J Orthop Res, 1997 Nov, 15(6), 919 - 26 Staphylococcal septic arthritis: antibiotic and nonsteroidal anti-inflammatory drug treatment in a rabbit model; Smith RL et al.; This study evaluated the effects of combining antibiotic therapy with the application of a nonsteroidal anti-inflammatory drug on the degradation of articular cartilage for an animal model of Staphylococcal septic arthritis . Rabbits were infected intra-articularly with Staphylococcus aureus . Antibiotic treatment started 18 hours after infection and continued for 7 days . Treatment with the nonsteroidal anti-inflammatory drug naproxen sodium started 24 hours before infection and continued for either 3 or 7 weeks . The cartilage matrix of uninfected and infected knees was quantified by analysis of glycosaminoglycan and collagen content . Three weeks after infection, the combined treatment of the nonsteroidal anti-inflammatory drug and antibiotics reduced the loss of glycosaminoglycan and collagen from the cartilage of the infected knee by 15 and 30%, respectively, compared with antibiotic treatment alone . Continuing treatment with naproxen sodium for 7 weeks reduced the loss of collagen by 50% when compared with antibiotic treatment alone . The longer period of treatment with naproxen sodium showed little further effect on the loss of glycosaminoglycan than that observed for the 3-week treatment . Treatment with this drug and antibiotics reduced swelling of the knee and levels of prostaglandin E2 in the synovial fluid . The data support the hypothesis that decreasing post-infectious inflammation by adding the drug to a standard antibiotic regimen reduces cartilage damage from Staphylococcal septic arthritis. Rev Assoc Med Bras, 1997 Jul-Sep, 43(3), 199 - 204 {Sensitivity pattern of 117 clinical isolates of Staphylococcus aureus from 12 hospitals}; Farias WV et al.; OBJECTIVE: To evaluate the antimicrobial susceptibility pattern of oxacillin susceptible (OSSA) and resistant Staphylococcus aureus (ORSA) isolates to other antimicrobial agents that can be used for the treatment of staphylococcal infections . MATERIAL AND METHOD: We evaluated 117 clinical S . aureus isolates from several Sao Paulo hospitals . Clinical isolates from Campinas, SP and from Joao Pessoa, PB, were also included . The in vitro susceptibility testing was performed by broth microdilution as described by the National Committee for Clinical Laboratory Standards (NCCLS) . The minimum inhibitory concentration (MIC) was evaluated for 24 antimicrobial agents, including beta-lactams, fluoroquinolones, aminoglycosides, glycopeptides, macrolides, lincosamides and streptogramins . Both commercially available and experimental drugs were included in the study . Cross-resistance among fluoroquinolones was evaluated by susceptibility testing 24 isolates to 10 fluoroquinolones . RESULTS: The antimicrobial agents that showed the highest in vitro activity were the glycopeptides, the streptogramin RP-59.500, and the mupirocin (100% susceptibility) . Eighty-seven percent of the OSSA and only 38% of the ORSA isolates were susceptible to ciprofloxacin (MIC50 0.25 microgram/mL and > 4 micrograms/mL, respectively) . Cross-resistance among fluoroquinolones were noted even for the experimental drugs . Two fluoroquinolones remained active against ciprofloxacin-resistant isolates, clinafloxacin and WIN-57.273 . However, the ciprofloxacin-resistant isolates had MICs eight-to 64-fold higher than the ciprofloxacin-susceptible isolates, suggesting that the MICs may continue to increase when these fluoroquinolones become commercially available . CONCLUSION: Our results showed a high rate of antimicrobial resistance among S . aureus from the Brazilian hospitals . Very few drugs can still be used for the treatment of staphylococcal infections. Curr Microbiol, 1998 Feb, 36(2), 119 - 23 Azithromycin and clarithromycin inhibition of 50S ribosomal subunit formation in Staphylococcus aureus cells; Champney WS et al.; The ID50 values for azithromycin and clarithromycin inhibition of translation and of 50S assembly in Staphylococcus aureus cells have been measured . For clarithromycin, 50% inhibition of growth occurred at 0.075 microg/ml, and the effects on translation and 50S formation were equivalent at 0.15 microg/ml . The inhibition of these processes by azithromycin was less effective, with an ID50 of 2.5 microg/ml for growth and 5 microg/ml for inhibition of translation and 50S formation . The additive effects of each of these drugs on translation and 50S formation account quantitatively for their observed influence on cellular growth rates . In macrolide-treated cells, there was also a direct relationship between the loss of ribosomal RNA from the 50S subunit and its accumulation as oligoribonucleotides . These results are compared with the previously described effects of erythromycin on these same processes. Enferm Intensiva, 1997 Oct-Dec, 8(4), 143 - 50 {Prevention of infections caused by venous catheters in intensive care units}; Diaz Chicano JF et al.; The importance of the prevention of infections related to venous catheters comes from the frequent morbility which derives from these devices in ICU and the foresecable increase of infections which are secondary to them with the consequent increase in the load of Nursing work and costs in Spain, bacteriemias related to central catheters are 8%, under 5% for Swan-Ganz and almost inexistent for peripherals . Germs responsible for infectious incidences caused by catheters are basically Staphylococcus coagulase-negative and Staphylococcus aureus . The most affected veins are the jugular, followed by femoral, antecubital, subclavian and peripheral . The colonization of the patient's skin and the connections of catheters are the most frequent origin of infections and, since certain germs create defensive structures which make them more resistant to treatment, it is very important to carry out protocols of prevention and care which should encompass hand washing efficiency, daily care of the wound, use of suitable disinfectants and, very especially, the protection of catheter connections. Eur J Clin Microbiol Infect Dis, 1997 Dec, 16(12), 893 - 7 Clonal heterogeneity, distribution, and pathogenicity of methicillin-resistant Staphylococcus aureus; Wichelhaus TA et al.; Four thousand eighty-eight Staphylococcus aureus isolates obtained from patients hospitalised in a university clinic and four community hospitals over a period of one year were screened for methicillin resistance . A resistance rate of 5% was detected among initial isolates . Distribution of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus showed an increased prevalence of MRSA in clinically significant specimens such as blood, central venous catheter tips, bronchial secretions, and wound secretions . Typing of 110 MRSA strains (initial isolates) by macrorestriction analysis of chromosomal DNA revealed 26 different genotypes that could be divided into five epidemic and 21 sporadic strains . More than 50% of all isolates belonged to one type that was confirmed to be closely related to the "southern-German" epidemic strain . Production of virulence factors such as enterotoxin A-D and toxic shock syndrome-toxin 1 among MRSA strains (initial isolates) occurred in ten of 26 different MRSA types . A strong correlation between genotype and toxin production was demonstrated. Indian J Dent Res, 1995 Oct-Dec, 6(4), 123 - 8 Antibacterial activity of ciprofloxacin-beta-cyclodextrin complex and its efficacy in dental implants; Aithal KS et al.; Ciprofloxacin forms an inclusion complex with beta-cyclodextrin . The in vitro antibacterial activity of ciprofloxacin on E . coli and Staphylococcus aureus was found better on complexation . The complex was found very effective as a local antibacterial agent when used in dental implants . Significant reduction in the gingival index, probing pocket depth and microbial growth coupled with gain in attachment at the test site compared to control on the 14th day was observed when the implants containing 2.0 mg of the complex equivalent to 0.4 mg of ciprofloxacin was used in clinical trials. Biotechniques, 1998 Feb, 24(2), 294 - 301 Gene VIII-based, phage-display vectors for selection against complex mixtures of ligands; Jacobsson K et al.; Selection of shotgun phage-display libraries against complex mixtures of components, such as cells or sera, may result in a high number of nonspecifically binding phage . Consequently, correct interactions may be difficult to identify . To enable discrimination between faithful and nonspecific interactions, a set of eight different gene VIII-based, phage-display vectors were constructed . All vectors contain a "universal" screening tag positioned in such a way that it is only expressed when the inserted DNA encodes an open reading frame, which corrects a shift of reading frames in the vector . A Staphylococcus aureus shotgun phage-display library was made in a stoichiometric mixture of all vectors . After affinity-selection against IgG, one vector completely outcompeted the others . This vector contains the promoter and signal sequence from the gene encoding staphylococcal protein A and one suppressible stop codon immediately upstream of gene VIII . An increase in the frequency of clones expressing the affinity tag in all pannings correlated with selection for ligand-binding clones . This enables detection of putatively correct clones after selection of a shotgun phage-display library both against purified ligands and more complex materials like calf serum. No To Shinkei, 1998 Jan, 50(1), 75 - 9 {Prevertebral abscesses with a protracted insidious clinical course and subsequent lethal, acute pyogenic meningitis and septic shock}; Ozawa T et al.; This report concerns a 66-year-old man suffering from prevertebral abscesses with a protracted insidious clinical course and subsequent lethal and acute pyogenic meningitis . The patient had a three-month history of mild neck pain, and died as a result of septic shock due to staphylococcus aureus (methicillin susceptible) infection two days after admission to the hospital . At autopsy, abscesses encapsulated by fibrous connective tissue were found on the ventral surfaces of the cervical and thoracic regions of the spine . The prevertebral abscess on the upper cervical region was organized with dense fibrous tissue and contained a small number of inflammatory cells . On the other hand, the prevertebral abscess on the thoracic region was purulent and contained numerous inflammatory cells, macrophages and gram-positive cocci . Pyogenic spondylitis and discitis accompanying the prevertebral abscesses were multiple and widespread . These features suggested that the abscesses developed initially on the cervical region, extended caudally through the prevertebral space, directly involving the corpus vertebrae and discs, and ultimately caused sepsis . It is important to note that prevertebral abscesses can exhibit a protracted clinical course with only mild symptom such as minor neck pain and then manifest abruptly as acute meningitis and sepsis. J Dairy Sci, 1998 Jan, 81(1), 107 - 15 Recombinant bovine interleukin-2 and dry cow therapy: efficacy to cure and prevent intramammary infections, safety, and effect on gestation; Erskine RJ et al.; Cows from eight commercial dairies were randomly assigned to intrammamary infusions of cephapirin or cephapirin plus interleukin-2 at the end of lactation . During the first phase of the trial, interleukin-2 was administered to 159 cows at a dose of 1 mg per gland by intracisternal infusion immediately after 300 mg of cephapirin were administered . One hundred sixty-one cows received infusions of a placebo (phosphate-buffered saline; PBS) immediately after cephapirin . In the second phase of the trial, 70 cows received 2 mg of interleukin-2 per gland, and 78 cows received the placebo . Cows were observed daily by the participating farmer for 72 h after infusion and also during routine feeding and care during the dry period and at calving . Potential side effects from udder infusions, particularly gross abnormalities of the udder and signs of systemic side effects were monitored . During the first phase, cure rates for intramammary infections caused by Staphylococcus aureus that were present at the end of lactation were 33.3% for quarters treated with cephapirin and 53.6% for quarters treated with cephapirin and interleukin-2 . Cure rates did not differ between treatment groups for all other pathogens or during the second phase of the trial . The incidence of new intramammary infections during the dry period was not affected by intramammary infusion of interleukin-2 . Eighteen of 229 (7.9%) cows treated with interleukin-2 aborted within 49 d of treatment compared with 4 of 239 (1.7%) cows treated with PBS . Eleven of the 18 (61.1%) abortions by cows treated with interleukin-2 occurred 3 to 7 d after infusion; none of the abortions by cows treated with PBS occurred until wk 7 after infusion. J Vet Med Sci, 1998 Jan, 60(1), 137 - 8 Cutaneous staphylococcal granuloma in a free living zebra (Equus burchelli) in Zambia; Pandey GS et al.; An outgrowth on the left anteriothoracic region behind the elbow joint was seen in a free living Zebra at the time of postmortem examination . The covering skin was ulcerated, nodular, hard with multiple fistula containing yellowish pus . A pure culture of coagulase positive Staphylococcus aureus was isolated from the deep tissue . Histopathology revealed pyogranulomatous dermatitis characterized by eosinophilic amorphous grains including bacterial colonies . This is the first report of cutaneous staphylococcal granuloma in Zebra in Zambia. Microbiol Immunol, 1997, 41(12), 991 - 8 Immunomodulatory activities of oat beta-glucan in vitro and in vivo; Estrada A et al.; Previous studies have shown that beta-glucans extracted from yeast or fungi potentiate immune responses . In the present study, the immunomodulatory activities of beta-(1-->3,1-->4)-glucan, derived from oats, were investigated . The ability of oat beta-glucan (ObetaG) to stimulate IL-1 and TNF-alpha release from murine peritoneal macrophages and the murine macrophage cell line P338D1, was assessed . In vitro stimulation of macrophages with ObetaG resulted in the production of IL-1 in a dose and time-dependent manner, whereas only small amounts of TNF-alpha could be detected in the culture supernatants . ObetaG also induced the production of IL-2, IFN-gamma and IL-4 secretion in a dose-dependent manner in cultured spleen cells . The intraperitoneal administration of ObetaG in mice resulted in the accumulation of leucocytes, predominantly macrophages, in the peritoneal cavity . Furthermore, ObetaG was tested for its ability to enhance non-specific resistance to a bacterial challenge in mice . Survival of mice challenged with Staphylococcus aureus was enhanced by a single intraperitoneal administration of 500 microg of ObetaG 3 days prior to bacterial challenge . In conclusion, these studies demonstrated that ObetaG possesses immunomodulatory activities capable of stimulating immune functions both in vitro and in vivo. Dermatol Surg, 1998 Feb, 24(2), 279 - 82 Infection with methicillin-resistant Staphylococcus aureus after carbon dioxide resurfacing of the face . Successful treatment with minocycline, rifampin, and mupiricin ointment; Bellman B et al.; BACKGROUND: The incidence of cutaneous bacterial infection after carbon dioxide (CO2 laser resurfacing is increasing . Patients with staphylococcal colonization of their anterior nares may be at greater risk for postoperative cutaneous colonization and/or infection, which can potentially cause scarring . OBJECTIVE: We present a case report of methicillin-resistant Staphylococcus aureus secondary infection of the skin after CO2 laser resurfacing . We discuss the possible etiologies of this patient's infection, her postoperative management, and preoperative suggestions for possibly preventing infection . METHODS: A 49-year-old woman was treated with CO2 laser resurfacing for moderate actinic damage and facial rhytides . She developed a cutaneous infection with methicillin-resistant S . aureus, which caused diffuse linear scarring on her cheeks and upper lip . RESULTS: The patient was successfully treated with oral minocycline, rifampin, and topical mupiricin ointment to her cutaneous erosions . CONCLUSIONS: We propose that it would be helpful for patients undergoing CO2 laser resurfacing to have their nares cultured to see if they are staphylococcal carriers . If a patient is found to be a carrier, mupiricin ointment can be used preoperatively treat to the nares, to help decrease the risk of infection of the skin from this potential source. Diagn Microbiol Infect Dis, 1998 Jan, 30(1), 17 - 20 A combined molecular approach to screen for mec gene variants from methicillin-resistant Staphylococcus aureus; Ahmadinejad M et al.; Previous reports have suggested a common origin for all methicillin resistance (mec) genes from methicillin-resistant Staphylococcus aureus (MRSA) isolates examined so far . The purpose of this study was to explore several molecular methods for screening MRSA isolates from different sources and, in some cases, with varying phenotypes . Eighty MRSA isolates from three teaching hospitals in the University of Louisville Medical Center were compared with MRSAs from a hospital in southern California and with methicillin-sensitive S . aureus isolates . The methods were used to detect the presence of mec gene and to screen for any polymorphisms in these genes for the respective strains . The mec gene for each isolate was amplified via the polymerase chain reaction, and each polymerase chain reaction product was compared to the others by restriction enzyme digestion, denaturing-gradient gel electrophoresis, and mutation detection enhancement . By these criteria, the mec genes from the 80 MRSA strains in this study seemed to be identical . Such a finding was not unexpected and supported the existing hypothesis of a common ancestor for all mec genes isolated in MRSA isolates . However, the combination of methods used in this study may facilitate screening of MRSA strains in population studies as mec gene variants begin to emerge. Nat Biotechnol, 1998 Feb, 16(2), 190 - 5 Design, synthesis, and application of a protein A mimetic; Li R et al.; Low-molecular-weight synthetic molecules that mimic the activity of native biological macromolecules have therapeutic potential, utility in large-scale production of biopharmaceuticals, and the capacity to act as probes to study molecular recognition events . We have developed a nonpeptidyl mimic for Staphylococcus aureus Protein A (SpA) . The specific recognition and complexation elements between the B domain (Fb) of SpA and the Fc fragment of IgG were identified from the x-ray crystallographic structure . Computer-aided molecular modeling was used to design a series of biomimetic molecules around the Phe132-Tyr133 dipeptide involved in its binding to IgG . One of the ligands binds IgG competitively with SpA in solution and when immobilized on agarose beads, with an affinity constant of 10(5)-10(6) M-1 . The immobilized artificial Protein A was used to purify IgG from human plasma and murine IgG from ascites fluid, and to remove bovine IgG from fetal calf serum. East Afr Med J, 1997 Sep, 74(9), 603 - 4 Recurrent staphylococcal scalded skin syndrome in children: report of two cases; Machang'u RS et al.; A localised "scalded skin syndrome" occurred in two male siblings aged five and ten years old, in Morogoro, Tanzania . This condition recurred in the same children within a period of about 12 months . A haemolytic ampicillin resistant Staphylococcus aureus was isolated from the bullous material, suggesting that the condition was staphylococcal scalded skin syndrome (SSSS) . This implies that the bacterial isolate was an exfoliative toxin (ET) producing S . aureus . This infection was, however, striking because SSSS occurs mostly in newborns, and it is rarely recurrent . It is possible that a new strain with particular adaptability, or an inherent susceptibility to the S . aureus of the affected children was the cause of this recurrency. JAMA, 1998 Feb 25, 279(8), 593 - 8 Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk; Herold BC et al.; CONTEXT: Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in children have occurred primarily in individuals with recognized predisposing risks . Community-acquired MRSA infections in the absence of identified risk factors have been reported infrequently . OBJECTIVES: To determine whether community-acquired MRSA infections in children with no identified predisposing risks are increasing and to define the spectrum of disease associated with MRSA isolation . DESIGN: Retrospective review of medical records . PATIENTS: Hospitalized children with S aureus isolated between August 1988 and July 1990 (1988-1990) and between August 1993 and July 1995 (1993-1995) . SETTING: The University of Chicago Children's Hospital . MAIN OUTCOME MEASURES: Prevalence of community-acquired MRSA over time, infecting vs colonizing isolates, and risk factors for disease . RESULTS: The number of children hospitalized with community-acquired MRSA disease increased from 8 in 1988-1990 to 35 in 1993-1995 . Moreover, the prevalence of community-acquired MRSA without identified risk increased from 10 per 100000 admissions in 1988-1990 to 259 per 100000 admissions in 1993-1995 (P<.001), and a greater proportion of isolates produced clinical infection . The clinical syndromes associated with MRSA in children without identified risk were similar to those associated with community-acquired methicillin-susceptible S aureus . Notably, 7 (70%) of 10 community-acquired MRSA isolates obtained from children with an identified risk were nonsusceptible to at least 2 drugs, compared with only 6 (24%) of 25 isolates obtained from children without an identified risk (P=.02) . CONCLUSIONS: These findings demonstrate that the prevalence of community-acquired MRSA among children without identified risk factors is increasing. Ann Otol Rhinol Laryngol, 1998 Feb, 107(2), 155 - 63 Effects of surgery on mucosal pathologic changes following experimental sinusitis in rabbit; Forsgren K et al.; In the present investigation, the regenerative capacity of the infected maxillary sinus mucosa following surgical procedures was studied in a rabbit model . Sinusitis was induced by occluding the ostium with and without the addition of Staphylococcus aureus or Bacteroides fragilis, or by provoking a prolonged bacterial infection with both pathogens . The surgical procedures performed were 1) widening of the natural sinus ostium (middle meatal antrostomy; MMA) and 2) removal of sinus mucosa without ostial interference (modified radical operation; MRO) . The histologic features of the entire nose-sinus complex were studied, graded semiquantitatively, and compared with findings in untreated sinusitis, or after surgery only . Whereas MMA and MRO both led to a decrease of the inflammatory features of the sinus mucosa in induced sinusitis, persistent local histopathology was observed in the ostial region following MMA surgery . This indicates the importance of local pathologic changes resulting from interactions of bacterial colonization, inflammation, and surgery in chronic sinusitis. Immunology, 1997 Nov, 92(3), 346 - 53 Effect of B-cell receptor engagement on CD40-stimulated B cells; Schilizzi BM et al.; Activation of human B cells in vitro either by cross-linking of surface immunoglobulins (sIg) or by triggering CD40 antigen, in the presence of interleukin-10 (IL-10) and interleukin-2 (IL-2), may result in high levels of immunoglobulin secretion in vitro . We studied the combined effects of ligation of the B-cell receptor (BCR) and CD40 {with anti-CD40 monoclonal antibody (mAb)} on B-cell proliferation and production of human immunoglobulin . For this purpose highly purified splenic B cells were cultured with various combinations of anti-CD40 and IL-10/IL-2 or IL-4 in the presence of CD32-transfected L cells . Simultaneous cross-linking of the BCR was achieved by mAb held on CD32-L cells or Staphylococcus aureus (SA) . We found that dual BCR and CD40 ligation with IL-10/IL-2 leads to reduced immunoglobulin G (IgG) secretion compared with B cells stimulated with either anti-CD40 and IL-10/IL-2, or compared with B cells stimulated with SA or anti-BCR mAb and IL-10/IL-2 . Dual BCR and CD40 ligation with anti-immunoglobulin mAb (anti-kappa + anti-lambda light chains) but not with SA induced a similar reduction in IgM production . The reduced immunoglobulin secretion found during dual ligation is accompanied by increased proliferation . This was independent of cytokine stimulation but SA/CD40-induced proliferation was increased in the presence of IL-10/IL-2, although not with IL-4 . The combination anti-kappa and anti-lambda with anti-CD40 showed a long-term suppression of IgG and IgM production (at least 14 days), while anti-kappa or anti-lambda alone, or SA, allowed a moderate recovery of immunoglobulin production by day 14 . These results suggest that simultaneous B-cell antigen receptor cross-linking and CD40 engagement via CD40L on T cells induces strong initial proliferation . This may be followed later by antibody production depending on the strength of the BCR signal and the presence of the appropriate cytokines. Nephrol Dial Transplant, 1998 Jan, 13(1), 139 - 45 Staphylococcus aureus bacteraemia among patients undergoing dialysis--focus on dialysis catheter-related cases; Nielsen J et al.; BACKGROUND: Central venous catheter-related infections are the most common cause of nosocomial S . aureus bacteraemia in Denmark . Central venous catheters are often used for dialysis, and patients on dialysis often run into staphylococcal infections . The purpose of this study was to investigate S . aureus bacteraemia among dialysis patients, especially those related to dialysis catheters . METHODS: This was a retrospective study of 14,387 consecutive S . aureus bacteraemia cases during the period 1976-93, of which 793 cases occurred among dialysis patients . By reviewing the case records, 65 dialysis catheter-related cases were described more thoroughly . RESULTS: The number of S . aureus bacteraemia cases among dialysis patients as a proportion of all cases in Denmark has increased from 5.2 to 14.7% during the study period, but the annual incidence among these patients has been almost stable during the period (median 5.7% (3.2-9.0%)) . Patients on dialysis had a lower mortality than other patients with S . aureus bacteraemia (18.9 vs 29.0%), but a four times higher mortality from central venous catheter-related S . aureus bacteraemia (5.3 vs 1.3%, P < 0.001) . The mortality from dialysis catheter-related S . aureus bacteraemia was correlated with greater age (median 71 years (57-73) vs median 56.5 years (15-76), P < 0.01) and with septic shock (55.5 vs 7.1%, P < 0.05) . Patients on dialysis had a lower frequency of S . aureus endocarditis (3.3 vs 5.4%, P < 0.01) and of S . aureus bone and joint infections (3.3 vs 8.2%, P < 0.001) than other patients . Patients undergoing dialysis had a later onset of catheter-related S . aureus bacteraemia than other patients (median 15 days (1-145) vs 5 days (1-134), P < 0.05) . CONCLUSIONS: Patients on dialysis are at a high risk of S . aureus bacteraemia and they have a four times higher mortality from central venous catheter-related S . aureus bacteraemia than other patients . There is need for prospective studies in which patients as well as catheters are followed more thoroughly to study the pathogenesis of dialysis catheter-related infections. Mikrobiol Z, 1997 Sep-Oct, 59(5), 53 - 6 {The production of the tumor necrosis factor in an experimental staphylococcal infection}; Iakovenko LF et al.; The paper deals with the study of production of tumour necrosis factor (TNF), the key mediator of inflammation and immune responses of the organism, under experimental and staphylococcus infection (Staphylococcus aureus, st . 