Allerg Immunol (Leipz), 1978, 24(1), 36 - 41 Demonstration of non-capsulated Haemophilus influenzae in the tissues of the respiratory tract in atopic and non-atopic subjects by means of an immunofluroescence technique; Csizer Z et al.; The use of an immunofluorescence method for demonstration of non-capsulated H . influenzae colonization and penetration in the tissues of the respiratory tract seems to be a useful and convenient laboratory method . However, in in the tissues of the lower respiratory tract H . influenzae in our materials could not be demonstrated. Scand J Infect Dis, 1978, 10(2), 135 - 42 Evaluation of spiramycin as a therapeutic agent for elimination of nasopharyngeal pathogens . Possible use of spiramycin for middle ear infections and for gonococcal and meningococcal nasopharyngeal carriage; Kamme C et al.; Varying doses of spiramycin were administered orally to healthy volunteers, and concentrations in serum and saliva were determined . The absorption of the drug was not significantly influenced by concomitant food intake . Saliva peak concentrations were 1.3--4.8 times higher than peak concentrations in serum . The elimination half life was 2--3 h in serum, and 4--8 h in saliva . Accumulation of the drug was seen in saliva but not in serum . The possible effect of spiramycin in eliminating bacteria from the nasopharynx was evaluated in vitro by comparing the spiramycin saliva concentrations with the MICs of bacteria known to establish themselves in the nasopharynx . At a concentration of 1.2 microgram/ml, spiramycin inhibited all investigated strains of group A streptococci, pneumococci and Branhamella catarrhalis, and at 2.4 microgram/ml all investigated gonococci . Concentrations of 19 and 38 microgram/ml, respectively, were required to inhibit all meningococci and Haemophilus influenzae . Following administration of 1.5 g spiramycin as a single daily dose for 3 days, the mean concentration in saliva reached or surpassed the MIC values of streptococci, pneumococci and Branhamella for 45 h, and of gonococci for 25 h . The possible use of spiramycin for prevention of relapses in acute otitis media and in treatment of serous otitis media is discussed, as well as the possible use of the drug in gonococcal and meningococcal nasopharyngeal carriage. Scand J Infect Dis, 1978, 10(1), 53 - 6 R-factor involvement in a local outbreak of ampicillin-resistant Haemophilus influenzae infections; Malmvall BE et al.; In a Swedish nursery 11 of 15 children harboured non-encapsulated Haemophilus influenzae in their nasopharynx . Six children had ampicillin-resistant and beta-lactamase-producing isolates . Five of these children had otitis whereas one was healthy . In order to identify the origin of the H . influenzae isolates their O-antigen determinants were studied by an immunodiffusion technique . 18 different rabbit antisera were used . For each isolate an O-antigen pattern was recorded . Five of the 6 resistant isolates had the same O-antigen pattern, indicating that their origin was one strain . The 6th isolate was from another strain . Different isolates from the same strain were found to be either sensitive or resistant to ampicillin . In one child the H . influenzae lost its resistance during trimethoprim-sulphamethoxazole treatment . It is concluded that an R-factor may have been involved in the distribution of ampicillin resistance in the H . influenzae studied . Previous in-vitro studies have shown that beta-lactamase production can be transmitted by a plasmid among H . influenzae strains. Immunology, 1978 Jan, 34(1), 149 - 56 The regulation of the immune response of mice to Haemophilus influenzae type b capsular polysaccharide; Lee CJ et al.; The regulation of age-related antibody response to Haemophilus influenzae type b polysaccharide (HITB-PS) was studied by measuring the splenic plaque forming cells (PFC) following immunization with this capsular polysaccharide . The magnitude of PFC response to HITB-PS was found to be dose-related, enhanced by Freund's complete adjuvant and influenced by the genetic strain of mice . Priming with a low dose of HITB-PS did not induce a state of immunological unresponsiveness . Treatment with antilymphocyte serum significantly increased the PFC response to HITB-PS . Athymic nude mice showed an enhanced ability to induce both IgG and IgA-PFC responses as well as a significant increase in the biosynthesis of protein and mitogenicity in spleen cells . These findings suggest that the immune response to HITB-PS is regulated by the suppressor T cell . The magnitude of the IgM-PFC response induced by HITB-PS in mice increased gradually from two weeks of age and reached a plateau at 8 weeks . Treatment with fetuin resulted in the inhibition of direct IgM and IgG-PFC responses to HITB-PS; the suppressive effect on the immune response was more profound and lasting in young than in adult mice. Scand J Immunol, 1978, 8(5), 369 - 75 The use of bacteria for the functional characterization of human lymphocyte subpopulations in various lymphoid organs; Rynnel-Dagoo B et al.; In a haemolytic plaque assay staphylococcal strain Cowan 1 was shown to induce polyclonal antibody secretion in human blood lymphocytes, whereas Haemophilus influenzae and Escherichia coli gave low responses . Diplococcus pneumoniae and haemolytic streptococci generally did not activate blood cells . All five bacteria could activate spleen, tonsil and adenoid cells both to polyclonal Ig secretion and increased DNA synthesis . Thus blood cell reactivity does not necessarily reflect the response pattern in other lymphatic organs . The adenoid was shown to contain lymphocytes more responsive to bacteria normally residing in nasopharynx than cells residing in other lymphatic organs . On the other hand, spleen and mesenteric lymph node contain a subpopulation of cells highly responsive to bacteria such as Escherichia coli normally residing in the bowel . Therefore, we conclude that there exists a functional compartmentalization of lymphocytes in distinct secondary lymphoid organs. N Z Med J, 1977 Dec 14, 86(601), 511 - 4 Bacterial meningitis in children; Lang SD; Cases of bacterial, non-tuberculous meningitis among Auckland children aged one month to 13 years were reviewed for the five year period September 1971 to September 1976 . The aetiological agent was established in 203 of 227 cases . Haemophilus influenzae was the most frequent cause and together with Streptococcus pneumoniae accounted for all sequelae S . pneumoniae was responsible for most fatal cases . It is an unusually common cause of meningitis in Auckland, particularly in children under a year of age . Polynesians contracted bacterial meningitis almost four times as often as Europeans . For a Polynesian child the risk of death due to bacterial meningitis was 12 times that of European. Ann Clin Res, 1977 Dec, 9(6), 359 - 64 Acquired tracheobronchomalacia . A bronchological follow-up study; Nuutinen J; Ninety-four patients with acquired tracheobronchomalacia were followed up between 1967-1977, for an average of 5.2 years . Fifty-six were still alive at the end of the period, and 47 of these were reexamined . Twenty-one patients had retired on pensions for lung disease . Of the 36 patients who underwent rebronchoscopy, tracheomalacia alone was seen in 3 and tracheobrochomalacia in 33 . Six out of the 9 cases of tracheomalacia and all the 5 cases of bronchomalacia had developed into tracheobronchomalacia . The malacia was mild in 6 (17%), moderate in 8 (22%) and severe in 22 (61%), against the figures of the preceding bronchoscopy: 13 (36%), 17 (47%) and 6 (17%), respectively . Mild bronchitic changes were seen in 9 (25%) and severe in 22 (61%) bacterial cultures grew Haemophilus, Proteus mirabilis and Klebsiella, and the culture was positive on 8 occasions (22%) . A fungal culture of the bronchial aspirate was positive in 9 cases (25%) . No pronounced eosinophilia on the bronchial mucosa was observed. Scott Med J, 1977 Dec, 22(5), 355 - 9 Erythromycin in respiratory tract infection; Gould JC; One of the main uses of erythromycin in respiratory tract infection has been in the treatment of acute streptococcal tonsillitis as an alternative to penicillin . Studies on the quantitative bacteriology of tonsils obtained at tonsillectomy have shown large numbers of both haemolytic streptococci and Haemophilus species in most samples and these organisms can be effectively reduced in number by preoperative treatment with antibiotics such as erythromycin . Such investigations suggest that erythromycin might have wider use in the treatment of respiratory tract infections, particularly where Haemophilus influenzae and other Haemophilus species are involved . Apart from specific infections such as those due to Mycoplasma pneumoniae, erythromycin is effective in the treatment of acute pneumonia due to organisms such as the pneumococcus, and this paper reports the further use of erythromycin in the treatment of acute exacerbations of chronic bronchitis where the clinical and bacteriological effects of treatment with this antibiotic are compared with those of ampicillin. Infect Immun, 1977 Dec, 18(3), 735 - 40 Cellular immunity to bacteria: impairment of in vitro lymphocyte responses to Pseudomonas aeruginosa in cystic fibrosis patients; Sorensen RU et al.; Lymphocyte responses to the mitogens phytohemagglutinin and concanavalin A and to Streptococcus pyogenes, Staphylococcus aureus, Haemophilus influenzae, and Pseudomonas aeruginosa were evaluated in patients with cystic fibrosis and in normal individuals . Lymphocyte proliferation in vitro was stimulated by gentamicin-killed whole bacteria, and the proliferative response was measured by {3H}thymidine incorporation . The in vitro lymphocyte responses to antibiotic-killed bacterial reached maximum thymidine incorporation after 5 days in culture and followed a unimodal dose-response curve for each of the bacteria studied . A significant specific incapacity to respond to P . aeruginosa was detected in cystic fibrosis patients with advanced clinical disease. Arch Dis Child, 1977 Dec, 52(12), 925 - 31 Diagnosis of acute bacterial pneumonia in Nigerian children . Value of needle aspiration of lung of countercurrent immunoelectrophoresis; Silverman M et al.; Eighty-eight Nigerian children with untreated, severe, acute pneumonia were investigated by standard bacteriological techniques (blood culture and culture of pharyngeal secretions) and by needle aspiration of the consolidated lung . Countercurrent immunoelectrophoresis (CIE) against grouped pneumococcal and Haemophilus influenzae type b antisera was carried out on serum samples from 45 patients . The aetiology of pneumonia was shown by examination of the needle aspirate in 70/88 patients (79%), by CIE in 9/45 patients (20%), and by blood culture in 4/36 patients (11%) . Overall, a bacterial cause for pneumonia was shown in 73/88 patients (83%) . The results of pharyngeal culture were misleading when compared with cultures of needle aspirates . The prediction of aetiology from the radiological appearance was alos inaccurate, even for labor pneumonia . Needle aspiration of the lung, with a low (5%) and minor complication rate, merits wider application in the diagnosis of acute pulmonary infections in children . Tradiational bacteriological techniques (blood culture and pharyngeal culture) are of very limited value . The place of CIE in the investigation of childhood pneumonia still needs thorough evaluation. J Bacteriol, 1977 Dec, 132(3), 1048 - 9 Heat sensitivity of Haemophilus influenzae containing defective prophage; Setlow JK; Strains of Haemophilus influenzae that carry a defective prophage are more sensitive to heat than is a strain that does not, even in the presence of a rec-1 mutation, which normally renders prophage noninducible . The prophage of HP1c1, a nondefective phage, does not affect the heat sensitivity. Nouv Presse Med, 1977 Nov 5, 6(37), 3391 - 6 {The rapid detection and specific identification of bacterial antigens by electro-immunodiffusion in 80 cases of purulent meningitis (author's transl)}; Denis F et al.; The cerebrospinal fluid of 120 subjects, 80 of whom were suffering from a purulent meningitis, were examined comparatively by classical bacteriological techniques (direct examination and culture) and by electro-immunodiffusion . This procedure makes it possible to detect not only viable bacteria, but also capsular polysaccharide antigens . It revealed the diagnosis in 96.9% of cases of meningococcal, pneumococcal and Haemophilus meningitis, as against 80.3% positive results using classical bacteriological techniques, for the same organisms . Electro-immunodiffusion provides a rapid answer (20 minutes) and, amongst other things, makes it possible: - to confirm the serotype or capsular type within the species, - to determine the aetiological diagnosis in certain types of meningitis where diagnosis is rendered difficult by blind antibiotic therapy, - to quantify and follow over a period of time the levels of polysaccharide antigens in the cerebrospinal fluid and serum of the patients . The sensitivity and specificity of electro-immunodiffusion render it a technique of the future in the diagnosis of purulent meningitis . By virtue of its simplicity, it should become a routine examination. S Afr Med J, 1977 Nov 5, 52(20), 798 - 800 A multicentre study of the susceptibility of a variety of bacteria to cephalothin, cefamandole, tobramycin and gentamicin; du T Naude W et al.; A multicentre study of antibiotic susceptibility was performed in South Africa . Sensitivity