Enterobacteriacea

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 Enterobacteriaceae (10(9) bacterial survivors/ml) . These findings were related to subinhibitory concentrations which were or not able to prevent or reduce the bacterial regrowth after the first exposure of the antibiotics.

J Clin Microbiol, 1981 May, 13(5), 934 - 9
Rapid identification and antimicrobial susceptibility testing of gram-negative bacilli from blood cultures by the AutoMicrobic system; Moore DF et al.; A procedure was developed which allows direct identification and antimicrobial susceptibility testing of fermentative and nonfermentative gram-negative bacilli from positive blood cultures . A 10-ml sample was removed from turbid blood culture bottles, and the bacteria were washed and concentrated by centrifugation . The bacterial pellet was used to inoculate an Enterobacteriaceae Plus Identification Card and a Gram-Negative General Susceptibility Card of the AutoMicrobic system . Results with these cards were compared with results obtained with standard technique for 196 blood cultures seeded with recent clinical isolates . Identification of most cultures was available in 8 h, whereas the antimicrobial susceptibility results were available in an average of 4.7 h for all organisms . Direct identification was correct for 95% of the cultures, whereas the antimicrobial susceptibility data had an average agreement of 87% with 3.8% very major and 1.4% major errors . In using this procedure it was possible to provide accurate preliminary identification and results of antimicrobial susceptibility tests for gram-negative bacilli on the same day that a blood culture was determined to be positive.

J Clin Microbiol, 1981 May, 13(5), 895 - 8
Laboratory evaluation of the AutoMicrobic system for identification of Enterobacteriaceae; Freeman JW et al.; The Enterobacteriaceae Biochemical Card used with the AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) was compared with the API 20E system (Analytab Products, Plainview, N.Y.) for identifying members of the family Enterobacteriaceae . A total of 1,401 clinical isolates representing 18 species were identified by the AutoMicrobic and API 20E systems over a 5-month period . Discrepancies between these systems were resolved by conventional methods . Overall, 98.3% of the isolates were identified correctly by the AutoMicrobic system in 8 h, with 94.2% having an AutoMicrobic system confidence level greater than or equal to 90%; 92.9% of the isolates were identified correctly by the 20E system after 24 h of incubation . Discrepancies between the two systems occurred in 3.1% of the isolates . Of these, 40.9 and 59.1% proved to be correct by the AutoMicrobic and API 20E systems, respectively.

J Urol, 1981 May, 125(5), 672 - 3
Pathogenesis of urinary infection in patients with acute spinal cord injury on intermittent catheterization; Moloney PJ et al.; In a small pilot study urinary tract infection in patients with acute spinal injury was preceded by the establishment of Enterobacteriaceae on the introitus, glans and urethra . Those patients who retain the normal flora do not become infected . The first infection most commonly is by Escherichia coli with universal antibiotic sensitivities . Female patients with a history of urinary infections and male patients with a history of bacterial prostatitis are at risk for suffering recurrent infections . Saline or chlorhexidine gluconate pre-catheter preparation does not appear to relate to a continual status free of infection.

J Med Microbiol, 1981 May, 14(2), 171 - 83
Acquired cross resistance to aminoglycosides in gentamicin-sensitive and gentamicin-resistant strains of enterobacteria; Al-Asadi MJ et al.; The development of non-specific resistance ot gentamicin, tobramycin and amikacin was studied in 12 clinical isolates of enterobacteria with various patterns of aminoglycoside resistance . Strains were characterised with respect to MIC, transferability of resistance and possession of acetylating and adenylylating enzymes . An increase in aminoglycoside resistance was induced in 10 strains by a single exposure to the concentration of gentamicin, tobramycin or amikacin immediately below the MIC . Such resistance was non-specific; all three aminoglycosides were affected irrespective of which one had been used to induce the increase . Increments in non-specific aminoglycoside resistance were also evoked by exposure of enterobacteria to changing drug concentrations similar to those achieved in plasma during therapy . When strains already resistant to gentamicin or other aminoglycosides were exposed to therapeutically achievable drug concentrations, no further increase in resistance was observed in most cases . This suggests that use of an aminoglycoside to which the organism is resistant, as during "blind" therapy, will not usually compromise subsequent treatment with related antibiotics . The possible relevance of non-specific aminoglycoside resistance to therapy is discussed.

Ann Otol Rhinol Laryngol Suppl, 1981 May-Jun, 90(3 Pt 3), 2 - 7
Clinical pharmacology of the antimicrobial agents for infections in the ear, nose and throat; Neu HC; Knowledge of which microorganisms cause infection in the ear, nose and throat must be coupled with an understanding of the susceptibility patterns of these bacteria as well as knowledge of the pharmacokinetic properties of antimicrobial agents . EVen though many of the bacteria which produce community-acquired infection are susceptible to the older agents, specific problems have developed with regard to species such as Hemophilus influenzae and to Staphylococcus aureus . Hospital-acquired infections due to Enterobacteriaceae may be resistant to the penicillin drugs and to some of the older cephalosporins and aminoglycosides . Use of the new agents often requires an understanding of how rapidly the compounds are cleared from the body or if they will accumulate to toxic levels in the elderly patient with decreased renal function . This article reviews the antimicrobial activity and clinical pharmacology of agents commonly used to treat infections of the ear, nose and throat.

Antimicrob Agents Chemother, 1981 May, 19(5), 773 - 6
Cefoperazone treatment of experimental endocarditis; Snepar RA et al.; Cefoperazone (10 mg/kg) and cephalothin (20 mg/kg) administered intramuscularly every 6 h were both effective in reducing the number of Staphylococcus aureus cells in vegetations in rabbits with endocarditis . Cefoperazone produced higher peak concentrations and greater bactericidal activity in serum than did cephalothin . Cefoperazone (40 mg/kg) administered every 6 h was significantly more effective than cefamandole (40 mg/kg) administered every 6 h in reducing the number of Enterobacter aerogenes cells in vegetations . Although cefamandole produced higher peak concentrations in serum, the serum bactericidal activity was greater with cefoperazone . The half-lives in serum were 0.64 h for cefoperazone and 0.46 h for cephalothin and cefamandole.

Jpn J Antibiot, 1981 May, 34(5), 800 - 16
{Laboratory and clinical studies of 6059-S in pediatric field (author's transl)}; Nishimura T et al.; The authors have carried out the laboratory and clinical studies of 6059-S . The results were as follows: The sensitivity was estimated by the plate dilution method on 27 strains of S . aureus, 26 strains of E . coli, K . pneumoniae and P . aeruginosa, 21 strains of Salmonella sp . and 9 strains of GM resistant P . aeruginosa isolated from patients . The distribution of sensitivity of S . aureus was 6.25-12.5 micrograms/ml and the peak of distribution was 6.25 micrograms/ml . The growth of 80.8% of E . coli was inhibited at concentration of less than 0.1 microgram/ml . The growth of 88.5% of K . pneumoniae was inhibited at concentration of less than 0.2 microgram/ml . The growth of 81.0% of Salmonella sp . was inhibited at concentration of less than 1.56 microgram/ml . The distribution of sensitivity of P . aeruginosa was 12.5- greater than 100 micrograms/ml and the peak of distribution was 25.0 micrograms/ml . The distribution of sensitivity of GM-resistance P . aeruginosa (greater than or equal to 25 micrograms/ml) was 12.5-50 microgram/ml and 5 of 8 strains were inhibited at concentration of less than 25 micrograms/ml . Phagocytosis was determined by Quie's method . Phagocytosis of E . coli, K . pneumoniae, Proteus vulgaris and Enterobacter cloacae by human polymorphonuclear neutrophil was more enhanced in the presence of 1 MIC and 1/2 MIC for 6059-S than for cefazolin at 4 and 6 hours after incubation . But phagocytosis of S . aureus did not enhanced in the presence of 6059-S . 6059-S was given by intravenous administration for 5 minutes and drip infusion for one hour at a single dose of 10 mg/kg of 6059-S to 3 and 4 children respectively . After intravenous administration of 6059-S, the mean peak serum level was 76.0 +/- 2.0 micrograms/ml at 15 minutes, 36.0 +/- 2.8 micrograms/ml at one hour, 1.5 +/- 0.4 micrograms/ml at 6 hours respectively . Half-life time was 1.3 hours . And after drip infusion of 6059-S was 39.9 +/- 9.7 micrograms/ml at one hour, 11.7 +/- 4.8 micrograms/ml at 3 hours and 1.8 +/- 1.4 micrograms/ml at 7 hours respectively . Half-life time was 1.4 hours . The mean urinary excretion rate was 90.4 +/- 6.1%, 76.5 +/- 16.0% up to 6 hours after intravenous administration and drip infusion respectively . 6059-S was effective in 17 cases out of 18 cases with bacterial infections . No side effects were observed except for 4 cases with elevation of serum transaminase, each on case of eosinophilia and of anemia.

Methods Find Exp Clin Pharmacol, 1981 May-Jun, 3(3), 183 - 7
Clinical experience with cefotaxime (HR-756) in surgical patients; Aznar J et al.; Twenty adult surgical patients aged between 15 and 83 years (mean:45), 10 of whom had wound infections (one complicated with septicaemia), 2 with septicaemia, 1 with gynecological infection complicated with endocarditis, 5 with urinary tract infections and 2 with lower respiratory tract infections, were treated with parentally-administered cefotaxime . Aetiology was Proteus 7, E . coli 4, Pseudomonas 3, Enterobacter 2, Klebsiella 2 and 2 Serratia . Susceptibility testing was determined by the agar dilution method, with MIC values ranging from 0.01 to 5 microgram/ml, with two urinary isolates of Pseudomonas with MIC of 20 microgram/ml . Clinical responses were excellent in 13 (65 per cent) cases, moderate in 2 (10 per cent) and 3 (15 per cent) failed to respond to therapy . Clinical assessment was not possible in three patients . Bacteriological responses were excellent in 14 (70 per cent) cases, poor in 4 (20 per cent) and in two there was no follow-up . Systemic tolerance was good in all patients except one.

Nature, 1981 Apr 30, 290(5809), 797 - 9
An inducible DNA replication-cell division coupling mechanism in E . coli; Huisman O et al.; Cell division is a tightly regulated periodic process . In steady-state cultures of Enterobacteriaceae, division takes place at a well defined cell mass and is strictly coordinated with DNA replication . In wild-type Escherichia coli the formation of cells lacking DNA is very rare, and interruptions of DNA replication arrest cell division . The molecular bases of this replication-division coupling have been elusive but several models have been proposed . It has been suggested, for example, that the termination of a round of DNA replication may trigger a key event required for cell division . A quite different model postulates the existence of a division inhibitor which prevents untimely division and whose synthesis is induced to high levels when DNA replication is perturbed . The work reported here establishes the existence of the latter type of replication-division coupling in E . coli, and shows that the sfiA gene product is an inducible component of this division inhibition mechanism which is synthesized at high levels after perturbations of DNA replication.

Am J Obstet Gynecol, 1981 Apr 15, 139(8), 915 - 21
Moxalactam for obstetric and gynecologic infections . In vitro and dose-finding studies; Cunningham FG et al.; Moxalactam (LY 127935), a "third-generation" beta-lactam antimicrobial, has been shown to have promising in vitro activity against a wide spectrum of pathogens similar to those isolated from women with pelvic infections . Pharmacodynamic studies have shown that its serum half life is longer than 2 hours, which permits less frequent dosing . The current investigation was carried out in two parts: In the first phase, the minimal inhibitory concentration of moxalactam against 519 clinical isolates was determined and compared to antimicrobials used in infections caused by these microbes . In vitro activity of moxalactam comparable to that of clindamycin was demonstrated against B . fragilis and other Bacteroides species . There was similar activity to penicillin G and clindamycin against anaerobic gram-positive cocci and activity superior to amikacin was demonstrated against Enterobacteriaceae . The second part of this investigation was a clinical one and 100 women with pelvic infections were given treatment with moxalactam . With an initial dose of 3 gm/day, women with posthysterectomy cellulitis and pelvic inflammatory disease did well . Women with pelvic infections following cesarean section responded less readily to this dose; however, when the initial dose was increased to 6 gm/day, a 91% cure rate was effected . The results of these investigations indicate that moxalactam is useful as a single-agent antimicrobial for treatment of polymicrobial female pelvic infection.

Zh Mikrobiol Epidemiol Immunobiol, 1981 Apr, (4), 82 - 5
{Conditionally pathogenic microflora of the Enterobacteriaceae family of healthy young children and children with acute intestinal infections of unknown etiology}; Kanareikina SK et al.; The study of quantitative and species composition of intestinal microflora in infants with acute intestinal infection of unknown etiology and in normal infants maintained on mixed feeding has revealed that most often bacteria belonging to the genus Proteus are found . The main difference between these groups consists in the presence of bacteria belonging to the genus Klebsiella, as well as other opportunistic intestinal bacteria, in greater amounts in sick infants than in healthy ones; at the time sick infants show a decrease in bifido- and lactobacteria.

Appl Environ Microbiol, 1981 Apr, 41(4), 894 - 902
Incidence of lysogeny, colicinogeny, and drug resistance in enterobacteria isolated from sewage and from rectum of humans and some domesticated species; Dhillon TS et al.; Enterobacteria were isolated by streaking swabs of sewage and rectal swabs from human volunteers from domesticated animals . Thirty strains of human origin were identified as Escherichia coli . Out of 1,367 rectal isolates of animal origin, 21% were lysogenic (phi+), 29% were colicinogenic (col+), and 7% were col+ phi+ . Out of 85 rectal samples more than 60% harbored variable numbers of col+ or phi+ bacteria . Lysogens harboring homoimmune prophages were detectable in six out of eight human subjects in sequential samples taken at weekly intervals . Chickens in Hong Kong are fed on antibiotic-containing feeds; the avian isolates contained the highest frequency (98%) of drug-resistant bacteria, whereas only 39% of the bovine and 61% of the human isolates were drug resistant . Transmissible drug resistance was demonstrable in sewage isolates and those from animal sources; the highest frequency (58%) of resistance donors was shown by the avian isolates, and the lowest (9%) was shown by the bovine isolates . Unselected marker analysis has shown that a vast majority of multiply resistant donors of diverse origins are able to transmit multiple resistance.

Antibiotiki, 1981 Apr, 26(4), 280 - 4
{Sensitivity to chemotherapeutic preparations of microflora isolated in chronic posttraumatic osteomyelitis}; Grinmaer TV et al.; Chronic post-traumatic osteomyelitis was mainly caused (59.3 per cent) by various gramnegative bacteria . Staphylococcus, Proteus and P . aeruginosa was most frequent . Bacteria were most frequently isolated from associations of 2-5 species and not from monocultures . However, when the patient microflora was studied in dynamics, the whole associations could not be detected in every of the cases . Sensitivity of the causative agents to 23 antibacterial drugs was tested and it was found that the majority of the organisms were sensitive to gentamicin, rifampicin, biseptol, hydroxyquinolines (5-NOK, enteroseptol), furazolidon (except P . aeruginosa) . P . aeruginosa was in addition sensitive to polymyxin . Proteus and other enterobacteria were sensitive to nevigramon, staphylococci and other grampositive bacteria were sensitive to oxacillin, lincomycin, novobiocin and fusidin.

Appl Environ Microbiol, 1981 Apr, 41(4), 867 - 72
Enterobacteriaceae associated with meats and meat handling; Stiles ME et al.; The source of Enterobacteriaceae on meats was shown to be associated with the meat-handling work surfaces in two packing plants studies . A total of 2,343 Enterobacteriaceae were isolated and identified from meat samples and work surfaces at the packing plants and at the retail facilities . Escherichia coli biotype I and Serratia liquefaciens were detected at all stages of meat handling, indicating that they may be present in meats throughout the meat-handling system . Enterobacter agglomerans and S . liquefaciens were the predominant Enterobacteriaceae at the retail level, but they had limited indicator potential for sanitation and hygiene, Klebsiella pneumoniae was a frequent isolate among Enterobacteriaceae from meats and meat-handling surfaces in the packing plants but not at the retail level, indicating that this organism might signal unhygienic handling of meats at the retail level.

Zh Mikrobiol Epidemiol Immunobiol, 1981 Apr, (4), 70 - 4
{Application of infrared spectroscopy to enterobacteria research}; Zhurko NP et al.; The influence of technology used in the preparation of spectroscopic specimens on the intensity of analytical adsorption bands in the infrared spectra of intact microbial cells has been studied with the use of mathematical planning methods . The optimal technology of specimen preparation by KBr immersion has been selected . This technology ensures the measuring of the relative optical density of the main analytical adsorption bands with an error not exceeding 3% . As an example, several E . coli strains have been used to demonstrate the possibility of their differentiation by the infrared adsorption spectra of intact cells.

Eur J Biochem, 1981 Apr, 115(3), 571 - 7
Structural studies on the hexose region of the core in lipopolysaccharides from Enterobacteriaceae; Jansson PE et al.; The structures for the hexose regions of cores from Enterobacteriaceae lipopolysaccharides have been investigated, using specific degradations and 1H NMR studies as the principal methods . Complete structures for these regions in the Salmonella, the Escherichia coli R1, R2, R3, R4, the E . coli K12 and E . coli B cores are proposed . Some complementary information on the structure of the heptose region has also been obtained.

