, and antiserum agar; Ingram DL et al.; Nasopharyngeal isolates of H . influenzae were typed by the slide agglutination test, the Quelling reaction, the latex agglutination test, countercurrent immunoelectrophoresis, and the antiserum agar test . These tests gave essentially comparable results, with countercurrent immunoelectrophoresis and latex agglutination being slightly more sensitive . Cross-reactive problems encountered with latex agglutination and the expense of performing countercurrent immunoelectrophoresis or the antiserum agar test made these tests less practical than the slide agglutination test to identify single strains that were already isolated . The Quellung reaction and slide agglutination were the most rapid tests used to type an organism . For mass screening of multiple samples, countercurrent immunoelectrophoresis was the simplest technique . The antiserum agar test was slow but was the best technique to screen nasopharyngeal swab cultures to identify the presence of any encapsulated strains in the mixed flora . Whether any of the above techniques were as sensitive as the immunofluorescence test was not evaluated in this study. J Bacteriol, 1979 May, 138(2), 584 - 97 Molecular nature of two Haemophilus influenzae R factors containing resistances and the multiple integration of drug resistance transposons; Jahn G et al.; The 36-megadalton Haemophilus influenzae R plasmid pHK539 was found to specify resistance to tetracycline (Tc) and ampicillin (Ap) . It was shown by molecular hybridization studies and by electron microscopy that the plasmid pHK539 contained the tetracycline translocation deoxyribonucleic acid (DNA)segment (TnTc) as well as the ampicillin translocation segment (TnAp) . The TnAp was integrated in the stem of TnTc . The 34-megadalton H . influenzae R plasmid pRI234 carried a translocatable DNA segment which specified both tetracycline and chloramphenicol (Cm) resistance . Self-annealing and DNA-DNA heteroduplex experiments indicated that this transposon is probably composed of TnTc containing an insertion of a chloramphenicol resistance transposon (TnCm) . TnCm is inserted into one of the components of the TnTc inverted repetitions and is itself flanked on both sides by long inverted repetitions . The H . influenzae plasmids pHK539 and pRI234 had more than 60% of their polynucleotide sequences in common with all the other 30- to 40-megadalton R factors recently found in H . influenzae isolates from different countries . The tetracycline-chloramphenicol resistance transposon of pRI234 was integrated twice at different sites in the plasmid after its growth in medium containing tetracycline . The presence of the two copies of the transposon was correlated with higher minimum inhibitory concentrations against tetracycline as well as against chloramphenicol . After its growth in medium containing tetracycline, the H . influenzae R plasmid pFR16017 specifying Tc resistance contained one, two, three, or even four copies of TnTc integrated at different sites in the plasmid, or the loop of TnTc was amplified . The heterogeneity of the pFR16017 plasmid was seen in all single-colony isolates and correlated with a higher minimum inhibitory concentration against tetracycline. Ann Microbiol (Paris), 1979 May-Jun, 130 A(4), 469 - 79 {Bactericidal activity of ampicillin, chloramphenicol and gentamicin, alone or in combinations against susceptible and resistant "Haemophilus influenzae" (author's transl)}; Dabernat HJ et al.; Bactericidal activity of three antibiotics, ampicillin, chloramphenicol and gentamicin, alone or in combinations, was determined against susceptible and resistant strains of Haemophilus influenzae . The various antibiotic combinations were studied for the determination of a synergistic or antagonistic effect . The study was done by the checkerboard method . A percentage of survivors inferior or equal to 0.01% of the inoculum represents the bactericidal activity . Ampicillin and chloramphenicol are bactericidal antibiotics against H . influenzae at concentrations of 1 microgram/ml and 4 microgram/ml, respectively . The combination of ampicillin and gentamicin exhibited a synergistic effect against strains sensitive and resistant to ampicillin . The combination of chloramphenicol and gentamicin was synergistic against all strains . Ampicillin and chloramphenicol, when combined, were antagonistic against two strains using a bacteriostatic concentration of chloramphenicol; and against the remaining strains the effects of the combination were indifferent. Ann Microbiol (Paris), 1979 May-Jun, 130 A(4), 461 - 7 Comparative activities of cefotaxime, a new cephalosporin derivative, and of selected beta-lactam antibiotics against Haemophilus species; Dabernat HJ et al.; The activity of cefotaxime (HR756), a new semi-synthetic cephalosporin, was compared with the activity of ampicillin, carbenicillin, cephalothin, cephaloridine, cefazolin, cefamandole