Enterobacteriacea

J Am Vet Med Assoc, 1984 Jan 15, 184(2), 175 - 8
Blood culture of the canine patient; Hirsh DC et al.; Blood for bacteriologic culture was obtained from 581 sick dogs . Of these, 134 (23%) were considered to have bacteremia . The conditions most frequently associated with bacteremia were malignant neoplasms and infections of the skeletal, cardiovascular, and urogenital systems . The most frequently isolated bacteria were members of the family Enterobacteriaceae and coagulase-positive staphylococci, in sum accounting for more than 50% of the 150 isolates . Most of the dogs with bacteremia had high proportions of immature neutrophils, segmented neutrophils, and monocytes in blood . Dogs with bacteremia and osteomyelitis due to staphylococci had normal hemograms . Blood from dogs with bacteremia due to gram-negative bacteria was more likely to have a high proportion of immature and segmented neutrophil leukocytes than was blood from dogs with bacteremia due to a gram-positive species . Toxic neutrophils were observed more often in blood obtained from patients with bacteremia due to gram-negative bacteria . The development of fever correlated with the bacteremic state regardless of the species of bacteria in the blood.

Antonie Van Leeuwenhoek, 1984, 50(1), 1 - 6
Enterobacteriaceae as indicators of good manufacturing practices in rendering plants; van Schothorst M et al.; Finished products and samples from the environment of the production line in rendering plants were checked for Enterobacteriaceae and salmonellae . Improvements in hygiene and measures taken to limit multiplication of microorganisms in the dry area of the production lines resulted in reduction of both numbers of Enterobacteriaceae in environmental samples and frequency of their occurrence in finished products . Simultaneously, there was an equivalent reduction of salmonellae positives in environmental samples and finished products . Consequently, the determination of Enterobacteriaceae can be used as an effective tool to assess the improvements in good manufacturing practices.

Antimicrob Agents Chemother, 1984 Jan, 25(1), 142 - 4
Effect of temocillin in combination with other beta-lactam antibiotics; Verbist L et al.; The antibacterial interactions of temocillin with other beta-lactams were tested by checkerboard combination in Mueller-Hinton agar against 146 strains of members of the family Enterobacteriaceae, 35 Pseudomonas aeruginosa strains, and 35 Staphylococcus aureus strains . Most combinations showed a moderate degree of synergism . In only one Klebsiella strain was minor antagonism observed between temocillin and ampicillin.

Appl Environ Microbiol, 1984 Jan, 47(1), 56 - 60
Bacterial interference with coliform colony sheen production on membrane filters; Burlingame GA et al.; The membrane filter (MF) method for detection and enumeration of coliform bacteria in drinking water requires that the coliforms both grow and produce a green metallic sheen when the filter is incubated on modified Endo medium at 35 degrees C for 22 h . Large numbers of noncoliform bacteria, which are enumerated by the standard plate count (SPC) technique, can interfere with the detection of coliforms on MF . This paper presents quantitative evidence from laboratory experiments on the interference of specific SPC bacteria on coliform colony sheen production on MF . Pseudomonas aeruginosa and Aeromonas hydrophila caused significant reductions in Escherichia coli sheen colony counts when present at 3,000 and 220 per filter, respectively . The Flavobacterium sp . and Bacillus sp . selected for this study from SPC did not interfere with coliform colony sheen production . Excessive crowding of E . coli and Enterobacter cloacae colonies on MF also caused a reduction in the number of colonies that produced sheen . Even when there was no crowding (14 colonies per filter), only a fraction of the E . cloacae colonies produced sheen colonies on modified Endo medium.

J Infect Dis, 1984 Jan, 149(1), 48 - 57
Killing of fabric-associated bacteria in hospital laundry by low-temperature washing; Blaser MJ et al.; Hospitals using 71.1 C water for laundering consume vast amounts of energy . We studied whether washing at 22 C would result in fabric-associated bacterial counts significantly different from those remaining after the high-temperature wash procedure in general use . Using a standard method to enumerate fabric-associated bacteria, we found that soiled sheets and terry cloth items were contaminated, respectively, with 10(6) and 10(8) cfu/100 cm2 of fabric area, predominantly gram-negative rods (especially Enterobacteriaceae and Pseudomonadaceae) . Staphylococcus species were the most common gram-positive organisms . A standard low-temperature washing cycle without laundry chemicals removed 3 log10 of bacteria by agitation, dilution, and drainage . When low-temperature laundry chemicals were used, 3 log10 of bacteria were killed after the bleach was added, and sheets and terry cloth items had postwash colony counts of 10(1)-10(2) cfu/100 cm2 . Drying removed an additional 1-2 log10 organisms . Bacterial counts and species from low- and high-temperature washed fabrics were comparable . Low-temperature washing is therefore as effective as high-temperature washing for eliminating pathogenic bacteria from hospital laundry.

Chemotherapy, 1984, 30(3), 158 - 64
Comparison of in vitro activities of eight new beta-lactam compounds against cephalothin-resistant Enterobacteriaceae from hospital patients; Costopoulos C et al.; The in vitro antibacterial activity of eight newer beta-lactam antibiotics (mecillinam, piperacillin, mezlocillin, cefoxitin, cefotaxime, moxalactam, ceftriaxone and ceftazidime) was determined against 87 cephalothin-resistant strains of Enterobacteriaceae isolated during 6 months in a general hospital . Ceftriaxone, cefotaxime, moxalactam and ceftazidime proved to be highly active; only a minority of strains required higher concentrations than 0.125 microgram/ml for inhibition of growth . Cefoxitin, mecillinam, mezlocillin and piperacillin were less active . Mecillinam displayed greater efficacy against Escherichia coli, Klebsiella and Enterobacter spp., while the same was the case for piperacillin against Proteus mirabilis and Serratia marcescens, and for cefoxitin against indole-positive Proteus spp . The production of beta-lactamase was correlated with a reduced activity of mecillinam, mezlocillin and piperacillin but not of cefoxitin or the other beta-lactamase-stable cephalosporins . However, some strains, mainly those of Proteus, Enterobacter and Serratia, though resistant to mecillinam, mezlocillin and piperacillin did not produce beta-lactamases . This observation might indicate that ceftriaxone, moxalactam, cefotaxime and ceftazidime, besides their indifference to beta-lactamases, are characterized also by a high degree of intrinsic activity.

J Antimicrob Chemother, 1984 Jan, 13(1), 5 - 13
In-vitro evaluation of miokamycin: bactericidal activity against streptococci; Lacey RW et al.; Miokamycin is a diacetyl derivative of the macrolide antibiotic, midecamycin . In vitro, it has an unusual spectrum, inhibiting the growth of Gram-positive cocci and anaerobes, but few Haemophilus spp; enterobacteria are highly resistant . Most erythromycin-resistant Staphylococcus aureus were sensitive (MIC approximately 0.8 mg/l) . Resistance to miokamycin in Staph . aureus and streptococci was difficult to select, unless the staphylococci were already resistant to erythromycin . Both miokamycin and erythromycin were bactericidal towards groups A,B,C and G streptococci . Clinical trials of the drug in pelvic, upper respiratory, skin and soft tissue and other staphylococcal infections may be worthwhile.

Clin Exp Immunol, 1984 Jan, 55(1), 74 - 80
HLA-B27 and the immune response to enterobacterial antigens in ankylosing spondylitis; Trull A et al.; Total serum immunoglobulins and class specific serum antibodies to Klebsiella pneumoniae, Salmonella typhimurium, Yersinia enterocolitica and Pseudomonas aeruginosa were measured in 107 patients with ankylosing spondylitis (AS) and 110 healthy tissue typed controls by enzyme linked immunosorbent assay (ELISA) . The specificity of this technique was confirmed by the use of specific bacterial murine antisera and by cross-absorption of human sera by specific bacteria . Total serum IgA in AS patients correlated with both erythrocyte sedimentation rate (ESR) (P less than 0.001) and C-reactive protein (P less than 0.05) and was significantly elevated compared to healthy individuals (P less than 0.001) . A significant elevation of IgA antibodies to K . pneumoniae was detected in the serum of AS patients with active disease when compared to healthy controls (P less than 0.01) . These studies support the involvement of an enterobacterial micro-organism in the pathogenesis of AS and further relate to the role of HLA-B27 in this disease.

Scand J Infect Dis Suppl, 1984, 42, 50 - 63
Basic design of beta-lactam antibiotics--cephalosporins; Price KE et al.; Since the introduction of cephaloglycin and cephalothin as the first commercially available cephalosporin C derivatives, there has been a proliferation of new agents, predominantly injectables . These have provided compounds with increased potency, improved spectrum, and/or pharmacokinetic advantages . The nature of the modifications producing these changes is the subject of the present report . The pathway generally followed by chemists working on a nucleus suitable for modification is initially a combination of trial and error and application of analogies from related areas . Once a moiety conferring a desirable effect has been identified, it or its analogs will be widely utilized in an effort to achieve further improvements . The choice of derivatives to be made is appreciably influenced by potential patentability and the feasibility of synthesis . For oral cephalosporins, to achieve adequate intrinsic bioavailability, the 7 beta-side chain has almost invariably been found to require a primary amino group on the alpha-carbon (D-configuration) . This has limited potential changes at the 7 beta-position and leaves the 3-position as the major site for introducing novel substituents . Among thousands of derivatives prepared, only a few have actually been developed for clinical use . For injectables, where oral absorption is not a factor, there are no such specific preferred entities for either the 3- or 7 beta-position . Because of this, cephalosporin derivatives containing a large and diverse group of substituents at these positions have been prepared . In addition, another substitution site was identified upon discovery of the cephamycins, antibiotics which differ from cephalosporins by the presence of a methoxy group at the 7 alpha-position . Substitution at this site confers remarkable beta-lactamase stability, but only methoxy has given acceptable potency . First generation injectables which have in the 3-position the naturally occurring acetoxymethyl group or other relatively simply substituents are very active against Gram-positive organisms and a few species of Gram-negatives . As new 3- and 7 beta-side chain moieties were studied, appropriate combinations yielded compounds active vs . a broader spectrum of Enterobacteriaceae and/or Pseudomonas aeruginosa or Bacteroides fragilis . Furthermore, dramatic changes in pharmacokinetics (longer half-lives) were achieved by both 3- and 7 beta-side chain modifications.(ABSTRACT TRUNCATED AT 400 WORDS)

Scand J Infect Dis Suppl, 1984, 42, 129 - 34
Beta-lactam antibiotics in lower respiratory tract infections; Schreiner A; Like in any infection, the choice of antibacterials in pulmonary infections of known bacterial etiology is simple . When etiology is not known, the choice must rest upon knowledge of the epidemiology of lower respiratory infections and the antibacterial spectrum of the antibiotics in question . The epidemiology of community-acquired lower respiratory infections is not too well studied . However, some studies indicate that approximately 50% of lower respiratory infections are caused by bacteria among which Streptococcus pneumoniae prevails, followed by Haemophilus influenzae . Streptococci, Branhamella catarrhalis and other Neisseria species, staphylococci and Enterobacteriaceae account for less than 10% each . The prevalence of Legionella pneumophila is unknown, but it is of limited significance . Mycoplasma pneumoniae varies in prevalence according to time and geographic area . In acute exacerbations of chronic bronchitis, the epidemiology is similar, except that H . influenzae is more commonly found than pneumococci . The traditional strong position of penicillin in the blind, primary treatment of community-acquired lower respiratory infections is challenged by the increasing frequency of penicillin-resistant H . influenzae and the discovery of new agents not sensitive to penicillins . The same can be said for the more recently introduced primary treatment with erythromycin . However, most community-acquired infections in the lower respiratory tract respond to penicillin; tetracycline or erythromycin may be used for treatment when the clinical response is unsatisfactory . In patients who are known or suspected to have compromised host defense, beta-lactams such as ureido-penicillins and the new cephalosporins should be used as primary therapy . In hospital-acquired lower respiratory tract infections, the etiological diagnosis is more likely to be made.(ABSTRACT TRUNCATED AT 250 WORDS)

Chemotherapy, 1984, 30(6), 387 - 91
In vitro combination effects of cefotetan with four aminoglycosides, piperacillin and mezlocillin on gram-positive and gram-negative nosocomial bacteria; Just HM et al.; The in vitro efficacy of cefotetan in combination with gentamicin, tobramycin, amikacin, netilmicin against Staphylococcus aureus, Staphylococcus epidermidis and Enterobacter cloacae and with piperacillin and mezlocillin against Escherichia coli, Klebsiella pneumoniae, Serratia marcescens and Enterobacter cloacae was compared by use of the checkerboard agar dilution technique . On average, 60% of the gram-negative and 46% of the gram-positive strains were inhibited by additive, but only 22% of the gram-negative and 2% of the gram-positive bacteria were inhibited by synergistic cefotetan-aminoglycoside combinations . Netilmicin combinations were least active . On gram-negative bacteria, 63% of the cefotetan-penicillin combinations were additive and 11% synergistic . No antagonism occurred with any of the combinations.

Ciba Found Symp, 1984, 102, 219 - 32
Evolutionary relationships among genes for antibiotic resistance; Davies J et al.; The genes that determine resistance to antibiotics are commonly found encoded by extrachromosomal elements in bacteria . These were described first in Enterobacteriaceae and subsequently in a variety of other genera; their spread is associated with the increased use of antibiotics in human and animal medicine . Antibiotic-resistance genes that determine the production of enzymes which modify (detoxify) the antibiotics have been detected in antibiotic-producing organisms . It has been suggested that the producing strains provided the source of antibiotic-resistance genes that were then 'picked-up' by recombination . Recent studies of the nucleotide sequence of certain antibiotic-resistance genes indicate regions of strong homology in the encoded proteins . The implications of these similarities are discussed.

Chemotherapy, 1984, 30(1), 44 - 8
Azthreonam activity against gram-negative bacilli; Bremner DA; The in vitro activity of azthreonam - a monocyclic beta-lactam antibiotic - was compared with the activities of ampicillin, cephalothin, cefuroxime, cefotaxime, cefoperazone, lamoxactam, ceftazidime, and N-formimidoyl thienamycin against 249 clinical isolates of gram-negative bacilli . Azthreonam was as active or more active than all the third-generation cephalosporins against all the Enterobacteriaceae except Klebsiella . Against Klebsiella azthreonam was more active than cefoperazone but less active than the other third-generation cephalosporins . Azthreonam, ceftazidime, and piperacillin were equally active against Pseudomonas aeruginosa.

J Hyg Epidemiol Microbiol Immunol, 1984, 28(4), 435 - 40
Enterobacter sakazakii: a tween 80 esterase-positive representative of the genus Enterobacter isolated from powdered milk specimens; Postupa R et al.; Enterobacter sakazakii is the new species name introduced in 1977 for yellow-pigmented strains originally designated as yellow Enterobacter cloacae . All of the six E.sakazakii strains isolated from powdered milk specimens were found to produce Tween 80 esterase after 7 days of incubation at 25 degrees C and 37 degrees C . From E.cloacae it is distinguishable by reactions in four, or even three, biochemical tests, i.e . by production of yellow pigment, positive production of Tween 80 esterase and by non-fermentation of sorbite and mucate; from the Serratia species it can be differentiated by the negative test for lecithinase production.

Microbiol Immunol, 1984, 28(11), 1169 - 79
Composition of O-antigenic lipopolysaccharides from Enterobacter cloacae; White PJ et al.; Analyses have been carried out on lipopolysaccharides (LPS) from 14 strains of Enterobacter cloacae representing different O serotypes . All of the products appeared to have a composition and architecture typical of enterobacterial LPS, but points of interest include the absence of phosphate residues from the core oligosaccharide, the presence of both L-glycero-D-mannoheptose and D-glycero-D-mannoheptose (ratio usually about 4:1), and the presence in lipid A of small amounts of fatty acids with odd numbers of carbon atoms (mainly C13) in addition to tetradecanoic acid and 3-hydroxytetradecanoic acid . Monosaccharides identified as components of polymeric fractions from the LPS were glucose, galactose, mannose, rhamnose, glucosamine, galactosamine, fucosamine, and galacturonic acid . Most polymeric fractions also probably contained an O-acetyl substituent . Closely similar chemotypes found for the polymeric fractions from the LPS of cross-reacting serotypes support the view that these fractions contain the O-antigenic determinants and represent the side chains of the LPS.

Urol Int, 1984, 39(5), 303 - 7
Effect of estrogen on the formation of struvite calculi in female rats; Matsushita K; The administration of 1 mg estradiol every other week for 12 weeks to female rats resulted in a high incidence (about 50%) of bladder stones . Most calculi were struvite, suggesting the predisposition to urinary tract infection . Enterobacteria, staphylococcus and streptococcus were identified as infecting organisms . Metaplasia of the transitional bladder epithelium by estrogen to a stratified or pseudostratified columnar epithelium may be involved in the underlying cause of urinary tract infection.

Intensive Care Med, 1984, 10(5), 233 - 7
Oropharyngeal flora as a source of bacteria colonizing the lower airways in patients on artificial ventilation; van Uffelen R et al.; During 1 year 27 patients admitted to the respiratory intensive care unit were monitored bacteriologically for a minimum of 10 days (mean: 26.7 days) . Oropharyngeal swabs and tracheal aspirates were qualitatively and semi-quantitatively cultured twice weekly . A correlation between oropharyngeal and tracheal flora was found: once a bacterial species colonized the oropharyngeal cavity in high numbers, the identical microorganism was frequently isolated (greater than 50%) from the lower respiratory tract . Six of the 27 patients acquired an infection of the lower airways in the respiratory intensive care unit . The bacteria involved belonged to the patients oropharyngeal flora: S . aureus, Enterobacteriaceae and Pseudomonadaceae . As a result of this study showing the oropharynx to be the source of lower airway colonization/infection, a policy for infection prevention has been outlined . This policy is based on the concept of source elimination by means of oropharyngeal decontamination.

Chemotherapy, 1984, 30(5), 297 - 304
Diffusion of metioprim, tetroxoprim and sulphadiazine in the cerebrospinal fluid of dogs with healthy meninges and dogs with experimental meningitis; Vergin H et al.; The diffusion of metioprim (MTP), tetroxoprim (TXP) and sulphadiazine (SDZ) in cerebrospinal fluid (CSF), following single intravenous doses and continuous infusions, was studied in dogs . The drugs penetrated well into the CSF of animals with and without experimental Staphylococcus aureus meningitis . In dogs with healthy meninges, the CSF bioavailability - expressed as the ratio of CSF/plasma area under the curve 0-5-hour values - following continuous infusion was determined to be 86.7% for MTP, 58.2% for TXP and 38.8% for SDZ . In infected animals, CSF availability following continuous infusion increases slightly to ratios of 96% (MTP), 70% (TXP) and 50% (SDZ) . For all drugs, the concentrations reached in CSF were above the minimum inhibition concentrations for the majority of Enterobacteriaceae, indicating their potential value in treatment of gram-negative bacillary meningitis.

J Hyg Epidemiol Microbiol Immunol, 1984, 28(2), 161 - 6
Transferable resistance to gentamicin and other antibiotics in Enterobacteriaceae isolates from municipal wastewater; Kralikova K et al.; In two sets of Enterobacteriaceae and Pseudomonas bacteria resistant to at least two antibiotics a distinctly upward trend was found in the incidence of strains resistant to gentamicin . The strains examined were either routine isolates from three municipal wastewater treatment facilities or from the Danube river samples collected near the outlet of municipal sewerage . The resistance to gentamicin points to the representation of strains originating from hospitalized patients and its incidence among wastewater strains is recordable since the summer of 1981 . Gentamicin resistance transfer could be demonstrated in a sewage sludge strain of Klebsiella pneumoniae resistant to seven antibiotics and in two multiresistant isolates from the river Danube . Resistance transfers in the case of other antibiotics, especially those susceptible to beta-lactamase (ampicillin, carbenicillin), were demonstrated in 10 out of the 24 di- and multiresistant strains tested . These findings show that both municipal wastewater and water in streams may function as the reservoirs of strains bearing the determinants of transferable resistance . Such strains may play an important role not only in the ecology and epidemiology of R plasmids, but also in the accidental spread of the so-called DNA recombinants that might escape during gene manipulations.

Clin Ther, 1984, 6(4), 560 - 70
Five cephalosporins: pharmacokinetics and their relation to antibacterial potency; Sohn C et al.; In a group of adult volunteers, pharmacokinetic profiles of five cephalosporins were correlated with their minimal inhibitory concentrations (MICs90) against Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Enterobacter aerogenes . Subjects received the following intravenous regimens in a randomized, crossover fashion: (1) 0.5 gm, 1 gm, or 2 gm of cefazolin; (2) 2 gm of cephalothin; (3) 1 gm of cephapirin; (4) 1 gm of cefoxitin; or (5) 0.5 gm of cefamandole . The 500-mg dose of cefazolin produced serum concentrations that exceeded those of any of the other cephalosporins at 0.5, 1, 2, 4, and 6 hours after administration . The area under the curve for this dose of cefazolin was at least twice that of any of the other antibiotics . Two hours after a 500-mg dose of cefazolin, serum levels exceeded the MIC90 for all seven groups of pathogens; at six hours, the 500-mg dose of cefazolin continued to achieve serum levels above the MIC90 against the majority of bacterial groups . In contrast, at two hours after administration none of the other cephalosporins maintained serum levels above the MIC90 for all pathogens; at six hours, the levels of cephapirin were adequate to inhibit the two streptococci, but serum levels of all other cephalosporins were inadequate to inhibit any of the pathogens . These data indicate that a 500-mg dose of cefazolin maintains serum levels above the MICs90 longer than any of the other cephalosporins tested and support the use of a 500-mg dose of cefazolin every eight hours for surgical prophylaxis and treatment of most community-acquired infections . Such a comparatively low dosage offers substantial savings to both patient and hospital.

J Hyg Epidemiol Microbiol Immunol, 1984, 29(3), 311 - 5
Antimicrobial profile of ceftazidime: the situation in three larger hospitals in Prague between 1981 and 1983; Hejzlar M et al.; As a part of preclinical trials of 2,996 clinical isolates from three larger hospitals in Prague were qualitatively and quantitatively assayed for in vitro sensitivity to ceftazidime . In gramnegative bacteria the incidence of resistance to ceftazidime in strain of Enterobacter, Serratia Proteus and Pseudomonas species ranged from 4% to 6% of strains . In grampositive bacteria only strains of enterococci, listeriae and anaerobic bacteria are excluded from the action of this broad-spectrum antibiotic . According to present experiences the antipseudomonal activity of ceftazidime is approximately the same as that of cefsulodine and cefoperazone . Alarmingly, one of the Pseudomonas aeruginosa isolates was found to show a distinct multiresistance to all available lactam, aminoglycoside and broad-spectrum antimicrobials, including ceftazidime.

J Mol Evol, 1984-85, 21(4), 317 - 22
Selection against dam methylation sites in the genomes of DNA of enterobacteriophages; McClelland M; Postreplicative methylation of adenine in Escherichia coli DNA to produce G6m ATC (where 6mA is 6-methyladenine) has been associated with preferential daughter-strand repair and possibly regulation of replication . An analysis was undertaken to determine if these, or other, as yet unknown roles of GATC, have had an effect on the frequency of GATC in E . coli or bacteriophage DNA . It was first ascertained that the most accurate predictions of GATC frequency were based on the observed frequencies of GAT and ATC, which would be expected since these predictors take into account preferences in codon usage . The predicted frequencies were compared with observed GATC frequencies in all available bacterial and phage nucleotide sequences . The frequency of GATC was close to the predicted frequency in most genes of E . coli and its RNA bacteriophages and in the genes of nonenteric bacteria and their bacteriophages . However, for DNA enterobacteriophages the observed frequency of GATC was generally significantly lower than predicted when assessed by the chi square test . No elevation in the rate of mutation of 6mA in GATC relative to other bases was found when pairs of DNA sequences from closely related phages or pairs of homologous genes from enterobacteria were compared, nor was any preferred pathway for mutation of 6mA evident in the E . coli DNA bacteriophages . This situation contrasts with that of 5-methylcytosine, which is hypermutable, with a preferred pathway to thymine . Thus, the low level of GATC in enterobacteriophages is probably due not to 6mA hypermutability, but no selection against GATC in order to bypass a GATC-mediated host function.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagn Microbiol Infect Dis, 1984 Jan, 2(1), 55 - 63
Temocillin: in vitro activity against 734 selected clinical isolates, including beta-lactamase-producing strains; Fuchs PC et al.; The in vitro activity of temocillin against 734 clinical isolates was tested by broth microdilution . Good activity was demonstrated against Enterobacteriaceae and both beta-lactamase-positive and -negative strains of Haemophilus influenzae and Neisseria gonorrhoeae . There was little to no activity against gram-positive cocci and nonfermenting gram-negative bacilli . Bactericidal activity and effect of inoculum size on temocillin activity were comparable to that of ticarcillin . Temocillin was stable to commonly encountered beta-lactamases and significantly inhibited Richmond-Sykes type 1 enzymes of Enterobacter cloacae.

Arzneimittelforschung, 1984, 34(12), 1775 - 8
Experience with ciprofloxacin in vitro and in vivo; Giamarellou H et al.; 1-Cyclopropyl-6-fluoro-1-dihydro-4-oxo-7-(1-piperazinyl)-1,4-dihydro-3- quinolinecarboxylic acid (ciprofloxacin, Bay-o 9867) a new quinoline carboxylic acid derivative, was tested in vitro against 233 various Gram-negative microorganisms, mostly resistant to nalidixic acid . Minimal inhibitory concentrations (MIC) against the Enterobacteriaceae and P . aeruginosa ranged between less than 0.003 to 1 mg/l and less than 0.003 to 8 mg/l respectively with MIC90 of 2 mg/l . However, when sensitivities were repeated with an acid broth they were increased by greater than or equal to 32 fold . This effect was more prominent when as nutrient pooled human urine was used and particularly for P . aeruginosa strains . Ciprofloxacin at a dose of 250 mg, or 500 mg, 12-hourly for 10 days was randomly given to 40 patients aged 23-76 years, suffering from upper (27) and lower (13) urinary tract infections (UTI) as proved from the "antibody coated bacteria" (ACB) test . Pathogens included E . coli (20), Proteus sp . (13), K . pneumoniae (1), C . freundii (1) and P . aeruginosa (5), with MICs between less than 0.06 to 2 mg/l . During treatment all but one of the patients responded favorably both clinically and bacteriologically, while at a six-week follow-up, nine patients with upper UTIs and underlying chronic pyelonephritis or/and structural abnormalities had relapsed, while only one became reinfected . Treatment schedule did not influence the results . No appreciable side effect or toxicity was observed . It is concluded that ciprofloxacin should have an important role to play in the treatment of UTI as well as in systemic infections whenever multiresistant pathogens are implicated.

Immunol Commun, 1984, 13(2), 151 - 60
Carbohydrate exposure on salmonella and E . coli bacteria after reaction with antibody IgG and secretory IgA (SIgA) assessed with fluorescent lectins; Magnusson KE et al.; The carbohydrate moieties exposed on enterobacteria before and after antibody binding have been tested with fluorescent lectins . Salmonella typhimurium 395 MS (S-type) and its Rd-mutant MR10 were coated with hyperimmune anti-MS and anti-MR 10 IgG, respectively . MR 10 bacteria and Escherichia coli O86 bacteria were coated with human colostral secretory IgA (SIgA) . There was a conspicuous binding of some of the lectins to untreated bacteria not always closely related to the sugar composition of the outer membrane lipopolysaccharide (LPS) or other known sugar residues . Antibody IgG and SIgA binding modified the affinity for the lectins . The binding of some lectins was reduced, presumably by masking the bacterial sugars . Antibody IgG binding to S . typhimurium MS and R 10 enhanced the affinity for RCA-I (Gal) and to a smaller extent for WGA (GlcNAc) which may be explained by exposure of IgG oligosaccharide . Antibody SIgA binding to S . typhimurium R 10 and E . coli O86 enhanced the affinity for the above lectins to a larger extent as well as for Con A (Man, Glc) . The corresponding sugars N-acetylglucosamine, mannose and glucose are present in the carbohydrate chain of the secretory component as well as in IgA indicating that when SIgA antibody binds its sugar components are exposed.

Scand J Infect Dis, 1984, 16(2), 181 - 5
The dialysis catheter and infectious peritonitis in intermittent peritoneal dialysis; Kolmos HJ et al.; 118 episodes of infectious peritonitis registered among 156 patients treated with intermittent peritoneal dialysis over a 5-yr period were analysed with special reference to potential routes of infection associated with the dialysis catheter . Peritonitis was randomly distributed among the patients, and the change of keeping free of peritonitis declined exponentially with time . The main factor determining the individual number of episodes was the total space of time, in which a patient had been wearing a dialysis catheter, whereas the number of catheter disconnections played no significant role . A relative preponderance of cases due to Enterobacteriaceae was noted within the first week after catheter implantation . In contrast with this, peritonitis with skin microorganisms was not associated with the implantation of catheters.

Arzneimittelforschung, 1984, 34(1), 62 - 5
{Parallel resistance between cephalosporins and penicillins}; Grimm H; Resistance of Enterobacter, Klebsiella and Pseudomonas aeruginosa to cefotaxime, cefoperazone, mezlocillin, azlocillin and piperacillin was induced by 15 culture transfers at subinhibitory concentrations . Information about a possible cross resistance between cephalosporins and penicillins was obtained by determining the MIC's of the five beta-lactam antibiotics studied before and after resistance was induced . The highest homologous resistance is induced in Enterobacter and Ps . aeruginosa by cefotaxime (factors 2021 and 42.2, respectively), and in Klebsiella by cefoperazone (factor 64) . The lowest increase in homologous resistance is induced in Ps . aeruginosa by cefoperazone (factor 9.9), and in Enterobacter and Klebsiella by mezlocillin (factor 10.6 and 4.6 respectively) . Resistance induced by cephalosporins is often accompanied by resistance to penicillins . Such cross resistance is observed especially in Ps . aeruginosa and Enterobacter . Resistance to cephalosporins is, however, only rarely induced by penicillins . These findings permit the conclusion that the use of all beta-lactam antibiotics may be prohibited by uncritical treatment with cephalosporins . Preference should therefore be given to acylureidopenicillins in primary treatment of emergency cases.

Arch Intern Med, 1984 Jan, 144(1), 57 - 62
Clinical efficacy of ceftazidime . Treatment of serious infection due to multiresistant Pseudomonas and other gram-negative bacteria; Scully BE et al.; Ceftazidime, a beta-lactamase stable cephalosporin, was administered to 57 patients . Substantial underlying disease was present in the majority of patients, and 50% were in critical or poor condition . Ceftazidime inhibited all initial isolates of Enterobacteriaceae at 8 mg/L or less, regardless of resistance to other antibiotics and the majority of Pseudomonas aeruginosa at 12 mg/L or less . The mean serum level after infusion of 1 g during 30 minutes was 62 mg/L . Overall clinical response was 84%, and the bacteriological response was 72% excluding cystic fibrosis patients . No major adverse effects were encountered . Resistance developed in Pseudomonas from patients with cystic fibrosis and in Enterobacter from two other patients . Ceftazidime was an effective, safe therapy for serious infection due to multiply resistant Pseudomonas and other aerobic gram-negative bacilli including aminoglycoside-resistant Serratia and Klebsiella.

J Med, 1984, 15(5-6), 437 - 40
Legionella and the enterobacterial common antigen; LaScolea LS et al.; Legionella pneumophilia Philadelphia 1 and Knoxville 1 were examined by in vitro hemagglutination and dermal hypersensitivity reactions in guinea pigs for the presence of the enterobacterial common antigen . No ECA was found and no cross reactivity was demonstrated between ECA and the proteinaceous cross reacting antigen.

Vet Med Nauki, 1984, 21(10), 67 - 74
{Proteolytic activity of the microflora of meat}; Enikova R et al.; Naturally occurring microflora and its proteolytic activity were studied in a water extract from raw untreated pork under various storing conditions . The dynamic was also followed up of th proteolytic activity in Enterobacteriaceae cultures isolated from the extract in succession during the period of storage at room and refrigerator temperature . It was found that the meat contained a good diversity of organisms of various potential capacity of producing proteolytic exoenzymes that changed dynamically at different intervals according to the period of staying for different time in different conditions within the meat extract . The activity of proteases as directly determined in the extract rose considerably in the process of storing at room temperature, while at refrigerator temperature it was but rarely determined within the range of sensitivity of the method employed . Stated is the importance of the microflora for the deterioration of meat as the organisms were the basic source of the respective enzymes along with the rate of the enzyme production associated with the natural microbial content of meat and the inductive nature of the bacterial exoproteases.

Antonie Van Leeuwenhoek, 1984, 50(5-6), 701 - 10
Host-parasite interaction in serious infections due to gram-negative bacteria; Schellekens JF et al.; Gram-negative rods such as Enterobacteriaceae and Pseudomonadaceae are normal habitants of the digestive tract . However, if defense mechanisms of the host are compromised by underlying diseases such as malignant neoplasms, renal insufficiency, extensive traumata, or immunosuppressive therapy, invasion of the blood-stream can occur . Gram-negative septicaemia is associated with high morbidity and mortality, despite intensive care and administration of potent antibiotics . A central role in the pathophysiology of life-threatening bacteriaemia is attributed to endotoxin, a constituent of the gram-negative cell wall . This paper reviews current concepts of septic shock, the acquisition of gram-negative bacteraemia and the role of endotoxin . It also deals with a new approach to prevention and control of severe gram-negative infections using serotherapy based on the structure of endotoxin.