Antibiotiki, 1981 Apr, 26(4), 275 - 9
{Conjugated plasmids of antibiotic resistance in conditionally pathogenic enterobacteria in infants with salmonellosis}; Gridnev VA et al.; Sensitivity to 10 antibiotics of 1074 strains of opportunistic enterobacteria isolated from 117 children at the age of 2 years was studied (57 healthy children and 60 children with salmonellosis) . The structure of the conjugative drug resistance of the opportunistic enterobacteria, the frequency of their isolation and the spectrum correlating with multiple resistance of the strains to 4-10 antibiotics were shown . The frequency of the conjugative determinants of the antibiotics resistance in the opportunistic bacteria isolated from the patients with salmonellosis was higher . The structure of the conjugative drug resistance of the opportunistic enterobacteria in the dynamics of the salmonellosis process was close to the transmissive R-plasmid resistance of S . typhimurium.

J Clin Microbiol, 1981 Apr, 13(4), 661 - 5
Rapid diagnostic test that uses isocitrate lyase activity for identification of Yersinia pestis; Hillier SL et al.; The presence of high levels of isocitrate lyase activity in Yersinia pestis grown on blood agar base medium, as compared with low levels of this enzyme in Yersinia pseudotuberculosis and Yersinia enterocolitica, suggested that the differences in the levels of this enzyme could be used for the presumptive identification of Y . pestis . A modified, semiquantitative assay for isocitrate lyase activity is described which requires no expensive instrumentation, utilizes readily available chemicals and substrates, and requires only 20 min for completion . This test yielded positive results with all 108 isolates of Y . pestis tested and negative results with all strains of Y . pseudotuberculosis (68 isolates) and Y . enterocolitica (202 isolates) tested . Less than 2% of the approximately 1,300 non-Yersinia isolates from the family Enterobacteriaceae and none of the 93 isolates from the family Pseudomonadaceae yielded positive results . We conclude that this test provides for rapid identification of Y . pestis and should be useful in the initial screening of isolates from rodent and flea populations and in the presumptive identification of this organism from suspected cases of human plague.

J Clin Microbiol, 1981 Apr, 13(4), 613 - 7
Co-trimoxazole susceptibility tests improved with separate trimethoprim and sulfamethoxazole disks; Amyes SG; It is impossible to test accurately bacterial susceptibility to the trimethoprim-sulfamethoxazole combination co-trimoxazole with a single combined susceptibility disk . However, a variety of factors still affect the result even when separate trimethoprim and sulfamethoxazole disks are used . Experiments with separate disks showed that the optimum conditions for testing the susceptibilities of enterobacteria to these drugs were to flood-seed an agar plate with an inoculum of 10(4) to 10(5) organisms per ml, take off the excess liquid, and place a disk of 1 microgram of trimethoprim and another of 50 micrograms of sulfamethoxazole on the surface of the agar with their centers exactly 25 mm apart . This method not only allowed the determination of resistance but also distinguished synergy.

Ann Intern Med, 1981 Apr, 94(4 pt 1), 505 - 18
Infective endocarditis: an analysis based on strict case definitions; Von Reyn CF et al.; Strict case definitions were applied to 123 clinically diagnosed cases of infective endocarditis . Cases were categorized as definite (19), probable (44), or possible (41) endocarditis or were rejected (19) . Compared to other published studies, our patients had an advanced mean age (57), high incidence of underlying valvular disease (66%), short mean duration of symptoms (27 days), and 15% mortality, the lowest reported for a large series . Most cases were caused by viridans streptococci, Staphylococcus aureus, or enterococci; Enterobacteriacae were absent, and negative cultures infrequent (5%) . Subgroups included nosocomial endocarditis (13%), usually with underlying valvular disease and invasive procedures; prosthesis endocarditis (12%); and cases requiring cardiac surgery (18%) . Deaths were caused by heart failure, neurologic events, or superinfection . Strict definitions are useful in managing suspect cases, and are essential in comparing clinical studies . Early recognition and treatment should be the focus of efforts to reduce mortality from endocarditis.

Jpn J Antibiot, 1981 Apr, 34(4), 599 - 607
{Clinical evaluation of 6059-S therapy in children (author's transl)}; Meguro H et al.; A new semisynthetic 1-oxa-beta-lactam derivative, 6059-S, was evaluated for its safety and efficacy in children . Twenty-five patients were treated with 10 to 274 mg/kg per day of 6059-S by intravenous administrations . The diagnosis of the patients were acute pharyngitis (2), acute bronchitis (2), pneumonia (4), pertussis (4), acute enterocolitis (2), recurrent urinary tract infection (2), suspected septicemia (3), and acute purulent meningitis (1); and the remaining 5 patients were considered to have nonbacterial infections . The pathogens recovered were Streptococcus pneumoniae (1), Haemophilus influenzae (4), Haemophilus parainfluenzae (1), Enterobacter cloacae (1), Enterobacter aerogenes (1), Proteus morganii (1), Psuedomonas aeruginosa (2) and Salmonella typhimurium (1) . All the patients of bacterial infections were cured after the 6059-S therapy . However, Pseudomonas aeruginosa and Salmonella typhimurium were not eradicated after the 6059-S therapy, and the rate of bacterial disappearance was 75% . Diarrhea (3), precordial pain (2, only in cases with high-dose therapy), transient elevation of GOT and GPT (2), and transient eosinophilia (2) were found to be associated with the 6059-S therapy . However, no severe adverse reactions were encountered . Half life of the serum 6059-S level was 1.34 +/- 0.16 hours . CSF concentrations in a case with Haemophilus influenzae meningitis ranged 4.0 to 9.7 mcg/ml after an intravenous injection of 34.3 to 75 mg/kg of 6059-S . From the present study, 6059-S appears to be a safe and effective antibiotic when used in children with susceptible bacterial infections . It remains to be further determined whether 6059-S is superior to ABPC in the treatment of Haemophilus influenzae meningitis.

J Antimicrob Chemother, 1981 Apr, 7(4), 343 - 52
Cefoperazone and cefotiam--two new cephalosporins: an in-vitro comparison; Wise R et al.; The in vitro activity of cefoperazone (CPZ) and cefotiam (CTM) was compared to other available cephalosporins . Using an agar dilution procedure both CTM and CPZ were more active against the Enterobacteriaceae tested than cefoxitin, cefuroxime and cefazolin; CTM being slightly more active than CPZ, in particular against Klebsiella spp Haemophilus influenzae were more susceptible to CPZ . CTM had no activity against Pseudomonas aeruginosa but CPZ exhibited considerable activity (mode MIC 4 mg/l) . Against Bacteroides fragilis CPZ had a similar activity to cefuroxime, but CTM was less active . CTM was about twice as active as CPZ against Staphylococcus aureus, cefazolin being the most active agent tested . The MBC was about twice the MIC for each compound and the presence of 75% serum had only a modest effect on the MIC and MBC . The protein binding of CPZ was 94% and CTM 62%.

Jpn J Antibiot, 1981 Apr, 34(4), 507 - 14
{Bacteriological and clinical studies on cefotaxime in obstetrics and gynecology (author's transl)}; Ninomiya K et al.; Fundamental and clinical studies of cefotaxime (CTX), a new semisynthetic cephalosporin antibiotic were carried out in the field of obstetrics and gynecology . The following results were obtained . 1 . CTX was almost equally active to SCE-1365 and less active than cefotiam (CTM) and cefazolin (CEZ) against S . aureus, much more active than these 3 antibiotics against E . coli, more active than the 3 antibiotics against Enterobacter, equally active to SCE-1365 and a little weaker than CEZ against anaerobic Gram positive cocci, and superior to SCE-1365 and CEZ against Bacteroides . 2 . CTX was more stable to B . fragilis-producing beta-lactamase than CET, CEZ and cefoperazone (CPZ) . 3 . The concentrations of CTX transferred to the female genital organs after CTX 1 g d . i . were sufficiently effective against facultative or strict anaerobic bacteria mainly isolated from obstetrical and gynecological infections . 4 . CTX was administered to 10 patients with genital infections . CTX was excellent in 1 case, good in 8 cases and poor in 1 case . The response rate of CTX was 90% . Bacteria, isolated in 5 cases before CTX treatment, were eradicated in 4 cases . The bacteriological effectiveness of CTX was thus 80% . 5 . No side effect attributable to CTX was observed.

J Biol Chem, 1981 Mar 10, 256(5), 2194 - 8
Comparison of the lipoprotein gene among the Enterobacteriaceae . DNA sequence of Erwinia amylovora lipoprotein gene; Yamagata H et al.; A DNA sequence of 816 base pairs encompassing the entire Erwinia amylovora lipoprotein gene was determined . Sequence comparison between E . amylovora, Escherichia coli, and Serratia marcescens suggests that the structure of the lipoprotein has been highly conserved under the constraint of efficient gene expression selecting promoter structure, mRNA secondary structure, and codon usage in addition to the polypeptide function . The sequence also suggests that the lpp gene of the three bacteria diverged sequentially in the course of evolution.

Schweiz Med Wochenschr, 1981 Mar 7, 111(10), 356 - 8
{In vitro activity of a new cephalosporin--cefoperazone--against Enterobacteriaceae and Pseudomonas aeruginosa}; Modde H; 431 recent clinical isolates from the families Enterobacteriaceae and Pseudomonadaceae drawn from the western part of Switzerland have been tested for Cefoperazone sensitivity . With 6 exceptions, all strains were susceptible or highly sensitive to the antibiotic . Striking was the excellent activity of cefoperazone against Pseudomonas aeruginosa, Serratia marcescens and indol-positive Proteus species, in contrast that of most of the already established cephalosporins.

Vopr Virusol, 1981 Mar-Apr, (2), 234 - 6
{Effect of enteroviruses on the ecology of intestinal bacteria}; Gutorova LD et al.; The rate of isolation of some enteric bacteria from normal children and those suffering from diseases caused by ECHO viruses was studied . Enterovirus infection was shown to cause characteristic disturbance of microbial biocenosis in the large intestine differing from similar disorders in other intestinal diseases: a decrease in the total number of enterobacteria with predominant replication of escherichia not fermenting lactose . Enteroviruses exert a mediated effect on enteric microorganism population changing the physico-chemical properties of their environment.

Am J Med, 1981 Mar, 70(3), 719 - 32
Nosocomial bacteremia . An epidemiologic overview; Maki DG; Each year nosocomial bacteremia develops in approximately 194,000 patients in U.S . hospitals (5/1,000); 75,000 die . These infections portend $.28 to $.86 billion added costs to health care . Most nosocomial bacteremias occur endemically and are secondary bacteremias, caused by postoperative wound or intra-abdominal infections, urinary tract infections or pneumonia; primary bacteremias most frequently originate from intravascular devices, but the source is unrecognized . Between 1965 and 1978, 97 epidemics of nosocomial bacteremia, including 11 of "pseudobacteremia," were reported . In contrast to endemic bacteremias, 78 percent of the epidemics involved primary bacteremias: 33 outbreaks stemmed from infusion therapy in some form, including seven epidemics traced to a contaminated commercial product . Two thirds of endemic nosocomial bacteremias and 79 percent of epidemics are caused by aerobic gram-negative bacilli . Pseudomonas cepacia, Pseudomonas maltophilia, Flavobacterium and Enterobacter agglomerans rarely cause endemic bacteremia and when encountered often signal an epidemic . Whereas predisposing host conditions greatly increase the risk of bacteremia endemically nosocomial epidemics occur mainly in immunocompetent patients and are related to what therapeutic measures have been taken: segregation in a special care unit (58 percent of outbreaks) or exposure to infusion therapy or other invasive procedures involving the bloodstream (65 percent) . At present only about one fourth of endemic nosocomial bacteremias are in theory preventable by more consistent application of existent knowledge of asepsis . The potential for prevention seems greatest for epidemic bacteremias, most of which are related to exposure to invasive devices, to a common source of contamination, or both.

Zentralbl Bakteriol A, 1981 Mar, 249(1), 63 - 75
{Bacteriocin typing of Enterobacter cloacae strains (author's transl)}; Freitag V et al.; By means of bacteriocin typing epidemic studies were carried out with regard to 65 strains of Enterobacter cloacae, isolated from various specimens of 59 patients . Based on detailed preliminary investigations the presentation with bacteriocins in liquid cultures induced by Mitomycin C was found most preferable . Since constant and reproducible results are essential, standardization of culture media, incubation temperature, incubation time and inoculum size is required . By means of 13 bacteriocin-producing strains the isolates could be typed and categorized into 24 types according to their sensitivity to bacteriocins . A rather varied picture emanated from the distribution of the individual types with regard to the different medical fields so that cross-infection with a certain strain was negligible . Seeing that one bacteriocin type was found predominantly in the intensive care unit, it can be maintained that this strain originated from the ward itself . The importance of bacteriocin typing for the interpretation of certain up-to-date epidemic situations is obvious which typing has also been successfully employed with regard to investigations of Enterobacter cloacae infections . However, it is doubtful whether bacteriocin production and bacteriocin sensitivity sufficiently constant in order to obtain comparable results over a more extended period of time and in different areas.

Antimicrob Agents Chemother, 1981 Mar, 19(3), 393 - 6
Differences between ceftizoxime and its stereoisomer in antibacterial activity and affinity for penicillin-binding proteins; Shigi Y et al.; A new cephalosporin derivative, ceftizoxime (syn FK 749), and its anti isomer, FR 14060, were compared in antibacterial activity, outer membrane permeability, stability to beta-lactamases, and affinity for penicillin-binding proteins (PBPs), using Escherichia coli NIHJ JC-2 and Enterobacter cloacae 58-5 as the test organisms . Although ceftizoxime was superior in antibacterial activity to FR 14060, no marked differences between the two agents were found in outer membrane permeability and stability to cephalosporinase . However, the affinity for PBPs and stability to penicillinase of ceftizoxime and FR 14060 differed significantly . Concentrations of ceftizoxime required to reduce {14C}penicillin G binding by 50% were below 1 microgram/ml for PBPs 1a and 1bs of E . cloacae 58-5 and below 3.2 microgram/ml for PBPs 1a and 1bs of E . coli NIHJ JC-2 . A more than 10-fold-higher concentration of FR 14060 was required for 50% reduction of (14C}penicillin G binding to PBP 1bs of strains tested . Ceftizoxime was severalfold more stable than FR 14060 to penicillinase, but the antibacterial activity of both drugs against penicillinase-producing E . coli was as strong as against non-penicillinase-producing E . coli . These results indicate that the difference between the two compounds in antibacterial activity is likely to be due to differences in their abilities to inhibit peptidoglycan polymerization.

J Clin Microbiol, 1981 Mar, 13(3), 491 - 7
Clinical laboratory evaluation of the Auto-Microbic system for rapid identification of Enterobacteriaceae; Hasyn JJ et al.; The capability of the Auto-Microbic system (Vitek Systems, Inc., Hazelwood, Mo.) has been expanded to identify members of the family Enterobacteriaceae with the use of a sealed, disposable accessory card (the Enterobacteriaceae Biochemical Card) containing 26 biochemical tests . To judge the accuracy of the AutoMicrobic system's identification in a hospital laboratory, 933 Enterobacteriaceae isolates were studied . The AutoMicrobic system provided the correct identification for 905 of the isolates (97%) . For Enterobacteriaceae excluding Escherichia coli (533 isolates not E . coli), 506 isolates were correctly identified (94.9%) . The AutoMicrobic system integrates well into the clinical microbiology laboratory, providing a simple, accurate, and efficient automated system for the rapid identification of Enterobacteriaceae.

J Clin Microbiol, 1981 Mar, 13(3), 483 - 90
Rapid identification of Enterobacteriaceae with microbial enzyme activity profiles; Godsey JH et al.; A total of 539 clinical isolates belonging to 10 species of the Enterobacteriaceae family were identified by enzyme activity profiles within 30 min of test inoculation . Each isolate was grown at 37 degrees C for 18 h on Mueller-Hinton agar and suspended to an optical density of 200 Klett units on 0.85% saline . Enzyme activity profiles were obtained by inoculating 18 fluorogenic substrates with the standardized bacterial suspension and monitoring initial rates of hydrolysis over the first 30 min of analysis . Individual enzyme activity profiles were entered into a coded data bank, and identifications were based on the Bayesian theory of probabilities . At a confidence level of 95%, five species were identified with a greater than 90% efficiency, three species were identified between 83 and 88% efficiency, and two species demonstrated a 72 and 75% efficiency of identification . The enzyme activity profile method of bacterial identification is rapid, easily automated, and reproducible.

Antimicrob Agents Chemother, 1981 Mar, 19(3), 407 - 13
Comparison of in vitro activities of eight beta-lactamase-stable cephalosporins against beta-lactamase-producing gram-negative bacilli; Verbist L; In vitro activities of eight beta-lactamase-stable cephalosporins, cefoxitin, cefuroxime, cefotaxime, moxalactam, SCE-1365, cefoperazone, ceftazidime, and cefsulodin, were compared against selected cephalothin-resistant or beta-lactamase-producing gram-negative bacilli or both . SCE-1365, cefotaxime, moxalactam, and ceftazidime had very similar activities against Enterobacteriaceae; SCE-1365 displayed the highest activity, and ceftazidime displayed the lowest activity . These four antibiotics were about 20 times more active than cefoperazone and 50 to 100 times more active than cefoxitin and cefuroxime . Against Pseudomonas aeruginosa and the other Pseudomonas species, ceftazidime showed the highest activity by far, followed by cefsulodin and cefoperazone . A close parallel resistance against P . aeruginosa isolates was observed between piperacillin on the one hand and cefoperazone and cefsulodin on the other.

