Obstet Gynecol, 1985 May, 65(5), 669 - 72 Microorganisms in semen used for artificial insemination; Leiva JL et al.; The effect of freezing semen in a cryopreservative media consisting of egg yolk glycerol with or without erythromycin was tested for its effect on the viability of microorganisms present in donor semen and on sexually transmitted pathogens seeded into semen . All donor semen contained two or three species of microorganisms that could be considered skin flora . Five of ten donor semen specimens contained Ureaplasma urealyticum that was not affected by either freezing or antimicrobial treatment . Some strains of Neisseria gonorrhoeae, when seeded into semen, survived all conditions except freezing in egg yolk glycerol containing erythromycin . Chlamydia trachomatis was erradicated when erythromycin was present in the cryopreservative . There was no detectable effect of any treatment tested on the survival of herpes simplex virus. J Clin Microbiol, 1985 May, 21(5), 857 - 8 Rapid enzyme system for the identification of pathogenic Neisseria spp; Brown JD et al.; Gonochek II is a combination of three enzyme substrates in one tube which will give a rapid identification (30 min) of those pathogenic Neisseria spp . which can be isolated on Thayer Martin or similar selective media . Eighty isolates were tested by Gonochek II and a carbohydrate utilization method; total agreement was achieved between the two methods. Sex Transm Dis, 1985 Apr-Jun, 12(2), 93 - 6 Effect of amoxicillin on simultaneous Chlamydia trachomatis infection in men with gonococcal urethritis: comparison of three dosage regimens; Csango PA et al.; Of 92 men with gonococcal urethritis who were treated orally with amoxicillin, 25 (27.1%) had a simultaneous Chlamydia trachomatis infection . At the first visit 25 patients were treated with a single dose of 1 g of amoxicillin plus 1 g of probenecid (group 1); 24 men were treated with 1 g of amoxicillin twice a day for two days (group 2); and 43 men were treated with 0.75 mg of amoxicillin three times a day for seven days (group 3) . At the follow-up visit, one patient in each group still had Neisseria gonorrhoeae-positive cultures . C . trachomatis was not isolated again after treatment from men in group 3, but was isolated from 81.8% in groups 1 and 2 combined (P less than 0.05) . One (10%) of the ten men in group 3 who were C . trachomatis-positive before treatment developed postgonococcal urethritis, as compared with seven (63.6%) of 11 in groups 1 and 2 combined (P less than 0.05) . Thus a multiple-dose amoxicillin regimen may prove to be a useful alternative to the present-day treatment of chlamydial infections of the urogenital tract. Antimicrob Agents Chemother, 1985 Apr, 27(4), 570 - 3 In vitro susceptibility of Neisseria gonorrhoeae to 2-acetylpyridine thiosemicarbazones; Christenson B et al.; MICs of 20 2-acetylpyridine thiosemicarbazones and penicillin were determined for 25 clinical isolates of beta-lactamase-positive and beta-lactamase-negative Neisseria gonorrhoeae strains . The compounds most active against the beta-lactamase-producing strains were the N4,N4-disubstituted derivatives and the thiosemicarbazone derivatives of the 2-acetylpyridines, followed by the other compounds related to the 2-acetylpyridine thiosemicarbazones. Sex Transm Dis, 1985 Apr-Jun, 12(2), 90 - 2 Treatment of uncomplicated gonorrhea in women with single-dose cefonicid; Handsfield HH et al.; The efficacy of cefonicid (1.0 g given in a single intramuscular dose) was assessed in 50 women with uncomplicated infections due to beta-lactamase-negative strains of Neisseria gonorrhoeae . Forty-three (96%) of 45 cervical infections but only 23 (82%) of 28 anorectal infections were eradicated; overall, 44 (90%) of 49 women were cured of anogenital gonorrhea . Cefonicid failed to eradicate six (55%) of 11 pharyngeal gonococcal infections and 17 (85%) of 20 endocervical infections with Chlamydia trachomatis . Cefonicid had good activity against N . gonorrhoeae in vitro; 41 (98%) of 42 isolates were inhibited by less than or equal to 1.0 micrograms/ml . However, because of its poor efficacy against anorectal and pharyngeal gonococcal infections, single-dose cefonicid is not suitable for the treatment of gonorrhea in women or homosexually active men. Sex Transm Dis, 1985 Apr-Jun, 12(2), 76 - 82 Construction and characterization of chimeric beta-lactamase plasmids of Neisseria gonorrhoeae with altered ability to be mobilized during conjugation; Tenover FC et al.; A series of chimeric plasmids derived from the transfer factor, beta-lactamase-encoding R factor, and cryptic plasmid of Neisseria gonorrhoeae was constructed . Two of these plasmids, each lacking a 1.9-kilobase-pair (kb) HinfI fragment, could not be mobilized by the 40-kb gonococcal transfer factor to recipient strains of N . gonorrhoeae or Escherichia coli during conjugation . The proteins encoded by both the naturally occurring and chimeric plasmids were examined with an E . coli cell-free transcription-translation system and in E . coli maxicells . Six plasmid-specific proteins were identified when DNA from a naturally occurring 7.1-kb R factor was used as template . A small protein (16,000 daltons), which is apparently not encoded by the two plasmids lacking the 1.9-kb HinfI fragment, appears to be necessary for plasmid transfer during conjugation. J Clin Microbiol, 1985 Apr, 21(4), 575 - 7 Proctitis associated with Neisseria cinerea misidentified as Neisseria gonorrhoeae in a child; Dossett JH et al.; An 8-year-old boy developed proctitis . Rectal swabs yielded a Neisseria sp . that was repeatedly identified by API (Analytab Products, Plainview, N.Y.), Minitek (BBL Microbiology Systems, Cockeysville, Md.), and Bactec (Johnston Laboratories, Towson, Md.) methods as Neisseria gonorrhoeae . Subsequent testing in a reference laboratory yielded an identification of Neisseria cinerea . It is suggested that identification of a Neisseria sp . isolated from genital or rectal sites in a child be confirmed by additional serological, growth, and antibiotic susceptibility tests and, if necessary, by a reference laboratory . The implications of such misidentifications are discussed. Surg Gynecol Obstet, 1985 Apr, 160(4), 304 - 6 Periappendicitis and chlamydial salpingitis; Mardh PA et al.; Periappendicitis seems to be a novel manifestation of infections with Chlamydia trachomatis . In seven of 112 women with laparoscopically verified acute salpingitis, secondary appendicitis was diagnosed and histologically confirmed . The genital tract in all seven patients harbored Chlamydia trachomatis but not Neisseria gonorrhoeae . The fallopian tubes should be scrutinized when an inflamed appendix is removed from a sexually active woman . Signs of salpingitis should then lead to appropriate microbiologic, therapeutic and epidemiologic measures, including contact tracing. J Bacteriol, 1985 Apr, 162(1), 170 - 5 Identity of Escherichia coli D-1-amino-2-propanol:NAD+ oxidoreductase with E . coli glycerol dehydrogenase but not with Neisseria gonorrhoeae 1,2-propanediol:NAD+ oxidoreductase; Kelley JJ et al.; The properties of D-1-amino-2-propanol oxidoreductase from wild-type Escherichia coli have been compared with those of a glycerol dehydrogenase from mutant E . coli 424 and of a 1,2-propanediol oxidoreductase from Neisseria gonorrhoeae . Several independent lines of evidence indicate that the former two enzymes are identical . (i) Both enzymatic activities purified to virtual homogeneity in an identical manner, and the ratio of specific activities (glycerol/aminopropanol) remained constant at all stages . (ii) When electrophoresed, both purified enzymes showed a major as well as a minor band of protein coincident with activity, and these two bands from each enzyme had the same mobility . (iii) The subunit molecular weights and isoelectric points were identical for each enzyme, and (iv) kinetic constants (Km and Vmax values) determined with three different substrates were the same . The somewhat greater stability of the glycerol dehydrogenase to controlled heat denaturation at 74 degrees C was the only difference observed between these two enzymes . In contrast, D-1-amino-2-propanol oxidoreductase was found to be immunochemically and kinetically distinct from the 1,2-propanediol oxidoreductase from N . gonorrhoeae. Genitourin Med, 1985 Apr, 61(2), 99 - 102 Auxotypes and serogroups of penicillinase producing and non-producing strains of Neisseria gonorrhoeae isolated in Franceville, Gabon; Yvert F et al.; The auxotypes and serogroups of 250 consecutive isolates of Neisseria gonorrhoeae from Franceville, Gabon, including 33 penicillinase producing (PPNG) strains, were identified and the results tabulated for four periods . The PPNG and certain non-PPNG strains were isolated in clusters against a relatively stable pattern of non-PPNG biotypes . Most of the non-PPNG strains were non-requiring or proline requiring strains of serogroup WII or non-requiring strains that could not be grouped with commercially available antisera . No strain requiring arginine, hypoxanthine, and uracil was observed . The PPNG strains were all serogroup WI or ungroupable and non-requiring or proline or arginine dependent auxotypes . Only one non-PPNG strain required proline or arginine and was not serogroup WII. Genitourin Med, 1985 Apr, 61(2), 103 - 5 Prepartal infection of the placenta with Neisseria gonorrhoeae; Yvert F et al.; Placentas from 191 consecutive deliveries were cultured for Neisseria gonorrhoeae and other bacteria before being examined histologically . N gonorrhoeae was seen on direct microscopical examination and cultured from two placentas, one of which had chorioamnionitis and the other had a granulocytic invasion of the membranes . In both patients, rupture of the membranes had occurred two hours or less before delivery, and thus after infection . A third patient was also found to have light gonococcal infection of the placenta . Six infections with group B streptococci were identified, but only one correlated with chorioamnionitis . Chorioamnionitis was observed in 16 (8.4%) and granulocytic infiltration of the membranes in 18 (9.4%) of the deliveries. Isr J Med Sci, 1985 Apr, 21(4), 346 - 50 Prevalence of low genital tract infectious agents in young Israeli women; Herman A et al.; Low genital tract infectious agents were examined 411 times in 386 young women . Each examination included anamnesis, physical examination and broad-spectrum microbiologic analysis for the detection of: Ureaplasma urealyticum, Chlamydia trachomatis, Trichomonas vaginalis, Candida species, Mycoplasma hominis, Streptococcus beta hemolyticus Group B, Hemophilus vaginalis, Neisseria gonorrhoeae and syphilis serology . Three hundred and six patients were symptomatic for low genital tract infection and 80 were asymptomatic . Most patients were young, 19.6 +/- 1.7 (SD) years old, single (84.7%) and sexually active (87.4%) . U . urealyticum and C . trachomatis were the most common agents recovered in 43.9 and 40.8% of symptomatic patients, respectively . All agents were isolated more frequently in the symptomatic group, but statistically significant group comparisons were obtained only for Candida sp . (P less than 0.001), T . vaginalis (P less than 0.005) and M . hominis (P less than 0.05) . N . gonorrhoeae was isolated in only one case (0.3%), which may reflect technical difficulties or a true very low prevalence of this agent . Clinical diagnoses of candidiasis and trichomoniasis in symptomatic patients were confirmed by laboratory results in only 34.9 and 54.9%, whereas negative clinical diagnoses were confirmed in 83.9 and 73.2%, respectively. Acta Pathol Microbiol Immunol Scand {B}, 1985 Apr, 93(2), 91 - 7 Phenotypic and genotypic characterization of penicillinase-producing strains of Neisseria gonorrhoeae; Falk ES et al.; Thirty penicillinase-producing Neisseria gonorrhoeae (PPNG) strains, 26 representing 9 serovars of the protein IB and 4 representing 2 serovars of the protein IA serogroup, had 10 different patterns when investigated by the restriction enzyme (RE) technique with Hind III enzyme . One RE pattern dominated, representing 11 strains with 6 different serovars of both the protein IA and IB serogroup . Identical serovars and RE patterns were found among 7 patients (3, 2 and 2, respectively) with positive epidemiology . The majority of the strains (24/30) were resistant to, or showed decreased sensitivity to, doxycycline with minimum inhibitory concentrations between 1 and 8 mg/l, consistent with the Far East origin . All the 30 PPNG strains showed by agarose gel electrophoresis to harbour a 2.8 Mdalton, a 4.4 Mdalton, as well as a 24.5 Mdalton plasmid, whereas the two non-PPNG strains had only the 2.8 Mdalton plasmid. JAMA, 1985 Mar 22-29, 253(12), 1749 - 54 Bacterial meningitis in the United States, 1978 through 1981 . The National Bacterial Meningitis Surveillance Study; Schlech WF 3rd et al.; From 1977 to 1981, 18,642 cases of bacterial meningitis were reported to the Centers for Disease Control . We analyzed data from 27 states with full participation from 1978 through 1981 . Hemophilus influenzae was the most frequent cause of bacterial meningitis (48.3%), followed by Neisseria meningitidis (19.6%) and Streptococcus pneumoniae (13.3%) . Overall attack rates for males were greater than for females (3.3 v 2.6 cases per 10(5) population per year) . Attack rates were highest in children under 1 year of age (76.7 per 10(5) population per year) . Case-fatality ratios were highest for gram-negative and miscellaneous causes of bacterial meningitis (33.7%) and lowest for meningitis caused by H influenzae (6.0%) . Neisseria meningitidis and S pneumonia meningitis occurred