Clin Ther, 1984, 7(1), 49 - 59
Multicenter clinical trials of cefoperazone in Japan; Saito A et al.; The safety and clinical efficacy of cefoperazone were evaluated at 149 institutions in Japan . A total of 979 hospitalized patients were treated with cefoperazone alone for 1,059 infections . In the 984 infections evaluated, there was an overall satisfactory clinical response in 824 (83.7%) . Cefoperazone was effective in 83.0% of the respiratory tract infections, 84.9% of urinary tract infections, and 89.6% of hepatobiliary tract infections . Clinical response was satisfactory in 90% or more of the cases in which Escherichia coli, Serratia sp, Haemophilus influenzae or Staphylococcus sp were isolated . Sixty percent to 90% of the infections with Klebsiella sp, Enterobacter sp, Proteus sp, and Pseudomonas aeruginosa responded satisfactorily to cefoperazone . Cefoperazone was effective in 76.2% of 260 evaluated cases that had failed to respond to prior treatment with other cephalosporins . The adverse reactions that occurred in 19 (1.9%) of the 979 patients included rash (1%), diarrhea (0.6%), and fever (0.4%) . Cefoperazone appears to be extremely useful in the treatment of various infections in hospitalized patients.

Eksp Onkol, 1984, 6(2), 8 - 14
{Possible approaches to the study of the immunological status of cancer patients and healthy people}; Montsevichiute-Eringene EV; The paper is a review of the investigations on the immunological status in patients and healthy people in the light of old and new ideas of immunological surveillance in cases of malignant growth . A discrepancy between peculiarities of malignant growth and changes in the immunological function of the organism is estimated . Some data are given in favour of the importance of revealing nonspecific immunological mechanisms of surveillance when malignant cells appear . The author shows her methods of determining the immunological status of an individual by means of normal antibodies to one of common enterobacterial antigens and the number of leukocytes and lymphocytes in peripheral blood . The immunological functions of the organism are classified . The tests and classification may be suitable for determining the immunological status of population . The last stage of the work can be carried out by means of a suitable mathematical model.

Ann Rech Vet, 1984, 15(1), 75 - 95
{Role of nonenterotoxigenic Escherichia coli strains (K99-,ST-) in the neonatal pathology of the calf}; De Rycke J; Enterotoxigenic strains of Escherichia coli have been extensively studied over the last ten years, especially in the calf . On the other hand, septicemic strains have received much less attention during the same period, in spite of a lack of information about their pathogenicity in the calf and about the attributes of their virulence . Virulence of septicemic E . coli includes invasion from the portal entry into the blood, multiplication in blood and organs, resistance to phagocytosis and lethal action of serum, and production of lesions by toxins . Most information obtained recently concerns the last phases of microbial pathogenicity, i.e . multiplication and production of lesions . Antigens K are considered to be mainly responsible for the resistance to phagocytosis . Antigens O would play the major role, qualitatively and quantitatively, in the resistance to bactericidal effect of serum . The ability to grow in iron-deficient medium would constitute a decisive advantage . This ability is attributed to proteins of the outer membrane, some of them being coded by plasmids . Endotoxin is the basic toxic principle that accounts for the production of lesions in the host . It is generally admitted that its toxic effect is due to the lipid A portion of LPS . The biochemical composition of lipid A being very homogeneous in Enterobacteriaceae, its pathological effect is considered to be directly related to the concentration in serum, i.e . without specific endotoxic activity exerted by some serotypes . Numerous clinical and experimental arguments suggest the occurrence of an enterotoxemic form of colibacillosis in calves . Enterotoxemic colibacillosis would result from the strictly intestinal multiplication of some strains of E . coli and the systemic diffusion of corresponding endotoxins . Such a syndrome has been well-documented in piglets, namely oedema disease . Oedema disease is attributed to a limited number of serotypes . Experimental reproduction has led to the evidence that two toxic principles are needed to fully produce the disease: the endotoxin and a neurotoxin, called EDP . These results, together with observations on humans and other animal species, raise two major questions: 1) what are the circumstances that favour the passage of endotoxins through intestinal epithelium ? 2) could a specific endotoxic activity be attributed to some serotypes of E . coli?

Swed Dent J, 1984, 8(2), 73 - 80
Denture stomatitis in nursing home patients; Palmqvist S et al.; All 352 patients in two nursing-homes in Orebro were examined . In one of the homes microbiological tests could be done on the patients with full upper dentures . The samples were taken both from the denture and the oral mucosa . Candida albicans, Yeast, Staph . aureus, B-hemolytic streptococci and Klebsiella/Enterobacter were controlled . In samples from the oral mucosa a correlation was found between stomatitis, Candida albicans and Staph . aureus (P less than 0.01) . A weak correlation was also found between stomatitis and Klebsiella/Enterobacter (0.01 less than P less than 0.05) . In samples from the dentures there were only a weaker correlation between Stomatitis, Candida albicans and Staph . aureus (0.1 less than P less than 0.05).

Microbios, 1984, 41(160), 79 - 86
Agglutinogens, White's 'Q' substance and the common proteins of Enterobacteriaceae; Barber C; Reassessment of the antigens involved in the cross-relation of Enterobacteriaceae point to the common proteins first discovered by White (1932) and named substance Q . All the serological characteristics of substance Q, as described by White, are identical with those obtained with pure enterobacterial proteins.

Clin Pharm, 1984 Jan-Feb, 3(1), 49 - 55
Treatment of chronic bacterial prostatitis; Hanus PM et al.; The pathogenesis, clinical signs and symptoms, diagnosis and treatment of chronic bacterial prostatitis (CBP) are reviewed . The most common organism associated with CBP is Escherichia coli, although infections with Klebsiella, Enterobacter, Proteus, Pseudomonas, and enterococci have also been documented . The only symptoms of CBP may be those of an acute urinary-tract infection . The use of simultaneous quantitative urine cultures represents the most accurate method for diagnosing CBP . The use of trimethoprim-sulfamethoxazole, the current drug of choice for CBP, is based on results in animals showing good penetration of trimethoprim into acidic prostatic fluid and the knowledge that normal human prostatic fluid is acidic . Studies in patients with CBP, who have alkaline prostatic fluid, have demonstrated poor penetration of trimethoprim into prostatic fluid, which may explain the cure rate of about 40% seen with trimethoprim-sulfamethoxazole . A few patients have been treated successfully with kanamycin and streptomycin, but these drugs must be given by injection . Carbenicillin indanyl sodium has been associated with cure rates of almost 70% in a small number of studies . Both doxycycline and minocycline have been used to treat CBP, but inadequate urine-culture data make these studies difficult to evaluate . Erythromycin produced a cure rate of 88% in one study in patients who received 500 mg (as the stearate salt) four times daily for 14 days . Local injection of antibiotics into the prostate has been reported to be effective in a few cases . Although controlled comparative trials with trimethoprim-sulfamethoxazole are needed, carbenicillin indanyl sodium and erythromycin appear to be the drugs of choice for treating CBP; trimethoprim-sulfamethoxazole should be reserved for patients with CBP unable to tolerate or unresponsive to therapy with these agents.

J Clin Microbiol, 1984 Jan, 19(1), 17 - 20
Bacterial growth and endotoxin production in lipid emulsion; Jarvis WR et al.; Klebsiella pneumoniae serotypes 21 and 24 and Enterobacter cloacae were responsible for an outbreak of polymicrobial bacteremia associated with the receipt of lipid emulsion . Since it is recommended that lipid emulsion be kept refrigerated between uses, we undertook a study to determine the growth characteristics of these organisms in lipid emulsion at 5 and 25 degrees C and to examine the use of alternative measurements (pH and endotoxin) to determine contamination by viable and nonviable microorganisms . The bacteria survived but did not proliferate at 5 degrees C; no endotoxin was detected, and the pH remained unchanged . In contrast, after a 2-h lag phase, all three organisms proliferated rapidly when incubated at 25 degrees C and reached concentrations of greater than or equal to 10(7) CFU/ml at 24 h . A decrease in pH was detected after proliferation to 10(7) CFU/ml . Endotoxin was detected after proliferation reached 10(2) CFU/ml . The amount of endotoxin elaborated by the three organisms differed and ranged from 0.013 ng per 8 X 10(2) CFU/ml to 1.3 ng per 2 X 10(3) CFU/ml at 8 h . Our findings show that these microorganisms do not proliferate at refrigerator temperature in lipid emulsion, but can reach significant levels at room temperature . It is, therefore, important to keep lipid emulsion refrigerated between uses . Furthermore, when lipid emulsion contamination is suspected, endotoxin and pH determinations should be considered as possible adjunctive tests while results of bacterial cultures are pending . The results of the present study are applicable to only selected gram-negative bacteria and may not apply to gram-positive bacteria and fungi . However, these data demonstrate that measurement of pH and detection of endotoxin is quite useful when lipid emulsion contamination occurs with selected gram-negative bacteria.

Boll Ist Sieroter Milan, 1984, 63(5), 447 - 52
{Combined antibacterial activity of clavulanic acid with amoxicillin and ampicillin against Gram-negative strains}; Mascellino MT et al.; Clavulanic acid was tested for in vitro synergistic activity with Ampicillin and Amoxycillin against 41 Gram-negative strains beta-lactamase positive or negative . Clavulanic acid provides progressive inhibition of the beta-lactamases of many bacteria . The better protective effect of CA on AM or AMX is at concentration of 100 mcg . Some synergy was seen against E . coli, Klebsiella and Proteus . Enterobacter and Pseudomonas remained resistant to the combination of AMX and AM with clavulanic acid . We have seen no synergistic effect when non beta-lactamase producing organisms were tested . Although CA alone has a broad antibacterial spectrum, the degree of activity is generally rather poor.

Chemotherapy, 1984, 30(6), 398 - 407
Interaction of Ro 17-2301 (AMA-1080) with beta-lactamases; Then RL; Against a variety of beta-lactamases tested, mostly of chromosomal origin, Ro 17-2301 (AMA-1080) proved to be more stable than the new cephalosporins and thus resembles aztreonam . Against the beta-lactamases from Klebsiella oxytoca and Pseudomonas vulgaris, however, Ro 17-2301 proved to be much more stable than aztreonam . Enzymatic hydrolysis, performed with the K . oxytoca beta-lactamase, yielded a single compound, viz . the microbiologically inactive, ring-opened structure . Ro 17-2301 is a potent and progressive inhibitor of cephalosporinases found, e.g., in Enterobacter cloacae and other gram-negative organisms . The IC50 and Ki values, however, showed that the affinity for these enzymes is lower than that of aztreonam.

Infection, 1984 Jan-Feb, 12(1), 40 - 5
Ceftizoxime (FK 749) in vitro antibacterial activity; Husson MO et al.; The minimal inhibitory concentrations of ceftizoxime, cefotaxime, moxalactam, cefoperazone, cefotiam and cefamandole were determined against various species of gram-negative bacteria and against Staphylococcus aureus . Ceftizoxime was more active against Enterobacteriaceae than cefamandole, cefotiam and cefoperazone and slightly more active than or similar to moxalactam and cefotaxime . Like cefotaxime and moxalactam, ceftizoxime was less active than cefoperazone against Pseudomonas aeruginosa and less active than cefamandole against S . aureus . Ceftizoxime was active against cephalosporinase-producing Enterobacteriaceae with a mean MIC of 0.19 mg/l . However, some isolates had an MIC above 32 mg/l.

Eur J Pediatr, 1984 Jan, 141(3), 143 - 6
The cephalosporin compounds in severe neonatal infection; Schaad UB; The new cephalosporin compounds have increased in vitro activity against gram-negative enteric bacilli and penetrate well into cerebrospinal fluid . Moreover, their pharmacokinetic properties are favorable and their safety seems adequate, although insufficiently evaluated to date . Interest has been focused on them as therapeutic agents for neonatal sepsis and meningitis caused by Enterobacteriaceae . In this review the third generation cephalosporins are evaluated for their possible use in the neonates; opinions are based on currently available data . It is concluded that moxalactam and cefotaxime and probably also ceftriaxone and ceftazidime represent valuable alternatives to aminoglycosides for therapy of severe neonatal infection.

J Bacteriol, 1984 Jan, 157(1), 89 - 94
Transfer of the chromosomal bla gene from Enterobacter cloacae to Escherichia coli by RP4::mini-Mu; Seeberg AH et al.; The resistance gene for beta-lactamase-stable cephalosporins from Enterobacter cloacae was transferred to Escherichia coli by the aid of RP4::mini-Mu . The R-prime plasmids generated carried 60 to 80 kilobases (kb) of E . cloacae DNA and coded for the chromosomal E . cloacae beta-lactamase . The gene was fully expressed in the recipient . Restriction endonuclease EcoRI fragments of the R-prime plasmid pBP100 were cloned into the vector pBP328, yielding the plasmid pBP102 with a size of 14 kb . A restriction map of this plasmid was constructed . By digesting pBP102 into seven PstI fragments, ligating the fragments, and looking for the smallest plasmid generated, pBP103 was isolated . It consisted of three PstI fragments, two of them (together 4.2 kb) necessary for resistance . During the experiment (performed in a recA+ background) the largest PstI fragment had undergone a substitution of a 0.3-kb segment of pBP102 by a 0.7-kb segment in pBP103 (as deduced by heteroduplex analysis) . The bla gene of resistant E . cloacae strains was dominant over the gene of susceptible organisms.

Chemotherapy, 1984, 30(5), 308 - 21
Characterization of two clinical, multiple-drug-resistant isolates of Enterobacter cloacae; Traub WH et al.; Two multiple drug resistant Enterobacter cloacae isolates (Nos . 460 and 493) varied phenotypically in bacteriocin susceptibility in the absence of significant O antigen variation . Both isolates were susceptible to chloramphenicol, nitrofurantoin, polymyxin B, nalidixic acid, norfloxacin, and enoxacin only . One isolate carried a non-conjugative resistance (R) plasmid, whereas the other isolate contained a conjugative, 'curable' R plasmid and a cryptic plasmid . Both wild-type isolates constitutively produced a chromosomal cephalosporinase (nitrocefin hydrolysis); 'cured' variants of E . cloacae isolate No . 493, which had become susceptible for lamoxactam, produced a cefazolin-inducible beta-lactamase . The two E . cloacae isolates, including their 'cured' variants, were of low-grade virulence for outbred NMRI mice . Both isolates differed somewhat in susceptibility to defibrinated human blood . Inhibitory (0.25 microgram/ml), but not subinhibitory (0.125 microgram/ml) concentrations of norfloxacin and enoxacin combined with human blood yielded additive effects against both E . cloacae isolates.

Diagn Microbiol Infect Dis, 1984 Jan, 2(1), 65 - 8
Cefotaxime, cephalothin, and cephapirin: antimicrobial activity and synergy studies of cephalosporins with significant in vivo desacetyl metabolite concentrations; Jones RN et al.; The desacetyl metabolites of cefotaxime, cephalothin, and cephapirin were 5-55% as active as the parent drug, depending upon the bacterial species tested . Synergy or partial synergy was demonstrated in 64% of 25 strains of Enterobacteriaceae and Staphylococcus aureus tested against cephalothin/desacetylcephalothin and cephapirin/desacetylcephapirin combinations . Some species variations were identified that influenced synergy rates, particularly among the S . aureus strains (for example, highest rates for cephapirin).

Annu Rev Genet, 1984, 18, 31 - 68
The population genetics of Escherichia coli; Hartl DL et al.; E . coli is a successful and diverse group of organisms, well defined by DNA hybridization within the Enterobacteriacae and including the closely related organisms Shigella and the Alkalescens-Dispar biogroup . The primary habitat of E . coli is the lower intestinal tract of warm-blooded animals, which is colonized shortly after birth . At any one time, most normal individuals carry several strains of E . coli in their intestinal tract, including a small number of resident clones exhibiting a rate of replacement measured in weeks or months and a much larger number of transient clones that are replaced in a matter of days or weeks . The secondary habitats of E . coli are soil, sediment, and water, where its half life is thought to be only a few days . Pathogenic forms of E . coli are associated with diarrheal diseases, urinary tract infections, neonatal meningitis, nosocomial infections, and in infections of domesticated animals . E . coli populations contain much genetic diversity, more than is found in most eukaryotes . Genetic diversity has been studied from the standpoint of (a) serology with respect to surface antigens, (b) biogrouping with respect to variable characters such as nutritional versatility, antibiotic resistance, and bacteriophage susceptibility, (c) electrophoresis of enzymes of intermediary metabolism or outer membrane proteins, (d) DNA hybridization, (e) restriction-fragment length polymorphisms, (f) DNA sequences, (g) insertion sequences, and (h) plasmids . However identified, strains of E . coli appear to have a wide, but not totally indiscriminate, host range . Aside from genes directly associated with virulence, genetic divergence between pathogenic and nonpathogenic strains, although statistically significant, is not pronounced . Electrophoretic studies indicate that, while some serotypes may represent a single genetic clone almost exclusively, other serotypes may represent two or more genetically unrelated clones . Unrelated clones may therefore converge to the same or very similar serotypes . Electrophoresis has also been used to define three groups of clones among natural isolates, perhaps corresponding to subspecies of E . coli . These groups are worldwide in distribution and have a wide host range . E . coli populations exhibit great linkage disequilibrium, which occurs as highly nonrandom combinations of alleles at different loci . Reproduction is evidently largely asexual, with insufficient genetic recombination to dissipate linkage disequilibrium.(ABSTRACT TRUNCATED AT 400 WORDS)

Scand J Urol Nephrol, 1984, 18(3), 187 - 92
Species distribution and antibiotic sensitivity of bacteria isolated pre- and postoperatively from patients undergoing transurethral prostatic resection; Grabe M et al.; The identity and antibiotic sensitivity of the isolated bacteria from 179 patients undergoing transurethral resection of the prostate were analysed . The patients were randomized into a group receiving a short course of cefotaxime in conjunction with the operation and a control group given no antibiotics . Preoperatively 70 patients had bacteriuria (greater than or equal to 10(7) CFU/l) with a predominance of Gram-negative bacteria (57 isolates, mainly Escherichia coli, Enterobacter, Klebsiella ssp, Proteus ssp), although Gram-positive species (24 isolates, mainly enterococci and Staphylococcus epidermidis) were also frequently encountered . Preoperatively isolated pathogens were evenly distributed in both groups and the sensitivity pattern was comparable . In the cefotaxime group postoperative recurrence of the preoperatively identified bacteria occurred in a lower frequency (11/43) than persistence in the control group (24/38) . Only Gram-negative pathogens were isolated from patients with postoperative septicemia and upper urinary tract infections indicating that it is most important to direct prophylaxis against Gram-negative bacteria . A high degree of sensitivity against cefotaxime, gentamicin, trimethoprim, co-trimazine and a combination of ampicillin and mecillinam was recorded among both pre- and postoperatively isolated bacteria.

Mol Gen Genet, 1984, 195(1-2), 321 - 8
DNA sequence analysis of the Serratia marcescens ompA gene: implications for the organisation of an enterobacterial outer membrane protein; Braun G et al.; The cloned ompA gene from Serratia marcescens was fully expressed in Escherichia coli and its product correctly assembled into the outer membrane . The S . marcescens polypeptide was not functionally equivalent to the E . coli OmpA protein, which serves as a phage receptor and as a component of several colicin uptake systems . DNA sequence analysis of the gene showed that three regions of the protein likely to be exposed on the cell surface not only differed extensively from the corresponding regions of the E . coli polypeptide but also from all other sequenced OmpA proteins . It is suggested that this sequence polymorphism represents a safety mechanism by which the various enterobacterial species can avoid cross-infection by noxious agents such as phages or colicins.

Mol Gen Genet, 1984, 195(1-2), 215 - 8
Evidence for clustering of RNA polymerase and ribosomal protein genes in six species of Enterobacteria; Tittawella IP; 32P-labelled DNA fragments from the E . coli beta operon were used as hybridisation probes for homologous DNA sequences in chromosomal digests of six species of Enterobacteria . In all species the hybridisation pattern suggested clustering of the genes comprising the beta operon.

Eur J Biochem, 1983 Dec 15, 137(3), 495 - 500
Molecular characterization of the gene coding for major outer membrane protein OmpA from Enterobacter aerogenes; Braun G et al.; The ompA gene from Enterobacter aerogenes was subcloned into a low-copy-number plasmid vector and the resultant plasmid, pTU7En, used to study its expression in Escherichia coli K12 . Although the gene was strongly expressed and large amounts of OmpA protein were present in the outer membrane its product was not functionally identical to the E . coli polypeptide . In particular, the E . aerogenes OmpA protein was unable to confer sensitivity to OmpA-specific phages of E . coli . When the primary structure of the protein was deduced from the nucleotide sequence of its gene it was found that three domains differed extensively from the corresponding regions of the E . coli protein . As two of these are known to be exposed on the cell surface we inferred that these alterations are responsible for differences in the biological activity of the two proteins.

Nature, 1983 Dec 8-14, 306(5943), 616 - 7
Plasmids of the same Inc groups in Enterobacteria before and after the medical use of antibiotics; Datta N et al.; Conjugative plasmids were common in enterobacteria isolated before the medical use of antibiotics . Plasmid F of Escherichia coli K-12 was one example and we identified others in over 20% of a collection of strains isolated between 1917 and 1954, the Murray collection . In the past 25 years, conjugative plasmids encoding antibiotic resistances have become common in bacteria of the same genera as those of the Murray Collection--Salmonella, Shigella, Klebsiella, Proteus, Escherichia . The present study was made to show whether the 'pre-antibiotic' plasmids belonged to the same groups, as defined by incompatibility tests (Inc groups), as modern R plasmids . Of 84 such plasmids established in E . coli K-12, none with antibiotic resistance determinants, 65 belonged to the same groups as present resistance (R) plasmids . Thus the remarkable way in which medically important bacteria have acquired antibiotic resistance in the past 25 years seems to have been by the insertion of new genes into existing plasmids rather than by the spread of previously rare plasmids.

J Mol Biol, 1983 Dec 5, 171(2), 237 - 8
Crystallographic data for the beta-lactamase from Enterobacter cloacae P99; Charlier P et al.; The beta-lactamase from Enterobacter cloacae P99 has been crystallized from polyethylene glycol solution at pH 7 . X-ray examination of the orthorhombic crystals shows the space group is P2(1)2(1)2 with unit cell dimensions a = 77.4 A, b = 69.4 A, and c = 63.6 A . There is one molecule of molecular weight 39,000 in the asymmetric unit.

Onderstepoort J Vet Res, 1983 Dec, 50(4), 271 - 4
Retardation of wool growth in Merino sheep caused by bacteria; Jansen BC et al.; A condition evidenced by retarded growth of wool with alteration of the yolk into a yellow, sticky, wax-like substance was investigated . The condition was associated with hyperaemia and cellular infiltration into the dermis in the affected areas . Three bacterial species, viz . Enterobacter aerogenes, E . agglomerans and Hafnia alvei, which could grow on the water-extractable component of wool-yolk, were incriminated as the cause of the condition.

J Vet Pharmacol Ther, 1983 Dec, 6(4), 281 - 92
Clinical pharmacology and pharmacokinetics of flumequine after intravenous, intramuscular and oral administration in pigeons (Columba livia); Dorrestein GM et al.; The in-vitro activity of flumequine against 157 strains of bacteria isolated from birds was determined . The minimum inhibitory concentration (MIC) of 96.3% of the Enterobacteriaceae, Proteus spp . and Yersinia pseudotuberculosis studied (n = 135) was less than or equal to 1 microgram/ml . Pharmacokinetics of flumequine in pigeons (Columba livia) was investigated after intravenous, intramuscular and oral administration . From the blood disappearance curves after i.v . bolus injection (10 mg/kg body weight) clearance rate, blood half-time and distribution volume were calculated . The recovery of unchanged flumequine from the droppings in 24 h was 37 +/- 10% of the administered dose . Flumequine was also given i.m . at two dose levels, 10 and 60 mg/kg body weight . The availability of flumequine as intact drug was 22 and 23%, respectively, in 24 h . Therapeutic blood levels were maintained for 4 and 10 h, respectively . After an oral dose of flumequine (60 mg/kg body weight) an availability of 6.7 +/- 2.5% and a peak blood concentration of 2.68 +/- 0.92 microgram/ml at 2 h after administration were found . The recovery of unchanged flumequine from the droppings in 24 h was 1.55 +/- 0.79% of the administered dose . With the exception of the i.m . dose of 10 mg/kg, all flumequine administrations made the pigeons vomit . It appears that blood concentrations below 3 micrograms/ml will not induce vomiting . On the basis of the present data, a dosage regimen for flumequine in pigeons of a priming dose of 30 mg/kg i.m., followed after 8 h by oral administration of 30 mg/kg, this dose being repeated every 8-12 h, would be expected to give blood concentrations between 1.44 and 2.88 micrograms/ml.

Monatsschr Kinderheilkd, 1983 Dec, 131(12), 853 - 6
{Bacterial colonization of the stomach in newborn infants with gastrostomy}; Kraeft H et al.; Quantitative bacterial cultures were carried out in 137 gastric aspirates of 52 neonates with gastrostomies due to intestinal malformations . In 28% there was no growth of any organism, in 72% we found one to four bacterial species . Most often enterobacteriaceae, enterococci, pseudomonas aeruginosa, staphylococcus epidermidis and candida albicans could be cultured . We could not find any influence of systemic antibiotic therapy on bacterial colonization of the stomach . On the other hand nystatin given orally significantly decreased colonization by candida albicans . Different types of formulas or breast milk had no influence on types of species isolated . Clinically it was interesting to note that 12/52 children developed diarrhea and that 6 newborns developed septicaemia caused by the same organisms as we had found in elevated numbers in their gastric aspirates.

J Hyg (Lond), 1983 Dec, 91(3), 535 - 41
Exposure of water consumers to mesophilic actinomycetes; Ojanen TH et al.; In autumn 1978 an epidemic of respiratory disease resembling allergic alveolitis occurred in a small Finnish community . The disease was caused by repeated exposures to tap water aerosol . The raw water of the community and the sand filters of the purification system were heavily contaminated with mesophilic actinomycetes . Fourteen different strains of actinomycetes were isolated . Exposed persons with and without symptoms as well as unexposed control persons were tested for antibodies against five of these actinomycetes and against Enterobacter agglomerans . Both the exposed and the control persons had antibodies to actinomycetes but the exposed persons had antibodies against more actinomycete strains than the control persons . Precipitating antibodies against E . agglomerans were also found in control persons as well as in patients . There was a significant difference between the patients and the exposed healthy persons in bacterial agglutination tests with flagellar antigen of one E . agglomerans strain . However, the role of mesophilic actinomycetes and E . agglomerans in the aetiology of the disease could not be firmly established.

South Med J, 1983 Dec, 76(12), 1591 - 2
Serratia ficaria isolated from a leg ulcer; Pien FD et al.; Serratia ficaria was isolated from culture of a leg ulcer of a 44-year-old woman who had venous insufficiency and alcoholic cirrhosis . Although Pseudomonas maltophilia, P acidovorans, and Enterobacter cloacae were also present, S ficaria was isolated in large numbers and was considered to contribute significantly to this infection . This represents the third known clinical isolation of this bacterium.

Jpn J Antibiot, 1983 Dec, 36(12), 3437 - 43
{In vitro antibacterial activity of cefoperazone}; Watanabe Y et al.; The in vitro antibacterial activities of cefoperazone (CPZ) against clinical isolates including various beta-lactamase-producing strains were studied and compared with those of cefotiam (CTM) . CPZ had a broad spectrum against Gram-negative and Gram-positive bacteria . Especially, CPZ showed apparently more potent antibacterial activities than CTM against Enterobacter cloacae, Serratia marcescens, and Pseudomonas aeruginosa . However, CPZ was less active than CTM against Staphylococcus aureus and Proteus mirabilis . The stability and affinity of CPZ for various types of beta-lactamase were also studied . CPZ was more resistant to hydrolysis by typical cephalosporinase (CSase) and cefuroximase (CXase) than CTM, but was less stable to penicillinase (PCase) . CPZ often showed higher affinity to beta-lactamases than CTM . The study for the inducer-activity revealed that CPZ hardly induced CSase production in E . cloacae and Proteus vulgaris while CTM highly induced in both strains . CPZ was more active against CSase-producers than CTM, especially against strains which inducibly produced the enzyme . It was speculated that this activity was responsible for the superior stability to CSase and low inducer-activity for CSase production.

Eur J Clin Microbiol, 1983 Dec, 2(6), 541 - 7
Susceptibility of gram-negative bacteria and Staphylococcus aureus to combinations of ticarcillin and clavulanic acid; Casey P et al.; Four hundred and fifty-nine blood culture isolates were tested for susceptibility to ticarcillin alone and ticarcillin plus clavulanic acid, a potent beta-lactamase inhibitor . The susceptibilities of the Staphylococcus aureus strains to cloxacillin, methicillin, vancomycin, rifampicin, cefoperazone, ceftriaxone and moxalactam and of the gram-negative strains to Augmentin, azlocillin, mezlocillin, piperacillin, cefoperazone, ceftriaxone, cefotaxime, cefsulodin and tobramycin were also measured . Seventy-one percent of staphylococcal strains were beta-lactamase positive . In the presence of clavulanic acid the ticarcillin spectrum was extended to include beta-lactamase producing Staphylococcus aureus, Serratia marcescens and Klebsiella . All the ticarcillin-resistant Enterobacteriaceae were rendered ticarcillin-sensitive by clavulanic acid . The anti-Pseudomonas activity of ticarcillin plus clavulanic acid differed little from that of azlocillin and piperacillin and was comparable to that of the third generation cephalosporins . The combination of ticarcillin with clavulanic acid should be tested in the treatment of patients with infections caused by ticarcillin-sensitive and ticarcillin-resistant bacteria.

Appl Environ Microbiol, 1983 Dec, 46(6), 1423 - 5
Enterobacteriaceae and Aeromonas hydrophila in Minnesota frogs and tadpoles (Rana pipiens); Hird DW et al.; In 222 Rana pipiens frogs and 34 tadpoles captured in and near Minnesota, Aeromonas hydrophila and 29 species of Enterobacteriaceae, including yersinia enterocolitica and Salmonella arizonae, were isolated from intestines . The prevalence of members of the family Enterobacteriaceae was lowest in frogs captured in early spring and highest in frogs captured in late summer.

Antimicrob Agents Chemother, 1983 Dec, 24(6), 909 - 14
Comparison of in vitro activity of FCE 22101, a new penem, with those of other beta-lactam antibiotics; Wise R et al.; The in vitro activity of FCE 22101, a new semisynthetic penem derivative, was compared with that of ceftriaxone, moxalactam, imipenem (formerly imipemide, N-formimidoyl thienamycin, or MK 0787), cefuroxime, ceftazidime, and other beta-lactams, when appropriate, against 472 recent isolates and known beta-lactam-resistant strains . The minimum inhibitory concentrations of FCE 22101 against 90% of the members of the family Enterobacteriaceae, Haemophilus influenzae, Staphylococcus aureus, Lancefield group D streptococci, and Bacteroides spp . were between 0.5 and 4 micrograms/ml . Methicillin-resistant strains of Staphylococcus aureus were susceptible . Ninety percent of the Neisseria gonorrhoeae and Streptococcus pneumoniae strains were susceptible to 0.25 microgram of FCE 22101 per ml . Pseudomonas aeruginosa strains were resistant to FCE 22101 (minimum inhibitory concentration, greater than 128 micrograms/ml) . The susceptibility of known, characterized beta-lactamase-producing strains of the Enterobacteriaceae suggested that FCE 22101 is resistant to many beta-lactamases . Generally, FCE 22101 was slightly less active than imipenem, moxalactam, ceftriaxone, and ceftazidime against members of the Enterobacteriaceae and considerably more active than the cephalosporins (including moxalactam) against Staphylococcus aureus . The human serum protein binding of FCE 22101 was about 40%, and human serum had little effect on the activity.

J Clin Microbiol, 1983 Dec, 18(6), 1301 - 9
Comparison of two automated instrument systems for rapid susceptibility testing of gram-negative bacilli; Johnson JE et al.; The Vitek AutoMicrobic System with GSC-plus cards and the Abbott MS-2 system were tested in parallel and the results were compared directly with those of a reference microdilution minimal inhibitory concentration (MIC) procedure on a group of 262 clinical isolates of the family Enterobacteriaceae and of Pseudomonas aeruginosa . Results of both systems were compared with the reference MIC for category agreement, and in addition, the Vitek MICs were compared with those obtained by the reference procedure . The Vitek system provided an essential category correlation of 89.4% for enteric bacteria and 97.0% for P . aeruginosa . Vitek MICs agreed within 1 twofold dilutional increment for 86.3% of the enteric bacteria tested and for 96.2% of the P . aeruginosa isolates . The Abbott MS-2 essential categoric agreement was 92.0% for enteric bacteria and 92.4% for P . aeruginosa . If only aminoglycosides or carbenicillin were considered for P . aeruginosa isolates, the essential category agreement was 92.5% for the Vitek and 93.3% for the MS-2 . The majority of MS-2 category errors (13 of 19) with P . aeruginosa involved gentamicin results on isolates whose reference MICs were 8 micrograms/ml and whose MS-2 results were susceptible (MIC less than or equal to 4 micrograms/ml) . Retesting of the P . aeruginosa isolates in calcium-supplemented MS-2 broth increased the essential agreement for the aminoglycosides to 97.5%.