to cephalothin, cefamandole, tobramycin and gentamicin was tested on a variety of aerobic and anaerobic bacteria . Two disc susceptibility techniques were used, i.e . the Kirby-Bauer technique (aerobes) and the broth-disc method (anaerobes); minimum inhibitory concentrations (MICs) were determined according to the International Collaborative Study techniques, and regression lines for individual centres were constructed . Satisfactory lines were obtained for cephalosporins, but, in some centres, problems were experienced with the aminoglycosides . Variations in MICs for Haemophilus influenzae were probably due to an inoculum effect . Accumulative percentage tables of the number of strains inhibited were compiled, and the comparative performance of the antibiotics was assessed. Am J Epidemiol, 1977 Nov, 106(5), 388 - 91 Bacterial meningitis in southwestern Alaska; Gilsdorf JR; Between July 1, 1971, and June 30, 1974, thirty-nine cases of bacterial meningitis were diagnosed at the Alaska Native Health Service Hospital at Bethel, Alaska . Thirty-two (82%) occurred in infants less than one year of age . Haemophilus influenzae (H . influenzae) was the predominant causative agent, and was isolated from 23 (72%) of the 32 patients under one year of age . The annual incidence of H . influenzae meningitis in the Bethel area was 63/100,000, and the annual incidence of H . influenzae meningitis in children less than five years of age was 474/100,000 cases. Nord Vet Med, 1977 Nov, 29(11), 465 - 73 Pleuropneumonia in swine caused by Haemophilus parahaemolyticus . A study of the epidemiology of the infection; Nielsen R et al.; Haemophilus parahaemolyticus infection was studied in a herd with continuous production, i.e., continuous introduction of stock to replace animals delivered for slaughter . None of 30 seronegative pigs contracted the infection when exposed to contact with two pigs that were seropositive after inoculation with H . Parahaemolyticus three weeks earlier . After aerosol infection had been applied in the building an acute outbreak with a morbidity rate of 100 per cent developed in less than 24 hours . Following recovery the majority of the 16 pigs present became seropositive, and when 30 seronegative pigs were introduced 7 weeks later, antibody response occurred in three of them . The persistence of H . parahaemolyticus in pigs that had been infected during the acute outbreak was confirmed at slaughter, in that the organism was re-isolated from the tonsils of 2 of these pigs . Most serum titres persisted for several months, but some animals showed just a transient antibody response. Clin Allergy, 1977 Nov, 7(6), 527 - 37 Precipitating antibody to antigens of Pseudomonas aeruginosa in chronic obstructive lung disease; Clarke CW; Two antigens designated Pseudomonas aeruginosa cytoplasmic antigen (P(1-5)) and P . aeruginosa cell wal antigen (PCW) were prepared by ultrasonic disintegration and hot phenol extraction of a smooth polyagglutinable strain of P . aeruginosa isolated from the respiratory tract . It was shown that P(1-5) and PCW are immunologically distinct, that P(1-5) is heat-labile while PCW contains a heat-stable component which stains positively for polysaccharide, is positive for endotoxin and cross-reacts with a cell wall antigen of Haemophilus influenzae prepared by hot phenol extraction . Both antigens were able to activate the alternate pathway for complement . A statistically significant number of patients with cystic fibrosis and bronchiectasis have precipitating antibody to that fraction of cytoplasmic antigen specific for P . aeruginosa (P(1-2)) and PCW compared to controls, whereas patients with asthma and chronic bronchitis do not . The use of both antigens increases the number of patients with antibody to P . aeruginosa . Radioactive immunodiffusion studies indicate that 80.8% of controls have precipitating antibody to PCW antigen and that antibody to it is IgG, IgA and IgM . These studies indicate that consideration should be given to PCW as well as P(1-5) in any consideration of the pathogenesis of P . aeruginosa in these conditions. Pediatrics, 1977 Nov, 60(5), 730 - 7 Haemophilus influenzae type b capsular polysaccharide vaccine in children: a double-blind field study of 100,000 vaccinees 3 months to 5 years of age in Finland; Peltola H et al.; A recently developed Haemophilus influenzae type b capsular polysaccharide vaccine was given to 48,977 children 3 months to 5 years of age; an equal number of children receiving group A meningococcal vaccine served as controls . The protection as well as serum antibody response was strongly age-dependent . Among children who had received the H . influenzae type b vaccine when 18 months of age or older, there were no cases of bacteremic disease caused by H . influenzae type b in the first year after vaccination . At the same time 11 such cases were seen in the control group of the same age, a highly significant difference . In the second year after vaccination two cases occurred in the H . influenzae type b-vaccinated group, five in the meningococcal-group A vaccinated group . No protection was seen among children who had been younger than 18 months when vaccinated, even if they received a booster dose of the vaccine . The serum antibody response to the H . influenzae type b polysaccharide, measured by radioimmunoassay, was poor in children below 18 months of age and good in those above it . No effect of the vaccine could be seen on the nasopharyngeal carriage of H . influenzae type b, which was approximately 6% in this age group . Adverse effects of the vaccine were mild. J Clin Pathol, 1977 Nov, 30(11), 1030 - 2 A comparison of three rapid methods for the detection of beta-lactamase activity in Haemophilus influenzae; Skinner A et al.; Three methods for rapidly detecting beta-lactamase activity in Haemophilus influenzae are compared . The chromogenic cephalosporin method was found to be the most easily performed and the reagents could be stored for up to three weeks . The phenol red method was simple to perform but the iodometric method was more time consuming . All three tests gave identical results. Mayo Clin Proc, 1977 Nov, 52(11), 707 - 10 Antibiotic therapy for severe infections in infants and children; Rhodes KH; Guidelines for the use of antibiotics in infants and children must take into account drug absorption, distribution, metabolism, and excretion . In the developing human being, these factors may differ significantly from those in the adult, and so there are differences in therapeutic efficacy and toxicity . Certain drugs should be avoided in the neonate because of known toxicity; these include the sulfonamides, tetracycline, and high doses of chloramphenicol . Antibiotic therapy should be modified in neonates in several ways because of the biologic immaturity of systems important for the termination of drug action, such as the liver and kidney . Because of poor conjugation, inactivation, or excretion, the administration of many antibiotics results in higher and more prolonged serum levels than those produced in older infants . Thus, in the neonate, the dosages of many antibiotics have to be lower and intervals between administration longer . In the case of gentamicin, studies in the 6-month to adult age group have shown that children less than 5 years old require almost twice as much of the drug as do children older than 10 years or adults to achieve similar peak concentrations . The appearance throughout the United States of strains of Haemophilus influenzae, type b, that are resistant to ampicillin has necessitated a change in the initial antibiotic therapy given to children with bacterial meningitis . There are few uses for tetracycline in pediatric practice. Am J Vet Res, 1977 Oct, 38(10), 1591 - 3 Infectious coryza: in vivo growth of Haemophilus gallinarum as a determinant for cross protection; Rimler RB et al.; Four strains of Haemophilus gallinarum representing 3 immunotypes were used in exposure and challenge exposure studies to determine if in vivo growth of the organism would induce cross protection in chickens . Birds which recovered from infection to 1 immunotype were refractory to reinfection with the heterologous immunotype . In contrast, in vitro-produced bacterins produced immunotype-specific protection. Am J Vet Res, 1977 Oct, 38(10), 1587 - 9 Infectious coryza: cross-protection studies, using seven strains of Haemophilus gallinarum; Rimler RB et al.; Bacterins prepared from 7 strains of Haemophilus gallinarum were used to immunized chickens for cross-protection studies . Three distinct immunotypes were distinguished . Slight protection between immunotypes was evident for some strains . Airsacculitis could be prevented by use of these bacterins; however, prevention was related to immunotype specificity . Hyaluronic acid found in 2 strains rendered them inagglutinable in homologous antiserums . Treatment with hyaluronidase rendered them agglutinable. J Am Vet Med Assoc, 1977 Oct 1, 171(7), 649 - 51 Haemophilus parasuis infection in swine; Riley MG et al.; Septicemic disease occurred in 49 of 126 pigs several days after being transported 80 km . All affected pigs died . The main changes in acutely affected pigs were skin discoloration, pulmonary edema, arthritis, meningitis, and renal glomerular thrombosis . In peracute cases, gross findings were minimal . Haemophilus parasuis was isolated from multiple organ sites in most affected pigs . Haemophilus parasuis was isolated from nasal swab specimens from 17 of 20 clinically normal pigs on the farm of origin . Fatal acute septicemia was reproduced in 2 pigs by intravenous or intratracheal exposure to an isolant of H parasuis obtained from 1 of of the 49 fatally affected pigs . Aerosol exposure of 5 pigs resulted in mild pneumonia in 4 pigs and severe pneumonia, pleurisy, pericarditis, and terminal septicemia in 1 pig. Mayo Clin Proc, 1977 Oct, 52(10), 635 - 40 Tetracyclines, chloramphenicol, erythromycin, and clindamycin; Wilson WR; Tetracyclines are active in vitro against most urinary tract pathogens, Chlamydia, Mycoplasma pneumoniae, Brucella, rickettsiae, and Nocardia . Chloramphenicol is used primarily for anaerobic infections, Haemophilus influenzae meningitis, and infections due to Salmonella typhi . Erythromycin is active in vitro against M . pneumoniae, Streptococcus pneumoniae, and group A beta-hemolytic streptococci . Erythromycin may be used as prophylactic therapy for subacute bacterial endocarditis and for recurrence of acute rheumatic fever in patients who are allergic to penicillin . Clindamycin should be used only for the treatment of anaerobic infections . Tetracycline may cause gastrointestinal upset; phototoxic dermatitis; hepatitis, especially in pregnant females; discoloration of teeth and bone dysplasia in the human fetus and children; and suprainfections, especially oral and anogenital candidiasis . Tetracycline should be used with caution in patients with renal insufficiency . The most important toxic effect of chloramphenicol is bone marrow suppression, which is dose related and idiosyncratic . The incidence of undesirable side effects associated with the use of erythromycin is low . Gastrointestinal irritation is the most common; cholestatic hepatitis may occur with erythromycin estolate . Pseudomembranous colitis is the most important toxic effect associated with clindamycin. Zentralbl Bakteriol {Orig A}, 1977 Oct, 239(2), 231 - 9 {The occurrence of neuraminidase and N-acetylneuraminate-pyruvate lyase in pathogenic haemophili of man (author's transl)}; Muller HE et al.; We investigated the following six Haemophilus species from man for the both enzymes neuraminidase and N-acetylneuraminate pyruvate lyase: H . aegypticus, H . aphrophilus, H . influenzae . H . parahaemolyticus, H . parainfluenzae and H . vaginalis . It is shown that H . vaginalis does not produce either neuraminidase or N-acetylneuraminate pyruvate lyase . He differs, therefore, from all other investigated haemophili producing both enzymes, neuraminidase and N-acetylneuraminate pyruvate lyase . Colominic acid, Na-salt, is splitted better than N-acetylneuraminyllactose . It can be concluded, therefore, some substrate specificity of the neuramindase of Haemophili in the sense that the alpha, 2 leads to 8 linkage of neuraminic acid is cleaved quicker than the alpha, 2 leads to 3 linkage . The physiological and pathologenic role of the both enzymes is discussed. Proc Natl Acad Sci U S A, 1977 Oct, 74(10), 4266 - 70 Structure of a promoter for T7 RNA polymerase; Oakley JL et al.; We have determined the nucleotide sequence of a Hpa II restriction fragment of the phage T7 DNA containing a promoter for the phage-specified RNA polymerase . (Hpa II is a restriction endonuclease from Haemophilus parainfluenzae.) Mapping of the Hpa II restriction fragments on the T7 genome shows this promoter to be the second of tandem promoters separated by approximately 170 base pairs that begin transcription by the T7 RNA polymerase at approximately 15% of the genome . Features of the sequence involved in recognition by the T7 RNA polymerase are discussed and include the following region of hyphenated 2-fold symmetry (boxed regions are related through a 2-fold axis of symmetry at the center of the sequence shown) . (See article) . This sequence includes the initiation site, since the message transcribed from this fragment begins pppG-G-G-A . Combination of our results with work of others has permitted this fragment to be mapped at the junction of T7 genes 1 and 1.1 . The RNA transcribed from this fragment begins