preponderantly during the winter, while H influenzae meningitis had peak activity in the spring and fall . Ampicillin resistance among H influenzae increased from 18.7% in 1978, to 23.9% in 1981 . Serogroup B Neisseria meningitidis was the most common serogroup identified during the reporting period (51.1%), followed by serogroup C (22.3%), serogroup Y (5.8%), and serogroup A (4.7%) infections. Am J Obstet Gynecol, 1985 Mar 15, 151(6), 765 - 71 Chlamydial endocervical infections and cytologic findings in sexually active female adolescents; Shafer MA et al.; The association of infection with Chlamydia trachomatis and cytologic changes on Papanicolaou smear was examined in 148 sexually active postmenarchial++ female subjects, aged 13 to 21 years (mean = 17.2) attending a teen clinic . Endocervical samples for micro-organisms (C . trachomatis and Neisseria gonorrhoeae) and a cervical sample for cytologic examination were taken . A detailed evaluation of the cytologic results was made independently of the C . trachomatis status . In 23 (15.5%) subjects tests for isolation of C . trachomatis were positive . Inflammatory changes in epithelial cells, nuclear changes in metaplastic cells, and lymphocytes in the inflammatory exudate were associated with C . trachomatis isolation but suspected "chlamydial inclusions" and cytoplasmic vacuoles in metaplastic cells were not . The results reported here do not support the use of cervical cytologic examination as a definitive diagnostic test for presence of an endocervical chlamydial infection . However, it may be possible to use the cytologic pattern described here to identify a population with a high prevalence of C . trachomatis. Am J Obstet Gynecol, 1985 Mar 15, 151(6), 771 - 7 Cefotaxime treatment for women with community-acquired pelvic abscesses; Hemsell DL et al.; Forty-one women with pelvic abscesses complicating salpingitis were treated with parenteral cefotaxime, a newer cephalosporin . Abscesses ranged in size from 4 by 4 to 13 by 15 cm, and in 10 women (24%) they were greater than or equal to 10 cm . Neisseria gonorrhoeae was recovered from the endocervix in 17 women (41%) . A mean of 26.7 gm of cefotaxime was given over a mean of 6.5 days, and operation was not required during initial therapy . Only two women (5%) required the addition of another antimicrobial . Chronic pelvic pain and recurrent infection were infrequent during the 31- to 43-month follow-up period . Five women (12%) were readmitted for elective surgical therapy because of persistent or recurrent adnexal mass 1 to 33 months following study entry . Six (15%) women became pregnant and were delivered of their infants a mean of 25 months following cefotaxime therapy. JAMA, 1985 Mar 8, 253(10), 1417 - 9 Comparative study of ceftriaxone and spectinomycin for treatment of pharyngeal and anorectal gonorrhea; Judson FN et al.; Of the currently recommended regimens for treatment of uncomplicated gonorrhea, only aqueous penicillin G procaine is effective against infections at all sites . However, procaine penicillin is not effective against penicillinase-producing Neisseria gonorrhoeae and suffers from poor patient acceptability owing to the 10-mL volume of injection and allergic and toxic procaine reactions . Ceftriaxone is a new extended-spectrum cephalosporin with a long serum half-life and is many times more active than penicillin G against both beta-lactamase-positive or -negative strains of N gonorrhoeae . Ceftriaxone was compared as a single, 125-mg, 0.5-mL injection with a single 2-g injection of spectinomycin in difficult to treat pharyngeal gonorrhea in men and women and anorectal gonorrhea of men . Ceftriaxone cured 30/32 (94%) pharyngeal and 52/52 anorectal infections, compared with 6/14 (43%) and 9/9, respectively, for spectinomycin . Both regimens were well tolerated . Ceftriaxone may prove to be a drug of choice for uncomplicated gonorrhea, particularly where homosexual men are treated and/or penicillinase-producing N gonorrhoeae is prevalent. Clin Rheumatol, 1985 Mar, 4(1), 83 - 5 Septic arthritis of the knee due to Neisseria mucosa; Abiteboul M et al.; We report a case of septic arthritis of the knee due to Neisseria mucosa a widespread commensal of the oropharynx following an infiltration of the joint . Evolution was favorable in ten weeks, with antibiotics (amoxicillin then erythromycin), and without surgery. Obstet Gynecol, 1985 Mar, 65(3), 384 - 8 Chlamydia trachomatis as a cause of prepubertal vaginitis; Bump RC; Chlamydia trachomatis was encountered in four cases during the evaluation of 29 premenarchal girls with gynecologic complaints during 1983 . Only one of the patients had antecedent infection with Neisseria gonorrhoeae . The importance of using specific tests to actively establish a definite diagnosis of chlamydia is stressed . The susceptibility of the thin premenarchal vaginal mucosa to chlamydial infection is discussed as is the role of chlamydia as a marker for sexual abuse . Once a diagnosis of chlamydial rectogenital infection is established in a child, it is mandatory to investigate for child abuse and sexual molestation as the source of the infection. J Reprod Med, 1985 Mar, 30(3 Suppl), 244 - 9 Problems in the culture diagnosis of gonorrhea; Schink JC et al.; PIP: The diagnosis of gonorrhea in men can be established by observing gram-negative intracellular diplococci in Gram's stained urethral discharge, but more sensitive screening is required for women, who may be asymptomatic in 80% of cases . Routine screening for gonorrhea detects only 65-85% of infected women . Careful sampling from the endocervix and use of a 2nd specimen can improve the yield . Care should be taken to avoid disenfectants and lubricants that might inhibit culture growth . Allowing adequate time for absorption of organisms onto the swab and prewarming the culture medium improve the recovery rate . Dacron and calcuim alginate swabs are theoretically better than cotton because they do not contain fatty acids hostile to N . gonorrhoeae . 3 media are recommended by the Centers for Disease Control: Martin-Lewis (ML), modified Thayer-Martin (MTM), and modified New York City (MNYC) . Each of the 3 has unique advantages and disadvantages, and each can enhance growth and isolation of Neisseria . Strains inhibited by the vancomycin in all 3 media can be detected by parallel cultures on chocolate agar, a procedure not always practical for routine screening . 16% fewer infections are detected when longterm transport of gonorrhea culture specimens is required instead of on-site bacteriologic testing . For longterm transport, culture media in a CO2 enriched environment are best . The JEMBEC system with a CO2 generating tablet enclosed in a ziploc bag is a convenient system . The cultures must be incubated before transport . For onsite testing and transport lasting less than 3 hours, a nonnutrient system such as modified Stuart's medium is sufficient . The JEMBEC system and direct plating on selective media with transport in a candle jar are also acceptable for short-term transport . Presumptive identification is based on 1) the opaque, convex, and gray-white appearance of colonies incubated for 24-48 hours at 35 degrees Celsius with increased CO2 2) identification of typical gram-negative diplococci on Gram's staining of a characteristic colony, and 3) demonstration of the presence of cytochrome oxidase in the colonies . Presumptive identification is at least 98% specific . Confirmation is usually based on carbohydrate utilization tests or immunologic methods, including fluorescent antibody and coagglutination systems . These tests are quicker than carbohydrate utilization tests but have a 2-3% false-positive rate . Carbohydrate utilization techniques require 48-72 hours but are more specific than immunologic methods and should be used for medicolegal cases . Trop Geogr Med, 1985 Mar, 37(1), 74 - 6 Sensitivity pattern and beta-lactamase screening of Neisseria gonorrhoeae strains isolated in Zaria, Northern Nigeria; Joshi RM et al.; One hundred and sixty strains of N . gonorrhoeae were studied for their in-vitro sensitivity to six different antimicrobial agents and tested for beta-lactamase production in Zaria, Northern Nigeria . While 82% of strains were sensitive to erythromycin, 70% to tetracycline and 61% to chloramphenicol, only 35%, 33% and 24% were sensitive to ampicillin, penicillin and streptomycin respectively . Penicillin is no more the drug of choice in the treatment of gonorrhoea in this environment since two thirds of strains are either partially resistant or completely resistant to penicillin and 44% of strains are beta-lactamase producers . Erythromycin/tetracycline are recommended as the drugs of choice. Ann Inst Pasteur Microbiol, 1985 Mar-Apr, 136A(2), 233 - 9 {Sensitivity of Neisseria polysacchareae to antibiotics}; Dabernat H et al.; A new taxon had previously been described in the genus Neisseria and it was proposed that "Neisseria polysacchareae" be the provisional epithet for this new "species" . In the present work, susceptibility to antibiotics was determined using agar dilution tests . The tested strains of "N . polysacchareae" were isolated from throat, those of N . meningitidis from cases and carriers, and those of other species of Neisseria were from culture collections . The strains of "N . polysacchareae" were less sensitive than those of N . meningitidis, particularly to rifampicin, mecillinam and macrolide antibiotics; they were resistant to colistin and vancomycin and could therefore be isolated on selective medium for pathogenic Neisseria spp. Diagn Microbiol Infect Dis, 1985 Mar, 3(2), 125 - 30 Evaluation of the RIM system and Gono Gen test for identification of Neisseria gonorrhoeae from clinical specimens; Robinson A et al.; RIM-N (Austin Biological Laboratories) and Gono Gen (Micro Media Systems) were evaluated for accuracy and compared with conventional carbohydrate degradation tests for identification of Neisseria gonorrhoeae . A total of 127 fresh clinical isolates of N . gonorrhoeae were tested; 118 (93%) were identified by RIM-N, and 100 (79%) yielded positive reactions with Gono Gen . Seventy nongonococcal isolates including other Neisseria species, Branhamella catarrhalis, Kingella kingae, and Moraxella species were evaluated to determine the specificity of the test methods . Both rapid tests were 100% specific in the identification of N . gonorrhoeae isolates . RIM-N was the most sensitive test for the identification of N . gonorrhoeae and offers a useful, more rapid alternative to conventional carbohydrate degradation methods. J Bacteriol, 1985 Mar, 161(3), 861 - 7 Role of lipid intermediate(s) in the synthesis of serogroup B Neisseria meningitidis capsular polysaccharide; Masson L et al.; Neisseria meningitidis serogroup B strain M986 was examined for the involvement of lipid intermediate(s) participating in the biosynthesis of the sialic acid capsular polysaccharide . The addition of exogenous undecaprenyl phosphate, phosphatidylethanolamine, or phosphatidylglycerol to particulate membranes, in the presence of cytidine 5'-monophosphosialic acid, resulted in the stimulation of sialyltransferase activity specifically by undecaprenyl phosphate . Sialyltransferase activity, after delipidation of particulate membrane proteins, was specifically reconstituted by undecaprenyl phosphate . After the addition of 14C-labeled cytidine 5'-monophosphosialic acid to particulate membranes, the level of labeled lipid intermediate(s), extracted by chloroform-methanol (2:1), increased up to a maximum level between 3.75 and 5.0 min, which subsequently decreased to a lower steady-state level . Pulse-chase experiments revealed a transient, solvent-extractable, lipid-linked component . The extracted N-acetylneuraminic acid was in polymeric form . Sequential oxidation and reduction of the extracted radioactivity followed by neuraminidase treatment revealed an average degree of polymerization of four or five N-acetylneuraminic acid residues . Bacitracin-sensitive peptidoglycan was synthesized in vitro by particulate membranes . Cross-competition experiments between peptidoglycan and capsular polysaccharide synthesis by preincubation of precursors of one pathway during synthesis of the other revealed a competitive effect for a common component . This component was believed to be a common pool of undecaprenyl phosphate . A model for the production and regulation of the capsular polysaccharide is proposed. J Bacteriol, 1985 Mar, 161(3), 1236 - 7 Type III 5-methylcytosine modification of DNA in Neisseria gonorrhoeae; Korch C et al.; We present here the first report of a type III methyltransferase that modifies a cytosine . Neisseria gonorrhoeae 82409/55 (pJD1) modifies the first cytosine on only one strand from the 5' end of the nonpalindromic sequence: (Formula; see text) . We have called this modifying activity M X NgoVIII. J Immunol, 1985 Mar, 134(3), 1920 - 5 Bactericidal but not nonbactericidal C5b-9 is associated with distinctive outer membrane proteins in Neisseria gonorrhoeae; Joiner KA et al.; In this study, we examined the bacterial constituents associated with the complement C5b-9 complex in detergent extracts from serum-treated Neisseria gonorrhoeae (GC) . 