Quad Sclavo Diagn, 1983 Dec, 19(4), 455 - 62
{Chemobiotic sensitivity of common Gram-negative bacteria in urinary tract infections, 1981-1982}; Mastandrea P et al.; 751 stems of Gram-negative bacteria isolated from urinary samples with bacterial charge greater than or equal to 100,000 CFU (Colony Forming Units)/ml gathered from January 1981 to December 1982 have been examined . The sensitivity to the following chemoantibiotics has been tested: ampicillin, cefuroxime, amikacin, gentamicin, tobramycin, nalidixic acid, pipemidic acid, nitrofurantoin, co-trimoxazole . A very good sensitivity to pipemidic acid, amikacin, from all species considered (Escherichia coli, Proteus mirabilis, gr . Klebsiella-Enterobacter, Pseudomonas) and a good sensitivity to co-trimoxazole (with the exception of Pseudomonas) have been found . A decidedly low sensitivity has been found to nitrofurantoin and ampicillin from all species considered . It is also pointed out how the stems isolated in hospital patients are more resistant (with statistical significance by analysis of variance) than the corresponding species isolated in ambulatory patients.

J Dairy Sci, 1983 Dec, 66(12), 2507 - 14
Production of 2,3-butylene glycol from whey by Klebsiella pneumoniae and Enterobacter aerogenes; Barrett EL et al.; Production of 2,3-butylene glycol from whey with Klebsiella pneumoniae and Enterobacter aerogenes was studied . Sterilization of the whey was unnecessary . Acid whey required neutralization, but sweet whey did not . Butylene glycol production was most efficient at 33 degrees C for Klebsiella pneumoniae and at 37 degrees C for Enterobacter aerogenes . Aeration significantly improved yields . Klebsiella pneumoniae produced more butylene glycol than did Enterobacter aerogenes in unsupplemented whey . The addition of 50 mM sodium acetate to whey increased the production of butylene glycol and acetoin by Enterobacter aerogenes; it also increased the production of glycol by Klebsiella pneumoniae, but the increase in this case was offset by a decrease of production of acetoin . Maximal yields of the glycol plus acetoin in whey were obtained in 48 to 64 h, but Enterobacter aerogenes required about 160 h for complete utilization of the lactose . Highest yields were about .3 M butylene glycol plus acetoin, which corresponds to the production of about 10 kg of glycol from 380 liters of whey.

Eur J Clin Microbiol, 1983 Dec, 2(6), 529 - 33
Performance of two four-hour identification systems with atypical strains of Enterobacteriaceae; Altwegg M; Two four-hour systems (Rapid 20E and Micro-ID) for identification of Enterobacteriaceae were evaluated using 66 strains isolated from clinical specimens which could not be identified by conventional methods . API 20E was used as reference method . Both systems had an acceptable identification rate (84.8% for Rapid 20E and 74.2% for Micro-ID) . After referral to API's computer facilities the identification rate of Rapid 20E rose to 92.4% . Micro-ID incorrectly identified 16.7% of the strains and Rapid 20E only 1.5% . On the other hand, no identification was achieved in 13.6% of the strains using Rapid 20E versus 6% using Micro-ID . On the basis of these findings Rapid 20E is considered the more suitable system for the rapid identification of Enterobacteriaceae strains which cannot be identified by conventional methods.

Isr J Med Sci, 1983 Dec, 19(12), 1039 - 45
Urinary tract infection and drug-resistant bacteria in different patient populations; Nitzan Y et al.; A 1-year survey of the pathogens causing urinary tract infections was conducted in three institutions: a rehabilitation hospital, a general hospital and outpatient clinics . Gram-negative rods accounted for 96% of the infections . In the general hospital and the outpatient clinics, Escherichia coli was the most prevalent pathogen, while Proteus sp . were most prevalent in the rehabilitation hospital . The frequency of drug-resistant isolates was significantly higher in the rehabilitation hospital than in the general hospital and the outpatient clinics . This was most conspicuous in the use of the beta-lactam antibiotics, aminoglycosides and sulfonamides against such organisms as E . coli, Klebsiella sp., Enterobacter sp . and Proteus sp . Urinary E . coli were more sensitive to antimicrobial drugs than were other urinary pathogens . Pseudomonas aeruginosa isolates were highly resistant to most antibiotics . About half of the isolates were resistant to gentamicin and another half to carbenicillin . In some instances the frequency of drug-resistant isolates was higher in the general hospital than in the outpatient clinics, reflecting the greater usage of antimicrobials in the general hospital.

Am J Surg, 1983 Dec, 146(6), 762 - 5
Preoperative antibiotics for abdominal gunshot wounds . A prospective, randomized study; Moore FA et al.; In an effort to define the optimal preventive antibiotics for gunshot wounds to the abdomen, 100 consecutive patients were randomized while in the emergency department to receive either combination ampicillin, amikacin, and clindamycin, combination doxycycline and penicillin, or carbenicillin (Groups I, II, and III, respectively) . Antibiotics were continued for 5 days in the presence of distal ileal or colonic injury . The study groups were comparable in age, sex, incidence of shock, degree of peritoneal contamination, and abdominal trauma index . The incidence of infection was not statistically different among the groups . Enterobacteriacea were the predominant offenders, although anaerobes were identified in all groups . The critical risk factor was distal ileal or colon injury . This study indicates that a regimen employing a single agent whose spectrum includes both aerobes and anaerobes is as effective as more expensive and potentially toxic multiagent regimens.

Infect Immun, 1983 Dec, 42(3), 1086 - 91
Enterobacterial common antigen-tetanus toxoid conjugate as immunogen; Lugowski C et al.; The methods of limited periodate oxidation and reductive amination were used to obtain covalently linked enterobacterial common antigen (ECA) with tetanus toxoid . This procedure is simple and gives a good yield of the conjugate with high ECA content (molecular ratio of ECA to tetanus toxoid, 6:1) . The ECA-tetanus toxoid conjugate is immunogenic in rabbits, in contrast to free ECA or a mixture of ECA with proteins . This conjugate produces high levels of ECA-specific immunoglobulin G antibodies, which can be used as a standard serum.

Jpn J Antibiot, 1983 Dec, 36(12), 3450 - 5
{In vivo effects of cefoperazone in local infection}; Kumano K et al.; The in vivo antibacterial activity and the penetration into inflammatory tissues of cefoperazone (CPZ) were compared with those of cefotiam (CTM) in local infection systems using mouse subcutaneous abscess and rat granuloma pouch . The serum levels of CPZ in subcutaneous abscess in mice caused by Staphylococcus aureus F-230 (penicillinase producing strain) were lower than that of CTM, but there was no significance between the therapeutic effects of both drugs . The same results were obtained using Staphylococcus aureus F-196 (penicillinase non-producing strain) . When infected with Enterobacter cloacae H-27 (cephalosporinase producing strain) in rat granuloma pouch, the exudate levels of CTM were lower than those of CPZ . Judging from these results, it was suggested that CPZ was a useful antibiotic for the treatment of bacterial-inflammatory tissues.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Dec, 256(2), 202 - 10
In vitro activity of temocillin, moxalactam and cefotaxime against gram negative bacteria sensitive or resistant to ureidopenicillins and/or cefacedone; Bartmann K et al.; Minimal inhibitory concentrations (MIC's) of temocillin, cefotaxime and moxalactam were determined by agar dilution technique for 225 strains belonging to various species of Enterobacteriaceae and for 58 strains of H . influenzae and H . parainfluenzae . For Enterobacteriaceae, the MIC's of temocillin are distinctly higher than that of cefotaxime and moxalactam . But temocillin activity was not affected by resistance against ureidopenicillins and/or cefacedone . No resistant strains were encountered among E . coli, K . pneumoniae, Proteus spp . except one strain of P . vulgaris . In E . cloacae- strains with resistance against cefotaxime, temocillin was more active than moxalactam . S . marcescens- strains with a high MIC of temocillin were sensitive to cefotaxime and moxalactam . Temocillin is of the same order of activity as ampicillin against ampicillin-sensitive strains of H . influenzae and H . parainfluenzae . Its MIC is not influenced by beta-lactamases of these species.

J Bacteriol, 1983 Dec, 156(3), 1006 - 11
Purification and reconstitution in lipid bilayer membranes of an outer membrane, pore-forming protein of Aeromonas salmonicida; Darveau RP et al.; We have purified a major outer membrane protein from Aeromonas salmonicida . This 42-kilodalton protein shared several physical characteristics with enterobacterial porins in that it was noncovalently associated with the peptidoglycan, it was released from the peptidoglycan in the presence of 0.1 M NaCl and sodium dodecyl sulfate, and its mobility on sodium dodecyl sulfate-polyacrylamide gels was dependent on the solubilization temperature before electrophoresis . When added to the aqueous solution bathing a planar bilayer membrane it caused the conductance of the membrane to increase by several orders of magnitude . At lower protein concentrations, single channels with an average conductance of 1.6 nS in 1 M KCl were incorporated into the membrane in a stepwise fashion . Evidence that the protein formed a large, relatively nonselective, water-filled channel was obtained by performing single-channel experiments at different NaCl concentrations and in a variety of different salts . Current through the channel was a linear function of the applied voltage, and no evidence of voltage gating was observed . In addition, we obtained evidence for a 43-kilodalton channel-forming protein in the outer membrane of A . hydrophila with a similar single-channel conductance as the 42-kilodalton protein in 1 M NaCl.

Infect Immun, 1983 Dec, 42(3), 1092 - 101
Effects of growth temperature, 47-megadalton plasmid, and calcium deficiency on the outer membrane protein porin and lipopolysaccharide composition of Yersinia pestis EV76; Darveau RP et al.; The expression of several virulence determinants of Yersinia pestis is known to be dependent on the in vitro growth temperature . One of these, calcium dependence, is associated with the presence of a 47-megadalton plasmid . We have examined the effects of incubation temperature, calcium in the growth medium, the presence of the 47-megadalton plasmid on the outer membrane protein, and the lipopolysaccharide composition of Y . pestis EV76 . When cells were grown at 37 degrees C as opposed to 26 degrees C, a change in lipopolysaccharide composition and a decrease in the amount of an outer membrane protein (protein E) were observed . The lipopolysaccharide obtained from cells incubated at 37 degrees C had a lower proportion of 2 keto-3-deoxyoctanate, a lower phosphate to 2-keto-3-deoxyoctanate ratio, and an increased gel mobility upon sodium dodecyl sulfate-polyacrylamide gel electrophoresis when compared with lipopolysaccharide obtained from cells grown at 26 degrees C . Because of its growth temperature-related abundance, we investigated the nature of protein E . This protein had physical properties similar to those of other enterobacterial porins, including apparent formation of an oligomer on sodium dodecyl sulfate-polyacrylamide gels when solubilized at low temperature, acidic isoelectric point, and strong noncovalent association with the peptidoglycan . Protein E was purified and shown to form an aqueous channel in planar lipid membranes with a conductance of 1.1 nS in 1 M KCl . In addition to growth temperature-related alterations in the lipopolysaccharide and porin components of the outer membrane, the amount of three spots in two-dimensional polyacrylamide gels was shown to be related to the temperature or the presence of calcium during growth . One of these spots was shown to contain residual unmodified portions of two major heat-modifiable proteins which failed to shift to their heat-modified positions on gels, despite solubilization at 100 degrees C for 10 min before electrophoresis . The other two spots were the heat-modified and unmodified forms of another outer membrane protein (J) which did not appear in the isoelectric focusing gel of cells grown at 37 degrees C . It is proposed that the appearance of these spots in two-dimensional analyses is related to the lipopolysaccharide composition of the cells from which the outer membrane is derived and reflects lipopolysaccharide-protein interactions or calcium-protein interactions.

Eur J Clin Microbiol, 1983 Dec, 2(6), 548 - 53
Comparison of the antibacterial in vitro and in vivo activity of ofloxacin (HOE 280 DL 8280) and nalidixic acid analogues; Seibert G et al.; The in vitro and in vivo activity of ofloxacin (DL 8280, HOE 280) was compared with that of other antibacterial compounds . Ofloxacin was found to have a broad antibacterial spectrum which includes both gram-positive and gram-negative aerobic and anaerobic species . Its activity is generally higher than that of pipemidic acid and nalidixic acid . Against staphylococci and streptococci, ofloxacin proved to be more active than norfloxacin . In the case of Enterobacteriaceae and Pseudomonadaceae, ofloxacin and norfloxacin possess comparable activities . Ofloxacin was the most active compound against a number of aerobic isolates which are resistant to cefotaxime and ceftriaxone . Of the compounds compared, ofloxacin was the only one which exhibited reasonable activity against anaerobes . It inhibited all strains of Bacteroides fragilis at a concentration of 3.125 mg/l and the gram-positive anaerobes at 0.5 mg/l . In mice experimentally infected with various gram-positive and gram-negative bacteria, ofloxacin was more active than norfloxacin and pipemidic acid . With the gram-negative pathogens, orally administered ofloxacin was as active as gentamicin used parenterally . We conclude from our studies that ofloxacin could be a valuable therapeutic agent with a variety of indications.

Sci Sin {B}, 1983 Dec, 26(12), 1258 - 68
Effect of nifA product on suppression of Nif- phenotype of gln mutation and constitutive synthesis of nitrogenase in Klebsiella pneumoniae; Zhu JB et al.; This paper describes the role of nifA product on the ammonia regulation of nitrogen fixation in K . pneumoniae . A plasmid carrying nifA gene under the promoter of tetracycline resistance gene was constructed . When this nifA carrying plasmid was introduced into a glnAG mutant, the Nif- phenotype of this gln mutant was suppressed . Furthermore, when the plasmid was introduced into the wild type and glnAG mutant, derepression of nitrogenase synthesis in ammonia occurred in both strains and the products of nif genes can be detected by two-dimensional gel electrophoresis in the extracts of these ammonia-grown bacterial cells . The constitutive synthesis of nitrogenase in NH4+ was also demonstrated in free living nitrogen-fixing bacteria, Enterobacter cloacae, when the bacteria received the plasmid carrying nifA gene from K . pneumoniae.

Rev Rhum Mal Osteoartic, 1983 Nov, 50(11), 719 - 22
{Intestinal bacteria incriminated in reactive arthritis}; Lemeland JF; Amongst the numerous microbial species which constitute the intestinal flora, three bacteria belonging to the family of Enterobacteria have been incriminated in cases of reactive arthritis: the Salmonellae, the Shigellae and the Klebsiellae . These bacteria are easy to isolate and identify, but they are difficult to classify because of the multiplicity of serotypes and species . The participation of these bacteria in reactive arthritis is far from being clear: their isolation does not always have pathological significance, as these bacteria are usually opportunistic pathogens . The serological reactions must be interpreted with great reservation: antibody titers vary greatly between subjects and crossed reactions are common.

Isr J Med Sci, 1983 Nov, 19(11), 963 - 6
Neonatal bacteremia . A 4-year prospective study; Karpuch J et al.; During the 4-year period 1978-81, 14,527 neonates were born at Assaf Harofeh Hospital, including 793 (5.5%) premature infants . During the same period, 41 bacteremias were recorded, making an overall incidence rate of 2.8/1,000 live births . Thirty of the 41 bloodstream infections occurred in premature infants (incidence rate 38/1,000) and 11 in full-term infants (incidence rate 0.8/1,000) . The overall case fatality rate was 19.5%, and in the premature group it was 26.7% . Aside from prematurity, the most common underlying conditions were respiratory distress syndrome and prolonged rupture of membranes . Premature infants were at much greater risk of becoming bacteremic (relative risk 47) than were full-term infants . The risk increased with a decrease in the weight of the infants . Of 43 pathogens, 31 were gram-negative (72.3%), and 11 were gram-positive (25.4%) . The most common of the gram-negative pathogens belonged to the Klebsiella-Enterobacter group--19 of 43 (44.2%) . Among the gram-positive pathogens, Enterococcus was most common--4 of 43 (9.3%) . No increased incidence of Group B Streptococcus infections was noted . The Klebsiella-Enterobacter group had by far the highest incidence in our hospital, and the bacteremia caused by these pathogens was nosocomial in nature in all but one case.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Nov, 256(1), 103 - 8
Tween-esterase activity in Enterobacter sakazakii; Aldova E et al.; Seventy-one of 73 E . sakazakii strains isolated in Czechoslovakia produced Tween 80 esterase; its production was slower and less intensive than in Serratia, vibrios and aeromonads . The E . sakazakii strains did not produce lecithinase (yolk reaction was negative for 8 days) . The following set of tests was recommended for verification of E . sakazakii identification: pigment (was produced by 100% of strains), Tween 80 esterase (was positive in 97.3%), mucate (negative in 100%) and sorbitol (negative in 100%).

Poult Sci, 1983 Nov, 62(11), 2169 - 75
Salmonella and other Enterobacteriaceae found in commercial poultry feed; Cox NA et al.; Poultry feed (mash and pelleted) and meat and bone meal samples were collected from commercial mills . All samples were analyzed for Enterobacteriaceae count (ENT) and Salmonella . The genus and species of the various Enterobacteriaceae present were also determined . The average ENT for mash, pelleted, and meal samples was log 4.1, .8, and 1.8/g, respectively . Enterobacteriaceae were present in 100, 60, and 92% and Salmonella in 58, 0, and 92% of the mash, pelleted, and meal samples, respectively . Overall, the Enterobacteriaceae most frequently isolated from all samples were Enterobacter agglomerans, Enterobacter cloacae, and Klebsiella pneumoniae . Although no Salmonella were found in the pelleted samples, the presence of other Enterobacteriaceae suggests that commercial pelleting may not totally destroy Salmonella since their heat resistance is similar to the other organisms found.

J Clin Microbiol, 1983 Nov, 18(5), 1079 - 83
O serotyping scheme for Enterobacter cloacae; Gaston MA et al.; A serotyping scheme for Enterobacter cloacae based on heat-stable somatic antigens is described . A total of 28 antisera were prepared in rabbits, and titers of agglutinins were high (greater than 640) . Some cross-reactions were observed, and 11 sera required absorption before routine use . Of 300 clinical isolates from 66 hospitals, 77.6% were typable, 11.4% were not agglutinated by any of the sera, and 11.0% were autoagglutinable in saline . The eight most frequent serotypes were O3 (21.3%), O8 (13.3%), O1 (7.6%), O13 (5.0%), O9 (4.7%), O10 (3.0%), O16 (3.0%), and O25 (3.0%).

Gan To Kagaku Ryoho, 1983 Nov, 10(11), 2377 - 81
{Sulbenicillin and amikacin for febrile patients with cancer--with special reference to granulocytopenia}; Sampi K et al.; Between March 1978 and March 1983 ninety-four episodes of fever in 56 mainly granulocytopenic patients with cancer were treated empirically with a combination of sulbenicillin (5.0 g, every 6 hours) and amikacin (200 mg, every 6 hours) in Saitama Cancer Center . Profound granulocytopenia at the beginning of treatment (less than 100/mm3 of granulocytes) was present in 66% of the patients . Oral absorbable or nonabsorbable antibiotics were used in 59 febrile episodes . WBC transfusion was not given . The response rate for all documented infections was 75%, including 10 of 13 (77%) of bacteremias . The majority of infections with identified organisms were caused by aerobic gram-negative bacilli: the major gram-negative pathogens being Ps . aeruginosa (11 cases), Klebsiella spp . (7 cases), E . coli (7 cases) and Enterobacter spp . (7 cases) . The response rate of gram-negative bacilliary infections was 74% . Pneumonia responded less satisfactorily than all other types of infection with the response rate of 20% . The response rate of 69% for profound persistent granulocytopenia (less than 100/mm3 of granulocytes without a rise during therapy) is higher than that of any other reports . The most common adverse effect was hepatotoxicity (19%), whereas oliguria or anuria occurred in two patients, by which they eventually expired.

J Antimicrob Chemother, 1983 Nov, 12(5), 507 - 10
Plasmid-determined beta-lactamases identified in a group of 204 ampicillin-resistant Enterobacteriaceae; Roy C et al.; Information is presented on the plasmid-determined beta-lactamases identified in 204 strains of ampicillin-resistant Enterobacteriaceae . The type most frequently identified was TEM-1 (in 85.3% of the strains), followed by SHV-1 (14.70%) . Two types of plasmid-determined beta-lactamase were identified in 20 strains; in 18 of them one of the two was TEM-1 and in 13, SHV-1 (the TEM-1 + SHV-1 combination was observed in 12 strains) . In the 41 Klebsiella strains the most frequently identified enzyme was SHV-1 (in 28 of the strains) and the proportion of strains with two plasmid-determined beta-lactamases was higher than in the other species studied.

Infect Control, 1983 Nov-Dec, 4(6), 444 - 7
Mechanisms of antibiotic resistance and their dissemination of resistance genes in the hospital environment; Wiedemann B; The dissemination of resistance determinants among bacterial populations depends on ecological and epidemiological properties as well as additional factors: 1) the mechanism of resistance or its specificity toward a certain drug, and 2) the genetic basis in relation to the mobility of the genetic material and its survival in bacteria . From two resistance mechanisms directed toward old-fashioned drugs, namely sulfonamides (Su) and streptomycin (Sm), we can deduce that a resistance mechanism is encoded by a special sort of genetic material . Thus the linked SmSu resistance mediated by a sulfonamide-resistant dihydropteroatsynthetase II and the aminoglycoside phosphotransferase APH-(3") is always located on very small pBP1-like plasmids . Such plasmids survive without selective pressure of drugs in Enterobacteriaceae in the bowel flora of humans and animals . Both resistance determinants can be mediated by a transposon which codes for the production of a dihydropteroatsynthetase I in connection with an aminoglycoside adenylyltransferase AAD-(3") . These two mechanisms are genetically linked as well . The basic structure is a transposon designated Tn2411, which belongs to a whole family of transposons, all including the basic structure; however, their genetic exchange and substitution leads to structures coding for many different enzymatic characters: ANT-(2") (Gentamicin resistance), CAT (Chloramphenicol resistance), AAC-(6') (resistance to all modern aminoglycosides), TEM-1, OXA-1, OXA-2, or PSE (beta-lactam resistance) . Resistance to the modern beta-lactamase-stable antibiotics is mediated by mutation in the regulatory genes of chromosomally-determined beta-lactamases . A spread of these resistance mechanisms can be avoided as long as the responsible genes are not located on sufficient structures like small plasmids or efficient transposons.

Infection, 1983 Nov-Dec, 11(6), 326 - 8
Activity of ciprofloxacin (BAYo 9867) against Pseudomonas aeruginosa and ampicillin-resistant Enterobacteriaceae; Roy C et al.; We studied the in vitro activity of ciprofloxacin against 570 strains of ampicillin-resistant Enterobacteriaceae and 286 Pseudomonas aeruginosa strains . 95.26% of the Enterobacteriaceae and 53.45% of the P . aeruginosa were inhibited by 0.1 mg/l of ciprofloxacin . 2 mg/l of ciprofloxacin inhibited all of the Enterobacteriaceae strains and 4 mg/l all of the P . aeruginosa . We compared the activity of ciprofloxacin with that of temocillin in the Enterobacteriaceae strains . In the P . aeruginosa strains, classified according to their susceptibility to carbenicillin and gentamicin, we compared the activity of ciprofloxacin with that of ceftazidime . In the strains studied, the in vitro activity of ciprofloxacin is superior to that of temocillin against the Enterobacteriaceae and to that of ceftazidime against the P . aeruginosa strains.

Vet Immunol Immunopathol, 1983 Nov, 5(1), 65 - 76
Failure of Brucella abortus lipopolysaccharide (LPS) to activate the alternative pathway of complement; Hoffmann EM et al.; Bovine erythrocytes (E) coated with either crude or purified preparations of Brucella abortus LPS were not lysed by human complement (C) in the presence of the chelating agent ethyleneglycol-bis-N, N'-tetraacetic acid (EGTA) . On the other hand, bovine red cells coated with Salmonella typhimurium LPS were lysed by human C in EGTA . B . abortus LPS preparations did not cause fluid phase human C consumption in the presence of calcium and magnesium ions . However, as expected, S . typhimurium LPS consumed C from human serum in a dose-dependent fashion . The results of these experiments indicate that B . abortus LPS differs from the Enterobacterial LPSs in that it cannot activate the alternative pathway of C in human serum . Furthermore, the failure of B . abortus LPS to consume C in the fluid phase in the presence of calcium and magnesium ions suggests that the LPS cannot cause antibody-independent activation of the classical pathway.

Arch Microbiol, 1983 Nov, 136(2), 131 - 6
On the redox control of synthesis of anaerobically induced enzymes in enterobacteriaceae; Pecher A et al.; Mutants of Escherichia coli were isolated in which transcription of the structural genes for hydrogenase (hyd) and for one of the components of formate dehydrogenase (fdh) (of the formate hydrogen-lyase complex) is coupled with that of the lacZ gene . They were--together with lac fusions of the nifH and nifL genes from Klebsiella--used to study regulation by redox control, of the expression of the respective structural genes . The following results were obtained: (i) beta-galactosidase synthesis was fully repressed in the presence of O2 or nitrate (anaerobically), and induced in the absence of an external electron acceptor . Fumarate as terminal electron acceptor only marginally affected nif expression and partially repressed hyd and fdh expression . Redox control of the synthesis of hydrogenase and formate dehydrogenase, therefore, (as well as that of nif) acts at the level of transcription; the size of the redox potential seems to be correlated with the amount of repression; (ii) beta-galactosidase synthesis in the hyd:: lac and fdh::lac fusion strains is induced by formate . At high concentrations formate reverses the repression by nitrate and fumarate but not that by oxygen.

Infection, 1983 Nov-Dec, 11(6), 315 - 7
Transferable resistance to cefotaxime, cefoxitin, cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and Serratia marcescens; Knothe H et al.; In conjugational crosses, three Klebsiella pneumoniae strains and one Serratia marcescens strain have been demonstrated to transfer resistance determinants to newer types of cephalosporins . While Klebsiella strains donated cefotaxime, cefamandole and cefuroxime resistance to Escherichia coli K-12 recipients, the genetic analysis of exconjugants after the transfer of plasmids from Serratia strains to Proteus or Salmonella recipients showed that the cefoxitin resistance determinant was also co-transferred . In subsequent transfer cycles of this plasmid, cefotaxime and cefoxitin resistance determinants segregated in contrast to the relative stability of plasmids derived from Klebsiella strains in subsequent transfer cycles . From results obtained in this study, it may be concluded that in some strains of nosocomial Enterobacteriaceae, resistance to newer cephalosporins could be transmissible and thus plasmid-located.

J Antibiot (Tokyo), 1983 Nov, 36(11), 1507 - 15
N-(functionalized alkyl) derivatives of 6-aminopenicillanic acid: a new series of specific inhibitors of beta-lactamase from Enterobacter cloacae P99; Calverley MJ et al.; Eight of nine new N-alkylaminopenicillanic acids (7a approximately c, e approximately j), prepared via efficient direct monoalkylation reactions, were found to be specific inhibitors of cephalosporinase P99 with IC50 less than or equal to 4 mg/liter, while representative corresponding S-oxidized derivatives were less active.

Antimicrob Agents Chemother, 1983 Nov, 24(5), 754 - 63
In vitro activity of enoxacin, a quinolone carboxylic acid, compared with those of norfloxacin, new beta-lactams, aminoglycosides, and trimethoprim; Chin NX et al.; Enoxacin is a new quinolone carboxylic acid compound . Its activity against 740 bacterial isolates was determined . It inhibited 90% Escherichia coli, Klebsiella sp., Aeromonas sp., Enterobacter spp., Serratia spp., Proteus mirabilis, and Morganella morganii at less than or equal to 0.8 micrograms/ml . The majority of Pseudomonas aeruginosa was inhibited by less than or equal to 3.1 micrograms/ml . Haemophilus spp . and Neisseria spp . were inhibited by less than 0.1 micrograms/ml . Although most Staphylococcus aureus were inhibited by 3.1 micrograms/ml, some streptococcal species had minimal inhibitory concentrations of 6.3 to 12.5 micrograms/ml and Bacteroides sp . had minimal inhibitory concentrations greater than or equal to 25 micrograms/ml . Activity of enoxacin and norfloxacin was similar . Enoxacin inhibited organisms resistant to cefotaxime, moxalactam, gentamicin, and piperacillin . Enoxacin was less active in urine at an acid pH than in broth, but serum did not decrease minimal inhibitory concentrations or minimal bactericidal concentrations . There was no major difference between minimal inhibitory concentrations and minimal bactericidal concentrations . Resistance frequency development was less than 10(-9) for most bacterial species.

Rev Infect Dis, 1983 Nov-Dec, 5 Suppl 5, S941 - 9
Composition and structure of lipopolysaccharides from Pseudomonas aeruginosa; Wilkinson SG; Lipopolysaccharides from Pseudomonas aeruginosa seem to have the same general architecture as those from enterobacteria . Points of difference include the fatty acid composition and the unusually high degree of phosphorylation (triphosphate residues have been detected) . The outer region of the core oligosaccharides is also distinctive; its components are D-glucose, L-rhamnose, D-galactosamine, and possibly L-alanine . Lipopolysaccharide preparations contain a relatively low proportion of complete (S-form) molecules, but in some cases contain a significant proportion of molecules that have a single O-specific repeating unit attached to the core oligosaccharide . The O-specific side chains are typically rich in amino sugars, including novel types . Components identified so far are 2-amino-2-deoxyglucose, 2-amino-2-deoxygalactose, 2-amino-2,6-dideoxyglucose, 2-amino-2,6-dideoxygalactose, 2-amino-2-deoxygalacturonic acid, 2,4-diamino-2,4,6-trideoxyglucose, 2,3-diamino-2,3-dideoxyhexuronic acids (with the D-gluco-, D-manno-, and L-gulo-configurations), and 2,3-(2-methyl-2-imidazolino-5,4)-2,3-dideoxymannuronic acid . In some cases, polymeric material enriched in neutral sugars can be isolated from the O-specific fractions of partly degraded polysaccharides.

Jikken Dobutsu, 1983 Oct, 32(4), 213 - 6
{Change in the vaginal smear cycle following conventionalization and monocontamination of germ-free rats with Enterobacter cloacae}; Shinoda M et al.; The relationship between the microbial organism infection and the vaginal smear cycle was investigated using 12 germfree Wistar Imamichi rats at 50 days of age . Germfree rats exhibited continuous vaginal cornification which occasionally interrupted by the appearance of nucleated epithelial cells . However, leukocytes which are characteristic of the metestrus and diestrus stage in conventional rats were not observed in the vaginal smear of these animals . At 70 days of age, 8 animals were taken out from the germfree isolator and conventionalized . In other 4 animals, the vaginal lumen was contaminated with Enterobacter cloacae in the isolator . Within 3 days after the treatments, leukocytes appeared in the vaginal smear of all animals in both groups . Thereafter, these animals continued the regular 4 days vaginal cycle to 90 days of age, at which the observation was terminated . The above results suggested that the appearance of leukocytes in the vaginal smear in the rat is closely related to the bacterial colonization in the lumen, together with the action of the progesterone secreted from the ovary.

Microbiologica, 1983 Oct, 6(4), 355 - 8
Possible diagnostic value of aminopeptidases detected by chromogenic substrates in Enterobacteriaceae; Giammanco G et al.; The presence of aminopeptidases revealed by three chromogenic substrates (chromozym PL, chromozym TH, and carbobenzoxy-glycyl-prolyl-arginine-p-nitranilide) has been investigated by a simple method in 153 strains of different genera and species of the family Enterobacteriaceae . The results suggest that the AP-PL, AP-TH, and AP-CGPA tests can be of diagnostic value for the identification of enterobacteria.

J Antibiot (Tokyo), 1983 Oct, 36(10), 1252 - 7
Two new monobactam antibiotics produced by a Flexibacter sp . I . Taxonomy, fermentation, isolation and biological properties; Cooper R et al.; Two new beta-lactam antibiotics, namely SQ 28,502 and SQ 28,503, have been isolated from fermentations of a Flexibacter sp . They are demethoxy monobactams with oligopeptide side chains and have molecular weights of 1,462 and 1,446, respectively . These beta-lactams show a high degree of stability to a variety of beta-lactamases and act as potent irreversible inactivators of P99 beta-lactamase from Enterobacter cloacae . They exhibit weak antibacterial activity.

J Trauma, 1983 Oct, 23(10), 882 - 90
Effect of circulating fibronectin on stimulation of leukocyte oxygen consumption and serum opsonizing function in burned patients; Dobke MK et al.; In a study of 27 thermally burned patients (mean TBSA, 58%; range, 32-96%) serum fibronectin levels were decreased with parallel decreased oxygen consumption of stimulated peripheral blood phagocytes and decreased EGTA-blocked burn serum opsonizing activity which correlated with serum fibronectin changes postburn . Normal and burn sera fibronectin content also correlated with the opsonizing times for zymosan and Staphylococcus aureus but not for Enterobacteriaceae . Although in vivo 14 cases showed circulating fibronectin 140 micrograms/ml or lower and a marked decrease in Staphylococcus aureus opsonization, only two patients from this group revealed positive Staphylococcus aureus blood cultures and serum fibronectin levels were higher in patients with Staphylococcus aureus sepsis than in patients with Enterobacteriaceae sepsis . Supplementary experiments on leukocyte oxidative response after zymosan stimulation in normal, fibronectin-depleted, and fibronectin-reconstituted serum demonstrated that the lag period of oxygen burst is a fibronectin-dependent reaction.

Am J Gastroenterol, 1983 Oct, 78(10), 641 - 4
Antibiotic penetration in liver infection: a case of tobramycin failure responsive to moxalactam; Schentag JJ et al.; A 23-year-old man sustained a severe liver laceration which subsequently became infected with Enterobacter aerogenes . Blood cultures were positive for this organism and the patient experienced sepsis . Over the course of 18 days, his bilirubin and serum creatinine increased from normal to 40 and 2.7 mg/dl, respectively . Tobramycin, clindamycin, and penicillin failed to control the infection despite in vitro sensitivity of the organism to tobramycin . Moxalactam was started as a last resort, and the symptoms of infection resolved in 12 h . Both hepatic and renal function returned to normal, and the patient was discharged without complications . Moxalactam concentrations in wound fluid exceeded serum concentrations and the usual minimum inhibitory concentration of the infecting organism . A likely explanation for response to moxalactam, in face of tobramycin failure, was that moxalactam was able to reach the site of infection.