209) on mice of C57B16 line . It is established that staphylococcus infection of animals lead to TNF induction . Dynamics of this cytokinin synthesis by peritoneal macrophages and splenocytes under the infection of mice with S . aureus in different doses differed in time and as to absolute values . In animals infected by staphylococcus in a dose of LD30 the TNF production was high as compared to the control for 72 h after the infection and was normalized on the 4-6th day of the experiment . When using staphylococcus in a dose of LD50, spontaneous production of this cytokinin was higher than that in the control for the whole period of observation. J Belge Radiol, 1997 Dec, 80(6), 289 - 91 {Isolated septic arthritis of the articular surface of the lumbar spine--the contribution of MRI}; Farrokh D; We describe the case of a 54 year-old-woman which isolated septic arthritis of the lumbar facet joint resulting from staphylococcus aureus . This infection is a rare condition, there are only a few previously reported cases of isolated septic arthritis of the facet joint in the literature . MRI is the preferred imaging method of diagnosis because of the ultiplanar imaging capability and the excellent soft tissue haracterization. J Biol Chem, 1998 Jan 30, 273(5), 2645 - 52 Molecular interactions between two global regulators, sar and agr, in Staphylococcus aureus; Chien Y et al.; The expression of many virulence determinants in Staphylococcus aureus is controlled by regulatory loci such as agr and sar . We have previously shown that the SarA protein is required for optimal transcription of RNAII and RNAIII in the agr locus . To define the specific molecular interaction, we overexpressed SarA as a glutathione S-transferase (GST) fusion protein by cloning the 372-base pair (bp) sarA gene into the vector . The purified GST-SarA as well as cleaved SarA were able to bind specifically to the P2, P3, and the combined P2-P3 promoter fragments of agr in gel shift assays . Using monoclonal antibodies to SarA, we found that SarA is a part of the retarded protein-DNA complex as evidenced by the formation of a supershifted band . The SarA binding site on the agr promoter, mapped by DNase I footprinting assay, covered a 29-bp region between the P2 and P3 promoters devoid of any direct repeats . A synthetic 45-bp fragment encompassing the 29-bp sequence also bound the SarA protein in band shift assays . Serial in-frame deletion analysis of sarA revealed that, with the exception of 15 residues in the N terminus, almost all of SarA (residues 16-124) is essential for agr binding activity . Northern analysis confirmed that only the sar mutant clone containing a truncated sarA gene with a 15-residue deletion in the N terminus (SarA16-124) could activate agr transcription to a level approaching that of the full-length counterpart (SarA1-124) . Taken together, these data indicated that SarA is a DNA-binding protein with binding specificity to the P2 and P3 interpromoter region of agr, thereby activating RNAII and RNAIII transcription. Vet Immunol Immunopathol, 1997 Nov, 59(3-4), 323 - 35 Effect of porcine reproductive and respiratory syndrome virus (PRRSV) (isolate ATCC VR-2385) infection on bactericidal activity of porcine pulmonary intravascular macrophages (PIMs): in vitro comparisons with pulmonary alveolar macrophages (PAMs); Thanawongnuwech R et al.; Porcine pulmonary intravascular macrophages (PIMs) were recovered by in situ pulmonary vascular perfusion with 0.025% collagenase in saline from six 8-week old, crossbred pigs . Pulmonary alveolar macrophages (PAMs) were recovered by bronchoalveolar lavage from the same pigs for comparisons in each assay . The macrophages were exposed to PRRSV (ATCC VR-2385) in vitro for 24 h and infection was confirmed by an indirect immunofluorescence test or transmission electron microscopy . Viral particles tended to accumulate in the vesicles of the Golgi apparatus or endoplasmic reticulum . Bactericidal function assays were performed on the recovered macrophages to determine the effects of the virus on macrophage functions . In vitro PRRSV infection reduced the bactericidal ability of PIMs from 68.3% to 56.4% (P < 0.09), and PAMs from 69.3% to 61.0% (P > 0.1) at 24 h post-infection . The mean percentage of bacteria killed by macrophages after PRRSV infection was not significantly different among the treatment groups or between the treatment groups and non-infected controls based on colorimetric MTT bactericidal (Staphylococcus aureus) assay . PRRSV did not affect the ability of PIMs or PAMs to internalize opsonized 125I-iododeoxyuridine-labeled S . aureus (P > 0.05) . PRRSV infection significantly decreased the production of superoxide anion (P < 0.01) by 67.0% in PIMs and by 69.4% in PAMs . PRRSV reduced the myeloperoxidase-H2O2-halide product (P < 0.01) by 36.5% for PIMs and by 48.1% for PAMs . The results suggest: (1) PIMs should be considered as an important replication site of PRRSV; (2) PRRSV may have a detrimental effect on both PIMs and PAMs; (3) loss of bactericidal function in PIMs may facilitate hematogenous bacterial infections. J Trop Pediatr, 1997 Dec, 43(6), 368 - 72 Omphalitis in term and preterm appropriate for gestational age and small for gestational age infants; Guvenc H et al.; To determine whether there is a difference on the historical and clinical characteristics of omphalitis among term and preterm appropriate for gestational age (AGA) and small for gestational age (SGA) infants, we prospectively investigated 85 newborns with bacteriologically proved omphalitis . Study groups were based on gestational age and being SGA . Preterm AGA infants had significantly lower mean age and neutrophil counts . Risk factors such as septic delivery including unplanned home delivery, and bacterial spectrum were similar in the groups . Staphylococcus aureus and Escherichia coli were the most frequent micro-organisms . Mortality rates for the study groups were similar and overall case fatality rate was 13 per cent . Immunological immaturity of preterm newborns may explain the earlier occurrence age of omphalitis and lower absolute neutrophil count . The following features such as early-onset infection, septic delivery including unplanned home delivery and abnormal temperature may be considered as determinants of poor prognosis . However, further studies are needed. Biol Pharm Bull, 1998 Jan, 21(1), 5 - 9 Preparation and characterization of everted membrane vesicles from cells of Staphylococcus aureus; Kodama K et al.; We developed a method for the preparation of everted membrane vesicles from cells of Staphylococcus aureus . The cells were first treated with ampicillin to weaken the peptidoglycan layer, then the cells were passed through a French press cell . The resulting vesicles were roughly 0.1 microm in diameter, judging from electron microscopic observations . We detected fairly high membrane-bound ATPase activity in the membrane vesicles . We observed respiratory-driven quenching of quinacrine fluorescence, which indicates that inward H+ transport took place . These results indicate that the vesicles are everted . We characterized the membrane-bound ATPase . We also detected Na+/H+ antiport, erythromycin/H+ antiport and chloramphenicol/H+ antiport activities in the membranes of S . aureus. Ann Pharmacother, 1998 Jan, 32(1), S7 - 16 New approaches to reduce Staphylococcus aureus nosocomial infection rates: treating S . aureus nasal carriage; Perl TM et al.; BACKGROUND: Nosocomial infections cause significant patient morbidity and mortality . The 2.5 million nosocomial infections that occur each year cost the US healthcare system $5 million to $10 million . Staphylococcus aureus has long been recognized as an important pathogen in human disease and is the most common cause of nosocomial infections . OBJECTIVE: To describe the epidemiology of S . aureus nosocomial infections that are attributable to patients' endogenous colonization . DATA SOURCES: Review of the English-language literature and a MEDLINE search (as of September 1997) . DATA SYNTHESIS: The ecologic niche of S . aureus is the anterior nares . The prevalence of S . aureus nasal carriage is approximately 20-25%, but varies among different populations, and is influenced by age, underlying illness, race, certain behaviors, and the environment in which the person lives or works . The link between S . aureus nasal carriage and development of subsequent S . aureus infections has been established in patients on hemodialysis, on continuous ambulatory peritoneal dialysis, and those undergoing surgery . S . aureus nasal carriers have a two-to tenfold increased risk of developing S . aureus surgical site or intravenous catheter infections . Thirty percent of 100% of S . aureus infections are due to endogenous flora and infecting strains were genetically identical to nasal strains . Three treatment strategies may eliminate nasal carriage: locally applied antibiotics or disinfectants, systemic antibiotics, and bacterial interference . Among these strategies, locally applied or systemic antibiotics are most commonly used . Nasal ointments or sprays and oral antibiotics have variable efficacy and their use frequently results in antimicrobial resistance among S . aureus strains . Of the commonly used agents, mupirocin (pseudomonic acid) ointment has been shown to be 97% effective in reducing S . aureus nasal carriage . However, resistance occurs when the ointment has been applied for a prolonged period over large surface areas . CONCLUSIONS: Given the importance of S . aureus nosocomial infections and the increased risk of S . aureus nasal carriage in patients with nosocomial infections, investigators need to study cost-effective strategies to prevent certain types of nosocomial infections or nosocomial infections that occur in specific settings . One potential strategy is to decrease S . aureus nasal carriage among certain patient populations. Infect Control Hosp Epidemiol, 1998 Jan, 19(1), 32 - 7 Risk factors for mortality in Staphylococcus aureus bacteremia; Conterno LO et al.; OBJECTIVE: To analyze risk factors for, and the role of methicillin resistance in, mortality in Staphylococcus aureus bacteremia . DESIGN: Nested case-control study . SETTING: General teaching hospital with a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains, in Sao Paulo, Brazil . PATIENTS: 136 patients over 14 years old with documented S aureus bacteremia . Those who died were compared with those who survived at least 14 days . RESULTS: Mortality within 14 days of bacteremia was 39% (53/136) . Mean age was 47 years . Hospital-acquired bacteremia represented 86% (117/136) of episodes . In 26% (35/136), infection was related to an intravascular catheter and in 13% (17/136) to the respiratory tract . Septic shock occurred in 22% (30/136) of cases . MRSA was isolated in 66% (90/136) . Multivariate analysis identified three variables that were significantly and independently associated with mortality: site of entry (lung, odds ratio {OR}, 17.0; unknown, OR, 12.3; others, OR, 6.6); occurrence of shock (OR, 8.9), and resistance of S aureus to methicillin (OR, 4.2) . CONCLUSION: Our study shows that S aureus bacteremia has a high mortality, especially when the lung is the source of infection and when shock develops; resistance to methicillin may be another risk factor for poor outcome. Drugs, 1997, 54 Suppl 6, 29 - 38 Anti-gram-positive agents . What we have and what we would like; Gruneberg RN; The usefulness of many anti-Gram-positive antibiotics is being compromised by the spread of antibiotic resistance in bacteria . The most reliable agents for serious infections are the glycopeptide agents vancomycin and teicoplanin . The appropriate maintenance dosage for teicoplanin in serious infections is 6 mg/kg/day, i.e . usually 400 mg/day . There are 3 exceptions for which the daily maintenance dosage should be 12 mg/kg/day and these are intravenous drug abusers, septic arthritis (but not osteomyelitis), and Staphylococcus aureus endocarditis treated with teicoplanin monotherapy . When teicoplanin is given at these doses, it achieves clinical and bacteriological results that are equivalent to those obtained with vancomycin, irrespective of pathogen or type of infection . The toxicity profile favours teicoplanin over vancomycin, especially when other, potentially toxic, drugs are coadministered . Teicoplanin also has an advantage in terms of ease and convenience of administration, which, together with its lack of need for routine blood level monitoring, facilitates its use outside hospital . New agents hold some promise for the future; however, oral agents, if developed, could present the risk of being overused, which might compromise their long term utility. Eye, 1997, 11 ( Pt 5), 618 - 21 The role of staphylococcal superantigens in the pathogenesis of marginal keratitis; Jayamanne DG et al.; Previous studies have demonstrated an increased incidence of delayed-type hypersensitivity to staphylococcal antigens in patients with blepharitis, but this does not predict subsequent development of marginal keratitis (MK) . Superantigens are potent immune-modifying molecules produced by pathogenic organisms including Staphylococcus aureus . To study whether staphylococcal superantigens play a role in the development of MK, conjunctival and lid margin cultures were taken from 26 subjects with MK and 24 controls . Four of 8 eyes with their first episode of MK grew strains of S . aureus, of which only one was superantigen-producing . None of the subjects with recurrent MK and only one control grew S . aureus . We conclude that staphylococcal superantigens are unlikely to play a central role in the development of MK . The absence of S . aureus on the lids of subjects with recurrent MK may reflect an alteration in lid flora due to previous topical antibiotic and steroid treatment. Acta Med Croatica, 1997, 51(4-5), 211 - 3 Local application of mupirocin ointment in the eradication of Staphylococcus aureus