125I surface-labeled GC were incubated in 10% serum, were washed, and were solubilized in the zwitterionic sulfobetaine detergent SB12 . Immunoprecipitation of 125I-GC from the extract with anti-C5 Sepharose was followed by 12.5% sodium dodecyl sulfate-polyacrylamide gel electrophoresis autoradiography of immunoprecipitated material . Polyacrylamide gel analysis of surface-labeled 125I-GC showed prominent bands for proteins I and III for both serum-resistant GC strain 6305 and serum-sensitive GC strain 7189 . These same bands were visible with similar intensity in the SB12 extracts from presensitized and non-presensitized 6305 and 7189 after serum incubation . For those organisms bearing bactericidal C5b-9 (6305 + IgG and 7189 +/- IgG), additional distinctive bands immunoprecipitated with antibody to C5 Sepharose . These components were of 93,000, 44,000 40,000, and 15,000 daltons for 6305 + IgG, and were of 90,000, 50,000, 44,000, and 19,000 daltons for 7189 +/- IgG . Nonbactericidal C5b-9 extracted from the surface of 6305 incubated in serum, but not sensitized with antibody, was not associated with these distinctive proteins . However, this nonbactericidal C5b-9 did have a different pattern of associated bacterial surface constituents from that observed in control samples incubated with antibody to human serum albumin, which were similar to those with nonserum-incubated organisms . These studies support our earlier experiments which demonstrated that C5b-9 is in a different molecular configuration on the surface of serum-resistant GC from that on the surface of serum-sensitive GC or resistant GC rendered sensitive with bactericidal antibody. Gastroenterology, 1985 Mar, 88(3), 804 - 7 Spontaneous bacterial peritonitis caused by Neisseria gonorrhoeae . Evidence for a transfallopian route of infection; Stassen WN et al.; We describe the clinical and laboratory features of a case of spontaneous bacterial peritonitis caused by Neisseria gonorrhoeae in a sexually active woman with Laennec's cirrhosis, ascites, and asymptomatic cervical gonorrhea . Treatment of the infection with high-dose parenteral penicillin was associated with resolution of the infection . This first report of spontaneous gonococcal peritonitis provides highly suggestive evidence that the transfallopian route is a mechanism whereby bacteria may enter the peritoneal cavity . Appropriate cultures for this organism should be included when a woman with chronic liver disease, who is sexually active, presents with spontaneous peritonitis. Adv Contracept, 1985 Mar, 1(1), 63 - 76 Pelvic inflammatory disease, intrauterine contraception, and the conduct of epidemiologic studies; Struthers BJ; Pelvic inflammatory disease (PID) has been described in the medical literature for more than a century as a specific entity . Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma hominis, along with Bacteroides fragilis and other anaerobic bacteria, have been most frequently associated with PID . Factors affecting the occurrence of PID have been extensively studied during the past two decades and include number of sexual partners, age, race, socioeconomic status, education, and contraceptive method . As knowledge concerning factors that contribute to PID increases, epidemiologic studies addressing such issues must become increasingly sophisticated, and the literature needs to be re-evaluated in light of present knowledge . Various risk factors for PID, types of epidemiologic studies, methods for conducting such studies, and data interpretation are reviewed. J Reprod Med, 1985 Mar, 30(3 Suppl), 290 - 4 Problems in specimen collection for sexually transmitted diseases; Larsen B; PIP: The diagnosis of infectious diseases including sexually transmitted diseases (STDs) requires adequate specimen collection, rapid transport to the laboratory, cultivation on appropriate media, and evaluation by experienced laboratory personnel, All available techniques should be sued in diagonsis, It is holpful to have knowledge of the population groups at highest risk, potential modes of transmission, and signs found on physical examination . Microscopy can be useful, especially in gonorrhea in men and syphillis in both sexes . Cytosmears may cntribute to the diagnosis of viral and chlamydial infection although the inclusions and cytopathologic changes are nonspecific . Microscopic evaluation alone may be sufficient for diagnosis of vaginal candidiasis, trichomoniasis, and Gardnerella vaginalis vaginitis . For either culture of immunologic techniques to be effective, adequate and appropriate specimens must be collected for laboratory analysis, Selecting the appropriate site for culture may be difficult, and extragenital sites of infection should be considered due to recent changes in sexual practices . Appropriate target media are essential because may STD agents are susceptible to such environmental influences as dessication . Direct innoculation of appropriate bacteriologic media for Neisseria gonorrhea G vaginalis, and Trichomonas vaginalis allows protection of the organisms . Selective growth media may be helpful for gonorrhea, but some strains of the gonococcus are inhibited by the vancomycin which is used to suppress growth of normal flora . The strains of gonococcus most frequently associated with disseminated infection are very sensitive to antibiotics, and may be associated frequently with asymptomatic disease . New York City medium has several advantages for gonococcus culture . chocolate agar containing 1% IsoVitalex and 3 mcg vancomycin provides a good selective medium for Hemophilus ducreyi, a fastidious organism . Care is needed for specimen preservation when fragile organisms including anaerobic bacteria, viral and chlamydial cultures are suspected . As much material as possible should be obtained for cultures to ensure success . Cultures should be obtained whenerer possible before initiating antimicrobial therapy . The clinician should be aware of potential problems in culture of material exposed to spermicides, douche preparations and lubricating gels . Immunologic tests for diagnosis of STDs apart from syphilis have been developed only recently . The Phadebact coagglutination test identifies gonococci after they have been grown byu standard culture techniques, and the Gonozyme test detects the gonococcal antigen in urogenital secretions, with no need for culture . Typically, both culture and rapid nonculture tests differ in therir sensitivity and specificity, depending on the population being studied--high or low risk, male or female, genital sites of extragenital sites . J Reprod Med, 1985 Mar, 30(3 Suppl), 250 - 7 Assessment of an enzyme immunoassay for diagnosing gonorrhea; Finch CA; PIP: Gonozyme, a nonculture enzyme immunoassay for the detection of Neisseria gonorrhea antigen from urogenital swab specimens, was introduced into the US in 1982 and modified to improve specificity in 1983 . The original Gonozyme assay was compared to culture in several independent studies . Populations with different disease prevalences were examined using study designs that varied considerably . The sensitivity and specificity of Gonozyme as compared to culture were sufficiently high in symptomatic male populations to indicate that Gonozyme was an acceptable diagnostic test, but sensitivity and specificity for female specimens were not as high . Clinical evaluations comparing the modified Gonozyme to culture were conducted on specimens from 410 males, 1245 high risk females and 1234 low risk females at 8 geographically dispersed sites in the US . A single specimen was collected from each patient and processed for culture and Gonozyme . Culture plates were incubated for 48 hours before being reported as negative . Gonozyme tests were done within 5 days of collection . In males the sensitivity and specificity of Gonozyme as compared to culture were both 100% at 3 of the 4 clinics . At the 4th the sensitivity and specificity were 93.1% and 98.8% respectively, giving Gonozyme an overall sensitivity and specificity of 98.0% and 99.4% . 2 males with positive Gonozyme and negative culture results also had urethral smears demonstrating intracellular gram-negative diplococci and were thus considered to have gonococcal infection . The sensitivity and specificity of Gonozyme with regard to gonococcal infections thus rose to 98.0% and 100.0% respectively . The high-risk female group was studied at 5 sites . The overall sensitivity and specificity to Gonozyme as compared to culture were 84.0% and 96.9% respectively . Sensitivity ranged from 80.5% to 90.7% and specificity from 95.8% to 99.2% . The overall sensitivity and specificity of Gonozyme in the low-risk female population studied at 4 cliniaal sites were 90.5% and 98.0% respecitively . Sensitivity ranged from 83.3% to 100.0% and specificity from 97.3% to 98.8% . Statistical tests demonstrated that the specificity of the modified Gonozyme as compared to the original had improved without an adverse effect on the sensitivity . Although Gonozyme specimens cannot be used for beta-lactamase testing or for confirmatory tests, the test offers advantages to clinics and physicians offices in which laboratory services are unavailable and transport conditions are uncertain . Ann Inst Pasteur Microbiol, 1985 Mar-Apr, 136A(2), 271 - 6 {Presence of plasmids in Neisseria meningitidis}; Prere MF et al.; The plasmid content of twenty-nine Neisseria meningitidis strains, isolated from CSF and blood cultures, was investigated by agarose gel electrophoresis . The strains (twenty-seven from serogroup B and two from serogroup C) were sensitive to antibiotics, but 50% were resistant to sulphonamide (MIC greater than or equal to 16 mg/l) . Two serogroup-B strains from CSF harboured an extrachromosomal element . These two cryptic plasmids differed in size: 8.4 Kb for pNMT1 and 82 Kb for pNMT2. Cell Immunol, 1985 Mar, 91(1), 119 - 31 Specific binding of endotoxin to human monocytes and mouse macrophages: serum requirement; Haeffner-Cavaillon N et al.; Specific binding of Bordetella pertussis and Neisseria meningitidis endotoxins to human monocytes and murine macrophages was demonstrated . Binding of B . pertussis endotoxin could be inhibited by endotoxins of Salmonella minnesota, Escherichia coli, and Klebsiella pneumoniae, the extent of inhibition being dependent on the origin of the lipopolysaccharides and on the origin of the mononuclear phagocytic cells . The binding of B . pertussis and N . meningitidis endotoxins which was mediated by the polysaccharide region of the endotoxins was serum dependent . The results indicated that the binding of endotoxin was promoted neither by natural antibodies directed against the endotoxin nor by proteins known to combine with endotoxins: immunoglobulins, albumin, or fibronectin; we have provided some evidence that complement components may play a role in the specific binding of endotoxins to the monocyte/macrophage membrane. J Gen Microbiol, 1985 Mar, 131 ( Pt 3), 601 - 10 Association of resistance of Neisseria gonorrhoeae to killing by human phagocytes with outer-membrane proteins of about 20 kilodaltons; Parsons NJ et al.; The determinant(s) of gonococcal resistance to killing by human phagocytes has been extracted from outer membrane vesicles (OMV) of a phagocyte-resistant strain, BS4 (agar), with sodium cholate (1%, w/v) . The extracts, like the OMV, nullified the effect of antiserum raised against whole BS4 (agar) to promote intracellular killing of the latter by human peripheral blood phagocytes . Fractionation of the extract on Sephadex G75 produced an active fraction with much less protein and lipopolysaccharide (LPS) than in the original extract . Furthermore, crude LPS prepared from the resistant gonococci was inactive . These results imply that the factor(s) promoting intracellular resistance is a protein . SDS-PAGE of the active fraction suggested that the factor was not a principal outer membrane protein nor one of three proteins previously thought to be associated with resistance . In contrast to a similar preparation from a phagocyte-susceptible strain, BSSH, the active fraction from BS4 (agar) showed faintly staining proteins in the regions of 20 and 60 kDal . When eluted from the gels, the former but not the latter neutralized the above effect of antisera, thus associating the 20 kDal protein(s) with resistance to intracellular killing. Vaccine, 1985 Mar, 3(1), 3 - 10 Pilus vaccines; Tramont EC et al.; Bacterial pili (fimbriae) are protein appendages which extend from the cell surface and serve to adhere the microorganism to body surfaces . These appendages have been isolated, purified and characterized as vaccine candidates . These vaccines stimulate an immune response which serves at least with regards to Neisseria gonorrhoeae to block the adherence of the microorganism to epithelial cells . Thus far, these vaccines have proven effective in some animal studies and in a limited number of human challenge studies . The problems that remain are: lack of broad cross reactivity of the vaccines thus far developed poor immunogenicity of the important binding ligands both in terms of quality and quantity of antibody produced and inadequate stimulation of antibody response at the local site of infection. Ann Cardiol Angeiol (Paris), 1985 Feb, 34(2), 89 - 92 {Emboligenic abscess of the aortic ring disclosing gonococcal endocarditis . Value of echocardiography}; Drui S et al.; Echocardiography has become a valuable diagnostic modality in bacterial endocarditis and of even more importance in following the subsequent course of the infection while on medical therapy . It can play an extremely important role in certain clinical circumstances, even before blood culture results are available or hemodynamic or auscultatory abnormalities appear . Nevertheless, in spite of this usefulness, the limitations of echocardiography should be recognized . The examination lacks absolute specificity and sensitivity which could result in inaccurate or delayed information in diagnosing a lesion or in recognizing local or regional complications . These advantages and limitations are well illustrated in an unusual case due to Neisseria gonorrhoeae, a causative agent whose incidence may increase