Antimicrob Agents Chemother, 1981 Mar, 19(3), 435 - 42
Comparative in vitro studies of Ro 13-9904, a new cephalosporin derivative; Eickhoff TC et al.; The in vitro activity of Ro 13-9904, a new cephalosporin derivative, was compared with the activities of cephalothin, cefamandole, cefoxitin, cefotaxime, and moxalactam against 591 clinical isolates of gram-negative and gram-positive organisms . The spectra of activity and potency of Ro 13-9904 and cefotaxime were quite similar; they were the most active agents against Enterobacteriaceae, Streptococcus pyogenes, Haemophilus influenzae, Neisseria gonorrhoeae, and Neisseria meningitidis . Moxalactam was only slightly less active against these organisms . Ro 13-9904, cefotaxime, and moxalactam were approximately equal in activity against Pseudomonas aeruginosa; concentrations of 50 to 100 microgram/ml inhibited over 90% of the strains tested . Cefamandole and cephalothin were the most active drugs tested against staphylococci . Moxalactam demonstrated the highest intrinsic activity against Bacteroides fragilis; a concentration of 1.6 microgram/ml inhibited over 50% of the strains . All six of the antibiotics were essentially inactive against group D streptococci . The action of all of the antibiotics was bactericidal, with minimal bactericidal concentrations generally being no more than twofold greater than minimal inhibitory concentrations . The only exception to this was found when large inocula of Staphylococcus aureus were tested . Increased inoculum size generally sharply reduced the activity of Ro 13-9904, cefotaxime, and moxalactam against Enterobacteriaceae and P . aeruginosa.

Antimicrob Agents Chemother, 1981 Mar, 19(3), 402 - 6
In vitro activity of N-formimidoyl thienamycin in comparison with cefotaxime, moxalactam, and ceftazidime; Verbist L et al.; The in vitro activity of N-formimidoyl thienamycin (N-f-thienamycin) was compared with the activities of other B-lactam antibiotics, using over 500 clinical bacterial isolates . N-f-Thienamycin inhibited 90% of the isolates of the common Enterobacteriaceae between 0.006 and 2 microgram/ml, regardless of their resistance to amoxicillin, ticarcillin, or cephalothin . It was, however, fourfold less active than moxalactam and ceftazidime and eightfold less active than cefotaxime . N-f-Thienamycin was nearly as active as ceftazidime against Pseudomonas aeruginosa (mean minimal inhibitory concentration, 3.0 microgram/ml) and eightfold more active than cefotaxime and moxalactam . In contrast to cefotaxime, moxalactam, and ceftazidime, N-f-thienamycin was highly active against enterococci (mean minimal inhibitory concentration, 1.3 microgram/ml) and staphylococci . The oxacillin-susceptible Staphylococcus aureus were inhibited between 0.03 and 0.12 microgram/ml, and the oxacillin-resistant S . aureus were inhibited between 0.12 and 2 microgram/ml . The high activity of N-f-thienamycin against both of the most important gram-positive and gram-negative organisms makes it a very promising new antibiotic.

Ann Microbiol (Paris), 1981 Mar-Apr, 132(2), 197 - 200
{gamma Glutamyltransferase activity in the genus "Yersinia" (author's transl)}; Bercovier H et al.; The expression of gamma-glutamyltransferase activity was studied among 87 strains representing all the Yersinia species . Y . pestis lacked constantly this enzyme, while y . pseudotuberculosis expressed it as a rule . This test, when positive, is useful for the exclusion of a suspected Y . pestis diagnosis . All the other Yersinia species, like most of the Enterobacteriaceae, showed a gamma-glutamyltransferase activity.

Nouv Presse Med, 1981 Feb 26, 10(8), 650 - 3
{Cefotaxime in bronchopulmonary infections (author's transl)}; Kermarec J et al.; Thirty-nine patients, 17 to 80 years old, were admitted to a pneumology department . The diagnosis was acute serious or severe respiratory tract infection in 25 patients, exacerbation of chronic bronchopulmonary infection in 6, purulent pneumonia in 4, purulent bronchitis in 4 . 28 infecting organisms were identified: Gram-positive cocci (Pneumococcus: 6, Streptococcus: 8 . Staphylococcus: 1) and 6 Haemophilus influenzae (3 of which were associated with 1 Pneumococcus) 7 Enterobacteria (isolated or associated) . Local, biological and systemic tolerance was generally very good in the majority of patients . Cefotaxime at a daily dose of 2 g intramuscularly for 12 days, showed very good efficacy in the treatment of various bacterial infections of the lower respiratory tract . The activity was evident against a variety of organisms in respiratory infections . The in vitro results of the antibiogram which indicated a superiority of cefotaxime in some cases on other antibiotics currently used in these indications were confirmed by the clinical results.

Nouv Presse Med, 1981 Feb 26, 10(8), 634 - 8
{Cefotaxime in the treatment of purulent meningitis in children (author's transl)}; Borderon JC et al.; Five meningitis due to Haemophilus influenzae and 6 meningitis due to Enterobacteria were treated with cefotaxime . The antibiotic was administered at a dose of 150 to 200 mg/kg/day in four 1 hour infusions . The pathogens were eradicated in all patients . Cefotaxime activity was efficient either against resistant pathogens (Haemophilus, Enterobacter) or against organism susceptible to ampicillin . Because cefotaxime is active at low concentration and has a good diffusion in the CSF, it provides a particularly effective treatment in Gram-negative meningitis in children . The initial use of cefotaxime should result in rapid eradication of the pathogen, with consequent improvement in the prognosis.

Nouv Presse Med, 1981 Feb 26, 10(8), 622 - 4
{Cefotaxime in the treatment of severe infections due to multiresistant Gram-negative bacilli (author's transl)}; Clumeck N et al.; Cefotaxime was used to treat 33 patients with serious Gram-negative bacillary infections . The dosage varied between 1.5 g and 4 g/day in patients without renal failure . Eighteen patients had urinary tract infections, 6 had pulmonary infections and 10 had miscellaneous infections . Sixteen patients were also bacteremic . Twenty-five infections were due to pathogens resistant to ampicillin, cephalothin, gentamicin and/or tobramycin, in vitro . Fifteen infections had failed to resolve during ampicillin, cefazolin, gentamicin or tobramycin therapy . Thirty-two patients responded favourably (cure or improvement) . Four patients developed superinfection with cefotaxime-resistant bacteria . One patient developed mild reversible renal insufficiency . Cefotaxime is a very active cephalosporin with potential use in serious multi-resistant enterobacteria infections.

Nouv Presse Med, 1981 Feb 26, 10(8), 607 - 11
{Clinical experience of cefotaxime (author's transl)}; Portier H et al.; Seventeen septicaemia, 18 urinary tract infections, 13 acute bacterial pulmonary infections and 7 infections at various other site were treated with cefotaxime, and, in 48 cases, with cefotaxime alone . The pathogenic organisms were mainly enterobacteria: 19 E . coli, 10 Klebsiella, 8 Proteus, 2 Serratia, 1 Enterobacter, almost all of them having a MIC less than or equal to 1 mcg/ml . The route of administration used was the i.m . route in 33 cases and the i.v . route in 18 cases, both routes having been used in 4 patients . The mean dosage was 45 mg/kg/day . A cure was obtained in 49 cases were clinical and bacteriological results were interpretable (85,7% of cases) . The cure rate was 80% in septicaemia, 88,2% in urinary infections and 91,6% in pulmonary infections . In 19 infections due to beta-lactamase producing strains of Gram-negative bacteria, the percentage of cure was 68,4% . The systemic and local tolerance was excellent . Cefotaxime is a very well tolerated and very effective antibiotic, even in prolonged treatment and even in monotherapy, at a mean dosage of 50 mg/kg/day.

Nouv Presse Med, 1981 Feb 26, 10(8), 598 - 600
{Place of cefotaxime in the treatment of septicaemias due to enterobacteriaceae (author's transl)}; Bastin R et al.; 10 patients with septicaemia caused by enterobacteriaceae were successfully treated with cefotaxime . 9 patients had previously received unsuccessful antimicrobial therapy . The pathogen was resistant in vitro to other antibiotics . Cefotaxime was administered alone or in combination with an aminoglycoside . No severe side-effects were noted.

Nouv Presse Med, 1981 Feb 26, 10(8), 594 - 7
{The use of cefotaxime against infections (author's transl)}; Lepeu G et al.; Cefotaxime was administered as sole treatment (49 cases) or after failure of another previous antibiotic (17 cases) to 66 patients suffering from infectious diseases . The 78 infections thus treated included urinary tract infections (35), septicaemia or endocarditis (25), respiratory tract infections (7), osteitis (5), meningitis (4), biliary infection (1), and skin infection (1) . The pathogens identified were more often enterobacteria: Serratia: 23, E . coli: 15, Klebsiella: 7, Proteus: 7, Enterobacter: 1, Providentia: 1, Pseudomonas: 5, Staphylococcus: 7, Pneumococcus: 4, Streptococcus: 2, Branhamella: 1 . Cefotaxime was given either intravenously (2/3 of cases) or intramuscularly, at an average daily dose of 3.75 g (mean: 1.5-8 g) . It was administered alone to 49 patients suffering from septicaemia and urinary tract infections caused by E . coli, Klebsiella and especially Serratia, and it was combined in 17 cases, particularly in meningitis and bone infections . The overall results of cefotaxime given in serious diseases were especially favourable in debilitated patients (88% therapeutic success) . The local tolerance was good and side effects were not observed in any patient . Cefotaxime seems to be an active antibiotic, indicated in many severe septicemic or not septicemic infections, more particularly in diseases with multiresistant Gram negative pathogens.

Nouv Presse Med, 1981 Feb 26, 10(8), 587 - 9
{A study of the transplacental passage of cefotaxime (author's transl)}; Pierre J et al.; The authors have studied the transplacental transfer of cefotaxime in 19 women at the end of pregnancy, after injection of 1 g i.m . Amniotic fluid and cord blood samples were collected during cesarean section . The diffusion of the drug was rapid in cord blood and the concentrations were parallel to those measured in maternal blood; they decreased from 3.8 to 2.1 micrograms/ml between the first and the fourth hour following the injection . In amniotic fluid, diffusion was delayed; the peak reached 3.6 micrograms/ml at the third hour and a the fourth hour, the concentrations were still measurable (2.3 micrograms/ml) . On the whole, cefotaxime concentrations measured in cord blood and amniotic fluid were superior to the MIC's of bacteria usually responsible for obstetrical infections; they may be efficient against most beta-lactamase producing enterobacteriaceae.

Nouv Presse Med, 1981 Feb 26, 10(8), 580 - 4
{Cefotaxime CSF levels in children with purulent meningitis (author's transl)}; Borderon JC et al.; Cefotaxime concentrations obtained in the C.S.F . of twelve children suffering from bacterial meningitis and undergoing monotherapy with this antibiotic are reported . Among these 12 patients, 4 infants (aged 3 to 28 days) had neonatal meningitis (due to Serratia marcescens, Proteus mirabilis, Enterobacter cloacae, Escherichia coli); one infant (2 months old) had meningitis due to Salmonella panama; 5 children (aged 5 to 11 months) had meningitis due to Haemophilus; and 2 children had belated superinfection caused by a ventriculo-peritoneal shunt due to Klebsiella pneumoniae and Pseudomonas aeruginosa . Cefotaxime concentration reached a high level as early as one hour after the injection (3 to 19 mcg/ml), remained at this level until the fifth hour (1,8 to 14,3 mcg/ml) and decreased without significant proportionality with the disappearance of the inflammatory symptoms . Compared to the M.I.C . of the bacteria which caused the twelve cases of meningitis, these results show that the concentrations in the C.S.F . are much higher than the M.I.C.'s . These results are comparable to those of previous studies . Cefotaxime diffuses in the C.S.F . and gives concentrations which ensures an antibacterial activity that ampicillin could not reach: in particular against Haemophilus influenzae and enterobacteriaceae.

Nouv Presse Med, 1981 Feb 26, 10(8), 545 - 7
{In vitro activity of cefotaxime against enterobacteriaceae . Comparison with cephalothin, cefazolin, cefamandole, cefoxitin and cefuroxime on 117 strains isolated from neutropenic patients (author's transl)}; Tancrede C et al.; The considerable activity of cefotaxime on enterobacteriaceae is especially useful in neutropenic patients who are particularly at risk of septicaemia complications . The rapidly fatal development of this type of infections necessitates the use of a presumably efficacious therapy even before the result of blood cultures are obtained . The in vitro activity of cefotaxime in enterobacteriaceae has been compared to that of cephalothin, cefazolin, cefamandole, cefoxitin and cefuroxime.

Nouv Presse Med, 1981 Feb 26, 10(8), 541 - 4
{Cefotaxime, syn isomer of a new methoxyimino cephalosporin with unusual activity (author's transl)}; Chabbert YA et al.; Cefotaxime, the - syn - derivative of 7 - {(2-(2-amino-4-4-thiazolyl)-2-methoxyimino) acetamido} cephalosporanic acid, is a new semisynthetic cephalosporin . In in vitro studies, it was 80 times more active than the - anti - derivative against beta-lactamase-producing strains of Gram-negative bacteria . The range of inhibitory concentrations of cefotaxime against Gram-negative bacteria, including Haemophilus influenzae, susceptible or resistant to penicillins and cephalosporins was from 0.01 to 0.1 micrograms/ml . This activity was consistently higher than that observed with cephalothin, cephaloridine, cephalexin, and cefazolin . Nevertheless, some strains of Enterobacter cloacae were resistant . Cefotaxime showed very similar activity to that of ampicillin against group A streptococci and Streptococcus pneumoniae.

Can Med Assoc J, 1981 Feb 15, 124(4), 415 - 8
Urinary tract infections due to Staphylococcus saprophyticus biotype 3; Anderson JD et al.; Staphylococcus saprophyticus biotype 3 (Micrococcus subgroup 3 or M3) has usually been shown to be the second commonset cause of urinary tract infections in European women who are not in hospital . It generally causes pyuria and symptoms as severe as those caused by Escherichia coli . Unlike S . epidermidis it is seldom found as a contaminant in midstream urine specimens, and almost exclusively infects women in their reproductive years . However, S . saprophyticus is seldom differentiated from S . epidermidis in Canadian clinical laboratories . Urinary isolates of S . saprophyticus were presumptively differentiated from other coagulase-negative Micrococcaceae by their resistance to novobiocin as demonstrated by a simple disc susceptibility test that misidentified the infecting organism in only 3.4% of specimens . These novobiocin-resistant, coagulase-negative organisms caused similar proportions of the urinary tract infections in young women in York, England and Vancouver -- 6.6% and 6.9% respectively . In York these organisms were associated with significantly greater pyuria than novobiocin-sensitive organisms or bile-tolerant streptococci but not S . aureus or Enterobacteriaceae . In both communities novobiocin-sensitive, coagulase-negative Micrococcaceae were appreciably more resistant to penicillin than novobiocin-resistant organisms . Thus, differentiating S . saprophyticus from novobiocin-sensitive, coagulase-negative organisms provides information that is clinically useful, particularly for primary care practitioners working in the community or in outpatient clinics.

Nature, 1981 Feb 12, 289(5798), 609 - 12
Distribution of the insertion sequence IS1 in gram-negative bacteria; Nyman K et al.; Translocation of DNA segments is a recombinational event seen in both eukaryotic and prokaryotic chromosomes, and it is thought to be involved in controlling gene expression and in the evolution of chromosomes . In bacteria, insertion (IS) and transposable (Tn) elements not only translocate their own DNA, but also promote the rearrangement of both bacterial chromosomes and the plasmic genomes carrying them . The insertion element IS1 is one such element which is 768 base pairs long . IS1 is involved in the generation of deletion mutations and in the fusion of two different plasmid genomes . It can also promote the translocation of DNA segments flanked by two copies of IS1 to give rise to transposable elements responsible for antibiotic resistance and enterotoxin production . We report here the distribution of the IS1 sequence in various bacterial DNAs, particularly in the family Enterobacteriaceae . Comparison of the results with the phylogenetic relationship of these bacteria suggests that IS1 was transferred from one bacterium to another after their divergence and in some bacteria the copy number of IS1 increased by translocation . The increase in the number of copies of IS1 in bacteria may increase the probability of the genetic rearrangement responsible for the generation of resistance and enterotoxin plasmids, the existence of which is a serious problem in medical microbiology.

Lancet, 1981 Feb 7, 1(8215), 293 - 5
Serological evidence for the role of Bacteroides fragilis and enterobacteriaceae in the pathogenesis of acute pelvic inflammatory disease; Paavonen J et al.; Pelvic inflammatory disease (PID) is classically divided into gonococcal and non-gonococcal forms depending on whether or not gonococcus is isolated from the lower genital tract . Chlamydia trachomatis seems to be another major pathogen in PID . In an attempt to determine the role of facultative enteric bacteria and anaerobic Bacteroides fragilis in the pathogenesis of PID antibodies to the enterobacterial common antigen (ECA) and B . fragilis capsular polysaccharide were measured in paired sera of 101 consecutive patients with PID . Significant ECA and B . fragilis antibody tires were each found in about a third of the patients whether or not the lower-genital-tract culture yielded gonococci or C . trachomatis . These results support the concept that PID is a polymicrobial infection in which both anaerobes and aerobic enteric bacteria, as well as gonococci and C . trachomatis, have an important role.