within gene 1 and contains the RNase III cleavage site that lies between genes 1 and 1.1 . This sequence is compared to other processing sites in T7 early message. J Infect Dis, 1977 Oct, 136(4), 593 - 6 Isolation of simian virus 40 from rhesus monkeys (Macaca mulatta) with spontaneous progressive multifocal leukoencephalopathy; Holmberg CA et al.; Isolates of virus from the brain tissue of two naturally occurring cases of progressive multifocal leukoencephalopathy in rhesus monkeys (Macaca mulatta) have been characterized . Both isolates were demonstrated to be simian virus 40 (SV40) by serological tests and analysis of cleavage fragments of viral deoxyribonucleic acid produced by restriction endonuclease from Haemophilus influenzae . SV40 virions and the nonvirion T antigen were demonstrated in the brain lesions of one monkey by the fluorescent antibody staining technique . SV40 was not demonstrated in the brain of normal rhesus monkeys from the same colony with use of the same methods of viral isolation or demonstration of antigen. N Engl J Med, 1977 Sep 29, 297(13), 686 - 91 Clinical efficacy of meningococcus group A capsular polysaccharide vaccine in children three months to five years of age; Peltola H et al.; We performed field trials in the course of an epidemic in Finland to learn whether Group A memingococcal capsular polysaccharide vaccine protects infants and young children from meningitis . The first trial involved 130,178 children between the ages of three months and five years; 49,295 children received the vaccine, 48,977 received a control Haemophilus influenzae Type b polysaccharide vaccine, and 31.906 remained unvaccinated . No cases of meningitis or sepsis caused by Group A meningococci were seen in the first year of observation among the children vaccinated with meningococcal vaccine whereas six occurred among those vaccinated with the H . influenzae vaccine and 13 among those not vaccinated . In the second trial 21,007 children of the same ages received the meningococcal vaccine . No cases caused by Group A occurred among those vaccinated, although five to seven would have been expected within the year . Meningococcal Group A vaccine appears efficacious in young infants and children. JAMA, 1977 Sep 5, 238(10), 1032 - 3 Acute purulent otitis media in children older than 5 years . Incidence of Haemophilus as a causative organism; Schwartz R et al.; It is generally believed that Haemophilus influenzae is not commonly a causative agent of otitis media in children older than 5 years of age . We recently studied cases of 58 children, aged from 5 to 9 years, who had acute otitis media . Haemophilus species were the causative agents in 36% of cases . This high incidence of Haemophilus isolation from the middle ear exudate of these children has important therapeutic implications; antibiotics effective against H influenzae should be employed when dealing with otitis media in this older age group. J Am Vet Med Assoc, 1977 Sep 1, 171(5), 435 - 7 Phycomycosis associated with encephalitis caused by Haemophilus somnus in a heifer; Seaman W; Numerous fungal hyphae resembling those of a phycomycete were found in thrombi, vessel walls, and areas of inflammatory cell infiltration within a large focus of necrosis in the brainstem of a 2-year-old heifer . Haemophilus somnus and Pasteurella multocida were isolated from the same lesion . Antemortem hyperglycemia was also demonstrated. J Clin Pathol, 1977 Sep, 30(9), 831 - 3 Radioimmunoassay of capsular polysaccharide antigens of groups A and C meningococci and Haemophilus influenzae type b in cerebrospinal fluid; Kayhty H et al.; Sensitive radioimmunoassays capable of measuring 0-5 ng/ml of the Haemophilus influenzae type b polysaccharide and 2 ng/ml of the groups A and C meningococcal polysaccharides were developed and used to detect these substances in cerebrospinal fluid (CSF) . Polysaccharide of the causative agent was detected in the CSF of 14 out of 15 patients with Haemophilus influenzae type b meningitis, in 18 out of 23 patients with group A, and in two out of four patients with group C meningococcal meningitis . In some cases the antigen could be detected even after three days of antibacterial treatment . No false positive reactions were seen . The assay procedure could be shortened to approximately three hours . These assays could be useful in routine diagnostic work and epidemiological investigations. Helv Paediatr Acta, 1977 Sep, 32(3), 207 - 16 Thiamphenicol in treatment of Haemophilus influenzae meningitis; Pfenninger J et al.; 17 infants and children with pyogenic meningitis (14 Haemophilus influenzae, 2 Diplococcus pneumoniae, 1 Neisseria meningitidis) were treated with thiamphenicol, 100 mg/kg body weight/day in 4 doses i.v., as single drug . In the H . influenzae group 10 patients were cured, 4 had relapses of meningitis, 3 with documented subdural effusions . This group is compared with 14 children matched for age, initial leucocyte and CSF cell count treated with ampicillin: all of these were cured, 1 had a subdural effusion . Thiamphenicol concentrations were determined in the serum and CSF 2 h after administration . The mean serum levels were between 10-12 mcg/ml, the mean CSF levels varied from 5.4 mcg/ml at the beginning to 1-1.9 mcg/ml at the end of meningitis . The MIC of H . influenzae was 0.6-12 mcg/ml . A significant, acute, and dose related bone marrow toxicity of thiamphenicol could be documented, but was always rapidly fully reversible . We conclude that thiamphenicol cannot replace chloramphenicol in the treatment of pyogenic meningitis as single systemic antibiotic . Special indications for thiamphenicol in this disease are discussed. Arch Dis Child, 1977 Sep, 52(9), 679 - 82 Choice of antibiotics in management of acute osteomyelitis and acute septic arthritis in children; Nade S; A survey of 158 children with acute haematogenous osteomyelitis, and of 94 children with acute septic arthritis over an 8-year period was made to determine which bacteria cause these infections . In the osteomyelitis group the organism most frequently detected was Staphylococcus aureus (74% of cases) . In 16% of cases streptococci were found . Staph . aureus was also the most frequently grown organism in cases of acute septic arthritis (55% of cases), but Haemophilus influenzae accounted for 24% of positive cultures . On the basis of the survey it is the current practice of the author to use a combination of methicillin or cloxacillin and penicillin for acute haematogenous osteomyelitis, and methicilline or cloxacillin and ampicillin for acute septic arthritis . The choice of antibiotics is vitally important as treatment must start before the results of culture are known . Repeated evaluation of trends in the pattern of causative organisms is strongly recommended, in order to be aware of changing sensitivity of organisms to antibiotics. Am J Clin Pathol, 1977 Sep, 68(3), 351 - 4 Evaluation of the capillary beta-lactamase test and antimicrobial susceptibility of Haemophilus influenzae; Watanakunakorn C et al.; The capillary beta-lactamase test for the detection of Haemophilus influenzae resistance to ampicillin was evaluated against 132 strains of H . influenzae recently isolated from clinical materials and four reference strains . Nineteen strains, including two of serotype b, were beta-lactamase-positive . The minimal inhibitory concentrations (MIC) of ampicillin for the 117 beta-lactamase-negative strains ranged from less than or equal to 0.125 to 2 microgram/ml (only one strain had a MIC of 2 microgram/ml) . The range of MIC's of ampicillin was 4 to 64 microgram/ml for the 19 beta-lactamase-positive strains; all but two strains required 8 microgram/ml or more for inhibition . The capillary beta-lactamase test is an easy, rapid and reliable test for the detection of H . influenzae resistance to ampicillin . It is suitable for routine use in the clinical microbiology laboratory . The MIC of carbenicillin was higher for ampicillin-resistant than for ampicillin-susceptible strains, but the highest MIC (32 microgram/ml) was within achievable serum concentrations . Both cefamandole and chloramphenicol were active against all strains. Acta Otolaryngol, 1977 Sep-Oct, 84(3-4), 292 - 5 Penetration of erythromycin stearate into maxillary sinus mucosa and secretion in chronic maxillary sinusitis; Paavolainen M et al.; The penetration of oral erythromycin stearate (Abboticin), administered in a dosage of 500 mg three times a day, into the maxillary sinus mucosa and secretion was studied in 15 patients (22 sinuses) operated on for chronic maxillary sinusitis . The average concentration in serum was 2.3 microgram/ml, 1.2 microgram/ml in secretion, and 1.8 microgram/ml in mucosa . These concentrations are highly effective against diplococci and most aerobic and anaerobic streptococci (MIC value 0.06 microgram/ml) but not against Haemophilus influenzae (MIC value for 80% of 2 microgram/ml). J Infect Dis, 1977 Sep, 136(3), 400 - 15 Acute bacterial meningitis at Boston City Hospital during 12 selected years, 1935-1972; Finland M et al.; Data are presented on the occurrence of and mortality rate from acute bacterial meningitis at Boston City Hospital during 12 years between 1935 and 1972 selected in relation to the introduction of potent antibacterial agents . The most frequent causative organisms were Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae, but large proportions were caused by other gram-positive cocci and gram-negative bacilli . The greatest reduction in mortality rate after antibiotics became widely used was in patients with meningococcal and influenzal meningitis who were less than or equal to 19 years old . Less striking reductions occurred in cases of other etiologies in patients less than or equal to 59 years old, but in those greater than or equal to 60 years old, the mortality rate remained high, and the proportion of cases of meningitis in that age group more than doubled . Comparisons with similar data on all bacteremic infections are presented. JAMA, 1977 Aug 15, 238(7), 604 - 7 Haemophilus influenzae type b disease . Incidence in a day-care center; Ginsburg CM et al.; Haemophilus influenzae type b (HIB) disease was observed during a 14-month period in seven of 48 infants attending a day-care center . Surveillance studies showed that 28 (58%) infants had positive nasopharyngeal cultures for HIB; four infants were colonized with HIB for nine to 12 months . Ampicillin trihydrate prophylaxis failed to reduce the HIB carrier rate . Haemophilus influenzae type b polysaccharide vaccine was administered to 34 of the children . Sera obtained prior to immunization showed detectable antibody in all infants . Only nine (26%) infants had twofold or greater rises in serum HIB antibody titers after vaccination . Antibody response was independent of age, preimmunization antibody concentration, and HIB carrier status . In one infant, HIB meningitis developed four months after she received polysaccharide vaccine . This outbreak emphasizes that HIB is highly contagious in closed populations of young, susceptible infants. N Engl J Med, 1977 Aug 4, 297(5), 245 - 8 Impaired humoral immunity in treated Hodgkin's disease; Weitzman SA et al.; To define the contribution of aggressive lymphoma treatment to the risk of post-splenectomy septicemia, we investigated the humoral immunity of 44 patients with Hodgkin's disease . Specific antibody against Haemophilus influenzae Type b was significantly reduced (mean, 147 ng per milliliter, P less than 0.01) in patients receiving combined treatment (radiotherapy and chemotherapy), whereas single treatment reduced titers marginally (chemotherapy) or not at all (radiotherapy) . Untreated patients had normal values (396 ng per milliliter), and splenectomy was without effect . In some patients who received combined treatment, titers were reduced to levels seen in infants . IgM levels were likewise normal in untreated patients . Chemotherapy, however, significantly reduced IgM levels (P less than 0.025), an effect potentiated by prior splenectomy . IgG, IgA, alternate-pathway activity, C3, C4 and CH50 were all normal or elevated . Aggressive treatment with chemotherapy and radiation impairs humoral defense against encapsulated micro-organisms, and thus magnifies the risk of post-splenectomy septicemia in patients with Hodgkin's disease. Am J Vet Res, 1977 Aug, 38(8), 1111 - 4 Serologic studies on porcine strains of Haemophilus parahaemolyticus (pleuropneumoniae): agglutination reactions; Gunnarsson A et al.; Fifteen strains of Haemophilus parahaemolyticus (pleuropneumoniae) represented by 6 American isolates, 6 Swedish isolates, and 3 reference strains of Nicolet's serotype 1, 2 and 3, were used in serologic studies by agglutination and agglutinin-adsorption tests . By whole cell-agglutination tests in rabbit antiserums, 3 additional serotypes, 4, 5, and 6, were identified . All strains had strong serotype-specific agglutinating properties . Occasional weak cross reactions could be eliminated by appropriate adsorptions without effect upon type-specific reactivity . The Swedish isolates were assigned to serotypes 2, 3, 4, and 6, and the American isolates, to serotypes 4 and 5 . All European isolates were distinct from 5 of the 6 American strains . An American culture isolated from a steer and another from a lamb were identical in their agglutination reactions with the porcine isolates of serotype 5 . The serotyping of isolated strains is important in the epizootiologic and immunologic studies of H parahaemolyticus infections. Am J Clin Pathol, 1977 