over the years to come. J Med Microbiol, 1985 Feb, 19(1), 115 - 25 Phagocytosis by human leukocytes, phagosomal pH and degradation of seven species of bacteria measured by flow cytometry; Bassoe CF et al.; Phagocytosis by human leukocytes, phagosomal pH and degradation of seven species of bacteria were studied by a flow cytometric method . The percentage of phagocytosing leukocytes was similar for all bacterial strains examined, but Salmonella typhi and Neisseria meningitidis were more slowly phagocytosed than other bacteria . The phagosomal pH surrounding the different bacterial species 15 min after the start of phagocytosis were: Streptococcus pneumoniae 4.4; N . meningitidis 4.9; Str . pyogenes 5.1; Staphylococcus aureus 5.2; Escherichia coli 5.3; S . typhi 5.4; and Klebsiella pneumoniae 5.7 . For longer incubation periods, the phagosomal pH remained nearly constant . Staph . aureus, E . coli and S . typhi were the most readily degraded of the species tested . The proteins of all bacteria were degraded more rapidly than their DNA as determined by measurements of the loss of fluorescein-isothiocyanate-fluorescence and ethidium bromide-fluorescence, respectively . The rate of degradation varied from one bacterial species to another . The degradation of proteins and DNA was maximal for bacteria residing in a phagosomal environment estimated to be between pH 5.2 and 5.4. Genitourin Med, 1985 Feb, 61(1), 48 - 50 Genital infections with Chlamydia trachomatis and Neisseria gonorrhoeae in Ghanaian women; Bentsi C et al.; PIP: The prevalence of Chlamydia trachomatis and Neisseria gonorrhoea in women of Accra, Ghana was estimated by culturing 162 gynecology clinic patients and 39 postpartum inpatients at Korle Bu Hospital . Chlamydia endocervical specimens were frozen and tested in Seattle by culture . N . gonorrhoea was identified by sugar tests, and isolated and tested for beta-lactamase with a cephalosporin assay . Sera from 95 patients were tested for IgG and IgM antibodies to C . trachomatis . Chlamydia were isolated from 8 (4.9%) of the 162 gynecology patients and from 3 (7.7%) of the postpartum patients . N . gonorrhoea was isolated from 5 (3.1%) of the gynecology patients and from 5 (3.4%) of the postpartum patients . C . trachomatis serovars D, E, F and G were the most common . C . trachomatis was more common than N . gonorrhoea in these women, and accounted for 10% of gynecology patients complaining of lower abdominal pain . Genitourin Med, 1985 Feb, 61(1), 39 - 43 Relation between nutritional requirements and susceptibilities to antibiotics of strains of Neisseria gonorrhoeae from pharyngeal and anogenital sites; Ansink-Schipper MC et al.; Auxotyping and antibiotic susceptibility testing was carried out on 100 consecutive isolates of non-penicillinase producing strains of Neisseria gonorrhoeae (non-PPNG) taken on the same occasion from throat and anogenital sites, 100 non-PPNG strains isolated from the throat only, and 100 non-PPNG strains from anogenital sites only . Non-requiring, non-requiring and phenylalanine inhibited, proline requiring, amino acid group requiring, and arginine requiring auxotypes predominated in all groups of patients . Strains of the arginine requiring type found in anogenital sites tended to have additional requirements . The auxotypes and susceptibility to antibiotics of 93 of the 100 paired cultures from the throat and anogenital sites were identical . There appeared to be a slight preponderance of moderately susceptible strains in isolates from the throat . A strong correlation was found between nutritional requirements and sensitivity to antibiotics . Auxotypes of and minimum inhibitory concentrations (MICs) for N gonorrhoeae isolated from the throat were mostly the same as the auxotypes of and MICs for strains that were circulating during the study period in Amsterdam. Genitourin Med, 1985 Feb, 61(1), 36 - 8 Survey of cases of gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae in the United Kingdom; Adler MW et al.; A postal survey of clinicians working in departments of genitourinary medicine in the United Kingdom was carried out to assess the accuracy of the routine surveillance system for penicillinase producing Neisseria gonorrhoeae (PPNG) . A discrepancy was found between the number of cases that had been seen by clinicians and those notified to the Communicable Disease Surveillance Centre . The difference varied from 4% in 1979 to 23% in 1981 . This increasing discrepancy presents problems for the control of PPNG strains, as the time when alternative strategies for the treatment of gonorrhoea should be implemented may go unnoticed. J Gen Microbiol, 1985 Feb, 131 ( Pt 2), 253 - 63 Turnover of the cell wall peptidoglycan during growth of Neisseria gonorrhoeae and Escherichia coli . Relative stability of newly synthesized material; Greenway DL et al.; The peptidoglycan of a number of strains of Neisseria gonorrhoeae and Escherichia coli turned over during exponential growth as monitored by the loss of radioactivity (supplied as {14C}glucosamine) from SDS-insoluble material . However, no turnover of the peptide side chains of E . coli peptidoglycan was observed (monitored by diamino{3H}pimelic acid) even though turnover of glycan material was occurring . Turnover rates of 9 to 15% per generation were recorded for all the N . gonorrhoeae strains studied except for the autolytic variant RD5 which showed a higher rate of turnover (20 to 26% per generation) . In contrast to previous interpretations, these rates of turnover were not affected by benzylpenicillin, unless sufficient antibiotic was present to affect culture turbidity, when lysis occurred . Examination of the fragments (monomer, dimer and their O-acetylated counterparts, and oligomers) produced by Chalaropsis B muramidase treatment of prelabelled peptidoglycan revealed that no fraction of the peptidoglycan was immune from turnover . However, peptidoglycan pulse-labelled for only 10 min did not show immediate turnover . The lapse of time before turnover commenced was strain dependent, with a maximum value of 1.5 generations . This work confirms that the peptidoglycan of N . gonorrhoeae undergoes a period of maturation and suggests that only mature peptidoglycan turns over. Infect Immun, 1985 Feb, 47(2), 527 - 33 Immunity and protection of mice against Neisseria meningitidis group B by vaccination, using polysaccharide complexed with outer membrane proteins: a comparison with purified B polysaccharide; Moreno C et al.; A methodology for preparing outer membrane proteins (type specific) complexed to group B polysaccharide of Neisseria meningitidis is described . These complexes, low in nucleic acid and lipopolysaccharide content, were immunogenic in mice with induction of humoral antigroup B and antiprotein responses . Immunized mice were also protected against challenge with N . meningitidis group B strains of the same or a different type from that used for vaccination . Both immunity and protection were enhanced when the mice received a secondary immunization with the protein-polysaccharide complex . Additional data have shown the capacity of purified B polysaccharide to induce immunological memory, even though it is incapable of inducing a humoral response when given alone. Infect Immun, 1985 Feb, 47(2), 401 - 7 Anaerobiosis increases resistance of Neisseria gonorrhoeae to O2-independent antimicrobial proteins from human polymorphonuclear granulocytes; Casey SG et al.; We investigated the in vitro resistance of Neisseria gonorrhoeae FA19 to the O2-independent antimicrobial systems of human polymorphonuclear leukocytes . Acid extracts of polymorphonuclear leukocyte granules (crude granule extracts) and a purified granule protein (57 kilodaltons) were, at low concentrations, bactericidal for gonococci under aerobic conditions that permitted growth . However, they were less effective under anaerobic conditions that imposed bacteriostasis . We found that adding sodium nitrite to reduced growth media permitted the growth of strain FA19 in an anaerobic environment . Under these conditions with nitrite, anaerobic cultures of strain FA19 were no more resistant to the crude granule extract and the 57-kilodalton protein than aerobic cultures . In contrast, Salmonella typhimurium SL-1004, a facultative anaerobe, was readily killed by both the crude granule extract and the 57-kilodalton antimicrobial protein regardless of the presence or absence of free molecular oxygen . This is the first demonstration that an isolated antimicrobial protein from polymorphonuclear leukocyte granules is active against bacteria under anaerobic conditions . Our results also indicated that the efficacy of human polymorphonuclear leukocyte O2-independent killing of N . gonorrhoeae may, in part, be inhibited by bacteriostatic conditions imposed by hypoxia. Ann Intern Med, 1985 Feb, 102(2), 229 - 43 Gonococcal infections; Hook EW 3rd et al.; Gonorrhea may be the most extensively studied infection of the past 20 years . The gonorrhea epidemic in the United States began in the early 1960s and peaked in 1975 . Ironically, since 1976 the declining overall incidence has been offset by the advent of plasmid-mediated beta-lactamase production by Neisseria gonorrhoeae and by a growing problem with outbreaks due to strains with chromosomally mediated penicillin and tetracycline resistance . This new antimicrobial resistance, coupled with the frequency of concurrent chlamydial infection in developed countries and concurrent syphilis in some developing countries, has created a need for new approaches to gonorrhea therapy . With the introduction of certain new antimicrobial agents, highly effective forms of therapy are again available . New approaches to rapid diagnosis are also becoming available, but require critical appraisal . Unfortunately, in most of the world's population, gonorrhea remains epidemic, diagnosis of gonorrhea in women is extremely difficult, and highly effective antimicrobial agents are no longer affordable . Thus, vaccine development remains an extremely important goal . Although no candidate gonococcal vaccine currently holds high promise, the increasing understanding of the biology of the gonococcus and the pathogenesis of gonorrhea will serve to focus future research on vaccine development. Infect Immun, 1985 Feb, 47(2), 388 - 94 Response of Neisseria gonorrhoeae to iron limitation: alterations in expression of membrane proteins without apparent siderophore production; West SE et al.; For acquisition of iron, an essential nutrient, most microorganisms produce siderophores (low-molecular-weight iron-chelating compounds) and membrane proteins to serve as receptors for the iron-siderophore complexes . The gonococcus does not appear to produce a siderophore, since the quantity of siderophore detected by bioassays of culture supernatants from strains F62 and FA19 was never greater than the amount present in the uninoculated medium . Iron limitation of the laboratory strains F62 and FA19 and 12 recent clinical isolates resulted in the expression of several iron-repressible membrane proteins . The expression of proteins in the apparent molecular weight range of 70,000 to 100,000 was strain dependent . All strains expressed 36,000-dalton (36K) and 19.5K proteins . FA19 and F62 were also grown in medium containing iron sources commonly encountered in vivo (i.e., transferrin, lactoferrin, hemoglobin, or hemin) . Comparison of growth rates indicates that transferrin and lactoferrin were more readily utilized as iron sources than hemin and hemoglobin were . Expression of the iron-repressible proteins varied depending upon the iron source . Fewer iron-repressible proteins were observed when cells were supplied with transferrin or lactoferrin than when the cultures were grown with either hemin or hemoglobin . The 36K protein was expressed with all four iron sources. Genitourin Med, 1985 Feb, 61(1), 44 - 7 Two regimens of sultamicillin in treating uncomplicated gonorrhoea; Farthing C et al.; Sultamicillin is a covalent union of ampicillin and the beta lactamase inhibitor, sulbactam (CP-45,899) . Two studies were conducted to assess its efficacy in treating uncomplicated gonorrhoea . In the first study treatment comprised sultamicillin 1.5 g and probenecid 1 g; 124 (89.2%) of 139 patients responded including seven of 11 patients harbouring beta lactamase (penicillinase) producing strains of Neisseria gonorrhoeae (PPNG) . In the second study sultamicillin 2.25 g and probenecid 1 g were given; 122 (93.8%) of 130 patients responded . Only two of seven pharyngeal infections resolved, and if pharyngeal infections are excluded the overall cure rate rose to 95.3% . Thirteen of 14 patients infected with PPNG strains were cured by the larger dose . Side effects were mild and transitory . It may be concluded that sultamicillin 2.25 g plus probenecid 1 g is an effective regimen to treat uncomplicated rectal and genital gonorrhoea and is useful for treating infections with PPNG strains . Most beta lactamase resistant antimicrobials must be given parenterally; sultamicillin is given by mouth. Zh Mikrobiol Epidemiol Immunobiol, 1985 Feb, (2), 32 - 4 {Production of immobilized SalI and PvuII restrictase preparations}; Bakh NL et al.; Conditions for the immobilization of specific endonucleases Sal I and Pvu II on BrCN-activated Sepharose 4B have been selected . Some physico-chemical properties of the preparations of immobilized restrictases Sal I and Pvu II have been characterized . The specific and general activity values of the preparations thus obtained have been established . The immobilized enzymes have been used for the multiple restriction of the DNA of phage lambda and the DNA of Neisseria meningitidis. Zh Mikrobiol Epidemiol