Scott Med J, 1982, 27 Spec No., S21 - 3 Augmentin: laboratory studies; Farrell ID et al.; Clavulanic acid is a beta-lactam antibiotic which, although it has little intrinsic activity, is a potent inhibitor of bacterial beta-lactamases . When combined with amoxycillin its range of activity includes penicillinase-producing strains of Staphylococcus aureus and many of the beta-lactamase-producing strains of Gram-negative bacilli . Bacteria sensitive to augmentin include amoxycillin-resistant strains of Haemophilus influenzae and Escherichia coli, in addition strains of Klebsiella aerogenes, Proteus mirabilis, Proteus vulgaris and Bacteroides fragilis are usually sensitive . The beta-lactamases produced by Enterobacter spp, Proteus morgani, Serratia marcescens and Pseudomonas aeruginosa are less susceptible to clavulanic acid and these bacteria are usually resistant to augmentin (1). Crit Rev Microbiol, 1982, 10(1), 1 - 76 Correlation of the results of antibiotic synergy and susceptibility testing in vitro with results in experimental mouse infections; Isenberg HD et al.; Recent clinical isolates (approximately 150 strains) of the family Enterobacteriaceae were examined by agar diffusion, microdilution, and the Autobac automated system for their responses to beta-lactam antibiotics singly and in combination with amdinocillin (formerly called mecillinam) . The ratio of ampicillin, carbenicillin, and cephalothin to amdinocillin was maintained at a 10:1 ratio in most of the evaluations . The same isolates were studied in mice challenged with 100 to 1000 LD50s and treated with graded doses of the antibiotics singly and in combination . Efficacy in vivo was based on the concentration of antibiotic in milligrams per kilograms (mg/kg) required to protect 50% of the animals (PD50) . After a single administration of the antibiotics, plasma levels were determined in the critical time period (30 min to 4 hr) during which the acute, overwhelming systemic infections could be controlled by appropriate therapy . Regression curves comparing in vivo and in vitro results were used to establish cut-off points for categorizing bacterial susceptibility in each of the laboratory tests for the single agents and combinations . A high degree of synergism between amdinocillin and the beta-lactam agents was demonstrated in animals (54 to 78% of the strains examined) and to a lesser extent by laboratory methodologies . There was an excellent correlation of in vivo and in vitro responses to ampicillin, carbenicillin, and cephalothin alone and in combination with amdinocillin for those species for which the single antibiotics are generally indicated . The correlations validated the chosen cut-off points . The correlation of in vivo and in vitro responses to the single or combined antibiotics was generally poorer for those species not usually responsive to the single antibiotics . The greatest difficulty in predicting proper in vivo responses, based on the results of in vitro tests, was observed with amdinocillin. Infection, 1982, 10(4), 228 - 32 Limited protective effect of rough mutant antisera in murine Escherichia coli bacteremia; Peter G et al.; Previous studies in mice have demonstrated differing immunoprophylactic activity of antisera against rough mutants of Enterobacteriaceae in the prevention of lethal gram-negative bacteremia . In this study, in which CF1 mice were made bacteremic with a serum-resistant Escherichia coli 06:K2:H1, the composite survival was significantly (p less than 0.001) enhanced by i . v . pre-treatment one to two hours before injection with either normal rabbit sera or antisera to the J5 mutant of E . coli 0111 . The protective efficacy of these preimmune and hyperimmune sera did not differ significantly . Since considerable variability in the mortality of control mice occurred in the 25 separate experiments, the results of individual experiments were grouped retrospectively according to survival in the individual control groups and compared for evidence of possible differences in the efficacy of these two sera . With the exception of a statistically significant difference in the efficacy in one group receiving an LD75-95 inoculum, no such differences were noted . Thus, the variable effects of a rough mutant antiserum were not explained by differences in the relative virulence in the inoculum . This study confirms earlier observations by others that the protective efficacy of the anti-J5 antisera in infected mice does not differ appreciably from that of normal rabbit sera, provided the same donor rabbits are the source of both preimmune and hyperimmune sera. Arkh Patol, 1982, 44(7), 18 - 24 {Pathological anatomy and pathogenesis of small intestine lesions due to opportunistic enterobacteria (Proteus and Klebsiella)}; Barshtein IuA et al.; Infection with opportunistic agents was reproduced in rabbits by introduction of Proteus and Klebsiella bacteria into a section of the narrowed (but not ligated) small intestine . The presence of infection was documented by clinical signs, isolation of the causative agents, and immunological changes . Light and electron microscopy revealed an inflammatory process of the type of catarrhal enteritis with predominant involvement of the epithelial sheet ("epithelitis") and reactive changes in the base of the mucous membrane and submucous layer . Morphological differences of the infections caused by Proteus and Klebsiella were demonstrated . The level and intensity of pathological changes appear to be associated with the degree of conditionality of the pathogenic properties of enterobacteria. Ophthalmologica, 1982, 185(2), 65 - 8 Metastatic Serratia marcescens endophthalmitis; Radda TM; Serratia marcescens, a gram-negative rod belonging to the family of the Enterobacteriaceae may be the cause of various ophthalmic infections, especially in patients with decreased resistance . The course of these ocular infections is always severe . This is the first description of a metastatic S . marcescens endophthalmitis . It developed in a patient with chronic lymphatic leukemia after prostatectomy . The purpose of this paper is to draw attention to S . marcescens, an organism of increasing importance as an ocular pathogen. Infection, 1982 Jan, 10(1), 9 - 14 In vitro adherence of bacteria to prosthetic vascular grafts; Sugarman B; The adherence of staphylococci and Enterobacteriaceae radiolabelled with 3H-thymidine to Dacron and polytetrafluoroethylene prosthetic vascular graft materials was investigated using an in vitro method . Adherence readily occurred after a few minutes of incubation . Enterobacteriaceae adhered to Dacron in a 10-100 times greater number per mm of length than to polytetrafluoroethylene . The addition of velour to the Dacron graft further increased the number of adherent bacteria . In contrast, the adherence of coagulase-negative and positive staphylococci per mm of length was roughly the same to Dacron and polytetrafluoroethylene . The adherence of bacteria to vascular graft materials may be part of the underlying pathogenesis of vascular graft infections and differential adherence amongst various graft materials could be of clinical importance . However, in the absence of controlled clinical studies, the significance of these findings remains to be determined. Infection, 1982, 10(3), 128 - 30 Non-specific influence of antibiotics on the course of infectious processes; Gillissen G; The clinical significance of a concomitant, non-specific influence of antibiotics on immune defence mechanisms was studied by evaluating the death rate in mice experimentally infected with highly resistant or primarily resistant microorganisms . It could be shown that the mortality rate of mice infected with Enterobacter cloacae or Candida albicans significantly increased under treatment with cefoxitin, whereas treatment with cefotaxine or lamoxactam either had no effect, or even resulted in a better survival rate in comparison to controls . These results run parallel to an inhibition (cefoxitin) or stimulation (cefotaxime and lamoxactam) of antibody production . The effect of cefoxitin on the course of experimental infections could be compensated for by the concomitant application of sodium-8-chlorotheophyllinate which promotes antibody formation . None of these antibiotics showed any additional effect in animals treated with cyclophosphamide . From these observations it was concluded that the influence of antibiotics on certain immunological parameters assayed in vitro may be reflected in comparable effects on the course of infections in vivo; this implies that under certain clinical conditions, the immunological side-effects of antibiotics may be of practical therapeutic significance. Scand J Infect Dis, 1982, 14(2), 159 - 60 A fixed combination of pivmecillinam and pivampicillin in complicated urinary tract infections . A double-blind comparison with pivmecillinam; Igesund A et al.; 23 urological patients, primarily with underlying disease of the urinary tract, received a 10-day treatment with either pivmecillinam/pivampicillin or pivmecillinam alone . Combination therapy eradicated urinary pathogens in the urine at a 48 h control in 11/11 patients treated with the combination compared with 6/12 patients receiving pivmecillinam alone (p less than 0.05) . Two of the treatment failures on pivmecillinam alone were caused by Enterobacteriaceae that were in vitro sensitive to mecillinam . A repeated course with the combination was successful in both of these patients . Apart from a rash seen in one patient in the combination group, no side effects were recorded. J Int Med Res, 1982, 10(3), 179 - 82 Long-term treatment with pivmecillinam in patients with recurrent bacteriuria; Bresky B et al.; Thirty out-patients with chronic recurrent urinary tract infections, who had failed to respond to 10 days treatment with either pivmecillinam and/or amoxycillin, received a 3-month course of pivmecillinam at a dose of 200 mg, three times daily . Twenty-seven patients had bacteriuria due to Enterobacteriaceae, mainly Escherichia coli, sensitive to mecillinam in vitro . Pivmecillinam eradicated all the initial urinary pathogens . Reinfections occurred during treatment in three patients, who remained asymptomatic . Four subjects complained of gastro-intestinal side-effects, and therapy was withdrawn in three instances . Another three patients described unusual adverse events towards the end of the course of treatment, described as an odd sensation in the body and a desire for salt . The sensation disappeared a few days after the end of treatment . Treatment with pivmecillinam had no adverse effect on haematopoietic, hepatic or renal function. Antimicrob Agents Chemother, 1982 Jan, 21(1), 188 - 91 In vitro activity of moxalactam and mecillinam, singly and in combination, against multi-drug-resistant Enterobacteriaceae and Pseudomonas species; Fass RJ; The in vitro interaction of moxalactam and mecillinam against multi-drug-resistant gram-negative enteric bacilli was studied by checkerboard microdilution susceptibility tests and by killing curve kinetics . Against Enterobacteriaceae, the combination was unpredictable; the frequencies of synergy, indifference, and antagonism were 11, 76, and 13%, respectively . Against Pseudomonas sp., the two drugs were consistently indifferent . Overall, the combination of moxalactam and mecillinam was no more active than moxalactam alone. Antimicrob Agents Chemother, 1982 Jan, 21(1), 119 - 24 Clinical efficacy of cefotaxime in serious infections; Karakusis PH et al.; Thirty-five patients underwent 38 treatment courses with cefotaxime . Documented infections included 11 bacteremias, 7 cases of nosocomial pneumonia, 6 surgical wound infections, 3 bone infections, 1 biliary infection, and 1 urinary tract infection . Granulocytopenic patients with fever received 15 courses of empiric cefotaxime therapy alone; in 8 courses, no definite site of infection or pathogen was isolated . Broad-spectrum antibiotics had been administered to 23 patients before cefotaxime . Thirty-seven bacterial pathogens were isolated from 25 patients . Three such pathogens were resistant to cefotaxime and required alternative therapies . Pathogenic isolates included 13 Serratia marcescens, 12 Pseudomonas aeruginosa, 4 Escherichia coli, 2 Klebsiella pneumoniae, 2 Providencia stuartii, 1 Enterobacter cloacae, 1 Haemophilus influenzae, 1 Enterococcus, and 1 Staphylococcus aureus . Of the treatment courses, 25 of 38 resulted in a favorable response to cefotaxime, including 9 of 15 in granulocytopenic patients . Superinfection was seen in one patient . The emergence of resistance was documented in another patient . Of 15 patients with multiply resistant pathogens, 12 improved with cefotaxime . Of 12 patients with Pseudomonas aeruginosa, 6 favorably responded . Possible complications of cefotaxime were observed in 14 of 42 treatment courses . Cefotaxime is most useful in treatment of infections due to multiply resistant, gram-negative pathogens other than Pseudomonas aeruginosa. Infection, 1982 Jan, 10(1), 21 - 2 Pivmecillinam plus pivampicillin in urinary tract infections . A double-blind comparison with pivmecillinam alone in hospitalized patients; Saltvedt EP et al.; Forty hospitalized patients with mostly uncomplicated urinary tract infections received treatment for ten days with either pivmecillinam/pivampicillin of pivmecillinam alone . The bacteriological cure rate immediately after therapy was discontinued was 82% (18/22) in the combination group and 72% (13/18) in the pivmecillinam group . The causative organisms were Enterobacteriaceae in 89% of the cases . All but one were sensitive in vitro to mecillinam alone . No side-effects were recorded. J Infect Dis, 1982 Jan, 145(1), 118 - 25 Resistance to cefamandole: a collaborative study of emerging clinical problems; Sanders CC et al.; Cefamandole resistance in five patients was studied . Microorganisms emerged resistant to cefamandole during therapy with the drug in three patients with complicated infections . This resistance was associated with an enhanced production of beta-lactamase and/or with a change in the substrates and the isoelectric focusing patterns of the enzymes . Cross-resistance to other beta-lactam antibiotics developed concurrently in isolates