and cefoxitin against 247 strains of Haemophilus sp.; 20 of these strains produce a beta-lactam inactivating enzyme . The minimal inhibitoring concentrations were determined by the agar plate dilution technique . Cefotaxime is not only more active than any other cephalosporin but also than ampicillin, generally estimated the most active drug against Haemophilus sp . Bacteriostatic concentrations of cefotaxime which inhibit 50 and 95% of the strains (BSC50 and BSC95) were 0,009 microgram/ml and 0,03 microgram/ml, respectively, showing an activity 20 times superior to that of ampicillin . Cefotaxime activity was unaffected by the production of beta-lactamase. Prax Klin Pneumol, 1979 Apr, 33 Suppl 1, 548 - 54 {Standardised antibiotic therapy in major lung surgery (author's transl)}; Liebig S et al.; Sputum and bronchial biopsies and smears were obtained from 221 patients who had undergone partial pneumonectomy without preceding antibiotic therapy . The results of 343 sputum examinations and of 126 bacteriological examinations of biopsies and smears were evaluated . Pathogenic bacteria were demonstrated in about 50% of the sputa and in about 25% of the biopsies and swabs . Anaerobic micro-organisms were extremely rare . Treatment was with tetracycline . Before antibiotic therapy Haemophilus influenzae, staphylococci and E . coli predominated, afterwards there were practically only staphylococci and Esch . coli . The incidence of primary resistance to the usual antibiotics was high, especially in respect of gram-negative organisms . The difference in incidence between primary and secondary resistance was one of degree . The least effective agents were ampicillin and amoxicillin, the most active were the aminoglycosides . Erycin proved satisfactory in infections with grampositive organisms while the cephalosporins were active against both gram-positive and gram-negative bacteria . The development of resistance and the clinical picture suggest that "eradication" of the infection during the postoperative stage is not advisable as it causes the selection of more or less drug-resistant organisms . A more satisfactory approach is gradually to reduce the infection until the immediate postoperative stage is over . Macroscopic and microscopic examination of the sputum is important, as the choice of the appropriate antibiotic is determined by the result of gram-staining. Mutat Res, 1979 Apr, 60(2), 121 - 33 Analysis of photoenzymatic repair of UV lesions in DNA by single light flashes . XII . Evidence for enhanced photolysis enzyme-substrate complexes by a 2-photon reaction; Harm W; Yeast photoreactivating enzyme (PRE), preilluminated with wavelengths ranging from the near-UV to the red spectral region, forms with 254 nm-irradiated transforming DNA of Haemophilus influenzae enzyme-substrate complexes that are more efficiently photorepaired than complexes formed from non-preilluminated PRE . The action spectrum for this "preillumination effect", previously shown to have a maximum in the near-UV region, has another maximum near 577 nm . In complexes formed from non-preilluminated PRE the repair probability per incident photon is only about 25% of that in complexes formed from preilluminated PRE, if low-intensity photoreactivating light is applied continuously or as a sequence of flashes . However, photoreactivating light in the form of a single, high-intensity flash of 1 msec duration raises the repair probability to greater than 50% . Two light flashes, discharged with a delay of slightly more than a millisecond, may already achieve less photorepair than the same energy given as a single flash . These results are explained by the assumption that the great majority of PRE molecules in a non-preilluminated preparation have reduced activity (of the order of 1/4 of maximal activity) . These less reactive molecules form enzyme-substrate complexes ("non-activated complexes") in which the repair probability per incident photon is considerably increased if 2 or more photons are absorbed within a time period of the order of milliseconds . This phenomenon, tentatively termed "2-photon photolysis" does not occur in "activated complexes" (i.e . those formed form preilluminated enzyme) . The data are compatible with suggestion that the first absorption leads to a metastable excited state of the complex, during which the repair probability is increased by absorption of another photon . The generally observed heterogeneity of the photolytic response of enzyme-substrate complexes can be partly explained by heterogeneity of PRE molecules regarding their activity . In particular, uncontrolled exposure of enzyme to almost any kind of room light before its experimental use can enhance the heterogeneity. Am J Vet Res, 1979 Apr, 40(4), 469 - 72 Serologic studies on porcine strains of Haemophilus parahaemolyticus (pleuropneumoniae): extraction of type-specific antigens; Gunnarsson A; By the use