Aug, 68(2), 284 - 9 Latex agglutination in diagnosis of bacterial infections, with special reference to patients with meningitis and septicemia; Kaldor J et al.; Antibody-sensitized latex particles were used to demonstrate specific bacterial antigens in cerebrospinal fluid, blood and urine . Difficulties with reported nonspecific agglutinations appear to have been overcome . The method seems to be sensitive, specific, and simple to perform, and shows a better detection rate than culture or countercurrent immunoelectrophoresis . Urinary excretion of Haemophilus influenzae antigens was followed . The diagnostic usefulness of demonstrating such antigens at a later stage of disease is discussed. J Infect Dis, 1977 Aug, 136 Suppl, S51 - 6 Interim report of a controlled field trial of immunization with capsular polysaccharides of Haemophilus influenzae type b and group C Neisseria meningitidis in Mecklenburg county, North Carolina (March 1974-March 1976); Parke JC Jr et al.; Approximately 16,000 children, from two months to five years of age, were vaccinated with the capsular polysaccharide of either Haemophilus influenzae type b or group C Neisseria meningitidis . Immunizations were carried out in a double-masked, randomized manner; the doses of immunogens used were 10 microgram of H . influenzae type b polysaccharide and 25 micron g of the group CN . meningitidis polysaccharide . Immunogenicity of the two vaccines was measured in single, random specimens of blood taken from vaccinees of all ages at various intervals after immunization . A positive effect on formation of serum antibody was observed in children of all ages vaccinated with N . meningitidis polysaccharide, but increased levels of serum antibody to H . influenzae type b were observed only in recipients of that vaccine who were three years of age or older . No untoward reactions to either vaccine were noted, and both vaccines retained their original molecular size after storage for three years . Too few cases of disease have been studied for a definitive assessment of vaccine efficacy; however, a slightly protective effect against meningitis was observed for the H . influenzae type b vaccine in infants up to one year of age. J Bacteriol, 1977 Aug, 131(2), 557 - 63 Molecular characterization of two beta-lactamase-specifying plasmids isolated from Neisseria gonorrhoeae; Roberts M et al.; The molecular nature of two distinct gonococcal R plasmids, 4.4 X 10(6) and 3.2 X 10(6) daltons, encoding beta-lactamase activity were examined . Both plasmids contained about 40% of the transposable ampicillin resistance sequence Tn2 . Deoxyribonucleic acid-deoxyribonucleic acid polynucleotide sequence studies have shown that the two gonococcal plasmids share about 70% of their sequences and are closely related to RSF0885, a 4.1 X 10(6)-dalton plasmid found in a beta-lactamase-producing strain of Haemophilus influenzae . All three of these R plasmids possess a guanine-plus-cytosine content of 0.40 to 0.41 mol fraction and are present as multicopy gene pools in their bacterial hosts. J Infect Dis, 1977 Aug, 136 Suppl, S25 - 30 Sickle cell anemia and severe infections due to encapsulated bacteria; Pearson HA; Overwhelming infections caused by encapsulated bacteria are an important cause of morbidity and death in children with sickle cell anemia . The most important contributing factors to this increased susceptibility to infections are an opsonophagocytic defect due to an abnormality of the alternate pathway of complement activation, a state of functional hyposplenia, and a lack of specific circulating antibodies as a developmental phenomenon . If the inordinately high, early mortality rate associated with sickle cell anemia is to be prevented, early diagnosis of affected infants is crucial . Prophylactic therapy with penicillin has been advocated in recognition of the fact that a majority of the causative organisms are sensitive to penicillin . However, no controlled studies have proved the effectiveness of such therapy . Immunization with broadly polyvalent vaccines against Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis may ultimately represent the most effective way to reduce the incidence of catastrophic infections. J Infect Dis, 1977 Aug, 136 Suppl, S186 - 90 The infant rat as a model of bacterial meningitis; Moxon ER et al.; The pathogenesis of bacterial meningitis was studied in infant rats . Intranasal intoculation of greater than 10(3) Haemophilus influenzae type b resulted in an incidence of bacteremia that was directly related to the size of hte challenge inoculum . The temporal and quantitative relationship of bacteremia to meningitis indicated that bacteria spread to the meninges by the hematogenous route and that the magnitude of bacteremia was a primary determinant in the development of meningitis . In a sparate series of experiments, infant rats that were fed Escherichia coli strain C94 (O7:K1:H-) became colonized and developed bacteremia and meningitis, but invasive disease was rare when rats were fed E . Coli strain Easter (O75:K100:H5) . A comparison of intranasal vs . oral challenge indicated that the nasopharynx was the most effective route for inducing H . influenzae bacteremia, whereas the gastrointestinal route was the more effective challenge route for the E . coli K1 serotype. Mutat Res, 1977 Aug, 44(2), 197 - 206 Attempts to induce mutations in Haemophilus influenzae with the base analogues 5-bromodeoxyuridine and 2-aminopurine; Kimball RF et al.; Attempts were made to induce mutations in Haemophilus influenzae with the base analogues 5-bromodeoxyuridine and 2-aminopurine . These attempts were unsuccessful . Incorporation studies with BrdUrd showed, in agreement with earlier studies on Escherichia coli, that BrdUrd was discriminated against when dThd was also present but was incorporated to essentially the same extent as dThd when only BrdUrd was present . In this latter case, strands fully substituted with BrdUrd was produced, but survival data suggest that bacteria deriving their DNA by replication on such fully substituted templates were inviable . However, bacteria with about 20% of the thymine substituted with bromouracil were usually viable . No mutations could be detected in the descendants of such bacteria . The reasons for this are discussed and it is concluded that in all probability the replication system in species rarely if every treats incorporated bromouracil as anything except a thymine analogue . The alternative possibility, that the negative results are a consequence of the absence of the reclex (SOS) error-prone repair system in this species, is considered much less likely. Mutat Res, 1977 Aug, 44(2), 183 - 96 Evidence that UV-inducible error-prone repair is absent in Haemophilus influenzae Rd, with a discussion of the relation to error-prone repair of alkylating-agent damage; Kimball RF et al.; Haemophilus influenzae Rd and its derivatives are mutated either not at all or to only a very small extent by ultraviolet (UV) radiation, X-rays, methyl methanesulfonate, and nitrogen mustard, though they are readily mutated by such agents as N-methyl-N'-nitro-N-nitrosoguanidine, ethyl methanesulfonate, and nitrosocarbaryl . In these respects H . influenzae Rd resembles the lexA mutants of Escherichia coli that lack the SOS or reclex UV-inducible error-prone repair system . This similarity is further brought out by the observation that chloramphenicol has little or no effect on post-replication repair after UV irradiation . In E . coli, chloramphenicol has been reported to considerably inhibit post-replication repair in the wild type but not in the lexA mutant . Earlier work has suggested that most or all the mutations induced in H . influenzae by NC result from error-prone repair . Combined treatment with NC and either X-rays or UV shows that the NC error-prone repair system does not produce mutations from the lesions induced by these radiations even while it is producing them from its own lesions . It is concluded that the NC error-prone repair system or systems and the reclex error-prone system are different. J Infect Dis, 1977 Aug, 136 Suppl, S63 - 70 Immunogenicity in weanling rabbits of a polyribophosphate complex from Haemophilus influenzae type b; Anderson P et al.; Polyribophosphate (PRP), the capsular polysaccharide of Haemophilus influenzae type b, is more effectively immunogenic when it is associated with the bacterium than when it is in the purified form that is being tested as a vaccine for humans . In an effort to analyze this difference, we isolated from H . influenzae type b a high-molecular-weight, soluble complex, in which PRP appears to be combined with protein (about 7% protein) . The pyrogenicity and limulus lysate gelation activity of the complex suggest that a small amount of lipopolysaccharide also is present . The protein was resolved into five polypeptides by electrophoresis in polyacrylamide gel containing sodium dodecyl sulfate . In weanling rabbits, which do not respond to purified PRP, the complex induces high titers of antibody of PRP, in an anamnestic pattern . Bactericidal antibody to other bacterial components was also elicited . Equilibrium density gradient centrifugation of the complex indicated that most of the immunogenicity of PRP resides in the least dense fractions, which are high in protein, low in polysaccharide, and active in the limulus lysate test; denser fractions that react strongly with limulus lysate but are poor in protein were much less immunogenic. J Infect Dis, 1977 Aug, 136 Suppl, S57 - 62 Antibody of polyribophate of Haemophilus influenzae type b in infants and children: effect of immunization with polyribophosphate; Anderson P et al.; Antibody to polyribophosphate, the capsular polysaccharide of Haemophilus influenzae type b, was measured in healthy ambulatory children by a radioactive antigen-binding assay . Titers fell from birth through nine months of age, then increased until six years, when they plateaued . Antibody activity was not correlated with the child's sex, ethnic status, or area of residence . Doses of 0.2-50 microgram of polyribophosphate given as single or booster doses had similar effects on antibody activity . Of 368 doses given to infants two to six months of age, 7% produced a significant antibody response; of 95 doses given to infants seven to 12 months old, 17% produced a response . The geometric mean titers of antibody resulting from immunization with polyribophosphate given at various times in relation to diphtheria-pertussistetanus vaccine did not differ significantly from one another or from titers observed in infants given only the latter vaccine . These data indicate that purified polyribophosphate will not provoke humoral immunity in young infants against H . influenzae type b and that it should no longer be considered as a candidate vaccine for this purpose. J Infect Dis, 1977 Aug, 136(2), 292 - 6 Circulating capsular antigen in infant rats infected with Haemophilus influenzae type b; Granoff DM et al.; The kinetics of bacteremia and capsular antigenemia in infant rats infected with Haemophilus influenzae type b were measured by quantitative bacterial counts in blood and counterimmunoelectrophoresis of plasma . After intraperitoneal inoculation with 10(4) colony-forming units (cfu) of H . influenzae type b, bacteremia was detected in 100% of animals at 12 hr after inoculation (mean, 16,500 cfu/ml) and by two days exceeded 10(5) cfu/ml in most animals . Despite these high levels of bacteremia, capsular antigen was detected infrequently during the early phase of experimental infection; it was present in 20% of animals at 12 hr and in 50% at one day . Peak levels of antigen in blood occurred two to three days after inoculation and coincided with the histologic appearance of meningitis . Thereafter, the frequency of antigenemia declined and paralleled the decline in quantitative bacterial counts in blood . Since detection of antigen was dependent on the occurrence of prolonged infection, counterimmunoelectrophoresis proved to be an insensitive method for early diagnosis. J Infect Dis, 1977 Aug, 136(2), 222 - 8 Pharyngeal colonization with Haemophilus influenzae type b: a longitudinal study of families with a child with meningitis or epiglottitis due to H . influenzae type b; Michaels RH et al.; A longitudinal study of pharyngeal colonization with Haemophilus influenzae type b included 264 members of families that had a child with meningitis or epiglottitis due to this organism . It was found that (1) 52 of 67 such families contained at least one carrier of H . influenzae type b, who was usually a sibling; (2) H . influenzae type b spread slowly in 39 families colonized continuously during a six-month period, with only eight of 19 uncolonized siblings acquiring the organism during that time; (3) 18 of 30 initially colonized families contained one or more carriers after 12 months, including 30% of initially colonized siblings; (4) the highest carrier rate of H . influenzae type b occurred in recovered patients, 80% of whom were colonized after hospital discharge; (5) titers of antibody in serum were higher in colonized than in uncolonized individuals (P less than 0.001); (6) levels of antibody in colonized children were lower in those younger than two years than in older children (P less than 0.001); and (7) prolonged or heavy colonization with H . influenzae type b was not associated with unusually high titers of antibody. J Clin Microbiol, 1977 Aug, 6(2), 172 - 3 Pneumonia due to Haemophilus influenzae (H . aegyptius) biotype 3; Marraro RV et al.; Haemophilus