J Infect Dis . 1983 Oct;148(4):765.
Nonspecific induction of beta-lactamase in Enterobacter cloacae; Cullmann W et al.; Since the introduction of the new beta-lactamase-stable beta-lactam compounds, inducible beta-lactamases have become increasingly important clinically {1} . It has recently been pointed out that most beta-lactam antibiotics appear to be affected by these derepressed enzymes either by hydrolysis or by the nonhydrolytic barrier mechanism {2} . Until now, it has generally been assumed that beta-lactamases are induced only by the beta-lactam compounds themselves . We investigated an E cloacae strain that exhibited high levels of resistance to most beta-lactam antibiotics . (MICs were greater than 32 micrograms/ml, except for N-formimidoyl thienamycin and the penem compound Sch 29482) . Spontaneous production of beta-lactamase (after overnight culture in Isosensitest broth) was only marginal . However, the induction potency of Schaedler's broth even exceeded that of cefoxitin, which is known to be a good inducer {2} . We evaluated the induction potency of various cyclic compounds, such as amino acids, vitamins, purine derivatives, and steroid hormones . Only tryptophane, thiamine, folic acid, and hemine proved to be effacious inducers . Consequently, we explored the possibility that biological fluids also exhibit induction potency . The addition of inactivated serum (at a concentration of 25%) to the Isosensitest medium led to an enzyme induction comparable to that of cefoxitin . Similar results could be obtained with the addition of pleural fluid, CSF, or urine . These observations confirm the previous report that Morganella morganii strains produced considerable amounts of beta-lactamase even in a group of animals that did not receive treatment with beta-lactam compounds (granuloma pouch model) {3}.(ABSTRACT TRUNCATED AT 250 WORDS)

J Gen Microbiol, 1983 Oct, 129 (Pt 10), 3121 - 37
Vero cell toxins in Escherichia coli and related bacteria: transfer by phage and conjugation and toxic action in laboratory animals, chickens and pigs; Smith HW et al.; Sixty-eight of 519 strains of Escherichia coli and six of 10 strains of Pseudomonas aeruginosa produced toxins acting on Vero cells (VT+); all of 63 Salmonella, Shigella, Klebsiella, Enterobacter and Proteus strains were VT- . Most of the VT+ E . coli strains were from weaned pigs suffering from oedema disease and/or diarrhoea and belonged to serogroups O141:K85,88, O141:K85, O138:K81, and O139:K82; six VT+ E . coli strains were from diarrhoeic human babies, four of serogroup O26 and two of serogroup O128 . The VT genes in two of the O26 strains and in the O128 strains were located in the genome of the phages with which they were lysogenized . One O141:K85,88 pig E . coli strain transferred its VT genes, probably by conjugation, to E . coli K12 . The VTs of the human E . coli strains, the pig E . coli strains and the P . aeruginosa strains were antigenically different from each other; unlike the others, the P . aeruginosa VT was heat-resistant . Cell-free preparations of cultures of E . coli K12 to which the VT genes of the four human E . coli strains had been transferred caused fluid accumulation in ligated segments of rabbit intestine . Inoculated intravenously, they were lethal for mice and rabbits; similar preparations of E . coli K12 to which the VT genes of the pig E . coli strain had been transferred produced a disease in pigs that clinically and pathologically resembled oedema disease.

J Antimicrob Chemother, 1983 Oct, 12 Suppl C, 97 - 104
Effects of clindamycin on derepression of beta-lactamases in gram-negative bacteria; Sanders CC et al.; Depression of beta-lactamases in certain non-fastidious Gram-negative bacilli has been responsible for (i) the rapid development of resistance to a variety of beta-lactam antibiotics and (ii) antagonism between beta-lactam antibiotics . Therefore, the effects of a variety of inhibitors of macro-molecular synthesis on derepression of beta-lactamase were investigated with four strains each of enterobacter and Pseudomonas aeruginosa . When tested at concentrations that were not inhibitory to growth, clindamycin was the most effective inhibitor of derepression of beta-lactamases in some of the strains examined . In one enterobacter isolate, clindamycin completely prevented derepression of beta-lactamases . This effect was highly specific as clindamycin did not influence constitutive beta-lactamase or depression of other inducible enzymes in this same strain . These results suggest that clindamycin may selectively inhibit synthesis of beta-lactamase under repressor control in some bacteria without affecting synthesis of other proteins or replication . Such selective inhibition may provide a new approach for the enhancement of the antibacterial activity of certain beta-lactam antibiotics.

Ann Ophthalmol, 1983 Oct, 15(10), 949 - 52
Corneal abscesses in silicone and soft contact lens wearers; Rosner M et al.; Fourteen cases of corneal abscesses in wearers of contact lenses were seen in our department during the last 3 years . The hospitalization period varied from a few days to seven weeks . In one case, it was necessary to perform penetrating keratoplasty in order to restore good vision . Cultures taken from the corneal abscesses were positive in six cases . Pseudomonas was found in five cases and Enterobacter in one case . During the three years of the survey, no hard contact lens wearers with corneal abscesses were hospitalized . Wearers of silicone contact lenses comprised 21.4% of the cases with corneal abscess . This is a high percentage considering the fact that these lenses are very rare among contact lens wearers in Israel.

J Antibiot (Tokyo), 1983 Oct, 36(10), 1387 - 95
Induction of cephalosporinase production by various penicillins in enterobacteriaceae; Minami S et al.; The inducer activity of seven penicillins for cephalosporinase (CSase) production and their antibacterial activity against CSase-producing strains were studied using clinical isolates of Proteus morganii, P . rettgeri, P . vulgaris, Enterobacter cloacae, and Serratia marcescens . Piperacillin, apalcillin, and methicillin showed rather low inducer activity for CSase production in all strains tested . On the other hand, ampicillin, carbenicillin, and sulbenicillin showed high inducer activity for CSase production . Piperacillin, apalcillin, and ampicillin were less stable to CSases than were carbenicillin, sulbenicillin, and methicillin, but much more stable than benzylpenicillin . In the growing culture of CSase-producing strains, piperacillin and apalcillin were rather stable . Against CSase-producing strains, piperacillin and apalcillin were more active than other penicillins tested.

Int J Appl Radiat Isot, 1983 Oct, 34(10), 1441 - 3
Sterilization of MacConkey agar and CLED medium by gamma-radiation; Bogokowsky B et al.; MacConkey agar and Cystine-Lactose-Electrolyte-Deficient (CLED) agar, media widely used in the bacteriological laboratory and recommended for the detection of urinary tract infections, were sterilized by gamma-radiation at a dose of 1.5 Mrad . Both were modified and adapted to radiation sterilization by adding sodium thioglycollate as a radioprotectant, and by increasing their indicator content . The media performed well when tested with different Enterobacteria and other micro-organisms . Growth and change of indicator reaction were equal in irradiated and autoclaved culture media . Culture media were also evaluated after storage for one month at room temperature and at 4 degrees C and compared well with freshly autoclaved media.

J Clin Microbiol, 1983 Oct, 18(4), 983 - 5
Accuracy of the KOH and vancomycin tests in determining the Gram reaction of non-enterobacterial rods; von Graevenitz A et al.; Two nonstaining tests for the Gram reaction, the KOH and vancomycin disk (5 micrograms) tests, were employed on 488 strains of aerobic gram-negative and gram-positive rods . Since each test may yield false results with certain species, the use of a combination is suggested.

Drugs, 1983 Oct, 26(4), 279 - 333
Moxalactam (latamoxef) . A review of its antibacterial activity, pharmacokinetic properties and therapeutic use; Carmine AA et al.; Moxalactam (latamoxef) is a new synthetic oxa-beta-lactam antibiotic administered intravenously or intramuscularly . It has a broad spectrum of activity against Gram-positive and Gram-negative aerobic and anaerobic bacteria, is particularly active against Enterobacteriaceae and is resistant to hydrolysis by beta-lactamases . Moxalactam has moderate activity against Pseudomonas aeruginosa, but on the basis of present evidence can not be recommended as sole antibiotic treatment of known or suspected pseudomonal infections . Like the related compounds, the cephalosporins, moxalactam is effective in the treatment of complicated urinary tract infections and lower respiratory tract infections caused by Gram-negative bacilli . As moxalactam is also active against Bacteroides fragilis it has considerable potential in the treatment of intra-abdominal infections in patients with normal immunological mechanisms, as well as in immunocompromised patients, when used alone or in combination with other antibiotics . Likewise, its ready penetration into the diseased central nervous system, its high level of activity against Gram-negative bacilli, and the lack of necessity to monitor drug plasma concentrations, indicate its potential value in the treatment of neonatal Gram-negative bacillary meningitis . Further clinical experience is needed before it can be determined whether moxalactam alone can be used in the treatment of conditions for which the aminoglycosides are drugs of choice, but if established as equally effective, moxalactam has the advantage of being devoid of nephrotoxicity . Bleeding is a potentially serious problem, however, particularly in the elderly, malnourished and in the presence of renal impairment.

Biochem J, 1983 Oct 1, 215(1), 29 - 38
Resistance to fusidic acid in Escherichia coli mediated by the type I variant of chloramphenicol acetyltransferase . A plasmid-encoded mechanism involving antibiotic binding; Bennett AD et al.; Plasmid-encoded fusidic acid resistance in Escherichia coli is mediated by a common variant of chloramphenicol acetyltransferase (EC 2.3.1.28), an enzyme which is an effector of chloramphenicol resistance . Resistance to chloramphenicol is a consequence of acetylation of the antibiotic catalysed by the enzyme and the failure of the 3-acetoxy product to bind to bacterial ribosomes . Cell-free coupled transcription and translation studies are in agreement with genetic studies which indicated that the entire structural gene for the type I chloramphenicol acetyltransferase is necessary for the fusidic acid resistance phenotype . The mechanism of resistance does not involve covalent modification of the antibiotic . The other naturally occurring enterobacterial chloramphenicol acetyltransferase variants (types II and III) do not cause fusidic acid resistance . Steady-state kinetic studies with the type I enzyme have shown that the binding of fusidic acid is competitive with respect to chloramphenicol . The inhibition of polypeptide chain elongation in vitro which is observed in the presence of fusidic acid is relieved by addition of purified chloramphenicol acetyltransferase, and equilibrium dialysis experiments with {3H}fusidate and the type I enzyme have defined the stoichiometry and apparent affinity of fusidate for the type I enzyme . Further binding studies with fusidate analogues, including bile salts, have shown some of the structural constraints on the steroidal skeleton of the ligand which are necessary for binding to the enzyme . Determinations of antibiotic resistance levels and estimates of intracellular chloramphenicol acetyltransferase concentrations in vivo support the data from experiments in vitro to give a coherent mechanism for fusidic acid resistance based on reversible binding of the antibiotic to the enzyme.

Eur J Clin Microbiol, 1983 Oct, 2(5), 501 - 4
Pharmacokinetic and microbial susceptibility studies of ceftriaxone; Baumgartner JD et al.; The in vitro activity of ceftriaxone, a new parenteral cephalosporin, was tested against 450 strains isolated from blood cultures and compared with that of various other antibiotics . The compound was comparable to cefotaxime for all species tested . It was more potent than cefoperazone, cefamandole and ticarcillin in inhibiting Enterobacteriaceae (Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, indole-positive Proteus spp . and Serratia marcescens) . The MIC95 of ceftriaxone for these strains was 0.5 microgram/ml . The drug was less active against Staphylococcus aureus than cefamandole, cloxacillin and vancomycin, but most isolates were inhibited by 4 micrograms/ml . Against Pseudomonas aeruginosa, ceftriaxone was comparable in activity to ticarcillin (MIC95 = 64 micrograms/ml), and inferior to cefoperazone, ceftazidime and cefsulodine . Levels of ceftriaxone in serum and various body fluids were determined by bio-assays . Due to its very long half-life (8 h), ceftriaxone serum levels 24 h after i.v . or i.m . injection of 1 and 2 g were still above the MIC95 of all strains tested except Pseudomonas aeruginosa . Levels in bile, synovial and cerebro-spinal fluids were high.

Eur J Clin Microbiol, 1983 Oct, 2(5), 432 - 8
Synergy between the iron chelator deferoxamine and the antimicrobial agents gentamicin, chloramphenicol, cefalothin, cefotiam and cefsulodin; van Asbeck BS et al.; Synergy between the iron chelator deferoxamine in the presence or absence of ascorbic acid and gentamicin, chloramphenicol, cephalothin, cefotiam or cefsulodin, used against Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Klebsiella pneumoniae, proteus mirabilis and species of Salmonella, Enterobacter, Pseudomonas and Providencia, was determined by measuring the effect of the drugs and combination of drugs on growth of the bacteria in an automated turbidimeter . The combination of drugs was considered to be synergistic when the growth inhibiting effect of the combination was greater than that of the combined action of each of the drugs separately . Deferoxamine plus ascorbic acid together with either gentamicin or cefsulodin showed synergy in 10 out of 10, and 5 out of 6 cultures respectively, whereas deferoxamine plus ascorbic acid with chloramphenicol, cephalothin or cefotiam was synergistic in 6 out of 14, 5 out of 11, and 3 out of 6 cultures . This synergistic effect was much lower when microorganisms were incubated with deferoxamine combined with the various antibiotics but without ascorbic acid . Ascorbic acid alone had no synergistic effect . When deferoxamine was saturated with iron, its antibacterial effect was completely abolished.

Antimicrob Agents Chemother, 1983 Oct, 24(4), 568 - 74
In vitro activity of ciprofloxacin (Bay o 9867); Fass RJ; The in vitro activities of ciprofloxacin (Bay o 9867) and seven comparative antimicrobial agents against 664 aerobic and facultatively anaerobic bacterial isolates were studied . Minimal inhibitory concentrations (MICs) of ciprofloxacin were less than or equal to 2 micrograms/ml for Enterobacteriaceae, less than or equal to 8 micrograms/ml for nonfermentative gram-negative bacilli, less than or equal to 4 micrograms/ml for gram-positive cocci, less than or equal to 0.03 micrograms/ml for Aeromonas hydrophila and Pasteurella multocida, and less than or equal to 1 microgram/ml for Listeria monocytogenes . MICs for multi-drug-resistant Enterobacteriaceae and Pseudomonas aeruginosa were less than or equal to 4 micrograms/ml . Ciprofloxacin MICs were consistently 0 to 4 (usually 2 to 3) dilution steps lower than those of a related drug, norfloxacin (P less than 0.0001) . For most species, they were lower than MICs of cefotaxime, aztreonam, theinamycin, mezlocillin, trimethoprim-sulfamethoxazole, and amikacin . With all eight drugs, increasing the inoculum size by 100-fold had a variable effect on MICs which was species related . Ciprofloxacin is a potent broad-spectrum new antimicrobial agent.

Infect Immun, 1983 Oct, 42(1), 250 - 6
Common lipopolysaccharide specificity: new type of antigen residing in the inner core region of S- and R-form lipopolysaccharides from different families of gram-negative bacteria; Brade H et al.; A new antigenic specificity, referred to here as common lipopolysaccharide (LPS) specificity, is described in the LPSs of gram-negative bacteria belonging to various families . The specificity is present in S- and R-form LPS but absent in Re mutants of different enterobacterial genera . By the use of purified LPS and monospecific antibodies obtained by immunoabsorption, the specificity is differentiated from the known core specificities of the genus Salmonella and the lipid A specificity by aid of the passive hemolysis and passive hemolysis inhibition test . In Salmonella minnesota R-form LPS, the specificity may be cryptic (R345, Rb2 mutant) or partly exposed in the intact molecule (R7, Rd1 mutant) . The specificity is either demasked or completely exposed after mild acid hydrolysis for a short time, whereas it is destroyed after prolonged hydrolysis . Periodate oxidation, reduction, and hydrolysis under conditions that do not affect the ketosidic linkages of 2-keto-3-deoxyoctulosonic acid destroy the specificity in R4 (Rd2 mutant) LPS, but do not do so in R7 LPS . It is suggested that 2-keto-3-deoxyoctulosonic acid and a following neutral sugar are the compositional requirements for expressing the specificity.

Lancet, 1983 Sep 3, 2(8349), 529 - 32
Double-blind study to compare the selection of antibiotic resistance by amoxycillin or cephradine in the commensal flora; Lacey RW et al.; Elderly patients with acute urinary infections were treated in a double-blind study with either amoxycillin or cephradine . In 52 patients who had received amoxycillin for one week about a third of all intestinal Escherichia coli were highly resistant to amoxycillin, and many were resistant to tetracycline, trimethoprim, or chloramphenicol . Cephradine selected less resistance . At a week after completion of chemotherapy, cephradine-resistant E coli were replaced by sensitive cultures at a greater frequency than were amoxycillin-resistant E coli . Neither antibiotic altered the skin flora . Amoxycillin, but not cephradine, selected for Enterobacteriaceae in the saliva . The propensity of amoxycillin to select resistance in E coli will limit its usefulness in treating urinary infections.

Proc Soc Exp Biol Med, 1983 Sep, 173(4), 574 - 8
Production by various Pseudomonas species of a factor modifying the enterobacterial common antigen; Ramia S et al.; The enterobacterial common antigen (ECA) is a common determinant shared by almost all members of the family Enterobacteriaceae . The antigen modifies erythrocytes for agglutination by ECA antibodies . Previously it was reported that Pseudomonas aeruginosa produces a factor (PF) which destroys the erythrocyte-modifying capacity of ECA . The present investigation was undertaken to determine whether other species of this genus also produce PF . The passive bacterial hemagglutination and hemagglutination inhibition tests were used . It was observed that 47 strains belonging to 8 species of the genus Pseudomonas produce this factor and 34 strains representing 12 other species do not . Multiple strains of a given species gave concordant results . Mucoid variants of P . aeruginosa produced more of this factor than did nonmucoid isolates recovered from the identical sputum specimens from patients with cystic fibrosis . ECA treated with PF no longer modifies erythrocytes for agglutination by ECA antibodies and exerts less antibody-neutralizing capacity than untreated antigen.

J Lab Clin Med, 1983 Sep, 102(3), 392 - 9
Detection of a specific bacterial antigen in urine of rats with Bacteroides fragilis infection; Rissing JP et al.; Human intra-abdominal infections frequently yield Bacteroides fragilis and require specific antimicrobial and surgical therapy . Noninvasive immunologic assessment of this organism might allow more optimum therapy . Therefore we raised antisera in goats to Bacteroides fragilis ATCC 23745 and allowed it to react with a solid-phase capsular polysaccharide-protein antigen extracted from the same organism . Preliminary work disclosed that 10 ng/ml antigen could be detected in competition assays in both saline and dialyzed rat urine . Results were manifest by diminution of bound antiglobulin alkaline phosphatase conjugate in an antigen-mediated antibody-inhibition enzyme-linked immunosorbent assay . Rats were then infected intra-abdominally with (1) B . fragilis ATCC 23745; (2) one of eight recent clinical isolates of B . fragilis; or (3) one of nine isolates representative of Enterobacteriaceae . Seventy-two rat urine samples obtained prior to infection disclosed essentially no assay inhibition: 98.3% +/- 10.3 (1 S.D.) . Mean values of reagent antibody activity after incubation with urine aliquots from 24 hr samples collected between 24 and 72 hr were (1) strain 23745 (n = 35) 70.9% +/- 2.6 (S.E.); (2) eight isolates of B . fragilis (n = 49) 86.8% +/- 1.9; (3) nine isolates of Enterobacteriaceae (n = 47) 100.9% +/- 1.0; and (4) shams (n = 29) 95.5% +/- 1.55 . Ascribing values less than or equal to 77.7% (2 S.D.) as positive, seven of the eight clinical B . fragilis isolates causing infection were detected in at least one 24 hr urine sample (sensitivity = 87% by organism); 12 of 17 infected rats were correctly identified as positive by at least one urine (sensitivity = 70.6% by rat) . Specificity, as assessed in the Enterobacteriaceae group, was 89% (by organism) and 94.5% (by rat) . Collectively, these results suggest the presence of a potentially specific, soluble antigen excreted in the urine of rats with B . fragilis infection.

Antimicrob Agents Chemother, 1983 Sep, 24(3), 321 - 4
Aztreonam, cefoperazone, and gentamicin in the treatment of experimental Enterobacter aerogenes endocarditis in rabbits; Kobasa WD et al.; The effectiveness of aztreonam, cefoperazone, and gentamicin alone and in combination was evaluated in Enterobacter aerogenes endocarditis in rabbits . The minimal inhibitory concentration/minimal bactericidal concentration ratios for E . aerogenes were as follows: aztreonam, 0.4/0.4 microgram/ml; cefoperazone, 0.8/0.8 microgram/ml; and gentamicin, 3.1/3.1 micrograms/ml . With an inoculum of 10(9) organisms per ml, aztreonam and cefoperazone were equivalent in reducing titers of E . aerogenes in broth, and both drugs demonstrated an increased rate of reduction when gentamicin was added; gentamicin alone was least effective . E . aerogenes endocarditis in rabbits was treated intramuscularly with aztreonam (60 mg/kg) every 6 h, with cefoperazone (60 mg/kg) every 6 h, with gentamicin (1.7 mg/kg) every 8 h, and with aztreonam plus gentamicin or cefoperazone plus gentamicin for 5 and 10 days, respectively . All of the therapeutic regimens were effective in reducing vegetation titers as compared with untreated controls . Aztreonam plus gentamicin was more effective than either aztreonam or gentamicin alone . Cefoperazone plus gentamicin was more effective than cefoperazone alone but was not more effective than gentamicin alone . Neither aztreonam and cefoperazone nor aztreonam and gentamicin differed significantly, but gentamicin was significantly more effective than cefoperazone . Aztreonam plus gentamicin did not differ significantly in effectiveness from cefoperazone plus gentamicin . Aztreonam gave a peak level of about 135 micrograms/ml and a half-life of 0.7 h . Cefoperazone gave a peak level of about 155 micrograms/ml and a half-life of 1.1 h . Gentamicin gave a peak level of 7.4 micrograms/ml and a half-life of 1.3 h.

J Dairy Sci, 1983 Sep, 66(9), 1825 - 34
Isolation and identification of ropy bacteria in raw milk; Cheung BA et al.; Approximately 4.2% of 4,000 Maryland-Virginia raw milk tanker samples developed ropiness when incubated at 10 degrees C . Of the 56 bacterial isolates 30 were identified by species . Klebsiella oxytoca and Pseudomonas aeruginosa were isolated most frequently . Other ropy isolates were identified as Pseudomonas spp., Chromobacterium, Flavobacterium multivorum, presumptive Yersinia pestis, Enterobacter agglomerans, Klebsiella pneumoniae, and Pasteurella-Actinobacter spp . Six of the Klebsiella oxytoca isolates were mesophilic (optimum temperatures of 32.0 to 37.8 degrees C) with two isolates having psychrotrophic tendencies (optimum temperature of 26.8 degrees C) . All Pseudomonas aeruginosa isolates appeared to be psychrotropic in their temperature requirements (optimum temperature of 23.0 to 31.0 degrees C) . Klebsiella oxytoca was significant in preliminary development of the ropy condition . All Klebsiella oxytoca isolates developed ropiness within 24 h . The Pseudomonas spp . and Klebsiella pneumoniae isolates required at long as 7 days to develop detectable ropiness at 10 degrees C . A recommended Klebsiella oxytoca differentiation agar is presented as a rapid screening method during outbreaks where Klebsiella oxytoca is the organism of significance.

J Clin Microbiol, 1983 Sep, 18(3), 727 - 9
Polymicrobial bacteremia caused by Ewingella americana (family Enterobacteriaceae) and an unusual Pseudomonas species; Pien FD et al.; Ewingella americana and a Pseudomonas species were isolated from three sets of blood cultures from a 41-year-old patient after coronary bypass surgery . This is the first well-described case of bacteremia due to E . americana . Based on data from 31 strains, a detailed description of E . americana is given.

J Clin Microbiol, 1983 Sep, 18(3), 472 - 5
Rapid species identification and biotyping of respiratory isolates of Haemophilus spp; Matthews JS et al.; Three commercially available systems, the 4-h Minitek Enterobacteriaceae III, the Haemophilus Trio-Tube, and the Micro-ID, were evaluated for their capacities to identify and biotype 308 respiratory isolates of Haemophilus spp . When compared with aminolevulinic acid test results, the definitive identification method used in this study, these systems demonstrated no significant differences in their capacities to differentiate Haemophilus influenzae from Haemophilus parainfluenzae . They were in agreement with the standard method of species identification approximately 50% of the time . When sucrose was added to the Minitek and Trio-Tube configurations, the efficiency rate of species identification increased to more than 95% . The Micro-ID could not be modified to incorporate this additional biochemical parameter . The performance of the sucrose-supplemented Minitek and Trio-Tube systems, compared to the combined results of Micro-ID and aminolevulinic acid, produced correlations of 94 and 90%, respectively . Rapid and accurate methodologies are available for combined species identification and biotyping of Haemophilus spp.

J Antimicrob Chemother, 1983 Sep, 12(3), 265 - 7
Differential susceptibility of Aeromonas hydrophila and Enterobacteriaceae to nalidixic acid; Zemelman R et al.; The susceptibility of 49 strains of Aeromonas hydrophila and 77 strains of Enterobacteriaceae towards nalidixic acid was compared by tube dilution and agar diffusion methods . A higher susceptibility was exhibited by Aerom . hydrophila and no overlap in MICs was found for strains of the two groups of microorganisms . Discs containing 0.25 microgram of nalidixic acid produced measurable zones of growth inhibition with Aerom . hydrophila and no zones with the Enterobacteriaceae . The use of a disc with 0.25 microgram of nalidixic acid for the primary differentiation of strains of Aerom . hydrophila from those of the Enterobacteriaceae with similar biochemical properties is suggested.

J Antimicrob Chemother, 1983 Sep, 12(3), 209 - 17
Netilmicin 150 mg every 12 hours in systemic infections; Haverkorn MJ; Most (76%) of the 284 gentamicin-resistant Enterobacteriaceae isolated from patients hospitalised in Eindhoven or its vicinity proved to be sensitive to netilmicin . The sensitivity rate was 96% for amikacin and 97% for cefotaxime . Thirty-four patients with systemic infections and isolation of netilmicin-sensitive Enterobacteriaceae were treated with 150 mg netilmicin intravenously every 12 h . All except one patient reacted favourably . The patient who did not had a netilmicin-sensitive Escherichia coli septicaemia which recurred during treatment . The treatment was well tolerated . No ototoxicity or permanent nephrotoxicity were noted . Although the variation of serum levels was as great for netilmicin as has been reported for other aminoglycosides, they were in general within acceptable limits . In patients with reduced renal function peak levels above 16 mg/l were found five times more frequently than in patients with normal renal function . However, serum levels should also be monitored in patients with normal renal function.

Antibiotiki, 1983 Sep, 28(9), 665 - 71
{Screening of beta-lactamase inhibitors among representatives of the genus Micromonospora and the genus Streptoverticillium}; Bibikova MV et al.; A total of 123 cultures of the genus Micromonospora and 89 cultures of the genus Streptoverticillium were studied for their capacity to produce beta-lactamase inhibitors . It was shown that streptoverticilla were highly resistant to beta-lactam antibiotics . No organisms producing beta-lactamase inhibitors were detected among the cultures of this genus . As for Micromonospora, 30 cultures (24.4 per cent) of this genus produced inhibitors . They were most frequently isolated from orange and brown cultures of Micromonospora . The inhibitors had no antibacterial activity, inhibited beta-lactamases of gram-negative bacteria and did not inhibit exogenic beta-lactamases of staphylococci . Their inhibitory activity was evident only with the use of isolated enzymes . With the use of intact growing cultures of gram-negative bacteria producing the same enzymes (Pseudomonas, Klebsiella, Enterobacter) no inhibitory activity was observed . Though the inhibitors had some features in common, they did not seem to be similar, since they had different spectra with respect to their effect on various beta-lactamases of gram-negative bacteria.

J Hand Surg {Am}, 1983 Sep, 8(5 Pt 1), 560 - 2
Cefamandole therapy in hand infections; Robson MC et al.; Hand lacerations, especially when inadequately treated, may result in infections caused by aerobic or anaerobic bacteria . Anaerobic infections most commonly result from human bite injuries in which there is contact between hand and mouth . The search continues for an ideal antibiotic to employ when anaerobic organisms are suspected . In this study cefamandole, a new cephalosporin antibiotic, was employed whenever anaerobic hand infections were suspected following trauma . In each patient quantitative cultures for both aerobic and anaerobic organisms were obtained . All organisms isolated were tested by standard susceptibility assays for both aerobes and anaerobes . In the case of anaerobes, minimum inhibitory concentration assays were also performed . After the initial culture was obtained, each patient received approximately 1.5 gm of cefamandole every 6 hours for a period of 5 days . This therapy was changed only if susceptibility studies indicated resistance to cefamandole . In our patients, 58% of the infectious organisms were aerobic and facultative anaerobic and 42% were obligate anaerobes . The predominant organisms isolated were Staphylococcus aureus and Peptostreptococcus anaerobius, which accounted for 42% of the infections . In most of the aerobic infections a single organism was isolated, whereas multiple organisms were identified in the anaerobic infections . All but one of the infections responded to cefamandole; the one that didn't was caused by Enterobacter cloacae and required treatment with an aminoglycoside . Because of its broad-spectrum coverage, which includes both aerobes and anaerobes, cefamandole is useful in treating infections, especially those resulting from human bites.

Infection, 1983 Sep-Oct, 11(5), 260 - 3
{Microbiological studies before and after endoscopic papillotomy (EPT)}; Ansorg R et al.; A microbiological check-up was made on 17 patients with choledocholithiasis while they were undergoing EPT and control ERCP . The endoscopes were contaminated in 56% of the 34 procedures . In 9% of the interventions there were indications that mouth flora had been transferred to the duodeno-biliary region . Bacteriaemia occurred in 3 (17%) patients in connection with EPT . After a mean of four months following EPT, the colony count and the number of germs in the duodenal and biliary juice tended to increase; bacteria of the Klebsiella-Enterobacter-Serratia group became dominant . More than 80% of the bile and blood isolates were sensitive to cefotaxime, cefamandole and co-trimoxazole . To minimize the risk of infection following EPT and ERCP, repeated controls of the disinfection of the endoscopes and periendoscopic antibiotic prophylaxis are suggested.

Zh Mikrobiol Epidemiol Immunobiol, 1983 Sep, (9), 53 - 60
{Dynamics of enterobacterial multiplication in a mouse model of intraperitoneal infection in the presence of iron cations as dependent on the availability and type of K antigens}; Petrovskaia VG et al.; In this work the results of research on the influence of iron cations on the characteristics of the infectious process caused by different enterobacteria (Shigella sonnei, Shigella flexneri, Escherichia coli) are analyzed . In the experimental intraperitoneal infection of mice in the presence of saccharose and iron cations S . sonnei in phase I showed the decrease of 1g LD50 by 3-4 orders, while S . flexneri in the S-form, by not more than 1 order . The absence of correlation between the virulence of the Shigella species used for comparison, as determined in the keratoconjunctival test, and their behavior in vitro in the presence of iron was revealed . E . coli reference strains synthetizing (according to the nomenclature of I . Orskov et al.) "true" K-antigens (K1, K10) or "not true" ones (K8, K9, K27, K57) also showed different virulence in the experimental infection used in this research: the behavior of the former group corresponded to that of S . sonnei in phase I, the latter group occupied the intermediate position between the former group and S . sonnei on one hand and S . flexneri on the other hand . The sharp drop of 1g LD50 after the injection of S . sonnei in phase I in combination with iron cations can be attributed to differences in the characteristics of bacterial surface structures with antiphagocytic function and indicates that the species-specific antigen of S . sonnei in phase I should be classified with K-antigens . The experimental intraperitoneal infection of mice in the presence of trivalent iron cations can be used for making a tentative judgement on the presence of K-antigens in enterobacteria.

Zh Mikrobiol Epidemiol Immunobiol, 1983 Sep, (9), 50 - 3
{Influence of hemolytic plasmids on the development of the "killing" effect in various species of enterobacteria}; Bondarenko VM et al.; Experiments on isogenic strains of different enterobacterial species, both carrying hemolytic plasmids and free from them, have demonstrated that their "killing" effect on mice is linked with the yield of hemolysin and does not depend on the origin of Hly plasmids or the chemotype of bacteria . Plasmid p IE 567 coding the synthesis of alpha-hemolysin has been shown to be capable of expression in Enterobacter aerogenes, Hafnia alvei and Salmonella typhimurium strains, but E . aerogenes 3/43, H . alvei alpha 773 and Escherichia coli J53 carrying p IE 567, in contrast to E . coli P 678 and S . typhimurium 415 carrying the same plasmid, produce less alpha-hemolysin and have no pronounced effect in reducing the survival time of intranasally infected mice.