from nasal mucosa in patients on chronic hemodialysis; Ladavac R et al.; Efficacy of locally applied mupirocin in the elimination of Staphylococcus aureus (SA) from the nasal mucosa in patients on maintenance hemodialysis was studied . SA was isolated in 27 patients (33.3% of the population of dialysis patients) and trials were carried out in 25 patients by applying a 2% mupirocin ointment for five days . The eradication amounted to 92% immediately upon therapy completion, and to 84%, 56%, 52% and 32% after 1, 2, 3 and 9 months . All SA strains isolated before and after the treatment were sensitive to mupirocin . The authors believe that mupirocin is efficient in the elimination of SA from nasal mucosa, however, control swabs should be periodically taken at two-month intervals. Pneumologie, 1997 Nov, 51(11), 1043 - 50 {Regulation of Staphylococcus aureus capsular polysaccharide type 5: in vitro and in vivo inhibition by CO2}; Herbert S et al.; Staphylococcus aureus capsular polysaccharide type 5 (CP5) expression was investigated in lung tissue and nasal polyps of two cystic fibrosis (CF) patients, in rats and in vitro using ELISA and immunofluorescence . In CF tissues, S . aureus expressed protein A and teichoic acid but only 1-5% of cells expressed CP5 . When rats were challenged with CP5-positive S . aureus in the granuloma pouch model, only 1-5% CP5-positive cells were detectable in pouch exsudates . CF and pouch isolates, however, re-expressed CP5 (70-90% of cells) when grown in vitro with air . Addition of 1% CO2 or more to air or to O2/N2 gas mixtures reduced CP5 expression significantly (p < 0.001) in a dose-dependent manner (1-6% CP5-positive cells) . The results show that S . aureus does not produce CP5 in CF airways and in rat granuloma pouches and that CO2 is an environmental signal which regulates CP5 expression. Am J Kidney Dis, 1998 Feb, 31(2), 273 - 82 Effect of glucose concentration, osmolality, and sterilization process of peritoneal dialysis fluids on cytokine production by peripheral blood mononuclear cells and polymorphonuclear cell functions in vitro; Cendoroglo M et al.; We sought to investigate the effects of high glucose concentration, osmolality, and heat sterilization of peritoneal dialysis fluids on tumor necrosis factor-alpha (TNF-alpha) production by peripheral blood mononuclear cells (PBMC) and polymorphonuclear cell (PMN) functions . Blood samples were obtained from eight healthy volunteers . PBMCs and PMNs were harvested by centrifugation with Ficoll-Hypaque (Sigma, St Louis, MO) . PBMC were incubated with an equal volume of test fluids and RPMI for 4 hours (pH equilibrated), followed by incubation for 20 hours in RPMI with or without endotoxin (10 ng/mL) . Total TNF-alpha production was measured by radioimmunoassay . PMNs were incubated with pH-adjusted test fluids for 30 minutes . After incubation, phagocytosis was determined by the uptake of 14C-labeled Staphylococcus aureus, oxidative burst by reduction of ferricytochrome C to ferrouscytochrome C on stimulation with phorbol myristate acetate, and enzyme release by measurement of endotoxin-stimulated bactericidal/permeability increasing factor . To study the effects of increasing glucose concentration and osmolality on PBMC and PMN functions, we compared conventional 1.5% Dianeal (1.5%D), (Baxter Healthcare Corp, Deerfield, IL) 2.5% Dianeal (2.5%D), 4.25% Dianeal (4.25%D), and control (RPMI for PBMCs and Hank's balanced salt solution for PMNs) . PMNs exposed to 4.25%D exhibited an inhibition of phagocytosis, phorbol myristate acetate (PMA)-stimulated oxidative burst, and bactericidal/permeability increasing factor release compared with control, 1.5%D, or 2.5%D . To study the effects of increased osmolality when controlled for glucose concentration, we compared 1.5%D with 1.5%D in which osmolality was increased to that of 4.25%D with the addition of either sodium chloride (1.5%D+NaCl) or mannitol (1.5%D+M) . High osmolality induced higher TNF-alpha production by unstimulated PBMCs and decreased TNF-alpha production by endotoxin-stimulated PBMCs . PMN functions were also inhibited by high osmolality . To study the effects of increased glucose concentration when controlled for osmolality, we compared 4.25%D with 1.5%D+NaCl and 1.5%D+M . High glucose concentration induced an increase in TNF-alpha production by unstimulated PBMCs, a decrease in TNF-alpha production by endotoxin-stimulated PBMCs, and an inhibition of PMN functions . Finally, to investigate the effects of heat sterilization, we compared 4.25%D (heat sterilized) to a filter-sterilized 4.25%D (4.25%D-F) . The filter-sterilized fluid induced less changes in PBMC and PMN functions compared with the heat-sterilized fluid . These data suggest that the high glucose concentration, high osmolality, and heat sterilization of peritoneal dialysis fluids adversely affect PBMC and PMN functions . These effects could predispose continuous ambulatory peritoneal dialysis patients to peritonitis, compromise host defense during infection, and jeopardize long-term survival of the peritoneal membrane. Zentralbl Veterinarmed B, 1997 Dec, 44(10), 599 - 607 Efficacy of a bovine Staphylococcus aureus vaccine using interleukin-2 as an adjuvant; Derosa DC et al.; The purpose of this study was to examine the efficacy of a vaccination protocol using recombinant bovine interleukin-2 (rBoIL-2) as an adjuvant with a Staphylococcus aureus vaccine . Holstein dairy cows were immunized with a S . aureus vaccine in conjunction with either saline solution (n = 3), Freund's incomplete adjuvant (FIA; n = 3) or rBoIL-2 (n = 3) . Whey and serum were analysed for antibody titer to specific S . aureus antigens . Isolated blood mononuclear cells (BMC) were examined for their ability to proliferate and to produce interleukin-2 (IL-2) and interferon (IFN) after either mitogenic or antigenic stimulation in vitro . Efficacy of the vaccination protocols was assessed by challenging experimental animals intramammarily with 100 colony forming units of S . aureus . Regardless of treatment, all cows exhibited similar serum antibody titers to S . aureus pseudocapsule . Cows treated with saline exhibited a significant increase in serum alpha-toxin antibody titer when compared to levels observed in FIA and rBoIL-2-treated cows . However, cows receiving rBoIL-2 treatment exhibited significantly higher lacteal pseudocapsule antibody titer compared to the other adjuvant groups . Administration of rBoIL-2 did not enhance BMC proliferative responses to the mitogens concanavalin A (ConA), phytohemagglutinin (PHA), pokeweed mitogen (PWM) or interleukin-2 (IL-2) when compared to FIA or saline treated cows . Although cows receiving rBoIL-2 treatment exhibited enhanced cytokine production upon antigenic stimulation, efficacy of the vaccination protocol was inferior compared to the protection offered by saline treatment. Arch Biochem Biophys, 1998 Feb 1, 350(1), 26 - 35 Differential effects of Staphylococcus aureus alpha-hemolysin on the synthesis of hyaluronan and chondroitin sulfate by rat chondrosarcoma chondrocytes; Goodstone NJ et al.; The plasma membranes of rat chondrosarcoma chondrocytes were permeabilized by treatment with alpha-hemolysin, the major toxin produced by Staphylococcus aureus, which forms small, stable, heptameric, transmembrane pores (1-2 nm in diameter) permitting influx/efflux of low-molecular-mass molecules (< or = 2000 Da) . Treated chondrocytes were permeable to entry of trypan blue and exit of ATP . We describe the effects of alpha-hemolysin on the synthesis of hyaluronan (HA) and chondroitin sulfate (CS) by chondrocytes using the simple sugar {3H}glucosamine as a metabolic precursor . Chondrocytes permeabilized with alpha-hemolysin in serum-free media decreased intracellular ATP and synthesis of CS to approximately 5% of control within 2-4 h, but synthesized HA (80% of control for 8 h; approximately 65% of control at 24 h) . Adding fresh medium (with or without serum) to permeabilized cells increased ATP significantly and increased HA synthesis to near initial control values . Under the same conditions, the recovery of CS synthesis approached initial levels in control but not permeabilized cells . Our model demonstrates that the biosynthesis of HA by these cells in vitro is remarkably stable to cellular perturbations which drastically inhibit synthesis of CS on proteoglycans. J Clin Microbiol, 1998 Feb, 36(2), 552 - 6 Evolution of an endemic methicillin-resistant Staphylococcus aureus population in an Australian hospital from 1967 to 1996; Givney R et al.; The evolution over 30 years of a population of methicillin-resistant Staphylococcus aureus (MRSA) from a tertiary referral hospital was studied by phylogenetic analysis of SmaI-generated restriction fragment length polymorphisms (RFLPs) . The results suggest that a new clone of MRSA appeared at the hospital in the early 1980s, which, although usually retaining its ancestral phage-type, developed four different RFLP pulsotypes in the next 16 years . This finding indicates that multiple RFLP patterns in MRSA do not necessarily represent multiple clones deriving from different mec gene transfer events . Such variation within a clone may be significant in the interpretation of RFLP patterns during outbreaks and emphasizes the need to use two typing methods in studies of such populations . Since the appearance of new clones of MRSA is a relatively rare event, cross-infection control is paramount in the prevention of MRSA dissemination. J Clin Microbiol, 1998 Feb, 36(2), 414 - 20 Phenotypic and genotypic characterization of nosocomial Staphylococcus aureus isolates from trauma patients; Na'was T et al.; Staphylococcus aureus is a major cause of nosocomial infections . During the period from March 1992 to March 1994, the patients admitted to the intensive care unit of the University of Maryland Shock Trauma Center were monitored for the development of S . aureus infections . Among the 776 patients eligible for the study, 60 (7.7%) patients developed 65 incidents of nosocomial S . aureus infections . Of the clinical isolates, 43.1% possessed a polysaccharide type 5 capsule, 44.6% possessed a type 8 capsule, and the remaining 12.3% had capsules that were not typed by the type 5 or type 8 antibodies . Six antibiogram types were noted among the infection-related isolates, with the majority of the types being resistant only to penicillin and ampicillin . It was noted that the majority of cases of pneumonia were caused by relatively susceptible strains, while resistant strains were isolated from patients with bacteremia and other infections . Only 16 (6.3%) of the isolates were found to be methicillin-resistant S . aureus (MRSA) . DNA fingerprinting by pulsed-field gel electrophoresis showed 36 different patterns, with characteristic patterns being found for MRSA strains and the strains with different capsular types . Clonal relationships were established, and the origins of the infection-related isolates in each patient were determined . We conclude that (i) nosocomial infection-related isolates from the shock trauma patients did not belong to a single clone, although the predominance of a methicillin-resistant genotype was noted, (ii) most infection-related S . aureus isolates were relatively susceptible to antibiotics, but a MRSA strain was endemic, and (iii) for practical purposes, the combination of the results of capsular and antibiogram typing can be used as a useful epidemiological marker. ASAIO J, 1998 Jan-Feb, 44(1), 98 - 107 National surveillance of dialysis associated diseases in the United States, 1995; Tokars JI et al.; Chronic hemodialysis centers in the United States were surveyed in 1995 regarding a number of hemodialysis associated diseases and practices . A total of 2,647 centers, representing 224,954 patients and 54,194 staff members, responded . Seventy-seven percent of centers reported that they reused disposable dialyzers . At the end of 1995, 65% of patients were treated with an arteriovenous graft, 22% an arteriovenous fistula, and 13% a temporary or permanent central catheter . By the end of 1995, at least three doses of hepatitis B vaccine had been administered to 35% of patients and to 82% of staff members . Acute infection with the hepatitis B virus (HBV) occurred in 0.06% of patients, and was more likely to be reported by centers with lower proportions of patients vaccinated against HBV . The prevalence of antibody to hepatitis C virus (HCV) was 10.4% among patients and 2.0% among staff . At least one patient with vancomycin resistant enterococci (VRE) was reported by 11.5% of centers, more commonly by hospital (vs freestanding centers not located in hospitals) and government centers, and centers located in certain geographic areas . Vancomycin was received by 7.2% of patients in December 1995 . The percentage of centers reporting patients with other pathogens was 7.9% for active tuberculosis, 39% for human immunodeficiency virus (HIV), and 40% for methicillin resistant Staphylococcus aureus (MRSA). ASAIO J, 1998 Jan-Feb, 44(1), 48 - 53 Removal of cytokine inducing substances by polymyxin-B immobilized polystyrene-derivative fibers during in vitro hemoperfusion of 10% human plasma containing Staphylococcus aureus challenge; Jaber BL et al.; Staphylococcus aureus (S . aureus) is frequently isolated from blood cultures in the hospital setting . The pathogenesis of S . aureus bacteremia probably replicates mechanisms implicated in gram negative bacterial infections . Cell wall components, such as peptidoglycans and lipoteichoic acids (LTA), can trigger cytokine production . Polymyxin-B (PMX-B) is a cationic peptide that binds endotoxin (ET) and inhibits its activity . Based on this principle, PMX-B was incorporated in polystyrene-derivative fibers, creating a hemoperfusion column (PMX-20R) that removes ET . The authors assessed whether S . aureus possesses PMX-B suppressible cytokine-inducing substances, and whether LTA, an anionic molecule, is one such substance . Heparinized blood