influenzae (H . aegyptius) biotype 3 was isolated from eye, nasopharyngeal, and sputum cultures of a 23-month-old male and from sputum and transtracheal aspirate cultures of his 39-year-old mother, both with diffuse bronchopneumonia. Am J Dis Child, 1977 Aug, 131(8), 854 - 6 Occlusion of the internal carotid artery complicating Haemophilus influenzae meningitis; Headings DL et al.; We report a patient with occlusion of the internal carotid artery complicating Haemophilus influenzae meningitis . The etiology of this complication is discussed, along with its role in the acute seizures of meningitis, and in the chronic neurological residua of this infection. Proc Natl Acad Sci U S A, 1977 Aug, 74(8), 3213 - 6 Cleavage specificity of the restriction endonuclease isolated from Haemophilus gallinarum (Hga I); Brown NL et al.; The nucleotide sequences in the replicative form (duplex) of phiX174 DNA around six sites cut by Hga I, a restriction endonuclease from Haemophilus gallinarum, have been compared . The enzyme produces a staggered cleavage resulting in a pentanucleotide 5'-terminal extension . The sequences within and immediately surrounding the pentanucleotide cleavage site have no obvious relationship . However, the sequence 5'-G-A-C-G-C-3' 3'-C-T-G-C-G-5' occurs five nucleotide pairs to the left of the cut in the upper strand and 10 nucleotide pairs to the left of the cut in the lower strand and, therefore, is believed to constitute the recognition site . This is a member of the class of restriction endonucleases in which recognition and cleavage sites lack 2-fold rotational symmetry . The method used to define the cleavage site is of general applicability. JAMA, 1977 Jul 25, 238(4), 319 - 21 Haemophilus influenzae pneumonia in adults; Everett ED et al.; Thirty cases of Haemophilus influenzae pneumonia with clinical and laboratory features have previously been recorded in adults . During the past three years, we have examined 18 patients in whom this diagnosis was established by transtracheal aspirate or blood culture . Our study suggests that H influenzae, both typable and nontypable strains, is a more frequent cause of pneumonia in adults than previously appreciated . We found no clinical values that distinguished H influenzae pneumonia from other bacterial pneumonias . A properly performed Gram's stain of a transtracheal aspirate specimen is classical in its appearance and facilitates instritution of appropriate initial treatment . The emergence of both typable and nontypable organisms resistant to ampicillin makes it important that organisms be isolated from reliable samples for sensitivity testing . With appropriate therapy, the prognosis for patients with H influenzae pneumonia appears to be good. Avian Dis, 1977 Jul-Sep, 21(3), 364 - 9 Experimental coryza in broiler chickens . I . Effects of vaccination with Haemophilus gallinarum bacterin and its components on weight gains and resistance to infection; Boycott BR et al.; Effects of a Haemophilus gallinarum bacterin and its components were studied in young broiler chickens . When the bacterin was administered subcutaneously in the dorsal neck region at 2 weeks of age, no significant differences in weight gains of vaccinated and control birds were detected at eight weeks of age . In four groups vaccinated at 1, 2, 3, or 4 weeks of age and challenged with virulent haemophilus organisms 3 weeks later, the incidence of clinical signs was 30% in the vaccinates and 60% in controls . The bacterin was equally protective at the four ages of administration . Caseous plugs were found at the vaccination sites in all birds which had received adjuvant either alone or in the complete bacterin . Signs of depression lasting about 24 hours were observed in the youngest birds injected with the bacterin, but overall weight gains were normal. Cornell Vet, 1977 Jul, 67(3), 327 - 32 Septicemia and meningoencephalitis in pastured cattle caused by a Haemophilus-like organism ("Haemophilus somnus"); Smith BP et al.; Septicemia and meningoencephalitis developed in 10 pastured cattle 7 months to 3 years of age . Two unrelated herds were involved . Necropsy findings were similar to those previously reported in cattle infected with a Haemophilus-like organism, including multifocal hemorrhages in some muscles, suppurative polyarthritis, and multifocal hemorrhagic thrombi in the brain . A Haemophilus-like organism was isolated from one animal . It was characterized by growth on blood agar or tryptose agar plus a feeder streak under raised carbon dioxide tension, and lack of response to Haemophilus growth factors X and V. Gene, 1977 Jul, 1(5-6), 323 - 9 A new sequence-specific endonuclease (Bsp) from Bacillus sphaericus; Kiss A et al.; A new restriction endonuclease has been isolated from Bacillus sphaericus R . The purification procedure includes Bio-Gel filtration, (NH4)2SO4 fractionation and phosphocellulose chromatography . After the phosphocellulose step the enzyme preparation is free of non-specific nucleases . Bsp cleaves double-stranded DNA with the same specificity as Bacillus subtilis (Bsu) and Haemophilus aegyptius (HaeIII) restriction endonucleases, as concluded from digests and double-digests of phiX174 replicative form DNA with Bsu and Bsp . The 5'-terminal nucleotide of the cleavage products was shown to be C . Bacillus sphaericus R produces Bsp in extremely large quantities and the enzyme can be easily purified in high yield. J Antimicrob Chemother, 1977 Jul, 3 Suppl B, 141 - 8 Pivmecillinam and amoxycillin as combined treatment in purulent exacerbations of chronic bronchitis; Pines A et al.; One hundred and thirty-two patients with purulent exacerbations of chronic bronchitis were randomly allotted to treatment in three groups . They received (a) amoxycillin 250 mg and pivmecillinam 200 mg; or (b) amoxycillin 500 mg; or (c) amoxycillin 500 mg and pivmecillinam 400 mg: three times daily for 10 days . By the 7th day of treatment there was significant improvement over amoxycillin alone for both groups given combined chemotherapy in conversion of sputum to mucoid and in general improvement; at the end of treatment results in patients given the higher doses of both antibiotics were still superior to amoxycillin alone . Patients were observed 2 to 4 weeks later, when those given amoxycillin alone relapsed much more frequently . The three treatments were well tolerated and succeeded equally in clearing potential pathogens from the sputum . Combined treatment may be superior due to synergy against Haemophilus influenzae or to the elimination of beta-lactamase producing organisms and should be investigated further. Infect Immun, 1977 Jul, 17(1), 83 - 90 Effect of neonatal gastrointestinal colonization with cross reacting Escherichia coli on anticapsular antibody production and bacteremia in experimental Haemophilus influenzae type b disease of rats; Myerowitz RL et al.; Neonatal gastrointestinal colonization of newborn rats with Escherichia coli 075:K100:H5, cross-reactive with the capsular polysaccharide of Haemophilus influenzae type b, was harmless but failed to stimulated detectable ( greater than 200 ng/ml) serum anticapsular antibodies . Neonatally colonized rats, when challenged at age 13 weeks by intraperitoneal inoculation of H . influenzae b, showed no difference in the frequency, magnitude, or duration of bacteremia or in the postinfection anticapsular antibody response when compared with saline-fed controls . However, neonatally colonized rats challenged at age 4 weeks had a significantly decreased incidence of sustained bacteremia and/or endophthalmitis when compared with controls . This decreased frequency of disease correlated with a significant increase in postinfection serum anticapsular antibodies . Neonatal gastrointestinal colonization with cross-reacting E . coli appears to "prime" the young host to respond to infection with H . influenzae b with an anticapsular antibody response that protects against sustained H . influenzae b bacteremia and its complications. Am J Dis Child, 1977 Jul, 131(7), 778 - 81 Intrafamily spread of Haemophilus type b infections; Tejani A et al.; Meningitis and epiglottitis are the clinical manifestations of severe Haemophilus influenzae serotype b infection . Compared with meningitis, epiglottitis occurs in older children . When secondary cases occur within the family, the type of clinical manifestation produced by this serotype is generally similar in siblings . This report concerns the unusual occurrence of meningitis developing in older child and epiglottitis developing in the younger one . We discuss the possible explanations for this unusual pattern . We also survey the spread of H influenzae both within and outside the family unit and review the present status of histocompatibility antigens and Haemophilus disease. J Bacteriol, 1977 Jul, 131(1), 356 - 62 Relationships among some R plasmids found in Haemophilus influenzae; Elwell LP et al.; Tetracycline resistance in a strain of Haemophilus influenzae isolated in the United Kingdom was found to be determined by an apparently non-selftransmissible plasmid of 31 X 10(6) daltons (31 MDal), designated pUB701 . Deoxyribonucleic acid hybridization studies indicated that pUB701 shares about 70% base sequence homology with the 30-MDal ampicillin resistance R plasmid RSF007 isolated in the United States from H . influenzae, and 64% sequence homology with the 38-MDal tetracycline and chloramphenicol resistance R plasmid pRI234, isolated in the Netherlands . Heteroduplex studies between RSF007 and pUB701 confirmed the fact that these plasmids were largely homologous, except that pUB701 contained the tetracycline resistance transposon TnD, whereas RSF007 contained the ampicillin resistance transposon TnA . A strain of H . parainfluenzae resistant to both chloramphenicol and tetracycline carried two species of plasmid deoxyribonucleic acid of 2.7 and 0.75 MDal . We were unable to prove that either resistance was plasmid-borne in this strain . Hybridization studies with a {3H}thymine-labeled tetracycline resistance enteric plasmid suggested that the tetracycline transposon was integrated into the chromosome of H . parainfluenzae UB2832 . We conclude either that the strains we studied received R factors of the same incompatibility group bearing different resistance genes, or that different resistance genes were translocated to a commom resident plasmid of H . influenzae. Nucleic Acids Res, 1977 Jul, 4(7), 2467 - 75 Restoration by T4 ligase of DNA sequences sensitive to "flush" cleaving restriction enzyme; Mottes M et al.; Fouteen "flush"-ended segments originate from the action of the restriction endonuclease Hae III of Haemophilus aegiptius on the DNA of the colicinogenic factor ColE 1 (A . Oka and M . Takanami, Nature, 264, 191, 1976) . They are joined by the T4 polynucleotide ligase . The reaction can be monitored by gel electrophoresis, electron microscopy and resistance to phosphatase of the 5'-32P labelled ends . The joined products are a random recombination of the original segments, and can be cleaved by the same Hae III endonuclease to restore the exact electrophoretic pattern of the Hae III-cut ColE 1 DNA . In a properly diluted mixture of 5'-32P segments treated with T4 ligase, the level of phosphatase resistance is very close to the frequency of circle-formation as determined by electron microscopy: thus, the joining of the "flush"-ends involves the formation of circular structures covalently closed in both strands. Gene, 1977 Jul, 1(5-6), 291 - 303 Specificity of cleavage by restriction nuclease from Bacillus subtilis; Heininger K et al.; The restriction nuclease from B . subtilis (Bsu) which cleaves in the middle of the tetra-nucleotide sequence 5'-GGCC-3' 3'-CCGG-5' has been found to decrease its substrate specificity at high nuclease concentrations . There are special conditions, high pH, low ionic strength, and high glycerol content, which strongly enhance splitting with decreased specificity and also lead to splitting of single-stranded DNA . By sequence analyses it is shown that the reduction in specificity of Bsu corresponds to cleavage predominantly at 5'-GC-3' 3'-CG-5' sequences . No comparable change in specificity has been observed in a restriction nuclease from Haemophilus aegyptius (HaeIII), and isoschizomer of Bsu. Med J Aust, 1977 Jun 25, 1(26), 956 - 7 A case of chancroid; Harvey K et al.; After a visit to Hong Kong, a 27-year-old salesman developed penile ulceration which failed to respond to three weeks' penicillin therapy . He then presented to hospital with acute paraphimosis . A clinical diagnosis of chancroid was confirmed by isolation of Haemophilus ducreyi . The ulcers healed after sulphonamide and streptomycin therapy . Although chancroid is an uncommon venereal disease in Australia, its incidence is still high in many tropical countries . It should be considered as a possible cause of genital ulceration in patients who have travelled overseas. Int J Epidemiol, 1977 Jun, 6(2), 101 - 5 Space-time and family characteristics of meningococcal disease and haemophilus meningitis; Goldacre MJ; Significant space-time clustering was found for cases of meningococcal disease . This result was entirely accounted for by the occurrence of a small number of sibling pairs, and clustering was no longer found when these were omitted from the analysis . Meningococcal disease should still be regarded as potentially communicable between siblings . However, in this region of England the current level of infectivity of the disease outside the family is low . Space-time clustering was not