of phenol water extraction it was possible to obtain strictly serotype-specific antigens from mucoid cell cultures of five serotypes of Haemophilus parahaemolyticus (pleuropneumoniae) . These serotype-specific antigens did not cross-react with each other in immunodiffusion tests . The type-specific precipitating phenol-water-fractions were composed of two to four antigenic components, presumably of polysaccharide or lipopolysaccharide nature. Pediatrics, 1979 Mar, 63(3), 451 - 5 Aerobic and anaerobic bacterial flora of the maternal cervix and newborn gastric fluid and conjunctiva: a prospective study; Brook I et al.; Aerobic and anaerobic cultures were performed on cervical swabs from 35 mothers and their newborn infants' gastric aspirates and conjunctival sacs . Four hundred seventy-nine isolates were obtained; 287 were aerobes and 192 were anaerobes . The cervical and gastric cultures overall yielded a similar flora, but this was not always the case when one compared mothers with their own newborn infants . The conjunctival cultures yielded about half of the number of bacteria per specimen that the gastric contents yielded, and a repeat conjunctival culture done 48 hours later showed a marked reduction in the number of potentially pathogenic bacteria isolated . The predominant aerobes isolated were Staphylococcus epidermidis, diphtheroids, viridans streptococci and Haemophilus vaginalis . The predominant anaerobes were the Bacteroides fragilis group, Propionibacterium acnes, Peptococcus, other Bacteroides and Peptostreptococcus organisms . Statistical analysis revealed significant positive correlation between the isolation of certain groups of organisms and increased duration of pregnancy, increased baby's weight, and prolonged duration of labor. Am J Med, 1979 Mar, 66(3), 543 - 6 Haemophilus parainfluenzae mitral valve vegetation without hemodynamic abnormality . Demonstration by angiography and serial echocardiography; Bamrah VS et al.; The occurrence of Haemophilus parainfluenzae endocarditis on a previously normal mitral valve of a drug addict is described . A large mitral valve vegetation was demonstrated by serial echocardiography and cineangiography . The vegetation did not produce hemodynamic abnormalities preventing detection by physical examination . Multiple septic emboli to various organs, including brain, resulted in death . The role of serial echocardiography and the levophase of right heart cineangiography in detecting mitral valve vegetation in a patient suspected of having infective endocarditis is emphasized. Medicine (Baltimore), 1979 Mar, 58(2), 145 - 58 Infective endocarditis caused by slow-growing, fastidious, Gram-negative bacteria; Ellner JJ et al.; In a review of endocarditis caused by fastidious, slow-growing gram-negative rods, similarities in the spectrum of disease overshadow differences among cases grouped by specific organisms . Cardiobacterium hominis, Actinobacillus actinomycetemcomitans and Haemophilus species usually seed previously damaged cardiac valves presumably during bacteremia from an upper respiratory site . The clinical presentation resembles that of Streptococcus viridans endocarditis and is usually subacute or chronic . Despite bacteriologic cure, severe CHF and/or systemic embolization frequently develops during or following the course of antibiotics, resulting in significant morbidity and a high mortality rate . This report of nine cases diagnosed at five hospitals in a 7-year period suggests that endocarditis due to these organisms is more common than previously appreciated and frequently goes unrecognized . This is probably due to a lack of attention to the requirements for culture of this group of bacteria with propensity for granular growth in broth . We have proposed specific cultural techniques appropriate to the search for these organisms in patients with apparent culture-negative endocarditis. J Clin Microbiol, 1979 Mar, 9(3), 409 - 12 Biochemical characteristics of 130 recent isolates from Haemophilus influenzae meningitis; Kilian M et al.; A total of 130 Haemophilus strains, comprising virtually all isolates from Danish and Norwegian cases of Haemophilus meningitis occurring in the period from October 1975 through September 1976, were examined by biochemical and serological means . All isolates were identified as H . influenzae and, except for one noncapsulated strain, possessed a capsule of serotype b . The vast majority of strains (93%) belonged to biotype I, which, in contrast to biotypes II and III, is rarely encountered as a commensal of the upper respiratory tract . This finding is a strong incentive for studies of possible additional virulence factors associated with biotype I organisms . The results are discussed in the light of North American reports, which have suggested changes in the etiology of Haemophilus meningitis. Pediatrics, 1979 Mar, 63(3), 402 - 7 Treatment of Haemophilus influenzae type B