from these patients . Disk diffusion tests did not detect resistance to cefamandole in the pretreatment isolate from the fourth patient; this isolate produced inactivating enzymes, and resistance was detected only in broth dilution tests . In the fifth patient, infection with a cefamandole-resistant Enterobacter developed during postoperative therapy with the drug . Resistance to cefamandole in the isolate from this patient was unstable and was associated with inducible beta-lactamase activity . These examples emphasize the need for close monitoring of patients who are given cefamandole and for thorough in vitro evaluation of isolates from the patients both before and after treatment. Ann Fr Anesth Reanim, 1982, 1(6), 655 - 60 {Treatment of septicemia with latamoxef . Multicentric study of 60 cases}; Salord JC et al.; Sixty patients including forty two males and eighteen females, age range: 18-87 years, received antibacterial single drug treatment with latamoxef for septicemia . Forty nine patients had underlying conditions including multiple trauma, neoplasm, cardiovascular, metabolic and respiratory tract diseases . Causative pathogens were isolated in all cases . The predominant isolates were E . coli (thirty), Klebsiella pneumoniae (tent) and Enterobacter (seven) . A single organism was isolated in fifty seven cases; in the other three cases two organisms were isolated from blood cultures . Mean daily dosage was 46.6 +/- 6.1 mg . kg-1 (range: 14-113 mg . kg-1) . In the majority of cases (fifty two) dosage was 3 g . d-1 or less; in thirty cases it was no higher than 2 g . d-1 . Duration of therapy ranged from six to thirty eight days . Serum titer was measured in many cases and latamoxef blood levels were assayed in nine patients . A satisfactory clinical response was achieved in fifty eight cases and fifty eight bacteriological cures were also obtained . There was no statistically significant difference in therapeutic response between the 2 g and 3 g daily dosage groups . Tolerance was very good; untoward effects were few and required drug discontinuation in one case only. Chemotherapy, 1982, 28(3), 204 - 8 In vitro comparative activity of moxalactam, GR 20263, and N-formimidoyl thienamycin to other beta-lactam antibiotics and tobramycin against enterobacteriaceae and staphylococci; Cynamon MH et al.; The in vitro activities of moxalactam, GR 20263, and N-formimidoyl thienamycin were compared to those of cephalothin, cefazolin, cefamandole, cefoxitin, and tobramycin against 152 strains of Enterobacteriaceae and staphylococci . The results showed that moxalactam, GR 20263, and N-formimidoyl thienamycin each had significantly improved activity toward the gram-negative organisms tested compared to the other beta-lactams and tobramycin . N-formimidoyl thienamycin was particularly impressive with respect to its activity toward Staphylococcus aureus and S . epidermidis as compared to moxalactam, GR 20263 and the older beta-lactam drugs. Carbohydr Res, 1981 Dec 1, 98(1), 105 - 13 Structure of the capsular polysaccharide of Klebsiella type 73 (Enterobacter aerogenes); Batavyal L et al.; The capsular polysaccharide from Klebsiella Type 73 (Enterobacter aerogenes) was found to contain equimolar amounts of D-galactose, D-glucose, L-rhamnose, and D-glucuronic acid . Acid hydrolysis of the polysaccharide gave one aldobio-and one aldotrio-uronic acid, whose structures were established by acid hydrolysis and by methylation analysis . The anomeric configurations of the different sugar residues were determined from the specific rotations of the polysaccharide and the aldobio-and aldotrio-uronic acids, and also by oxidation of the native and the carboxyl-reduced polysaccharide with chromium trioxide . Methylation analysis of the polysaccharide provided information about the linkages of the different sugar residues . Based on all of these results, the structure assigned to the repeating unit of the polysaccharide is as follows . (Formula: see text). Appl Environ Microbiol, 1981 Dec, 42(6), 1043 - 50 Role of pH, lactate, and anaerobiosis in controlling the growth of some fermentative Gram-negative bacteria on beef; Grau FH; At 5 degrees C four strains of fermentative, gram-negative bacteria (Serratia liquefaciens, Yersinia enterocolitica, Enterobacter cloacae, and Aeromonas hydrophila) grew aerobically and anaerobically on adipose tissue removed from beef muscle of low pH (5.4 to 5.6) . All four strains also grew aerobically and anaerobically on muscle tissue of high pH (6.0 to 6.3) . However, none of the four grew anaerobically on beef muscle of low pH, and the aeromonad strain also failed to grow aerobically on such muscle . Growth of S . liquefaciens and E.cloacae on vacuum-packaged beef muscle was dependent on the pH of the tissue and the oxygen transmission rate of the packaging film . Although the four strains grew in broth buffered at pH 5.55, L-lactate, at the concentration found in muscle of low pH (ca . 100 mM), prevented anaerobic growth of all four isolates and prevented the aerobic growth of th aeromonad . At pH 6.1 in buffered broth, the concentration of L-lactate occurring in muscle of high pH did not prevent aerobic or anaerobic growth of any of the strains. Int J Zoonoses, 1981 Dec, 8(2), 107 - 10 A survey of salmonellae in trade cattle slaughtered at Nsukka abattoir; Oboegbulem SI et al.; A survey was carried out to determine the occurrence and carrier rate of Salmonella in trade cattle slaughtered for human consumption at Nsukka abattoir in Anambra State . Two hundred Zebu cattle were screened . A total of 424 specimens comprising of gall bladders, messenteric lymph nodes and rectal faeces were subjected to enterobacteriological studies . Identification of isolants was based on biochemical reactions and the use of polyvalent and group-specific antisera . Two Salmonella serotypes made up of Sal . typhimurium (3 strains) and Sal . dublin (5 strains) were obtained from 6 of the 200 cattle . A carrier rate of 3% was recorded . Two animals were carriers of Sal . typhimurium, while 4 cattle harboured Sal . dublin . Two strains of Sal . typhimurium and 3 of Sal . dublin were isolated from the gall bladder . The public health significance of the occurrence of anthropozoonotic Salmonellae in food animals as well as the hazard of consumption of bile are discussed. J Clin Microbiol, 1981 Dec, 14(6), 665 - 70 Time-motion and cost comparison study of micro-ID, API 20E, and conventional biochemical testing in identification of Enterobacteriaceae; Bale MJ et al.; A total of 730 Enterobacteriaceae strains isolated from 567 cultures were evaluated by a rapid kit method (Micro-ID; General Diagnostics, Morris Plains, N.J.; 4 h), an overnight incubation kit method (API 20E; Analytab Products, Plainview, N.Y.), and conventional biochemical test methodology (mostly overnight incubation and some rapid methods) to compare the amount of laboratory effort required, timing, and cost parameters . We assessed the amount of technologist time expended, the time sequence of culture reporting to physicians, the number of isolates requiring repeat testing or additional biochemical testing, the number of cultures held due to the need for identification of other organisms, the cost of total work-up, etc . Cultures evaluated included urines, respiratory cultures, wound cultures, body fluids, genital cultures, and cultures from miscellaneous categories . A total of 64% of the Enterobacteriaceae strains processed by the Micro-ID method could be identified within 24 h of receipt of the specimens in the clinical laboratories, in contrast to the need for an additional day required by the API or conventional biochemical methods . The Micro-ID method also required less technologist time (4.5 min) for set-up and interpretation than did either the API method (6 min) or conventional methods (7 min) . Total direct costs (June 1981) per organism identified were: Micro-ID, $4.30; API 20E, $4.96; conventional biochemicals with commercially prepared media, $5.66 . An estimate of 80% technologist time efficiency was made in all procedures. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1981 Dec, 251(1), 62 - 9 Comparative clinical evaluation of the effect of sucrose in a new anaerobic blood culture medium; Dankert J et al.; In order to study the effect of excess sucrose on microorganisms, growth curves of 5 anaerobic and 5 aerobic microorganisms were performed in Diagnostic Anaerobic Growth (DAG) medium, and in a variant of DAG supplemented with 200 g/l sucrose (DAG-S) . It was found that both aerobes and anaerobes were suppressed by the additional sucrose . In a clinical trial 1,800 blood cultures froms 1,332 patients were simultaneously inoculated into DAG and DAG-S . Results showed that excess sucrose did not improve the yield of anaerobic or aerobic microorganisms and rather tended to inhibit their growth . The only microorganisms which possibly benefitted from DAG-S were some Enterobacteriaceae species. Drugs, 1981 Dec, 22(6), 423 - 60 Cefoperazone: A review of its in vitro antimicrobial activity, pharmacological properties and therapeutic efficacy; Brogden RN et al.; Cefoperazone is a new 'third generation' semisynthetic injectable cephalosporin . It has a broad spectrum of antibacterial activity which includes Pseudomonas aeruginosa (unlike older cephalosporins), along with the Enterobacteriaceae and other Gram-negative bacteria, Gram-positive bacteria and anaerobic bacteria . Unlike other cephalosporins, cefoperazone is excreted to a considerable extent by extrarenal mechanisms . Given by intravenous or intramuscular injection, cefoperazone is effective against a wide variety of infections caused by Gram-negative or Gram-positive aerobes, including infections of the biliary tract, and in many anaerobic infections . It is generally well tolerated, diarrhoea and skin rashes being the most frequently reported side effects. J Cardiovasc Surg (Torino), 1981 Nov-Dec, 22(6), 581 - 4 Penetration of gentamicin into heart valves, subcutaneous and muscular tissue of patients undergoing open heart surgery; Daschner FD et al.; Concentrations of gentamicin in plasma, heart valves, subcutaneous tissue and muscle were determined in 38 patients undergoing open heart surgery . Gentamicin reached peak levels in plasma and tissue within 60 min after a 5 min intravenous bolus injection of 1.5 mg/kg body weight . Subcutaneous and muscle concentrations varied between 0.51 microgram/g and 2.1 microgram/g . Gentamicin peak concentrations in cardiac valvar tissue wre 3.6 mug/g between 2 and 5 hours after administration; gentamicin heart valve concentrations varied between 1.2 microgram/g and 1.59 microgram/g . Gentamicin tissue concentrations during open heart surgery are high enough to inhibit most Klebsiella/Enterobacter and Staphylococcus aureus and epidermidis strains . However Gentamicin heart valve concentrations do not exceed 1.5 microgram/g for more than 1 h, which may explain treatment failures of patients with endocarditis. Johns Hopkins Med J, 1981 Nov, 149(5), 175 - 8 Fever, shock and chills in gram-negative bacillemia: clinical correlations in 100 cases; Rector WG Jr; Patterns of fever, shock, and chills in 100 episodes of febrile, Gram-negative bacillemia were retrospectively analyzed to determine features predictive of the site of infection, organism, and prognosis . Pneumonias most often produced morning temperature rises, whereas infections in other sites were usually associated with an afternoon or evening peak . Peritonitis (usually due to Bacteroides fragilis) tended to cause an indolent temperature rise (over a day or more), whereas pyelonephritis and cholangitis typically produced an abrupt "spike." Relatively low fevers characterized Enterobacter pneumonias while very high fevers were noted in Pseudomonas aeruginosa infections in patients with leukemia . Chills occurred with unusually high frequency in cholangitis and in Klebsiella bacteremia . Patients going into shock had higher fevers than those who did not . More importantly, the development of shock was shown to be related to severity of underlying disease . Shock never developed if the disease was not serious, unless the bacteremia was caused by instrumentation, but occurred in 73% of patients with leukemia or lymphoma . The clinical setting, pattern of fever, and presence or absence of a chill can in many cases usefully guide diagnosis and therapy in patients with Gram-negative bacillemia. J Clin Microbiol, 1981 Nov, 14(5), 596 - 7 Enteric group 15 (Enterobacteriaceae) associated with pneumonia; Bae BH et al.; A gram-negative, oxidase-negative, fermentative rod belonging to enteric group 15 of Enterobacteriaceae was isolated in mixed culture from two patients with pneumonia . Both were elderly patients with chronic heart disease. Infect Immun, 1981 Nov, 34(2), 373 - 7 Effect of proteins on the immunogenicity of enterobacterial common antigen; Kuhn HM et al.; Enterobacterial common antigen isolated by two independent extraction procedures was found to precipitate with a number of basic or hydrophobic proteins . Complexes of enterobacterial common antigen with protamine sulfate, with methylated bovine serum albumin or with a fraction of outer membrane proteins of two different Shigella wild types proved to be highly immunogenic in rabbits upon intravenous immunization, in contrast to the enterobacterial common antigen preparations by themselves . This explains why crude isolates of enterobacterial common antigen usually are good immunogens in contrast to the isolated antigen, which was described to be either not or only very poorly immunogenic. J Lab Clin Med, 1981 Nov, 98(5), 784 - 94 Assessment of lipopolysaccharide and outer membrane of Bacteroides fragilis by an antibody-inhibition enzyme-linked immunosorbent assay in physiologic fluids and infected animals; Rissing JP et al.; LPS antigen of Bacteroides fragilis (CDC strain 5462) was measured in vitro in physiologic buffer and undilute human sera by using an antibody-inhibition ELISA system . Other studies were performed to assess detection of the outer membrane antigen from this organism . LPS was repetitively detected at 20 to 50 ng/ml dry weight, and outer membranes were detected at 200 ng/ml total protein in physiologic buffers and human membranes were detected at 200 ng/ml total protein in physiologic buffers and human sera . LPS of other type strains was also detected . Prior incubation of the reagent antibody with multiple whole Enterobacteriaceae organisms and Pseudomonas aeruginosa did not alter test results . Bacteremic rats were easily separated into those with B . fragilis (N = 15) and Escherichia coli (N = 14) bacteremias . Sera from rats in which subcutaneous abscesses were produced with 18 strains of Enterobacteriaceae inhibited detection antibody significantly less than did sera from 30 rats in which abscesses were produced with 11 strains of b . fragilis (p less than 0.01) . Although values from the group of animals challenged with B . fragilis were significantly different from the group challenged with Enterobacteriaceae, the present results lack significant sensitivity and specificity for clinical application. Ann Intern Med, 1981 Nov, 95(5), 585 - 8 An outbreak of pseudobacteremia caused by Enterobacter cloacae from a phlebotomist's vial of thrombin; Graham DR et al.; In a 15-day period, seven patients in a small hospital each had one blood culture positive for Enterobacter cloacae . None of the seven patients was septic . All seven positive culture specimens had been obtained by phlebotomist A, who also had obtained 13 negative culture specimens in the same period . Seven other phlebotomists had drawn 69 blood samples for culture during the same period; none had yielded any microorganism (p = 0.00001) . Vials of thrombin, routinely used to coagulate blood specimens for chemical analysis, had been carried on the phlebotomy trays . We observed that phlebotomist A occasionally spilled drops of the viscous thrombin on her finger during the procedures . Culture of the thrombin on her tray yielded E . cloacae . No further cases of E . cloacae bacteremia occurred after she stopped drawing blood for culture and the thrombin on her tray was removed from use. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1981 Nov, 250(4), 511 - 20 {An oral enteritis-vaccine composed of twelve heat-inactivated Enterobacteriaceae 3 . Communication: studies on efficacy tests in mice protection tests (author's transl)}; Raettig H; The polyvalent vaccine consists of twelve heat-inactivated species of Enterobacteriaceae (six strains of Salmonellae, two strains of Shigellae, four strains of Dyspepsia coli) . The above vaccine is administered orally (6) to man for prophylactic purposes against local infections . The present communication describes the efficacy results of the vaccine obtained for different parameters by the mouse protection test . For this purpose, seven different infection models were used: oral infection with a strain of S . typhimurium and a strain of S . enteritidis, respectively, and intraperitoneal infection with the following five strains: S.l typhimurium, S . panama, S . enteritidis, Sh . flexneri 2a, or E . coli 2380 . For 10 days the mice were daily immunized with the twelve-fold vaccine orally administered by means of a probang . On the 10th day after the last orally applied antigen, the animals were challenged with the seven strains mentioned above . The success of vaccination was determined by the difference of mortality between vaccinated and non-vaccinated mice . The results show (Table 1) following the vaccination that a significant effect could be observed and statistically be evaluated for 6 models of infection . Optimal values showing the highest consistency rate were found for the model of intraperitoneal infection with the strain of E . coli 2380 . Which is why, studies were made for the following parameters by using the latter mode of infection . The efficacy of the oral immunization depends on the dosage of the vaccine (Table 2) . Even at a dilution of 1 : 1000, the effect of the vaccine was still sufficient . Only a dilution of 1 : 10 000 made the vaccination almost ineffective . - The content of humidity of the lyophilized vaccine in a range of 4% to 12% did not influence the immunogenicity (Table 3) . - The protection obtained by vaccination was found to last unexpectedly long . The vaccinated mice were still well protected even one year after the oral vaccination (Table 4), which means - when referred to the life-span of mice - that protection is effected for almost a life-time . The lyophilized vaccine does not even loose its immunogenicity after storage at 22 degrees C and 40 degrees C over a period of 3 years (Table 5) . These polyvalent lyophilized vaccine are, therefore, storable even under tropical conditions without cooling . This is a further great advantage of this vaccine. Zentralbl Bakteriol Mikrobiol Hyg {A}, 1981 Nov, 250(4), 490 - 6 Towards serodiagnosis of Serratia marcescens infections: examination of sera from noninfected patients and from experimentally infected rabbits for anti-H and anti-O antibodies; S . marcescens O-antigen cross-reactions with those of other enterobacteriaceae; Traub WH; Sera from 100 patients not infected with Serratia marcescens at the time of hospital admission lacked detectable H-immobilizing antibodies against all 20 currently recognized H-antigens of this microorganism . However, various patient sera revealed elevated titers of O-agglutinins against several of the 20 O-antigens of S . marcescens, in a particular O-antigens, O1, O3, O4, O5, O7, O8, O10, O11, O16, O17, O18, O19, and O20 . Rabbit anti-Shigella serogroup B immune serum cross-reacted with S . marcescens O-antigens O1 and O10; anti-Shigella serogroup C serum cross-reacted weakly with S . marcescens O-antigen O8 . Conversely, rabbit anti-S . marcescens O1 and O10 immune sera cross-reacted with a clinical isolate of Shigella flexneri . None of the anti-S . marcescens O1-O20 rabbit immune sera reacted with commercial febrile antigens of Salmonella serogroups A, B, C1,2, D, E1,2,3,4, Brucella abortus, Francisella tularensis, and Proteus OX19 . However, a reference strain of Salmonella typhi (9;d,-) was agglutinated by anti S . marcescens anti-O8 and O10 sera, a reference strain of S . paratyphi B (4,5;-,-) weakly by anti-S . marcescens O8 serum, and a reference strain of S . paratyphi C (6,8;-,-) by anti-S . marcescens anti-O10 and O16 rabbit immune sera . None of the anti-S . marcescens H-antisera cross-reacted with H-antigens of S . typhi (o;d,-), S . paratyphi A (1,2;a,-), S . paratyphi B (4,5;b,0), S . choleraesuis (6,7;-,1,5), typhimurium (4,5;,i,-), and S . enteritidis (9;gm,-) . Yersinia enterocolitica reference strain Ye 75 (OI = O3) eas agglutinated weakly by anti-S . marcescens O2 serum, whereas Y . enterocolitica reference strain Ye 373 (OV = O9) cross-reacted with S . marcescens anti-O5 rabbit immune serum . Intravenously and tissue cage-infected rabbits developed anti-H and anti-O-antibodies within 5 to 12 days after infection with representative test strains of S . marcescens . Therefore, it is suggested that the serodiagnosis of human S . marcescens infections consist of serial monitoring of both anti-H and anti-O agglutinins, because determinations of the latter alone might yield false-positive, i.e., potentially misleading results. J Urol, 1981 Nov, 126(5), 630 - 4 The bacterial flora of the vaginal vestibule, urethra and vagina in premenopausal women with recurrent urinary tract infections; Pfau A et al.; Gram-negative enteric bacteria, mainly Escherichia coli, form the predominant microbial flora of the introitus, vagina and urethra in women with a normal genitourinary tract but who are prone to suffer recurrent urinary infections . The infections in these women tend to occur in greater numbers and persist for long intervals, compared to normal control women who never experience urinary infections and in whom the main introital, vaginal and urethral microbial flora consists of lactobacilli and staphylococci . The appearance of gram-negative enterobacteria in the normal and control subjects usually is a rare and transitory event . The majority of urinary tract infections that developed in our population during this study was preceded by a persistent similar gram-negative vulvovaginal and urethral microbial flora . However, prolonged spontaneous intervals occurred occasionally during which the introital, vaginal and urethral cultures were free of gram-negative bacteria, with simultaneous intervals free of infection . Nevertheless, all of these intervals ended with documented urinary tract infections . The introital culture is a reliable mirror of the vulvovaginal and urethral microbial flora and, therefore, it is adequate in the study of urinary infections in women. Antimicrob Agents Chemother, 1981 Nov, 20(5), 702 - 4 Superior activity of N-formimidoyl thienamycin against gentamicin-resistant Pseudomonas aeruginosa; Michael PR et al.; N-Formimidoyl thienamycin (N-F-thienamycin), cefotaxime, moxalactam, and cefsulodin were tested by agar dilution against 125 isolates of Pseudomonas aeruginosa, Serratia marcescens, Klebsiella pneumoniae, and Providencia stuartii . Against gentamicin-susceptible P . aeruginosa, N-F-thienamycin and cefsulodin were most active . Only N-F-thienamycin inhibited gentamicin-resistant P . aeruginosa at less than or equal to 4 microgram/ml . N-F-thienamycin's activity equaled or surpassed that of the other antibiotics tested against both the gentamicin-susceptible and -resistant Enterobacteriaceae. Arch Intern Med, 1981 Nov, 141(12), 1607 - 12 Moxalactam therapy for bacterial infections; Winston DJ et al.; Moxalactam, a novel beta-lactam antimicrobial agent in which oxygen has replaced sulfur in the six-membered ring of the conventional cephem nucleus, has in vitro activity against almost all commonly isolated bacterial pathogens including Staphylococcus aureus, the Enterobacteriaceae, Pseudomonas aeruginosa, Bacteroides fragilis, and Haemophilus influenzae . The clinical efficacy an toxicity of moxalactam alone was evaluated in the treatment of 100 infections, including 22 septicemias . Thirty-two infections involved P aeruginosa, while organisms resistant to one or more of the currently available cephalosporins or cefoxitin were isolated from cultures in 63 of the cases . The overall clinical response was favorable (infection cured or improved) in 86% of the infections . A child with Klebsiella pneumoniae ventriculitis and meningitis was cured with intravenous moxalactam alone . Six of 14 treatment failures involved P . aeruginosa, and P aeruginosa isolates resistant to moxalactam emerged during therapy of 12 infections . Side effects, usually mild diarrhea, occurred in only 8.8% of the patients . Except for some severe P aeruginosa infections outside the urinary tract, moxalactam is effective and safe single-agent therapy for infections caused by susceptible organisms and represents a major advancement in beta-lactam antimicrobial therapy. Antimicrob Agents Chemother, 1981 Nov, 20(5), 620 - 4 Selective suppression of alimentary tract microbial flora as prophylaxis during granulocytopenia; Hargadon MT et al.; Oral nonabsorbable antibiotics have been used to suppress the rectal flora in granulocytopenic patients . Problems with these therapies, i.e., compliance, acquisition of undesirable flora, and cost, motivated the search for an alternative therapy which would increase compliance and effectively reduce the Enterobacteriaceae without creating a microbiol vacuum . Trimethoprim-sulfamethoxazole was found to be easily taken, to suppress the Enterobacteriaceae, and to maintain the anaerobic rectal flora for biological stability of the rectal ecosystem . However, concurrent use of parenteral antibiotics profoundly influenced rectal flora and temporarily destroyed the colonization resistance afforded by the anaerobes. Gut, 1981 Oct, 22(10), 849 - 53 Endotoxin and liver diseases . High titres of enterobacterial common antigen antibodies in patients with alcoholic cirrhosis; Turunen U et al.; We have measured antibodies to the enterobacterial common antigen (ECA) in sera of 86 patients with various liver diseases . ECA is a component of the cell wall of all enteric bacteria, and ECA antibodies are a specific indication of the presence of enterobacterial components . Patients with alcoholic cirrhosis with or without signs of alcoholic hepatitis had significantly raised anti-ECA titres compared with healthy control subjects . Other groups of patients (alcoholic hepatitis and/or fatty liver, primary biliary cirrhosis, chronic active hepatitis, or liver metastases) did not differ significantly from controls in the height of their anti-ECA titres . The results support the concept that Gram-negative bacterial components may have some role in the pathophysiology of alcoholic cirrhosis. Jikken Dobutsu, 1981 Oct, 30(4), 503 - 5 Enterobacter cloacae, Serratia marcescens and Yersinia enterocolitica in colonies of laboratory mice, rats and rabbits: an attempt of isolation; Shimoda K et al.; An attempt to isolate Enterobacter cloacae, Serratia marcescens and Yersinia enterocolitica was made in a total of 931 laboratory animals (mice, rats and rabbits) from five representative commercial breeders in this country and from our laboratory colonies . E . cloacae organisms were isolated from feces and other specimens of 15 mice and 17 rats between November 1979 and July 1980 . Neither S . marcescens nor Y . enterocolitica was detectable in any specimen of feces, fur and skin, nasal discharge, lungs, urinary bladder or urine from the animals examined. J Hyg (Lond), 1981 Oct, 87(2), 287 - 97 Comparison of the Microbact-12E and 24E systems and the API-20E system for the identification of Enterobacteriaceae; Mugg P et al.; The Microbact-24E and the Microbact-12E systems are two new miniaturized identification systems for the identification of organisms belonging to the family Enterobacteriaceae . These two systems were compared to the API-20E system for the identification of 352 fresh clinical isolates of Enterobacteriaceae . All three systems were easy to use and came complete with computerized profile registers to assist with final identification of the isolates . The Microbact-24E identified 98%, the API-20E and MB-12E identifying 94.3% and 88.6% respectively . Where different identifications were obtained with the Microbact-24E and API-20E conventional biochemical tests, motility and serology were performed . The Microbact-24E system proved to be a very accurate and convenient means of identifying members of the family Enterobacteriaceae. J Clin Microbiol, 1981 Oct, 14(4), 370 - 5 Clinical laboratory evaluation of the automicrobic system Enterobacteriaceae biochemical card; Davis JR et al.; The AutoMicrobic System Enterobacteriaceae Biochemical Card (AMS-EBC; Vitek Systems, Inc.) was evaluated in two clinical microbiology laboratories . A total of 502 consecutive clinical isolates representing members of the family Enterobacteriaceae were tested in parallel with the AMS-EBC, API 20E, and Enterotube II systems . Discrepancies between systems were resolved with the conventional methods of Edwards and Ewing (P . R . Edwards and W . H . Ewing {ed.