Infection, 1983 Sep-Oct, 11(5), 275 - 9
The Antibacterial activity in vitro and beta-lactamase stability of the new cephalosporin HR 810 in comparison with five other cephalosporins and two aminoglycosides; Seibert G et al.; The antibacterial activity of the cephalosporin antibiotic HR 810 was evaluated in comparison with cefoperazone, cefotaxime, ceftazidime, ceftriaxone, latamoxef, gentamicin and amikacin against 1500 clinical isolates . HR 810 is the antibiotic with the broadest antimicrobial spectrum . It is also highly active against isolates of the genera Pseudomonas, Enterobacter, Staphylococcus and enterococci . HR 810 is very stable against hydrolysis by plasmid-coded and chromosomally coded beta-lactamases.

J Clin Microbiol, 1983 Sep, 18(3), 709 - 12
Viability of organisms held in the isolator blood culture system for 15 h and their rapid detection by acridine orange staining; Cashman JS et al.; Sets of three Isolator blood culture tubes were seeded with low numbers of 96 strains of 26 bacterial species (fresh and stock clinical isolates) . One tube was processed immediately, and the other two were held at 22 and 34 degrees C for 15 h before processing . Organism recovery was 99, 99, and 98%, respectively . Organism numbers increased at both 22 degrees C (60% of strains) and 34 degrees C (79% of strains) . Especially notable was that the increases were seen with most strains of Staphylococcus aureus, streptococcal species, Pseudomonas, and all of the Enterobacteriaceae tested . Seven strains, including Streptococcus pneumoniae and Haemophilus influenzae, although viable, were recovered with a decreased number of organisms at each temperature . Acridine orange staining detected organisms in 53% of those Isolator tubes being held and 71% of those demonstrating a numerical increase, after incubation at 34 degrees C . In addition, it was noted that after processing, 48% of the strains that had increased in number while being held at 34 degrees C resulted in visible growth on agar media in 6 h . The results suggest that up to a 15-h delay in processing Isolator tubes may be possible and that acridine orange staining for the rapid detection of positive cultures may be useful in such a circumstance.

Am J Med, 1983 Aug 29, 75(2A), 9 - 20
Penicillin-binding proteins and role of amdinocillin in causing bacterial cell death; Neu HC; The activity of penicillins against bacteria is in large part related to binding to specific receptor proteins involved in cell wall biosynthesis . These proteins have been designated penicillin-binding proteins . They can be separated into distinct entities through the use of acrylamide gel electrophoresis and binding of radioactive 14C-labeled penicillin G . Six major proteins have been defined in the Enterobacteriaceae, penicillin-binding proteins 1 to 6 . Selection of mutants has shown that there are three essential proteins: penicillin-binding protein 1, which is divided into penicillin-binding protein 1Bs, a peptidoglycan transpeptidase, and penicillin-binding protein 1A, which acts as a replacement for penicillin-binding protein 1Bs . Penicillin-binding protein 2 is a murein-elongation initiating enzyme and penicillin-binding protein 3 is a septal murein-synthesizing enzyme . Penicillin-binding proteins 4, 5, and 6 are not essential for bacterial survival . Binding of penicillins to penicillin-binding protein 1Bs produces lysis, binding to penicillin-binding protein 2 produces round cells, and binding to penicillin-binding protein 3 produces long filaments . Amdinocillin is a beta-amidino penicillanic acid derivative that binds specifically to penicillin-binding protein 2 . The compound is more beta-lactamase stable than ampicillin and has no major delay in entry into the periplasmic space as do some penicillins . Amdinocillin inhibits most of the Enterobacteriaceae, with the exception of some indole-positive Proteus species, but it does not inhibit gram-positive cocci or Pseudomonas aeruginosa . Amdinocillin produces spherical bacterial cells that eventually lyse . Its activity in vitro is markedly affected by ionic content of media . This agent acts synergistically with many penicillins, such as ampicillin, carbenicillin, and the like, and with cephalosporins, cefazolin, cefamandole, or cefoxitin to inhibit gram-negative bacilli, probably on the basis of binding to different proteins needed for the production of the peptidoglycan of the bacterial cell wall . Amdinocillin possesses a number of the essentials for effective antimicrobial activity and, by virtue of its enhancement of the activity of other beta-lactams, may prove to be a useful agent in the chemotherapy of certain infections.

Am J Med, 1983 Aug 29, 75(2A), 72 - 81
Review of clinical experience with amdinocillin monotherapy and comparative studies; Demos CH et al.; Activity against gram-negative bacilli and frequent synergism with other beta-lactam antibiotics were demonstrated by amdinocillin in urinary tract infections, urosepsis, and in a variety of other infections . In a prospective study, 299 patients were assigned at random to receive amdinocillin or another antibiotic considered standard treatment for the infection . The majority of infections were of the urinary tract, and 58 of 59 patients treated with amdinocillin responded clinically, with cures in 49 . Of the 52 patients treated with tobramycin or other comparative agents, 49 responded, and 42 were cured . Escherichia coli and other Enterobacteriaceae were the usual pathogens . Immediately after treatment, 90 percent of urine samples were negative in both treatment groups . At four to six weeks follow-up, relapse or reinfection rates were about 20 percent in either group . Miscellaneous infections were treated with either amdinocillin or a comparative agent . Eleven of 15 infections responded favorably to amdinocillin, and seven were cured . Adverse effects were usually mild and characteristic of the penicillins.

Am J Med, 1983 Aug 29, 75(2A), 48 - 53
Amdinocillin therapy of experimental animal infections; Gordin FM et al.; Amdinocillin has been shown to have broad coverage in vitro against many strains of Enterobacteriaceae . Synergy has been demonstrated in vitro with several other beta-lactam antibiotics . The rabbit model of meningitis was used to study the in vivo effectiveness of amdinocillin when combined with other beta-lactams for serious infections . Organisms that showed an enhanced in vitro bactericidal effect from the combination of amdinocillin and another beta-lactam showed more rapid elimination of the organisms in vivo.

Am J Med, 1983 Aug 29, 75(2A), 42 - 7
Study of the enhancement of beta-lactam activity by amdinocillin in a model of the human urinary bladder; Anderson JD et al.; Synergy between a 2:1 combination of ampicillin and amdinocillin was studied with 10 urinary isolates of Enterobacteriaceae . Synergy was observed with six organisms in a bladder model that reproduced many features of the milieu of the human bladder . Antibiotic susceptibility of these organisms was also determined by the agar incorporation plate method, by tube dilution (urine and broth), microtiter method (urine and broth) and disk susceptibility test . Minimal inhibitory concentrations of individual antibiotics were of no value in predicting the synergistic response and were sometimes misleading . None of the laboratory tests could predict synergy in the bladder model . Evidence is available that the bladder model may be superior to other in vitro tests for synergy studies.

Nucleic Acids Res, 1983 Aug 25, 11(16), 5413 - 31
Detection and mapping of homologous, repeated and amplified DNA sequences by DNA renaturation in agarose gels; Roninson IB; A new molecular hybridization approach to the analysis of complex genomes has been developed . Tracer and driver DNAs were digested with the same restriction enzyme(s), and tracer DNA was labeled with 32P using T4 DNA polymerase . Tracer DNA was mixed with an excess amount of driver, and the mixture was electrophoresed in an agarose gel . Following electrophoresis, DNA was alkali-denatured in situ and allowed to reanneal in the gel, so that tracer DNA fragments could hybridize to the driver only when homologous driver DNA sequences were present at the same place in the gel, i.e . within a restriction fragment of the same size . After reannealing, unhybridized single-stranded DNA was digested in situ with S1 nuclease . The hybridized tracer DNA was detected by autoradiography . The general applicability of this technique was demonstrated in the following experiments . The common EcoRI restriction fragments were identified in the genomes of E . coli and four other species of bacteria . Two of these fragments are conserved in all Enterobacteriaceae . In other experiments, repeated EcoRI fragments of eukaryotic DNA were visualized as bands of various intensity after reassociation of a total genomic restriction digest in the gel . The situation of gene amplification was modeled by the addition of varying amounts of lambda phage DNA to eukaryotic DNA prior to restriction enzyme digestion . Restriction fragments of lambda DNA were detectable at a ratio of 15 copies per chicken genome and 30 copies per human genome . This approach was used to detect amplified DNA fragments in methotrexate (MTX)-resistant mouse cells and to identify commonly amplified fragments in two independently derived MTX-resistant lines.

Nucleic Acids Res, 1983 Aug 11, 11(15), 5257 - 66
Complete nucleotide sequence of the Escherichia coli gdhA gene; McPherson MJ et al.; The DNA sequence of the gdhA gene of Escherichia coli K12, which encodes the 447 amino acid polypeptide subunit of NADP-specific glutamate dehydrogenase, is presented . The deduced protein sequence is strongly homologous to the corresponding enzyme of the eukaryotic fungus Neurospora crassa . The upstream DNA sequence includes several overlapping promoter consensus sequences . The downstream DNA sequence contains inverted repeats, predicted as forming long stable stem-loop structures in RNA, homologous to those found in several enterobacterial intergenic regions.

Antimicrob Agents Chemother, 1983 Aug, 24(2), 293 - 6
Antimicrobial activity and other in vitro properties of cefoperazone A, the principal metabolite of cefoperazone sodium; Jones RN et al.; Cefoperazone A, the principal metabolite of cefoperazone, was found to have an antimicrobial activity ranging from slightly below to 16-fold less than that of the parent drug . Like cefoperazone, the metabolite is bactericidal, penetrates well into bacterial cells, and has moderate beta-lactamase stability, some strains of members of the family Enterobacteriaceae produce an inoculum effect on the metabolite activity.

Int J Clin Pharmacol Ther Toxicol, 1983 Aug, 21(8), 399 - 403
Microbiologic and clinical studies with cefuroxime; Graber H et al.; The microbiologic and therapeutic efficacy of cefuroxime, a lactamase-stable cephalosporin, was studied . Of the 2532 bacterial isolates of clinical origin, 80-95% of the E . coli, indole-negative Proteus, Klebsiella-enterobacter, Staphylococcus aureus, and 72-74% of indole-positive Proteus and Streptococcus B haemolyticus strains were found susceptible to cefuroxime by the disc method . Forty-three bacterial infections of 36 patients were treated; most of them were critically or seriously ill at the start of treatment . Half of the patients had failed to respond to previous antibacterial therapy . Cefuroxime was administered in doses of 750 and 1500 mg, three times daily, for an average of 11 days (6-37 days) . Ten patients received an aminoglycoside in addition to cefuroxime . Forty-one infections of 34 patients were cured, one relapsed, and one did not respond . The pathogen was identified in 36 infections; in 34 it was eradicated . Cefuroxime was well tolerated by all patients including one with penicillin allergy . No side effects occurred except local pain at the site of i.m . injections in two cases . It is concluded that cefuroxime has a high efficacy against resistant strains and an outstanding value in severe bacterial infections.

Antimicrob Agents Chemother, 1983 Aug, 24(2), 201 - 8
Transfer of plasmids from Escherichia coli to Pseudomonas aeruginosa: characterization of a Pseudomonas aeruginosa mutant with enhanced recipient ability for enterobacterial plasmids; Tardif G et al.; Pseudomonas aeruginosa strain GT424, derived by the transfer of plasmid R45 to strain GT1, was shown to have an Era+ phenotype (enhanced recipient ability) for enterobacterial plasmids from incompatibility (Inc) groups C, FI, FII, J, N, W, and X . Increase in transfer frequency ranged from 10 to 10(6)-fold . Plasmids of IncFII, IncJ, and IncX were found to be transmissible only to the Era+ strain . Plasmids of Inc groups A-C, M, and T transferred at low frequency (less than 10(-7)) to both GT1 and GT424 and did not respond to the Era+ character of the latter . Also not responsive to the Era character were plasmids R144drd3 (IncI alpha) and RP1 (IncP), which transferred to both GT424 and GT1 at intermediate (10(-4)) and high frequencies (10(-1)), respectively . All plasmid-mediated antibiotic resistances that could be measured as well as UV resistance and susceptibility were found to be expressed in P . aeruginosa . Plasmid-coded phage susceptibilities, however, generally were not phenotypically manifested in the P . aeruginosa strains . The physical structure of plasmids in P . aeruginosa could be classified into four major types . Some of the plasmids underwent additions or deletions and were unstable; the majority, however, appeared to integrate into the chromosome . Some members of IncN, IncC, IncJ, and IncP were found to be transmissible from P . aeruginosa back to Escherichia coli . This is the first report of the successful transfer to P . aeruginosa of plasmids from many of the Inc groups that have been defined in Enterobacteriaceae, namely, FI, I alpha, J, M, T, and X.

Antibiotiki, 1983 Aug, 28(8), 566 - 73
{Characteristics of the substrate specificity of the crude endogenous beta-lactamases of gram-negative bacteria}; Bibikova MV et al.; Fifty clinical strains of Gram-negative bacteria highly resistant to beta-lactam antibiotics were studied and 9 strains producing beta-lactamases were selected . From these cultures crude beta-lactamases were isolated . The substrate specificity of these crude preparations and their sensitivity to the inhibitory effect of dicloxacillin, methicillin and carbenicillin were studied with the spectrophotometric and hydroxylamine methods . The results of the study obtained with the 2 methods were in the main comparable . 5 crude preparations had the properties of broad-spectrum beta-lactamases without pronounced selectivity with respect to any beta-lactamide . However, they differed in the level of inhibition by dicloxacillin, methicillin and carbenicillin . 4 crude preparations with a pronounced substrate profile were recommended for use in screening and investigation of natural inhibitors of beta-lactamases and beta-lactam antibiotics . These 4 preparations were cephalosporinase from Enterobacter cloaceae 975, oxacillinase from Pseudomonas aeruginosa 10380, carbenicillinase from Pseudomonas aeruginosa 10538 and beta-lactamase of the TEM type from Enterobacter cloaceae 980.

J Appl Bacteriol, 1983 Aug, 55(1), 49 - 56
The microbial flora of herring fillets after storage in carbon dioxide, nitrogen or air at 2 degrees C; Molin G et al.; Herring fillets from the Baltic Sea were stored in glass vessels in air, nitrogen or carbon dioxide (CO2) at 2 degrees C and the microbial development was studied . The microbiological shelf-life of the herring (the time to reach 10(7) organisms/g) was prolonged by a factor of 3.5 in CO2 as compared to air . The corresponding factor in nitrogen was 1.5 . The microflora of fresh and spoiled herring was classified . The initial microflora was dominated by coryneforms, Flavobacterium spp., Moraxella-like organisms and Pseudomonas spp . The spoilage-flora in air (after 9 d) was dominated by Pseudomonas spp . and Moraxella-like organisms, and in nitrogen (14 d) Enterobacteriaceae, Vibrionaceae and Lactobacillus spp . were dominant . Homofermentative Lactobacillus spp . were the only organisms isolated from fillets stored in CO2 (28 d) . It was concluded that storing fresh fish in pure CO2 at low refrigeration temperatures is a method with industrial potential . The method (1) improves the microbiological stability and (2) reduces the microbiological health hazards of the fish.

Antimicrob Agents Chemother, 1983 Aug, 24(2), 176 - 80
Use of ceftazidime in the therapy of serious infections, including those due to multiresistant organisms; Clumeck N et al.; Ceftazidime was administered intravenously or intramuscularly or both in doses of 1 to 6 g per day to 33 patients with serious gram-negative bacillary infections (12 pulmonary, 10 urinary tract, 4 soft tissue, 4 intraabdominal, and 3 miscellaneous infections) . Twenty-one patients were septicemic . We identified 20 isolates of members of the family Enterobacteriaceae and 13 isolates of Pseudomonas aeruginosa . Seventeen patients had failed to respond to previous antimicrobial therapy . A total of 23 patients were clinically cured, 7 patients improved, and 3 patients failed to respond to therapy . The selection or emergence of resistant organisms during treatment (mostly Candida spp., Staphylococcus aureus, and enterococci) was noted in 11 patients . Toxicity was minimal (reversible mild liver function abnormalities and eosinophilia) . The results of this study suggest that ceftazidime is an effective and well-tolerated new cephalosporin for the therapy of serious infections due to susceptible gram-negative organisms.

J Clin Microbiol, 1983 Aug, 18(2), 300 - 4
Comparative recovery of bacteria and yeasts from lysis-centrifugation and a conventional blood culture system; Kiehn TE et al.; Blood cultures obtained with a lysis-centrifugation (L-C) system and a conventional two-bottle broth system were compared for the recovery of bacteria and yeasts from 7,000 cultures . The L-C system recovered significantly more total organisms, Escherichia coli, and Candida spp . and detected more patients with bacteremia and fungemia due to members of the family Enterobacteriaceae and yeasts . The broth system recovered significantly more streptococci and detected significantly more low-level Pseudomonas bacteremias . Polymicrobic bacteremia and fungemia were detected equally well by either culture system . Aerobic organisms grew equally well on blood, chocolate, or brain heart infusion agar plates used for L-C inoculation . A total of 82% of colony counts measured no more than 10 CFU/ml of blood, and it was at these low levels that enhanced detection of organisms by either system was observed . The L-C system isolated organisms and detected yeasts more rapidly than did the broth system . Contaminants occurred in 8.2% of L-C cultures and 1.9% of broth cultures . Low colony counts on L-C plates occurred for both Staphylococcus epidermidis contamination and septicemia.

J Bacteriol, 1983 Aug, 155(2), 937 - 9
Chloramphenicol acetyltransferase may confer resistance to fusidic acid by sequestering the drug; Proctor GN et al.; Enterobacterial chloramphenicol acetyltransferase bound fusidic acid with high affinity, but did not acetylate the drug at an experimentally detectable rate . The enzyme may therefore confer resistance to fusidic acid by sequestering the drug and thereby preventing the drug from binding to translational elongation factor G.

Antimicrob Agents Chemother, 1983 Aug, 24(2), 302 - 4
Comparative activities of ciprofloxacin (Bay o 9867), norfloxacin, pipemidic acid, and nalidixic acid; Muytjens HL et al.; An agar dilution method was used to measure the minimal inhibitory concentrations of ciprofloxacin (Bay o 9867), norfloxacin, pipemidic acid, and nalidixic acid against 496 clinical isolates . Ciprofloxacin and norfloxacin were active against all species tested (90% minimal inhibitory concentrations less than or equal to 8 micrograms/ml), although ciprofloxacin was somewhat more active, e.g., against gram-positive cocci . Pipemidic acid and nalidixic acid were active against most of the members of the Enterobacteriaceae, but Klebsiella species and Providencia stuartii were only inhibited by a high concentration of nalidixic acid.

J Bacteriol, 1983 Aug, 155(2), 860 - 5
Type 3 fimbriae of Klebsiella sp.: molecular characterization and role in bacterial adhesion to plant roots; Korhonen TK et al.; Type 3 fimbriae of Klebsiella were purified and characterized . The fimbriae were 4 to 5 nm in diameter and 0.5 to 2 microns long . In sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the fimbrillin had an apparent molecular weight of 23,500, and it differed from enterobacterial type 1 fimbrillins in its amino acid composition . Hydrophobic amino acids comprised 33.6% of all amino acids in the fimbrillin, which lacked cystine, phenylalanine, and arginine . Serologically, the type 3 fimbriae were also distinct from the type 1 fimbriae . Purified type 3 fimbriae agglutinated tannin-treated human blood group O erythrocytes; this confirms the role of type 3 fimbriae as hemagglutinins . Purified 125I-labeled type 3 fimbriae bound to the roots of Poa pratensis, and this binding could be inhibited by Fab fragments to the purified fimbriae . Anti-type 3 fimbriae Fab fragments also inhibited bacterial adhesion to plant roots . These results demonstrate that type 3 fimbriae mediate adhesion of klebsiellas to plant roots . Eight nitrogen-fixing strains of Klebsiella also produced type 3 fimbriae when grown under anaerobic nitrogen fixation conditions . It is proposed that type 3 fimbriae are involved in the establishment of the plant-bacterium association concerning nitrogen-fixing Klebsiella strains.

Klin Wochenschr, 1983 Jul 15, 61(14), 691 - 8
Antimicrobial prophylaxis in acute leukaemia: prospective randomized study comparing two methods of selective decontamination; Kurrle E et al.; In a prospective study the efficacy of two regimens for selective decontamination of the digestive tract was studied in patients with acute leukaemia during remission induction therapy . Seventy-eight patients were randomized to receive either a combination of cotrimoxazole, polymyxin B and nystatin (group A) or a combination of nalidixic acid, polymyxin B, neomycin and nystatin . With both regimens the gastrointestinal tract could be decontaminated equally effectively from potential pathogens . In the oropharyngeal region the decontamination from Enterobacteriaceae was significantly better in group A (P less than 0.01) . In both groups less than 10% of the acquired infections were caused by gram-negative bacilli and no gram-negative septicaemia occurred in either group . The median time interval until the first acquired infection was 17 days in group A and 36 days in group B, respectively (P less than 0.05) . It is concluded that regimen A might be more effective than regimen B though both regimens prevent reliably severe gram-negative infections.

J Biol Chem, 1983 Jul 10, 258(13), 8139 - 45
Comparison of the lipoprotein gene among the enterobacteriaceae . DNA sequence of Morganella morganii lipoprotein gene and its expression in Escherichia coli; Huang YX et al.; A DNA sequence of 532 base pairs encompassing the entire Morganella morganii lipoprotein gene (lpp) was determined . Sequence comparisons of the M . morganii lpp gene with the lpp genes from Escherichia coli, Serratia marcescens, and Erwinia amylovora reveal that the M . morganii lpp gene is more distantly related to the E . coli lpp gene than any of the other lpp genes examined . Between the E . coli and M . morganii lpp genes, the following homologies were found: 44% in the promoter region (bases, -45 to -1), 88% in the 5'-end untranslated region of the mRNA, 58% in the signal sequence coding region, 75% in the coding region for the first 51 and 43% for the last 7 amino acid residues . Upstream of the promoter region and downstream of the termination codon, there are extensive insertions, deletions, and base substitutions . In spite of the differences in the DNA sequences, the lipoprotein structure was found to be highly conserved except for the carboxyl-terminal sequence of 7 amino residues . The coding region of the M . morganii lpp gene including the signal sequence was inserted into an expression cloning vector so that the production of the M . morganii lipoprotein could be induced in E . coli by a lac inducer, isopropyl-beta-D-thioglactoside . It was found that when induced, the M . morganii prolipoprotein was apparently secreted normally across the E . coli cytoplasmic membrane, modified with glycerol and palmitic acid, processed to the mature lipoprotein, and assembled in the E . coli outer membrane . The bound form covalently linked to the peptidoglycan was also found.

J Infect Dis, 1983 Jul, 148(1), 18 - 23
Retrospective analysis of plasmid patterns in a study of burn unit outbreaks of infection due to Enterobacter cloacae; Markowitz SM et al.; To evaluate the usefulness of plasmid pattern analysis as an epidemiologic tool and to determine the mechanism of resistance to silver sulfadiazine and mafenide acetate, silver sulfadiazine-resistant, mafenide acetate-resistant Enterobacter cloacae isolates from a 1976 outbreak of infections in a burn unit (group I) were analyzed retrospectively . These strains were compared with various E cloacae isolates (groups II-V), including E cloacae isolates from a more recent (1982) burn unit outbreak (group V) . Agarose gel electrophoresis (AGE) of DNA isolated from "epidemic" strains of E cloacae revealed a uniform pattern of four plasmid DNA bands, ranging in molecular size from 66 to 2 megadaltons . No such plasmid pattern was seen in silver sulfadiazine-, mafenide acetate-susceptible isolates of E cloacae in groups II, III, and V . Analysis of non-E cloacae coisolates suggested that silver sulfadiazine resistance was associated with the 55-megadalton plasmid . Plasmid pattern analysis easily separated "epidemic" E cloacae isolated in 1976 from those isolated in 1982.

J Clin Microbiol, 1983 Jul, 18(1), 115 - 20
Analysis of eight cases of neonatal meningitis and sepsis due to Enterobacter sakazakii; Muytjens HL et al.; Eight cases of neonatal meningitis due to Enterobacter sakazakii (formerly known as yellow-pigmented Enterobacter cloacae) which occurred in The Netherlands during the last 6 years were investigated retrospectively . Two patients had necrotizing enterocolitis and meningitis simultaneously . Despite treatment (in most cases with ampicillin and gentamicin), the fatality rate was 75% . Strains were much more susceptible to some of the new beta-lactam antibiotics than to ampicillin . A mode of transmission other than passage through the birth canal was likely, at least for some patients . A cluster of four patient strains in one hospital had almost identical plasmid DNA profiles . However, two strains isolated from formula at the same hospital 2 days after the onset of one case had different profiles, as did the strains from patients in other hospitals.

J Antibiot (Tokyo), 1983 Jul, 36(7), 907 - 10
Penicillin-binding proteins in Bacteroides fragilis; Georgopapadakou NH et al.; The penicillin binding proteins (PBSs) of Bacteroides fragilis, a clinically important Gram-negative rod, were studied . Four PBPs were detected by polyacrylamide gel electrophoresis/fluorography, PBP 4 (molecular weight, 35,000) being a minor PBP . The PBP pattern was thus different from that of the Enterobacteria and Pseudomonads . Antibacterial activity of beta-lactam antibiotics was associated with binding to PBP 1 (molecular weight, 100,000), 2 (molecular weight, 86,000) and 3 (molecular weight, 68,000) . Binding to PBP 2 was associated with filamentation while binding to PBP 1 resulted in cell lysis.

Arch Intern Med, 1983 Jul, 143(7), 1350 - 2
Transient bacteremia following endoscopic injection sclerotherapy of esophageal varices; Camara DS et al.; The incidence of transient bacteremia following endoscopic injection sclerotherapy of esophageal varices was evaluated in 18 patients subjected to 40 sessions of injection sclerotherapy . Blood cultures were obtained before sclerotherapy and at five minutes, 30 minutes, and 24 hours after sclerotherapy . The injectors as well as the endoscope were cultured before and after the procedure . Blood cultures were positive in two patients after injection sclerotherapy (Enterobacter cloacae and Staphylococcus species, coagulase-negative, respectively) for an incidence of 5% of transient bacteremia . Pseudomonas aeruginosa was the most frequent bacteria isolated from the injector after sclerotherapy . We conclude that the incidence of transient bacteremia after sclerotherapy is no higher than routine upper-intestinal endoscopy.

Antimicrob Agents Chemother, 1983 Jul, 24(1), 18 - 22
Pharmacology of aztreonam after intravenous infusion; Scully BE et al.; The pharmacokinetics of aztreonam, a monocyclic beta-lactam which inhibits most members of the family Enterobacteriaceae at concentrations of less than 1 microgram/ml and most Pseudomonas aeruginosa isolates at concentrations of less than 16 micrograms/ml, were examined in healthy male volunteers after 30-min intravenous infusions of 0.5, 1, and 2 g of the drug . Mean peak levels of the drug in serum at the end of infusion were 65.5, 164, 255 micrograms/ml after 0.5 1, and 2 g, respectively, with levels of the drug in serum of 1.8, 3, and 8.5 micrograms/ml at 8.5 h for the three doses, respectively . The half-life was approximately 2 h for all three doses . The total serum clearance averaged 1 ml/min per kg . The apparent volume of distribution averaged 0.17 liter/kg for the three doses . Overall excretion of the drug in urine was 61%, with mean levels in urine of 23, 52, and 109 micrograms/ml at 8.5 to 12.5 h after 0.5, 1, and 2 g of aztreonam, respectively . Concentrations of the drug in serum after a 1-g dose exceeded the minimal inhibitory concentration for 90% of the members of the Enterobacteriaceae by four- to eightfold for 8 h and exceeded the minimal inhibitory concentration for P . aeruginosa isolates for 4 h.

Jpn J Antibiot, 1983 Jul, 36(7), 1699 - 705
{Effects of rectal administration of an ampicillin suppository (KS-R1) on cecal microflora and cecal weight in mice}; Nishimura K et al.; KS-R1 is a new rectal preparation of ampicillin (ABPC) sodium . Changes of cecal microflora, changes of cecal weight and ABPC concentrations in the cecum after rectal administration of KS-R1 to mice were compared with those after oral and subcutaneous administration of ABPC . When KS-R1 was administered to mice by 25.0 mg/kg 3 times a day for 10 days continuously, a little changes were observed in the number of Enterobacteriaceae, Staphylococcus and Lactobacillus in the cecum . However, at the fifth day after completing the rectal administrations, normal level of microflora was gained . This change of microflora closely resemble those in case when ABPC sodium was administered subcutaneously . On the other hand, when ABPC was administered orally, changes of microflora were large, i.e . the number of Enterobacteriaceae and Streptococcus increased remarkably, the number of Fusobacterium increased and the number of Staphylococcus and Bacteroides decreased . Recovery of normal level of microflora was late . The cecal weight did not show changes but the increase observed in the case when ABPC was orally administered . This increase was due to the increase of moisture in the cecum . The concentrations of ABPC in the cecum when administered by 25.0 mg/kg were in the order of oral administration greater than rectal administration (KS-R1) greater than subcutaneous administration . The highest concentrations were respectively 219.6, 54.1 and 5.1 micrograms/g . Changes of microflora in the cecum was great in proportion to the concentrations of ABPC.(ABSTRACT TRUNCATED AT 250 WORDS)

Med Trop (Mars), 1983 Jul-Aug, 43(4), 331 - 40
{Bacterio-parasitic interactions . Enterobacteria and schistosomes (Salmonella - schistosome association)}; Penaud A et al.; The description of a case imported from Chad of an association of Salmonella typhi - Schistosoma haematobium and, in this connection, a new revised general account . The association Salmonella-Schistomas is wide-spread . It corresponds to a salmonello - schistosomo - micro - association by the fixation of precise bacteria in the case of a bacteriemia on the cutaneous surface of male schistosomes in clearly defined places . These Salmonella constitute a permanent antigenic solicitation and they are capable of mobilization and rejection (bacteriuria after passage through the blood-stream) whereas bacteriosis remains asymptomatic . In fact, on the practical level, a clear and absolute distinction must be made between:--the bacteriemia with the concomitant bacteriuria, which are largely physiological in nature, very frequent and originating from various germs, connected with the emunctory function of the kidneys and which can be observed in any subject.--the schistosomal bacteriuria which are specific entities and evidence of a veritable micro-association of a symbiotic nature between the Salmonella and the schistosome, a micro-association which the bacteriuria reveals unexpectedly whereas the clinical symptoms are absent, not clearly discernible or totally misleading.

Antimicrob Agents Chemother, 1983 Jul, 24(1), 123 - 5
Antibacterial activity of cefoperazone alone and in combination against cephalosporinase-producing Enterobacter cloacae; Minami S et al.; The activity of cefoperazone against a strain with an inducible cephalosporinase and a mutant that produces the enzyme constitutively indicates that the low inducer activity of this antibiotic plays an important role in its activity against Enterobacter cloacae.

J Clin Microbiol, 1983 Jul, 18(1), 79 - 83
Infection caused by thymidine-requiring, trimethoprim-resistant bacteria; King CH et al.; We first noted the appearance of thymidine-requiring, gram-negative bacilli in clinical specimens 2 years ago . Since then we have seen 10 patients colonized or infected with these organisms . These strains do not grow on Mueller-Hinton media, growth on MacConkey agar is variable, and growth in API 20E (Analytab Products) and Enterobacteriaceae-Plus Cards (AutoMicrobic system; Vitek Systems Inc.) is inadequate for reliable identifications . Thymidine-requiring organisms are routinely resistant to sulfonamides and trimethoprim . Infection or colonization is associated with previous sulfamethoxazole-trimethoprim therapy in most cases . Of 10 patients, 1 had septicemia of urinary tract origin, 5 had urinary tract colonization or infection, 2 had wound colonization, and two had colonization of respiratory secretions . Thymidine-requiring, gram-negative bacilli can be pathogens and present potential problems in diagnosis, identification, and susceptibility testing.

J Bacteriol, 1983 Jul, 155(1), 153 - 8
Nontoxic lipopolysaccharide from Rhodopseudomonas sphaeroides ATCC 17023; Strittmatter W et al.; Chemical analysis of the lipopolysaccharide from Rhodopseudomonas sphaeroides ATCC 17023, isolated by the phenol-chloroform-petroleum ether method, revealed the presence of glucuronic acid, 2-keto-3-deoxyoctonate, threonine, and phosphorus in the polysaccharide moiety . The lipid A component contained glucosamine, glucosamine phosphate, amide-bound 3-oxotetradecanoic acid and 3-hydroxytetradecanoic acid, and ester-bound 3-hydroxydecanoic acid and 7-tetradecenoic acid . Structural similarity of the lipid A from R . sphaeroides ATCC 17023 to enterobacterial lipid A is indicated by the existence of a serological cross-reaction occurring between the lipid A from R . sphaeroides ATCC 17023 and that from Salmonella minnesota R595 . The lipopolysaccharide and lipid A of R . sphaeroides, however, were found to be neither toxic in mice nor pyrogenic in rabbits.

Antimicrob Agents Chemother, 1983 Jul, 24(1), 48 - 53
Influence of clindamycin on derepression of beta-lactamases in Enterobacter spp . and Pseudomonas aeruginosa; Sanders CC et al.; Previous studies in this and other laboratories have shown that derepression of beta-lactamases in strains of Enterobacter and Pseudomonas spp . is responsible for the rapid development of resistance to a variety of beta-lactam antibiotics . The purpose of the current study was to evaluate the effects of clindamycin on derepression of beta-lactamases in these two genera . In tests with four strains of each genus, clindamycin diminished derepression in one isolate of each genus and completely prevented derepression in a second Enterobacter isolate (strain 55) . Additional tests with strain 55 revealed that other inhibitors of macromolecular synthesis did not completely prevent derepression of beta-lactamase when tested at concentrations that did not inhibit replication . However, clindamycin did not affect synthesis of beta-lactamase that was constitutively produced in a mutant of this strain (55M) . It also did not inhibit derepression of beta-galactosidase in either strain 55 or 55M . Clindamycin did not diminish the bactericidal effects of beta-lactam antibiotics against Enterobacter or Pseudomonas spp . However, it enhanced the bactericidal activity of cefamandole against strain 55 . These in vitro effects of clindamycin on strain 55 that were related to prevention of derepression of beta-lactamase were confirmed in vivo with an animal model of infection . These results indicate that in some strains, clindamycin can specifically prevent derepression of beta-lactamases without inhibiting growth . Such a selective effect may provide a new approach for the enhancement of the antibacterial activity of certain beta-lactam antibiotics.