was obtained from healthy volunteers, peripheral blood mononuclear cells (PBMC) were isolated by Ficoll-Hypaque separation, and 10% human plasma prepared . PBMC were incubated with 1, 5, or 10 microg/ml of S . aureus LTA, with and without 10 microg/ml of PMX-B . Also, using PMX-20R, in vitro hemoperfusion (IVH) was performed with 10% human plasma containing a 1:1,000 dilution of S . aureus challenge at 100 ml/min for 2 hours at 37 degrees C, and plasma obtained before and after IVH was incubated with PBMC . After a 24 hour incubation at 37 degrees C, PBMC were subjected to three freeze-thaw cycles, and total TNFalpha was measured by radioimmunoassay . TNFalpha production by PBMC incubated with LTA was 164+/-4 pg, 324+/-54 pg, 657+/-55 pg, and 1143+/-215 pg in control, and LTA 1, 5, and 10 microg/ml, respectively . The addition of PMX-B resulted in a 40+/-12% (p = 0.02), 61+/-6% (p = 0.002), and 62+/-14% (p = 0.02) decrease in TNFalpha production, respectively . Before IVH, TNFalpha production by PBMC incubated with 10% plasma containing S . aureus challenge was 1275+/-70 pg . After 2 hours of IVH, the decrease in TNFalpha production was 20+/-4% (p = 0.002) . In conclusion, S . aureus LTA induces TNFalpha production that is significantly suppressed by PMX-B . Consequently, S . aureus cytokine-inducing substances are removed during IVH with PMX-20R, and this may be due to stoichiometric binding of LTA to PMX-B. Mol Microbiol, 1998 Jan, 27(1), 9 - 21 Identification of a gene essential for O-acetylation of the Staphylococcus aureus type 5 capsular polysaccharide; Bhasin N et al.; The Staphylococcus aureus serotype 5 capsular polysaccharide (CP5) has a trisaccharide repeating unit of (-->4)-3-O-Ac-beta-D-ManNAcAp-(1-->4)-alpha-L-FucNAcp-(1-->3 )-beta-D-FucNAcp-(1-->) . Tn918 mutagenesis of strain Reynolds yielded a mutant that produced wild-type levels of O-deacetylated CP5 . The site and orientation of the single transposon insertion in mutant JL232 were determined by analysis of Southern blots and amplification of DNA flanking the transposon . DNA sequencing revealed that Tn918 was inserted within an open reading frame of 627 bp . The predicted amino acid sequence encodes a protein of approximately 26 kDa with homology to members of the NodL-LacA-CysE family of bacterial acetyltransferases . Southern blot analysis showed that genes similar to cap5H were present only in strains of S . aureus belonging to capsular serotypes 2, 4 and 5 . In an in vitro assay, the parental strain was more resistant to opsonophagocytic killing than the mutant strain . In a mouse model of staphylococcal infection, the parental strain was able to seed the bloodstream from the peritoneal cavity and colonize the kidneys more efficiently than the O-deacetylated mutant . When cap5H was provided to the mutant in trans, it fully restored CP5 O-acetylation . The virulence of the complemented mutant strain closely approximated that of the parental strain. Am J Obstet Gynecol, 1998 Jan, 178(1 Pt 1), 50 - 3 Cytokine and prostaglandin production by amnion cells in response to the addition of different bacteria; Reisenberger K et al.; OBJECTIVE: Our goal was to evaluate the effect of Escherichia coli, Bacteroides fragilis, Mycoplasma hominis, and Staphylococcus aureus on cytokine and prostaglandin production by amnion cells in vitro . STUDY DESIGN: Amnion cells were obtained from women undergoing elective cesarean section before the onset of labor and cultured in a primary cell culture . Confluent amnion cells were incubated with heat-inactivated bacteria in different concentrations (10(1) to 10(6) colony-forming units/ml) for 48 hours . Samples for quantification of interleukin-1 beta, interleukin-6, interleukin-8, tumor necrosis factor-alpha, and prostaglandin E2 were collected at 6, 12, 24, and 48 hours . RESULTS: Under basal conditions, minor amounts of interleukin-6 and interleukin-8 were detectable . Incubation of amnion cells with E . coli enhanced the secretion of interleukin-8 and also induced an transient increase of prostaglandin E2 in a dose-dependent manner . B . fragilis produced an increase in the secretion of interleukin-6 and interleukin-8 . M . hominis and S . aureus did not cause an increase in either interleukin-6, interleukin-8, or prostaglandin E2 . CONCLUSION: The gram-negative bacteria E . coli and B . fragilis stimulated interleukin-6 and interleukin-8 to a greater degree than the other bacteria investigated in this study . This finding may be of clinical interest in the onset of preterm birth. J Antimicrob Chemother, 1997 Dec, 40(6), 873 - 6 Killing of methicillin-resistant Staphylococcus aureus in vitro using aluminium disulphonated phthalocyanine, a light-activated antimicrobial agent; Griffiths MA et al.; The aim of this study was to determine whether 16 epidemic methicillin-resistant strains of Staphylococcus aureus (EMRSA) could be killed by the light-activated antimicrobial agent aluminium disulphonated phthalocyanine (AIPcS2) . EMRSA suspensions were irradiated with light from a laser diode in the presence of AIPcS2 and survivors enumerated . All strains were susceptible to killing, the bactericidal effect being dependent on the AIPcS2 concentration and the light dose . AIPcS2 rendered the bacteria light-sensitive almost immediately and killing was unaffected by the growth phase of the organism . Scavengers of singlet oxygen and free radicals protected the bacteria from killing . These results imply that light-activated antimicrobial agents may be useful in eliminating EMRSA from wounds or carriage sites. Acta Orthop Scand, 1997 Dec, 68(6), 554 - 8 Osteoarticular bacterial infections are rare in HIV-infected patients . 14 cases found among 4,023 HIV-infected patients; Ventura G et al.; Among 4,023 HIV-infected patients admitted to a large Italian university hospital in the period 1985-1996, 14 had concomitant HIV and bacterial osteoarticular infections . Staphylococcus aureus infections were commonest and were diagnosed in 8 patients . Intravenous drug addiction was the only risk factor significantly associated with the development of osteoarticular infection (p = 0.04) . In contrast, no statistical correlations were found with age, sex, absolute number of circulating T-CD4+ lymphocytes, neutrophils and stage of HIV infection . In conclusion, osteoarticular infections are uncommon in HIV-infected patients and are more directly related to parenteral drug abuse than to HIV. J Nat Prod, 1998 Jan, 61(1), 13 - 6 Antineoplastic agents . 386 . Isolation of sesterstatins 1-3 from the marine sponge Hyrtios erecta; Pettit GR et al.; The Republic of Maldives' black marine sponge Hyrtios erecta has been found to contain three cancer cell-line inhibitory pentacyclic sesterterpenes designated sesterstatins 1-3 (2-4) . One of the sesterterpenes, sesterstatin 2, specifically inhibited the Gram-positive opportunist Staphylococcus aureus . All three of the P-388 lymphocytic-leukemia-active (ED50 0.46 to 4.3 micrograms/mL) sesterstatins were obtained in trace quantities (3.0 x 10-7 to 5.4 x 10-7% yields) and represent structural variations on the more usual scalarin-type porifera sesterterpenes . The structures were elucidated by highfield (500 MHz) 2D NMR techniques augmented by HRMS results. Vet Microbiol, 1997 Dec, 59(1), 53 - 8 Prevalence of capsular serotypes among Staphylococcus aureus isolates from cows with mastitis in the United States; Guidry A et al.; Development of an appropriate Staphylococcus aureus vaccine for bovine mastitis has eluded researchers for decades . The ability of S . aureus to form a protective exopolysaccharide capsule has posed a major obstacle because of the multiple serotypes and the poor immune response elicited by exopolysaccharides . This study characterized S . aureus serotypes isolated from cases of bovine mastitis obtained from veterinary diagnostic laboratories that service 44% of the dairy cattle in the United States . Major milk producing areas of the northeast, north central, Pacific coast and southwest were proportionately represented . Sub-samples of mastitic milk that contained S . aureus were frozen and sent to our laboratory for strain serotyping . The only other regional serotyping of S . aureus from bovine mastitis to date was done in France . The primary serotypes found were types 5 (51%) and 8 (18%) and 31% were non-typeable . In the current study, serotype 5 accounted for 18% of the isolates and serotype 8 for 23% . More importantly 59% of the isolates were not typeable with either type 5 or 8 antisera . These data indicate that S . aureus vaccines employing serotypes 5 and 8 would only be marginally effective in the United States . These data also suggest that development of a S . aureus vaccine for bovine mastitis should take into account regional variation in S . aureus serotypes. J Clin Invest, 1998 Jan 1, 101(1), 178 - 87 Platelet microbicidal proteins and neutrophil defensin disrupt the Staphylococcus aureus cytoplasmic membrane by distinct mechanisms of action; Yeaman MR et al.; Platelet microbicidal proteins (PMPs) are hypothesized to exert microbicidal effects via cytoplasmic membrane disruption . Transmission electron microscopy demonstrated a temporal association between PMP exposure, damage of the Staphylococcus aureus cytoplasmic membrane ultrastructure, and subsequent cell death . To investigate the mechanisms of action of PMPs leading to membrane damage, we used flow cytometry to compare the effects of two distinct PMPs (thrombin-induced PMP-1 {tPMP-1} or PMP-2) with human neutrophil defensin-1 (hNP-1) on transmembrane potential (Deltapsi), membrane permeabilization, and killing of S . aureus . Related strains 6850 (Deltapsi -150 mV) and JB-1 (Deltapsi -100 mV; a respiration-deficient menadione auxotroph of 6850) were used to assess the influence of Deltapsi on peptide microbicidal effects . Propidium iodide (PI) uptake was used to detect membrane permeabilization, retention of 3,3'-dipentyloxacarbocyanine (DiOC5) was used to monitor membrane depolarization (Deltapsi), and quantitative culture or acridine orange accumulation was used to measure viability . PMP-2 rapidly depolarized and permeabilized strain 6850, with the extent of permeabilization inversely related to pH . tPMP-1 failed to depolarize strain 6850, but did permeabilize this strain in a manner directly related to pH . Depolarization, permeabilization, and killing of strain JB-1 due to PMPs were significantly less than in strain 6850 . Growth in menadione reconstituted Deltapsi of JB-1 to a level equivalent to 6850, and was associated with greater depolarization due to PMP-2, but not tPMP-1 . Reconstitution of Deltapsi also enhanced permeabilization and killing of JB-1 due to tPMP-1 or PMP-2 . Both PMP-2 and tPMP-1 caused significant reductions in viability of strain 6850 . In contrast to tPMP-1 or PMP-2, defensin hNP-1 depolarized, permeabilized, and killed both strains 6850 and JB-1 equally, and in a manner directly related to pH . Collectively, these data indicate that membrane dysfunction and cell death due to tPMP-1, PMP-2, or hNP-1 likely involve different mechanisms . These findings may also reveal new insights into the microbicidal activities versus mammalian cell toxicities of antimicrobial peptides. J Clin Microbiol, 1998 Jan, 36(1), 219 - 22 Association of borderline oxacillin-susceptible strains of Staphylococcus aureus with surgical wound infections; Kernodle DS et al.; Staphylococcus aureus isolates which produce type A staphylococcal beta-lactamase have been associated with wound infections complicating the use of cefazolin prophylaxis in surgery . To further evaluate this finding, 215 wound isolates from 14 cities in the United States were characterized by antimicrobial susceptibility and beta-lactamase type and correlated with the preoperative prophylactic regimen . Borderline-susceptible S . aureus isolates of phage group 5 (BSSA-5), which produce large amounts of type A beta-lactamase and exhibit borderline susceptibility to oxacillin, comprised a greater percentage of the 120 wound isolates associated with cefazolin prophylaxis than they did of the 95 isolates associated with other prophylactic regimens (25% versus 12.6%, respectively; P < 0.05) . In contrast, methicillin-resistant S . aureus isolates were distributed evenly between the two groups (8.3% versus 11.6%, respectively) . In vitro assays demonstrated that cefazolin was hydrolyzed faster by BSSA-5 strains than by other beta-lactamase-producing, methicillin-susceptible strains (1.54 versus 0.50 microg/min/10(8) CFU, respectively; P < 0.0001) . These data demonstrate that BSSA-5 strains are a distinct subpopulation of methicillin-susceptible S . aureus which frequently cause deep surgical wound infections . Cefazolin use in prophylaxis is a risk factor for BSSA-5 infection. J Clin Microbiol, 1998 Jan, 36(1), 81 - 5 Characterization of gentamicin-susceptible strains of methicillin-resistant Staphylococcus aureus involved in nosocomial spread; Lemaitre N et al.; We report an outbreak of epidemic Staphylococcus aureus strains characterized by an unusual heterogeneous resistance to methicillin and resistance to tobramycin but susceptibility to gentamicin (gentamicin-susceptible methicillin-resistant S . aureus {GS-MRSA}), contrasting with gentamicin-resistant homogeneous MRSA (GR-MRSA) that have been endemic in our hospital since the 1970s . A total of 97 GS-MRSA strains, which were shown by DNA hybridization to carry the mecA and ant(4')-Ia genes, were studied . The 40 GS-MRSA strains isolated at the beginning of the outbreak (January 1992 to June 1993) were typed by using resistance patterns, phage typing, serotyping, and pulsed-field gel electrophoresis and were compared with GR-MRSA and methicillin-susceptible S . aureus (MSSA) strains isolated during the same period . Two dominant clones, A::1 and B::3, and one minor clone, C::5, were identified among the 40 GS-MRSA strains, according to pulsotypes (A to C) and their resistance patterns (1, 3, and 5), which were distinguishable