convincingly demonstrated for haemophilus meningitis . This emphasizes that, even with diseases of known microbial aetiology, evidence for such clustering may be difficult to obtain . Only a small number of cases of haemophilus meningitis occurred in single-child families . Cases of single-child families tended to occur in older children than the remainder . Although children under three years of age are most susceptible to haemophilus meningitis, it is likely that the organism is usually introduced into the family by an older sibling. Zentralbl Bakteriol {Orig A}, 1977 Jun, 238(2), 244 - 50 {Polyacrylamid-gel-electrophoresis of Haemophilus proteins (author's transl)}; Neumann U et al.; After phenol-acetic-acid extraction the following Haemophilus strains resp . their proteins were subjected the polyacrylamid-gel-electrophoresis in presence of 8 M urea: Strains of the serovar A of H . paragallinarum: 0083, 1516, 1598, 2213, 1645, 1646, Lohren, 2671, 1385, 758, 17756; strains of serovar B of H . paragallinarum: 0222, 2600, 733, 2028, 1596, 2026, 1676, 245, the S and R-form of 2403 as well as the strains 782 and 1655, which were not serotyped; strains of H . paravium sp . nova (HINZ: Inst . J . Syst . Bacteriol . in press): 1762, 62 (Serovar 1), 2654, 2659 (Serovar 2), 780 (Serovar 3), 94 (Serovar 4) and 1254, 0002, 0003, which were not serotyped . H . parainfluenzae (NCTC 4101) and H . parasuis were examined in the same way . The Coomassie Blue-stained protein patterns show that each of the strains tested developed its characteristic protein pattern, with exception of the S- and R-form of the strain 2403, which developed identical pattern . Interrelations between electrophoretic pattern and biological properties such as biochemical activities or pathogenicity could not be proved . However, the procedure described seems to be suitable for strain- or clon-identification on the subspecies level . The electrophoresis apparatus, which was made according to our instructions was less expensive than corresponding available equipments and proved to be usable for the polyacrylamid-gel-electrophoresis. Carbohydr Res, 1977 Jun, 56(1), 117 - 22 The structure of the capsular antigen from Haemophilus influenzae type A; Branefors-Helander P; Structural investigation of the capsular antigen from Haemophilus influenzae type a has shown it to be composed of 4-O-beta-D-glucopyranosyl-D-ribitol residues joined through phosphoric diester linkages between O-4 of D-glucose and O-5 of D-ribitol . Chemical degradations and 13C-n.m.r . spectroscopy were the main methods used. S Afr Med J, 1977 May 28, 51(22), 800 - 2 The use of counter-immuno-electrophoresis to identify causative organisms in bacterial meningitis: experience in Cape Town; van den Ende J et al.; Crebrospinal fluid (CSF) from 142 patients was tested for the presence of Haemophilus influenzae, pneumococcal and meningococcal antigens by counter-immuno-electrophoresis with commercial antisera . Group- or type-specific antigen was detected in the CSF of 67% of 64 patients with meningitis proved by culture to be due to these organisms, and in 10 of 25 patients with purulent meningitis but negative cultures . No false positive results were obtained in 24 normal CSF specimens, or in the CSF of 29 patients with meningitis caused by other organisms . The diagnostic usefulness of this specific, relatively simple and rapid procedure is confirmed. Pathol Biol (Paris), 1977 May, 25(5), 323 - 32 {Drug sensitivity of Haemophilus sp . and transfer of resistance into E . coli (author's transl)}; Goldstein FW et al.; From June 1973 to July 1976, 742 strains of Haemophilus influenzae and parainfluenzae, isolated from clinical specimens, were routinely tested for in vitro sensitivity to twelve antibiotics: penicillin, ampicillin, cephalothin, streptomycin, kanamycin, gentamicin, chloramphenicol, tetracyclin, minocyclin, erythromycin, sulfamethoxazol, trimethoprim . 61 strains were found resistant to one or more of these antibiotics (ampicillin, kanamycin, chloramphenicol and tetracyclin) . The MICs of 23 antibiotics were determined by the agar dilution method on most of the resistant strains and on 60 sensitive strains isolated during the same period and considered as control . 21 strains transferred their resistance determinants into E . coli K12; 23 plasmids were obtained isolated from these strains: 2 strains contained two different plasmids . 90% of the transconjugants were stable after repeated subcultures. J Clin Pathol, 1977 May, 30(5), 417 - 20 Routine laboratory assessment of postoperative chest infection: a prospective study; Wilkinson PJ et al.; Postoperative chest infection was studied prospectively in 73 patients in order to evaluate standard laboratory methods of sputum examination and to relate the results to the patients' clinical state and to antibiotic therapy . When a culture medium selective for haemophilus was used in addition to unselective media, homogenisation of the specimen gave no advantage . Laboratory and clinical findings usually corresponded well . Profuse growths of Streptococcus pneumoniae or Haemophilus influenzae were clearly associated with clinical evidence of chest infection but other Gramnegative bacilli and Staphylococcus aureus much less so . Coliforms were more prominent after antibiotic therapy. Bol Med Hosp Infant Mex, 1977 May-Jun, 34(3), 661 - 8 {Severe infections by Haemophilus influenzae in children}; Herrera Labarca P et al.; Severity and increasing incidence of serious infections due to Haemophilus influenzae in children have been stressed in recent publications . An analysis of the clinical records of the Department of Pediatrics, Hospital Roberto del Rio (Santiago, Chile) was made in order to gather information about frequency and clinical feature of this kind of infections in our environement . 120 children under 3 years of age in whom H . influenzae was isolated in samples of one or more of the following sources: CSF, blood, bone marrow, pleural and synovial fluids, were admitted from January 1970 to March 1976 . Among the different syndromes observed, bacterial meningitis (83.3%) was associated with other localizations in 27% . Empyema (12.5%) was often (46.6%) associated with meningitis . Both clinical entities were the most common and with a definite tendency to increase their frequency in last years . Cultures of CSF, blood and bone marrow were considered effective tests for diagnosis in severe infections due to H . influenzae . Although precise incidence figures may not be obtained from the present data, this kind of diseases may be considered frequent and severe (mortality: 26.6% in this study). Ann Microbiol (Paris), 1977 May-Jun, 128A(4), 383 - 91 {Plasmidic resistance of "Haemophilus sp." to aminoglycoside antibiotics: isolation and study of a new phosphotransferase (author's transl)}; Goffic FL et al.; Plasmid mediated phosphorylating activities have been found in Haemophilus sp . strains resistant to some aminoglycoside antibiotics . The enzymes responsible for this phenomenon have been purified and studied . They belong to the group of aminoglycoside phosphotransferases which are able to phosphorylate these antibiotics on the 3'- or 5"-hydroxyl group . The first enzyme studied is closely related to APH(3')I whereas the second one is different from the former on the basis of substrate specificities and physicochemical properties . We propose to call this second enzyme APH(3')Ib as compared to APH(3')I which will be called APH(3')Ia. Laryngol Rhinol Otol (Stuttg), 1977 May, 56(5), 460 - 6 {Bacteriological findings in chronic infantile tonsillitis (author's transl)}; Mann W et al.; Under general anaesthesia cultures were taken from infantile tonsils prior to T & A . The bacteriological results and the serological classification of hemophilus are questionning literature reports . According to our findings one must consider haemophilus influencae as a resident of the common oral flora . There was no significant difference culturing tonsils with or without repeated antibiotic treatment . Hemophilus influencae combined with beta-hemolytic streptococci is common . Immunological considerations against infantile T & A, based on bacteriological observations are questioned. J Laryngol Otol, 1977 Apr, 91(4), 295 - 302 Acute epiglottitis in adults; Kander PL et al.; Nine cases of acute epiglottitis in adults, seen over a period of ten years, are presented . The presence of severe pain and dysphagia as universal presenting features are stressed, and the frequent absence of pharyngeal injection is noted . We found that the disease in adults differs from that in children in that pain and dysphagia are more marked, that stridor is a less prominent feature, and that Haemophilus influenzae appears not to be the sole causative organism. Mayo Clin Proc, 1977 Apr, 52(4), 209 - 15 Haemophilus endocarditis . Report of 14 patients; Geraci JE et al.; From 1963 through December 1976, 14 patients with Haemophilus endocarditis were seen, 10 since January 1972 . Four different species representing 15 isolates were cultured from the 14 patients: H . influenzae (1), H . aphrophilus (5), H . PARAPHROPHILUS (5), and H . parainfluenzae (4) . One patient had infection with both H . aphrophilus and H . paraphrophilus . Minimal inhibitory concentrations of 12 of the tested 14 strains with ampicillin were 1.25 mug/ml or less . Tube dilution tests were not possible for minimal bactericidal concentrations (7 times) or serum bactericidal titers (5 times) of the 12 tested strains . The clinical picture varied from an insidious onset and mild uncomplicated disease to abrupt onset with severe multisystem disease . Twelve patients had murmurs on admission; congestive heart failure was absent in all 14 but embolization occurred in 6 . Treatment periods of 3 to 7 weeks consisted of penicillin G or ampicillin plus aminoglycoside in nine patients and ampicillin alone in five . All 14 patients were cured; no relapses occurred . Value surgery was not needed for bacteriologic cure but was necessary 15 days after therapy in one patient and in four others from 12 to 22 months after therapy . We believe that ampicillin, 12 g/day alone for 3 weeks, is adequate treatment for Haemophilus endocarditis. Cornell Vet, 1977 Apr, 67(2), 300 - 5 Septicemia and meningoencephalitis in pastured cattle caused by a Haemophilus-like organism ("Haemophilus somnus"); Smith BP et al.; Septicemia and meningoencephalitis developed in 10 pastured cattle 7 months to 3 years of age . Two unrelated herds were involved . Necropsy findings were similar to those previously reported in cattle infected with a Haemophilus-like organism, including multifocal intramuscular hemorrhages, suppurative polyarthritis, and multifocal hemorrhagic thrombi in the brain . A Haemophilus-like organism was isolated from one animal . It was characterized by growth on blood agar or tryptose agar plus a feeder streak under raised carbon dioxide tension, and lack of response to Haemophilus growth factors X and V. J Clin Microbiol, 1977 Apr, 5(4), 490 - 1 Screening for cross-reacting capsular polysaccharide K antigens of Escherichia coli using antiserum agar; Counts GW et al.; Agar plates containing antiserum against group B meningococcus or Haemophilus influenzae type b were used to determine the prevalence of cross-reacting K1 and K100 capsular polysaccharide antigens in 265 isolates of disease-causing Escherichia coli . K1 antigen was found in 22% of isolates from various sites . K100 antigen was found in only three isolates . This technique is a convenient method to detect specific E . coli K antigens for evaluation as possible factors important in the virulence of the organism. Infect Immun, 1977 Apr, 16(1), 400 - 2 Activation of the alternative complement pathway by Haemophilus influenzae type B; Quinn PH et al.; The results of the following study demonstrate that Haemophilus influenzae type B (HITB) is able to activate the alternative complement pathway . They also demonstrate that the activation of the alternative pathway by HITB is not mediated by the capsule. Infect Immun, 1977 Apr, 16(1), 218 - 25 Immunology of the infant rat experimental model of Haemophilus influenzae type b meningitis; Myerowitz RL et al.; The age-related acquisition of serum anticapsular and bactericidal antibodies to Haemophilus influenzae type b observed in rats was similar to that of humans . The antigenic source for this "natural" immunity was not identified since neither pharyngeal infection with H . influenzae b nor enteric colonization by cross-reacting bacteria was detected . Infant rats surviving H . influenzae b bacteremia failed to respond immunologically to the capsular polysaccharide . However, surviving rats demonstrated no impairment of immune responsiveness to this antigen after subsequent immunization with live bacteria in adulthood . In passive protection experiments, antibodies directed against the type b capsular polysaccharide represented the major protective specificity . However, a small protective effect of antibodies to noncapsular antigens also appeared to have been demonstrated. J Virol, 1977 Apr, 22(1), 47 - 53 Effects of x irradiation on a temperate bacteriophage of Haemophilus influenzae; Boling ME et al.; The inactivation of bacteriophage HP1c1 by X rays in a complex medium was found to be exponential, with a D0 (the X-ray exposure necessary to reduce the survival of the phage to 37%) of approximately 90 kR . Analysis of results of sucrose sedimentation of DNA from X-irradiated whole phage showed that the D0 for intactness of single strands