J Antimicrob Chemother, 1983 Jul, 12 Suppl A, 213 - 7
Ceftazidime therapy of infections caused by Enterobacteriaceae and Pseudomonas aeruginosa; Maslow MJ et al.; Sixteen patients with serious Gram-negative bacillary infections were treated with intravenous ceftazidime, 2 g every 8 h . The majority of patients had bacteraemia or pneumonitis or both . Ten patients were cured and six improved . Seven of ten patients infected with Pseudomonas aeruginosa were cured, and three improved . No adverse reactions occurred . Four strains of Ps . aeruginosa became resistant to ceftazidime in patients who were cured or improved clinically . Ceftazidime is effective as single drug therapy for serious Gram-negative infections, including those due to Ps . aeruginosa.

Br Poult Sci, 1983 Jul, 24(3), 391 - 5
The bacterial flora of candling-reject and dead-in-shell turkey eggs; Bruce J et al.; The incidence of bacterial contamination in turkey eggs which were rejected at candling or were "dead in shell" was about 4% . This incidence was lower than that previously found in chicken eggs . Analysis of the bacterial flora indicated that the proportion of Enterobacteriaceae was higher and the proportion of Micrococcus spp . lower in turkey eggs.

Infect Control, 1983 Jul-Aug, 4(4), 221 - 4
Control of aminoglycoside resistance by barrier precautions; Gaynes RP et al.; The efficacy of antibiotic resistance (barrier) precautions for control of aminoglycoside resistance was evaluated from 1978 to 1981 . Despite increasing aminoglycoside use and a 13-fold increase in aminoglycoside-resistant isolates on a newly opened oncology unit, the hospital-wide frequency of aminoglycoside resistant Enterobacteriaceae remained low, supporting the continued value of barrier precautions which were initiated in our hospital in 1974 . This control enabled us to focus on exceptions to the effectiveness of barrier precautions . These were traced to environmental reservoirs, very chronic and heavily infected patients, asymptomatic carriers of Serratia, and oncology patients receiving oral non-absorbable aminoglycosides . In addition, resistance in Pseudomonas aeruginosa paralleled aminoglycoside use and, as in our prior experience, continued to rise . With increasing adoption of barrier precautions by others such exceptions should be anticipated.

Clin Exp Rheumatol, 1983 Jul-Sep, 1(3), 207 - 10
The attachment of certain gram negative bacteria to buccal epithelial cells from patients with Yersinia arthritis; Robinson S et al.; The frequency of attachment of certain members of the Enterobacteriaceae implicated in arthritis to buccal epithelial cells from patients with post-Yersinia reactive arthritis, Yersinia enteritis and from healthy controls was examined using a fluorescent labelling technique . Klebsiella K43 bound significantly more frequently to cells from reactive arthritis patients compared healthy controls (2 p less than 0.05) and after incubation overnight at 37 degrees C this binding increased still further . In addition, under these conditions Escherichia coli bound more frequently to arthritis cells as compared with controls (2 p less than 0.01) . Upon examination for the presence of HLA B27 . Yersinia 03 was found to bind significantly more frequently to B27 positive reactive arthritis patients compared with B27 negative individuals when the bacteria and cells were incubated overnight at 37 degrees C (2 p less than 0.01).

Scand J Gastroenterol, 1983 Jul, 18(5), 619 - 25
Intestinal bypass . Bacteriological studies from different parts of the small intestine in rats; Viddal KO et al.; Forty-five rats were divided into four groups according to type of operation: 1) end-to-side jejunoileal bypass (ES), 10 rats; 2) end-to-end jejunoileal bypass (EE), 10 rats; 3) jejunoileal resection (R), 10 rats; and 4) no operation, 15 rats . The luminal contents from the proximal jejunum and distal ileum, in groups 1 and 2 also from the proximal and distal part of the excluded small intestine, were examined bacteriologically 5-11 months after operation . The total number of aerobic and anaerobic microbes in the jejunum was equal in all groups . The number of aerobic bacteria in the ileum was significantly higher in the ES group than in the R and U groups . The number of bacteria capable of producing gas in glucose-supplemented media was increased both in the jejunum and ileum after ES bypass . Enterobacteriaceae and Bacteroides were commonly present in the ileum after both types of bypass but were not cultured in jejunal contents . The proximal part of the excluded intestinal segment in groups 1 and 2 contained very low numbers of microbes, whereas the flora of its distal part was similar to that of the ileum in continuity in group 1 . Thus, the most marked changes of the intestinal flora occurred after ES bypass in the region of the anastomosis and distal to this.

Microbiologica, 1983 Jul, 6(3), 229 - 37
A plasmid-linked caseinolytic activity in Enterobacteriaceae; Mignatti P et al.; We have tested for production of caseinolytic activity the strain of E . coli K12 J62 carrying different R factors from various Enterobacteriaceae of clinical isolates . The results obtained showed the presence of a caseinolytic activity in 7 out of 139 R factors tested . All of these positive (cas+) R factors derived from strains of Klebsiella pneumoniae and all were able to transfer a strong lac+ phenotype as well as multiple antibiotic resistances (R-lac factors) . Another strain of E . coli K12, J53, which is plasmid-free, produced levels of caseinolytic activity comparable to those of the Klebsiella R factors; J62, on the contrary, appeared to possess an inhibitor specific for the caseinolytic activities of J53 and of the R factors but not of other cas+ Gram+ and Gram- organisms . The hypothesis that the expression of the cas+ phenotype in E . coli K12 may be due to the presence of plasmid-linked regulatory genes is discussed.

Antibiotiki, 1983 Jul, 28(7), 521 - 6
{Evaluation of the functions of human neutrophils by their reaction to a bacterial stimulus}; Maianskii DN et al.; The principle of functional loading, i.e . stimulation of the neutrophiles with enterobacterial inactivated vaccine in vitro or with bacterial polysaccharides in vivo followed by the NBT-test is recommended for adequate estimation of the neutrophile link in the system of the host defense from infections . 97 practically healthy persons were examined in Novosibirsk and Norilsk and it was shown that in the regions of the Far North there were differences among the population with respect to the initial functional activity of the neutrophiles and especially with respect to their reaction to the stimulation . The effect of neutrophile stimulation in vitro with an inactivated vaccine of Serratia marcescens was higher and more stable than that with a single inhalation of prodigiosan . The prevalence of the least pathway providing increased resistance of the phagocytosing cells to infection in the population of the Far North might be the cause of a significant risk of infectious diseases in them.

Rev Infect Dis, 1983 Jul-Aug, 5(4), 639 - 48
Emergence of resistance during therapy with the newer beta-lactam antibiotics: role of inducible beta-lactamases and implications for the future; Sanders CC et al.; A number of beta-lactam antibiotics that are relatively resistant to hydrolysis by beta-lactamases have been developed . This characteristic has expanded the antibacterial spectrum of the drugs beyond that of their progenitors . However, it also appears responsible for several problems that have been observed with the new drugs, including the development of microbial cross-resistance to multiple beta-lactam antibiotics and occasionally to the aminoglycosides . Strains most often involved are Enterobacter, Serratia, and Pseudomonas-genera that characteristically possess inducible beta-lactamases . Derepression of these enzymes is one mechanism shown to be responsible for the development of resistance to multiple beta-lactam antibiotics . Since in most instances the drugs are not susceptible to hydrolysis by these enzymes, resistance is produced by a nonhydrolytic barrier mechanism; i.e., the beta-lactamases bind the drugs, thus preventing their access to target proteins . Alterations in permeability and in penicillin-binding proteins are other possible mechanisms by which resistance may develop; however, these have not been investigated extensively . In addition to the problem of emergence of resistance, potential problems include the impact of multiply beta-lactam-resistant strains as nosocomial pathogens and antagonism between beta-lactam antibiotics used in combination . Only through a careful assessment of the relative advantages and disadvantages of these new beta-lactam antibiotics can their appropriate place in chemotherapy and chemoprophylaxis be identified.

Rev Infect Dis, 1983 Jul-Aug, 5(4), 629 - 38
Analysis of 1,186 episodes of gram-negative bacteremia in non-university hospitals: the effects of antimicrobial therapy; Bryan CS et al.; Over the five-year period 1977-1981, we studied 1,186 episodes of bacteremia due to Enterobacteriaceae and Pseudomonadaceae in the four non-university hospitals of a single metropolitan area . Overall patient mortality was 36.3%, and mortality attributed specifically to infection was 19.0% . The importance of severity of underlying disease, site of infection, microorganism, and age--previously determined to be prognostic factors in studies conducted at tertiary-care centers--was confirmed . Appropriate initial antimicrobial therapy (defined as the administration of an effective agent in adequate dose and by a suitable route of administration on the first calendar day on which blood cultures were positive) did not improve survival compared with the use of an ineffective antimicrobial agent or no therapy at all . However, appropriate antimicrobial therapy subsequent to the first calendar day on which blood cultures were positive clearly affected survival . These findings confirm previous conclusions regarding the frequency and severity of gram-negative bacteremia and the overall impact of antimicrobial therapy on this condition . These studies also suggest the possibility that the definition of optimal initial therapy in some groups of patients should be reconsidered.

J Antimicrob Chemother, 1983 Jul, 12 Suppl A, 53 - 7
A random comparative trial of 0.25, 0.5 and 1.0 g ceftazidime twice daily in urinary tract infection; Gentry LO et al.; One hundred and sixty-six patients with complicated and uncomplicated urinary tract infections were randomized to therapy with either 0.25, 0.50 or 1.00 g of ceftazidime im or iv twice daily for five days . Bacteriological data were complete in 138 patients . Escherichia coli caused 50% of all infections, Klebsiella and Enterobacter spp . caused 10.9%, Pseudomonas spp caused 10.9%, Proteus spp . caused 10.7%, and 8.7% were caused by other Gram-negative bacteria . Staphylococcus and Streptococcus spp . caused 9.4% . Cure rate was lowest in infections caused by Pseudomonas (53.3%) and Proteus spp . (64.3%); however, most of these infections were complicated . No significant dose-related difference in efficacy was observed, but the 0.25 g dose had the lowest cure rate in each category . Nausea was the only side effect . The most common laboratory abnormalities were elevated liver function tests . Minimal changes in haematological and renal function were seen.

J Antimicrob Chemother, 1983 Jul, 12 Suppl A, 389 - 93
An open study of the use of ceftazidime in Gram-negative infections; Wardle JK et al.; An open study of the use of ceftazidime in patients with Gram-negative infections was undertaken in a district general hospital . Ceftazidime was used in three groups of patients: 17 adults with infections due to Pseudomonas sp . or multi-resistant enterobacteria, three children with cystic fibrosis who had chest infections, and two premature neonates with severe pseudomonal pneumonia . The infections in the adult group included respiratory tract (6), urinary tract (4), wound infection (3), abdominal sepsis (2), osteomyelitis and panophthalmitis . In this group, ceftazidime was given as 1-2 g tid intravenously . In three patients, gentamicin was used concurrently and in four metronidazole was added . 76% of the adult group achieved complete clinical cure, all three cystic fibrosis cases improved markedly, and the two neonates showed complete resolution of the pneumonia . No adverse biochemical or haematological side effects occurred, although one patient developed an urticarial skin rash on the last day of a ten-day treatment course which resolved after discontinuing the ceftazidime.

J Antimicrob Chemother, 1983 Jul, 12 Suppl A, 153 - 9
Evaluation of ceftazidime in the treatment of severe bacterial infection; Bouza E et al.; We investigated the clinical efficiency and safety of ceftazidime for treatment of 33 episodes of infection in 30 patients (17 males and 13 females), whose ages ranged from 9 to 92 years (mean 52.5) . Fourteen patients had ultimately fatal disease and the remaining 16 had non-fatal diseases . The clinical condition of patients at the beginning of treatment was critical or poor in 16 cases . Episodes of infection treated were: 24 urinary tract infections (eight of them with concomitant bacteraemia), seven wound infections (one with concomitant bacteraemia and three with osteomyelitis), and two episodes of pneumonia . Twenty-nine episodes of infection were monomicrobial and the four remaining ones were polymicrobial . Significant organisms isolated were all aerobic or facultatively anaerobic Gram-negative rods and were responsible for the following episodes of infection: Escherichia coli (14), Pseudomonas aeruginosa (12), Pseudomonas cepacia (1), Proteus mirabilis (5), Serratia marcescens (2), Klebsiella (2), Enterobacter aerogenes (1) and Haemophilus influenzae (1) . Total dosage of ceftazidime ranged from 28 to 240 g (mean 82.4 g), and mean duration of therapy was 17 days (range 8 to 44 days) . The overall rate of clinical response to ceftazidime was 91% . Local and general tolerance to the drug was excellent . Enterococcal and/or candida colonization occurred in 12 episodes (36%) and superinfections by the same micro-organisms occurred in three episodes . Ceftazidime seems to be an effective and safe single agent for therapy of many bacterial infections, including those caused by Ps . aeruginosa.

J Antimicrob Chemother, 1983 Jul, 12 Suppl A, 131 - 7
The evaluation of ceftazidime in the treatment of bacterial infections in eighty seriously ill patients; Walstad RA et al.; Eighty patients with suspected or diagnosed bacterial infections were treated with ceftazidime . Sixty-five patients with 88 sites of infections could be assessed clinically . A cure or improvement was achieved in 61 patients (94%) with a total of 83 infection sites (94%) . Failures were seen in four critically ill patients with severe underlying diseases . Eighty-six pathogens, most frequently Enterobacteriaceae, were isolated from appropriate specimens . The infecting organisms were all eradicated during therapy . In two patients reinfection with a new strain occurred . Except for a severe anaphylactic reaction in one patient, ceftazidime was well tolerated.

Infection, 1983 Jul-Aug, 11(4), 239 - 42
Adherence of enterobacteria in infantile diarrhea and its prevention; Guggenbichler JP; Adherence of enterobacteria on intestinal epithelial cells is considered a major pathogenic mechanism of infantile diarrhea . In 36 of 40 infants with diarrhea of more than five days' duration, bacterial organisms were isolated from the duodenum . Adherence of these bacteria was investigated by different methods: hemagglutination of 0 + human red blood cells was used as a screening; adherence of bacteria on isolated intestinal epithelial cells was studied by a radiolabeled filtration assay, observation of epithelia under the light microscope and calculation of the number of bacteria/cell was counted . The correlation between these methods was high; 20 of 36 strains showed adherence by all methods . The cell-free carbohydrate fraction of carrot soup and a 2% solution of carob, the fruit of the Mediterranean locust tree, were able to block hemagglutination and adherence of Escherichia coli on isolated intestinal epithelial cells to a great extent . The active blocking agent was found in the oligosaccharide fraction of the carob solution . Blockage of adherence of bacteria isolated from the upper small intestinal tract of children with severe, protracted diarrhea could explain the therapeutic effectiveness of empirically proven diarrheal remedies.

Appl Environ Microbiol, 1983 Jul, 46(1), 152 - 9
Glycine betaine, an osmotic effector in Klebsiella pneumoniae and other members of the Enterobacteriaceae; Le Rudulier D et al.; Osmoregulation was examined in members of the Enterobacteriaceae . Exogenous glycine betaine at a concentration as low as 1 mM was found to stimulate the growth rate of Escherichia coli, Salmonella typhimurium, and Klebsiella pneumoniae in media of inhibitory osmotic strength . The stimulation was shown to be independent of any specific solutes, electrolytes, or nonelectrolytes . Therefore, the stimulatory effect of glycine betaine was a consequence of high osmotic potential . This effect was found to be far greater than the proline effect previously observed in S . typhimurium . Whereas nitrogen fixation by K . pneumoniae is completely inhibited under conditions of osmotic stress, nitrogenase activity could be partially restored by the addition of exogenous glycine betaine to the culture medium . Furthermore, glycine betaine in combination with proline, especially proline produced internally at a high level because of regulatory mutations affecting proline biosynthesis, strongly stimulated nitrogen fixation activity during osmotic stress . Glycine betaine was accumulated by the cells, and the amount taken up was correlated with the osmolarity of the medium . These findings are discussed in relation to the possible mechanisms by which glycine betaine might cause enhanced osmotolerance.

J Clin Microbiol, 1983 Jul, 18(1), 92 - 100
ompA gene in the detection of Escherichia coli and other Enterobacteriaceae by nucleic acid sandwich hybridization; Palva AM; The applicability of the DNA sandwich hybridization method to detection of bacterial DNA from crude samples is demonstrated using Escherichia coli as a model . In sandwich hybridization the sample DNA mediates the binding of a labeled probe DNA fragment to a second DNA bound on filter . For this study the DNA reagents were prepared by subclonings from a recombinant plasmid containing the E . coli K-12 ompA gene and an adjacent fragment of E . coli DNA . The 5' half of the ompA gene (738 base pairs) in pBR322 served as the filter reagent . The 3' half of the ompA gene (300 base pairs) and the adjacent 1,500 base pairs of E . coli DNA were cloned into the single-stranded phage vector M13mp7, and the resulting recombinant phage DNA was labeled with 125I and used as probe in the hybridizations . For maximal hybridization the DNA reagents had to be present in excess of the sample nucleic acid, which was preferably fragmented before testing . In the optimized test, 3 X 10(6) molecules of E . coli DNA from lysed cells were detected by an overnight reaction; the sensitivity of the test was not affected by the presence of 10(9) unrelated bacteria . With the ompA reagents, all members of the family Enterobacteriaceae tested were detected even if the sensitivity was decreased as compared with that for the homologous bacteria . With all other bacteria, including aerobic and anaerobic species of clinical importance, the test was negative . These findings suggest that it may be possible to find group-specific reagents to be used in diagnostic bacteriology.

J Clin Microbiol, 1983 Jul, 18(1), 211 - 4
Disk agar diffusion susceptibility testing with 30-micrograms ceftazidime disks: confirmation of interpretive breakpoints and quality control guidelines; Jones RN et al.; Ceftazidime is a wide-spectrum, beta-lactamase-stable cephalosporin with remarkable potency against Pseudomonas spp., Enterobacteriaceae, and some gram-positive species . The reevaluation of the 30-micrograms ceftazidime disk diffusion tests with commercially prepared disks confirms the proposed susceptibility breakpoint zone of greater than or equal to 17 mm (minimal inhibitory concentration correlate, less than or equal to 8.0 micrograms/ml) and the resistance breakpoint zone of less than or equal to 13 mm (minimal inhibitory concentration correlate, greater than or equal to 32 micrograms/ml) . Major and minor interpretive errors were only 4.4%, and these errors could be further reduced to 1.1% by not testing gram-positive organisms, particularly enterococci and Staphylococcus spp . On the basis of the results from a multilaboratory quality control study, the following zone diameter quality control guidelines are suggested: Escherichia coli ATCC 25922, 27 to 31 mm; Staphylococcus aureus, ATCC 25923, 16 to 20 mm; Pseudomonas aeruginosa ATCC 27853, 24 to 28 mm.

J Clin Microbiol, 1983 Jul, 18(1), 150 - 3
Rapid method for identification and susceptibility testing of Escherichia coli bacteriuria; Dennstedt FE et al.; This report describes a rapid method for the identification and susceptibility testing of Escherichia coli bacteriuria by use of the Autobac urine screen (AUS), a 5-h indole test, and the AutoMicrobic system E . coli Susceptibility Card (AMS-ECSC) . All specimens that were AUS negative at 3 and 5 h were reported as negative . All specimens that were AUS positive at 3 or 5 h were removed from the refrigerator and streaked to a MacConkey-blood agar biplate with a 0.001-ml calibrated loop and incubated at 35 degrees C . The standard method for identification and susceptibility testing consisted of inoculating isolated colonies into the AutoMicrobic system Enterobacteriaceae-Plus Biochemical Card and the AutoMicrobic system General Susceptibility Card . Of 915 specimens, 212 (23.2%) were AUS positive at 3 h, of which 112 (52.8%) were indole positive when tryptophan broth was tested at 5 h . The sensitivity and specificity of this screening method for E . coli bacteriuria were 78.8 and 72.2%, respectively . If contaminated cultures were excluded, specificity was 94.4% . When the indole test was positive, 10 microliters of growth from tryptophan broth was used as inoculum for the AMS-ECSC . AMS-ECSC results were final at 12 h . The sensitivity and specificity of the AMS-ECSC for identification of E . coli were 90.4 and 55.0%, respectively . If contaminated cultures were excluded, specificity was 100% . AMS-ECSC susceptibility results demonstrated an overall agreement of 94.3% with the standard method, with 0.5% very major, 3.4% major, and 1.8% minor discrepancies . The biplate was examined after overnight incubation, and when colonies compatible in morphology with E . coli were present in significant numbers, AMS-ECSC results were reported . When discrepancies were found between biplate and AMS-ECSC results, the biplate was processed in the conventional manner . A rapid method for identifying and performing susceptibility tests for approximately 70% of the specimens with E . coli bacteriuria is described.

J Antimicrob Chemother, 1983 Jul, 12(1), 65 - 78
Ceftriaxone therapy of serious bacterial infections; Eron LJ et al.; Ceftriaxone, a broad spectrum cephalosporin with a markedly extended half-life, was administered to 68 patients with 71 infections in an open trial . Sixty-three infections (89%) had a satisfactory clinical response with eradication of bacteria present at the initiation of therapy in 62 infections (87%) . The eight treatment failures correlated well with the development of resistance to ceftriaxone during therapy in Enterobacter and Pseudomonas species (two cases) and with superinfection with Bacteroides fragilis (three cases) . Treatment was discontinued in eight patients because of unwanted effects . Serious side effects included leukopenia, rash, fever, and enterocolitis.

Anticancer Res, 1983 Jul-Aug, 3(4), 233 - 4
Integrated management of bacteraemic shock in neutropenia; Bannatyne RM et al.; The neutropenic mouse model of endotoxin-associated, enterobacterial sepsis was used to evaluate the individual and cumulative effects of anti-infective, anti-endotoxic, anti-inflammatory and anti-endorphic strategies . Survival was maximized following the administration of ticarcillin, polymyxin, methylprednisolone and naloxone.

Antimicrob Agents Chemother, 1983 Jul, 24(1), 78 - 84
In vitro and in vivo antibacterial activity of AT-2266; Kouno K et al.; AT-2266 {1-ethyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-1,8-naphthyridine-3-carbo xylic acid} showed a broad spectrum of antibacterial activity against gram-positive and gram-negative microorganisms, including Pseudomonas aeruginosa . The in vitro antibacterial activity of AT-2266 was in general comparable to that of norfloxacin, but much higher than that of pipemidic or nalidixic acid . The 90% minimal inhibitory concentrations (MIC90s) of AT-2266 for P . aeruginosa resistant to gentamicin (MIC range, 25 to greater than 200 microgram/ml) and Enterobacteriaceae resistant to nalidixic acid (25 to greater than 1,600 micrograms/ml) were 3.13 and 12.5 micrograms/ml, respectively . The to nalidixic acid (25 to 1,600 micrograms/ml) were 3.13 and 12.5 micrograms/ml, respectively . The MICs of AT-2266 were only slightly affected by the addition of horse serum or sodium cholate, by the pH of the medium, and by inoculum size . AT-2266 was sodium cholate, by the pH of the medium, and by inoculum size . AT-2266 was bactericidal at concentrations near its MIC value . The 50% effective doses of AT-2266 after oral administration against systemic infections in mice were about 1/2 those of norfloxacin, about 1/10 those of pipemidic acid, and between 1/20 and 1/40 those of nalidixic acid.

J Gen Microbiol, 1983 Jul, 129 (Pt 7), 2175 - 80
Fimbrial haemagglutinins in Enterobacter species; Adegbola RA et al.; Fifty-two strains from seven species of Enterobacter, grown under a variety of conditions, were examined in rocked-tile tests for production of haemagglutinins and with the electron microscope for fimbriae . Thirteen non-haemagglutinating strains were non-fimbriate . Most (33) of the 39 haemagglutinating strains produced only one kind of haemagglutinin, either the mannose-sensitive haemagglutinin associated with type -1 Fimbriae or, the mannose-resistant, Klebsiella-like haemagglutinin associated with type-3 fimbriae . Multiply haemagglutinating strains were most common in E . aerogenes, in which species a third kind of haemagglutinin, also mannose-resistant, was found . The findings are discussed briefly in the light of the current taxonomy of Enterobacter.

Sem Hop, 1983 Jun 30, 59(26), 1953 - 7
{In vitro evaluation of moxalactam on enterobacteria producing beta-lactamases}; Kazmierczak A et al.; We have studied strains of enterobacteria which are resistant to first generation cephalosporins, in relation to their cephalosporinase production . Therefore, this is not an epidemiological study . For these selected strains, if a difference in MIC greater than or equal to 2 base 2 logarithms is considered to be significant, Moxalactam appears as more potent than cefotaxim . An appropriate study shows that these findings are related to the production of cephalosporinase . If very little cephalosporinase is produced, cefotaxim is more potent, implying better accession to the lethal target of the bacteria . Conversely, when cephalosporinase production is higher, Moxalactam is more potent . Moxalactam can be shown to be more resistant to hydrolysis by cephalosporinases.

Sem Hop, 1983 Jun 30, 59(26), 1949 - 52
{In vitro action of moxalactam on hospital bacteria . Results of a multicenter survey}; Duval J et al.; The high potency of Moxalactam on three major groups of bacteria, i.e . Enterobacteriae, Haemophilus and Bacteroides, predicted by previous studies, has been confirmed by the study of hospital strains in this multicenter investigation . Among these groups, the proportion of resistant strains is very low . However, Moxalactam is not superior to older agents on staphylococci, Streptococci and Listeria, and is less active than certain new agents on Pseudomonas . Moxalactam is one of the best "third generation" cephalosporins . It is remarkable by its potency against Bacteroides fragilis and its weak activity on Streptococci and Pneumococci . The unanswered question concerns the future of resistant strains: will they remain exceptional or will they multiply?

J Dairy Sci, 1983 Jun, 66(6), 1377 - 83
Antibacterial activity of bovine blood neutrophils and their cationic proteins; Hakak-Berenji SN et al.; Six cationic protein bands were identified in extracts of both normal bovine blood neutrophils and their granules subjected to polyacrylamide disc gel electrophoresis . Band 1, the most cationic protein, was as positively charged as crystalline egg white lysozyme, and band 2 was as positively charged as ribonuclease . Antibacterial activity of various leukocyte fractions and cationic proteins was determined in vitro for Enterobacter aerogenes strain 2412-2 . Antibacterial activity of various preparations was proportional to amount of test material present and varied inversely with number of bacteria in the test system . Comparative evaluations revealed that the neutrophil granule fraction had greater antibacterial activity than the whole cell homogenate or individual cationic proteins . Among cationic proteins, band 1 had the highest antibacterial activity, band 2 had the lowest, and band 3 had intermediate antibacterial activity . Cationic protein bands 4, 5, and 6 exhibited growth stimulatory rather than a growth inhibitory activity.

J Antimicrob Chemother, 1983 Jun, 11(6), 525 - 33
Aminoglycoside-modifying enzymes associated with hospital isolates of Gram-negative rods; Obbink DJ et al.; Multi-resistant Enterobacteriaceae and Pseudomonas isolated from clinical specimens at RNS were characterized for resistance phenotype and transferred resistant phenotype . These isolates were obtained over a two year period from different specimens and from patients with varying clinical syndromes . Twenty-six of these isolates were further characterized with respect to their aminoglycoside modifying enzymes . Only three enzymes were detected: AAC(3)-I, APH(3')-I and AAD(2")-II . The substrate range of these enzymes was investigated and not always found to coincide with the transferred phenotype . AAD(2")-II was found only in association with APH(3')-I and not alone . The substrate range of AAC(3)-I from Pseudomonas was different from AAC(3)-I from Enterobacteriaceae but not sufficiently dissimilar to classify them as separate isoenzymes . The relatively few aminoglycoside-inactivating enzymes suggest that within this hospital there may be a limited gene pool for these enzymes.

J Clin Microbiol, 1983 Jun, 17(6), 1057 - 60
Providencia rustigianii: a new species in the family Enterobacteriaceae formerly known as Providencia alcalifaciens biogroup 3; Hickman-Brenner FW et al.; The name Providencia rustigianii sp . nov . is proposed for a group of organisms previously known as Providencia alcalifaciens biogroup 3 . By DNA hybridization, strains of P . rustigianii were 81 to 99% related to each other at 60 degrees C, but only 44 to 49% related to P . alcalifaciens biogroups 1 and 2 and 26 to 33% related to Providencia stuartii . P . rustigianii could be differentiated from P . alcalifaciens and P . stuartii by simple biochemical tests . P . rustigianii produced acid from D-galactose but not from trehalose; P . stuartii produced acid from both; and P . alcalifaciens produced acid from neither . P . rustigianii could be distinguished from Providencia rettgeri (formerly Proteus rettgeri) by urea hydrolysis and acid production from D-arabitol; P . rustigianii was negative for these two tests, but P . rettgeri was positive . Strains of P . rustiganii were 32 to 34% related to strains of P . rettgeri . Three of the 11 strains of P . rustigianii were isolated from stools, but the sources of the other isolates are unknown . Three strains (27%) were sensitive to colistin, and 82 to 100% were sensitive to ampicillin, carbenicillin, cephalothin, gentamicin, kanamycin, nalidixic acid, streptomycin, and tetracycline . Strain ATCC 33673 (CDC no . 0132-68) is the type strain for this species.

J Clin Microbiol, 1983 Jun, 17(6), 1045 - 9
Controlled evaluation of hypertonic sucrose medium at a 1:5 ratio of blood to broth for detection of bacteremia and fungemia in supplemented peptone broth; Reimer LG et al.; The value of hypertonic media in the detection of bacteremia and fungemia is controversial, since prior clinical trials have yielded conflicting results with different media . Earlier, we showed that the addition of 10% sucrose to supplemented peptone broth at a 1:10 ratio of blood to broth yielded better recovery of Staphylococcus epidermidis, the Enterobacteriaceae, Pseudomonas aeruginosa, and yeasts . To evaluate the effect of 10% sucrose on blood cultured at a 1:5 ratio, we compared the yield and speed of detection of clinically important microorganisms from adult patients in 5,839 blood samples cultured in supplemented peptone broth with 0.03% sodium polyanetholesulfonate with and without 10% sucrose . The atmosphere of incubation (open venting units), 1:5 ratio of blood to broth, and methods of processing were the same for both bottles . Recovery of facultative gram-positive (P less than 0.02) and gram-negative (P less than 0.02) bacteria was improved, but the recovery of anaerobic gram-negative bacteria was both reduced (P less than 0.01) and delayed (P less than 0.02) by sucrose . The total yield of microorganisms including fungi, however, was increased with sucrose . The effect of sucrose on blood cultures appears to depend on the ratio of blood to broth as well as on the medium used and strains of microorganisms encountered.

J Clin Microbiol, 1983 Jun, 17(6), 1039 - 44
New selective plating medium for isolation of Vibrio vulnificus biogroup 1; Brayton PR et al.; A new plating medium (VV agar) has been developed as an alternative to thiosulfate-citrate-bile salts-sucrose (TCBS) agar for the isolation of Vibrio vulnificus . Salicin (2% wt/vol) is employed as the source of carbohydrate, with potassium tellurite (0.0005% wt/vol), crystal violet (0.00015% wt/vol), oxgall (0.8% wt/vol), and a pH of 8.6 to inhibit growth of gram-positive and gram-negative organisms other than V . vulnificus . Because strains of V . vulnificus do not strongly ferment salicin in VV agar, a pH indicator has not been included in the medium . Growth of V . vulnificus appears on VV agar as large grey colonies with black centers . Other non-Vibrio strains which grow on the medium produce smaller colonies and fail to take up tellurite . VV agar has proved to be more effective than TCBS agar in inhibiting members of the Enterobacteriaceae as well as gram-positive cocci . Only Vibrio strains capable of utilizing salicin grow well on VV agar . Recovery and growth of V . vulnificus are superior on VV agar, compared with TCBS agar.

Trop Geogr Med, 1983 Jun, 35(2), 193 - 7
Machakos project studies agents affecting health of mother and child in a rural area of Kenya . XXIII bacterial contamination of foods commonly eaten by young children in Machakos, Kenya; van Steenbergen WM et al.; A simplified method, the Agar Immersion Plating and Contact (AIPC) slide technique was applied for the bacteriological examination of children's dishes and drinking water in Machakos District, Kenya . A total of 214 samples, collected from 106 households, were examined for degree of colonization by Enterobacteriaceae (E) and Staph . aureus (ST) . Fourty four percent of the dishes and two percent of the water samples were unsafe with respect to Enterobacteriaceae . In 12% of the dishes and none of the water samples Staph . aureus occurred at levels above the threshold of acceptability . Colonization increased with storage time . Implications of these results in relation to diarrhoea morbidity patterns among young children are being investigated elsewhere.