from those of GR-MRSA and MSSA strains . A selection of 57 GS-MRSA strains, isolated from 1994 to 1996, were clustered in the same three clones . However, their distribution had changed in comparison with that in the 1992 to 1993 period: clone A::1 remained dominant (47 versus 42.5%), whereas clone B::3 progressively declined (5 versus 35%) and clone C::5, the most susceptible to antibiotics, spread (44 versus 2.5%) . Epidemiological investigations revealed that some clones had been introduced via patients transferred from other hospitals and that cross-infection occurred within and between wards . Major changes in the use of antibiotics, especially aminoglycosides, cyclines, and macrolides, likely played a role in the emergence and spread of GS-MRSA strains. Protein Eng, 1997 Aug, 10(8), 935 - 41 Use of protein A gene fusions for the analysis of structure-function relationship of the transactivator protein C of bacteriophage Mu; De A et al.; A sensitive dimerization assay for DNA binding proteins has been developed using gene fusion technology . For this purpose, we have engineered a gene fusion using protein A gene of Staphylococcus aureus and C gene, the late gene transactivator of bacteriophage Mu . The C gene was fused to the 3' end of the gene for protein A to generate an A-C fusion . The overexpressed fusion protein was purified in a single step using immunoglobulin affinity chromatography . Purified fusion protein exhibits DNA binding activity as demonstrated by electrophoretic mobility shift assays . When the fusion protein A-C was mixed with C and analyzed for DNA binding, in addition to C and A-C specific complexes, a single intermediate complex comprising of a heterodimer of C and A-C fusion proteins was observed . Further, the protein A moiety in the fusion protein A-C does not contribute to DNA binding as demonstrated by proteolytic cleavage and circular dichroism (CD) analysis . The assay has also been applied to analyze the DNA binding domain of C protein by generating fusions between protein A and N- and C-terminal deletion mutants of C . The results indicate a role for the region towards the carboxy terminal of the protein in DNA binding . The general applicability of this method is discussed. J Mol Biol, 1997 Nov 28, 274(2), 152 - 9 NMR analysis of main-chain conformational preferences in an unfolded fibronectin-binding protein; Penkett CJ et al.; A 130-residue fragment of the Staphylococcus aureus fibronectin-binding protein has been found to exist in a highly unfolded conformation at neutral pH . Measurement of experimental NMR 3JHNalpha coupling constants provides evidence for individual residues having distinct main-chain conformational preferences that are dependent both on the amino acid concerned and on neighbouring residues in the sequence . Analysis shows that these variations in the populations of individual residues can be explained in detail in terms of statistical distributions of conformational states derived from the protein data base . In particular, when the preceding residue has a beta-branched or aromatic side-chain, a significant increase occurs in the population of the less sterically restricted b region of phi,psi space . The results indicate that the local structure of the fibronectin binding protein in solution, under conditions where it displays full activity, approximates very closely to a statistical random coil structure . This may be an important feature in the biological role of this and other polypeptides involved in protein-protein interactions . Med Clin (Barc), 1997 Mar 22, 108(11), 401 - 4 {Impact of control measures on the course of an outbreak of methicillin-resistant Staphylococcus aureus}; Sopena N et al.; BACKGROUND: Outbreaks of nosocomial infection by methicillin resistent Staphylococcus aureus (MRSA) are a problem in many hospitals with the control measures to be adopted being controversial . An outbreak of MRSA in a 550-bed university hospital is herein described and the impact of the adopted control measures on the evolution of the epidemic in the general hospitalization area (GHA) was analyzed . PATIENTS AND METHODS: The adopted control measures in the GHA were: microbiologic surveillance, cutaneous isolation measures, treatment of nasal carrier, and the early discharge of the cases . Hand washing was reinforced and a study of carriers was carried out on detection of sporadic cases (not related to the ICU) . A molecular study of 70 strains of MRSA was performed with analysis of total plasmids, plasmid restriction pattern and chromosomic DNA analysis by pulsed field gel electrophoresis (PFGE) . RESULTS: From December 1990 to December 1993, 273 cases of MRSA were reported . One hundred seventy-two cases originated in the ICU and 101 cases in the GHA (sporadic cases) . The incidence of MRSA in 1991-1993 was 13.6, 14.3, and 6.6% in the ICU and 0.17, 0.36, and 0.15% in the GHA, respectively . Molecular study of MRSA isolates (1991 and 1992) demonstrated two plasmid and two chromosomic patterns . The latter had a similarity coefficient > 0.90, probably belonging to the same "clone" . CONCLUSIONS: Despite the control measures adopted in the GHA the outbreak of MRSA originated in the ICU thereafter extending to the GHA . The rates of colonization detected, however, remained stable during the 3 years studied . On the other hand, the observation of a single "clone", responsible for the epidemic, suggest that most of the sporadic cases were autoctonous and due to failure in fulfillment of the established norms. J Neurosurg Sci, 1997 Jun, 41(2), 219 - 23 Cervical epidural abscess: serial MRI study; Giuffrida S et al.; Cervical epidural abscess (CEA) at first often goes unrecognized and it is to be suspected in patients suffering by spinal ache, root pain, neurological deficit and fever . Staphylococcus aureus is the most frequent etiologic agent . At present MRI is the study of choice for the diagnosis of CEA . We suggest a serial MRI study in close time in at first doubtful cases of CEA . When the responsible organism is not identified and there are also compressive signs of the spinal cord, the treatment of choice is surgical decompression followed by selective antibiotic therapy . The duration of antibiotic therapy may be established not only by clinical judgement, but also by serial MRI study, which gives direct information about disease evolution. Chem Biol, 1995 Feb, 2(2), 99 - 105 An intermediate in the assembly of a pore-forming protein trapped with a genetically-engineered switch; Walker B et al.; BACKGROUND: Studies of the mechanisms by which certain water-soluble proteins can assemble into lipid bilayers are relevant to several areas of biology, including the biosynthesis of membrane and secreted proteins, virus membrane fusion and the action of immune proteins such as complement and perforin . The alpha-hemolysin (alpha HL) protein, an exotoxin secreted by Staphylococcus aureus that forms heptameric pores in lipid bilayers, is a useful model for studying membrane protein assembly . In addition, modified alpha HL might be useful as a component of biosensors or in drug delivery . We have therefore used protein engineering to produce variants of alpha HL that contain molecular triggers and switches with which pore-forming activity can be modulated at will . Previously, we showed that the conductance of pores formed by the mutant hemolysin alpha HL-H5, which contains a Zn(II)-binding pentahistidine sequence, is blocked by Zn(II) from either side of the lipid bilayer, suggesting that residues from the pentahistidine sequence line the lumen of the transmembrane channel . RESULTS: Here we show that Zn(II) can arrest the assembly of alpha HL-H5 before pore formation by preventing an impermeable oligomeric prepore from proceeding to the fully assembled state . The prepore is a heptamer . Limited proteolysis shows that, unlike the functional pore, the prepore contains sites near the amino terminus of the polypeptide chain that are exposed to the aqueous phase . Upon removal of the bound Zn(II) with EDTA, pore formation is completed and the sites near the amino terminus become occluded . Conversion of the prepore to the active pore is the rate-determining step in assembly and cannot be reversed by the subsequent addition of excess Zn(II) . CONCLUSIONS: The introduction of a simple Zn(II)-binding motif into a pore-forming protein has allowed the isolation of a defined intermediate in assembly . Genetically-engineered switches for trapping and releasing intermediates that are actuated by metal coordination or other chemistries might be generally useful for analyzing the assembly of membrane proteins and other supramolecular structures. Mol Microbiol, 1997 Oct, 26(2), 399 - 407 Identification of Staphylococcus aureus virulence genes in a murine model of bacteraemia using signature-tagged mutagenesis; Mei JM et al.; Signature-tagged mutagenesis with transposon Tn917 was used to identify genes of Staphylococcus aureus required for virulence in a murine model of bacteraemia . Screening 1248 mutant strains in pools of 96 resulted in the provisional identification of 50 mutants attenuated in virulence . Subsequent individual analysis of many of these mutants confirmed that they are attenuated in virulence . DNA sequence analysis of regions flanking their transposon insertion points revealed that approximately half of them represent genes with unknown function, while most of the remainder are involved in nutrient biosynthesis and cell surface metabolism . Three mutants were found with transposon insertions in different positions in femA, and one mutant had an insertion in femB . Both femA and femB are involved in the formation of cell wall peptidoglycan pentaglycine cross-bridges . A further mutation occurred in a previously unknown gene that shares significant similarity to femB . Mutations were also obtained in recA and lsp (encoding the S . aureus prolipoprotein signal peptidase) . On the basis of sequence similarities to proteins of known function, the products of other genes are probably involved in the synthesis of diaminopimelic acid (a component of peptidoglycan), maintenance of surface adhesins and cell surface membrane transport, showing that many components of the S . aureus cell surface are critical for the survival and replication of this pathogen in blood. Unfallchirurgie, 1997 Aug, 23(4), 161 - 70 {Perioperative antibiotic prophylaxis in hip operations . Penetration into bone, capsule tissue and cartilage exemplified by cefuroxime}; Katzer A et al.; The most serious complication of accident surgery is postoperative osteitis . At the same time, perioperative antibiotic prophylaxis is generally recommended in order to reduce the rate of infection in joint surgery . The criteria for the suitability of a substance as prophylaxis include inter alia the activity spectrum with respect to the expected microorganisms, its retention time in the body and its ability to penetrate the endangered tissue . In the present study, the systemic and local activity levels after a single i.v . dose of 1500 mg cefuroxime was investigated in relation to the time of administration in 30 patients who had to undergo total hip replacement owing to a medial fracture of the neck of the femur . The tissue and serum samples were analyzed by high pressure liquid chromatography (HPLC) . The results show that the tissue levels of the intermediary cephalosporin after an i.v . single shot dose are on average still several times higher than the minimum inhibitory concentration (MIC) of the most frequent bacterium . Staphylococcus aureus, as late as 4 hours after application . The optimal time for the administration form selected was immediately prior to the operation and the concentrations measured suggest that several repeat doses of cefuroxime for short-term prophylaxis are not necessary. Ugeskr Laeger, 1997 Oct 13, 159(42), 6199 - 204 {Atopic dermatitis}; Bindslev-Jensen C et al.; Nowadays about 15% of a birth cohort develops atopic dermatitis of varying severity, while only about 3% were affected in the sixties . The pathogenesis of the disease is multifactorial, based on genetic (polygenic inheritance) and environmental factors, the latter presumably accounting for the rising incidence . Several genes of importance for the immune pathogenesis of atopic diseases, including atopic dermatitis, have been identified . Exogenous factors, for instance air humidity and colonization of the skin with Staphylococcus aureus and Pityrosporum ovale are also important in the pathogenesis . Specific allergies, for instance dust mite allergy and food allergy, may be contributory causes . Treatment is directed against the dry skin, the eczematous reaction, skin infections and potential, specific allergies . Information given to patients and parents through "eczema schools" might be an important part of therapy with focus on atopic diseases, treatment strategy and prevention. Lijec Vjesn, 1997 May-Jun, 119(5-6), 166 - 71 {Methicillin-resistant Staphylococcus aureus (MRSA), a predictor of the end of the antibiotic era--diagnosis, epidemiology, therapy and dissemination prevention}; Tambic A; Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent nosocomial pathogen worldwide, especially in large teaching hospitals . After the beginning of the war in Croatia, we have noticed a substantial increase in MRSA incidence in our country too . Mechanisms of resistance to methicillin differ from those mediated by the beta-lactamase production, and strains resistant to methicillin are at the same time resistant to the whole group of beta-lactam antibiotics . These strains represent a great therapeutic problem because there is often no antibiotic but vancomycin to be used for the treatment of MRSA infections . Vancomycin is an expensive and in long term therapy not well tolerated antibiotic, so to prevent the spread of these resistant strains is of ultimate importance . Among the general precautions hand washing is the single most important preventive measure . For MRSA strains additional precautions like patient isolation and tagging of discharged patient's notes should be implemented as well. Rev Neurol, 1997 Sep, 25(145), 1416 - 9 {Hematogenous meningitis caused by Staphylococcus aureus with sacro-iliitis and multiple abscesses . An infrequent association}; Nunez-Fernandez MJ et al.; INTRODUCTION: Meningitis due to Staphylococcus aureus (MSA) is an uncommon infectious condition . It forms from 1-9% of all cases of bacterial meningitis, and is characterized by a high morbidity and mortality . Ever since the first publications dealing with this type of meningitis, two basic mechanism have been described for the development of this infection: post-neurosurgical and hematogenous, also known as spontaneous . CLINICAL CASE: Our objective is to present the case of a 65 year old woman who developed hematogenous Staphylococcus aureus meningitis, without any predisposing factors . During clinical investigation, the meningeal infection was seen to be associated with septic arthritis of the right sacro-iliac joint (shown on isotope studies) and with retro-peritoneal and gluteal abscesses (shown on computerized tomography) . In this patient the pathological findings were: MSA, retroperitoneal and gluteal abscesses, and unilateral sacro-ileitis . To date such a combination has not been described (Medline search from January 1982 up to june 1996) . CONCLUSIONS: After analysis of the pathogenic findings of the MSA directly involved in this case we conclude by emphasizing the following points: 1 . It is very important to make a thorough search for a primary infectious focus responsible for MSA, completing the physical examination of the patient with imaging techniques (conventional radiology, CT, isotope studies, etc.) . 