}, Identification of Enterobacteriaceae, 1972) and Ewing and Martin (W . H . Ewing and W . J . Martin, in Manual of Clinical Microbiology, 1974) AMS-EBC correctly identified 96.6% and incorrectly identified 3.4% of the isolates . When 12 or more isolates of a species were evaluated, Serratia marcescens, Proteus mirabilis, and Enterobacter cloacae posed the greatest challenge to the systems, with 92.6, 95.2, and 95.3%, respectively, being correctly identified . To confirm the accuracy of identification when all systems agreed, 93 randomly selected isolates were identified by conventional methods . The percent agreement was 100% . The reproducibility of triplicate determinations on 93 randomly selected isolates with the AMS-EBC was 99.6% . The AMS-EBC was found to be an easy, rapid, and accurate method for identification of Enterobacteriaceae. Arch Microbiol, 1981 Oct, 130(2), 93 - 5 Possible role of membrane proteins in mercury resistance of Enterobacter aerogenes; Pan-Hou HS et al.; Mercury resistance shown by a strain of Enterobacter aerogenes was found to be determined by a plasmid . The resistance appeared to be not due to enzymatic volatilization of mercury, but due to the alteration in cellular permeability to mercury . Comparison of the outer membrane proteins was made between the resistant cells and the sensitive counterparts obtained by the treatment with mitomycin C, showing that two proteins with molecular weight of 46,000 and 44,000 had disappeared from the outer membrane along with the plasmid by the curing . These results suggest that the two membrane proteins mediating the cellular permeability to mercury compound may be responsible for the mercury resistance of the strain. Am J Obstet Gynecol, 1981 Oct 1, 141(3), 246 - 51 Antimicrobial therapy of postpartum endomyometritis . II . Prospective, randomized trial of mezlocillin versus ampicillin; Sorrell TC et al.; Seventy patients with postpartum endomyometritis were treated with either intravenous mezlocillin (16 gm/day) or ampicillin (8 gm/day) in a prospective, randomized, double-blind comparison . Endocervical dilatation was routinely performed . Clindamycin (2 gm/day) was added if patients failed to improve within 48 hours of beginning therapy . Pretreatment clinical and microbiologic profiles were comparable in the two groups . Bacteremia was documented in 21 patients (30%) . Anaerobic cocci and Bacteroides spp . (non-B . fragilis) comprised 19 of 29 (65%) blood isolates . Thirty of 33 mezlocillin-treated patients (91%) and 30 of 37 ampicillin-treated patients (81%) responded to initial therapy (P greater than 0.4) . Resolution was noted after the addition of clindamycin in all ten nonresponders; two of these patients also required surgical wound debridement . Objective parameters of clinical response were not significantly different in the two treatment groups . Side effects of mezlocillin therapy were minimal . We conclude that mezlocillin and ampicillin are equally effective and safe for therapy of postpartum endomyometritis . That mezlocillin was not superior to ampicillin, despite expanded activity against B . fragilis and members of Enterobacteriaceae, suggests that these pathogens are less important than was previously considered in postpartum endomyometritis. Antimicrob Agents Chemother, 1981 Oct, 20(4), 463 - 9 In vitro and in vivo studies of three antibiotic combinations against gram-negative bacteria and Staphylococcus aureus; Zinner SH et al.; The activities of azlocillin, cefotaxime, and amikacin alone and in combination were evaluated in in vitro checkerboard studies, in infected neutropenic mice, and in human volunteers . The combination of cefotaxime plus amikacin was more synergistic in vitro than the others against the Enterobacteriaceae tested, and the combination of azlocillin plus amikacin was more synergistic against Pseudomonas aeruginosa and Staphylococcus aureus . Survival of neutropenic mice infected with Escherichia coli and Klebsiella pneumoniae, respectively, was greater with azlocillin plus amikacin (24 of 40 and 11 of 40) and with cefotaxime plus amikacin (21 of 40 and 17 of 40) than with azlocillin plus cefotaxime (22 of 40 and 3 of 40; P less than 0.05) . Median serum bactericidal activity in volunteers receiving these antibiotics alone and in combination was greater than or equal to 1:8 with most agents and with all combinations tested against 10 strains each of E . coli, K . pneumoniae, P . aeruginosa, and S . aureus . These data suggest that clinical trials with combinations of azlocillin or cefotaxime plus amikacin deserve further study in febrile neutropenic patients. S Afr Med J, 1981 Sep 19, 60(12), 451 - 2 Aminoglycoside resistance among isolates of nosocomial Enterobacteriaceae; Botha PL et al.; Fifty-seven gentamicin-resistant isolates of Enterobacteriaceae, obtained from patients attending hospital, were examined for the production of aminoglycoside-modifying enzymes . Of the 51 strains producing such enzymes, 34 were presumptively plasmid-mediated as indicated by conjugation experiments. Br Med J (Clin Res Ed), 1981 Sep 19, 283(6294), 755 - 6 Dissemination of resistance plasmids among gentamicin-resistant enterobacteria from hospital patients; Knight S et al.; Out of 184 patients who were infected or colonised with gentamicin-resistant enterobacteria, 17 (9%) harboured more than one strain . Single antibiotic-resistance plasmids were common to more than one of the different organisms isolated from nine patients, strongly suggestive of in-vivo conjugation . An "epidemic" plasmid with a molecular weight of approximately 110 megadaltons was found in 11 distinct strains isolated from four patients . Seven of the organisms harbouring this plasmid were Klebsiella aerogenes . Spread of multiple-resistance plasmids among endemic gentamicin-resistant enterobacteria is not uncommon, and these organisms provide a reservoir of plasmids that may ultimately spread to more pathogenic genera. N Z Med J, 1981 Sep 9, 94(691), 173 - 4 Susceptibility of clinical strains of bacteria to cefoxitin; Bremner DA; The susceptibility of 3044 bacterial strains isolated from patients at Auckland Hospital were tested by the disc diffusion of cefoxitin, cephalothin and ampicillin . 86.5 percent of these strains were sensitive to cefoxitin, 71.3 percent sensitive to cephalothin and 41.6 percent ot ampicillin . A significant difference between cefoxitin and cephalothin was observed with E . coli, Klebsiella, Enterobacter and Proteus species . S . epidermidis alone showed significantly less strains susceptible to cefoxitin than cephalothin. Ann Microbiol (Paris), 1981 Sep-Oct, 132B(2), 157 - 70 {A method to select diagnostic criteria from Bayes' theorem and information theory (author's transl)}; Descamps P et al.; An algorithm is proposed to order a list of characteristics according to their efficiency for diagnosis . Two diagnostic ability coefficients (DAC), INF and TAX, are described . The calculus of INF coefficient is based on Bayes' theorem, using the occurrence of various diagnosis, and on information theory . TAX coefficient is a linear approach of the former . Both coefficients are tested with the study of 1891 strains of Enterobacteriaceae, originating from urines . The results are compared with those given by Gyllenberg's separation and characterization figures . Theoretical examples are also provided for computing purposes. Can J Microbiol, 1981 Sep, 27(9), 937 - 41 An abbreviated scheme for identification of Yersinia enterocolitica isolated from food enrichments on CIN (cefsulodin-irgasan-novobiocin) agar; Devenish JA et al.; An abbreviated procedure for the biochemical identification of Yersinia enterocolitica isolated from food enrichments on CIN (cefsulodin-irgasan-novobiocin) agar was investigated . A total of 170 colonies resembling Y . enterocolitica in colonial morphology and appearance on CIN agar were selected for identification using API strips . Ninety-three of these isolates were examined with the PathoTec ornithine decarboxylase, Voges-Proskauer, and urease test strips . The PathoTec urease strip alone was adequate for identification of all isolates of Y . enterocolitica . Christensen's urea agar was applied to the remaining 77 isolates and found less specific in the 1 isolate of Enterobacter agglomerans was urease positive along with 10 isolates of Y . enterocolitica . CIN agar is a highly specific medium for isolation of Y . enterocolitica, requiring only Kligler iron agar and urea slants for confirmation of presumptive colonies. Klin Padiatr, 1981 Sep, 193(5), 394 - 7 {Septicaemia caused by Erwinia herbicola in an 8-year-old boy (author's transl)}; Marklein G et al.; A child suffering from osteomyelitis of the left ankle developed fulminant septicaemia with repetitive isolation of Erwinia herbicola in pure culture . Plants are considered to be the primary source of the infective agent and lacerations as well as stab wounds from thorns might be the port of entry . The boy's septicaemia could be governed by parenteral therapy with tobramycin, cephalothin, and carbenicillin . In the course of his illness, the child has produced antibodies against the homologous Erwinia strain . Typical criteria allowing the identification and differential diagnosis against other Enterobacteriaceae are the lack of the amino acid decarboxylase and dihydrolase activities, the absence of H2S and indole production, the synthesis of a gelatinase and of a yellow pigment . It appears that, although classically thought of as plant pathogens, members of the Erwinia genus can produce infection in man . Therefore they should receive the same attention in hospital hygiene as other opportunistic human pathogens. J Clin Microbiol, 1981 Sep, 14(3), 247 - 51 Evaluation of sucrose and magnesium sulfate as additives in aerobic blood culture medium; Eng J; Clinical blood cultures were made in duplicate in brain heart infusion broth with sodium polyanetholsulfonate and gelatin (P broth) and in the same medium with 20% sucrose (S broth) . In part of the study, 0.1% magnesium sulfate was also included in the medium with sucrose (SMg broth) . The results from 1,287 positive blood cultures are reported . Significant differences among the rates and speeds of isolations from these media were found in Enterobacteriaceae and Staphylococcus aureus, which were isolated more frequently from S broth and SMg broth than from P broth; in addition, recoveries were accomplished earlier (1 or more days) from S broth and SMg broth than from P broth more often than the reverse growth patterns . An additional effect of magnesium sulfate upon recoveries could not be concluded . The possible mechanisms by which sucrose promotes recoveries from clinical blood cultures are discussed. J Thorac Cardiovasc Surg, 1981 Sep, 82(3), 341 - 4 Management of necrotizing tracheostomy infections; Snow N et al.; Management of three patients with necrotizing tracheostomy infections resulting in tracheal dissolution was reviewed with respect to presentation, cause, and management . Loss of tracheal substance led to difficulty in ventilation because of a large air leak . The stomal area cavitated in two patients, denuding the right common carotid artery in one . Purulent peristomal drainage was present in all three patients . Common factors of possible etiologic significance included necrotizing polymicrobial gram-negative tracheobronchial infections caused by Pseudomonas, Enterobacter, and Klebsiella species . Also of possible importance were suture fixation of the appliance, history of neurologic injury, and closure of the incision . Immediate therapy consisted of oral intubation for ventilatory purposes and a regimen of hourly application of 1% neomycin dressings . Seven to 21 days were necessary to allow formation of sufficient granulation tissue to support replacement of the tracheostomy appliance for continued mechanical ventilation . Once spontaneous ventilation was possible, a Montgomery T-tube was inserted for long-term tracheal stenting prior to reconstruction . The two patients treated by tracheal stenting are long-term survivors . Avoidance of suture fixation of the appliance, aggressive treatment of bronchopulmonary infection, and adequate stomal toilet may help to avoid this devastating complication. Ann Clin Lab Sci, 1981 Sep-Oct, 11(5), 411 - 5 Evaluation of a bioassay method for serum amikacin concentrations; Manos JP et al.; The bioassay system from American Diagnostic for amikacin was compared to the same company's radioimmunoassay (RIA) technique used in this hospital . The bioassay is performed by adding serum from a patient to wells cut in agar which have been seeded with a susceptible fast growing microorganism (Enterobacter) . After incubation of five hours at 37 degrees, the zones of inhibition for four standards are measured and plotted . The amount of amikacin in the serum sample is then determined from the linear graph . Ten replicates of a serum with 8 microgram per ml of amikacin and 10 replicates of a serum with 20 microgram per ml of amikacin were assayed on each of four days . Aliquots of the same samples were assayed in a similar manner by RIA . The coefficients of variation (CVs) of the within run assays by the bioassay and RIA methods for the low amikacin test sample ranged from 4.7 to 7.2 percent and 6.2 to 13.0 percent, respectively . The within run CVs for the high amikacin test sample for the bioassay and RIA methods ranged from 5.2 to 6.9 percent and 5.0 to 13.9 percent, respectively . The day