was about 105kR, and for intactness of double strands, it was much higher . The D0 for attachment of X-irradiated phage to the host was roughly estimated as about 1,100 kR . Loss of DNA from the phage occurred and was probably due to lysis of the phage by X irradiation, but the significance of the damage is not clear . The production of single-strand breaks approaches the rate of survival loss after X irradiation . However, single-strand breaks produced by UV irradiation, in the presence of H2O2, equivalent to 215 kR of X rays, showed no lethal effect on the phage . Although UV-sensitive mutants of the host cell, Haemophilus influenzae, have been shown to reactivate UV-irradiated phage less than does the wild-type host cell, X-irradiated phage survive equally well on the mutants as on the wild type, a fact suggesting that other repair systems are involved in X-ray repair. J Infect Dis, 1977 Apr, 135(4), 641 - 5 Potentiation of experimental meningitis due to Haemophilus influenzae by influenza A virus; Michaels RH et al.; When Haemophilus influenzae type b was given intranasally to infant rats, a very large dose was required to produce histologic evidence of meningitis in even half of the animals tested; meningitis developed in 16 of 31 rats that received 10(7) viable bacteria at the age of five days . However, when the animals first received influenza virus, the dose of bacteria required to produce meningitis was reduced 100-fold; meningitis occurred in 10 of 21 rats given virus at two days and 10(5) viable bacteria at five days . These results suggest that prior viral infection of the upper respiratory tract may be a factor in the pathogenesis of haemophilus meningitis. Helv Paediatr Acta, 1977 Apr, 31(6), 499 - 501 Neonatal haemophilus aphrophilus meningitis; Miano A et al.; Case report of a neonatal meningitis due to Haemophilus influenzae . The treatment with ampicillin was ineffective because of insensitivity . This case demonstrates the importance of a proper bacteriological identification in order to avoid ineffective or delayed treatment. J Clin Microbiol, 1977 Apr, 5(4), 405 - 9 Counterimmunoelectrophoresis in the diagnosis of bacterial meningitis; Colding H et al.; The aim of the present study was to investigate whether counterimmunoelectrophoresis (CIE) would facilitate the rapid, etiological diagnosis of bacterial meningitis when used in parallel with other routine methods in a medical bacteriological laboratory . Of 3,674 consecutive specimens of cerebrospinal fluid (CSF) received at the Department of Diagnostic Bacteriology, Statens Seruminstitu, 283 specimens (each representing one patient) were selected for examination by CIE on the basis of the following criteria: bacteria or pleocytosis or both by microscopy or positive culture or both . CIE was performed with antisera to Neisseria meningitidis (groups A, B and C), Streptococcus pneumoniae (omni-serum and pools A to 1), and Haemophilus influenzae type b . Antigen was detected in 57% (72/126) of specimens in which cultures revealed these three kinds of microorganisms in CSF and in 12% (17/139) of the culture-negative specimens . CSF specimens from 21 patients with bacterial meningitis caused by other species were all negative in CIE, except four, three of which contained Escherichia coli antigen reacting with antiserum to N . meningitidis group B and one E . coli antigen reacting with antiserum to H . influenzae type b . Specific diagnosis was achieved in 60% (170/283) of the specimens studied and could be extablished within 1 h in 85% (145/170) by the combined results of microscopy and CIE . Ten specimens, nine of which showed a reaction with antiserum to N . meningitidis group A, were positive by CIE only. Lancet, 1977 Mar 26, 1(8013), 663 - 6 Frequency of E . coli K antigens in urinary-tract infections in children; Kaijser B et al.; The somatic (O) and casular (K) antigens of Escherichia coli from the urine of patients with acute pyelonephritis, acute cystitis, and asymptomatic bacteriuria, and in the faeces of healthy schoolchildren have been investigated . Typing antisera for sixteen capsular acidic polysaccharide K antigens were used, and five (numbers 1, 2, 3, 12, and 13) accounted for 70% of isolates from patients with acute pyelonephritis . These five K antigens were found to a lesser extent in the three other study groups . Thus, only a few K polysaccharides are associated with virulent properties of E . coli for the upper urinary tract . This finding is similar to the association of only some capsular types of pneumococci, meningococci, and Haemophilus influenzae with invasiveness . The identification of virulence markers for E . coli associated with upper-urinary-tract disease may permit more successful control with reference to preventive immunisation. Biochim Biophys Acta, 1977 Mar 18, 475(2), 315 - 22 Formation of a thymine photoproduct in transforming DNA by near ultraviolet irradiation; Carbera-Juarez E et al.; Irradiation at 334 and 365 nm of a highly purified preparation of thymine-labeled transforming DNA from Haemophilus influenzae produced a photo product containing label from thymine but different from the cyclobutane dimer . The photoproduct is soluble in water and in ethanol and Rf values in a number of solvents are presented . The photoproduct has properties similar in a number of respects to those of the spore photoproduct, 5-thyminyl-5,6-dihydrothymine . The near ultraviolet photoproduct is more likely to affect the oxygen independent inactivation of transforming DNA rather than its mutagenesis, as judged by the quantitative relationship between amount of photboproduct and inactivation and mutagenesis. Medicine (Baltimore), 1977 Mar, 56(2), 99 - 113 Haemophilus parainfluenzae infective endocarditis; Chunn CJ et al.; Seven young to middle-aged patients with Haemophilus parainfluenzae endocarditis are reported . Three patients had underlying heart disease and three patients had recent events predisposing for endocarditis . The clinical presentation was subacute or acute and new pathologic murmurs were uncommon . Diagnosis was prolonged because of difficulties in isolating the organism . Routine subculturing of blood cultures to chocolate agar with incubation in CO2 is recommended . A prominent complication, occurring in six patients, was major arterial occlusion secondary to emboli . Antibiotic control of infection was difficult and best achieved by the concomitant administration of ampicillin and gentamicin . Killing curves proved useful in assessing antibiotic efficacy . There were two medical failures and one death in the series . It appears H . parainfluenzae endocarditis is characterized by distinctive clinical features, difficult in vitro isolation of the organism, and the necessity for combination antibiotic therapy. Medicine (Baltimore), 1977 Mar, 56(2), 115 - 28 Haemophilus parainfluenzae and influenzae endocarditis: a review of forty cases; Lynn DJ et al.; Two cases of bacterial endocarditis caused by Haemophilus parainfluenzae are reported with a review of 33 other cases of H . parainfluenzae endocarditis and 5 cases of H . influenzae endocarditis . Although H . parainfluenzae is usually considered a non-pathogenic microorganism, this review firmly establishes its role as a causative agent in endocarditis . Furthermore, several clinical features were noted which were atypical when compared to findings usually present in patients with bacterial endocarditis . The mean age of the patients was only 27 years . Over 60% of the patients had no identifiable predisposing illness, an unexpected finding in view of the low degree of pathogenicity associated with this microorganism . Polymicrobial bacteremia, usually with viridans streptococci, was found in 11% of patients . Major arterial emboli were documented in 57% of patients, an incidence unchanged from the pre-antibiotic era . Diagnosis of the disease is dependent upon an awareness of the fastidious cultural requirements necessary for isolation of Haemophilus species . Culture media must contain a source of X and V factors . Mortality from H . parainfluenzae endocarditis has been reduced from 100 per cent prior to 1940 to about 12 per cent by use of appropriate antimicrobial agents . Awareness that Haemophilus species can cause bacterial endocarditis is important because the diagnosis is dependent upon utilization of special culture methods and the patient may not respond to some of the empiric regimens used for treating bacterial endocarditis . It should be especially considered as a possible cause of "culture-negative" or "abacteremic" endocarditis. Am J Clin Pathol, 1977 Mar, 67(3), 264 - 8 Standardized disk-diffusion susceptibility test for Haemophilus influenzae; Jorgensen JH et al.; The emergence of ampicillin-resistant strains of Haemophilus influenzae has emphasized the need for an improved practical method for routine susceptibility testing of clinical isolates . We have previously described a simplified medium for quantitative dilution susceptibility testing that is composed of Mueller-Hinton medium plus Supplement C (Difco) . In the present study, paired broth-dilution and disk-diffusion susceptibility tests with ampicillin and chloramphenicol were performed on 100 strains of Haemophilus (95 H . influenzae and five H . parainfluenzae), including 30 strains with previously documented ampicillin resistance . Disk-diffusion tests were performed in exactly the same manner as the standardized Kirby-Bauer procedure used for less fastidious organisms, except that supplemented Mueller-Hinton agar plates were incubated in an increased-CO2 atmosphere . Using this method, ampicillin-susceptible strains of Haemophilus produced zone diameters of 22 mm or more, while ampicillin-resistant strains produced zones of 18 mm or less . All strains were chloramphenicol-susceptible and produced zone diameters of 30 mm or more . This method would allow routine disk-diffusion testing of isolates of H . influenzae by hospital diagnostic laboratories, using a clear medium that closely resembles unsupplemented Mueller-Hinton agar. J Virol, 1977 Mar, 21(3), 1210 - 4 Human papillomavirus DNA: physical mapping of the cleavage sites of Bacillus amyloliquefaciens (BamI) and Haemophilus parainfluenzae (HpaII) endonucleases and evidence for partial heterogeneity; Favre M et al.; The DNA of human papillomavirus (HPV) obtained from a pool of plantar warts is cleaved by bacillus amyloliquefaciens (BamI) and Haemophilus parainfluenzae (HpaII) restriction endonucleases at one and four specific sites, respectively . These sites were localized on the previously established cleavage map of HPV DNA, using the Hind, HindIII, HpaI, and EcoRI endonuclease restriction sites as reference . The four HpaII sites were mapped, clockwise, at 1.4, 41.1, 44.3, and 52.8% of the genome length from the unique BamI cleavage site taken as point zero . The HpaII site mapped at 1.4% of the genome length was absent in 40 to 50% of the molecules, thus showing a genetic heterogeneity of HPV DNA. Vet Rec, 1977 Feb 12, 100(7), 126 - 7 The isolation of Haemophilus somnus following sudden deaths in suckler calves in Scotland; Pritchard DG et al.; A blood or yeast dependent pleomorphic Gram-negative bacillus was isolated from the pneumonic lung of a suckled calf which died suddenly . The organism was biochemically similar to American strains of Haemophilus somnus and was shown to be serologically similar by rapid slide agglutination, tube agglutination and micro-complement fixation tests . The possible importance of this organism in disease syndromes in cattle in the United Kingdom is discussed. Zentralbl Bakteriol {Orig A}, 1977 Feb, 237(1), 72 - 9 {The occurrence of neuraminidase and N-acylneuraminate pyruvate lyase in Haemophilus paragallinarum and Haemophilus paravium n.sp (author's transl)}; Hinz KH et al.; 14 strains of H . paragallinarum, isolated from fowls suffering from infectious coryza or received from other investigators for comparison, and a collective consisting of 9 strains of the new species H . paravium nova species, also isolated from fowls, were shown to possess both enzymes, neuraminidase (EC 3.2.1.18) and N-Acylneuraminate-pyruvate lyase (EC 4.1.3.3) . The detection of the enzymes was made initially by paper chromatography using N-acetyl-neuraminyllactose as substrate and secondly by the colorimetric assay of Warren's thiobarbituric acid method using N-acetylneuraminyllactose, colomic acid, Na salt, bovine submaxillary mucin, human serum and furthermore N-acetyl-neuraminate as substrates for neuraminidase and N-acylneuraminate pyruvate lyase respectively . The enzyme activities of the strains of H . paravium are stronger than those of H . paragallinarum. Chest, 1977 Feb, 71(2), 146 - 9 Bacterial endocarditis due to Haemophilus parainfluenzae; Blair DC et al.; We have evaluated three patients with Haemophilus parainfluenzae endocarditis . Two of the three had underlying heart disease . All presented with fever, chills and malaise of less than two weeks' duration . Mitral valve involvement led to congestive heart failure in two of three cases . Treatment proved difficult, despite normally adequate dosages of antibiotics to which the pathogens were sensitive in vitro (ampicillin, 12-20 gm/dag; gentamicin, 3-5 mg/kg/day) . Two patients were cured; one died . There was a suggestion of an inverse correlation between vegetation mass and favorable clinical response . Review of the English literature disclosed 22 documented cases of H parainfluenzae endocarditis, including 12 in the antibiotic era. Br J Ind Med, 1977 Feb, 