Jpn J Antibiot, 1983 Jun, 36(6), 1354 - 8
{Clinical evaluation of the efficacy of cefmetazole in respiratory tract infections of patients with underlying respiratory diseases}; Motojima S et al.; Respiratory infections of 10 subjects with underlying respiratory diseases were treated with cefmetazole (CMZ) and its clinical effects were studied . Five subjects of them were respiratory tract infection, 3 subjects were pneumonia and 2 subjects were pneumonia followed by empyema . The underlying diseases were chronic pulmonary emphysema in 4 subjects, diffuse panbronchiolitis in 3, chronic bronchitis in 2 and bronchial asthma in 1 . The doses of CMZ were 4 to 8 grams per day and the durations of administration ranged 3 to 39 days . The clinical effects were judged from the changes of fever, cough, amount of sputum, dyspnea, rale, chest X-ray, white blood cell counts, erythrocyte sedimentation rates, sputum culture and PaO2 . The clinical effects of 6 subjects were evaluated as good, those of 3 were fair and that of 1 was poor . In 3 subjects H . influenzae in the sputum was eliminated and in 1 subject both H . aphrophilus and alpha-Streptococcus found in the pleural effusion were eliminated . In 1 subject Klebsiella in the sputum was eliminated and replaced by Enterobacter . No side effects were observed . We conclude that CMZ is considerably useful in the treatment of respiratory infections of the patients with underlying respiratory diseases.

Aust N Z J Surg, 1983 Jun, 53(3), 249 - 51
Wound infection rates after gastric surgery in a Melbourne hospital; Kune GA et al.; In four groups of 25 patients in whom perioperative prophylactic antibiotics were not used, the wound infection rates after partial gastrectomy were 40% in gastric cancer, 44% in chronic gastric ulcer, 24% in chronic duodenal ulcer and after trunkal vagotomy and pyloroplasty, the wound infection rate was 12% . In gastric cancer and chronic gastric ulcer, most wound infections were caused by enterobacteria, while in chronic duodenal ulcer almost all infections were caused by Staphylococcus aureus . Appropriate short-term perioperative prophylactic antibiotic use is likely to decrease wound sepsis rate in patients who have a gastric resection in the presence of gastric cancer or gastric ulcer.

Antimicrob Agents Chemother, 1983 Jun, 23(6), 918 - 25
Chromosomal beta-lactamases of Enterobacter cloacae are responsible for resistance to third-generation cephalosporins; Seeberg AH et al.; About 70% of all Enterobacter cloacae strains tested possessed one of two species-specific beta-lactamases . These enzymes, E . cloacae beta-lactamase A and E . cloacae beta-lactamase B, with isoelectric points of 8.8 and 7.8, respectively, had the same pH and temperature optima . Both showed similar enzyme kinetics and were inhibited by cloxacillin but not by p-chloromercuribenzoate . E . cloacae beta-lactamase B appeared to be identical with the enzyme of E . cloacae P99 . By a mutation in a regulatory gene, inducible enzyme production could be converted into constitutive expression . In E . cloacae, both enzymes did not hydrolyze third-generation cephalosporins, but they were solely responsible for resistance toward these drugs . This was demonstrated by the characterization of Escherichia coli strains expressing an identical resistance pattern after transfer of the corresponding Enterobacter gene.

Zh Mikrobiol Epidemiol Immunobiol, 1983 Jun, (6), 53 - 5
{Enterotoxigenicity of opportunistic enterobacteria in acute intestinal diseases in children}; Mnatsakanov ST; The enterotoxigenicity of 244 cultures of opportunistic enterobacteria isolated from 129 infants (up to 1 year old) with acute intestinal diseases and of 120 cultures of opportunistic enterobacteria isolated from 60 practically healthy children of the same age, having no record of intestinal disorders in their medical history, was studied . The study revealed that enterotoxigenic opportunistic enterobacteria were isolated from 68.99% of sick children, while from healthy children enterotoxigenic cultures were isolated in 3.33% of cases . Besides E . coli, enterotoxigenicity was also detected in other representatives of the family Enterobacteriaceae: C . freundii, Arizona, K . pneumoniae, H . alvei, Pr . vulgaris, Pr . morganii, Pr . rettgeri, Y . enterocolitica.

Zh Mikrobiol Epidemiol Immunobiol, 1983 Jun, (6), 46 - 9
{Possibilities of biochemical identification of the Enterobacteriaceae family by conventional methods}; Dombrovskii AM; A total of 579 strains of the family Enterobacteriaceae, isolated from differential diagnostic media, were analyzed by means of 20 standard tests . In 1.8% of the analyzed strains their species and genus could not be determined due to unusual reactions in the tests of amino acid decarboxylation and utilization of some carbohydrates.

Pathol Biol (Paris), 1983 Jun, 31(6), 483 - 7
{In vitro study of combinations between third-generation cephalosporins and aminoglycosides on Enterobacteriaceae}; Fosse T et al.; Four cephalosporins (cefotaxime, moxalactam, cefoperazone and ceftriaxone) were tested in combination with four aminoglycosides (gentamicin, tobramycin, netilmicin and amikacin) . We examined 16 clinically isolates of Enterobacteriaceae of which 8 were resistant to newer cephalosporins . The synergy studies was evaluated with a microtiter checkerboard broth dilution . Studies of synergy revealed that cephalosporins in combination with amikacin were often synergistic against third generation cephalosporins resistant strains . These results suggest that amikacin may be facilitate the cephalosporin antibacterial activity.

Gut, 1983 Jun, 24(6), 538 - 41
Increased adhesion of Escherichia coli to mucosal cells from infants with protracted diarrhoea: a possible factor in the pathogenesis of bacterial overgrowth and diarrhoea; Candy DC et al.; Mucosal adhesion of bacteria has been studied in eight infants with protracted diarrhoea and malnutrition, using a buccal epithelial cell technique . A known non-adhesive strain of Escherichia coli (O1:K1:H7) adhered to a significantly greater (p less than 0.001) proportion of buccal epithelial cells from patients with protracted diarrhoea, compared with children with acute diarrhoea, healthy infants, and healthy adults . Also, Enterobacteria isolated from the jejunum or stools of patients with protracted diarrhoea adhered to far greater numbers of their own buccal epithelial cells compared with healthy adults . These results suggest that bacterial adhesion may play an important role in the pathogenesis of protracted diarrhoea.

Am J Clin Pathol, 1983 Jun, 79(6), 683 - 7
Comparison of automated and rapid manual methods for the same-day identification of Enterobacteriaceae; Jorgensen JH et al.; The Vitek AMS automated instrument method for identification of Enterobacteriaceae was compared with two rapid manual methods intended for the same purpose, the Micro ID System and the API 20E Same-Day procedure, on a series of 400 consecutive fresh clinical isolates . Results were compared with identifications obtained using the API 20E System with overnight incubation and supplemental tube biochemicals (when needed) . Both the final (8-hour) and a manually requested, presumptive 5-hour result from the AMS were compared with the 4-hour results provided by the Micro ID and the 5-hour results provided by the API . The Micro ID system proved to be the most rapid and accurate of the three test systems by correctly identifying 96.8% (387/400) of isolates . The API 20E using 5-hour readings identified 90.7% (363/400) of isolates, although 96.8% (387/400) could be identified if supplemental overnight tests were employed to separate profile codes with "good likelihood, but low selectivity." The AMS correctly identified 88.8% (355/400) isolates after 5 hours, and 95.0% (380/400) following 8 hours incubation.

Afr J Med Med Sci, 1983 Jun, 12(2), 113 - 6
In vitro antibacterial activity of water-soluble extract of aghalokpe; Williams B et al.; Water-soluble extracts of the bark of aghalokpe, a big tropical tree which grows in the rainforest of Bendel State of Nigeria, showed in vitro antibacterial activity against several of the Enterobacteriaceae . The activity was more pronounced with gram-positive than the gram-negative species . The minimum inhibitory concentration (MIC) which is in the range of 3.125-50 micrograms/ml, compares well with some broad-spectrum antibiotics on the market . The extract was remarkably effective against Neisseria gonorrhoea.

Pathol Biol (Paris), 1983 Jun, 31(6), 480 - 2
{In vitro activity of combinations of cefotaxime and moxalactam with aminoglycosides on beta-lactamase-producing Enterobacteriaceae}; Sirot J et al.; The in vitro synergistic activities of cefotaxime (Ctx) or moxalactam (Mox) in combination with gentamicin, amikacin, dibekacin or netilmicin were compared against 15 beta-lactamases non-producing or producing isolates of Enterobacteriaceae . The strains were classified according to their resistance to ampicillin (Am), carbenicillin (Cb) and cephalotin (Ce), but all were sensitive to the antibiotics tested in combination . In vitro checkerboard studies were performed using a microtiter technique for the selected strains . The FIC index was less than or equal to 0.62 for AmR CbR CeR strains (E . coli, E . cloacae, Serratia), for AmR CbS CeR strains (E . cloacae, Serratia, P . vulgaris) and for AmS CbS CeR strains (Serratia, P . morganii) . These combinations were frequently additive (FIC = 0.75 - 1.0) against the AmS CbS CeS or AmR CbR CeS strains . Thus, the synergistic activities of Ctx and Mox in combination with an aminoglycoside seem to be correlated with beta-lactamase type produced by the Enterobacteriaceae.

Antimicrob Agents Chemother, 1983 Jun, 23(6), 902 - 6
Early synergistic interaction between semisynthetic penicillins and aminoglycosidic aminocyclitols against Enterobacteriaceae; Glew RH et al.; Time-kill curves were used to assess the relative in vitro efficacy of the early interaction of three semisynthetic penicillins with two aminoglycosides against 48 Enterobacteriaceae strains . The most efficacious combinations were piperacillin plus amikacin, which demonstrated synergism (greater than or equal to 2 logs of increased kill after 7 h of incubation) against 43 of 48 (90%) strains, and piperacillin plus gentamicin, which exhibited synergism against 25 of 48 (52%) strains . With the combinations of carbenicillin or ticarcillin plus amikacin or gentamicin, early synergistic killing was demonstrated against only 12 to 29% of the strains.

Eur J Clin Microbiol, 1983 Jun, 2(3), 235 - 41
Comparative in vitro activity of norfloxacin against urinary tract pathogens; Haase D et al.; The in vitro activity of norfloxacin (MK366) against 477 aerobic gram-negative and gram-positive clinical isolates was compared to that of nalidixic acid, nitrofurantoin, ampicillin, cephalexin, trimethoprim, sulfamethoxazole, and the combination trimethoprim-sulfamethoxazole . Norfloxacin was more active than the other agents against all gram-negative organisms tested . Minimal inhibitory concentrations (MICs) of Pseudomonas aeruginosa were less than or equal to 0.125-32 mg/l with 90% inhibited (MIC90) by 4 mg/l; MICs of the Enterobacteriaceae including Serratia marcescens were less than or equal to 0.125-8 mg/l with an MIC90 of less than or equal to 4 mg/l . There was also excellent activity against the gram-positive cocci including Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus and the enterococci, with MICs less than or equal to 0.125-4 mg/l and an MIC90 less than or equal to 4 mg/l . Only 8 of 477 organisms were norfloxacin-resistant (MIC greater than or equal to 16 mg/l): 3 of 100 Pseudomonas aeruginosa, 3 of 10 Pseudomonas maltophilia and 2 of 15 Streptococcus bovis strains . In contrast, 97% of the gram-positive cocci and 49% of the gram-negative bacilli were nalidixic acid-resistant (MIC greater than or equal to 32 mg/l) . Norfloxacin shows excellent activity against a wide range of bacteria and merits further study as a urinary antibacterial agent.

Pathol Biol (Paris), 1983 Jun, 31(6), 477 - 9
{Value of moxalactam in the treatment of meningitis: efficacy and meningeal diffusion}; Fosse T et al.; 15 bacterial meningitis (Haemophilus: 7, Meningococci: 3, Proteus: 1, Enterobacter: 2, E . coli: 1 and Klebsiella: 1) are treated with moxalactam . The diffusion of moxalactam into the cerebrospinal fluid is good and regular . Excellent clinical results are obtained.

Can J Microbiol, 1983 Jun, 29(6), 729 - 31
The detection of positive blood cultures in children using the acridine orange, gram, and methylene blue stains; La Scolea LJ Jr et al.; The efficacy of the acridine orange (AO), gram (G), and methylene blue (MB) microscopic procedures was analyzed using positive blood cultures monitored by a radiometric procedure (Bactec) in children . Sixty-eight positive cultures included the following isolates: Haemophilus influenzae type b, Neisseria meningitidis, Streptococcus pneumoniae, Enterobacteriaceae, Staphylococcus aureus, Candida spp., and seven other pathogens . The MB stain yielded the highest detection rate, 99%, in comparison with 94 and 93% for the AO and G stains, respectively . Since the MB stain yielded comparable results to the AO procedure with no requirement for a fluorescent microscope, the former method is recommended for confirming the presence and initial characterization of microorganisms in blood cultures monitored by Bactec from children.

Presse Med, 1983 May 14, 12(21), 1341 - 4
{Resistance of enterobacteria to the sulfonamide-trimethoprim combination . Course during the last 10 years}; Goldstein FW et al.; From january 1972 to december 1981, nearly 54.000 strains of enterobacteria isolated from clinical specimens were tested for susceptibility to the trimethoprim-sulfamide combination (co-trimoxazole) . During that period, the overall resistance to trimethoprim increased from 17.9% to 32.7%, and there was a fourfold increase in the number of strains exhibiting high level resistance; 246 trimethoprim-resistant plasmids were transferred into E . coli K 12 . The number and frequency of the other resistance markers co-transferred with trimethoprim are constantly increasing and as a result, more and more antibiotics are likely to be responsible for the selection of trimethoprim-resistant plasmids . In contrast, the proportion of trimethoprim-resistant mutants decreased from 11% to 5% . The use of co-trimoxazole in France may explain this low incidence.

FEBS Lett, 1983 May 2, 155(1), 97 - 101
EaeI: a restriction endonuclease from Enterobacter aerogenes; Whitehead PR et al.; We describe the isolation and characterization of a type II restriction endonuclease from Enterobacter aerogenes . This recognises and cleaves the family of related sequences: 5'-Py-G-G-C-C-Pu-3' to generate DNA fragments with 5'-tetranucleotide extensions . EaeI may be useful in molecular cloning experiments, especially in conjunction with other enzymes which generate the same terminal extensions . Potential problems in the methods used to determine the cleavage specificity are discussed.

Clin Cardiol, 1983 May, 6(5), 217 - 9
Penetration of netilmicin into heart valves, subcutaneous and muscular tissue of patients undergoing heart surgery; Just HM et al.; In 57 patients undergoing heart surgery concentrations of netilmicin in plasma, heart valves, muscle, and subcutaneous tissue were determined after a 5 min intravenous bolus injection of 1.5 mg/kg body weight . Within 8 h netilmicin serum concentration declined from 3 micrograms/ml to 1 microgram/ml . In heart valves the concentrations during heart surgery were high enough to inhibit most staphylococci, Klebisiella, Enterobacter and Escherichia coli strains . No different serum and tissue concentrations in patients with and without extracorporal circulation could be found.

Ann Microbiol (Paris), 1983 May-Jun, 134A(3), 241 - 5
DNA relatedness between Enterobacter sakazakii and other members of the genus Enterobacter; Izard D et al.; A DNA-DNA hybridization study (nitrocellulose filter method) was carried out with 13 strains of Enterobacter sakazakii and 38 strains belonging to other Enterobacter species (E . cloacae, E . amnigenus, E . intermedium and E . gergoviae) . E . sakazakii strains were highly related (mean relative binding ratio +/- standard deviation: 89% +/- 10) to the strain R 16-76 (labelled DNA) . No close relationship was found with the other Enterobacter species . The low relative binding ratios were not due to a difference in genome size (as shown by reciprocal binding experiments).

J Antimicrob Chemother, 1983 May, 11 Suppl B, 69 - 75
Clinical experience with azlocillin; Sanders WE Jr; Mezlocillin and azlocillin are new semi-synthetic ureidopenicillins . Both possess a broad spectrum of activity in vitro . Potency of activity against Gram-positive and fastidious Gram-negative organisms and against obligate anaerobes is comparable . Mezlocillin is more active against Enterobacteriaceae while azlocillin is more potent against Pseudomonas species . Although direct comparative studies in serious Gram-negative bacillary infections have not been performed, it would appear prudent to administer mezlocillin in disease due to Enterobacteriaceae, and to prescribe azlocillin preferentially when the aetiological agent is presumed or known to be Pseudomonas . The use of azlocillin to treat serious infections with Ps . aeruginosa is described here . A variety of clinical and laboratory observations may permit implication of Pseudomonas in the aetiology of specific infections.

J Antimicrob Chemother, 1983 May, 11 Suppl B, 21 - 31
Azlocillin: a new broad spectrum penicillin; Sanders CC; Azlocillin is a new semisynthetic penicillin with a broad spectrum of antibacterial activity . Azlocillin is highly active against Pseudomonas aeruginosa including many strains that are resistant to carbenicillin and ticarcillin . Unlike many other penicillins with activity against Enterobacteriaceae and Pseudomonas, azlocillin retains a high degree of potency against Gram-positive organisms, fastidious Gram-negative organisms, and many obligate anaerobes . Because azlocillin is susceptible to certain beta-lactamases it is not highly active against bacteria that are resistant to other penicillins and/or cephalosporins due to the production of such enzymes . Like other penicillins, azlocillin is bactericidal for susceptible strains . It also interacts synergistically with aminoglycosides against enterococci, certain Enterobacteriaceae, and Ps . aeruginosa.

J Antimicrob Chemother, 1983 May, 11 Suppl B, 15 - 20
The in-vitro activity of azlocillin: a community hospital study of 1900 clinical isolates; Parry MF; The in-vitro activity of azlocillin was evaluated against 1900 fresh clinical isolates from a 320-bed community hospital . Azlocillin inhibited over 90% of Pseudomonas aeruginosa isolates at less than or equal to 16 mg/l; it was four-fold more active than ticarcillin and 8- to 16-fold more active than carbenicillin . Against members of the Enterobacteriaceae azlocillin was less active than piperacillin but still inhibited over 90% of Klebsiella, Serratia and Proteus mirabilis at achievable blood levels (less than or equal to 64 mg/l) . It was the most active agent against enterococci inhibiting 80% at less than or equal to 1 mg/l . Azlocillin will be a useful addition to the antibiotic formulary of the community hospital because of its exceptional anti-pseudomonal activity.

Infect Control, 1983 May-Jun, 4(3), 148 - 52
An outbreak of gentamicin-resistant Enterobacter cloacae infections in a pediatric intensive care unit; Anderson EL et al.; The intensive care unit at Children's Medical Center in Dallas is a medical-surgical unit that cares for pediatric patients of all ages . In 1978 an outbreak of infections occurred that was caused by a gentamicin-resistant strain of Enterobacter cloacae . Thirty of the 34 patients involved in the outbreak were neonates . Six patients developed bacteremia, five of them neonates . The neonates who became infected were significantly smaller (less 1500 g) and more premature (less than 35 weeks) than control patients . Neonates with bacteremia had a significantly higher incidence of congenital anomalies . In a multi-specialty pediatric intensive care unit newborn infants were the group of patients at high risk for nosocomial infection.

J Antimicrob Chemother, 1983 May, 11 Suppl B, 121 - 6
Serum bactericidal activity and kinetics of azlocillin and moxalactam after single and combined administration; Lode H et al.; Ten healthy volunteers received 5 g azlocillin and 2 g moxalactam iv in single and combined administration . Serum and urine concentrations were measured with bioassay and HPLC (high pressure liquid chromatography), and serum bactericidal activity (SBA) was determined at 1 h and 6 h against 6 different clinical isolates . The combined applications of both antibiotics resulted in minor differences in serum kinetics and urine recovery in comparison to single administration . SBAs of both antibiotics against Enterobacteriaceae were between 1:4 and 1:8.4 for azlocillin and between 1:3 and 1:8 for moxalactam after 1 h . The combination of both beta-lactam antibiotics did not result in a decrease in SBA against any strain; rather all Enterobacteriaceae showed a slight increase of SBA at 1 h . It can be concluded from these results that combination therapy with azlocillin and moxalactam has no adverse influence on the pharmacokinetics or the bactericidal activity of either substance.

Can J Microbiol, 1983 May, 29(5), 471 - 5
{Inhibition of the growth of bacterial populations by suspensions obtained from Pseudomonas aeruginosa pyocinogenic strains}; Garcia-Quintana HG et al.; Suspensions obtained from five Pseudomonas aeruginosa pyocinogenic strains showed inhibitory and variable activity against bacterial strains belonging to the Nocardiaceae, Micrococcaceae, Neisseriaceae, Streptococcaceae, Vibrionaceae, Enterobacteriaceae, and Pseudomonadaceae families . Under special conditions, the same pyocinogenic P . aeruginosa strain can be affected by it own suspensions . These pyocinlike particles could be considered as a regulatory factor acting on the rate and size of the population growth.

J Antibiot (Tokyo), 1983 May, 36(5), 522 - 31
New broad-spectrum cephalosporins with anti-pseudomonal activity . I . Synthesis and antibacterial activity of 7 beta-{D-2-{(4-hydroxy-1,5-naphthyridine-3-carbonylamino)- and (4-hydroxypyridine-3-carbonylamino)}-2-(4-hydoxyphenyl)acetamido} cephalosporins; Yamada H et al.; The synthesis and the antibacterial activity of 7 beta-{D-2-{(4-hydroxy-1,5-naphthyridine-3-carbonylamino)- and (4-hydroxypyridine-3-carbonylamino)}-2-(4-hydroxyphenyl)acetamido}-cephalosporins with various substituents at the 3-position in the cephem nucleus are described . These compounds exhibited strong antibacterial activities against a variety of Gram-positive and Gram-negative bacteria, including Pseudomonas aeruginosa and Enterobacter aerogenes, which are insensitive to cefazolin and cefmetazole . The compounds (3e, 4e) having a 1-methyl-1H-tetrazolylthiomethyl group at the 3-position appeared to show the best activity in each series . The 4-hydroxypyridine-3-carbonylamino derivative 4e gave higher peak serum concentrations and urinary recovery rates than those of the 4-hydroxy-1,5-naphthyridine derivative 3e when administered subcutaneously to mice and intramuscularly to rats.

Pediatr Infect Dis, 1983 May-Jun, 2(3), 203 - 8
Polymicrobial bacteremia associated with lipid emulsion in a neonatal intensive care unit; Jarvis WR et al.; Polymicrobial bacteremia developed in 5 of 20 infants in a neonatal intensive care unit during a 48-hour period; 2 infants died . Klebsiella pneumoniae serotypes 21 and 24 and Enterobacter cloacae were isolated from four infants, and K . pneumoniae serotype 24 and E . cloacae were isolated from the other infant . Case-control studies revealed an association between receipt of lipid emulsion on one day and the subsequent development of bacteremia (P = 0.0005) . Epidemiologic evidence suggested that extrinsic contamination of the lipid emulsion bottles had occurred when the hands of a nurse became transiently colonized with these organisms while she was caring for an infant colonized with K . pneumoniae and E . cloacae . Repeated entry of the lipid emulsion bottle, which was used as a multidose medication, probably resulted in contamination . No further cases occurred after lipid emulsion administration practices were changed . We recommend that, except in a pharmacy where conditions for unit dose distribution exist, lipid emulsion should not be used as a multiple dose medication because repeated entry of the bottles increases the risk of contamination . Furthermore lipid emulsion from one container should be administered to only one infant.

Infect Immun, 1983 May, 40(2), 696 - 700
Modification of the lipid moiety of the enterobacterial common antigen by the "Pseudomonas factor"; Kuhn HM et al.; Pseudomonas aeruginosa produces a factor (PF) which affects the enterobacterial common antigen (ECA); resulting in failure of the antigen to modify erythrocytes for hemagglutination by ECA antibodies . In the present study the nature of PF was determined . Pronase treatment abolished its activity, indicating the protein nature of PF . PF-treated ECA no longer coated erythrocytes but still reacted with ECA antibodies in immunoelectrophoresis tests with monospecific antiserum to ECA, although differences were noted between the precipitation patterns of PF-treated and untreated ECA . Therefore, PF does not significantly affect the antigenic determinant of ECA but rather affects its lipid carrier, an L-glycerophosphatide . Accordingly, differences in the sugar chain could not be detected by high-voltage paper electrophoretic examinations of partial hydrolysates of PF-treated and untreated ECA . PF liberates all fatty acids from ECA, similarly to commercial lipases, as evidenced by the liberation of unsubstituted glycerol upon HF degradation at 0 degrees C of PF-treated ECA . The lipase activity of PF is indicated also by the observation that a strain of P . aeruginosa with reduced lipase production and an exolipase-negative strain affect ECA either less or not at all . We conclude that PF is a lipase acting on the lipid moiety of ECA, which is responsible for the coating of erythrocytes, but not significantly on the serological determinant, the amino sugar chain.

Pathol Biol (Paris), 1983 May, 31(5), 311 - 8
{Antibacterial activity of apalcillin against 300 strains of enterobacteria}; Coulet M et al.; The in vitro bacteriostatic activity of apalcillin was compared with those of piperacillin, mezlocillin and carbenicillin . The minimal inhibitory concentrations determined by a microtiter dilution method, show a bi-modal distribution: apalcillin, piperacillin: 1 mg/l - greater than 128 mg/l; mezlocillin: 2 mg/l - greater than 128 mg/l; carbenicillin: 4 mg/l - greater than 128 mg/l . Two thirds of the isolates are inhibited by 8 mg/l of any antibiotic, except carbenicillin (128 g/l) . Two genus seem less susceptible: Klebsiella display modal MIC of apalcillin and piperacillin equal to 4 mg/l and above 128 mg/l: Serratia isolates resist to 128 mg/l, whatever antibiotic is considered . The in vitro bactericidal activity of apalcillin was evaluated by killing-curves method against 8 Enterobacteriaceae strains . Used at a concentration equal to the MIC or twice the MIC, apalcillin produces a 1,5-2 log10 reduction in viable count, 3 hours after the addition of antibiotic.

Contraception, 1983 May, 27(5), 497 - 504
Vaginal colonization of Escherichia coli and its relation to contraceptive methods; Percival-Smith R et al.; PIP: The prevalence rate of vaginal colonization with E . coli was studied prospectively over the January-April 1982 period among 495 healthy premenopausal women, and factors associated with vaginal carriage of E . coli were examined . The study was conducted at the University of British Columbia Student Health Service . A confidential questionnaire was administered for information regarding present sexual activity, methods of contraception, menstrual hygiene, previous history of genital and urinary tract infections, and recent antibiotic use . A manual pelvic examination was performed and vaginal culture was obtained . 28% of the women were seen in the Clinic because of genital symptoms including vaginal discharge with or without irritation, abnormal menstruation, or pelvic pain . 71% of the women attended the Clinic for an annual physical examination and had no genital complaints . E . coli was isolated in 61 women (12%) . Other Enterobactericeae were cultured from 6 additional women . Factors significantly associated with vaginal colonization of E . coli included phase of the menstrual cycle, prior use of antibiotics, previous history of urinary tract infection, concurrent presence of gential complaints, and use of diaphragm or cervical cap contraceptive method . Difference in prevalence rates of vaginal E . coli in women using diaphragm or cervical cap compared to rates among women using other contraceptive methods remained statistically significant when other confounding factors such as phase of menstrual cycle, presence of genital complaints, previous history of urinary tract infection, or prior use of antibiotics were kept constant . No significant correlation with vaginal E . coli was observed regarding prior vaginal infection within 2 weeks, sexual activity, intercourse during menstruation, or use of vaginal douche or spray .

J Clin Microbiol, 1983 May, 17(5), 807 - 13
Evaluation of the AutoSCAN-3 and Sceptor systems for Enterobacteriaceae identification; Woolfrey BF et al.; To evaluate the accuracy and cost effectiveness of the AutoSCAN-3 (Micro-Scan Systems of America, Sacramento, Calif.) and Sceptor (BBL Microbiology Systems, Cockeysville, Md.) systems for identification of members of the Enterobacteriaceae, we performed parallel tests on 678 stock cultures of well-characterized clinical isolates of Enterobacteriaceae . Automated results by AutoSCAN-3 correctly identified 95.1% at the genus level and 94.9% at the species level . However, 15 of 42 Shigella isolates were misidentified as members of other genera . In contrast to the automated results, visual interpretation of panels produced 97.9% agreement at the genus level, missing only three Shigella isolates . Sceptor correctly identified 96.8% at the genus level and 93.4% at the species level . Of 42 Shigella isolates, 3 were missed and were designated as Salmonella spp . Although all Salmonella spp . were correctly identified, six other isolates were misidentified as Salmonella spp . Test costs were found to be comparable for each system, with the cost per test increasing markedly with fewer than 10 to 15 tests performed per day.

J Clin Oncol, 1983 May, 1(5), 302 - 7
Trimethoprim/sulfamethoxazole versus placebo: a double-blind comparison of infection prophylaxis in patients with small cell carcinoma of the lung; de Jongh CA et al.; The suppression of pathogenic aerobes and the preservation of anaerobes provides a degree of infection prevention during granulocytopenia . Trimethoprim/sulfamethoxazole (TMP/SMZ) suppresses Enterobacteriaceae and probably maintains colonization resistance through sparing of anaerobes . TMP/SMZ (320/1600 mg/day) treatment was compared to placebo in a double-blind, randomized trial in patients with newly diagnosed small cell carcinoma of the lung during the initial courses of chemotherapy with cyclophosphamide, doxorubicin, and etoposide . Infections were evaluated as microbiologically documented, with or without bacteremia, and clinically documented and were correlated to granulocytopenia . Of the 61 patients evaluated, 32 were given TMP/SMZ and 29 were given placebo; both groups had similar characteristics with regard to disease extent, performance status, age, sex, chemotherapy, and days of granulocytopenia . Incidence of infection at less than 100 granulocytes/microliters was significantly reduced in the TMP/SMZ group (2 infections/100 days) compared to placebo (11 infections/100 days, p = 0.005) . Also reduced were the number of bacteremias and the mean proportion of study time on broad-spectrum antibiotics (p less than 0.01) . Compared to placebo, TMP/SMZ provided infection prophylaxis without an increase in marrow suppression among patients with small cell carcinoma of the lung receiving intensive chemotherapy.

Pathol Biol (Paris), 1983 May, 31(5), 357 - 61
{In vitro activity of cefatiolene (RP 42,980) against hospital bacteria . Comparison with cefotaxime and lamoxactam . Results of a multicenter study}; Duval J et al.; This work reports a multicenter study of antibacterial activity of cefatiolene (RP 42 980), a new third generation cephalosporin, in comparison with cefotaxime and lamoxactam . On the basis of MIC, activity of the three products is similar or Gram negative rods, but cefotaxime is a little more active on Enterobacteriaceae . The activity against Staphylococci requires further studies, indeed the determination of IC 50 of some strains showed a better activity of cefatiolene, but this was not observed by determination of MIC . As cefotaxime and contrary to lamoxactam, cefatiolene is active at low concentrations on other Streptococci than Enterococci, but a little on Bacteroides.

Pathol Biol (Paris), 1983 May, 31(5), 351 - 6
{In vitro activity of cefmenoxime (SCE 1365) against 616 hospital strains of gram-negative bacilli chosen for beta-lactam resistance . Comparison with cefotaxime, lamoxactam and ceftazidime}; Le Noc P et al.; The in vitro activity of a new cephalosporin, cefmenoxime, was tested by an agar dilution procedure against 616 strains of Gram negative rods resistant to various beta-lactams and was compared with that of cefotaxime, lamoxactam, ceftazidime (and cefsulodin against P . aeruginosa) . A high activity was demonstrated on many species of tested Enterobacteriaceae including E . coli, K . pneumoniae, S . marcescens, E . cloacae resistant to the first generation cephalosporins, Proteus sp., Providencia and C . freundii, with MIC geometric mean values from 0,028 to 0,33 microgram by ml . These values were nearly similar to those given by cefotaxime or lamoxactam and inferior to those given by ceftazidime . Cefmenoxime however showed a low activity (MIC geometric means from 19,5 to 25,5 micrograms by ml) against E . cloacae resistant to second generation cephalosporins (the better agent was lamoxactam), A . calcoaceticus (the better agent was ceftazidime) and carbenicillin-resistant P . aeruginosa (here ceftazidime and cefsulodin gave better performances).

Pathol Biol (Paris), 1983 May, 31(5), 336 - 42
{Cefotaxime, moxalactam and ceftriaxone: comparison of in vitro activity against hospital strains of Enterobacteriaceae belonging to the 4 principal phenotypes of sensitivity to beta-lactams}; Jarlier V et al.; MIC of ceftriaxone, moxalactam and cefotaxime is determined for 827 strains of Enterobacteriaceae isolated in the Central Laboratory of the Pitie-Salpetriere Hospital between december 1981 and september 1982 . Results are distributed according to the species involved and the pattern of sensitivity (S) and resistance (R) to ampicillin (A), carbenicilline (Ca) and cephalotin (Ct) . Among the strains ASCaSCtS and ARCaRCtS cefotaxime and ceftriaxone have the lowest MICs . Among the most sensitive strains ARCaSCtR and ARCaRCtR cefotaxime, ceftriaxone and moxalactam have the similar MICs, whereas among the less sensitive ones moxalactam has the lowest MICs . The latter might be the cephalosporin of choice for the treatment of serious infection due to the less sensitive Enterobacteriaceae . On the other hand, cefotaxime and ceftriaxone might be the cephalosporins of choice for the treatment of serious infections due to the most sensitive Enterobacteriaceae.