to day and overall CVs for the bioassay and RIA methods for the low amikacin test sample were 1.5 and 5.8 percent and 7.4 and 11.8 percent, respectively . For the high amikacin test sample, they were 0.4 and 6.0 percent and 4.0 and 9.6 percent, respectively . The correlation coefficient for 49 sera from patients on amikacin was 94 percent between the two methods. Appl Environ Microbiol, 1981 Sep, 42(3), 506 - 12 Coliform inhibition by bacteriocin-like substances in drinking water distribution systems; Means EG et al.; Bacterial isolates from an unchlorinated potable groundwater system and a chlorinated surface water system were screened by an agar overlay method for the ability to produce bacteriocin-like substances (BLS) inhibitory to the growth of Escherichia coli, Klebsiella sp., and Enterobacter aerogenes . The production of coliform-specific BLS by noncoliform bacteria varied with the site and date of isolation as well as the genus of the producer strain . A total of 448 bacterial isolates were screened from the chlorinated system, and 22.1% produced BLS specific for at least one of the three coliforms . In the unchlorinated system, 7.9% (n = 696) possessed this ability . Flavobacterium/Moraxella comprised 57.1% of all bacteria (from both systems) producing BLS . The possibility that BLS interfere with coliform detection in standard bacteriological water quality tests is discussed. J Clin Microbiol, 1981 Sep, 14(3), 326 - 8 Preliminary evaluation of the autoSCAN-3, an instrument for automated reading an interpretation of microdilution trays: identification of aerobic gram-negative bacilli; Ellner PD et al.; The autoSCAN-3, an instrument for the automated reading and interpretation of Microscan microdilution trays, was evaluated for its ability to identify gram-negative bacilli . The results obtained by the visual reading of microdilution trays were compared with the results obtained with the machine . A total 387 clinical isolates of Enterobacteriaceae and nonfermenters were compared by both methods . In 369 instances (95%), the identification obtained by visual reading of the microdilution tray agreed with the identification obtained with the autoSCAN-3 . In eight instances, the visual identification differed completely from that of the machine, and in nine cases, the machine was unable to provide an identification. J Clin Microbiol, 1981 Sep, 14(3), 295 - 7 Rapid identification by the Micro-ID system of Enterobacteriaceae detected by urine screening; Kelly MT et al.; Previous studies have demonstrated that organisms detected by urine screening can be processed for rapid identification and antimicrobial susceptibility testing directly from urine or urine screening broth . In the present study, an improved method for processing such specimens was evaluated . Organisms were harvested by centrifugation from positive urine screening broth, and inocula were prepared for rapid identification by the Micro-ID system and rapid susceptibility testing by the Autobac system . Nearly 2,500 urine specimens were analyzed by urine screening, and 206 specimens had significant growth of gram-negative, oxidase-negative bacilli . These organisms, prepared by the centrifugation procedure, were identified and tested for susceptibility to antimicrobial agents . For comparison, identifications by the Micro-ID system and antimicrobial susceptibility tests by the Autobac system were performed on the same organisms the next day with inocula prepared from colonies growing from standard urine cultures . The results demonstrated that 95% of the organisms were correctly identified by this procedure, and susceptibility testing by the rapid method gave results in 94% agreement with the standard method . These results demonstrate that organisms detected by urine screening can be accurately identified and tested for antimicrobial susceptibility after centrifugation from urine screening broth . This system provides a practical procedure or same-day reporting of urine culture results. Antimicrob Agents Chemother, 1981 Sep, 20(3), 398 - 400 Pharmacokinetics of moxalactam in patients with renal failure and during hemodialysis; Srinivasan S et al.; The pharmacokinetics of moxalactam were determined in eight patients with end stage renal disease who were undergoing chronic hemodialysis . The mean half-life of moxalactam in the interdialysis period was 19 h, with a range of 9 to 30 h . The mean half-life of moxalactam during dialysis was 4 +/- 0.58 h . Serum levels of 30 +/- 10 micrograms/ml were present 24 h after a 1-g dose in the interdialysis period . A dose of 1 g at the end of each dialysis period in patients undergoing thrice-weekly hemodialysis would provide levels far in excess of the minimal inhibitory levels against Enterobacteriaceae. Ann Intern Med, 1981 Sep, 95(3), 302 - 5 Successful treatment of gram-negative bacillary meningitis with moxalactam; Olson DA et al.; Meningitis caused by enteric gram-negative bacilli is relatively uncommon but is very difficult to treat despite susceptibility in vitro to many antimicrobics . A major problem appears to be poor entry of many drugs into the central nervous system . Moxalactam is an investigational cephalosporin that attains concentrations in the cerebrospinal fluid that are 15% to 30% of contemporaneous serum concentrations; moreover, it is quite active against many of the enteric gram-negative bacilli . We used moxalactam to treat meningitis caused by Enterobacter cloacae, Klebsiella pneumoniae, and Escherichia coli in four adults and one child, giving up to 100 mg/kg body weight per day by intravenous injection . The concentrations of moxalactam in serum, lumbar, and ventricular cerebrospinal fluid exceeded the minimal lethal concentrations of all causative bacteria . The patients were cured . In this small series, moxalactam, when administered intravenously as the sole agent of therapy, was effective in the treatment of meningitis caused by susceptible gram-negative bacilli. Antimicrob Agents Chemother, 1981 Sep, 20(3), 327 - 31 6 beta-Iodopenicillanic acid (UI-38,006), a beta-lactamase inhibitor that extends the antibacterial spectrum of beta-lactam compounds: initial bacteriological characterization; Moore BA et al.; UK-38,006, 6 beta-iodopenicillanic acid, was shown to be a potent inhibitor of beta-lactamase enzymes . It potentiated the antibacterial action of ampicillin in vitro against beta-lactamase-producing strains of Staphylococcus aureus, Haemophilus influenzae, Bacteroides fragilis . Neisseria gonorrhoeae, and many Enterobacteriaceae . This ability to synergize with ampicillin was also demonstrated in vivo after oral administration of UK-38,006 to experimentally infected mice . UK-38,006 was also shown to synergize in vitro with other penicillins and cephalosporins against beta-lactamase-producing strains of Escherichia coli, Proteus mirabilis, and Klebsiella species. Am J Med, 1981 Sep, 71(3), 435 - 42 Use of cefotaxime, a beta-lactamase stable cephalosporin, in the therapy of serious infections, including those due to multiresistant organisms; Francke EL et al.; Cefotaxime is a cephalosporin active against most gram-positive and gram-negative organisms, including streptococci, Staphylococcus aureus, Enterobacteriaceae, Proteus, and many Pseudomonas and Bacteroides fragilis--all but the latter two are inhibited at concentrations below 0.5 micrograms/ml . We evaluated cefotaxime as the sole therapy for 32 infections in 31 patients . Infection sites included 18 bacteremias; pulmonary, urinary tract, deep tissue infections; and meningitis . Clinical cures were achieved in 88 percent and bacteriologic cures in 86 percent of the patients--including those with infections due to organisms resistant to cephalosporins, chloramphenicol, carbenicillin and aminoglycosides; and in two patients with meningitis due to multiresistant Klebsiella pneumoniae . Serum and cerebrospinal levels were readily maintained above the inhibitory levels of susceptible organisms . Adverse reactions were minimal . Cefotaxime was a safe, effective antibiotic in the treatment of infections due to susceptible organisms, including those resistant to other agents. J Biol Chem, 1981 Aug 10, 256(15), 7715 - 8 Isolation of adenosine 5'-diphosphate-D-glycero-D-mannoheptose . An intermediate in lipopolysaccharide biosynthesis of Shigella sonnei; Kontrohr T et al.; From a Shigella sonnei R mutant which incorporates into its cell wall lipopolysaccharide D-glycero-D-mannoheptose and contains no L-glycero-D-mannoheptose, a nucleotide-linked sugar was isolated and identified as adenosine 5'-diphosphate-D-glycero-d-mannoheptose by chemical and chromatographic analysis . This intermediary compound is assumed to play a role in heptose biosynthesis of Enterobacteria. Antimicrob Agents Chemother, 1981 Aug, 20(2), 247 - 51 In vitro studies with Win 42122-2: comparison with gentamicin, netilmicin, and amikacin; Sanders CC et al.; The in vitro activity of Win 42122-2 against gram-negative clinical isolates was compared in serial twofold broth dilution tests with gentamicin, netilmicin, and amikacin . Against 173 gentamicin-susceptible Enterobacteriaceae, the activity of Win 42122-2 was generally twofold less than those of gentamicin or netilmicin and similar to that of amikacin . Against 60 gentamicin-susceptible nonfermentative gram-negative bacilli, including P . aeruginosa, the activity of Win 42122-2 was four- to eightfold less than that of gentamicin or netilmicin and two- to fourfold less than that of amikacin . Minimal bacterial concentrations for Win 42122-2 were usually similar to minimal inhibitory concentrations . Win 42122-2 was not highly active against gentamicin-resistant bacteria . Win 42122-2 was as active as gentamicin against Mycobacterium tuberculosis but was less active than gentamicin or amikacin against atypical mycobacteria . Win 42122-2 interacted synergistically with penicillin G against enterococci, including strains highly resistant to streptomycin. Antimicrob Agents Chemother, 1981 Aug, 20(2), 226 - 30 Comparative in vitro study in new cephalosporins; Bodey GP et al.; Three new cephalosporins, ceftazidime, ceftizoxime, and cefotiam, were evaluated in vitro against clinical isolates, and their activities were compared with those of other cephalosporins, mezlocillin, and tobramycin . All three new cephalosporins were very active against gram-positive cocci (except enterococci), but mezlocillin was more active against Streptococcus ssp . Cefotiam and cefamandole were the most active antibiotics against Streptococcus aureus . Ceftazidime had broad-spectrum activity against all gram-negative bacilli tested, except Enterobacter spp . Ceftizoxime was active against all, except Enterobacter spp . and Pseudomonas aeruginosa . Although cefotiam was quite active against Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis, it was inactive against indole-positive Proteus spp., Serratia spp, and P . aeruginosa . The in vitro activity suggests that ceftazidime should prove useful as a broad-spectrum antibiotic, in those settings in which the most likely pathogens are gram-negative bacilli. J Infect Dis, 1981 Aug, 144(2), 128 - 36 Risk factors for infections of the oropharynx and the respiratory tract in patients with acute leukemia; Kurrle E et al.; The pathogenicity of microorganisms isolated by surveillance cultures, the neutrophil count in the peripheral blood, and the interaction of the two factors were analyzed as risk factors for infections of the oropharynx and the respiratory tract in patients with acute leukemia being treated in strict reverse isolation under antimicrobial modulation . A statistical method was developed for the identification of bacteria, the presence of which was correlated with an increased risk of infection . A significantly increased risk was found mainly for species of Klebsiella, Enterobacter, Proteus, and Pseudomonas . The degree of neutropenia was significantly correlated with the risk of infection, which was influenced by the microbiologic state of the oropharynx . Thus, patients with gram negative bacilli had significantly more days with infection at all levels of neutropenia than patients without gram-negative bacilli . These two risks factors were additive but did not potentiate each other. Am J Dis Child, 1981 Aug, 135(8), 693 - 8 Infections acquired by young infants; Maguire GC et al.; Infections occurring among hospitalized young infants were surveyed for 24 months . Almost 10% of the 7,339 infants received antimicrobial therapy for five or more days for suspected community-acquired infections . Infants admitted directly to the normal-newborn nursery acquired infections at a rate of 0.6 per 100, whereas infants admitted to intensive care nurseries acquired infections at a rate of 16.9 per 100 infants . Bacteremia in association with nosocomial infection occurred frequently . The pathogens associated with community-acquired and nosocomial infections are different . Species of streptococci and relatively antibiotic-susceptible Enterobacteriaceae predominate as pathogens associated with infections in previously nonhospitalized infants . Organisms acquired in the hospital tend to be more antibiotic resistant. Am J Clin Pathol, 1981 Aug, 76(2), 208 - 11 Evaluation of urine culture screening by light-scatter photometry; Hale DC et al.; Urine screening for bacteriuria by light-scatter photometry (Autobac) was evaluated for accuracy and compared with a colony count by the calibrated loop method . Incubation time, inoculum size, precision, and interference of particulate matter were evaluated in an effort to standardize the screening procedure . Results showed that urines could be accurately screened for Enterobacteriaceae by inoculating a single Autobac cuvette chamber with 0.1 or 0.2 ml of urine and determining the voltage change after four hours . A change of greater than or equal to 0.2 units indicates significant bacteriuria . Decreased accuracy was noted for urines having greater than 10(5) cfu/ml of Pseudomonas species or gram-positive cocci, possibly because these organisms grow more slowly. Zentralbl Bakteriol A, 1981 Aug, 249(3), 382 - 91 Phosphate localization in carbohydrates - a study on enterobacterial lipopolysaccharides; Feige U et al.; The localization of the