Immunobiol, 1985 Feb, (2), 57 - 60 {Cell motility in a system of mononuclear phagocytes from different strains of mice in the presence of bacteria and their components}; Taranov VA; The motility of organospecific macrophages of the abdominal cavity, spleen, lungs and liver, observed in the presence of serogroup A Neisseria meningitidis polysaccharide, formalin-killed Bordetella pertussis and acetone-treated Salmonella typhimurium, has been studied . In these experiments CBA, C57BL/6 and (CBA X C57BL/6)F1 mice have been used . The in vitro study of the motility of cells in the system of mononuclear phagocytes in the presence of bacterial antigens has revealed that these cells are functionally heterogeneous, which is manifested differently in mice of varying strains. Am J Obstet Gynecol, 1985 Jan 15, 151(2), 185 - 90 The association of sexually transmitted diseases with cervical intraepithelial neoplasia: a case-control study; Guijon FB et al.; Thirty-three women with histologically confirmed cervical intraepithelial neoplasia (grades I to III, with one case of microinvasive carcinoma) and 54 women without evidence of the disease were prospectively studied to determine the relationship of genital infection to cervical neoplasia . Demographic and sexual data for patients and control subjects were collected, with standardized clinical and colposcopic evaluation by means of predefined diagnostic categories . Cultures from the cervix were examined for herpes simplex virus, cytomegalovirus, Chlamydia trachomatis, and Neisseria gonorrhoeae . Human papilloma virus infection was identified by characteristic changes of koilocytosis in cytologic or histopathologic specimen . Cultures from the vagina were evaluated for Gardnerella vaginalis, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Candida albicans, and other yeasts . Separate Gram strains were prepared from endocervical secretions and from vaginal secretions . More lifetime sexual partners, larger area of transformation zone, evidence of human papilloma virus infection, and altered vaginal flora were observed in women with cervical intraepithelial neoplasia . The association of human papilloma virus infection and altered vaginal flora with cervical intraepithelial neoplasia was independent of sexual experience. Scand J Infect Dis, 1985, 17(3), 233 - 43 Kingella kingae infections: a review and a presentation of data from 10 Swedish cases; Claesson B et al.; Kingella kingae is a fastidious gram-negative rod related to the Neisseriae . Together with data from published cases of K . kingae infection, we report the clinical and laboratory findings from 10 cases in western Sweden; a specific serological reaction is also described . The diagnoses were osteomyelitis, septic arthritis, discitis, endocarditis, occult bacteraemia and phlegmon . The data from the Swedish cases, together with those from previous reports in the literature provided the basis for an analysis of a total of 33 cases, ranging from self-limiting to potentially fatal infections . In orthopaedic infections (n = 19), including 3 cases of discitis, the course was usually protracted but subacute and benign, although the full-blown, acute septic arthritis was also encountered . Endocarditis (n = 10) was characterized by a stormy clinical course and the development of significant sequelae . The majority of the patients were previously healthy children . 42% of them had a current or recent upper respiratory tract infection . After start of antibiotic treatment patients were afebrile within a few days . Betalactam antibiotics should be regarded as the drugs of choice for coping with K . kingae . We stress the insidious course of skeletal infections in children and urge the importance of early puncture of a suspected focus to establish a correct diagnosis without delay . The clinical data suggest that K . kingae should be regarded as a significant pathogen. Ann Clin Res, 1985, 17(2), 60 - 3 A prospective study of Chlamydia trachomatis in first trimester abortion; Shiootz H et al.; Chlamydia trachomatis was isolated from 34 (17.9%) of 190 unselected women applying for first trimester abortion and from 27 (15.9%) of the 170 women who actually had the operation . C . trachomatis was more common among the younger women . Neisseria gonorrhoeae was isolated from 3 (1.6%) of 190 women . Culture positive patients and partners were given antibiotic treatment for 10 days, usually postoperatively . Early postoperative genital infection developed in 2 (7.4%) of the 27 chlamydia-positive and in 3 (2.0%) of the 143 chlamydia-negative women . There were no late infections . The antibiotic treatment significantly reduced the rate of postoperative pelvic inflammatory disease . At examination after 4-7 weeks all cultures were negative . Significantly more women with chlamydia-positive cultures were sero-positive preoperatively: with a microimmunofluorescence method, IgG titres greater than or equal to 1:160 were found in 74.1% of culture positive and in 47.6% of culture negative patients (p = 0.01) . However, serological IgG screening does not identify individual high risk patients and so is of little clinical use in this context . We recommend preoperative screening for C . trachomatis in all women requesting an abortion and 10 days antibiotic treatment for all carriers. Dermatologica, 1985, 170(6), 276 - 9 {Gonorrhea and pustules of the hands}; Dubois D et al.; Two similar cases of disseminated infection by Neisseria gonorrhoeae were observed at the same time . The patients presented with fever, arthralgia, tenosynovitis, cutaneous pustules of the extremities . In one case, N . gonorrhoeae has been recovered from vaginal discharge; in the other, bacteriological investigations failed . From a review of the literature, it appears that: (1) acral vesiculo-pustular lesions and tenosynovitis represent the most suggestive signs of the disease; (2) it is obviously important to repeat the bacteriological investigations; (3) biological data, included serology, are useless . However, immunofluorescence techniques might detect altered germs in the skin. Hinyokika Kiyo, 1985 Jan, 31(1), 193 - 6 {Clinical effectiveness of pipemidic acid on gonorrhoeal urethritis}; Yasumoto R et al.; Twenty cases of gonorrhoeal urethritis were orally treated with pipemidic acid (PPA) . The results are as follows . The clinical effect of PPA was excellent in 9 cases and good in 6 cases, the efficacy rate being 75% . The usefulness of PPA was satisfactory in 12 cases (60%) . No side effects were observed . The minimal inhibitory concentrations against 14 isolated Neisseria gonorrhoeal strains ranged from 0.78 to 3.13 micrograms/ml with a median value of 1.56 micrograms/ml . A beta-lactamase-producing strain was observed among the 14 strains and the case infected by this strain was successfully treated with PPA . These results indicate that PPA is a useful drug for the treatment of gonorrhoeal urethritis. Diagn Microbiol Infect Dis, 1985 Jan, 3(1), 65 - 7 Branhamella catarrhalis bacteraemia and immunosuppression--part of a larger problem? Bannatyne RM, Kolodej V. Attention is drawn to the striking association between bacteraemia due to Branhamella catarrhalis and immunosuppression and evidence is cited suggesting a special relationship between this and other Neisseria of intermediate virulence and systemic disease in the immunologically compromised. Bull World Health Organ, 1985, 63(6), 1107 - 13 Tubal infertility in the Gambia: chlamydial and gonococcal serology in women with tubal occlusion compared with pregnant controls; Mabey DC et al.; PIP: Levels of immunoglobulin G (IgG) antibodies to Chlamydia trachomatis and Neisseria gonorrhoeae were determined by enzyme-linked immunosorbent assay (ELISA) in 37 infertile Gambian women with bilateral fallopian tube occlusion and in 37 pregnant controls matched for age, ethnic group, and domicile . The infertile women had a significantly higher prevalence of antibodies to C . trachomatis serotype L1 (P=0.1) and to purified N . gonorrhoeae pili, outer membrane, and Lipopolysaccharide antigens (P0.01 in each case) . Serological studies of immunoglobulin A (IgA) antibodies to C . trachomatis were less sensitive than the IgG studies in discriminating between the pregnant and infertile groups, suggesting that much of the infertility due to chlamydiae was the result of past rather than current infection . Data suggest that both C . trachomatis and N . gonorrhoea are important causes of infertility due to tubal pathology in Gambian women . (author's) Microbiol Immunol, 1985, 29(10), 921 - 6 Plasmid profiles of Neisseria gonorrhoeae in Peninsular Malaysia; Kalaimathee KK et al.; The plasmid profiles of 160 strains of Neisseria gonorrhoeae isolated in Peninsular Malaysia, comprising 80 penicillinase-producing (PPNG) and 80 non-penicillinase-producing (non-PPNG) isolates, were determined . The 80 PPNG isolates were divided into two plasmid groups . All of them harbored two common plasmid species, a 4.4 megadalton (Md) R plasmid previously associated with beta-lactamase production in PPNG strains from the Far East and a 2.6 Md multicopy plasmid of unknown function . In addition to these two plasmids, 60 (75%) PPNG isolates also carried a large 24.5 Md conjugative plasmid . In contrast, the 80 non-PPNG strains were divided into three plasmid groups . All of them possessed the 2.6 Md cryptic plasmid, and 35 (44%) isolates also harbored the 24.5 Md transfer plasmid . Besides these two plasmids, one non-PPNG isolate carried an additional 7.8 Md cryptic plasmid. Dermatologica, 1985, 171(4), 264 - 8 Treatment of gonorrhoea with cefotiam: activity in vitro and clinical results of a 1-gram single-dose regimen; Korting HC et al.; Cefotiam is clearly more active against Neisseria gonorrhoeae in vitro than penicillin . This applies especially to strains producing beta-lactamase but also to those which do not . No strain requires more than 0.25 micrograms/ml for inhibition . 1 g of cefotiam dissolved in 3 ml of 1% lidocaine solution cures 90.0% of patients suffering from uncomplicated genital gonorrhoea if injected once intramuscularly . Tolerance of this regimen is very good, no major side-effect being found. Dermatologica, 1985, 171(3), 175 - 9 {Importance of the auxotyping of Neisseria gonorrhoeae for evaluating gonorrhea therapy studies}; Korting HC et al.; So far, there was no absolutely reliable way to distinguish between failure and reinfection in clinical trials on the treatment of gonorrhoea . If one, however, analyzes the auxotypes of the gonococcal strains isolated before and after application of the drug from non-cured patients, reinfection can clearly be demonstrated in cases with a changed auxotype . Thus, in a trial on the single intramuscular application of cefotiam 1 g for uncomplicated gonorrhoea, the bacteriological cure rate increased from 90 to at least 95%. Scan Electron Microsc, 1985, (Pt 3), 1183 - 90 Scanning and transmission electron microscopy of bacterial attachment to mucosal surfaces with particular reference to the human fallopian tube; Cooper MD et al.; Neisseria gonorrhoeae and Chlamydia trachomatis are the common bacteria isolated from bacterial cervicitis and are the leading etiological agents for pelvic inflammatory disease . Neisseria gonorrhoeae cause infection of the mucosa of fallopian tubes in organ culture by attaching to microvilli of nonciliated cells, phagocytosis by these cells, transport across and exocytosis from the epithelial cells . In contrast the Chlamydia attach to the epithelial surface without apparent ligand binding and are taken into the cytoplasm of the epithelial cell . Exocytosis of Chlamydia is into the tubal lumen and not into the subepithelial spaces . The ciliated epithelial cells of the fallopian tube are damaged by a gonococcal toxin but chlamydia do not exhibit such activity . These observations suggest that the mechanism of attachment to and invasion of the mucosal epithelium by gonococci and chlamydia are quite different and their potential for disease production occurs by different methods. Chemotherapy, 1985, 31(5), 346 - 50 Activity of nine antibacterial agents on penicillinase- and nonpenicillinase-producing Neisseria gonorrhoeae isolated from clinical specimens obtained in northern Norway; Melby K et al.; 34 penicillinase-producing (PPNG) and 102 nonpenicillinase producing (non-PPNG) strains of Neisseria gonorrhoeae were tested against 9 antibacterial agents . Cefoxitin, latamoxef, cefotaxime and imipenem inhibited all PPNG (MIC less than 2 mg/l); chloramphenicol (2 mg/l) inhibited 86%, and 3% and 8%, respectively, were inhibited by 1 mg/l of doxycycline when disk diffusion or agar dilution sensitivity testing were performed . All PPNG strains were sensitive to spectinomycin (MIC less than 32 mg/l) . Non-PPNG strains were uniformly sensitive to all antibacterial agents, doxycycline being slightly less active than the other compounds. Ann Clin Res, 1985, 17(2), 73 - 5 Localization of gonococci in the anterior oral cavity--a possible reservoir of the gonococcal infection? Tikjob G, Petersen CS, Ousted M, Ohlenschlaeger J. In a 6 months period pharyngeal gonococci were detected by routine cultures in 74 (8%) of 951 patients with gonorrhoea . In approximately one third of the 74 patients, a positive culture from the pharynx was the only sign of a gonococcal infection . Fourteen (19%) of the 74 patients with pharyngeal gonorrhoea also had positive cultures of Neisseria gonorrhoea from vestibulum oris . In spite of thorough contact tracing and interview concerning sexual practices in all these patients and when possible their sexual partners, we were not able to show directly that gonococci located in the oral cavity and especially in