Am J Med, 1981 Feb, 70(2), 393 - 7
Comparison of endemic and epidemic nosocomial infections; Stamm WE et al.; Epidemics account for a small proportion of preventable infections acquired in hospitals, but they have been important in defining sources, modes of spread, and methods for prevention and control of nosocomial infections . To characterize hospital-based epidemics, 265 consecutive outbreaks investigated by the Center for Disease Control between 1956 and 1979 were reviewed . Pseudoepidemics were found in 11 percent of the investigations, most often resulting from errors in processing microbiologic specimens or from surveillance artifacts . In 223 actual epidemics, the pathogens most commonly involved were Staphylococcus aureus (19 percent), tribe Klebsielleae (14 percent), Salmonella (13 percent), hepatitis B virus (8 percent), enteropathogenic Escherichia coli (5 percent), Pseudomonas (4 percent) and group A streptococci (4 percent) . Sites of epidemic infection were closely linked to the responsible pathogens . Gastroenteritis (21 percent), skin infection (18 percent), bacteremia (12 percent), meningitis (11 percent) and hepatitis (10 percent), infrequent causes of endemic nosocomial infections, were frequently involved in epidemics . Over the 25-year period reviewed, staphylococcal epidemics and outbreaks of gastroenteritis due to Salmonella and Esch . coli declined in frequency and those due to gram-negative bacilli and hepatitis B virus increased . Since 1970, clusters of primary bacteremia were the most frequently investigated type of epidemic . Many epidemic strains of staphylococci obtained since 1975 or Enterobacteriaceae obtained since 1970 exhibited unusual drug resistance . Specific site-pathogen combinations were closely associated with characteristic reservoirs and modes of spread.

Zh Mikrobiol Epidemiol Immunobiol, 1981 Feb, (2), 53 - 7
{Reactivity to normal intestinal microflora in persons continuously residing in the Far North}; Maianskii DN et al.; The titers of antibodies to the common allergenically active fraction of enterobacterial antigens in clinically healthy males aged 20-35 years, constantly living at the moderate (Kazan) and high (Norilsk) latitudes, were studied . The most essential changes in the character of the titer distribution were revealed in the populations of persons who had been constant residents of the Arctic regions for 5-10 years . This was manifested by an increase in the number of sera with excessively high (exceeding 1:5120) and low (less than or equal to 1:20) titers . The average indices of the reactivity to intestinal automicroflora were significantly higher in the residents of the Arctic regions than in the corresponding control group . In persons living in the North for still longer periods, as well as in those who lived at high latitudes since their birth, such shifts in the reactivity to enterobacteria were less pronounced.

Infect Immun, 1981 Feb, 31(2), 831 - 2
Comparison of the effects of different lipopolysaccharides on the serum bactericidal reactions of two strains of Escherichia coli; Allen RJ et al.; The serum killing of Escherichia coli ML308 225 and PB94 was inhibited by lipopolysaccharide extracted from either organism, but not by lipopolysaccharide from three pathogenic Enterobacteriaceae.

J Clin Microbiol, 1981 Feb, 13(2), 331 - 4
Evaluation of an automated, computerized system (automicrobic system) for Enterobacteriaceae identification; Burdash NM et al.; The automated and computerized AutoMicrobic system (AMS; Vitek Systems, Inc., subsidiary of McDonnell Douglas, Hazelwood, Mo.) was evaluated as a means of identifying the Enterobacteriaceae . The Micro-ID system (General Diagnostics, Morris Plains, N.J.) and, when necessary, conventional tubed media were used for comparison . Identification by AMS and Micro-ID differed in only 12 of 1,528 isolates (0.8%) . Disagreements occurred primarily with Enterobacter spp . Precision testing of the AMS showed only 1 of 72 tests (1.4%) deviating from the expected . The AMS was found to be an accurate and precise method for the identification of Enterobacteriaceae.

Tijdschr Diergeneeskd, 1981 Feb 1, 106(3), 97 - 105
{Hygienic aspects of bovine udders: collection, storage and processing (author's transl)}; Bijker PG et al.; The status of hygiene during collection, storage and processing of bovine udders at 73 locations (50 abattoirs, 14 freezing-storage factories and 9 processing plants) was assessed . We found unacceptable low levels of hygiene at the abattoirs . Udders were contaminated during slaughtering by contact with animal skin, unclean tools and the unwashed hands of the personnel . Storage and transport of udders in large containers prevented effective cooling . Bacteriological analysis of deep frozen udder tissue revealed a quality decline as compared to similar analysis directly after slaughtering . Approximately 80 per cent of the samples were found to have an aerobic count of 10(5)-10(7) and 30 per cent of the samples contained 10(3)-10(5) Enterobacteriaceae/g . Frozen samples collected directly before processing revealed practically no increase in bacterial count as compared to counts found in freezing-storage factories.

J Antibiot (Tokyo), 1981 Feb, 34(2), 202 - 5
Cefonicid: a stable beta-lactamase inhibitor; Mehta RJ et al.; The stability of cefonicid (SK&F 75073) towards representatives of six major classes of beta-lactamases was determined using a spectrophotometric assay . Cefonicid was stable to hydrolysis by the Type I enzyme from Enterobacter cloacae and by the enzyme from the anaerobe, Bacteroides fragilis . It was 6 to 7 times more stable than cefamandole to the Type IIIA and B enzymes from Escherichia coli, a little less stable than this antibiotic to the Type V enzyme from E . coli, and of equal stability to the Type IV enzyme from Klebsiella aerogenes . Cefonicid was a non-competitive inhibitor (Ki of 0.8 x 10(-6)M) of cephalothin hydrolysis by the Type I enzyme.

Rev Rhum Mal Osteoartic, 1981 Feb, 48(2), 133 - 40
{Osteoarticular infections due to Gram-negative bacilli}; Lopitaux R et al.; An enquiry carried out on 20 French rheumatology units led us to find, out of a total of 1,202 cases of non-tuberculous osteo-arthritis of the adult, 137 gram negative bacillary infections . These were 64 cases of spondylodiscitis and 73 cases of septic arthritis, due mainly to Escherichia Coli, Pseudomonas and other enterobacteria . The frequency of gram-negative bacilli was 11.4% i.e . 9.2% in the case of arthritis and 15.6% in the case of spondylodiscitis . It is higher than in the middle of this century but does not seem to be progressing now . However, the seventy of this type of infection, which may cause important functional sequelae and numerous deaths (8 patients) justifies the routine search for these bacilli in appropriate culture media, in order to test their sensitivity to antibiotics.

Antimicrob Agents Chemother, 1981 Feb, 19(2), 294 - 7
In vitro antibacterial activity of fluorinated analogs of chloramphenicol and thiamphenicol; Syriopoulou VP et al.; We evaluated the in vitro antimicrobial activity of Sch 24893, Sch 25298, and Sch 25393, three novel analogs of chloramphenicol and thiamphenicol . All of the analogs had minimal inhibitory concentrations of less than or equal to 10 micrograms/ml for 18 chloramphenicol-thiamphenicol-resistant strains of Shigella dysenteriae and 21 strains of resistant Salmonella typhi . The analogs were also more active than were chloramphenicol and thiamphenicol against chloramphenicol-resistant enteric bacteria, including six strains of Escherichia coli, seven strains of Klebsiella pneumoniae, and two strains of Enterobacter cloacae . Fifty-three strains of ampicillin-resistant Haemophilus influenzae were uniformly susceptible to chloramphenicol, thiamphenicol, and the three analogs . Sch 25298 was the most active compound tested (minimal inhibitory concentration, 0.5 microgram/ml for all strains) . Four of seven chloramphenicol-thiamphenicol-resistant Haemophilus strains were susceptible to the fluorinated analogs . Of the three Haemophilus strains which were resistant to chloramphenicol, thiamphenicol, and the analogs, two contained less than 10% of the chloramphenicol acetyltransferase activity of the strains which were resistant to only chloramphenicol and thiamphenicol . We conclude that fluorinated analogs of chloramphenicol and thiamphenicol have considerable in vitro activity against a broad spectrum of chloramphenicol-thiamphenicol-resistant, gram-negative bacteria.

J Bacteriol, 1981 Jan, 145(1), 138 - 44
Structure of the heptose region of lipopolysaccharies from Rhodospirillum tenue; Radziejewska-Lebrecht J et al.; There is a common structure (core region) in the lipopolysaccharides of Rhodospirillum tenue . It is composed of a branched trisaccharide of L-glycero-D-mannoheptose (and of 2-keto-3-deoxyoctonate), as revealed by methylation analyses of degraded polysaccharides of four different R . tenue strains . The structure is similar or might even be identical to the inner core of enterobacterial O antigens . In addition, each of the four R . tenue lipopolysaccharides contains a strain-specific region that consists of heptose(s) (L-glycero-D-mannoheptose or D-glycero-D-mannoheptose or both) or hexoses . There is a partial substitution of the core region and the strain-specific region by phosphorus, showing microheterogeneity.

Ann Rech Vet, 1981, 12(1), 11 - 7
{Sensibility of rabbits to treatment with ampicillin and gentamycin (author's transl)}; Escoula L et al.; Ampicillin administered to rabbits (20 mg/kg per day) over a period of three days subsequently provoked a death rate of 40% . No deaths were observed after treatment with gentamycin (10 mg/kg per day) or with a combination of ampicillin and gentamycin . On the fourth day weight loss in the three treated groups was 12%, 11% and 9%, respectively, compared to controls . At the same time food intake in the treated groups was only 15% to 20% of the amount consumed by controls . In the caecum, ampicillin treatment resulted in dominance of a strain of Enterobacter aerogenes . Gentamycin had no effect on bacterial flora, although in combination with ampicillin, the number of caecal bacteria (aerobic and anaerobic) was reduced . Flora modification might be responsible for accumulation of NH3 and an unbalance of free acids . Caecotrophy was inhibited by administration of ampicillin . When administered intramuscularly, ampicillin produced results comparable with those obtained orally, although gentamycin was ineffective.

Helv Paediatr Acta, 1981, 36(6), 573 - 7
Neonatal enterobacter suppurative arthritis and osteomyelitis; Shahar E et al.; Suppurative arthritis of the right knee and osteomyelitis of the adjacent femur complicated a urinary tract infection in an 18-day-old infant with a posterior urethral valve causing urinary flow obstruction . Initially cephalosporine sensitive Enterobacter caused the urinary tract infection . Shortly following cephazolin therapy, cephalosporine resistant Enterobacter microorganisms were isolated both from the urine and the knee joint fluid . These two infections were successfully treated with a combination of gentamicin and Co-trimoxazole . Gram-negative bacteria should be considered among the pathogens in neonatal osteoarticular infections, particularly if a urinary tract infection co-exists.

Scand J Infect Dis, 1981, 13(3), 195 - 202
Epidemiologic features of urinary infections due to enterobacteriaceae resistant to nalidixic acid and trimethoprim; Light RB et al.; For a period of one year we identified all urinary isolates of Enterobacteriaceae resistant to either nalidixic acid (NA) or trimethoprim (TMP) . Host and organism characteristics associated with the occurrence of 68 NA and 61 TMP-resistant isolates were compared with 61 matched antimicrobial-susceptible controls . Minimum inhibitory concentrations to NA and TMP were carried out on all isolates, Escherichia coli isolates were biotyped and TMP-sulfamethoxazole (SMX) synergy studies were performed on TMP-resistant isolates . Study patients were reviewed with regard to age, renal function, presence of structural urinary tract abnormality, history of antimicrobial treatment and persistence of study strains within the urinary tract . Resistance to both drugs was associated with prior treatment with the relevant antimicrobial and with underlying urinary tract abnormality . No association was noted between resistance and patient age or renal function . Once resistant organisms infected an abnormal urinary tract, they were able to persist almost indefinitely . Patients with persistent urinary infections associated with structural urinary tract abnormality account for most NA or TMP-resistant infections in our hospital and constitute an identifiable group in whom the therapeutic usefulness of these drugs is limited.

J Med Primatol, 1981, 10(1), 46 - 51
Response of small intestinal flora to elemental diet and pancreatic duct ligation in vervet monkey; Gyr K et al.; The small intestinal flora of vervet monkeys (cercopithecus aethiops) was examined before and after feeding elemental diet and after ligation of the pancreatic duct . Elemental diet did not produce significant changes of the intestinal microbial flora . However, an increase of the microbial count consisting mainly of Enterobacteriaceae, molds and yeasts was observed in the duct-ligated animals, significantly more pronounced than in the sham-operated controls . The data confirm previous studies demonstrating the possible role of the exocrine pancreas in the maintenance of a normal intestinal flora.

Boll Ist Sieroter Milan, 1981, 60(1), 26 - 30
Beta-glucuronidase activity in Enterobacteriaceae; Massenti MF et al.; Beta-glucuronidase activity has been investigated in 1,221 Enterobacteriaceae strains . The test, using p-nitrophenyl-beta-D-glucuronide (pNPGlcU) agar culture, can be included easily in the routine Enterobacteriaceae biochemical assays . The test is discriminating for Enterobacteriaceae genera and species and useful for identification of some monophasic serotypes of Salmonella.

Antonie Van Leeuwenhoek, 1981, 47(3), 247 - 54
Isolation efficiency and its clinical importance in patients with burns; Hendriks WD et al.; Nine severely burned patients were submitted to reverse isolation in a mass airflow system . Their burns became colonized by Enterobacteriaceae biotypes which were not found in the patients own flora on admission . They were, therefore, probably derived from the food which was obtained from the central kitchen . These strains did not cause bacteriaemia . Suggestions to improve the isolation efficiency are made.

J Immunol Methods, 1981, 43(2), 199 - 207
Sensitive measurement of endotoxin by radio-rocket immunoelectrophoresis using {125I} Staphylococcus aureus protein A; Stevens P et al.; Antibody directed against the core glycolipid antigen (CGL) of the mutant Salmonella minnesota Re 595 has been shown to cross-react with endotoxin from bacteria within the group Enterobacteriaceae . Using this cross-reactive CGL antibody we have developed a sensitive (250 pg) radio-rocket immunoelectrophoretic technique to measure endotoxin . We used the principles of rocket immunoelectrophoresis and increased the sensitivity by using 125 I-labelled staphylococcal protein A which serves as a sensitive probe to bind to the Fc portion of the IgG complexed with antigen . The rocket-shaped {125I} protein A labelled immune complexes were detected by radioautography . The sensitivity is 100-fold greater than conventional Coomassie brilliant blue staining . Measurement of CGL was inhibited by normal human serum . However, the assay had the capacity to quantitate endotoxin in buffer extracts of clinically isolated Escherichia coli, Serratia marcescens, Klebsiella pneumoniae but not Pseudomonas aeruginosa . Analysis of various preparations of CGL obtained from different investigators demonstrated wide variation in their immunoreactivity . Because of the significant cross-reaction to detect various endotoxins this method has the potential to measure endotoxemia and assess the immunochemical quality of various endotoxin preparations . Additionally, the technique of using {125I} protein A has wide applicability for the sensitive measurement of other antigens.

Acta Microbiol Acad Sci Hung, 1981, 28(1), 67 - 81
Klebsiella and Enterobacter strains derived from hospital infections . I . Correlation between species, phage type and antibiotic sensitivity; Nguyen TK et al.; Four hundred and seventy Klebsiella and 103 Enterobacter strains derived from urogenital infections, upper respiratory tract and wound infections were examined . (i) K . aerogenes was the most common among Klebsiella species, K . ozaenae and K . atlantae occurred frequently, K . pneumoniae, K . rhinoscleromatis, K . edwardsii and K . oxytoca were found rarely . The strains isolated from urine showed the most heterogeneous species distribution . Enterobacter species were in the order of frequency E . cloacae, E . liquefaciens, E . aerogenes . (ii) K . aerogenes strains belonged to 10, K . atlantae strains to 6 phage types; phage type II.A1 was the most frequent phage types . Typability varied between 23.7% and 48.0% with the different Klebsiella species, except K . edwardsii and K . oxytoca strains . None of the strains of these species were typable by phages . Among the Enterobacter species examined, only one E . liquefaciens strain was typable by phages . Strains of genus Enterobacter were lysed by the diagnostic phage C14 in 64%, no lysis was observed in the strains of genus Klebsiella . (iii) Multiple resistance was demonstrated in 36.6% of Klebsiella strains and in 16.5% of Enterobacter strains . The majority of the multiresistant strains was isolated from urine in both genera . Multiresistant strains belonged to the species K . aerogenes, E . cloacae and E . liquefaciens . Strains resistant to ampicillin were divided into 6 groups on the basis of cephaloridine and cephalothin resistance . The rate of multiresistant strains was higher among the Klebsiella and Enterobacter strains not typable by phages than in the typable ones.