phosphate substituents in the core oligosaccharide of the lipopolysaccharides of Enterobacteriaceae has been reported for Salmonella minnesota and Escherichia coli B only . In these cases the localizations were done by a beta-elimination reaction in mild alkaline solution after periodate oxidation . We report now on a method generally applicable on carbohydrates . The localization of phosphate groups and the extent of substitution with phosphate residues in carbohydrates can be determined by the following reaction sequence: methylation, dephosphorylation, and reetherification (labelling) with C2H3J or C2H5J followed by derivatizing to partially methylated alditol acetates and analysis by combined gas liquid chromatography/mass spectrometry . The results presented here are obtained by application of this method to isolated core oligosaccharides of lipopolysaccharides from E . coli C23.1, E . coli C71, E . coli F2515, and P . mirabilis R4/O 28 . Phosphate is localized at C-4 of the chain heptoses in the lipopolysaccharides of E . coli C and E . coli R4, and at C-7 of the branching heptose in the lipopolysaccharide of P . mirabilis R4/O 28. J Bacteriol, 1981 Aug, 147(2), 602 - 11 Localization of enterobacterial common antigen in Yersinia enterocolitica by the immunoferritin technique; Acker G et al.; Rabbits were immunized with the enterobacterial common antigen (ECA)-immunogenic strain Escherichia coli F470 . ECA-specific antiserum was obtained by absorbing the resulting antisera with the genetically closely related ECA-negative strain E . coli F1283 . These two strains also served as positive and negative controls in the localization study of ECA in Yersinia enterocolitica strain 75, smooth and rough forms (Ye75S and Ye75R), by the indirect immunoferritin technique . Cells of Ye75S grown at 22 degrees C showed no labeling with ferritin after treatment with the ECA-specific antiserum and subsequent ferritin-conjugated goat anti-rabbit antibodies . If the cells were grown at 40 degrees C, however, most of the cells showed weak ferritin labeling . At this higher growth temperature, the lipopolysaccharide of this strain contains less O-specific chains (6-deoxy-L-altrose), as was shown in a previous study . The rough mutant Ye75R, which lacks O-specific chains completely, showed denser labeling with ferritin . These results indicate that ECA on the cell surface of Ye75S is covered by O-specific chains of the lipopolysaccharide if grown at 22 degrees C and is therefore not accessible to ECA antibodies . It becomes accessible, however, when O-chains are lacking (R mutants) or when they are reduced in size or amount (growth at 40 degrees C). Dig Dis Sci, 1981 Aug, 26(8), 728 - 36 Studies on isolated gut mucosal lymphocytes in inflammatory bowel disease . Detection of activated T cells and enhanced proliferation to Staphylococcus aureus and lipopolysaccharides; Fiocchi C et al.; To determine whether a defective proliferation of gut mucosal lymphocytes is a contributory factor to the pathogenesis of inflammatory bowel disease, we assessed their reactivity toward mitogens and bacterial antigens . Spontaneous replication of intestinal lymphoid cells was higher than that of patient-matched peripheral blood lymphocytes . That gut mucosal lymphocytes appear to be activated in loco was confirmed by a striking, time-dependent increase in the number of stable E rosettes generated by culturing unstimulated Crohn's disease intestinal lymphoid cells . The responses of lymphocytes from inflamed and normal mucosa to polyclonal mitogens were not only comparable to each other, but to those of corresponding peripheral lymphocytes, as well . Peripheral blood lymphocytes from patients with Crohn's disease showed less proliferation to Bacteroides and lipopolysaccharide antigens than did those from control individuals, but replicated similarly in response to Staphylococcus aureus and the enterobacterial common antigen: In contrast, when cultured with Staphylococcus aureus or with lipopolysaccharides, but mucosal lymphocytes from Crohn's disease proliferated 3-5 times more than did those from normal mucosa, while lymphoid cells from both sources were equally stimulated by Kunin antigen . Overall, this study found no evidence for a defective proliferative capacity of immune competent cells at the gut mucosal level in inflammatory bowel disease. Antimicrob Agents Chemother, 1981 Aug, 20(2), 197 - 203 Mezlocillin: tentative interpretive standards for disk diffusion susceptibility testing; Fuchs PC et al.; The susceptibility of 447 clinical bacterial isolates to mezlocillin and carbenicillin was tested by standardized agar disk diffusion and reference broth micro-dilution methods . Tentative interpretive criteria for disk susceptibility testing by using 75 micrograms mezlocillin disks are proposed: susceptible, greater than or equal to 16 mm; indeterminate, 13 to 15 mm; and resistant, less than or equal to 12 mm . These would be applicable to both Pseudomonas species and the Enterobacteriaceae, but not to Staphylococcus aureus . For S . aureus, the breakpoints for susceptible, greater than or equal to 29 mm, and resistant, less than or equal to 28 mm, hold for mezlocillin as well as for the other penicillinase-susceptible penicillins. J Gen Microbiol, 1981 Aug, 125(Pt 2), 285 - 92 Porin from the outer membrane of Escherichia coli: immunological characterization of native and heat-dissociated forms; Hofstra H et al.; Antisera against porin oligomers isolated from the outer membrane of Escherichia coli O26K60 and against porin monomers from the same bacterial strain were elicited in rabbits by intramuscular administration with Freund's complete adjuvant . Antibodies against native porin oligomers reacted strongly with porin oligomers, as revealed by sodium dodecyl sulphate-polyacrylamide gel immunoperoxidase (SGIP) analysis, the enzyme-linked immunosorbent assay (ELISA) and immunodiffusion, but showed no significant reaction with denatured monomers . The antibodies were completely absorbed by the intact outer membrane-peptidoglycan complex, which suggests that they were directed against antigenic determinants expressed on the outside of the intact outer membrane . Antibodies directed against denatured porin monomers reacted strongly with monomers in all tests but reacted only very weakly with porin oligomers . They were not absorbed by the native porin situated in the intact outer membrane . This indicates that the major antigenic determinants of the denatured porin monomer are hardly related to those of the native trimer situated in the intact outer membrane . The antigenic determinants of the denatured monomer seem to become fully expressed only after dissociation and denaturation of the porin . It is concluded that the immunological relationship of denatured porin monomers derived from many strains of E . coli and other Enterobacteriaceae which was reported in previous studies may not indicate that native porin trimers of these strains are also related. Antimicrob Agents Chemother, 1981 Aug, 20(2), 159 - 67 In vivo activity of ceftriaxone (Ro 13-9904), a new broad-spectrum semisynthetic cephalosporin; Beskid G et al.; Ceftriaxone (Ro 13-9904) was compared with other newer beta-lactam antibiotics for activity in experimental infections of mice with Enterobacteriaceae, Haemophilus influenzae, Pseudomonas aeruginosa, and gram-positive bacteria . Overall, ceftriaxone was equal or superior to cefotaxime and cefoperazone against systemic infections . All three drugs were highly potent against most organisms but were considerably less active against P . aeruginosa . However, ceftriaxone tended to be more active than the other two agents against 8 of the 10 P . aeruginosa strains tested . Ceftriaxone, cefmenoxime (SCE 1365), and moxalactam were all highly active against systemic infections with 16 strains of Enterobacteriaceae, whereas ceftriaxone was more active against infections with two strains of streptococci . When the drugs were administered at various time intervals before infection, ceftriaxone was superior to cefotaxime, cefmenoxime, and moxalactam . This suggested that ceftriaxone might be eliminated from mice more slowly than the other drugs . In the case of cefotaxime, this was directly confirmed by microbiological assays of plasma samples . In a murine meningitis model induced by Klebsiella pneumoniae or Streptococcus pneumoniae, ceftriaxone was more active than ampicillin or cefotaxime . Ceftriaxone was more active than ampicillin, cefotaxime, piperacillin, cefamandole, or carbenicillin in a pneumococcal, pneumonia model in mice . These studies indicate that ceftriaxone is a potent, broad-spectrum cephalosporin with unusual pharmacokinetic properties. Tijdschr Diergeneeskd, 1981 Jul 15, 106(14), 124 - 30 The effect of different bird washers on the microbiological quality of broiler carcasses; Mulder RW et al.; The effect of spray washers and inside-and-outside bird washers on the microbiological quality of broiler carcasses was examined in 13 poultry slaughterhouses . The carcasses were sampled by means of the carcass rinse method; total and Enterobacteriaceae counts were estimated . The decrease in total and Enterobacteriaceae counts due to spray washing was as high as with the use of an inside-and-outside bird washer . From this investigation the conclusion can be drawn that the use of an inside-and-outside bird washer does not guarantee a better microbiological cleaning of the inside of the carcasses made 'mandatory' by EEC regulations. J Clin Microbiol, 1981 Jul, 14(1), 79 - 88 Tatumella ptyseos gen . nov., sp . nov., a member of the family Enterobacteriaceae found in clinical specimens; Hollis DG et al.; The name Tatumella ptyseos gen . nov., sp . nov., is proposed for a group of organisms (previously called group EF-9) isolated from clinical sources in the United States, Canada, and Puerto Rico . A total of 68% of these isolates were from sputum specimens . T . ptyseos strains are gram-negative, oxidase-negative, fermentative rods that grow on MacConkey agar . The distinctive biochemical characteristics of 44 T . ptyseos isolates were as follows: acid but no gas from D-glucose, sucrose, and, usually (71%), D-xylose (62% delayed); no acid from lactose, maltose, or D-mannitol; negative tests for indole, urea, methyl red, gelatin, L-lysine decarboxylase, and L-ornithine decarboxylase; L-arginine dihydrolase variable; phenylalanine deaminase positive; Voges-Proskauer positive by the Coblentz method but negative by the O'Meara method; nonmotile at 36 degrees C but 66% weakly motile (30% delayed) at 25 degrees C; Simmons citrate positive at 25 degrees C (89%) but Simmons citrate negative at 36 degrees C . Deoxyribonucleic acid-deoxyribonucleic acid relatedness studies on 26 T . ptyseos strains showed that they were 80 to 100% related at 60 degrees C, which indicated that they comprise a single species . The deoxyribonucleic acid relatedness to other species within the Enterobacteriaceae was 7 to 38% . This is evidence that this species belongs in this family, is distinct from all described species and is best placed in a new genus . The T . ptyseos isolates studied were susceptible to all of the antimicrobial agents tested by broth dilution; these antimicrobial agents were amikacin, ampicillin, cephalothin, chloramphenicol, gentamicin, kanamycin, tetracycline, and tobramycin . Three striking differences between T . ptyseos and other members of the Enterobacteriaceae were its large zone of inhibition around penicillin (mean diameter 24 mm), its tendency to die on some laboratory media (such as blood agar) within 7 days, and its small number (usually one) of flagella . Strain H36 (=ATCC 33301, =CDC D6168, =CDC 9591-78) is the type strain of this new species . T . ptyseos is the type species for the genus Tatumella. Arch Dermatol, 1981 Jul, 117(7), 430 - 1 Unilateral palpable purpura . A manifestation of septic emboli from an infected aortofemoral bypass graft eroding the jejunum; Goette DK; A 48-year-old man had a palpable purpuric eruption of the right lower extremity several years after a right aortofemoral bypass graft for obstructive atherosclerotic disease . Histologic examination revealed a leukocytoclastic angitis, and belated tissue Gram's stains disclosed clumps of Gram-negative organisms . The focus for the unilateral purpura proved to be an erosion of the jejunum by the bypass that yielded Enterobacter aerogenes on culture, as did one preoperative blood sample. Infect Control, 1981 Jul-Aug, 2(4), 315 - 6 Bacteriologic studies on electronic hospital thermometers; Smith L et al.; Electronic thermometers used in many hospitals require insertion into the mouth of a temperature-sensing probe covered by a pre-packaged probe cover . Handling procedures used by hospital personnel can lead to inadvertent manual contact with the probe cover . We attempted to determine the rate of non-sterility of these probe covers under normal hospital conditions and the extent to which pathogens could be detected on these and other components of the thermometer . Probe covers were removed before entry into the patient's mouth and aseptically inoculated into fluid thioglycollate medium . Subcultures were made to appropriate differential media . Over a 13-week period, 180 covers were cultured on two private hospital services . Forty-three percent were found to be non-sterile; control covers from central supply were only 6% non-sterile . Four percent of the probe covers harbored potential pathogens: coagulase positive Staphylococcus aureus, Streptococcus pyogenes, Enterobacter, and Bacteroides . No attempt was made to correlate these findings with infection . These results indicated a potential infection hazard for high-risk patient groups and a need by hospital personnel to consider this as a possible source of contamination. Antibiotiki, 1981 Jul, 26(7), 509 - 14 {Simplified technic of determining the Enterobacteriaceae R-plasmid incompatibility groups suitable for epidemiologic studies}; Belokrysenko SS; An economical technique for classification of newly isolated R plasmids according to the incompatibility groups with the use of a set of standard test-plasmids is described . The plasmid under study is transferred into E . coli P678 nal-r or C600 rif-r and