epiglottitis; Faden HS; During 1969-1977, 48 children with blood cultures proved positive for Haemophilus influenzae type B epiglottitis were evaluated and treated . The fatality rate was 2%; one child died and another developed irreversible hypoxic brain damage . Ninety-five percent of the children were intubated and none required tracheostomy . The endotracheal tubes remained in place for 3.3 +/- 1.5 days . Short-term parenteral antimicrobial therapy, 4.0 +/- 1.4 days, was sufficient to eradicate bacteremia and prevent metastatic infectious foci . This report demonstrates the excellent results achieved in the treatment of epiglottitis with brief intubation and parenteral antimicrobial therapy. J Bacteriol, 1979 Mar, 137(3), 1081 - 3 Features of the damage produced by proflavine on transforming deoxyribonucleic acid; Cabrera-Juarez E et al.; Proflavine formed a complex with transforming deoxyribonucleic acid (DNA) from Haemophilus influenzae, with optimal formation at a ratio of proflavine to DNA of 0.06 . The rate of dissociation of the complex by dialysis increased in the order: native, denatured, renatured DNA . The transforming activity of the DNA was reduced by its interaction with proflavine . This inactivation was dependent on the physical state of the DNA, the proflavine concentration, and the temperature . DNA that had been denatured and renatured was most sensitive; native DNA was much less sensitive . The inactivation remained after dialysis and was stable to prolonged storage . It is concluded that the inactivation of transforming DNA by proflavine takes place by a mechanism different from that of DNA-proflavine complex formation. Arch Intern Med, 1979 Mar, 139(3), 368 - 9 Haemophilus influenzae cellulitis in an adult; Shaw RA et al.; Cellulitis due to Haemophilus influenzae type B in adults has only recently been reported . We report a case in which the patient's antibody levels documented an immunologic response to the organism . The efficacy of a new cephalosporin antibiotic, cefoxitin sodium, in treating this infection also was established . Cefoxitin has activity against ampicillin-resistant H influenzae and would be an alternative in treating H influenzae cellulitis. Clin Exp Pharmacol Physiol, 1979 Mar-Apr, 6(2), 139 - 49 Comparison of vaccination of mice and rats with Haemophilus influenzae and Bordetella pertussis as models of atopy; Terpstra GK et al.; 1 . Rats and mice were vaccinated with Haemophilus influenzae in different vaccination schedules whereafter blood eosinophils were counted . In rats a single vaccination resulted in a dose-dependent effect on the blood eosinophil count in a pattern comparable with that after Bordetella pertussis vaccination . In a long-term vaccination schedule (five times a week for 5 weeks) rats developed a constant eosinophilia . In mice a single vaccination resulted in an eosinopenia of a consistent pattern which differed from the response after Bordetella pertussis vaccination; in a long-term vaccination schedule, eosinophilia was evoked for a period of about 13 days . 2 . Thirty minutes after an adrenaline injection in vaccinated rats and mice with Haemophilus influenzae, hyperglycaemic and eosinophilic responses were measured . The eosinophilic response after adrenaline was inhibited in both species; the hyperglycaemic response in rats was unaltered, in mice the response was slightly but significantly (P less than 0.05) decreased . 3 . The sensitivity to several drugs was tested in mice, 5 days after vaccination with Haemophilus influenzae or Bordetella pertussis . Haemophilus influenzae vaccination reduced the isoprenaline sensitivity and increased the noradrenaline sensitivity . Bordetella pertussis vaccination reduced the isoprenaline sensitivity while the sensitivity to histamine and adrenaline was raised . 4 . The Haemophilus influenzae vaccinated experimental animal provides a model that is possibly more related to human atopy than the Bordetella pertussis vaccinated animal. J Gen Microbiol, 1979 Mar, 111(1), 223 - 31 Molecular characterization of a small Haemophilus influenzae plasmid specifying beta-lactamase and its relationship to R factors from Neisseria gonorrhoeae; Laufs R et al.; The ampicillin-resistant Haemophilus influenzae strain Ve445 which caused purulent meningitis and septicaemia in a newborn child in Germany contained a 4.4 megadalton (Mdal) plasmid (pVe445) and produced a TEM type beta-lactamase . The transformation to ampicillin resistance of a sensitive Escherichia coli strain with isolated pVe445 DNA proved that the structural gene for the beta-lactamase resided on this plasmid genome . Molecular DNA-DNA hybridization studies and electron microscope DNA heteroduplex analysis indicated that pVe445 probably contained 38 to 41% of the ampicillin translocation DNA segment (TnA) found on R factors of enteric origin . The TnA fragment present in pVe445 most likely does not contain both of