2 . Depending on the primary focus found in an MSA, antibiotic treatment may sometimes have to be complemented by other methods of treatment to avoid subsequent complications. Zentralbl Hyg Umweltmed, 1996 Mar, 198(4), 355 - 80 {Typing, resistance behavior and occurrence of methicillin-resistant Staphylococcus aureus strains in a surgical intensive care unit}; Schmitz FJ et al.; Over a period of three years, the frequency of the appearance of methicillin-resistant S . aureus strains (MRSA) was observed on a surgical intensive care unit . During this above-mentioned period of investigation it came to a heaped occurrence of nosocomial infections on this ICU with altogether 332 S . aureus-stems being isolated from different patient specimen . 204 (61.5%) of these were resistant against methicillin and could be divided into 48 first- and 156 follow-up-isolates . The thereupon accomplished differentiation of the 48 MRSA-first isolates by means of lysotyping and the pioneered GenePath Strain Typing System for a standardized pulsed-field-gel-electrophoresis (PFGE) gave the proof of 7 different MRSA-types . Around 7 different, in part parallel chains of infection on this ICU were observed, which could be led back to different strains . In reference to all analyzed S . aureus, an especially high rate (90%) of MRSA on this ICU could be isolated in taken wound-swabs, followed by 83.3% MRSA at catheter tips and 71,9% in tracheal and bronchial secretion . A consideration of the antibiotic susceptibility yielded, that also gentamicin and the quinolones showed an in-vitro resistance against MRSA, while fosfomycin, fusidic acid, chloramphenicol and trimethoprim/sulfamethoxazole reached positive responding rates between 80 and 100% . On the other hand, presently still 100% of the explored MRSA-strains are susceptible for glycopeptides such as vancomycin and teicoplanin . Because of intensive hospital hygienic measures the number of newly isolated MRSA could be reduced clearly on this ward. J Hosp Infect, 1997 Dec, 37(4), 325 - 9 Methicillin-resistance among Turkish isolates of Staphylococcus aureus strains from nosocomial and community infections and their resistance patterns using various antimicrobial agents; Durmaz B et al.; The purposes of this study were to determine the prevalence of Turkish isolates of methicillin-resistant Staphylococcus aureus (MRSA) in nosocomial and community infections and their antibiotic resistant patterns . The oxacillin disk diffusion method for the detection of methicillin resistance and the Kirby-Bauer disk diffusion for antibiotic susceptibility tests were used . A total 383 S . aureus strains were identified from different patients . The prevalence of methicillin resistance among S . aureus strains was 31.3% (120/383) . The proportions of MRSA isolated from nosocomial and community infections were 26.4% (46/174) and 35.4% (74/209), respectively . The resistance rates of MRSA to other antibiotics were as follows: 71% resistant to erythromycin, 54% to clindamycin, 52% to gentamicin, 44.5% to trimethoprim-sulfamethoxazole and 36% to ciprofloxacin . No strain resistant to vancomycin was recorded in this study. Clin Microbiol Rev, 1998 Jan, 11(1), 81 - 120 Gram-positive anaerobic cocci; Murdoch DA; Gram-positive anaerobic cocci (GPAC) are a heterogeneous group of organisms defined by their morphological appearance and their inability to grow in the presence of oxygen; most clinical isolates are identified to species in the genus Peptostreptococcus . GPAC are part of the normal flora of all mucocutaneous surfaces and are often isolated from infections such as deep organ abscesses, obstetric and gynecological sepsis, and intraoral infections . They have been little studied for several reasons, which include an inadequate classification, difficulties with laboratory identification, and the mixed nature of the infections from which they are usually isolated . Nucleic acid studies indicate that the classification is in need of radical revision at the genus level . Several species of Peptostreptococcus have recently been described, but others still await formal recognition . Identification has been based on carbohydrate fermentation tests, but most GPAC are asaccharolytic and use the products of protein degradation for their metabolism; the introduction of commercially available preformed enzyme kits affords a physiologically more appropriate method of identification, which is simple and relatively rapid and can be used in routine diagnostic laboratories . Recent reports have documented the isolation in pure culture of several species, notably Peptostreptococcus magnus, from serious infections . Studies of P . magnus have elucidated several virulence factors which correlate with the site of infection, and reveal some similarities to Staphylococcus aureus . P . micros is a strongly proteolytic species; it is increasingly recognized as an important pathogen in intraoral infections, particularly periodontitis, and mixed anaerobic deep-organ abscesses . Comparison of antibiotic susceptibility patterns reveals major differences between species . Penicillins are the antibiotics of choice, although some strains of P . anaerobius show broad-spectrum beta-lactam resistance. Am Surg, 1998 Jan, 64(1), 39 - 45; discussion 45-6 Current options in prosthetic vascular graft infection; Henke PK et al.; Debate continues over which procedure is the best treatment for prosthetic graft infections . We retrospectively reviewed the medical records at our institution for all vascular graft infections that occurred from 1985 to 1995 to evaluate their occurrence, treatment, and outcome . Twenty-four patients had prosthetic graft infections . The average patient age was 62 years, and 67 per cent of the patients studied were men . The initial operation was for treatment of occlusive disease in 92 per cent of the patients, and aortofemoral bypasses were the most common procedures performed (15 of 24 patients, 63%) . The average interval from graft implantation to presentation of infection was 29 months . In lower-extremity bypasses, the site of infection was most commonly in the groin (87%) . Gram-positive organisms, including coagulase-negative Staphylococcus (32%) and Staphylococcus aureus (28%), were the most frequently isolated bacteria . Thirty procedures were performed for management of the graft infections . Extra-anatomic bypass was associated with no recurrent graft infections . Graft preservation was successful in two cases of early S . aureus infection (less than 1 year after original procedure), and in situ graft replacement was successful in all four cases of late-appearing coagulase-negative Staphylococcus infection (more than 1 year after original procedure) . Both treatments failed in all five cases of Gram-negative infection (P = 0.008 by Fisher's exact test) . The overall mortality and amputation rates were 17 per cent and 21 per cent, respectively, without significant differences between the treatment modalities . Extra-anatomic bypass remains the best treatment for prosthetic graft infection . In situ replacement and graft preservation treatments should be selective and based on presentation of the infection and the type of pathogenic organism. Clin Rheumatol, 1997 Nov, 16(6), 557 - 61 Association between high antistaphylolysin and teichoic acid antibody titres with rheumatic syndromes; Valtonen JM et al.; To analyse which rheumatic syndromes are associated with serological evidence of recent Staphylococcus aureus infection, we studied retrospectively 44 adult patients, gathered between 1979-1990, having an acute arthritis syndrome or an exacerbation in their chronic rheumatic disease and simultaneously a high antistaphylolysin (ASTA > 4,0) and/or high teichoic acid antibody titre (TAA > 8) . Patients with septic arthritis or endoprosthetic infections were not included . 25 patients had arthritis/arthralgia associated with a known rheumatic disease, 9 patients had reactive arthritis and 8 patients had arthralgia . The frequency of HLA-B27 in tested patients was significantly higher in the whole patient group than in the healthy Finnish population (43% v 14%, p < 0.001) . It is concluded that high ASTA and/or TAA titres are associated with various acute rheumatic syndromes including reactive arthritis. Clin Diagn Lab Immunol, 1998 Jan, 5(1), 78 - 81 Cytokine production in cell culture by peripheral blood mononuclear cells from immunocompetent hosts; Katial RK et al.; The production of interleukin 2 (IL-2) gamma interferon, IL-4, tumor necrosis factor alpha (TNF-alpha), TNF-beta, IL-5, and IL-10 in vitro by peripheral blood mononuclear cells cultured from healthy immunocompetent subjects after mitogen stimulation was determined . The mitogens used were concanavalin A, phytohemagglutinin, pokeweed mitogen, and Staphylococcus aureus Cowen . The results obtained provide a normal range for the production of these cytokines under specified conditions in vitro. Kansenshogaku Zasshi, 1997 Nov, 71(11), 1108 - 12 {Antibacterial sensitivity, phage group and coagulase type of Staphylococcus aureus isolated from bullous impetigo}; Kagami K et al.; Bullous Impetigo caused mainly by S . aureus is seen in high incidence in children . Three decades ago CEMs were much more effective for bullous impetigo than today . Recently, the causative S . aureus obtained resistance against not only PCs but multiple antibacterial drugs except a few agents . Therefore the therapy for the disease has become difficult, especially the first choice effective antibacterial drugs for general use . Sensitivity of antibacterial drugs against S . auresu isolated from skin lesions, including some MRSA was studied in 113 patients with bullous impetigo . The agents with high sensitivity against all strains were VCM (100%), MINO (100%), CLDM (96.5%), FMOX (96.3%) and against 39 MRSA strains were VCM (100%), MINO (100%), OFLX (92.3%), CLDM (87.2%) and FOM (82.1%) . Clinically available antibacterial drugs for children are MINO granules and FOM drysyrup . Phage group and coagulase type of the S . aureus were simultaneously examined to elucidate which strains were causative or secondary infectious agents of the bullous impetigo. Infect Immun, 1998 Feb, 66(2), 573 - 80 Activation of bovine lymphocyte subpopulations by staphylococcal enterotoxin C; Ferens WA et al.; Staphylococcus aureus is a major mastitis-causing pathogen in cattle . The chronic nature of bovine staphylococcal mastitis suggests that some products or components of S . aureus may interfere with the development of protective immunity . One class of molecules that could be involved are superantigens (SAgs) . Although a significant number of mastitis isolates produce SAgs, the effect of these molecules on the bovine immune system is unresolved . To determine if immunosuppression caused by SAgs could play a role in pathogenesis, we monitored bovine lymphocytes exposed to staphylococcal enterotoxin C1 (SEC1) . Activation of bovine lymphocytes by either SEC1 or concanavalin A (ConA) was influenced by the gammadelta/alphabeta T-cell ratio in the culture . Compared to ConA-induced stimulation, cultures stimulated with SEC1 generated small numbers of CD4+ alphabeta T cells expressing high levels of interleukin-2 receptor alpha chain (IL-2R alpha) and major histocompatibility complex class II (MHCII), suggesting that SAg exposure does not lead to full activation of these cells . This state of partial activation was most pronounced in cultures with a high gammadelta/alphabeta ratio . In contrast, significant numbers of CD8+ alphabeta T cells expressed high levels of IL-2R alpha and MHCII, regardless of the gammadelta/alphabeta ratio and the stimulant used . CD8+ blasts in cultures stimulated with SEC1 also expressed another activation marker, ACT3, previously detected predominantly on thymocytes and CD4+ T cells . Although gammadelta CD2- and CD2+ T cells expressed MHCII and IL-2R alpha following stimulation with SEC1, only a few cells increased to blast size, suggesting that they were only partially activated . The results suggest ways in which SAgs might facilitate immunosuppression that promotes the persistence of bacteria in cattle and contributes to chronic intramammary infection. Infect Immun, 1998 