crossed with the carrier strains sensitive to nalidixic acid and rifampicin of the standard test plasmids . The crossed strains are subjected to mixed cultivation in separate sectors of the dishes with full-value agar . After incubation the bacterial growth is transferred from the sectors with a velvet replicator onto the agar containing rifampicin or nalidixic acid and antibiotics for isolation of transconjugants carrying the standard test-plasmids with different resistance markers in addition to the plasmid being studied . The transconjugants are incubated and additionally twice replicated onto an analogous fresh selection medium with incubation each time for 6-16 hours at 37 degrees C . In case of incompatibility with one of the standard plasmids the plasmid being studied segregates in the transconjugant in the respective sectors during the replications and growth . Segregation of the plasmid is detected when the transconjugant is replicated from the sectors of the third selection dish onto the agar with the antibiotics, resistance to which is controlled by the R plasmid being studied . The growth is determined until the 4th-6th hour of growth at 37 degrees C . After that period retardation in the growth of the transconjugants is most evident in the sector where segregation of the plasmid being studied takes place . The transconjugant growth in the other sectors is used as control. Am J Vet Res, 1981 Jul, 42(7), 1269 - 73 Use of the API 20E system to identify non-Enterobacteriaceae from veterinary medical sources; Collins MT et al.; The capability of the API 20E system to identify gram-negative nonfermenters and nonenteric fermenters was evaluated for 272 isolates from veterinary sources . Two different methods were used for interpreting the carbohydrate fermentation reactions on the strip . In method I, weakly fermented (yellow-green) carbohydrates were considered positive for all oxidase-positive organisms, and in method II, yellow-green carbohydrates were considered positive for all organisms requiring incubation for 48 hours . By both methods, the API system correctly identified 62% of the isolates . With method I, 31% of the isolates were misidentified and 6% were not identified . With method II, 21% of the isolates were misidentified and 17% received no identification . Organisms most affected by these 2 methods of interpretation were Pasteurella and Actinobacillus . Identifications reached by the API system were also compared with identifications made by veterinary diagnostic laboratories . The frequency of identifications agreements was not significantly affected by the method of API carbohydrate fermentation reaction interpretation . Generally, 30% of the identifications agreed (diagnostic laboratories vs API) when using only the API Index, whereas 51% agreed when the entire API computer data base identifications were included . The type of identification disagreements between diagnostic laboratories and the API system, however, was significantly affected by the method of API strip interpretation . With method I, 42% of the identifications were different and 6% were not in the API data base . With method II, 33% of the identifications were different and 17% were not in the API data base . Biotype differences between human and veterinary isolates were also compared . Significant differences between the predicted and actual reactions were noted for Pseudomonas aeruginosa and Bordetella bronchiseptica; however, these differences did not affect their correct identification to the API Index . For Pasteurella multocida, most profile numbers were not listed in the API Index because of differences in the actual vs predicted oxidase and nitrate reduction reactions; however, they were correctly identified with the total computer data base. J Clin Microbiol, 1981 Jul, 14(1), 61 - 6 Preservation and transportation of bacteria by a simple gelatin disk method; Obara Y et al.; A wide range of bacterial species, e.g., Enterobacteriaceae and Neisseria, Streptococcus, Branhamella, Haemophilus, Gemella, Pseudomonas, Flavobacterium, and Bacteroides species, were successfully preserved for 1 to 5 years by our gelatin disk drying method . The beta-lactamase activity of penicillinase-producing Neisseria gonorrhoeae was retained for more than 3 years with this method . Good results were also obtained upon airmailing many strains of N . gonorrhoeae embedded in gelatin disks from Japan to the United States . Neisseria, Branhamella, Gemella, and Haemophilus organisms suspended in the reagent used in the preparation of the gelatin disks could be preserved for 6 to 12 months after freezing the cell suspensions at -20 degrees C . Furthermore, modification of our gelatin disk preservation method made possible the safe long- and short-distance transportation of clinical isolates . Our methods can be used by any small laboratory, since they require only conventional instruments and reagents. Antimicrob Agents Chemother, 1981 Jul, 20(1), 38 - 46 BRL 17421, a novel beta-lactam antibiotic, highly resistant to beta-lactamases, giving high and prolonged serum levels in humans; Slocombe B et al.; BRL 17421 is a new semisynthetic beta-lactam antibiotic with an unusual spectrum of antibacterial activity . The compound exhibits exceptional stability to a wide range of bacterial beta-lactamases and is active against the majority of Enterobacteriaceae, including strains highly resistant to many of the penicillins and cephalosporins currently available . Among the clinical isolates of Enterobacteriaceae tested, the frequency of strains resistant to BRL 17421 was found to be low, and there was a slow rate of emergence of resistance during in vitro studies . BRL 17421 was highly active against Haemophilus influenzae and Neisseria gonorrhoeae, including beta-lactamase-producing strains . The compound was markedly less active against Pseudomonas aeruginosa and Bacteroides fragilis than against the Enterobacteriaceae . Against the gram-positive bacteria, BRL 17421 showed a very low level of activity . BRL 17421 was found to be 85% bound to human serum, and the antibacterial activity was diminished two- to fourfold in the presence of human serum . Against experimental infections in mice, the activity of BRL 17421 reflected the properties observed in vitro . Studies in human volunteers showed unusually high and prolonged serum concentrations of the compound after parenteral dosage, with a serum half-life of about 5 h, and approximately 85% of the dose was recovered unchanged in the urine . BRL 17421 was poorly absorbed after oral administration . The compound was well tolerated after intramuscular and intravenous administration in volunteers, with no adverse side effects. J Clin Microbiol, 1981 Jul, 14(1), 15 - 9 Bacteriocins as tools in analysis of nosocomial Klebsiella pneumoniae infections; Bauernfeind A et al.; Epidemiological analysis of isolates from nosocomial infections caused by Klebsiella pneumoniae was improved by the use of bacteriocins in addition to capsular serotyping . Screening for bacteriocins produced by 77 reference strains for capsular serotyping identified 39 strains, and 8 of these strains were selected as a typing set . Using this set, we found that 241 to 259 (91%) nonepidemic clinical isolates of K . pneumoniae were inhibited by one or more of the eight producers . Of the most frequent bacteriocin type there were 31 examples (12%) . High reproducibility of typing patterns (83.3%) and easy practicability of typing were achieved with a streak-and-point method avoiding the use of suspensions of bacteriocins and the risk of instability . The Klebsiella bacteriocins were active also on Enterobacter and Shigella species and on Escherichia coli strains, but were ineffective on other Enterobacteriacae. J Immunol, 1981 Jul, 127(1), 184 - 91 Correlation of the biologic responses of C3H/HEJ mice to endotoxin with the chemical and structural properties of the lipopolysaccharides from Pseudomonas aeruginosa and Escherichia coli; Pier GB et al.; The basis of the biologic responses of C3H/HeJ mice to endotoxin administration in relation to the structural linkages in the lipid A portion of the lipopolysaccharide (LPS) of Pseudomonas aeruginosa and Escherichia coli were investigated . P . aeruginosa LPS was found to be immunogenic, mitogenic, and toxic, but not lethal, in C3H/HeJ mice . The observed mitogenicity in spleen cells was directed toward immunoglobulin- (Ig) bearing cells, was present in response to isolated and solubilized lipid A, and was inhibitable by polymixin B . The P . aeruginosa LPS was chemically analyzed in order to define its composition and exclude the presence of contaminating proteins being responsible for the biologic responses of C3H/HeJ mice that were observed . Structural analysis of the linkages of the fatty acids to the glucosamine backbone in the lipid A of P . aeruginosa and E . coli revealed similarities in terms of the ratio of hydroxy fatty acids to straight chain fatty acids and the way in which these 2 types of fatty acids were linked to the backbone . Differences were seen in the carbon chain length of the fatty acid substituents, and the substituent on the hydroxy fatty acid that is directly ester linked to the glucosamine backbone . These data indicate that the refractivity of C3H/HeJ mice to the biologic effects after the administration of Gram-negative endotoxins may be limited to enterobacterial LPS . Those differences we found in the chain length and/or linkages of the fatty acid substituents in the lipid A portion of the LPS between P . aeruginosa and E . coli may be sufficient to render C3H/HeJ mice responsive to the biologic effects of nonenterobacterial endotoxins. J Urol, 1981 Jun, 125(6), 825 - 7 Comparison of cinoxacin and trimethoprim-sulfamethoxazole in the treatment of urinary tract infections; Schaeffer AJ et al.; Forty women with uncomplicated urinary tract infections owing to susceptible organisms were assigned randomly to 500 mg . cinoxacin or 160--800 mg . trimethoprim-sulfamethoxazole twice daily for 10 days . Of 20 patients receiving cinoxacin none had bacteriuria during or 7 days after therapy, and 2 of 15 (13 per cent) were reinfected within 30 days . Of 20 patients receiving trimethoprim-sulfamethoxazole 1 (5 per cent) had bacteriuria during therapy, 19 were uninfected during and 7 days after therapy, and 3 of 15 (20 per cent) were reinfected within 30 days . Adverse reactions occurred in 2 patients (10 per cent) in each group . Anal and vaginal Enterobacteriaceae maintained their sensitivity to cinoxacin . Three patients (20 per cent) on trimethoprim-sulfamethoxazole presented with and 3 acquired anal Enterobacteriaceae resistant to the drug and 2 (13 per cent) acquired vaginal Enterobacteriaceae that were resistant . Cinoxacin was as effective as trimethoprim-sulfamethoxazole without the emergence of resistant bacteria associated with trimethoprim-sulfamethoxazole. Pediatrics, 1981 Jun, 67(6), 891 - 5 Aerobic and anaerobic bacteriology of cutaneous abscesses in children; Brook I et al.; Specimens from 209 cutaneous abscesses in children were cultured for aerobic and anaerobic microorganisms . Of these, nine (4%) were sterile and 51 (24%) yielded pure cultures that were predominantly Staphylococcus aureus . The rest of the abscesses yielded growth of two or more aerobic and/or anaerobic organisms . The data were organized according to these anatomic locations: head, neck, trunk, finger, nailbed, hand, leg, buttocks, perirectal, and vulvovaginal areas . Aerobic bacteria only were present in 92 specimens (46%), anaerobes only were isolated in 52 (26%), and mixed aerobic and anaerobic bacteria were present in 56 abscesses (28%) . A total of 467 isolates (270 anaerobes and 197 aerobes) were recovered, accounting for 2.3 isolates per specimen (1.3 anaerobes and 1.0 aerobes) . The presence of more than one anaerobe per abscess was obtained from the vulvo-vaginal, buttocks, perirectal, finger, nailbed, and head areas . Aerobes were more prevalent in the neck, hand, leg, and trunk areas . The predominant aerobes recovered were: S aureus (89 isolates), alpha- and nonhemolytic streptococci (29), group A beta-hemolytic streptococci (16), Enterobacter (10), and Escherichia coli (8) . The predominant anaerobes recovered were anaerobic Gram-positive cocci (79 isolates), Bacteroides sp (116, including 31 B melaninogenicus group and 29 B fragilis group), and Fusobacterium sp (39) . Our findings indicate the polymicrobial nature and predominance of anaerobes in cutaneous abscesses in children in perirectal, head, finger, and nailbed areas. J Thorac Cardiovasc Surg, 1981 Jun, 81(6), 934 - 42 Pathological study of infective endocarditis on Hancock porcine bioprostheses; Bortolotti U et al.; A pathological study has been performed on 10 infected Hancock bioprostheses removed from nine patients who died of prosthetic endocarditis . The devices had been in place from 2 to 87 months (average 37.5), the interval between operation and onset of infection averaging 30 months . The offending organisms were Gram negative bacteria in three patients (Klebsiella pneumoniae, Enterobacter cloacae, and Serratia marcescens), Gram positive bacteria in two (Staphylococcus aureus and Streptococcus viridans), and fungi in four (Candida species in three and Aspergillus species in one) . Gross examination of the explants revealed in most cases a vegetative endocarditis of one porcine valve leaflets . Septic embolization occurred in five cases owing to the high friability of the vegetations . Prosthetic valve incompetence was the commonest type to dysfunction observed because of tears, perforations, and even complete destruction of the cusps . Prosthetic valve stenosis following obstruction of the valve orifice by infected polypous masses was noted in two cases . Clumps of infective organisms were detected deep in the cusp tissue in most cases on histologic examination . Infection located on the paraprosthetic tissues, associated with ring abscess, valve detachment, and insufficiency, was observed only once . According to the results of investigation, endocarditis on porcine bioprostheses is associated with a better preserved native valvular ring as viewed at reoperation . Therefore surgical intervention appears appropriate in the presence of severe hemodynamic complications after adequate antibiotic treatment . However, infection of these particular prostheses still carries an extremely high mortality . In the present series, this poor outcome might be explained by the frequently associated septic and thromboembolic events. Zh Mikrobiol Epidemiol Immunobiol, 1981 Jun, (6), 43 - 6 {Collection of Shigella strains of provisional serovars . II . Antigens and antigenic relations}; Khomenko NA; In the serological study of 17 strains from the collection of Shigella provisory serovars (3873-50, 2000-53, 3341-55, 3615-53, 2710-54, 1621-54) differences in the content of K-antigens were revealed: some of them (3341-55, 3615-53) were in the K-form, others (2000-53, 1621-54) in the O-form, and the rest in the OK-form . No antigenic affinity between the representatives of the enterobacterial group under study was established . The partial composition of O-antigen in bacteria of serovar 2000-53 and antigenically affined E . coli strains, serogroup 06, was studied . E . coli 06 O-antigen was shown to be heterogeneous and had the structure of type a, b--a, c . On the basis of the antigenic structure thus established, as well as its cultural and biochemical properties described in earlier works, serovar 2000-53 should be excluded from the group of Shigella provisory serovars and classified with the genus Escherichia under the designation E . coli 06a . 