its anterior part also served as a reservoir of infection . However, three patients with exclusively pharyngeal gonorrhoea denied genito-oral sexual intercourse and could probably have been infected by strictly oro-oral contact . It is concluded that the existence of pathogenic bacteria in the anterior oral cavity in a large proportion of patients with pharyngeal gonococcal infection strengthen the possibility of this localization as a source of the infection. Med Microbiol Immunol (Berl), 1985, 174(3), 151 - 6 Adherence and hydrophobicity in Neisseria meningitidis and their relationship with surface charge; Criado MT et al.; The influence of surface charge on hydrophobicity and adherence of four strains of Neisseria meningitidis was studied . After neutralization of negative (treatment with EDC-methylamine), positive (treatment with formaldehyde) or both charges, adherence to buccal cells and hydrophobicity were determined and analysed . It was found that surface charges are relevant for adherent processes . Surface hydrophobicity was also found to be influenced by charge but uncorrelated with adherence. Exp Biol, 1985, 43(4), 251 - 6 Effect of subminimal inhibitory concentrations of antibiotics on adherence of Neisseria gonorrhoeae in an experimental model; Jacques M et al.; The effect of subminimal inhibitory concentrations (subMICs) of six commonly used antibiotics on adherence of Neisseria gonorrhoeae to rabbit mesentery was studied . We found that, at 1/2 MIC, ampicillin, cefoxitin and penicillin G decreased adherence of gonococci by more than 65%, and erythromycin by approximately 40%; doxycycline and tetracycline had no appreciable effect . Results suggest that subMICs of some antibiotics could affect interactions of gonococci with some mammalian cells, more specifically adherence, a critical step in the pathogenesis of an infection. Exp Biol, 1985, 43(4), 231 - 42 Comparison of bacteriostatic and bactericidal inhibitors of Neisseria gonorrhoeae growth produced in vitro by urogenital staphylococci; Bisaillon JG et al.; Coagulase-negative staphylococci are known to produce bactericidal and bacteriostatic antigonococcal activities . Out of 12 staphylococci, Staphylococcus haemolyticus (four isolates) was identified as the principal source of bactericidal activity, whereas Staphylococcus epidermidis (six isolates) was primarily responsible for producing bacteriostatic activity . A comparison of the bacteriostatic substance produced by S . epidermidis isolate 66 with the bactericidal substance produced by S . haemolyticus isolate 7, which had been previously purified, showed that they were similar lipoproteins or lipid-associated proteins . However, these two inhibitors migrated differently under electrophoresis on agarose gel . The protein component of the bacteriostatic inhibitor was more difficult to separate from the lipid component when chromatographed on Ultrogel AcA 54 in the presence of urea (4 M) than the protein component of the bactericidal inhibitor . The protein component of both types of inhibitors was responsible for the antigonococcal activity and was dissociable into subunits of approximately 1,400 daltons . However, these protein components had different migration patterns on agarose gel . The bacteriostatic substance displayed a bactericidal effect when dissociated from its lipidic component suggesting that the lipids might play a role in the type of inhibitory activity produced . All of the bactericidal and bacteriostatic substances contained in the different crude preparations were antigenically related. Exp Biol, 1985, 43(4), 225 - 30 Quantitative determination of catalase activity produced by Neisseria gonorrhoeae, Staphylococcus epidermidis, Neisseria meningitidis and other bacterial strains using the Catalasemeter; Bisaillon JG et al.; The conventional catalase test only gives qualitative or semi-quantitative information of the amount of catalase activity produced . Using such a method, we have selected two strong catalase activity producers (Neisseria gonorrhoeae G-10, Staphylococcus epidermidis 66) and a weak producer (Neisseria meningitidis 34702) . Quantitative determination of the catalase activity produced by these strains was done by the disk-flotation method using the Catalasemeter . The production of catalase activity in liquid culture by N . gonorrhoeae, S . epidermidis and N . meningitidis occurred mainly during the logarithmic growth phase . The maximum concentration of catalase activity found in these cultures was, for both strong producers, 160 units (U)/ml while it was around 20 U/ml for the weak producer . Some of the other bacteria tested showed high concentrations of catalase activity (130-162 U/ml) and these were: N . gonorrhoeae strain PR 77112 (penicillin resistant), Staphylococcus strain 7 (coagulase negative), Micrococcus sp . strains 2 and 42. Antimicrob Agents Chemother, 1985 Jan, 27(1), 76 - 8 Activities of new quinoline derivatives against genital pathogens; Aznar J et al.; The in vitro activities of four quinoline carboxylic acids against 48 strains of Neisseria gonorrhoeae, 10 of Chlamydia trachomatis, and 32 of Ureaplasma urealyticum were compared . Ciprofloxacin was the most active against N . gonorrhoeae and C . trachomatis but had poor bactericidal activity against U . urealyticum, whereas ofloxacin showed the most bactericidal activity against U . urealyticum but was less active than ciprofloxacin against the two former pathogens . Norfloxacin and enoxacin were less active against all the studied pathogens. J Clin Microbiol, 1985 Jan, 21(1), 127 - 8 Comparison of the effect of refrigerated versus room temperature media on the isolation of Neisseria gonorrhoeae from genital specimens; Ratner HB et al.; We evaluated the effect of medium temperature at the time of inoculation on the isolation of Neisseria gonorrhoeae from urethral and cervical swabs . There were no major differences in the isolation rates of 176 positive cultures on cold or warm media . Colonies tended to be larger and more numerous on room temperature plates after 24 h; however, colonies on most refrigerated plates were easily recognized at 24 h, and growth was essentially the same on both plates after 48 h. Diagn Microbiol Infect Dis, 1985 Jan, 3(1), 41 - 6 Evaluation of GonoGen coagglutination test for serodiagnosis of Neisseria gonorrhoeae: identification of problem isolates by auxotyping, serotyping, and with a fluorescent antibody reagent; Minshew BH et al.; GonoGen (Micro-Media Systems, Potomac, MD) is a commercially available coagglutination test for the identification of Neisseria gonorrhoeae . We tested 84 strains of Neisseria spp . and Branhamella catarrhalis, including 50 clinical isolates of N . gonorrhoeae . Eighty-six percent (51/59) of N . gonorrhoeae, including 86% (43/50) of clinical isolates of N . gonorrhoeae, were identified correctly in the GonoGen test . In contrast, all N . gonorrhoeae isolates reacted with a fluorescent antibody research reagent composed of monoclonal antibodies . Both reagents were specific for N . gonorrhoeae . Clinical isolates were classified by auxotyping and were serotyped with research monoclonal antibody reagents in coagglutination tests to characterize problem isolates; two auxotype/serovar classes, prototrophic/IA-4 and proline-requiring/IA-4, accounted for 71% (5/7) of GonoGen-negative clinical isolates . Five of the seven isolates that were missed with the first GonoGen lot we tested did react with a second lot of GonoGen reagent . Investigators from different cities in the U.S . have reported different rates of success with GonoGen . Our results indicate that certain N . gonorrhoeae serovars may account for the difference in performance observed with serological tests. J Infect Dis, 1985 Jan, 151(1), 33 - 41 Opsonophagocytosis of Neisseria gonorrhoeae: interaction of local and disseminated isolates with complement and neutrophils; Ross SC et al.; The phagocytosis of serum-sensitive (SS) and serum-resistant (SR) gonococci by neutrophils was examined . SS strains were more rapidly and completely ingested and killed than were SR strains (8.8% +/- 3.4% vs . 64.4% +/- 7.7% survival at 30 min {P less than .005}) in C8-deficient serum or C8-depleted normal serum . Opsonic requirements of the two types of isolates differed . Heat-labile and -stable serum factors played an important role in the phagocytosis of SS but not SR strains . Indeed, killing of SR strains by polymorphonuclear neutrophils did not vary over a 1,000-fold change in serum concentration . SS strains consumed and fixed C3 more rapidly and in greater amounts than did SR strains (83.3% +/- 17.4% vs . 20.8% +/- 5.0% at 10 min {P less than .01}) . However, this difference in C3 consumption and fixation did not completely account for the difference in phagocytosis because killing of SS strains was still greater than that of SR strains under conditions of equal C3 fixation. Biomed Pharmacother, 1985, 39(4), 170 - 3 Infection and Branhamella catarrhalis; McLeod DT et al.; Of the Gram-negative cocci found in the nasopharynx to which any pathogenic status can be attributed, Neisseria meningitidis and Neisseria (Branhamella) catarrhalis have gained significant notoriety . Traditionally, B . catarrhalis is regarded as a nasopharyngeal commensal and thus there is, in general, considerable reluctance to accept that B . catarrhalis may be a pathogen when it is seen . Hence, it is under-reported or totally ignored though there is more awareness regarding its pathogenic potential, particularly as an increasingly high incidence of beta lactamase producing strains is being reported from many countries . The importance of this development concerns the choice of routine antibiotic therapy as ampicillin, to which this organism was previously sensitive, may no longer be effective. Prog Clin Biol Res, 1985, 189, 67 - 79 Interaction of endotoxins, blood elements and the vessel wall; Osterud B; Endotoxins are potent activators of the complement system . Formed activated complement factors, in turn, are capable of inducing metabolite production that may be essential in the killing of parasites . However, the products formed may also induce severe damage and cause great pathological changes that can be fatal for the individual infected . In the present review article the interaction of endotoxin with monocytes, granulocytes and endothelial cells, as well as the central role of complement activation will be discussed . Also a method is provided for the detection of cell activation in Neisseria meningitidis infection. Sex Transm Dis, 1985 Jan-Mar, 12(1), 52 - 4 Efficacy of gentamicin and kanamycin in the treatment of uncomplicated gonococcal urethritis in Zambia; Hira SK et al.; As a result of the sudden increase in the incidence of penicillinase-producing Neisseria gonorrhoeae (PPNG) from 3.2% in 1980 to 25% in 1982 at a sexually transmitted disease clinic in Lusaka, Zambia, an open clinical trial comparing single-dose gentamicin (280 mg) and kanamycin (2 g) was performed; the drugs were administered intramuscularly to male patients with gonococcal urethritis . Gentamicin was given to 302 men, 220 of whom were followed for two weeks . Kanamycin was given to 113 men, 89 of whom were followed for the same interval . Cure rates of 98% and 95%, respectively, were obtained . Both drugs were well tolerated, with no adverse reactions . All isolates were screened for penicillinase production by the rapid iodometric method; the incidence of PPNG was 41.0% . In view of the high incidence of PPNG associated with failures of penicillin treatment, this drug is no longer useful in situations like that studied here . Since gentamicin and kanamycin have proved to be effective, they are now recommended for the treatment of gonococcal urethritis in Zambia. Sex Transm Dis, 1985 Jan-Mar, 12(1), 49 - 51 The outcome of single-dose cefuroxime treatment in patients with pharyngeal gonorrhea; Graudal C et al.; This study of single-dose cefuroxime treatment of pharyngeal gonorrhea included 13 patients from whose throat specimens taken on the day of treatment Neisseria gonorrhoeae was isolated and who returned for follow-up examinations one and two weeks later . The regimen used was cefuroxime (1.5 g im) plus probenecid (1 g orally) . The treatment failed in six patients (46%) . Failure of treatment was not associated with decreased in vitro susceptibility of the infecting strain to cefuroxime . In pharyngeal gonorrhea the diagnosis by culture and effective control of treatment require repeated sampling for bacteriologic examinations. Sex Transm Dis, 1985 Jan-Mar, 12(1), 19 - 24 Use of gonococcal W serogrouping in the evaluation of a clinical trial of rosoxacin; Ruden AK et al.; Serogrouping by co-agglutination was used for the characterization of isolates of Neisseria gonorrhoeae in a clinical trial of rosoxacin in Stockholm . Twenty-four isolates (56%) belonged to serogroup WI, 17 (40%) to WII, and two (5%) to WIII . The proportion of WI isolates in Stockholm was reported in earlier studies to be approximately 40% . On the basis of serogrouping data and clinical information, five (10%) of 48 patients in this study were classified as therapeutic failures . Of the initial WI isolates, 22 (92%) of 24 were inhibited by less than or equal to 0.03 microgram of rosoxacin/ml, as compared with ten (59%) of 17 of the initial WII isolates (.05 greater than P greater than .01) . Thus, this study might underestimate the failure rate as compared with that for patient populations in which WII isolates are more prevalent, since WI isolates are more susceptible to rosoxacin than WII isolates . A certain WII serovar was correlated with decreased susceptibility to rosoxacin (P less than .001) . Correlations