Acta Microbiol Acad Sci Hung, 1981, 28(2), 171 - 96
Klebsiella and Enterobacter strains derived from hospital infections . II . Occurrence and characterization of R-, Lac- and Col- plasmids and their clinical-epidemiological significance; Milch H et al.; A total of 269 hospital Klebsiella strains and 103 hospital Enterobacter strains showed 34 and 10 different antibiotic resistance patterns, respectively . Among multiple resistant Klebsiella and Enterobacter strains the Ap Sm Cm Tc resistance pattern was the most frequent (K . aerogenes) . Antibiotic resistant strains carried R-plasmids in 27.5% . The presence of R-plasmids was demonstrable in 2.9% of single antibiotic resistant, in 12.8% of double antibiotic resistant, and in 71.4% of multiple antibiotic resistant Klebsiella strains . R-plasmid carriage was most frequent in strains of the species K . pneumoniae and K . atlantae . Transfer frequency of R-plasmids of multiple resistant strains was generally higher into Escherichia coli K12 recipient (10-1 to 10-2) than into K . pneumoniae recipient (10-3 to 10-5) . Regarding the individual resistance determinants, transfer frequency of Km-Nm resistance was the highest (65.1%) . The lac-plasmid was demonstrable in 18 out of the 77 R-plasmid carrying Klebsiella strains . R- and Lac-plasmids of single and multiple resistant Klebsiella strains could be transferred into E . coli and Klebsiella recipients in mice in vivo . As many as 67% showed fi- and 33% showed fi+ character among the demonstrated 112 R-plasmids . Regarding their incompatibility, the studied five plasmids belonged to groups FI, FII and I alpha . Altogether 14 different groups could be distinguished among R-plasmids on the basis of their phage restriction capability on phage lambda and coliphages T, and another group of R-plasmids showing no restriction at all . Fi+ character was demonstrated in 54.5% of R-plasmids showing phage restriction capability and in 10.9% of R-plasmids showing no phage restriction . Nearly twice as many R-plasmids carrier strains were found among non-typable ones as among those typable by phages . Three R-plasmids showed phage-modification among 51 R-plasmids restrictive for phages . In addition to the phage-type of Klebsiella strains, R-plasmids can also be used as an epidemiologic marker.

Chemotherapy, 1981, 27 Suppl 1, 57 - 61
Treatment of purulent meningitis with a new cephalosporin-Rocephin (Ro 13-9904) . Clinical, bacteriological and pharmacological observations in 24 cases; Cadoz M et al.; In 21 of the 24 cases the diagnosis of purulent meningitis was confirmed by culturing the causal agent and/or by immunological diagnosis . The daily dosage of Rocephin ranged between 15 and 200 mg/kg administered in 2 i.m . injections . A cure was achieved in cases of meningococcal meningitis (1 case with sequelae: blindness in one eye), in 5 out of 6 cases of Haemophilus influenzae meningitis (1 case with severe neuropsychiatric sequelae), in 3 out of 9 cases of pneumococcal meningitis and in 2 out of 4 cases of enterobacterial meningitis . The tolerance was generally excellent . Sterilisation of the cerebrospinal fluid (CSF) was achieved in all 20 cases of meningitis confirmed by culture . The MIC levels are lower than the lowest CSF peak for Rocephin found in this study . The unusual pharmacological behavior of Rocephin makes it possible to achieve and to maintain for a long time highly satisfactory concentration levels in the CSF . These properties of Rocephin should lift the long-standing objections to the use of cephalosporins for the treatment of purulent meningitis.

Arch Exp Veterinarmed, 1981, 35(2), 291 - 7
{Further characterization of lipopolysaccharides from Pasteurella multocida}; Erler W et al.; The biological properties, sedimentation behaviour, and electron-optically visualised structures of lipopolysaccharides from Pasteurella multocida were found to be identical with lipopolysaccharides from Enterobacteriaceae . Hard evidence to the effect that lipopolysaccharides from Pasteurella multocida are R-lipopolysaccharides were produced by the composition of monosaccharides together with experiments on the basis of disc electrophoresis.

Antimicrob Agents Chemother, 1981 Jan, 19(1), 66 - 71
Activity of a new cephalosporin antibiotic, Ro 13-9904 against dense populations of selected enterobacteria; Greenwood D et al.; Ro 13-9904 is a new cephalosporin antibiotic with a wide spectrum of activity similar to that of cefotaxime and some other newer beta-lactam compounds . In the present study, the response to Ro 13-9904 of 13 strains of enterobacteria, selected on the basis of differential patterns of susceptibility to beta-lactam agents, was investigated . The new cephalosporin displayed high intrinsic activity against most of the enterobacteria tested, but a group of Klebsiella and Hafnia alvei strains was identified against which Ro 13-9904 (and cefotaxime) exhibited reduced activity . Investigation of these strains revealed several different types of response to Ro 13-9904 and cefotaxime . Although such "difficult" strains represent a small minority of clinical isolates, it is likely that it is this group of strains against which the new generation of highly potent, broad-spectrum beta-lactam antibiotics will display significant differential activity.

Cell Tissue Res, 1981, 217(2), 311 - 20
An ultrastructural and autoradiographic study of the immune response in Hyalophora cecropia pupae; Abu-Hakima R et al.; Three types of hemocytes are found in the Cecropia pupa, plasmatocytes, granular cells, and spherule cells . The granular cells are the major phagocytic blood cells, taking up the bacterium Enterobacter cloacae when this is injected into the pupae . Disintegrating blood cells are observed near the pericardial tissue . No other changes in ultrastructure are noted in hemocytes and pericardial cells which could be correlated with the immune response in these pupae . The fat body cells from pupae injected with bacteria contain abundant RER and Golgi bodies, whereas those from wounded (saline injected) and untreated controls do not . The fat body is the only tissue that responds to bacterial injection by increased incorporation of 3H-uridine into RNA . These findings support the idea that the fat body is the main site of synthesis of the immune proteins.

Chemotherapy, 1981, 27(3), 192 - 9
Mechanisms of trimethoprim resistance in enterobacteria isolated in Finland; Then RL et al.; Dihydrofolate reductases (DHFR) were studied in two groups of trimethoprim (TMP)-resistant Enterobacteria, isolated in Turku, Finland . The first group consisted of six strains with a high level of TMP resistance (MIC greater than 1,000 mg/l) and all of them were found to harbour an additional TMP-insensitive DHFR thought to be responsible for the high degree of resistance . Three Proteus mirabilis strains in this group synthesized chromosomal reductases with reduced TMP sensitivity as well . A second group of six strains, exhibiting MIC values for TMP between 16 and 512 mg/l was seen to be resistant by the production of a chromosomally altered TMP-insensitive DHFR, produced either in normal or slightly elevated amounts . With one exception these strains were all fully susceptible to sulfadiazine and strong synergism with TMP was present . Resistance to nalidixic acid was also frequently observed in this group . In conclusion, three different basic mechanisms were found to be responsible for TMP resistance in Enterobacteria from Finland and these were seen to occur not only independently but also simultaneously in the same strain.

Chemotherapy, 1981, 27(3), 166 - 72
Cefamandole bone diffusion in patients undergoing total hip replacement; Roncoroni AJ et al.; Cefamandole penetration was studied in 32 normal bone specimens . No antibiotic bone binding was found . Blood contamination of bone samples was measured by the haemoglobin method . Mean corrected levels attained (5.8 micrograms/g) exceed MIC values of sensitive Staphylococcus aureus, Haemophilus influenzae and Enterobacteriaceae . Similar diffusion was observed in cortical and trabecular bone . The results obtained invite further studies on preoperative prophylaxis and treatment of osteomyelitis.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1981 Jan, 172(4-5), 401 - 10
Microbiological quality of frozen precooked and peeled shrimp from South-East Asia and from the North Sea; Beckers HJ et al.; The microbiological quality of frozen precooked and peeled shrimp is largely dependent upon the method of processing . The investigations were carried out in order to study the difference between the microbiological quality of shrimp from South-East Asia and from the North Sea and to determine whether both can meet draft FAO/WHO and ICMSF-specifications; 100 samples of frozen precooked and peeled shrimp from South-East Asia and 50 samples of shrimp from the North Sea were examined . In 45% of the shrimp samples from South-East Asia and in 78% of the samples of North Sea shrimp the number of aerobic mesophiles was over 10(6) per g . The number of Staph . aureus was higher in the samples of shrimp from South-East Asia than in those from the North Sea: 34% of the samples from South-East Asia had over 2 x 10(3) Staph . aureus per g., whereas only 6% of the samples of North Sea shrimp exceeded this number . Gram-positive mesophilic cocci were predominant in shrimp from South-East Asia . Gram-negative psychrophilic bacteria were predominant in North Sea shrimp . This difference in bacterial flora is caused by a difference in processing . The number of Enterobacteriaceae was usually low (less than 2 x 10(2) per g) in both kinds of shrimp . In three lots of South-East Asian shrimp Salmonella was detected . Vibrio parahaemolyticus was not found . On the basis of draft FAO/WHO endproduct specifications all lots of both South-East Asian and North Sea shrimp would have been rejected . On the basis of ICMSF specifications the rejection amounted to 90 and 80% of the lots, for the two types of shrimp respectively . Preservatives were not detected in shrimp from South-East Asia, whereas benzoic acid was present in all samples of North Sea shrimp . It was concluded that the ammonia content is a valuable objective quality index only in case of North Sea shrimp.

Can J Microbiol, 1981 Jan, 27(1), 8 - 14
A single medium for the isolation of acetylene-reducing (dinitrogen-fixing) bacteria from soils; Rennie RJ; A single medium, containing standard basal salts and three common carbon sources (sucrose, mannitol, and sodium lactate) is proposed to replace nitrogen-free media in common use for isolating dinitrogen-fixing bacteria . Eight commonly isolated genera of dinitrogen-fixing bacterial exhibited growth on this combined carbon medium that equalled or bettered growth on other carbon-containing media . Combined carbon medium also yielded the highest counts of putative dinitrogen-fixing bacteria from three southern Alberta soils . A survey of the bacteria isolated aerobically from the Burdett soil on combined carbon agar indicated that, at higher dilutions, 75% of the isolates exhibited acetylene reduction . These bacteria were identified as Azospirillum spp., Bacillus polymyxa, B . macerans, Klebsiella pneumoniae, Erwinia herbicola, and Enterobacter cloacae . The inclusion of yeast extract in combined carbon medium is considered essential to supply organic growth factors and may supply "starter" nitrogen that promotes growth without inhibiting acetylene reduction.

Surv Ophthalmol, 1981 Jan-Feb, 25(4), 253 - 62
Orbital mucopyoceles . Two cases and a review; Kaufman SJ; Two patients with superior orbital masses that were initially diagnosed as orbital cellulitis with abscess formation had orbital mucopyoceles, from which Enterobacteriaceae was cultured . Both patients had frontal sinus involvement and one had massive destruction with posterior extension abutting the frontal lobes . The radiology, computerized tomography, surgical procedures, and histopathologic findings pertaining to each case and the disease entity are reviewed . Antibiotic usage is discussed.

Intensive Care Med, 1981 Jan, 7(2), 63 - 9
The control of burn wound sepsis; MacMillan BG; This presentation reviews the course of burn wound sepsis in a group of 621 acute patients treated at the Shriners Burns Institute, Cincinnati Unit, between 1970 and 1976 . During this period of time, the overall mortality rate fell from 14% in 1970 to 3 and 5%, respectively, in 1975 and 1976 . Staphylococcus aureus was the most commonly recovered organism from the burn wound, colonizing 85% of the burn patients . Beta hemolytic streptococcus represented a potential threat despite the fact that it was recovered from only 5 to 10% of the patients . Pseudomonas aeruginosa showed a decrease in colonization during the period of this study, from 50% of the wounds in 1970 to 21% in 1976 . Candida albicans was the fungal organism most commonly recovered from the burn wound and from the blood stream . Fifteen deaths occurred in this group as a result of invasive infection, one from S . aureus, five from P . aeruginosa, two from Klebsiella-Enterobacter, and one from Escherichia coli, as well as six fungal deaths, five from Candida albicans and one from mucormycosis . Therapeutic measures used to control burn wound sepsis consisted of prevention of contamination from exogenous sources, control of burn wound pathogens, early recognition of invasive burn wound sepsis, aggressive management of the burn wound, and optimal nutritional support . During this period the extent of burn associated with a survival of 50% has risen from 50% in 1970 to 80% in 1976 . This improvement in survival is directly related to progressive improvement in local and systemic measures available for the control of infection.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1981, 250(1-2), 104 - 12
Enterobacteria differentiated by gas-liquid chromatography of metabolites; Salveson A et al.; The short chain acids of 47 strains within the family Enterobacteriaceae grown on prereduced, anaerobically sterilized peptone yeast-extract glucose broth (PRAS PY G) under standardized conditions were determined by gas-liquid chromatography (GLC) . The bacteria could be subdivided into six groups on the basis of their metabolites . Acetate, lactate, succinate and ethanol were detected from all strains and constituted a set of basic fermentation products, P, mirabilis, in addition, produced propanol, and was distinguished from P . morganii which formed propionate, pyruvate, methanol and oxalacetate, P . rettgeri only produced methanol along with the basic metabolites . Butanol and 2, 3-butanediol were characteristic of bacteria with the butanediol modification of mixed-acid fermentation, but could only be detected after anaerobic growth . Additionally, Hafnia produced propanol, which differentiated these strains from Enterobacter, Klebsiella, Serratia and Erwinia . The results indicate that GLC of metabolites may render supplementary information utilizable in identification of enteric bacteria.

Vet Med Nauki, 1981, 18(7), 10 - 25
{Current animal feeds with antimicrobial activity}; Drumev D; Among the growth-promoting substances and factors contributing to fodder utilization in growing farm animals, also called nutritive, ergotropic means, the antibiotics and some synthetic chemotherapeutics have acquired special importance . To avoid the hazardous effect in humans consuming products of animal origin there should be no residual amounts of these stimulating agents in such products . That is why it has been assumed in a number of countries to use for the same purpose only nutritive means that are not applied as therapeutic agents . Such means should neither induce resistence to antibiotics and chemotherapeutics in microorganism nor should they be resorbed by the alimentary tract (or resorption should be negligible) or they are rapidly eliminated from the animal body, leaving no residual amounts . They should likewise act chiefly against gram-positive organisms, inducing no allergic reactions in the animals . Described are the following nutritive antibiotics: flavophospholipol (bambermycin, menomycin--flavomycin, producing a nutritive effect also in ruminants with a developed forestomach, and rebuilds sensitivity in antibiotic-resistant organisms belonging to Enterobacteriaceae), avoparcin (avotan--also active in ruminants with a developed forestomach), virginiamycin (staphylomycin--escalin, stafac), zincbacitracin (bacipharmin, baciferm), grisin (kormogrisin, of a road spectrum, with an antimycotic effect, raising the fertilization rate and activating phagocitosis), vitamycin-A (vitamycin--active also at retinol deficiency, lambdamycin, nosiheptide (primofax), efrotomycin . Due consideration is given to such chemotherapeutics as nitrovin (payson, paison), carbadox (mecadox, fortigro, of a broad spectrum retained for a longer period in the body of pigs), olaquindox (bio-N-celbar--of a broad spectrum, particularly with regard to gram-negative organisms, applied at present as a therapeutic and prophylactic preparation), cyadox (with a broad sprectrum) . The following polyether ionophoric antibiotics are mentioned: monensine (rumensine, elancoban), lassalocide (avatek, lasotek), slinomycin(eustin, ustin, coxistac), lonomycin (emercide), harasine . Dosage rates and other data are given characterising the respective preparations.

Mol Gen Genet, 1981, 184(3), 489 - 92
Screening for mutants temperature sensitive in protein synthesis by using methionine analogues; Schmidt A et al.; Two new mutants are described which are temperature sensitive in protein synthesis . The mutants were obtained by a screening procedure using methionine analogues . The method is based on two findings: a) that in E . coli, and in other members of the Enterobacteriaceae, sensitivity to methionine analogues increases with the growth temperature, and b) that cells which are not synthesizing proteins during treatment with methionine analogues have a shorter lag in resuming growth subsequent to removal of the analogue.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1981, 250(1-2), 72 - 7
{Comparison of two enrichment methods and five selective media for the isolation of Yersinia enterocolitica from tonsils of slaughter pigs (author's transl)}; Weber A et al.; 115 tonsils of healthy slaughter pigs were culturally examined for presence of Yersinia (Y.) enterocolitica . For this purpose each sample was enriched both in phosphate buffered saline solution (pH 7.6; stored at 4 degrees C and plated every week, thrice all together) and modified Rappaport broth (plated after an incubation of two days at 22 degrees C) . Each such enrichment was plated on 5 different selective media: Yersinia selective agar proposed by Wauters (1973), deoxycholate-citrate-mannitol agar (Saari and Jansen, 1979), pectin agar (Bowen and Kominos), MacConkey and Leifson agar as used in the routine, diagnostic of Enterobacteriaceae . Each agar plate was incubated at 28 degrees C for two days . By cold enrichment method were isolated 11 strains of human pathogenic Y . enterocolitica (9 X O-group I syn . serotype O:3; 2X O-group V syn . serotype O:9) . With the modified Rappaport medium were recovered 33 strains (24X O-group I, 9 X O O-group V) . The most recoveries were done over the Yersinia selective agar with 65.2%, then followed deoxycholate-citrate-mannitol agar with 57.6%, Leifson agar with 45.5%, MacConkey agar with 42.3% and pectin agar only with 18.2% of the isolations . Not only the type of enrichment medium has a marked effect in the recovery efficiency of Y . enterocolitica out of samples but also number and type of the used selective media on which the enrichment is plated.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1981, 173(3-4), 233 - 41
{Hygienic quality of lakes which are used as open-air bath . 2 . Communication: Comparison of biochemical typed Escherichia coli strains isolated from lake water and bird excrements (author's transl)}; Dott W et al.; 368 strains of Escherichia coli were isolated from lakewaters and bird excrements (mainly black-headed gulls) using mandatory methods for drinking water examination . All strains were further characterized by 43 biochemical physiological and 30 morphological features . Besides the API 30 E Enterobacteriaceae system and the Roche Enterotube system of biochemical testing were used comparatively . The analysis using numerical methods for taxonomy pointed out that a single biotop could be characterized by the small physiological variation of the strains.