Feb, 66(2), 567 - 72 Identification and characterization of the PutP proline permease that contributes to in vivo survival of Staphylococcus aureus in animal models; Schwan WR et al.; Staphylococcus aureus is an important pathogen of humans and other animals, causing bacteremia, abscesses, endocarditis, and other infectious syndromes . A signature-tagged mutagenesis (STM) system was adapted for use in studying the genes required for in vivo survival of S . aureus . An STM library was ultimately created in S . aureus RN6390, with Tn917 being used to create the transposon mutations . Pools of S . aureus RN6390 mutants were screened in mouse abscess, bacteremia, and wound infection models for growth attenuation after in vivo passage . One of the mutants that was identified displayed marked attenuation following large-pool screening in all three animal models, which was confirmed in bacteremia and endocarditis models of infection with a smaller pool of mutants . Sequence analysis of the entire open reading frame showed a 99% identity to the high-affinity proline permease (putP) gene characterized in another strain of S . aureus . In wound and murine abscess infection models, the putP mutant was approximately 10-fold more attenuated than was wild-type strain RN6390 . Another S . aureus strain transduced with the putP mutation also displayed an attenuated phenotype after passage in the wound model . A {3H}proline uptake assay showed that less proline was specifically transported into the putP mutant than into strain RN6390 . The reduced viability of the bacteria possessing the mutation in the S . aureus high-affinity proline permease suggests that proline scavenging by the bacteria is important for in vivo growth and proliferation and that analogs of proline may serve as potential antistaphylococcal therapeutic agents. Tohoku J Exp Med, 1997 Sep, 183(1), 75 - 82 The case fatality rate of methicillin-resistant Staphylococcus aureus (MRSA) infection among the elderly in a geriatric hospital and their risk factors; Washio M et al.; From April 1991 to March 1993, there were 49 elderly patients with methicillin-resistant Staphylococcus aureus (MRSA) infection in a geriatric hospital in Fukuoka, Japan . The retrospective study was carried out in order to evaluate the various factors which may influence the case fatality rate of MRSA infection among the elderly . Among them, 33 patients (67.3%) died while only 16 patients became culture-negative for MRSA and discharged after recovering from MRSA infection . A univariate analysis revealed that male sex (odds ratio {OR} = 12.25, 95% confidence interval {CI} = 2.80-53.55), hypoalbuminemia (OR = 3.83, 95% CI = 1.11-13.21) and an excessive usage of antibiotics (OR = 6.67, 95% CI = 1.70-26.09) were risk factors for death among the patients with MRSA infection . In a multivariate analysis, male sex and an excessive usage of antibiotics were still risk factors while hypoalbuminemia was not . However, hypoalbuminemina was more common in male patients than female patients (78.3% vs . 42.3%, p < 0.05) . These findings suggest that the case fatality rate of MRSA infection may be high and also suggest that the elderly with MRSA infection who had hypoalbuminemia and/or received many antibiotics may have a poor prognosis. Clin Infect Dis, 1997 Dec, 25(6), 1369 - 73 Toxin involvement in staphylococcal scalded skin syndrome; Lina G et al.; The production of staphylococcal exfoliative toxin A (ETA) and toxin B (ETB), toxic shock syndrome toxin (TSST-1), and enterotoxins A-E was analyzed in 60 Staphylococcus aureus strains isolated from children with scalded skin syndrome (15 with generalized exfoliative syndrome, 28 with bullous impetigo, and 17 with staphylococcal scarlet fever) . All strains isolated from patients with generalized exfoliative syndrome or bullous impetigo produced ETA and/or ETB and caused a Nikolsky's sign when injected subcutaneously into newborn mice . In contrast, exfoliative toxin was detected in an S . aureus strain from only one of 17 case of staphylococcal scarlet fever; the 16 other S . aureus strains produced TSST-1 and/or an enterotoxin . In conclusion, enterotoxins or TSST-1 are more frequently associated with staphylococcal scarlet fever than are exfoliative toxins . Hence staphylococcal scarlet fever may well represent an abortive form of toxic shock syndrome rather than a milder form of staphylococcal scalded skin syndrome. Clin Infect Dis, 1997 Dec, 25(6), 1318 - 26 Osteomyelitis of the foot in diabetic patients; Lipsky BA; Osteomyelitis of the foot, a common and serious problem in diabetic patients, results from diabetes complications, especially peripheral neuropathy . Infection generally develops by spread of contiguous soft-tissue infection to underlying bone . The major diagnostic difficulty in diabetic patients is distinguishing bone infection from noninfectious neuropathic bony lesions . Certain clinical signs suggest osteomyelitis, but imaging tests are usually needed . The 111In-labeled leukocyte scan and magnetic resonance imaging are the most diagnostically useful . Staphylococcus aureus is the most common etiologic agent, followed by other aerobic gram-positive cocci . Aerobic gram-negative bacilli and anaerobes are occasionally isolated, often in mixed infections . Antimicrobial therapy is best directed by cultures of the infected bone, obtained percutaneously or at surgery . Antibiotic therapy should usually be given parenterally, at least initially, and continued for at least 6 weeks . Surgical debridement or resection of the infected bone, when feasible, improves the outcome . With appropriate therapy most cases of osteomyelitis can be successfully managed. Cytokine, 1997 Nov, 9(11), 809 - 17 Correlation between the release of IL-2 and granule-associated DNase activity in human lymphomononuclear cells stimulated with immunomodulating peptides and proteins . Role of different antigen-presenting cells; Migliaccio M et al.; The authors have already described that a series of short peptides, modelled after sequences related to human extracellular matrix (ECM) proteins and sharing some common structural features, activate Th1 clones through a process involving peptide presentation in HLA-DR proteins . Those peptides induce also LAK- and NK-dependent cytotoxicity as well as activation of monocytes/macrophages present in human peripheral blood mononuclear cell (PBMC) populations . The release of interleukin 2 (IL-2) and interferon gamma (IFN-gamma) by Th cells present in PBMC depleted of macrophages, or B cells is reported, after incubation in the presence of those peptides, fibronectin or Staphylococcus aureus protein A . The authors found that all the molecules tested needed at least the presence of a type of antigen-presenting cell (APC) to exert their stimulatory effect . Some peptides seem to be preferentially presented to Th cells by B cells, while others seem to depend on monocyte/macrophages for this presentation . The dependence on one or another APC seems to be due to differences in the sequences of these peptides . The immunomodulatory agents studied also gave rise to a clear increase in a DNase activity associated with secretion granules of PBMC . That there is a correlation between the release of IL-2 and this DNase activity when using a complete PBMC population, B cell-depleted PBMC or macrophage-depleted PBMC stimulated with the peptides tested has been found . Zentralbl Veterinarmed B, 1997 Nov, 44(9), 551 - 60 Relatedness of Staphylococcus aureus strains isolated from milk and human handlers in dairy farms in Trinidad; Adesiyun AA et al.; The susceptibility of S . aureus strains isolated from milk and human handlers in dairy farms in Trinidad to bacteriophages was determined . Of the 110 strains isolated from bulk milk, 73 (66.4%) were typable either at routine test dilution (RTD) or 100-RDT compared to 108 (72.5%) of 149 strains from composite milk sensitive but the difference was not statistically significant (P > or = 0.05; chi 2) . Strains of S . aureus from human handlers had significantly (P < or = 0.05; chi 2) lower sensitivity, with only 90 (59.6%) of 151 strains typable . Phages in various groups were predominantly more active on both milk isolates, 54.1% (98 of 181) and human strains, 73.3% (66 of 90) . Phage 42D alone lysed 22 (12.2%) but with other phages typed 90 (49.7%) of 181 typable strains from milk compared to a lytic activity of only 1.1% (1 of 90) alone and 35 (38.9%) with other phages for strains isolated from human handlers . The differences were however not statistically significant (P > or = 0.05; chi 2) . Relatedness of S . aureus strains isolated from bulk milk, composite milk and human handlers on each farm was demonstrated in 21 (46.7%) of 45 dairy farms using the phage patterns detected . Similarly, the relatedness of S . aureus strains isolated from the anterior nares and hands of each human milker was detected on 10 (35.7%) of 28 dairy farms studied . It was concluded that S . aureus strains from human milkers contaminated both composite and bulk milk on the farms studied while bovine strains of S . aureus were also acquired by humans during milking. Vet Microbiol, 1997 Oct 31, 58(1), 31 - 43 Expression of functions by normal sheep alveolar macrophages and their alteration by interaction with Mycoplasma ovipneumoniae; Niang M et al.; Normal sheep alveolar macrophages collected by bronchial lavage were exposed to live or heat-killed Mycoplasma ovipneumoniae organisms, and their capability to ingest Staphylococcus aureus and to elicit antibody-dependent cellular cytotoxicity against sensitized chicken red blood cells was tested . Controls consisted of non-infected macrophages in M199 medium . In addition, the effect of M . ovipneumoniae on expression of surface molecules on these sheep alveolar macrophages was determined . The percentage of S . aureus ingested by nontreated sheep alveolar macrophages was significantly higher than that of infected macrophages . Live mycoplasmas were more effective in suppressing the ingestion of S . aureus by these macrophages than killed mycoplasmas . Both live and killed mycoplasmas suppressed the cytolytic effect of the sheep alveolar macrophages to a similar degree . About 78% and 45% of the normal sheep alveolar macrophages had IgG and complement receptors, respectively . Infection of these macrophages with M . ovipneumoniae decreased significantly the expression of IgG receptors but had no effects on complement receptors . There were substantial increases in the expression of both MHC class I and class II by the mycoplasma-induced macrophages as compared with unstimulated macrophages . Live mycoplasmas were more effective in inducing expression of both classes than killed mycoplasmas . The results, taken together, suggest that M . ovipneumoniae induced alterations in macrophage activities and this may be a contributing factor in the pathogenesis of respiratory disease induced by the organism. Brain Res Mol Brain Res, 1997 Dec 1, 52(1), 90 - 7 Induction of nerve growth factor synthesis by sphingomyelinase and ceramide in primary astrocyte cultures; Galve-Roperh I et al.; Astrocytes synthesize nerve growth factor (NGF) in response to pro-inflammatory cytokines . To further study the signaling mechanism involved in this induction of NGF production, the sphingomyelin (SM) pathway was studied . Addition of exogenous neutral SMase (Staphylococcus aureus) or C2-ceramide to primary cultures of newborn rat cortical astrocytes elicited a dose-response increase of NGF synthesis, with maximal effect at 1 U/ml and 25 microM, respectively . Induction of NGF synthesis by SMase and ceramide was shown to be independent of classical PKC activity . Intracellular cAMP-raising agents, such as forskolin and 3-isobutyl-1-methylxanthine, partially prevented the SMase- and C2-ceramide-induced secretion of NGF to the cell supernatant . PD098059 and apigenin, inhibitors of the mitogen-activated protein (MAP) kinase pathway, produced a dose-response inhibition of the SMase- and C2-cer-induced release of NGF . This observation points to the possibility that regulation of NGF synthesis and secretion by the SMase pathway may be mediated downstream by the MAP kinase cascade . As a matter of fact, pre-treatment of astrocytes with SMase or C8-ceramide led to an increased phosphorylation of raf-1 . Moreover, MAP kinase activity was enhanced in astrocytes treated with SMase or both ceramides . In conclusion, results suggest that the SMase pathway may control NGF synthesis in the central nervous system, and raise the possibility of an involvement of the MAP kinase cascade in this process. Arzneimittelforschung, 1997 Dec, 47(12), 1402 - 5 Effects of nimodipine and ofloxacin on staphylococcal brain abscesses in rats; Ceviz A et al.; The therapeutic effects of nimodipine (CAS 66085-59-4) and ofloxacin (CAS 82419-36-1) were investigated against experimental brain abscess formation in rats . Nimodipine, a 1,4-dihydropyridine derivative, is chemically related to nifedipine but the smooth muscle relaxant effect preferentially acts on cerebral arteries . Ofloxacin is a member of 4-Quinolone broad spectrum antibiotics . Ninety-six male Sprague-Dawley rats were inoculated intracortically with Staphylococcus aureus and then different groups were treated with either saline, ofloxacin or the combination of ofloxacin and nimodipine . The rate of brain abscess formation and mortality were considerably decreased by nimodipine and ofloxacin therapy . Combination therapy was found histologically to be considerably more effective than ofloxacin alone against brain abscess formation in rats. Cell Mol Biol (Noisy-le-grand), 1997 Nov, 43(7), 1153 - 60 Profile of HIV patients with and without bacterial endocarditis; Rivera Del Rio JR et al.; Bacterial endocarditis (BE) is a serious medical condition seen in the injecting drug users (IDU) with or without HIV . Studies report a low prevalence of BE in HIV/AIDS patients and the clinical manifestations have been considered non-