were found between decreased susceptibility to rosoxacin and decreased susceptibility to other antibiotics (P less than or equal to .01) . A high frequency of side effects (40%) was seen among the patients studied. Sex Transm Dis, 1985 Jan-Mar, 12(1), 1 - 4 Women at risk for gonorrhea: comparison of rosaramicin and ampicillin plus probenecid in the eradication of Neisseria gonorrhoeae, Chlamydia trachomatis and genital mycoplasmas; Batteiger BE et al.; Rosaramicin is a macrolide antibiotic with activity against Neisseria gonorrhoeae, Chlamydia trachomatis, and the genital mycoplasmas Ureaplasma urealyticum and Mycoplasma hominis . Its efficacy in the treatment of genital infections was evaluated and compared with that of single-dose ampicillin plus probenecid in women with known, or suspected, uncomplicated gonococcal infection . Isolation rates for N . gonorrhoeae, C . trachomatis, U . urealyticum, and M . hominis were 72%, 44%, 95%, and 65%, respectively . Rosaramicin cured 24 (89%) of 27 gonococcal infections and 11 (92%) of 12 chlamydial infections . It transiently reduced the carriage of U . urealyticum but had little effect on carriage of M . hominis . Rosaramicin may be of value in the treatment of concurrent gonococcal and chlamydial infections when tetracycline is contraindicated. Antimicrob Agents Chemother, 1985 Jan, 27(1), 120 - 4 Multiresistance plasmid from commensal Neisseria strains; Pintado C et al.; Antibiotic-resistant commensal strains of Neisseria spp . and Branhamella catarrhalis were isolated from throat cultures, on the basis of their capacity to grow in the presence of penicillin, streptomycin, or sulfamethoxazole-trimethoprim . Several strains, which belonged to different species of Neisseria, were resistant to beta-lactams, streptomycin, sulfamethoxazole, and trimethoprim, harbored a 6.0-megadalton plasmid with identical HinfI restriction patterns, and produced beta-lactamase and streptomycin phosphotransferase . The resistance determinants for beta-lactams, streptomycin, and sulfamethoxazole, but not for trimethoprim, were transferred from all these strains to Escherichia coli by conjugation or transformation . The resulting transconjugants or transformants acquired the plasmid and the capacity to produce beta-lactamase and streptomycin phosphotransferase . The 6.0-megadalton plasmid complemented a mutation which determines production of thermosensitive dihydropteroate synthetase in E . coli . We conclude that an R plasmid coding for beta-lactamase, streptomycin phosphotransferase, and a sulfonamide-resistant dihydropteroate synthetase is common to these strains. Acta Obstet Gynecol Scand, 1985, 64(2), 145 - 9 Chlamydia, mycoplasmas, ureaplasmas, and yeasts in the lower genital tract of females . Comparison between a group attending a venereal disease clinic and a control group; Moller BR et al.; 162 women were investigated . Group I consisted of 85 women, who were partners to men with non-gonococcal urethritis (NGU) or presented macroscopic signs of cervicitis; patients who had harbored Neisseria gonorrhoeae were excluded from the study . Group II was a control group of 77 women without any complaints from the urogenital tract and with normal findings at pelvic examination . All the women were tested for infection with Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, and Candida albicans . In group I, chlamydiae and mycoplasmas were recovered in 44% and 36%, respectively, the corresponding figures for the control group (group II) being 5% and 19% . The difference is highly significant . No such difference between the two groups was found for ureaplasmas . Sixteen percent of the patients in group I were positive for C . albicans; 12% were positive in group II . Fifty per cent of asymptomatic NGU-partners were chlamydia-positive, and about one-third of patients with either dysuria or vaginal discharge harbored the organism . No difference in the isolation frequency of mycoplasmas was observed between asymptomatic partners to male NGU carriers and women with increased vaginal discharge, whereas the organism was isolated more frequently from patients with dysuria . Fifty-nine per cent of patients with cervicitis were chlamydia-positive, compared with 30% of patients with normal cervical appearance and normal vaginal discharge . Samples obtained from the cervix were more often positive than samples from the urethra . In conclusion, if samples can be taken from only one of the two sites in patients with lower genital tract infection, the cervix is the optimal sampling site. J Clin Microbiol, 1985 Jan, 21(1), 1 - 3 Nosocomial pneumonia caused by a glucose-metabolizing strain of Neisseria cinerea; Boyce JM et al.; We describe what appears to be the first reported case of nosocomial pneumonia caused by Neisseria cinerea . The isolate metabolized glucose when tested in BACTEC Neisseria Differentiation Kits (Johnston Laboratories), but did not produce detectable acid in cystine-Trypticase (BBL Microbiology Systems) agar medium or in modified oxidation-fermentation medium . Clinical laboratories that rely on the BACTEC method for differentiation of pathogenic neisseriae should be aware of the fact that N . cinerea may mimic N . gonorrhoeae when tested in BACTEC Neisseria Differentiation kits . The ability of N . cinerea to grow well on tryptic soy and Mueller-Hinton agars and its inability to grow on modified Thayer-Martin medium are characteristics which help to distinguish N . cinerea from N . gonorrhoeae. Drugs, 1985, 29 Suppl 5, 18 - 23 In vitro activity of temocillin against Neisseria gonorrhoeae including penicillinase-producing strains; Jephcott AE et al.; 169 penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) isolated in the United Kingdom were examined for susceptibility to temocillin and spectinomycin . A further 25 PPNG strains and 214 non-penicillinase-producing strains were examined against temocillin, spectinomycin, amoxycillin, cefuroxime and penicillin . Minimum inhibitory temocillin concentrations ranged from 0.36 to 5.0 mg/L with a mode at 1.25 mg/L . The distributions of sensitivities to other agents were in keeping with those previously described. Infect Immun, 1985 Jan, 47(1), 322 - 5 Cloning of the gene for the common pathogenic Neisseria H.8 antigen from Neisseria gonorrhoeae; Black WJ et al.; Neisseria gonorrhoeae DNA that encodes the pathogenic Neisseria H.8 common antigen was cloned in the lambda phage sep6 . The recombinant phage, designated s6H.8, was detected immunologically with a monoclonal antibody that binds to the H.8 antigen . The gonococcal and s6H.8 forms of the antigen yielded identical partial proteolysis epitope maps . Neisseria species that did not manifest the H.8 antigen showed little or no DNA homology with s6H.8 . This clone should facilitate investigation into the clinical utility of this antigen and determination of its possible function in gonococcal pathogenesis. Curr Med Res Opin, 1985, 9(9), 591 - 3 The use of aztreonam in the treatment of uncomplicated gonorrhoea; Spencer RC et al.; A total of 57 men and 26 women with uncomplicated gonorrhoea was treated with 1 g aztreonam intramuscularly . The cure rate was 96% and included successful treatment of 4 infections due to beta-lactamase producing organisms and 8 patients with pharyngeal involvement . The minimum inhibitory concentrations of aztreonam in vitro were lower than those of penicillin and similar to cefuroxime, and side-effects were minimal . It is concluded that aztreonam is effective against Neisseria gonorrhoeae in vivo and in vitro. Int Urol Nephrol, 1985, 17(4), 349 - 58 The causes of male infertility in 504 consecutive Nigerian patients; Osegbe DN et al.; The causes of infertility in 504 men were studied prospectively . The major causes were varicocele (28.8%), infection (20.8%), bilateral testicular failure (15%), idiopathic oligospermia (6.6%), multifactorial (5.6%), cryptorchidism (4%), sexual problems (3.8%) and surgical injury (1.6%) . Unilateral testicular torsion and sickle cell disease though of less frequent occurrence were of particular interest because their roles are only now beginning to be realized . Gonadotrophin deficiency was an insignificant cause of subfertility . In spite of the high incidence of infection and past history of urethritis Neisseria gonorrheae was surprisingly not isolated from any patient . Compared with Caucasian studies, the high incidence of infection, and the low incidence of gonadotrophin deficiency are major points of difference. Immunol Lett, 1985, 10(1), 35 - 41 The role of serum in interleukin 1 production by human monocytes activated by endotoxins and their polysaccharide moieties; Cavaillon JM et al.; Lipopolysaccharides (LPS) as well as polysaccharide (PS) moieties of Bordetella pertussis and Neisseria meningitidis endotoxins induced in vitro interleukin 1 (IL 1) secretion by human monocytes as evaluated by the co-mitogenic assay on C3H/HeJ thymocytes . Because of the role of serum in the specific binding of endotoxins to monocytes mediated by the polysaccharide region {12}, experiments were undertaken to study the effect of serum on IL 1 induction . Although the presence of serum is not necessary for the secretion of IL 1 by monocytes stimulated by LPS or PS, the addition of very small amounts of human serum (0.1-1.6%) to the cultures of human adherent cells potentiated the IL 1 secretion, without modifying the background values . Natural anti-B . pertussis antibodies present in the serum were not responsible for the observed phenomenon . Heating at 56 degrees C for 30 min did not alter the enhancing effect . The data presented suggest that the serum component(s) and the IL 1 inducers (LPS or PS) act in synergism by two different pathways since the two signals can be delivered sequentially. Exp Biol, 1985, 43(4), 257 - 62 Inhibitory effects of mannose and N-acetylneuraminic acid on the envelope and the adherence of a Neisseria gonorrhoeae isolate to rabbit mesentery; Jacques M et al.; Sugars and sugar derivatives were investigated as potential inhibitors of adherence of Neisseria gonorrhoeae; in this experiment rabbit mesentery was used as a reliable and convenient tissue . The adherence of N . gonorrhoeae isolate 2299 was reduced by half and more, as compared to controls, in the presence of 1,0 mg N-acetylneuraminic acid or D-mannose per ml of culture media, but not by the other sugars tested . Our data suggest that the N . gonorrhoeae isolate used in this work has mannose-binding related activity which participates in the process of its adherence to rabbit mesentery cells . In addition we observed that pretreatment of rabbit mesentery with concanavalin A, but not with peanut and wheat germ agglutinins, markedly decreased the adherence of gonococci as determined by microscopic counts of adhering bacterial cells. Acta Pathol Microbiol Immunol Scand {C}, 1984 Dec, 92(6), 341 - 9 C3 nephritic factor in a patient with recurrent Neisseria meningitidis infections; Teisner B et al.; A 15-year-old female experienced two systemic infections with N.meningitidis (group C and B) within a two months period . Classical as well as alternative pathway CH50 determinations on the patients serum showed no lysis . All individual complement factor concentrations, except for C3, were found to be within the reference area . Crossed immunoelectrophoretic analysis of C3 revealed no demonstrable native C3 . The patient had normal levels of C3c and a markedly elevated C3d concentration . Serum from the patient was found to convert all native C3 in normal sera within 10 minutes at 37 degrees C . The active converting principle, present in the IgG fraction activated C3 in C4-depleted serum, and had a dose dependent stabilizing effect on the EA-C3bBb complex . The isolated factor showing the characteristics of C3 nephritic factor (C3 NeF), was unchanged in the patients serum over a ten months observation period . Circulating immune complexes (IC) could not be demonstrated by a C1q-dependent assay but the patients capacity to solubilize preformed IC in vitro was virtually abolished . The patient had no signs of renal disease or lipodystrophy. Pediatrie, 1984 Dec, 39(8), 635 - 8 {Bacterial meningitis with initially clear CSF}; Teyssier G et al.; 16 bacterial meningitis on 150 observations of purulent meningitis have clear or normal CSM at the initial lumbar puncture . Neisseria meningitidis is the principal germ and there is often purpura and moderate shock . Bacteremia is present in three of the six observations with normal CSF . CSF in controlled a second time 9 to 48 h after the first control . In 14 cases CSF is purulent . Treatment is delayed in eight cases. Fam Pract, 1984 Dec, 1(4), 219 - 21 Problems of venereal disease in Nigeria . 1 . Gonococcal resistance to antibiotics and treatment of gonorrhoea; Oboho KO; Venereal disease is becoming an increasingly serious problem in developing countries . The availability of antibiotics in chemists' shops has encouraged self-medication with sub-therapeutic doses and inadequate treatment regimens . At a health centre in Nigeria, a diagnosis of gonococcal urethritis was made in 159 out of 429 men presenting with urethritis . Neisseria gonorrhoeae was cultured in 141 cases and the sensitivity pattern to a number of antibiotics freely available at chemists was determined . The organisms were highly resistant to penicillin (84%), ampicillin (80%), tetracycline (68%), streptomycin (78%) and co-trimoxazole (83%) . These were the cheapest of the drugs available, leaving only erythromycin and the more expensive drugs gentamicin and cefotaxime still effective for general use in treatment programmes. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1984 Dec, 258(2-3), 156 - 8 Inhibition of Neisseria meningitidis by alpha-amylase; Berger U; alpha-Amylase inhibits growth not only of N . gonorrhoeae and Legionella pneumophila as obtained in literature (2), but also of N . meningitidis and certain isolates of different bacterial species . Therefore, tests for differentiation of gonococci from other species based upon sensitivity to alpha-amylase are of questionable value. J Gen Microbiol, 1984 Dec, 130 ( Pt 12), 3189 - 201 A study by high-resolution two-dimensional polyacrylamide gel electrophoresis of relationships between Neisseria gonorrhoeae and other bacteria; Jackson P et al.; High-resolution two-dimensional polyacrylamide gel electrophoresis was used to analyse the soluble proteins from seven strains of Neisseria gonorrhoeae, six strains of Neisseria meningitidis and one or two strains of twelve other species . Approximately 200 individual polypeptides could be visualized as Coomassie Blue stained spots on an electrophoretogram of N . gonorrhoeae and similar numbers were found for the other bacteria . Each species of bacterium had a distinctly different pattern of spots which could be recognized . Quantitative comparisons of 48 selected spots derived from one strain of N . gonorrhoeae with those of five other strains of gonococcus, three strains of N . meningitidis and one of Branhamella catarrhalis, showed relationships in agreement with their current taxonomic classification but with a higher level of discrimination than that of previously used methods . It was also possible to distinguish the individual gonococcal strains . It is suggested that the method could be useful for bacterial classification and identification. J Clin Microbiol, 1984 Dec, 20(6), 1126 - 9 Preparation and stability of freeze-dried Neisseria gonorrhoeae cultures used for external quality control; Mehaffey MA et al.; In 1976, the Center for Disease Control initiated an external quality control program for the isolation and identification of Neisseria gonorrhoeae . This program required microbial samples of sufficient stability for shipment to laboratories throughout the United States . The Centers for Disease Control undertook studies to determine the most appropriate media for the propagation of strains for freeze-drying, the cell-suspending media that would afford protection during and after freeze-drying, the most favorable growth conditions, the proper times and methods for harvesting cells, the appropriate lyophilization conditions, the critical residual moisture content, and the stability of samples . These studies resulted in the development of methods for preparing and testing freeze-dried samples suitable for shipment. Pathol Biol (Paris), 1984 Dec, 32(10), 1013 - 8 {Epidemiological surveillance of beta-lactamase-producing gonococci . II--Characterization of plasmids of 66 strains isolated in France (May 1979-March 1983)}; Labidi A et al.; Penicillinase producing Neisseria gonorrhoeae PPNG (66 strains have been examined for the presence of plasmids coding for beta-lactamase . The 3.2 Mdal plasmid was present in 27/66 (41%) of strains . The 4.5 Mdal plasmid was present in 30/66 (45%) of strains . The association 2.6 Mdal 4.5 Mdal plasmids were only present in 9/66 (13.6%) of strains . The cryptic plasmid of 2.6 Mdal was always present. J Pharm Sci, 1984 Dec, 73(12), 1763 - 7 2-Acetylpyridine thiosemicarbazones XI: 2-(alpha-Hydroxyacetyl)pyridine thiosemicarbazones as antimalarial and antibacterial agents; Klayman DL et al.; A series of 2-(alpha-hydroxyacetyl)pyridine thiosemicarbazones was synthesized as potential antimalarial and antibacterial agents . Their synthesis was achieved by the condensation of N4-mono- or N4,N4-disubstituted thiosemicarbazides with 2-(alpha-hydroxyacetyl)pyridine . The latter was prepared by selective bromine oxidation of (2-pyridinyl)-1,2-ethanediol . The new compounds show potent inhibitory activity against penicillin-sensitive as well as penicillin-resistant Neisseria gonorrhoeae (MIC, 0.5-0.004 micrograms/mL), against Neisseria meningitidis (MIC, 0.5-0.032 micrograms/mL), and Staphylococcus aureus (MIC, 0.5-2 micrograms/mL) . Good in vitro antimalarial effects against Plasmodium falciparum (Smith strain; ID50, 6.7-38 ng/mL) were observed in most of these new agents, but only 3 of 12 compounds exhibit moderate in vivo activity against Plasmodium berghei . These new agents appear to be less toxic to the host and more water soluble than the corresponding 2-acetylpyridine thiosemicarbazones. Trop Geogr Med, 1984 Dec, 36(4), 341 - 4 Antibiotic resistance of Neisseria gonorrhoea in Curaçao; Eustatia JM et al.; Beta lactamase producing Neisseria gonorrhoea strains are only occasionally found in Curacao; of the non beta lactamase producing strains isolated from civilians a high percentage was moderately to highly resistant to penicillin and moderately resistant to tetracyclin . These percentages were even high in the case of gonococcal strains isolated from prostitutes . Strains which are resistant to spectinomycin were not found . These findings may warrant considering the use of alternative antibiotics in the treatment of gonococcal infections in this community. J Antibiot (Tokyo), 1984 Dec, 37(12), 1525 - 7 Spenolimycin, a new spectinomycin-type antibiotic . III . Biological properties; Fernandes PB et al.; Spenolimycin is a new spectinomycin-type antibiotic isolated from Streptomyces gilvospiralis sp . nov . In vitro, it was active against a wide variety of aerobic Gram-positive and Gram-negative bacteria and Neisseria gonorrhoeae . It was two to four-fold more active against N . gonorrhoeae than spectinomycin . Spenolimycin was effective in the standard mouse protection test against Escherichia coli, Klebsiella pneumoniae and Streptococcus pneumoniae. Br J Vener Dis, 1984 Dec, 60(6), 374 - 9 Susceptibility to antimicrobials of Neisseria gonorrhoeae isolated in Singapore: implications on the need for more effective treatment regimens and control strategies; Sng EH et al.; The antimicrobial susceptibility of gonococci isolated in Singapore has been studied over several years . In 1983, the prevalence of penicillinase producing Neisseria gonorrhoeae (PPNG) was 33.5% and 64% of non-PPNG isolates had minimum inhibitory concentrations (MICs) of penicillin of greater than or equal to 0.5 mg/l . After a control programme, the isolation of the gonococcus from prostitutes was reduced and there was improvement in its susceptibility to antimicrobials . The incidence of PPNG strains was stabilised with a change in the treatment regimen . An influx of foreign prostitutes, however, had an unfavourable impact on these variables . Countries in South East Asia have a high prevalence of PPNG and non-PPNG strains that have reduced susceptibility to antimicrobials . In view of increased air travel the problem should be seen from a global perspective . Better treatment regimens and control strategies are urgently needed. J Exp Med, 1984 Dec 1, 160(6), 1782 - 91 Antigenic analysis of gonococcal pili using monoclonal antibodies; Edwards M et al.; A bank of mouse monoclonal antibodies has been produced with reactivity to gonococcal pili to investigate epitopes of the pilus structural protein, pilin . Pili of Neisseria gonorrhoeae strains R10 and MS11 were used as immunogens to elicit 19 monoclonal antibodies reactive with the homologous pili type in ELISA . Of the 19 antibodies, 16 demonstrated type-specific reactivity and 3 were cross-reactive with heterologous pili . Reactivity of the antibodies with the carboxyterminal, cyanogen bromide fragment (CB-3) of R10 pilin allowed their classification into three groups . The first group (10 antibodies) were R10 specific and equally reactive with the R10 CB-3 fragment . The second group (6) were also type specific but demonstrated poor reactivity with the CB-3 fragment . This suggested that the epitopes of the first group are linear, and those of the second group, nonlinear . The third group (3), consisting of the cross-reactive antibodies, were not reactive with the CB-3 fragment . Two of the antibodies in group 3 were examined in detail to localize their epitopes . The epitope of one, 9B9/H5, was shown to be a linear determinant . This antibody was reactive with a fragment of MS11 pilin (residues 31-111) and to a synthetic peptide representing residues 69-84 in MS11 pilin . The epitope was more finely mapped, with shorter synthetic peptides conjugated to bovine serum albumin, to an eight amino acid segment (residues 69-76) . The epitope of 1E8/G8, a strongly reactive antibody, proved elusive to this type of analysis and probably results from conformational restraints . The significance of species-specific epitopes in the pilin protein is discussed. J Med Microbiol, 1984 Dec, 18(3), 347 - 54 The systematic serology of Neisseria gonorrhoeae: antigens associated with pathogenesis in Neisseria spp . from man; Saikh KU et al.; Sonicates of eight Neisseria species from man were analysed in a micro-Ouchterlony double-diffusion absorption assay in comparison with a gonococcal reference antiserum-antigen system . Five major gonococcal precipitin zones were identified which comprised genus-, species- and type-specific components . One antigen was found in all strains of three species with pathogenic capability--N . gonorrhoeae, N . meningitidis and N . flavescens . It was not detected in N . lactamica, N . pharyngis, N . elongata, N . cinerea or N . catarrhalis. J Gen Microbiol, 1984 Dec, 130 ( Pt 12), 3165 - 73 On the role of pili in transformation of Neisseria gonorrhoeae; Mathis LS et al.; Transformation of competent transformable Neisseria gonorrhoeae F62 to streptomycin resistance was unaffected by antibodies directed against the pilus protein (pilin) of this organism . The pilin component of either crude or purified pilus preparations, separated by SDS gel electrophoresis and transferred to nitrocellulose, failed to bind detectable amounts of DNA; DNA binding to other gonococcal polypeptides was observed under these conditions . These results suggest that gonococcal pilin does not play a direct role in gonococcal transformation. Lancet, 1984 Dec 1, 2(8414), 1234 - 7 Single-dose kanamycin therapy of gonococcal ophthalmia neonatorum; Fransen L et al.; 117 infants with gonococcal ophthalmia neonatorum, including 27 with infections due to penicillinase-producing Neisseria gonorrhoeae, were treated as outpatients with five different regimens of single-dose intramuscular kanamycin (75 mg or 150 mg) with saline eye washes, gentamicin eye ointment, or chloramphenicol eye drops . There were no treatment failures among 68 patients treated with 75 mg or 150 mg kanamycin and gentamicin eye ointment (for 3 days) . However, the minimum and maximum cumulative probabilities of cure of single-dose kanamycin with saline eye washes (for 3 days) were only 60% and 89% . 1 patient of 15 treated with 150 mg kanamycin plus chloramphenicol eye drops did not respond to treatment . Postgonococcal conjunctivitis developed in 14 (12%) infants, of whom 13 had positive cultures for Chlamydia trachomatis . Nasopharyngeal infection with N gonorrhoeae was eradicated in 9 of 11 infants colonised. Clin Orthop, 1984 Nov, (190), 36 - 49 The use of penicillins in orthopaedic surgery; Cunha BA; The main use of the penicillins in orthopedic surgery is in the treatment of infections due to Hemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, Neisseria gonorrhoeae, Escherichia coli, Proteus mirabilis, Streptococcus pneumoniae, and Group D streptococci (enterococci) . Penicillins have antimicrobial activity and have a characteristic pharmacodynamic action, including side effects . The tissue penetration characteristics of the penicillins into synovial fluid and human bone are significant . Semisynthetic penicillins, antistaphylococcal penicillins, and the antipseudomonal penicillins are used for treatment of septic arthritis and osteomyelitis . Oral penicillin therapy can be useful in treatment of osteomyelitis. J Gen Microbiol, 1984 Nov, 130 ( Pt 11), 2767 - 70 Red blood cells, a source of factors which induce Neisseria gonorrhoeae to resistance to complement-mediated killing by human serum; Patel PV et al.; Lysates of guinea pig or human red blood cells (RBC) contain far more of the factors that induce resistance in gonococci to complement-mediated killing by fresh human serum that do plasma or serum . As was previously found with serum, most of the resistance-inducing activity of guinea pig RBC lysates was found in ultrafiltrates with molecular weights of less than 5000 . In contrast, and as with human serum, most of the resistance-inducing activity of human RBC lysates did not pass ultrafilters which removed molecules of less than 5000 daltons, although some active material of low molecular weight was present. Rev Infect Dis, 1984 Nov-Dec, 6 Suppl 4, S875 - 9 Single-dose treatment of uncomplicated gonorrhea: a comparison of cefonicid and penicillin; Duncan WC et al.; Cefonicid, a parenteral semisynthetic cephalosporin, achieves high and sustained serum levels in humans . Activity against strains of Neisseria gonorrhoeae, including those that produce beta-lactamase, has been shown in vitro . The efficacy of 1.0 g of cefonicid was evaluated noncomparatively in 50 men with gonococcal urethritis; four failed to respond to treatment . Additionally, 57 men and 34 women received either 1.0 g of cefonicid or 4.8 X 10(6) units of procaine penicillin G plus 1.0 g of probenecid in a double-blind study . Among 17 men treated with penicillin, two failed to respond, and one failed among the 33 patients treated with cefonicid . Seventeen women received 1.0 g of cefonicid, and all cervical infections were cured . Among those who received cefonicid, 13 had rectal infections;