Pol Arch Weter, 1981, 23(1), 31 - 41
{CA antibodies (Enterobacteriaceae common antigen) in the sera of domestic animals}; Molenda J; Using the indirect hemagglutination test, antibodies against Enterobacteriaceae common antigen (CA) were tested in the sera of 123 horses, 142 cows, 108 sheep, 142 mature pigs and 60 piglets (3-4 weeks of age) . Anti CA antibody level and antibody titers for somatic antigens (phenol-water extracts) various serogroups of E . coli (0149, 0138, 0115, 078, 09) and S . typhimurium were compared . Ca antibodies in titer equal or higher than 1:15 were found to occur in 100% of the examined horses and cows, while in the sera of 92% sheep, 80% of mature pigs and 60% of piglets antibodies to the common Enterobacterial antigen were present in titer equal or higher than 1:7.5 . In all sera examined the antibody level to somatic antigens of E . coli and S . typhimurium exceeded that to Enterobacteriaceae common antigen . The influence of absorption of sera with CA preparation on the antibody level to heterologous antigens was also examined . It was found that the absorption caused a statistically significant decrease of the titers to O antigens E . coli and S . typhimurium in comparison with those found in unabsorbed sera.

Zentralbl Bakteriol Naturwiss, 1981, 136(2), 146 - 51
Comparative study of several culture media to determine coliforms and E . coli in dairy and cocoa products; Bindschedler O et al.; Five culture media have been evaluated for the detection of coliforms, E . coli, and Enterobacteriaceae in several varieties of dairy products (fresh and dehydrated) and dehydrated cocoa products . Those media were: Brilliant green bile, Lauryl sulfate tryptone, Lactose glutamic acid, Enteric Enrichment broth, and Lactose broth . The medium with the highest sensitivity to coliforms detection was Lactose glutamic acid broth . Several times Brilliant green bile, Lactose or Enteric Enrichment broth were significantly less sensitive than the other two media . Except once, when it was significantly better, Lauryl sulfate broth was not significantly different from the other media . False positive results were most frequently found during the examination of dairy products with Lactose glutamic acid and Lactose broth, consequently confirmation reactions have to be carried out when these media are used . Frequently, Enteric Enrichment broth was less satisfactory for the detection of Enterobacteriaceae than the other media used . All five media showed more coliforms after 48 h than after 24 h of incubation at 30 degrees C . Whenever a significant difference existed in the sensitivity to determine E . coli, Lactose glutamic acid broth was significantly better than the other media.

Acta Chir Scand, 1981, 147(1), 61 - 5
Postoperative wound infection after appendicectomy . Evaluation of infection risk with qualitative and quantitative incisional wound culture; Nystrom PO et al.; The predictive value for postoperative infection of incisional wound cultures obtained at wound closure was studied in two series of appendicectomies, comprising 404 patients studied with qualitative swab cultures, and 491 patients studied with quantitative velvet pad imprint cultures . 17% and 19%, respectively, of the patients in the two series yielded cultures positive with Gram-negative enterobacteria . The postoperative wound infection rate among contaminated cases was 36.1% and 26.9%, respectively, which was a significantly higher rate (p less than 0.001) as compared to operations yielding negative cultures . Using quantitative culture technique, 63% of all infections was shown to occur in the 15% of all patients whose culture yielded two or more colonies of enterobacteria . Of these high risk patients, those who were given antibiotics at operation had an infection rate of 25%, and those not given antibiotics had a rate of 48% . The remaining 85% of the patients had an infection rate of less than 5%.

Appl Environ Microbiol, 1981 Jan, 41(1), 35 - 45
Bacteria associated with false-positive most-probable-number coliform test results for shellfish and estuaries; Hussong D et al.; Aerobic and facultatively anaerobic bacteria isolated from false-positive, presumptive, total coliform, most-probable-number tests of Chesapeake Bay oyster, water, and sediment samples were characterized and then classified by numerical taxonomy . A total of 538 bacterial strains clustered into 17 phena, the predominant groups of which were Enterobacteriaceae (including Escherichia coli), Aeromonas spp., and Bacillus spp . Bacillus spp . were recovered most frequently from sediment samples . Gas-producing strains which were not members of the Enterobacteriaceae were not isolated during this study . However, disproportionately large numbers of atypical and anaerogenic lactose-fermenting strains were encountered . We concluded that no single, specific bacterial group can be identified as being responsible for the false-positive reaction in the presumptive coliform test . Instead, the false-positive reaction is a result of complex interactions among various genera, representing predominantly bacteria other than coliforms.

Rev Infect Dis, 1981 Jan-Feb, 3(1), 74 - 83
Comparative studies of intermittent and continuous administration of aminoglycosides in the treatment of bronchopulmonary infections due to gram-negative bacteria; Klastersky J et al.; The positive correlation between the protein concentration in bronchial secretions and the penetration of amikacin and tobramycin in the present study suggests that inflammation favorably affects the penetration of aminoglycosides into these secretions . As shown in this and other studies, local inactivation of aminoglycosides might counterbalance this effect to some extent . The relatively low penetration of aminoglycosides into the bronchial secretions (approximately 20%) probably accounts for the poor antibacterial activity of bronchial secretions of aminoglycoside-treated patients and, possibly, for the poor clinical outcome of bronchopneumonia due to gram-negative bacteria . Continuous infusion of these antibiotics, even at high dosage, does not appear to solve the problem; it does not achieve at any time satisfactory inhibitory activity against Enterobacteriaceae or Pseudomonas aeruginosa in the bronchial secretions . Although intermittent injections can result in higher levels of aminoglycosides within the bronchial secretions, such levels cannot be maintained for prolonged periods unless the dosage is increased . Thus endotracheal administration of aminoglycosides might still be indicated as an adjunct for therapy of severe bronchial infections due to gram-negative bacteria.

Can J Microbiol, 1981 Jan, 27(1), 98 - 106
{Taxonomic study of enterobacteria belonging or related to Escherichia coli species}; Gavini F et al.; Phenetic (numerical analysis) and genetic (DNA-DNA hybridization) studies were carried out on strains belonging or related to the species Escherichia coli . They have shown the diversity of its phenotypes, by the presence of plasmidic characters (citrate+, urease+, H2S+, tetrathionate reductase+, raffinose+, and saccharose+) . New strains related phenetically to E . coli are also individualized . They showed less than 30% DNA relatedness with E . coli . A new definition of E . coli is presented.

J Clin Microbiol, 1981 Jan, 13(1), 151 - 7
Accurate automated identification of selected Enterobacteriaceae at four hours; Ferraro MJ et al.; The Enterobacteriaceae Biochemical Card of the AutoMicrobic system Vitek Systems, Inc., Hazelwood, Mo.) provides completely automated identification of members of this family within an 8-h test period . Identification of 776 clinical and stock isolates to species level by the Enterobacteriaceae Biochemical Card under routine operating conditions correlated at 96% with our present 18- to 24-h methods of identification . Further, utilizing a special program, we investigated presumptive identification of certain organisms within 4-h--an interval that provides greater practical clinical usefulness on a real-time rapid basis . In a single year, 1978, 97% of 23,464 Enterobacteriaceae isolated in our diagnostic laboratory belonged to 11 species of six genera . Our results suggest that, by limiting the number of the identified Enterobacteriaceae that could be actually presumptively reported to those 11 species of six genera . Our results suggest that, by limiting the number of the identified Enterobacteriaceae that could be actually presumptively reported to those 11 species with the highest frequency of occurrence, we could have correctly identified and presumptively reported 83% of these to genus or species after only 4 h . Approximately 2% of the isolates would have been presumptively identified and reported incorrectly, whereas the identification of the remaining 15% would not have been reported before the completed 8-h incubation period.

J Clin Microbiol, 1981 Jan, 13(1), 120 - 5
Correlation studies of entero-set 20, API 20E and conventional media systems for Enterobacteriaceae identification; Aldridge KE et al.; The Entero-Set kit (Fisher Diagnostics) is a 20-biochemical-test system used in the identification of members of the Enterobacteriaceae . This kit was compared with the API 20E (Analytab Products) and conventional media systems, using 505 (303 stock and 202 clinical) strains of Enterobacteriaceae . When the Entero-Set and API 20E results were compared with those of the conventional media system, the Entero-Set performed as well as the API 20E in overall identification . Comparison of common biochemical tests among the various systems showed that citrate, arabinose, adonitol, inositol, and malonate gave correlations below 90% . The majority of the discrepancies were found among stock cultures . In addition, most discrepancies occurred with species of Enterobacter, Salmonella, Proteus, Klebsiella, and Serratia . Reproducibility studies showed the Entero-Set system to perform with a high degree of accuracy and reproducibility.

Am J Clin Pathol, 1981 Jan, 75(1), 88 - 91
Four-hour presumptive identification of Enterobacteriaceae from blood cultures; Smith EG et al.; A modification of the Minitek identification system for the four-hour identification of gram-negative bacilli recovered from blood cultures was developed . This method enabled our laboratory to identify correctly 99 of 100 consecutive isolates of all members of Enterobacteriaceae representing seven genera and nine species . All rapid identifications were confirmed using conventional biochemical methods . The procedure employs 11 Minitek biochemical discs inoculated with 0.1 ml of a dense organism suspension . Two-tenths milliliter of this suspension was added to a blank well for motility testing . In most instances, identification reactions were identical to those routinely used for the Minitek system . Only with the biochemical citrate disc does the interpretation vary from the Minitek standard . In addition to the blood culture isolates, 22 unknown organisms were also tested . All were correctly identified within four hours of the detection of visible turbidity in broth . This method offers a convenient, economic, and rapid means of identifying gram-negative bacilli isolated from blood cultures.

Chemotherapy, 1981, 27 Suppl 1, 25 - 31
Properties of Ro 13-99041 as a substrate and inhibitor of beta-lactamases; Then RL; Ro 13-9904 is a novel semisynthetic and highly active parenteral cephalosporin . Its stability against hydrolysis by several beta-lactamases was studied . The enzymes were isolated from various Enterobacteriaceae or Staphylococcus aureus and several commercially available enzyme preparations were also included . Most of the penicillinases, cephalosporinases or the TEM-type beta-lactamase studied were unable to hydrolyze this novel cephalosporin . The cephalosporinases from Bacillus cereus 569/H9 and Proteus vulgaris 1028, however, were found to readily cleave all new cephalosporins like cefuroxime, cefotaxime and Ro 13-9904, but not cefoxitin . Ro 13-9904 was seen to be a potent inhibitor of several cephalosporinases, but had little or no affinity for penicillinases or the TEM lactamase.

Curr Med Res Opin, 1981, 7(3), 196 - 203
A comparison of cefamandole, cefoxitin, cefuroxime, cefotaxime and cefoperazone: an in vitro test on a number of beta-lactamase producing strains of 9 species and 1 genus of bacteria; Kuipers JS; The sensitivity of a number of beta-lactamase producing strains of Enterobacter aerogenes, Enterobacter cloacae, Enterobacter species, Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa and Serratia marcescens to cefamandole, cefoxitin, cefuroxime, cefotaxime and cefoperazone was determined in vitro . All bacterial cultures were examined for beta-lactamase production using the chromogenic cephalosporin compound 87/312 . All strains were typed by means of antibiotic and chemotherapeutic sensitivities . Only non-identical strains were used . A tray method was used to determine the quantity of antimicrobial product necessary for a complete growth inhibition at various culture dilutions . The results showed that all strains of H . influenzae, especially in the dilution 2.10(6), were sensitive to the five cephalosporins . The other species and genus of bacteria had a varying sensitivity to the five cephalosporins . Cefoperazone had potent activity against Ps . aeruginosa . Differences between the five cephalosporins with regard to the effect of culture dilution were only small.

Can J Ophthalmol, 1981 Jan, 16(1), 22 - 6
Netilmicin: new aminoglycoside effective against bacterial endophthalmitis; Sloane H et al.; Bacterial endophthalmitis is difficult to treat because antibiotics administered systemically, subconjuctivally or topically cannot be delivered in bactericidal amounts to the infected tissues . Netilmicin, a new aminoglycoside, is active against Pseudomonas aeruginosa, Staphylococcus and most Enterobacteriaceae, including Escherichia coll, Klebsiella and Enterobacter, that have been resistant to other aminoglycosides . In rabbits an intravitreal injection of 250 mu g/0.1 ml rapidly provided a bactericidal concentration (greater than 10 mu g/ml) in the vitreous, and this level was maintained for 100 hours . This dose was not toxic to ocular tissues, unlike higher doses (1000 to 2000 mu g) . Intravenous, subconjunctival and topical administration yielded only low concentrations of the drug in the vitreous, although subconjunctival injection yield significant concentrations in the aqueous for 4 hours . Experimentally induced Staphylococcus aureus endophthalmitis was quickly eradicated by a single intravitreal dose of netilmicin without detectable sequelae in 9 to 10 eyes studied . A solution of netilmicin infused during vitrectomy and lensectomy prevented infection.

Antimicrob Agents Chemother, 1981 Jan, 19(1), 201 - 4
N-formimidoyl thienamycin (MK0787): in vitro study; Shadomy S et al.; N-Formimidoyl thienamycin (MK0787) was compared in vitro with three other beta-lactam and two aminoglycoside antibiotics . It was second in activity only to cefotaxime against members of the Enterobacteriaceae and to amikacin against Pseudomonas species . It was the most active antibiotic against Staphylococcus aureus . Resistance (minimal inhibitory concentration, greater than 128 microgram/ml) to N-formimidoyl thienamycin was not observed.

Am J Med Sci, 1981 Jan-Feb, 281(1), 35 - 42
Mycotic aneurysm due to Yersinia enterocolitica; Plotkin GR et al.; Infections of the cardiovascular system, besides involving both natural and prosthetic heart valves, vascular grafts, and indwelling venous and arterial cannulas, may cause mycotic aneurysms . The latter frequently complicate endocarditis; however, they may occur as isolated phenomena . Enterobacteriaceae are uncommon etiologic agents in vascular infections; however, a patient is reported who presented initially with a bacteremia due to Yersinia enterocolitica biogroup 4 and despite antimicrobial therapy developed a mycotic aneurysm of the left internal carotid artery . Clinical manifestations, pathogenesis, and treatment of yersiniosis are reviewed.

Int J Oral Surg, 1981, 10(Suppl 1), 37 - 41
The calcifying epithelial odontogenic tumor: a case report; Gornitsky M; A case report of a rather rare neoplasm, the calcifying epithelial odontogenic tumor, is added to the literature . An aggressiveness not normally associated with this tumor is described . The treatment, involving the segmental resection of the left mandible and immediate reconstruction, is reported . A complication with the infective organism Enterobacter cloacae and the subsequent necessity to regraft the area is noted . Long-term inter-maxillary fixation resulted in adequate occlusion and only slight deviation in the final successful result . A 4-year 4-month follow-up is presented.

Pathology, 1981 Jan, 13(1), 73 - 7
Antibacterial activity of five cephalosporins; Mutton KJ et al.; The in vitro susceptibilities of 7 commonly isolated species of bacteria to cephalothin, cefoxitin, and 3 new cephalosporins--cephamandole, cefuroxime, and cefoperazone--were studied using an agar dilution method . Cephalothin and cephamandole were the most active agents against staphylococci . Against members of the Enterobacteriaceae all the newer agents were more active than cephalothin; however, important individual differences emerged . Only cefoperazone had significant activity against Pseudomonas aeruginosa.

Infect Immun, 1981 Jan, 31(1), 362 - 70
Biological activities of Brucella abortus lipopolysaccharides; Moreno E et al.; Purified lipopolysaccharide (LPS) from smooth (s) and rough (R) strains of Brucella abortus and lipid A isolated from S-LPS by mild acid hydrolysis were examined in several assays of biological activity . Brucella S- and R-LPSs and Brucella lipid A activated the complement cascade . Previously reported mitogenic activation by Brucella LPSs of spleen cells from endotoxin-resistant C3H/HeJ mice was confirmed and also produced by isolated Brucella lipid A . Mitogenicity was not inhibited by polymyxin B, and amino acid analysis showed no binding of polymyxin B to Brucella LPS under conditions in which mitogenicity of phenol-water-extracted Escherichia coli LPS was inhibited . S and R Brucella LPSs and lipid A all produced equivalent polyclonal stimulation of C3H/HeJ and C3H/HeAU spleen cells . Crude and purified LPS from S but not from R B . abortus was toxic for outbred mice, with 50% lethal doses approximately six times greater than that for E . coli LPS . S- and R-LPSs were abortifacient in pregnant outbred mice . S Brucella LPS was lethal for carrageenen-pretreated C3H/HeJ and C3H/HeAU mice, whereas only C3H/HeAU mice were killed by E . coli LPS . The data are consistent with the hypothesis that the unique fatty acid composition of Brucella lipid A is responsible for its biological activity in endotoxin-resistant C3H/HeJ mice . The participation of the protein strongly bound to the lipid A cannot be excluded, but its mode of action, if any, is different from that of the lipid A-associated protein of enterobacterial LPS.