6b : K? : H--. J Clin Microbiol, 1981 Jun, 13(6), 1074 - 9 Antibodies to the enterobacterial common antigen: standardization of the passive hemagglutination test and levels in normal human sera; Malkamaki M; The passive hemagglutination test for antibodies against the enterobacterial common antigen (ECA) of Kunin was standardized for diagnostic purposes . Human erythrocytes were coated with a soluble ECA+ preparation from Salmonella typhimurium or, as specificity controls, with a similar ECA- preparation from congenic ECA-negative bacteria with saline, and the hemagglutination assay was performed on microtiter plates . The specificity of the test was ascertained further by inhibition assays with purified ECA and with crude ECA+ and ECA- preparations . The reproducibility of the tests was 96.4%; on this basis, a fourfold or larger difference in titers was regarded as significant . The anti-ECA titers in 649 serum samples from healthy persons ranged from less than 4 to 8,192 . The titers increased with age, so that th geometric mean titers were 57 at 1.5 years of age and 201 at 45 years of age . After this, the titers decreased again, to a low of 52 in persons more than 70 years old . Women had higher titers than men up to the age of 40 years. Infect Immun, 1981 Jun, 32(3), 1242 - 8 Phagocytic and chemiluminescent responses of mouse peritoneal macrophages to living and killed Salmonella typhimurium and other bacteria; Tomita T et al.; In the presence of luminol, resident as well as thioglycolate-induced and immunized macrophages emitted chemiluminescence more efficiently when the cells were exposed to living Salmonella typhimurium than when they were exposed to the same bacterium killed by ultraviolet light or heat . This phenomenon was observed whether or not the bacterium was opsonized . The different response to living and killed bacteria was also found with Escherichia coli, Pseudomonas aeruginosa, Proteus morganii, and Enterobacter aerogenes, but not with Shigella sonnei, Klebsiella pneumoniae, and Propionibacterium acnes . The results suggest that macrophages respond better to living, motile bacteria than to nonmotile or killed bacteria . The experimental results obtained with motility mutants of S . typhimurium, E . coli, and P . aeruginosa confirm that macrophages exposed to the motile bacteria emit chemiluminescence more efficiently and ingest the motile bacteria at a much faster rate than the nonmotile bacteria. J Antibiot (Tokyo), 1981 Jun, 34(6), 739 - 52 Synergistic effect of cephalexin with mecillinam; Otsuki M; In vitro and in vivo synergistic effects of cephalexin and mecillinam against Escherichia coli, Klebsiella pneumoniae, Enterobacter sp., Serratia marcescens and Proteus sp . were demonstrated and their action mechanism were also discussed . The growth curve after the exposure of cephalexin and mecillinam at the concentrations at which these antibiotics had no effects when given alone showed a decreased of the turbidity and the presence of a bactericidal effect . In experimental infection in mice, the combination of both drugs showed a synergistic effect and excellent therapeutic effect . The blood concentration ratio of cephalexin to mecillinam was coincident with the concentration ratio of these antibiotics at which the synergistic effect was observed in vitro . Phase-contrast and scanning electron somewhat elongated bacteria and formation of spindle cells with swelling in the central part . A leakage of the cellular contents from part of the swelled cell wall was observed by transmission electron microscope . Cephalexin showed an affinity for penicillin binding proteins (PBPs)-1a and 3 in Escherichia coli and mecillinam showed an affinity for PBP-2 . When these antibiotics were used concurrently, they exerted an additive effect to increase the affinity for PBPs . The lytic activity was increased much more after the combination of two antibiotics than after a single exposure. Can J Microbiol, 1981 Jun, 27(6), 616 - 26 The genetic and physical basis of variability in Escherichia coli strains carrying a reference Inc N group plasmid; Konarska-Kozlowska M et al.; The nature of basis of variability in the conjugational behaviour of RM98+ (RM98-carrying) strains of Escherichia coli K-12 that are otherwise similar in phenotype was studied . An explanation for such variability is provided . Some RM98+ strains of E . coli have a plasmid aggregate, which upon conjugation yields two different conjugative plasmids . The first (pCU1) is an N conjugative group plasmid by all available criteria . The second (pCU2) could not be placed in any conjugative group known among the Enterobacteriaceae . Reciprocal DNA hybridization experiments and the gel patterns displayed by the two plasmid DNAs upon digestion with different restriction endonucleases indicate no extensive sequence homology between pCU1 and pCU2 . PCU2 DNA is much longer than pCU1 DNA . Despite the absence of extensive homology, the DNA of pCU1 and pCU2 can interact . Derivatives can be selected that have all the antibiotic markers of the aggregate plasmid but that neither contain nor segregate pCU2 . It is shown that in such strains a DNA fragment of molecular weight 7.9 X 10(6) has been added to pCU1 concurrently with a tetracycline resistance marker originally present in pCU2 and absent in pCU1 . These observations suggest that tetracycline resistance in pCU2 may be part of a large translocatable element . RM98 has been used to designate a reference Inc N group plasmid . The results presented indicate that this can lead to ambiguity . pCU1 would now be the appropriate reference plasmid. J Clin Microbiol, 1981 Jun, 13(6), 1088 - 95 Screening of uropathogenic Escherichia coli for expression of mannose-selective adhesins: importance of culture conditions; Fein JE; I surveyed the prevalence of mannose-sensitive adherence factors (adhesins) in uropathogenic Escherichia coli isolates by using several rapid screening tests based on the agglutination of stained yeast cells . Mannose-sensitive adhesin activity was demonstrated best for bacteria grown in aerobic static broth cultures . Under these conditions, the majority of the strains from patients with significant bacteriuria (55{85%} of 181 isolates) or upper urinary tract infections (19{79%} incidence of mannose-sensitive adhesion activity was detected for strains cultured on solid medium . Thus, only 26 (51%) of 51 fresh isolates from cases of significant bacteriuria appeared to have mannose-sensitive adhesin activity when they were tested directly on the primary isolation medium (MacConkey agar), whereas after serial static broth subculturing, 45 (88%) of these strains were active . Many of the nonagglutinating weakly agglutinating strains detected were also nonmotile . Various other enterobacteria showed strong agglutinating activity toward the yeast cells, and in most cases these reactions were blocked by mannose . However, a few notable exceptions were found. Zh Mikrobiol Epidemiol Immunobiol, 1981 May, (5), 41 - 3 {Errors in the bacteriologic diagnosis of dysentery and ways of eliminating them}; Proskuriakova NB et al.; The study of 1023 strains, formerly identified as Shigella, has revealed that 67 of these strains belong to Escherichia, Enterobacter, Klebsiella, Providencia, Pseudomonas, Flavobacterium . Such errors are due to the insufficient use of biochemical tests in the process of identification . To improve Shigella identification, after the evaluation of changes in Olkenitsky's medium of trisaccharide agar the tests for urease activity, citrate and acetate assimilation, lysine decarboxylase, mobility at 22 degrees C, sensitivity to Shigella bacteriophage, oxidase are recommended. Appl Environ Microbiol, 1981 May, 41(5), 1128 - 31 Heat inactivation of staphylococcus epidermidis at various water activities; Verrips CT et al.; Members of the family Micrococcaceae play an important role in food spoilage and even in food poisoning . In contrast to members of the family Enterobacteriaceae, these bacteria can grow in media with low water activities . Therefore, the heat resistance of Staphylococcus epidermidis, a rather resistant member of the family Micrococcaceae, was studied at water activities between 0.87 and 1.00 . The heat inactivation curves were clearly biphasic at all temperatures and water activities tested . Especially at low water activities, the D-values of the tail phase were extremely high (at 0.87 water activity, a D-value at 70 degrees C of 500 s was recorded). J Clin Microbiol, 1981 May, 13(5), 919 - 33 Kluyvera, a new (redefined) genus in the family Enterobacteriaceae: identification of Kluyvera ascorbata sp . nov . and Kluyvera cryocrescens sp . nov . in clinical specimens; Farmer JJ 3rd et al.; Kluyvera is proposed as a new genus for the group of organisms formerly known as Enteric Group 8 (synonym = API group 1) . Strains of Kluyvera share the properties of most members of the family Enterobacteriaceae: they are gram-negative rods, motile with peritrichous flagella, catalase positive, and oxidase negative; they grow on MacConkey agar, ferment D-glucose with the production of acid and gas, and are susceptible to many antibiotics . Strains are usually indole positive, methyl red positive, Voges-Proskauer negative, citrate positive, H2S (triple sugar iron) negative, urea negative, phenylalanine deaminase negative, lysine decarboxylase positive, arginine dihydrolase negative, and ornithine decarboxylase positive . Kluyvera strains ferment many of the sugars and polyhydroxyl alcohols used in identification . By deoxyribonucleic acid-deoxyribonucleic acid hybridization, strains of Kluyvera were divided into three groups . Kluyvera ascorbata is proposed as the type species for the genus . Most strains of K . ascorbata have been isolated from clinical specimens . K . cryocrescens is proposed as the second species . It was occasionally isolated from clinical specimens, but it was isolated more commonly from the environment . Kluyvera species group 3 was heterogeneous, but was distinct from the two named species by deoxyribonucleic acid hybridization . This group was rare, so no species name will be proposed at this time . K . ascorbata can be differentiated from K . cryocrescens by its positive ascorbate test, inability to grow at 5 degrees C in a refrigerator, and smaller zones of inhibition around carbenicillin and cephalothin disks . The test normally used for identification does not clearly differentiate these two species . Kluyvera species are probably infrequent opportunistic pathogens . The most common source is sputum, where they are probably not clinically significant . Five strains have been from blood cultures . More information is needed about the incidence and clinical significance of the genus Kluyvera. Antimicrob Agents Chemother, 1981 May, 19(5), 813 - 20 Bacteriological aspects of selective decontamination of the digestive tract as a method of infection prevention in granulocytopenic patients; de Vries-Hospers HG et al.; We describe the bacteriological results of a controlled clinical trial of selective decontamination of the digestive tract as a method of infection prevention in granulocytopenic patients . Selective elimination of Enterobacteriaceae and Pseudomonadaceae species was accomplished by the oral administration of nalidixic acid, co-trimoxazole, or polymyxin . Yeasts were eliminated selectively by amphotericin B or nystatin treatment . The drugs used in this study were chosen because of their capacities to selectively eliminate gram-negative rods and yeast without affecting the anaerobic part of the gut flora which is responsible for colonization resistance . Compared with the control group, the selectively decontaminated patients had significantly fewer (P less than 0.0005) gram-negative rods or yeasts or both in their throat swab cultures and in their feces . This reduction may explain the clinical effectiveness of selective decontamination. Ann Microbiol (Paris), 1981 May-Jun, 132(3), 293 - 306 {Bactericidal activity of amoxicillin and cefaclor in an "in vitro" kinetic model (author's transl)}; Pothier P et al.; The bactericidal activity against Staphylococcus aureus 290-P, Escherichia coli NIHJ-JC2 and Klebsiella pneumoniae ATCC-10031 (10(6)/ml) was studied during 24 h, using an in vitro kinetic model which simulates the drug concentrations occurring in human serum after oral doses of amoxicillin (0.5 g or 1 g) or cefaclor (0.25 g or 0.50 g), 2 or 3 times a day . After the first antibiotic exposure, a high level of bactericidal activity (99-99.9%) was observed . Complete bactericidal activity was observed in all cases against S . aureus, but only after 3 times per day exposures in the case of E . coli and K . pneumoniae . Twice per day exposures of amoxicillin or cefaclor were invariably ineffective for these two species of Ente