J Antimicrob Chemother, 1983 May, 11 Suppl C, 91 - 5
Prospective randomized comparative studies of mezlocillin/cefotaxime vs . gentamicin/cefoxitin; Kosmidis J et al.; In 54 patients suffering from a variety of severe systemic infections the combination of mezlocillin (4 g iv 6-hourly) plus cefotaxime (2 g iv 8-hourly) was compared to that of gentamicin (1.5 mg/kg im or iv 8-hourly) plus cefoxitin (2 g iv 6-hourly) . In the gentamicin/cefoxitin group metronidazole (500 mg iv 8-hourly) was added for anaerobic infections . Treatment assignment was randomized . The patients' diagnoses were: pyelonephritis (24), pneumonia (14), infected burns (9), osteomyelitis (2), and abdominal infections (5) . Pathogens included: Escherichia coli (31), other Enterobacteriaceae (21), Pseudomonas aeruginosa (13), anaerobes (4), and others (2) . Treatment with mezlocillin/cefotaxime cured 20 (74%) of 27 patients and caused improvement in 5, while in 19 (70%) patients the pathogens were eradicated . In the gentamicin/cefoxitin group 17 (63%) of 27 patients were cured and 6 improved, while in 15 (56%) pathogens were eradicated . One patient in the first group developed a rash, while in the second group two patients developed thrombophlebitis and another two transient nephrotoxicity . The combination of mezlocillin and cefotaxime can be recommended for the rational and empirical treatment of serious systemic infections.

Antimicrob Agents Chemother, 1983 May, 23(5), 731 - 7
Ceftriaxone therapy of bone and soft tissue infections in hospital and outpatient settings; Eron LJ et al.; Ceftriaxone, a broad-spectrum cephalosporin with a markedly extended half-life, was administered to 100 patients with 56 bone and 44 soft tissue infections . Sixty-eight received 1 g twice daily, and 32 received 2 g once daily intravenously . Overall, 91% had a satisfactory clinical response, with similar efficacies in both treatment regimens . In six patients, failure to achieve a cure correlated well with the development of resistance to ceftriaxone during therapy in Enterobacter and Pseudomonas species (two cases) and with superinfection with Bacteroides fragilis (four cases) . In 41 patients, intravenous drug therapy was continued after discharge from the hospital . In this group, 1,093 patient-days of hospitalization were saved, amounting to $150,020 in cost savings . The prolonged half-life facilitated the administration of ceftriaxone in this setting.

Infect Immun, 1983 May, 40(2), 453 - 9
Role of antibody and enterobactin in controlling growth of Escherichia coli in human milk and acquisition of lactoferrin- and transferrin-bound iron by Escherichia coli; Brock JH et al.; Growth of Escherichia coli NCTC 8623 in human milk was slow during the first 10 h of incubation, but this bacteriostatic effect had disappeared by 24 h . The bacteriostatic phase could be abolished by adding sufficient iron to saturate the lactoferrin in human milk, and also by adding supernatant from a 24-h milk culture or by adding enterobactin, an enterobacterial iron chelator . Growth in the presence of enterobactin was even more rapid than in the presence of excess iron . Partial loss of bacteriostatic activity could be achieved by absorbing the milk with bacterial antigens, but no clear correlation with removal of antibodies to O, K, or H antigens was apparent . When E . coli was grown in human serum trace-labeled with 59Fe, the organisms acquired iron from transferrin during growth . Cultivation of E . coli in a minimal medium supplemented with transferrin or lactoferrin doubly labeled with 125I and 59Fe showed that iron acquisition occurred without either assimilation or degradation of the iron-binding proteins.

Nature, 1983 Apr 21, 302(5910), 725 - 6
Conjugative plasmids in bacteria of the 'pre-antibiotic' era; Hughes VM et al.; Antibiotic resistance is common in bacteria that cause disease in man and animals and is usually determined by plasmids . The prevalence of such plasmids, and the range of drugs to which they confer resistance, have increased greatly in the past 25 yr . It has become clear from work in many laboratories that plasmids have acquired resistance genes, of ultimately unknown origin, as insertions into their circular DNA . The intensive use of antibiotics since their introduction in the 1940s can explain the spread of plasmids that have acquired such genes but little is known of the incidence of plasmids in pathogenic bacteria before the widespread use of antibiotics in medicine . E.D.G . Murray collected strains of Enterobacteriaceae from 1917 to 1954; we now report that 24% of these encode information for the transfer of DNA from one bacterium to another . From at least 19% of the strains, conjugative plasmids carrying no antibiotic resistance were transferred to Escherichia coli K-12.

Zh Mikrobiol Epidemiol Immunobiol, 1983 Apr, (4), 27 - 30
{Determination of the formation of hydrogen sulfide in a dry differentiating medium of the Kligler agar type}; Gorchenina LV et al.; The indicator system for hydrogen sulfide detection in media analogous to Kligler's agar, intended for the primary identification of enterobacteria, has been studied . The indicator system under study, in contrast to the known formulas, contains sodium metabisulfite for improving the capacity for detecting hydrogen sulfide production in bacteria which produce it in small amounts from inorganic sulfur compounds.

Antimicrob Agents Chemother, 1983 Apr, 23(4), 617 - 8
Isolation of trimethoprim-resistant, sulfonamide-susceptible Enterobacteriaceae from urinary tract infections; Towner KJ et al.; The isolation of trimethoprim-resistant, sulfonamide-susceptible Enterobacteriaceae causing urinary tract infections is reported . The appearance of these strains followed the introduction of trimethoprim alone for use as treatment . Trimethoprim resistance was attributable to plasmids or transposons less frequently in sulfonamide-susceptible Escherichia coli isolates than in sulfonamide-resistant strains.

J Antimicrob Chemother, 1983 Apr, 11(4), 339 - 47
Effects of erythromycin and gentamicin in experimental peritonitis; Pressey A et al.; Erythromycin and gentamicin were used to analyse the concept of bacterial synergy in an experimental model of acute appendicitis . Erythromycin given orally suppressed the aerobic flora other than the Enterobacteriaceae . When given by injection, a notable reduction in the counts of bacteroides and other anaerobic Gram-negative bacteria was also achieved . The addition of gentamicin, itself inactive against bacteroides, resulted in their total suppression . The implications of these findings are discussed.

J Appl Bacteriol, 1983 Apr, 54(2), 209 - 15
Dynamics of salmonella isolation with modified Rappaport's medium (R10); van Schothorst M et al.; Enhanced growth of salmonellas in Rappaport's medium as modified by Vassiliadis et al . (1976) after pre-enrichment in buffered peptone water during the first 6 h was obtained by replacement of tryptone by soya peptone . The competing bacteria, i.e . those which grow on brilliant green agar and which may interfere with the isolation of salmonellas when Rappaport's medium (R10) incubated at 43 degrees C is used for enrichment were inhibited or reduced in numbers when the normal amount of 5 g soya peptone/litre was used . When the amount was increased to 10 g/l, growth occurred, mainly of Enterobacter and Klebsiella species . The isolation of salmonellas was found to be largely dependent on the number and the ratio of their competitors . Every measure taken to reduce the number of competitive bacteria increases the possibility of isolating salmonellas . This explains the effect of improved selectivity of Rappaport's medium when small inocula are used . Rapid onset of growth of salmonellas by employing soya peptone introduces the possibility of using shorter incubation times 48 h.

Exp Parasitol, 1983 Apr, 55(2), 258 - 63
Neoaplectana species: specificity of association with bacteria of the genus Xenorhabdus; Akhurst RJ; Each of five Neoaplectana (Nematoda: Steinernematidae) species was cultured monoxenically with various Xenorhabdus (Eubacteriales: Enterobacteriaceae) isolates . The nematodes were usually able to reproduce when cultured with the bacterial symbiont of any one of the five Neoaplectana spp . but never with Xenorhabdus luminescens, symbiotic with Heterorhabditis spp., or with the Xenorhabdus sp . isolated from an undescribed steinernematid species . Only Neoaplectana bibionis could be cultured with the Xenorhabdus symbiont of Steinernema kraussei . A high proportion of infectives were able to carry within their intestine X . nematophilus isolated from other strains of the same nematode species; a small proportion of infectives were able to carry X . nematophilus isolated from other nematode species.

J Antimicrob Chemother, 1983 Apr, 11(4), 319 - 24
Comparative in-vitro activity of temocillin (BRL 17421), a new penicillin; Clarke AM et al.; The activity in vitro of the new parenteral penicillin, temocillin, was determined by an agar dilution technique at two inocula against 201 recent clinical isolates and also against reference strains that produced characterized beta-lactamases . Ampicillin, ticarcillin, latamoxef (moxalactam) and cefoxitin were used as comparative agents . Temocillin showed no useful activity against Pseudomonas aeruginosa or the Bacteroides fragilis group but was highly active against the Enterobacteriaceae, inhibiting all isolates (Serratia marcescens excepted) at less than or equal to 8 mg/l . The MIC50 and MIC90 were usually within one dilution and results with both inoculum sizes were similar . Temocillin also had good activity against Haemophilus influenzae and beta-lactamase producing strains were as susceptible as non-beta-lactamase producers . Neither for the Enterobacteriaceae nor for H . influenzae did a 1000-fold increase in inoculum result in a greater than two-fold increase in MIC . The above results implied excellent stability to beta-lactamases and this was borne out by the activity of temocillin against strains containing chromosomal cephalosporinases, the 'broad-spectrum' Class IV enzyme and the plasmid mediated enzymes TEM-1, OXA-1 and SHV-1 . The protein binding of temocillin was found to be 87%.

J Antimicrob Chemother, 1983 Apr, 11(4), 299 - 310
Broad-spectrum beta-lactam resistance in Enterobacter: emergence during treatment and mechanisms of resistance; Olson B et al.; Of three patients with Enterobacter mediastinitis treated with cefamandole, two failed initial treatment due to emergence of strains resistant to cefamandole and third generation cephalosporins . Extracts of the sensitive strains showed inducible hydrolysis of cephalothin; resistant strains (wild and laboratory derived) showed constitutive hydrolysis of cephalothin and cefamandole and bound but did not hydrolyze cefotaxime and latamoxef (moxalactam) . In one mutant, increased latamoxef resistance appeared due to non-enzymatic mechanism(s) . The Enterobacter strain from the patient who was treated successfully with cefamandole yielded only low level resistant mutants with lower cephalosporin binding than obtained with the other strains.

J Antibiot (Tokyo), 1983 Apr, 36(4), 398 - 406
Synthesis and beta-lactamase inhibitory activities of some clavulanic acid analogues; Mak CP et al.; Clavulanic acid analogs lacking the C-3 carboxyl group are potent inhibitors of both plasmid and chromosomally mediated beta-lactamases . They exhibit only low intrinsic anti-bacterial activity, but potentiate the activity of ampicillin and cephaloridine against beta-lactamase producing Escherichia coli and Enterobacter cloacae in vitro . No synergism was observed in beta-lactamase negative strains . The E . coli TEM 1 and the E . cloacae P99 enzymes are inhibited in a progressive and irreversible manner by these compounds.

Pathology, 1983 Apr, 15(2), 159 - 60
Azthreonam: in vitro activity against urinary pathogens; Lang SD et al.; The in vitro activity of azthreonam, a novel monocyclic beta-lactam antibiotic, was investigated for Gram negative urinary pathogens by determining the susceptibilities of 105 consecutive isolates from specimens submitted to the Auckland Hospital microbiology laboratory . All were sensitive or of intermediate sensitivity by disc diffusion testing . Minimum inhibitory concentrations (MICs) were 0.25 mg/l for 97 per cent of Enterobacteriaceae and ranged from 2-16 mg/l for Pseudomonas aeruginosa . Of antibiotics tested routinely in this laboratory only tobramycin showed comparable potency.

Acta Pathol Microbiol Immunol Scand {B}, 1983 Apr, 91(2), 135 - 9
The in vitro activity of gentamicin, tobramycin and netilmicin against 500 clinical isolates of bacteria . A comparative study using three different test media; Digranes A et al.; The in vitro activities of the three aminoglycoside antibiotics, gentamicin, and tobramycin have been compared against 500 isolates of Enterobacteriaceae, Pseudomonas aeruginosa and Staphylococcus aureus . An agar dilution method was employed with three sensitivity media: Iso-Sensitest Agar, Mueller-Hinton Agar and PDM-Antibiotic Sensitivity Medium . All three aminoglycosides were highly active against S . aureus (MIC less than or equal to 0.5 mg/l) and the majority of Enterobacteriaceae (MIC90 approx . 1 mg/l) . Tobramycin showed the highest activity against P . aeruginosa (MIC less than or equal to 1 mg/l) . No major difference in measured MIC were found on the three media . Gentamicin and netilmicin were somewhat less active against P . aeruginosa on Mueller-Hinton Agar . MICs for tobramycin against Enterobacteriaceae were a little higher on PDM than on the other two agars . Our results show that measured MIC varied very little on the three sensitivity media . All media are suitable for routine use, provided that control strains are employed.

Zh Mikrobiol Epidemiol Immunobiol, 1983 Apr, (4), 20 - 3
{A paper indicator system for the identification of Enterobacteria}; Andreeva ZM et al.; A paper indicator system has been developed in the USSR for the accelerated identification of vibrios and proposed for the identification of enterobacteria . This system consists of paper discs or strips impregnated with definite substrates (carbohydrates, polyatomic alcohols, amino acids, etc.) in combination with an indicator and stabilized with the polymer coating . Two kits for the identification of enterobacteria to the level of the genus (kit A for 9 tests) and to the level of the species (kit B for 25 tests) are presented.

J Clin Microbiol, 1983 Apr, 17(4), 647 - 54
Evaluation of the Sensititre system for identification of Enterobacteriaceae; Staneck JL et al.; The Sensititre identification system (Seward Laboratory/GIBCO Laboratories) consists of a microplate containing a pattern of 24 biochemicals repeated four times together with an automatic inoculation device and a microcomputer-assisted data interpretation component . A total of 1,415 isolates of Enterobacteriaceae plus 6 isolates of other glucose-fermenting gram-negative bacilli were tested in three hospital laboratories in parallel with API 20E (Analytab Products) . Discrepancies were resolved by conventional biochemical testing . Sensititre yielded correct identifications at the species level with 94.6% of the isolates and at the genus level with an additional 1.9% . API 20E yielded correct species identification with 91.1% and genus only identification with an additional 6.7% of the isolates . For the routine identification of clinical Enterobacteriaceae isolates, the Sensititre system compares favorably with API 20E and offers clinical laboratories the economy of a microtiter plate system as well as the benefit of a microcomputer capable of other microbiological and data management applications.

Ann Rheum Dis, 1983 Apr, 42(2), 176 - 81
Depressed lymphocyte transformation by yersinia and Escherichia coli in yersinia arthritis; Leino R et al.; Lymphocyte transformation responses were studied in 21 patients with acute yersinia infection followed-up after the acute infection for up to one year . Eight patients had reactive arthritis caused by yersinia . The responses to the causative serotype of yersinia were significantly lower (p less than 0.05) in patients with arthritis than in those without arthritis . Stimulation with Escherichia coli gave lower responses than with yersinia, but with E . coli the difference between arthritic and nonarthritic groups was more significant (p less than 0.02) . The responses to yersinia and E . coli were not correlated with the presence of HLA B27 . Lymphocyte transformation by purified protein derivative of tuberculin, streptokinase-streptodornase, phytohaemagglutinin, or concanavalin-A revealed no significant differences between the arthritic and nonarthritic groups . The role of the enterobacterial common antigen in the pathogenesis of reactive arthritis and ankylosing spondylitis is discussed.

Antimicrob Agents Chemother, 1983 Apr, 23(4), 559 - 64
In vitro activity of Bay 09867, a new quinoline derivative, compared with those of other antimicrobial agents; Wise R et al.; The in vitro activity of Bay 09867, a new quinoline derivative, was compared with those of norfloxacin, nalidixic acid, ceftazidime, cefaclor, cefuroxime, gentamicin, and other antimicrobial agents, when appropriate, against 410 recent clinical isolates . The minimal inhibitory concentrations of Bay 09867 for 90% of Enterobacteriaceae, Pseudomonas aeruginosa, Haemophilus influenzae, Neisseria gonorrhoeae, streptococci, Staphylococcus aureus, and Bacteroides fragilis strains were between 0.008 and 2 micrograms/ml . Bay 09867 was considerably more active against the gram-negative bacteria tested than were other agents tested . Gentamicin-resistant Enterobacteriaceae, P . aeruginosa, and methicillin-resistant S . aureus were highly susceptible to Bay 09867 . Strains less susceptible to nalidixic acid and norfloxacin tended to be less susceptible to Bay 09867 . The protein binding of Bay 09867 was about 20%.

Drug Intell Clin Pharm, 1983 Apr, 17(4), 277 - 9
Antibiotic penetration in abdominal infection: a case of tobramycin failure responsive to moxalactam; Carson HB et al.; A 50-year-old male developed an Enterobacter cloacae abdominal infection as the result of gangrene of a gastric remnant after gastrectomy . Aggressive antibiotic treatment with tobramycin and clindamycin was instituted, but despite documented in vitro bacterial sensitivity and high serum tobramycin levels, the patient's clinical condition worsened . Enterobacter cloacae continued to grow in the abdominal drainage cultures . As a last resort, moxalactam therapy was started . Within 36 hours, dramatic clinical improvement was seen and Enterobacter disappeared from the abdominal fluid cultures . Antibiotic assays showed that abdominal fluid contained approximately 50 percent of the simultaneous serum moxalactam concentration, while tobramycin was present in abdominal fluid at less than 15 percent of the serum concentration . In spite of bacterial sensitivity to both drugs, it is likely that moxalactam produced better results than did tobramycin, because of better tissue penetration characteristics.

Acta Pathol Microbiol Immunol Scand {B}, 1983 Apr, 91(2), 101 - 6
Physico-chemical surface properties of Shigella sonnei; Edebo L et al.; In partition in two-phase systems as well as in hydrophobic and ion exchange chromatography a number of Sh . sonnei isolates with different phage patterns showed similar physico-chemical surface properties . All the isolates displayed hydrophobicity and a small negative charge . In this way the shigellae were different from salmonella S-strains and E . coli strains associated with infantile diarrhoea which have shown hydrophilic properties and nearly no charge . They were also different from E . coli strains with typical K-antigen often grown from patients with septicemia and upper urinary tract infection, which have shown hydrophilic properties and a great negative charge . However, the Sh . sonnei isolates were similar to E . coli strains belonging to certain serogroups which have been grown from patients with dysentery-like diseases . The results indicate that physico-chemical surface properties are related among enterobacteria belonging to different genera which have been grown from similar types of infections.

Presse Med, 1983 Mar 26, 12(14), 893 - 7
{Post-operative peritonitis . Surgical tactics and antibiotic therapy}; Fagniez PL et al.; Despite progress in general supportive measures the mortality in post-operative peritonitis remains high (around 50%) . Reoperation and antimicrobial therapy are two major steps in the care of such patients . Reoperation should be considered on clinical grounds . Its major aim is to suppress the source of peritoneal infection, usually in this setting a breach in intestinal integrity . This is best achieved by temporary cutaneous enterostomy . Thorough peritoneal lavage is mandatory to ensure the removal of all particulate matter and pus . The procedure is ended by wound closing, leaving the skin layer open . Very infrequently, laparostomy has to be performed, either because of necrotizing wound infection, or deliberately, in face of peritoneal failure . If possible, when rapid healing permits delayed wound closure, laparostomy should be temporary . Antimicrobial therapy is started preferably with or just before reoperation, and is aimed at the known pathogens in post-operative abdominal sepsis, namely Bacteroides fragilis and enterobacteriaceae . A combination of nitro-imidazole and aminoglycoside or 3rd generation cephalosporin appears suitable in most cases . The duration of antimicrobial therapy is difficult to define at present but it should at least encompass the operation itself and the following 48 hours . The value of more prolonged use has not yet been established.

Minerva Med, 1983 Mar 10, 74(9-10), 427 - 31
{Activity of new cephalosporins against polyresistant bacterial strains}; De Toffoli A et al.; Activities of four new Cephalosporins (Cephamandole, Cefoxitin, Cefuroxime, Cefotaxime) and of some of the most used Aminoglycosidic antibiotics were tested against Gram-negative bacteria (Pseudomonas and some Enterobacteriaceae) that are often formed to be multi-resistant . 266 strains were observed . An evident increase or resistance to Aminoglycosidic antibiotics was confirmed, while the new Cephalosporins demonstrated an remarkable activity against the majority of resistant bacteria, often superior to Aminoglycosidics.

Presse Med, 1983 Mar 5, 12(10), 615 - 9
{Treatment of enterobacterial meningitis in adults with intravenous lamoxactam}; Wolff M et al.; Meningitis caused by Gram-negative bacilli creates difficult problems since most strains are multiresistant . The purpose of this study was to evaluate the effectiveness of lamoxactam administered intravenously . Eleven patients admitted to an intensive care unit with meningitis due to Gram-negative bacilli were treated with this antibiotic, administered alone in 9 cases . Three patients had ventriculitis . Eight survived . The MICs ranged from 0.06 to 0.5 microgram/ml in 10 cases . The CSF was sterilized and rapidly became normal . Meningeal concentrations varied from 1-5 to 62 micrograms/ml and the CSF was bactericidal . In one female patient the CSF was sterile on the 5th day of treatment but remained abnormal; the meningeal concentration of lamoxactam (35 micrograms/ml) was much higher than the MIC (2 micrograms/ml) but below the MBC (128 micrograms/ml), which was consistent with the absence of bactericidal effect of the CSF . Owing to its very low CMIs and satisfactory passage through the blood-brain barrier, lamoxactam administered alone can be successful in the treatment of Gram-negative meningitis and ventriculitis . However, the bactericidal effect of the CSF should be rapidly assessed.

Thorax, 1983 Mar, 38(3), 205 - 8
Pathogenic significance of Klebsiella oxytoca in acute respiratory tract infection; Power JT et al.; A retrospective study of all Klebsiella isolations from patients admitted to hospital with acute respiratory tract infections over a 27-month period was carried out . Ten of the Klebsiella isolations from sputum and one from a blood culture were identified as Klebsiella oxytoca . The clinical and radiological features of six patients are described . Four of these patients had lobar pneumonia, one bronchopneumonia, and one acute respiratory tract infection superimposed on cryptogenic fibrosing alveolitis . One of the patients with lobar pneumonia had a small-cell carcinoma of the bronchus . We concluded that Klebsiella oxytoca was of definite pathogenic significance in these six patients and of uncertain significance in the remaining five patients . Klebsiella oxytoca has not previously been described as a specific pathogen in the respiratory tract . Close co-operation between clinicians and microbiologists in the management of patients with respiratory infections associated with the Enterobacteriaceae is desirable.

Naturwissenschaften, 1983 Mar, 70(3), 115 - 8
{Biosynthesis of phenylalanine and tyrosine: arogenic acid, a new intermediate product}; Lingens F et al.; With the discovery of arogenic acid two new pathways for the biosynthesis of phenylalanine and tyrosine have been revealed . The occurrence of two, three, or four pathways for the biosynthesis of phenylalanine and tyrosine in microorganisms and plants may be a useful tool for taxonomic classifications . Investigations on enterobacteriaceae, pseudomonads, flavobacteria, streptomycetes, archaebacteria, and on Sphaerotilus, Trichococcus and Leptothrix species from bulking sludge are described . The possible role of arogenate in the evolution of the pathways for tyrosine and phenylalanine biosynthesis is discussed.

Appl Environ Microbiol, 1983 Mar, 45(3), 1049 - 59
Sewage coliphages studied by electron microscopy; Ackermann HW et al.; Sewage was enriched with 35 Escherichia coli strains, and sediments of enrichment cultures were studied in the electron microscope . They contained up to 10 varieties of morphologically different particles . T-even-type phages predominated in 14 samples . Thirteen phages were enriched, representing the families Myoviridae (seven), Styloviridae (two), Podoviridae (three), and Microviridae (one) . Twelve of these corresponded to known enterobacterial phage species, namely, 121, K19, FC3-9, O1, 9266, T2, 16-19, kappa, beta 4, N4, T7, and phi X174 . Cubic RNA phages and filamentous phages were not detected . Types 121 and 9266 have previously been observed only in Romania and South Africa . Identification by morphology is usually simple . Our investigative technique is qualitative and will not detect all phages present . Most enrichment strains are polyvalent, and electron microscopy is always required for phage identification . In a general way, electron microscopy seems to be the method of choice for investigation of phage geography and ecology.

J Clin Microbiol, 1983 Mar, 17(3), 493 - 9
Comparison of four rapid methods for identification of Enterobacteriaceae from blood cultures; Malloy PJ et al.; Positive blood cultures containing gram-negative bacilli were utilized for direct identification by two automated systems, the AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) and the MS-2 (Abbott Diagnostics, Dallas, Tex.), and two commercial kits, the Micro-ID system (General Diagnostics, Warner-Lambert Co., Morris Plains, N.J.) and the same-day API 20E (Analytab Products, Plainview, N.Y.) . Samples of 10 to 15 ml were aseptically removed from radiometrically positive BACTEC bottles (Johnston Laboratories, Cockeysville, Md.) and divided among four sterile tubes . The tubes were centrifuged at 107 X g for 10 min . The supernatants were centrifuged at 1,510 X g for 10 min, and pellets were tested for cytochrome oxidase by means of Pathotec strips . Oxidase-negative pellets were suspended in appropriate media as suggested by the manufacturers . All systems were inoculated, incubated, and interpreted according to the instructions of the manufacturers . The Micro-ID system was read after 4 h of incubation; the three remaining systems were read after 5 h . Results were compared with those of the 18-h API 20E inoculated from pure subcultures of the organisms . Correlation of 90% or more with the API 20E was achieved by the AutoMicrobic and Micro-ID systems . The same-day API 20E and the MS-2 demonstrated 60 and 44% correlation, respectively, with the 18-h API 20E.

J Clin Microbiol, 1983 Mar, 17(3), 436 - 44
Collaborative evaluation of the microbial profile system for quantitative antimicrobial susceptibility testing; Gerlach EH et al.; This three-center collaborative study was conducted to evaluate samples of the Microbial Profile System (MPS) antimicrobial microdilution panels {previously produced by Minnesota Mining & Manufacturing Co., (3M Co.), St . Paul, Minn . and currently produced by Flow Laboratories, Inc., Rockville, Md.) . This was a three-phase study . In phase I, the inter- and intralaboratory agreement was determined by using strains with selected ranges of susceptibility . The MPS and reference microdilution minimum inhibitory concentrations were within acceptable variation, +/- 1 dilution for 97.7% for the MPS and 98.8% for the reference microdilution panels for the intralaboratory comparisons . The percentage of strains with minimum inhibitory concentrations in the acceptable range for the interlaboratory variation was 96.2% for the MPS and 96.0% for the reference microdilution panels . The phase II studies used strains with known resistance mechanisms . The percent agreement with these strains was: Enterobacteriaceae, 94.5%; nonenteric gram-negative rods, 95.4%; staphylococci, 92.3%; and streptococci, 96.6% . The overall agreement within acceptable limits was 94.7% with these strains . When testing 359 clinical isolates, the frequency of strains within the acceptable range of agreement between the two methods was 97.3% . The MPS panels gave results in each of the three study phases equivalent to those obtained with the reference microdilution panels.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1983 Mar, 254(1), 95 - 108
A hydrogen sulphide producing Gram-negative rod from water; Aldova E et al.; The biochemical properties of a hydrogen sulphide-producing Gram-negative rod, provisionally designated HG group, were compared with those of the known H2S-producing and H2S-negative Enterobacteriaceae and related organisms . Sixty-four tests were used as a basis for numerical identification . All these tests demonstrated a distinctness of the HG group from other members of Enterobacteriaceae and related organisms . Results of numerical identification are discussed . According to the guanine-plus-cytosine molar content in DNA the bacterium could belong to the tribe Escherichiae of the family Enterobacteriaceae . Plasmids of different molecular size or linear fragments of DNA were found in 17 of 19 strains which indicates that the H2S production is not in correlation with the occurrence of a plasmid of definite size . So far, the only habitat of the HG group had been water, and it seems to be no rarity . Among 28 HG strains a single isolate HG16 was found which differs from HG group in biochemical properties . The distinctness of this single isolate has been confirmed also by numerical identification . Note: On the basis of DNA-DNA hybridization performed by Dr . P.A.D . Grimont and coworkers the HG group has been established as a new genus and a single species . The authors accordingly propose for the group the generic name Budvicia and the specific epithet aquatica.

Ann Microbiol (Paris), 1983 Mar-Apr, 134A(2), 127 - 39
{Immunological study of glyceraldehyde-3-phosphate dehydrogenase in Enterobacteriaceae; taxonomic value}; Trinel PA et al.; The antigenic structure of glyceraldehyde-3-phosphate dehydrogenase of the most representative Enterobacteriaceae species were compared with an antiserum to Escherichia coli glyceraldehyde-3-phosphate dehydrogenase . The results of the immunodiffusion experiments were confirmed and specified by micro-complement fixation studies . They demonstrated a total immunological identity between the E . coli enzyme and the enzymes of Alcalescens-dispar and the Shigella species, a marked relatedness of the Salmonella species enzyme and a more or less significant relation of the enzymes of the other Enterobacteriaceae species . Moreover, the micro-complement fixation had the same sensitivity and a better selectivity than the DNA/DNA hybridizations . The results show that, like DNA polymerase, this enzyme has evolved more slowly than the other enzymes studied at this time.

Vopr Pitan, 1983 Mar-Apr, (2), 63 - 5
{Effect of intravenous and intragastric feeding on the microflora of the rat intestine}; Klimzo ON et al.; During intravenous feeding, the contents of the cecum showed a dramatic fall in the amount of anaerobic lactobacilli and the growth of the content of enterobacteria and enterococci . The level of staphylococci and streptococci remained unchanged . These changes did not depend on the presence of fatty component in the nutritive mixture . The switch over of the animals from oral to intragastric feeding did not produce any changes in the microbile profile of the cecum . However, a distinct relationship was noticed between the overall amount of all the representatives of the microflora and the feeding pattern . Apart from an increase in the content of the microorganisms caused by administering a full-value nutritive mixture to the stomach, there was an appreciable rise in the cecum mass.

Infect Control, 1983 Mar-Apr, 4(2), 93 - 9
Endemic resistance to amikacin among hospital isolates of gram-negative bacilli: implications for therapy; Wormser GP et al.; We reviewed the records of the microbiology laboratory of the Veterans Administration Medical Center, Bronx, New York in order to determine the prevalence, epidemiology and complete antibiotic susceptibility profile of amikacin-resistant aerobic and facultative gram-negative bacilli isolated from clinical specimens submitted for culture between January 1, 1980 and May 1, 1981 . Of more than 5000 gram-negative rods isolated during this 16-month period, 2.8% were determined to be resistant to amikacin by the disc diffusion method . Eighty-eight of the amikacin-resistant organisms were unique isolates derived from cultures on 74 patients located throughout the hospital . Urine (51%) and sputum (27%) were the predominant sources of specimens yielding resistant strains . These organisms represented seven different genera of Enterobacteriaceae (58%) or Pseudomonas aeruginosa (31%) and other glucose non-fermenting species (11%) . Resistance to amikacin was usually associated with resistance to gentamicin, tobramycin and most of the other antimicrobials tested . Twenty percent of isolates were susceptible to only a single antimicrobial, and another 5% were resistant to every agent routinely tested . Although geographic clustering of a small number of amikacin-resistant organisms occurred twice (a strain of Proteus mirabilis on the spinal cord injury service and a strain of P . aeruginosa on one medical ward), the vast majority of isolations were consistent with a pattern of endemic resistance.

Vopr Med Khim, 1983 Mar-Apr, 29(2), 29 - 35
{Deoxyribonuclease of Proteus mirabilis}; Iusupova DV et al.; DNAase was isolated and purified from cell-free extracts of Proteus mirabilis by means of fractionation with ammonium sulfate and CM cellulose chromatography . The enzyme exhibited the endonuclease specificity with DNA as a substrate, split off the native DNA by the "single-strike" mechanism, had a pH optimum in alkaline zone, required Me2+ and was inhibited by tRNA . The highest specific activity and the specific rate of the enzyme synthesis were found at lag phase, before the exponential phase of the cell population growth . Microorganisms of Proteus and Salmonella genera had the highest enzymatic activity in cell-free extracts as compared with other enterobacteria . Possible biological functions of the enzyme are discussed.

Pharmacotherapy, 1983 Mar-Apr, 3(2 Pt 1), 82 - 100
Cefuroxime: mechanisms of action, antimicrobial activity, pharmacokinetics, clinical applications, adverse reactions and therapeutic indications; Gold B et al.; Cefuroxime is a second generation cephalosporin with a broad antimicrobial activity against both Gram-positive and Gram-negative organisms . It has excellent in vitro activity against staphylococcal strains, streptococcal strains (other than enterococci), N . gonorrhoeae, H . influenzae and N . meningitidis . It also has excellent in vitro activity against members of the Enterobacteriaceae with the exception of Serratia and indole-positive Proteus . Ps . aeruginosa and B . fragilis are resistant . Cefuroxime is relatively free of serious side effects . It is metabolically stable, and most of it is excreted unchanged in the urine . Three fourths of it are distributed in the extravascular compartment . Blood levels exceed the in vitro minimum inhibitory concentrations for many important gram negative pathogens . Clinical studies have shown cefuroxime to be effective therapy for infections of soft tissue, respiratory tract, urinary tract, genital tract (caused by N . gonorrhoeae) and the central nervous system . Superinfections with Ps . aeruginosa and enterococcal strains may present a problem . In spite of excellent diffusion into bone and joint tissues, the available clinical data are too limited to make a recommendation for its use in bone and joint infections.

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