Microbios, 1981, 32(129-130), 155 - 61
Classification and actual antigenic composition of Salmonellae; Barber C; The synthesis by Enterobacteriaceae grown on artificial media of proteins, with a diversity of specificities previously found with the help of antiprotein sera, is confirmed with antibacterial sera prepared with species belonging to different serogroups . An earlier recognition of the existence of these materials was hindered by the devised schemes of classification and the claims relating 'O' factors to the bacterial polysaccharides . The synthesis, on artificial media, of mixtures of heterologous proteins by all the analysed species is no proof that their behaviour in vivo is identical; notwithstanding their high amounts in the mixtures, few of the heterologous proteins are involved in cross-protection of a host against its natural pathogen.

Drugs, 1981, 22 Suppl 1, 72 - 5
A clinical trial with cefoperazone in pneumonia and pyelonephritis; Park SC et al.; 15 cases of pneumonia and 15 cases of pyelonephritis were included in a clinical trial of parenteral cefoperazone . The organisms isolated from patients with bacterial pneumonia were: Staphylococcus aureus (6), Klebsiella pneumoniae (5), Diplococcus pneumoniae (3), Pseudomonas species (2), and 6 others . Amongst those with pyelonephritis, Escherichia coli (12), Enterobacter (1), and 3 other pathogens, were isolated . All were sensitive to cefoperazone . The efficacy of cefoperazone in patients with pneumonia was: good in 11 (73%), fair in 3, and poor in 1 . In pyelonephritis, 12 (80%) responded well and in the other 3 response was fair . There were no significant side effects or hypersensitivity reactions.

Drugs, 1981, 22 Suppl 1, 108 - 18
Worldwide clinical experience with cefoperazone; Gerber AU et al.; The safety and clinical efficacy of cefoperazone 1 to 2g 12-hourly was evaluated in clinical trials conducted in the United States, Europe, South and Latin America, and Japan . 1046 patients were treated in 4 comparative and 9 non-comparative studies . An overall satisfactory clinical response for cefoperazone therapy was achieved in 540 (88%) of the 615 evaluable patients . Cefoperazone was effective in 92% of lower respiratory tract infections, 81% of urinary tract infections, 98% of gynaecological infections and 90% of a mixture of intra-abdominal, wound and soft tissue infections . A satisfactory clinical response was obtained in over 90% of patients infected with organisms normally susceptible to cephalosporins, such as staphylococci, streptococci, Escherichia coli, Klebsiella and Proteus species . 50 to 90% of infections caused by organisms resistant to presently available cephalosporins, such as Enterobacter species, Proteus vulgaris, Providencia species, Morganella morganii, Serratia species, Pseudomonas aeruginosa, and Bacteroides fragilis responded satisfactorily to cefoperazone . In the 4 clinical trials comparing cefoperazone with cefamandole, cephazolin or carbenicillin, cefoperazone therapy resulted in a similar or higher rate of satisfactory clinical response . Adverse reactions related to cefoperazone occurred in 8% of patients and were mainly diarrhoea (4%), skin reactions (3%) and phlebitis (1%) . Twice daily dosing with cefoperazone appears to be effective against numerous Gram-positive and Gram-negative bacteria in a variety of clinical infections.

Chemotherapy, 1981, 27(5), 318 - 24
Activity and specific beta-lactamase susceptibility of cefoperazone and moxalactam . Comparison with other cephalosporins; Mouton RP et al.; Comparison of the activity of cefoperazone, cefamandole, cefotaxime, cephalothin and moxalactam against Enterobacteriaceae showed cefoperazone to be twofold (Escherichia coli, Klebsiella) to eigthfold (Enterobacter) more active than cefamandole . The lowes MIC values were found for cefotaxime (0.03 - 0.25 microgram/ml) followed by moxalactam (0.06 - 0.25 microgram/ml) . Cefoperazone stood out in activity against Pseudomonas aeruginosa (MIC50 4 microgram/ml) . Cephalothin resistance affected the MIC values of cefoperazone and moxalactam only to a small degree . From beta-lactamase susceptibility studies it was concluded that cefoperazone may be hydrolyzed by TEM type beta-lactamases, but that the cephalosporinases (class I) and the chromosomal broad-spectrum beta-lactamases (class IV) only have little effect on this antibiotic . Moxalactam was not degraded by any of the beta-lactamase preparations tested.

Z Allg Mikrobiol, 1981, 21(8), 611 - 21
{Distribution of transferable trimethoprim and gentamicin resistance plasmids in Enterobacteriaceae}; Tschape H et al.; Following the employment of trimethoprim/sulfonamid and gentamicin in the general clinical praxis transferable plasmids with respective resistance function were identified at first in enteric bacteria from sewage before they could be detected in patient strains . Whereas the trimethoprim resistance plasmids represent different incompatibility groups (C, FII, I5, K, M, N, S, U) the gentamicin resistance plasmids are very similar IncM members of 62 MD in size . Therefore a clonal distribution of a particular gentamicin resistance plasmid has to be taken into consideration.

Clin Ther, 1981, 4(3), 201 - 11
Cefotaxime: clinical and bacteriologic evaluation; Saroglou G et al.; Cefotaxime, a new parenteral beta-lactamase-resistant cephalosporin, was tested against 78 cephalothin-resistant clinical isolates of Enterobacteriaceae and Pseudomonas species . The anti-bacterial activity of the drug was compared with activities of cefazolin and cefuroxime and was found considerably more active . Most of the cephalothin-resistant strains were resistant to cephazin, too . The antipseudomonal activity of cefotaxime was found limited . The drug was found effective against 23 infections in hospitalized patients with only one clinical failure and two colonizations with cefotaxime-resistant bacteria . Cephalosporinases hydrolyzing cefotaxime were detected in two cefotaxime-resistant strains . Also, beta-lactamases hydrolyzing cefoxitin and cefuroxime were produced by the cefotaxime-resistant isolates studied.

Drugs, 1981, 22 Suppl 1, 60 - 4
Potential value of cefoperazone in bacterial meningitis: experimental studies; Durack DT et al.; To assess the potential value of cefoperazone in treating bacterial meningitis, its pharmacokinetics in the cerebrospinal fluid of rabbits were studied . Cefoperazone penetrated poorly into the cerebrospinal fluid of rabbits with uninflamed meninges, but in the presence of meningitis concentrations increased 2- to 3-fold . These concentrations were above the minimum inhibitory concentrations for the majority of Enterobacteriaceae, indicating the potential value of cefoperazone in treating bacterial meningitis . The half-lives of cefoperazone and moxalactam in cerebrospinal fluid, measured by a bioassay, were marked prolonged by meningeal inflammation . In contrast, the half-life of cefotaxime in cerebrospinal fluid was short . Consequently both cefoperazone and moxalactam provided significantly better antibacterial effect in cerebrospinal fluid than did cefotaxime.

Pharmatherapeutica, 1981, 2(9), 581 - 6
Pivmecillinam plus pivampicillin in urinary tract infections: a randomized, open comparison with co-trimoxazole in hospitalized patients; Ravn TJ; The efficacy and tolerance of a fixed-dose combination of 200 mg pivmecillinam and 250 mg pivampicllin was compared with that of co-trimoxazole (800 mg sulphamethoxazole plus 160 mg trimethoprim) in 42 hospital in-patients with complicated urinary tract infections . Patients received a 10-day course of tablets of either agent twice daily . The infecting organisms, which were Enterobacteriaceae (79%) and enterococci (21%), were eradicated in 17(89%) of the 19 patients given co-trimoxazole and in all 23 subjects who received pivmecillinam/pivampicillin . Sixteen (89%) of the 18 symptomatic patients responded clinically to co-trimoxazole . Pivmecillinam/pivampicillin was effective in 19 (95%) of 20 patients with symptomatic infections . There was a fairly good correlation between the bacteriological and clinical responses . No serious side-effects were recorded and all patients completed the prescribed course of treatment.

Arzneimittelforschung, 1981, 31(6), 982 - 6
Antibacterial activity of moxalactam (LY-127935) compared with cefotaxime and other beta-lactam antibiotics against clinical isolates of enterobacteriacea and non-fermenters; Verbist L; The in vitro activity of moxalactam, a new semisynthetic 1-oxa-beta-lactam, was compared to those cefotaxime, cefuroxime, cephalothin, piperacillin and tobramycin against more than 500 clinical isolates of Enterobacteriaceae and non-fermenters . The geometric mean MIC against 450 Enterobacteriaceae in microgram/ml was 0.09 for moxalactam, 0.08 for cefotaxime, 5.3 for cefuroxime, 22.9 for cephalothin, 3.5 for piperacillin and 0.72 for tobramycin . The geometric mean MIC in microgram/ml against 60 P . aeruginosa strains was 12.7 for moxalactam, 22.9 for cefotaxime, 6.8 for piperacillin, 1.5 for tobramycin and 2.9 for cefsoludin . The minimum inhibitory and the bactericidal concentrations of moxalactam were almost the same in most species . The effect of the inoculum on the bactericidal concentration was slight, between 10(3) and 10(7) CFU/ml for the E . coli and the Klebsiella strains . In isolates of S . marcescens and P . aeruginosa the bactericidal concentrations increased by 4 to 5 log2 and in isolates of P . mirabilis the increased by 9 log2 with the largest inoculum.

Chemotherapy, 1981, 27(1), 34 - 8
In vitro comparison of three new cephalosporins: LY-127935, cefotaxime and cefoperazone; Trager GM et al.; The comparative in vitro activity of three new cephalosporin antibiotics Ly-127935 (LY), cefotaxime (CTX) and cefoperazone (CFP) was examined . LY, CTX and CFP had similar activity against Staphylococcus aureus, Escherichia coli and Proteus mirabilis while CFP was less inhibitory than LY or CTX against Klebsiella spp.; indole + Proteus and gentamicin (GM)-susceptible Serratia . LY and CTX were effective while CFP was inactive against Enterobacter spp . and GM-resistant Serratia . CFP was more active than LY or CTX against GM-susceptible Pseudomonas aeruginosa but was the least active agent against GM-resistant isolates . Bacteroides fragilis were more susceptible to LY than CTX or CFP . Combination studies against P . aeruginosa with cephalosporin-GM pairs demonstrated synergy.

Chemotherapy, 1981, 27(2), 106 - 13
Appraisal of disk sensitivity tests with mecillinam; Anderson JD et al.; Disk susceptibility tests for mecillinam were carried out on 167 hospital isolates of Enterobacteriaceae from Vancouver . Inhibition zone sizes with eight experimental variations were compared by three-way analysis of variance . The Association of Clinical Pathologists' method gave significantly (p = 0.0002) larger zones than the Kirby Bauer method (24.9 +/- SD 7.5 and 23.4 +/- 7.3 mm, respectively) . 10 microgram mecillinam disks from Mast Laboratories gave significantly (p = 0.0004) larger zones than the Baltimore Biological Laboratories (BBL) equivalent (24.9 +/- 7.6 and 23.4 +/- 7.2 mm, respectively) . Differences between Oxoid Iso-sensitest agar and BBL Mueller Hinton agar were not quite significant (24.5 +/- 7.9 and 23.8 +/- 6.9 mm, respectively, p = 0.061) . Each disk test method was significantly different from at least one other (Duncan multiple range test, alpha = 0.05) . A semilogarithmic regression was established between the antibiotic disk inhibition zone and the MIC for each experimental variation . BBL Mueller Hinton and Oxoid Iso-sensitest media did not give significantly different results in MIC determinants by a surface inoculation method . An additional 146 organisms from hospitals in New York provided a wider range of organisms from a different location . Pooled data from both centres were used to identify breakpoints for mecillinam in the disk susceptibility test using the Kirby Bauer method with BBL disks and media . A 16-mm breakpoint with 10 microgram mecillinam disks provides a realistic and conservative prediction of probable response to attainable serum concentrations of this antibiotic.

Acta Microbiol Acad Sci Hung, 1981, 28(1), 119 - 27
Incidence of enteritis of Enterobacteriaceae isolates possessing human colonization factor antigen . New human colonization factors; Czirok E et al.; Of 462 Enterobacteriaceae strains including 435 Escherichia coli isolated from 250 patients, 298 haemagglutinating (HA) cultures were classified into 36 different HA groups . Sixteen of them belonged to Evan's I or II groups, although none possessed CF I or CF II antigen detectable by slide agglutination . Seventy-seven strains showed 4+ mannose resistant (MR) HA with human (53), bovine (2), chicken (6), guinea pig (7) or human and guinea pig (9) erythrocytes . These strains were significantly more frequent in patients under one year of age . Eighty-eight percent of the typable strains belonged to E . coli serogroups O1, O2, O4, O6, O18 . HA positivity and fimbrial structures were correlated in 2 isolates (15/1, O18a, c:-K77: H-; 12/2/1 O1: K1: H .) . Fimbriae of the two strains exhibited adhesive properties . Their fimbrial antigens differed serologically from each other and from those of the reference strains H 10407 and PB 176 . Forty-nine of 4+ human MRHA strains showed variable reactions in the two sera for the new fimbrial antigens.

Am J Obstet Gynecol, 1980 Dec 1, 138(7 Pt 2), 969 - 73
Pelvic inflammatory disease and puerperal sepsis in Ethiopia . I . Etiology; Perine PL et al.; Among 100 outpatient women with symptoms and signs of pelvic inflammatory disease and 200 asymptomatic, postpartum women, the prevalence rates of Neisseria gonorrhoeae were 19% and 9%, respectively . Of 46 women hospitalized for PID, 33% were culture-negative, 22% grew Enterobacteriaceae, 20% grew streptococci, 15% grew gonococci, and 15% grew anaerobes from blood, pus, or abscesses . One third of 67 women hospitalized for puerperal sepsis (PPS) were culture-negative; the bacteria isolated most frequently from the uterus, blood, urine, and pus were Enterobacteriaceae (36%), gonococci (28%), streptococci (25%), and anaerobes (4%) . The low frequency of isolation of anaerobes in women with PID and PPS was due largely to limitations placed on the collection and processing of specimens for anaerobic bacteriology.

J Hyg (Lond), 1980 Dec, 85(3), 343 - 5
A note on some Enterobacteriaceae from the faeces of small wild British mammals; Healing TD et al.; Over a four-year period 878 samples of faeces were collected from five species of small wild rodents and two species of shrews at sites in England, Scotland and Wales . A search was made for Salmonella in these samples but no isolations of this genus were made . Several other genera of Enterobacteriaceae were identified.

Am J Dis Child, 1980 Dec, 134(12), 1152 - 4
Necrotizing enterocolitis . Epidemic following an outbreak of Enterobacter cloacae type 3305573 in a neonatal intensive care unit; Powell J et al.; Twelve cases of necrotizing enterocolitis (NEC) occurred within three weeks in a neonatal intensive care unit (NICU) with 325 annual admissions . Enterobacter cloacae type 3305573 was found in stool and/or blood cultures from affected babies prior to the onset of the disease . This bacterium could not be grown in cultures from infants in the same NICU six weeks later . A causal relationship between E cloacae and the epidemic of NEC is suggested.

Int J Zoonoses, 1980 Dec, 7(2), 164 - 70
Prophylactic effect of tea on pathogenic micro-organism infection to human and animals . (1) . Growth inhibitive and bacteriocidal effect of tea on food poisoning and other pathogenic enterobacterium in vitro; Ryu E; 0.5% tea powder of Oolong tea, green tea and black tea, respectively added to Tryptic soy agar (TSA) plates prepared non aseptically could inhibit the growth of colonies of St . aureus and airborne bacteria, but only very few fungi colonies . 0.5% tea powder of oolong tea, green tea and black tea, respectively added to Tryptic soy agar (TSA) plates prepared non aseptically could also inhibit the colonial growth of V . cholerae, V . parahaemorrhagiae, Sal . dysenteriae, Sal . typhi, Sal . paratyphi A and B . The suspension (10(-3) approximately 10(-4)) of E . coli could inhibit the colonial growth . 3% suspension of oolong tea, green tea, and black tea, respectively could kill V . cholerae and V . parahaemorrhagiae in 30 minutes . 3% suspension of oolong tea and green tea, respectively could kill Sal . Typhi B.

Antimicrob Agents Chemother, 1980 Dec, 18(6), 872 - 6
In vitro antagonism by erythromycin of the bactericidal action of antimicrobial agents against common respiratory pathogens; Cohn JR et al.; Ten strains each of Staphylococcus aureus, Haemophilus influenzae, Enterobacter spp., Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Streptococcus pneumoniae were tested in vitro against erythromycin combined with ampicillin, cefamandole, or gentamicin . Antagonism by erythromycin occurred with 47% of the combinations involving strains of S . aureus and to a lesser degree with H . influenzae . Synergy occurred most commonly with H . influenzae (27%) . The high frequency of antagonism and synergy with these organisms was associated with a broad range of bacteriostatic action by erythromycin against these same bacteria . The implications for the treatment of pneumonia are discussed.

Acta Pathol Microbiol Scand {B}, 1980 Dec, 88(6), 347 - 8
Deoxyribonucleic acid is a significant component of the small-intestinal mucus; Ferencz A et al.; During investigations into the role of intestinal mucus for the attachment of Enterobacteriaceae to the intestinal surface it was surprisingly found that DNA was a significant component of the mucus from the rabbit small intestine.

NIPH Ann, 1980 Dec, 3(2), 141 - 7
The in vitro activity of cefamandole against 3312 bacterial isolates . A Norwegian multicentre study; Digranes A et al.; In a multicentre study the in vitro activity of cefamandole against 3312 bacterial isolates was compared to the antibacterial activity of cephalothin, ampicillin, oxacillin, doxycycline and tobramycin . Cefamandole and tobramycin showed the highest activity against the Enterobacteriaceae isolates, whereas the Staphylococcus aureus isolates were slightly less sensitive to cefamandole than to cephalothin and oxacillin . There was no significant difference between the activity of cephalothin and cefamandole against the isolates of Haemophilus influenzae and enterococci.