34(1), 11 - 8 Occupational formalin asthma; Hendrick DJ et al.; Hypersensitivity to formalin used to sterilise artificial kidney machines was shown by inhalation provocation tests to be responsible for attacks of wheezing accompanied by productive cough in two members of the nursing staff of a haemodialysis unit . Three further members of the staff of 28 who were continually exposed to this substance occupationally had developed similar recurrent but less frequent episodes since joining the unit . Two underwent inhalation provocation tests with formalin which did not reproduce these symptoms.Single episodes of these symptoms had been noted by three additional staff members so that altogether eight (29%) had experienced attacks described as bronchitic since becoming exposed to formalin . We suggest that, while exposure to formalin did not seem to be directly responsible in all cases, it might have increased susceptibility to other provoking agents or induced a hyper-reactive responsiveness of the airways . The responses observed in the two nurses after inhalation provocation tests with fromalin were predominantly of airways obstruction . Wheezing began between two and three hours after exposure, and peak expiratory flow rates fell maximally by approximately 50% . Reactions persisted for 10 hours to 10 days depending on the exposure dose . A productive cough was a prominent feature . The sputum appeared to be mucopurulent, but culture produced a scanty growth of Haemophilus influenzae only, together with upper respiratory tract commensals . The cellular content was not homogeneous, neutrophil leucocytes and eosinophil leucocoytes variably dominating . Variable responses of neutrophil and eosinophil leucocytes were also seen in the peripheral blood. Pathol Biol (Paris), 1977 Feb, 25(2), 83 - 7 {Sensitivity of "Haemophilus influenzae" to 5 antibiotics and rapid detection of its resistance to ampicilin (author's transl)}; Piot P et al.; Sensitivity of Haemophilus influenzae to 5 antibiotics has been determined by the agar dilution method . Two strains out of 165 are resistant to ampicillin and 5% to tetracycline . All strains were sensitive to chloramphenicol, cotrimoxazole and cefuroxime . A simple test for rapid detection of beta-lactamase with a chromogenic cephalosporin and sensitivity testing by an agar diffusion method were evaluated for Haemophilus. J Clin Microbiol, 1977 Feb, 5(2), 142 - 4 Rapid speciation of Haemophilus with the porphyrin production test versus the satellite test for X; Lund ME et al.; The detection of porphyrins produced from omega-aminolevulinic acid was evaluated for use in speciation of the Haemophilus . Two hundred and forty-eight clinical isolates of nonhemolytic Haemophilus were tested concurrently for porphyrin production and for X and V requirements . The porphyrin production test was more rapid (4 h) and more accurate than the satellite test. Am J Dis Child, 1977 Feb, 131(2), 213 - 4 Meningitis due to two serotypes of Escherichia coli . An infant who recovered; Goldenberg RI et al.; A newborn infant with hyaline membrane disease and aspiration pneumonia developed purulent meningitis on day 19, three days after discontinuation of ampicillin sodium and gentamicin sulfate therapy . Therapy with gentamicin, both systemically and intrathecally, for two weeks was ineffective . During this time each of four specimens of cerebrospinal fluid contained two serotypes of Escherichia coli, namely, O83:H4 and O75:H5 . The antibiograms of the two strains were identical, both being susceptible to gentamicin and ampicillin . Treatment with ampicillin resulted in prompt disappearance of the infecting microorganisms and recovery from the infection . One of the strains (O75:H5) produced an antigen cross-reacting with the capsular antigen of Haemophilus influenzae type B; the other did not . The patient developed O antibodies in substantial titers against E coli O83 but not against E coli O75. Infect Immun, 1977 Feb, 15(2), 472 - 7 Isolation of the capsular polysaccharide from culture supernatant of Haemophilus influenzae type b; Anderson P et al.; The capsular polysaccharide (CP) of Haemophilus influenzae type b is known to be spontaneously released from the cells in culture . The CP is precipitable from culture supernatant by the cationic detergent hexadecyltrimethylammonium . Most of the nucleic acid and some of the protein, but almost none of the endotoxin, in the supernatant are co-precipitated . Extraction of the precipitate with progressively stronger NaCl solutions separates nucleic acid and protein from the CP and also effects a molecular size fractionation . Residual endotoxin and protein can be reduced by extraction with cold phenol and ultracentrifugation . The resulting preparation has ribose, ribitol, and phosphate as principal components and contains less than 1% other sugars, protein, or nucleic acid; it elutes on Sepharose 2B as a symmetrical peak with Kav 0.51. Infect Immun, 1977 Feb, 15(2), 453 - 60 Immunoprotective activity of ribosomes from Haemophilus influenzae; Lynn M et al.; Immunization with ribosomal preparations from Haemophilus influenzae type b elicited protective immunity in mice . Ribosomes from disrupted cells where isolated by differential centrifugation using sodium dodecyl sulfate . The washed ribosomes contained 25% protein and 75% ribonucleic acid and sedimented as a single peak on sucrose density gradient analysis with a sedimentation coefficient of 67S, using Escherichia coli ribosomes as a 70S marker . Immunodiffusion tests with antipolyribose phosphate serum showed that the ribosomes were free from capsular material . Mice immunized subcutaneously with ribosomes, with or without adjuvant, were challenged intraperitoneally with 100 to 1,000 mean lethal doses of H . influenzae type b suspended in gastric mucin . Significant protection was induced by ribosomes and was compared to that obtained after sublethal infection with live cells . The protection was greatly enhanced after incorporation of ribosomes into adjuvants . Maximum protection (90 to 95%) was observed at 1 to 2 weeks after immunization . Ribosomes from a nonencapsulated strain of H . influenzae were as immunogenic as those from the encapsulated strain, demonstrating that the capsular material is not responsible for immunogenicity of Haemophilus ribosomes. J Med Microbiol, 1977 Feb, 10(1), 127 - 31 A comparison of chloramphenicol and ampicillin as bactericidal agents for Haemophilus influenzae type B; Turk DC; In tests of bactericidal action against H . influenzae type b strains isolated from patients with meningitis, chloramphenicol was found to be far more reliable than ampicillin in dealing with large inocula, and more rapidly effective against both large and relatively small inocula . These findings provide a laboratory explanation for the somewhat better record of chloramphenicol as an agent for treatment of haemophilus meningitis. J Infect Dis, 1977 Feb, 135(2), 303 - 7 Haemophilus influenzae meningitis in infant rats: role of bacteremia in pathogenesis of age-dependent inflammatory responses in cerebrospinal fluid; Moxon ER et al.; Abnormalities in cerebrospinal fluid associated with meningitis due to Haemophilus influenzae type b were characterized in infant rats . After intranasal inoculation of bacteria, the development of intense bacteremia (greater than 10(4) colony-forming units/ml) correlated with cultures of cerebrospinal fluid positive for H . influenzae, with pleocytosis, and with hisotologic evidence of meningitis . The degree of pleocytosis was related to the age of the animal, the amount of time since inoculation, and the severity of the meningitis. J Infect Dis, 1977 Feb, 135(2), 210 - 6 Cefamandole and ampicillin therapy in experimental Haemophilus influenzae meningitis; Strausbaugh LJ et al.; Cefamandole and ampicillin were compared in the therapy of experimental Haemophilus influenzae meningitis in rabbits . Three dosages of each drug were administered as a continuous intravenous infusion for 8 hr to 24 infected animals . Samples of serum and cerebrospinal fluid (CSF) were obtained at 0, 4, and 8 hr for determination of antibiotic concentrations and bacterial titers in CSF . Serum levels of cefamandole were higher, but CSF concentrations of both antibiotics were similar . With the 60-mg/kg per hr dose, the mean serum level was 106 +/- 61 mug/ml for cefamandole and 58 +/- 32 mug/ml for ampicillin (P less than 0.05) . With this dosage the mean level in CSF was 7.3 +/- 8.4 mug/ml for cefamandole and 9.5 +/- 5.4 mug/ml for ampicillin (P = 0.26) . The percentage penetration ({concentration in CSF/concentration in serum} X 100%) was higher for ampicillin (mean, 18.8% +/- 8.9%) than for cefamandole (mean, 5.6% +/- 3.8%) with all dosages tested (P less than 0.001) . The rate of bacterial killing in vivo during therapy was similar with both drugs . The efficacy of cefamandole and ampicillin given intramuscularly for five days (250 mg every 8 hr) was examined in 42 rabbits . Twelve of 14 untreated control rabbits died within 24-72 hr of inoculation . In contrast, 11 of 14 rabbits treated with cafamandole and 10 of 14 rabbits treated with ampicillin were cured of their infections . Cefamandole compared favorably with ampicillin in the therapy of experimental H . influenzae meningitis. Am J Dis Child, 1977 Feb, 131(2), 215 - 7 Hypopyon and orbital cellulitis associated with Haemophilus influenzae type B meningitis . Diagnostic and therapeutic implications; Gomez-Barreto J et al.; Three children, 8 months to 2 years of age, demonstrated unusual manifestations in association with Haemophilus influenzae septicemia and meningitis . After one child had been diagnosed as having orbital cellulitis in conjunction with H influenzae meningitis, a second child, with orbital cellulitis and no clinical evidence of meningitis, had a lumbar tap indicative of a meningitis . A third child developed a hypopyon in association with H influenzae meningitis and septic arthritis of several joints . We report the problem of diagnosis and treatment of orbital cellulitis in the context of our cases and those previously reported. J Gen Microbiol, 1977 Feb, 98(2), 349 - 54 The effect of sodium chloride and NADH on the growth of six strains of haemophilus species pathogenic to chickens; Rimler RB et al.; Six strains of Haemophilus species, pathogenic to chickens, required 1-0 to 1-5% (w/v) NaCl for optimum growth . The requirement was for Na+ rather than NaCl . A sodium salt buffer influenced the optimum NaCl requirement and enhanced growth . Each strain required a different concentration of NADH for an optimum rate of growth. Arch Exp Veterinarmed, 1977, 31(1), 129 - 37 {Contribution to the experimental haemophilus infection (haemophilus parahemolyticus, haemophilus parasuis) in specific pathogen-free piglets . 1 . microbiology, experimental arrangement, results}; Janetschke P et al.; Experimental infections were applied to specific pathogen free (SPF) piglets and store pigs, using five haemophilus (H.) parahaemolyticus and two H.-parasuis strains . Different germs counts and modes of application were chosen for each of the animals involved (intratracheal, intranasal, and subcutaneous routes).Clinical and pathologico-anatomic changes typical of haemorrhagic-necrotising pleuropneumonia were obtained from all germ counts and methods of application . Only one of the test animals could be successfully infected to exhibit manifestations of pneumonia or serositis when H . parasuis was used . The high pathogenicity of H . parahaemolyticus, as recorded from the above experiments, was in agreement with the growing incidence of that haemophilosis recordable for some time from pig stock. Avian Dis, 1977 Jan-Mar, 21(1), 39 - 49 Production and properties of hemagglutinin of Haemophilus gallinarum; Iritani Y et al.; Production of hemagglutinin (HA) of Haemophilus gallinarum was compared in some media, and its properties were studied . HA was produced in Kato's media, brain heart infusion (BHI) broth containing beta-diphosphopyridine nucleotide, and chicken meat infusion (CMI) broth . The HA in CMI broth different according to the concentration of the chicken serum; no HA titer was found in 0.5% or more chicken serum, but HA was activated by storage in a refrigerator . Cells of H . gallinarum cultured for a long time had markedly decreased HA titer . A weak HA was produced in blood and Kato's agars, but no titer appeared in CMI and BHI agars . HA of H . gallinarum was heat-labile and inactivated by formalin, ethanol, methanol, and ethyl acetate . On the other hand, HA was resistant to chloroform, acetone, and some enzymes . Moreover, the HA titer of cell cultured in CMI broth was enhanced by hyaluronidase . H . gallinarum in Kato's and BHI broths were pleomorphic rods with or without a capsule, but were capsulated ovoid cells in CMI broth, according to electron microscopy. Scand J Infect Dis, 1977, 9(1), 13 - 7 Serum immunoglobulin levels in the course of bacterial meningitis in children; Kouvalainen K et al.; Serum levels of 5 immunoglobulins (IgG, IgA, IgM, IgD and IgE) were determined at frequent intervals in the course of bacterial meningitis in children . 59 patients were examined; 27 with Haemophilus influenzae meningitis, 23 with meningococcal and 9 with pneumococcal meningitis . All 5 immunoglobulins increased during the 2-week course of bacterial meningitis . IgM was the immunoglobulin class responding most rapidly, regularly and intensively . IgG increased moderately . However, practically no rise of the IgG level was observed in childr