Pathol Biol (Paris), 1980 Dec, 28(10), 681 - 4
Evaluation of Micro-ID, for identification of Enterobacteriaceae; Izard D et al.; Micro-ID system is a new identification kit for Enterobacteriaceae which provides the identification at the species level 4 hours after primary isolation . When compared with conventional biochemical tube media, micro-ID gave a 94% agreement . Comparison of Micro-ID with Api 20 E showed a 90% agreement . A comparison of all 3 systems showed that for 90% of the time, the isolates were named the same by the all systems.

Antimicrob Agents Chemother, 1980 Dec, 18(6), 853 - 7
Purification and properties of a cephalosporinase from Enterobacter cloacae; Minami S et al.; A cephalosporin beta-lactamase (cephalosporinase) was extracted from Enterobacter cloacae GN7471 and purified by means of column chromatography . The resulting preparation gave a single protein band upon polyacrylamide gel electrophoresis . The enzyme's isoelectric point was 8.4, and its molecular weight was 44,000 . The optimal pH was 8.5, and the optimal temperature was 40 degrees C . The enzyme hydrolyzed cephalosporins much more readily than penicillins . The enzyme activity was inhibited by iodine, semisynthetic penicillins, cefuroxime-type cephalosporins, and cephamycin derivatives . The enzymological properties of the purified enzyme were compared with those of beta-lactamases derived from other gram-negative enteric bacteria.

J Clin Microbiol, 1980 Dec, 12(6), 725 - 31
Potential hazards associated with microbial contamination of in-line filters during intravenous therapy; Holmes CJ et al.; The survival and multiplication of Enterobacter agglomerans, Klebsiella pneumoniae, Serratia marcescens, and Pseudomonas aeruginosa in 0.45- and 0.22-micrometer in-line filter sets during simulated infusions were studied to evaluate the ability of each filter type to prevent infusions of these bacteria into patients . Bacteria were found to proliferate in the upstream compartment of sets housing both filter porosities . None of the 0.22-micrometer in-line filters were penetrated by the test bacteria . In contrast, P . aeruginosa was observed to penetrate each 0.45-micrometer in-line filter examined within 12 h of continuous infusion . Tribe Klebsielleae organisms penetrated a proportion of the 0.45-micrometer filters usually between 48 and 72 h of infusion . In addition, the elution of endotoxin from gram-negative bacteria trapped in the filter set during infusion is reported . Collected infusion filtrate exhibited a trend of increasing endotoxin-like activity with an increasing duration of infusion . In the case of E . agglomerans, mean peak levels of approximately 65 pg of Escherichia coli endotoxin per ml were attained after 72 h . Other bacteria produced similar results, except mean peak levels ranged from 5 to 30 pg/ml . It was noted that endotoxin-like activity was not detected in filtrate eluted from contaminated filter sets during the initial 24 h of infusion . We conclude that to avoid potential hazards of bacterial penetration and endotoxin production during continuous use of in-line filter sets, the 0.22-micrometer filter type must be employed and replaced every 24 h.

Antimicrob Agents Chemother, 1980 Dec, 18(6), 906 - 12
Activity of mecillinam alone and in combination with other beta-lactam antibiotics; Fass RJ; The in vitro activities of mecillinam, ticarcillin, cefamandole, and cefoxitin, singly and in all possible combinations, against 53 clinical isolates were studied by a checkerboard method of determining minimal inhibitory concentrations . For selected representative strains, bactericidal activity was determined by minimal bactericidal concentrations and killing curves . Mecillinam was the least active antibiotic against gram-positive cocci, Pseudomonas aeruginosa, and Bacteroides fragilis and the most active against Enterobacteriaceae . Reproducibility of mecillinam minimal inhibitory concentrations for susceptible Enterobacteriaceae was often poor, however, due to minor variations in inoculum size . When mecillinam resistance was observed with Enterobacteriaceae, partial inhibition could be demonstrated at concentrations below minimal inhibitory concentrations, and bacterial cells were consistently ovoid or round; under those conditions the addition of a second study antibiotic resulted in marked synergistic inhibition and killing which was independent of inoculum size and susceptibility to the second antibiotic . In contrast, synergy with mecillinam against mecillinam-susceptible strains or with other antibiotic combinations against any species was not consistently observed.

Med Clin (Barc), 1980 Nov 25, 75(9), 373 - 9
{Studies on antibacterial activity of cephotaxime (HR 756), a new antibiotic of the cephalosporin group (author's transl)}; Foz A et al.; Cephotaxime (HR 756) is a new cephalosporin antibiotic of wide spectrum and extraordinary activity, suitable for parenteral administration . It is highly resistant to the beta-lactamases of Gram negative bacilli, being thus especially active against microorganisms such as indole-positive Proteus, Serratia marcencens, and others usually resistant to most beta-lactamic antibiotics because of their ability to produce beta-lactamases of high activity . The sensitivity of 355 different bacterial strains to cephotaxime has been determined by the disc method, along with the minimal inhibitory concentration (MIC) of the drug to the same strains, and regression lines have been constructed . The extraordinary activity of cephotaxime against Enterobacteriaceae, Vibrio Cholerae, Haemophilus, and Neisseria meningitidis is noteworthy . Of the 220 strains of Enterobacteriaceae studied, 55% produced beta-lactamase . The MIC of cephotaxime for beta-lactamase forming strains was similar to that for non-forming strains.

Sem Hop, 1980 Nov 8-15, 56(41-42), 1671 - 6
{Cerebral aneurysms complicating bacterial endocarditis . Seven cases (author's transl)}; Pecker J et al.; The authors report seven cases of cerebral aneurysms complicating bacterial endocarditis . The evolution was good in three cases, two of which without sequelae . The bacteries involved were staphylococcus, streptococcus, and enterobacter . The cardiopathy was mitral in four cases . Two patients presented an isolated focal neurological impairment, while the other five presented a severe coma either isolated (one case) or associated with focal neurological deficits (four cases) . An intracerebral hematoma was diagnosed in five cases (four died) . Only one patient was not operated . The surgical treatment was as follows: one carotid ligation (good result), two evacuations of intracerebral hematomas (both died), two evacuations of intracerebral hematomas with clipping of the aneurysms (one died, one had a fair result in despite of residual hemiplegia), one clipping of aneurysm (good result) . Repeated cerebral angiographies should be systematically performed in cases of bacterial endocarditis in order to disclose and follow up cerebral aneurysms which may occur in this condition . Except in cases of emergency, surgery should be differed, in particular, in cases of proximal or multiple aneurysms . Aneurysms of the peripheral cortical arteries are more accessible to treatment and may be operated in the acute phase.

Appl Environ Microbiol, 1980 Nov, 40(5), 973 - 6
Growth of Enterobacter cloacae in the presence of 25% sodium dodecyl sulfate; Kramer VC et al.; The growth of Enterobacter cloacae in 25% sodium dodecyl sulfate is described . The bacteria appeared to tolerate sodium dodecyl sulfate rather than metabolize it . The process was energy dependent, and cell lysis occurred during stationary phase . Extreme detergent resistance may be characteristic of the genus Enterobacter.

Appl Environ Microbiol, 1980 Nov, 40(5), 922 - 30
Enumeration and characterization of standard plate count bacteria in chlorinated and raw water supplies; LeChevallier MW et al.; Nearly 700 standard plate count (SPC) bacteria were isolated from drinking water and untreated surface water and identified according to a scheme developed to permit the rapid, simple classification of microorganisms to genus, species, or group . Actinomycetes and Aeromonas species were the two most common groups of SPC bacteria in chlorinated distribution water . Aeromonas spp . and Enterobacter agglomerans were the two most common groups of SPC bacteria in raw water . Identification of bacterial populations before and after contact with chlorine (1 to 2 mg/liter) for 1 h revealed that chlorination selected for gram-positive bacteria . Water that contained high densities of bacteria known to be antagonistic to coliforms had low coliform isolation rates . The membrane filtration technique for enumerating SPC bacteria recovered significantly higher numbers (P < 0.001) than the standard pour plate technique.

Antimicrob Agents Chemother, 1980 Nov, 18(5), 773 - 9
Compound A49759, the 3-O-demethyl derivative of fortimicin A: in vitro comparison with six other aminoglycoside antibiotics; Jones RN et al.; O-Demethylfortimicin A (compound A49759) was tested against 445 bacteria, and the results were compared with those obtained with fortimicin A, amikacin, gentamicin, netilmicin, sisomicin, and tobramycin . A49759 was found to be active and bactericidal against the Enterobacteriaceae, nonfermentative gram-negative bacilli, and Staphylococcus aureus . A49759 was two- to fourfold more active than fortimicin A against most species tested, but generally fourfold less active than amikacin against this population of Pseudomonas aeruginosa (85% inhibited at less than or equal to 16 microgram of amikacin per ml and 85% inhibited at less than or equal to 64 microgram of A49759 per ml) . Only amikacin and A49759 were resistant to most aminoglucoside-inactivating enzymes and also had significant antipseudomonal activity . Amikacin was inactivated by aminoglycoside 6'-acetyltransferase, and A49759 was inactivated by aminoglycoside 3-acetyltransferase . The minimal inhibitory concentrations of all tested aminoglycosides were increased by augmenting the inoculum size.

Am Surg, 1980 Nov, 46(11), 624 - 6
Anaerobic and aerobic bacteriology of decubitus ulcers in children; Brook I; Forty-two children with decubitus ulcers were studied using aerobic and anaerobic techniques . Anaerobic bacteria were isolated in 21 (50%) of the patients, five times as the only isolates and 16 times mixed with aerobes . Aerobes only were present in 20 (48%) of the patients . There were a total of 83 isolates, 46 aerobes and 37 anaerobes, with an average of two species per specimen (1.1 aerobes and 0.9 anaerobes) . The predominant anaerobic isolates were gram-positive cocci (17), Bacteroides fragilis (6), and Fusobacterium nucleatum (4) . The most common aerobic isolates were Staphylococcus aureus (23), Group A beta hemolytic streptococci (6), Hemophilus influenzae (5), and Enterobacter agglomerans (5) . The polymicrobial etiology of decubitus ulcers in hospitalized children is demonstrated.

J Clin Microbiol, 1980 Nov, 12(5), 684 - 9
Evaluation of the MS-2 system for rapid identification of Enterobacteriaceae; McCracken AW et al.; The precision, accuracy, and other performance characteristics of the MS-2 (Abbott Laboratories, Diagnostic Division, Dallas, Tex.) system for the identification of Enterobacteriaceae were evaluated in a collaborative study involving three clinical laboratories . When identifying 150 unknown, coded organisms, the MS-2 system was 97%, 98%, and 93% accurate, respectively, in three laboratories . The system showed an overall accuracy of 94% when compared with conventional manual tube methods in identifying 1,154 clinical isolates of 26 species of Enterobacteriaceae . Discrepancies between automated and conventional methods were chiefly caused by biochemical variants, especially among Enterobacter species . The MS-2 system was rapid and simple to operate and produced printed results of bacterial identification in 5 h . The cost of disposable components compared favorably with commercial, visually read systems for identifying Enterobacteriaceae.

J Clin Microbiol, 1980 Nov, 12(5), 659 - 62
Comparison of the automicrobic system with API, enterotube, micro-ID, micro-media systems, and conventional methods for identification of Enterobacteriaceae; Kelly MT et al.; Identification of Enterobacteriaceae by the AutoMicrobic System Enterobacteriaceae Biochemical Card was evaluated . Recent clinical isolates of enteric gram-negative bacilli (192) and glucose nonfermenters (3) were identified by the AutoMicrobic System, Micro-Media Systems, Micro-ID, API, and Enterotube II in comparison with conventional methods . The AutoMicrobic System and Micro-Media Systems correctly identified 97% of the organisms tested . Micro-ID, API, and Enterotube II correctly identified 94, 92, and 84% of the organisms, respectively . In addition to a high degree of identification accuracy, the AutoMicrobic System was convenient to operate and produced identification results in 8 h . Operation of the AutoMicrobic System also required minimal personnel time because it automatically monitored and interpreted the biochemical reactions and reported organism identifications . The AutoMicrobic System appears to be an efficient and accurate system for the identification of Enterobacteriaceae.

Dis Mon, 1980 Nov, 27(2), 1 - 56
The gram-negative bacillary pneumonias; Lerner AM; With increasing age, chronic underlying disease, and debility, the oropharyngeal flora are colonized with aerobic gram-negative bacilli . In this debilitated population, gram-negative bacillary pneumonias (GNBP) are increasingly common . GNBP account for two of every three pneumonia deaths today . As a group, the mortality of GNBP is about 50% . Although the original epidemiologic surveys were done 15 years ago, there is little evidence for an improving case fatality rate despite the appearance of aminoglycoside antibiotics, carbenicillin, and cephalosporins . In susceptible patients, GNBP pneumonias occur both in the community and as nosocomial infections . Recognition of the dangers of contaminated reservoir nebulizers or other similar devices used in inhalation therapy has led to epidemiologic measures within hospitals that have markedly decreased the incidence of this nosocomial GNBP . The role of Gram stain and culture of expectorated sputum and similar examinations of specimens obtained by transtracheal aspiration, fiberoptic bronchoscopy, and lung biopsy in the diagnosis of GNBP are discussed in this review (see Criteria for Diagnosis) . In the presence of pulmonary emphysema, congestive heart failure, mixed gram-negative bacillary infections, or the use of immunosuppressive drugs, typical characteristics of individual GNBP may not be apparent . Typical features of Pseudomonas aeruginosa, Escherichia coli, Enterobacter, Proteus, Hemophilus, and anaerobic pulmonary infections are described . Early recognition and institution of appropriate antibacterial agents are emphasized, particularly in GNBP caused by Pseudomonas aeruginosa, Escherichia coli, or Friedlander's bacillus, where the mortality approaches 70% . The mortality of GNBP, including Enterobacter, Proteus, Hemophilus, and anaerobic GNBP, is about 20% . The latter figure is the same as the mortality of pneumococcal pneumonia in similar patients.

J Bacteriol, 1980 Nov, 144(2), 630 - 40
Size heterogeneity of Salmonella typhimurium lipopolysaccharides in outer membranes and culture supernatant membrane fragments; Munford RS et al.; Enterobacteriaceae cells growing in liquid media shed fragments of their outer membranes . These fragments, which may constitute a biologically important form of gram-negative bacterial endotoxin, have been reported to contain proteins, phospholipids, and lipopolysaccharides (LPS) . In this study we compared the sizes of LPS molecules in shed membrane fragments and outer membranes from cells growing in broth cultures . Using conditional mutants of Salmonella typhimurium which incorporate specific sugars into LPS, we analyzed radiolabeled LPS by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . This technique revealed that S . typhimurium LPS are more heterogeneous than previously known; molecules possessing from 0 to more than 30 O-chain repeat units were identified in outer membranes, supernatant fragments, and purified LPS . The size distributions of LPS molecules in outer membranes and supernatant fragments were similar; supernatant fragments appeared to be slightly enriched in molecules with long O-polysaccharide chains . Our results indicate the LPS molecules of many sizes are synthesized, translocated to outer membranes, and released into culture supernatants . Since the hydrophilic O-polysaccharides extend from bacterial surfaces into the aqueous environment, our findings suggest that the cell surface topography of this bacterium may be very irregular . We also speculate that heterogeneity in the degree of polymerization of O-antigenic side chains may influence the interactions of the toxic moiety of LPS (lipid A) with host constituents.

Res Vet Sci, 1980 Nov, 29(3), 342 - 5
Transmissible drug resistance in human and animal trains of Enterobacteriaceae and Pseudomonas aeruginosa; Adetosoye AI; In an investigation carried out over a period of six months, 53 strains of Enterobacteriaceae and nine strains of Pseudomonas aeruginosa were examined for antibiotic resistance and transmissible drug resistance factor . Seventeen antibiotic resistance patterns were found among 51 drug resistant Enterobacteriaceae . Of the 62 strains, 23 were capable of transferring a part or all of the antibiotic resistance pattern to sensitive Escherichia coli . The P aeruginosa isolated from both man and piglets harboured R-factors which were transferable at high frequencies to the sensitive recipients, while only one of the six single resistant E coli isolated from piglets transferred resistance to the sensitive recipients . The minimum inhibitory concentrations of oxytetracycline, ampicillin, chloramphenicol, sulphadimidine and streptomycin of the resistant E coli, P aeruginosa, Salmonella spp and Proteus spp were 500 to 625, 62 to 500, 500 to 625, 500 and 7.8 to 500 micrograms/ml, respectively.

Zentralbl Bakteriol A, 1980 Nov, 248(2), 177 - 81
{An oral enteritis-vaccine composed of twelve heat inactivated Enterobacteriaceae . 2 . Communication: the immunogenicity after treatment with simulated gastric and intestinal juice proved in an active mouse protection test (author's transl)}; Raettig H et al.; In the first communication (3), we reported on the conception, the composition, and the efficacy of the polyvalent oral vaccine from 6 strains of salmonellae, 2 strains of shigellae, and 4 strains of dyspepsia coli . The inactivation took place at 100 degrees C/3 min . The question going to be answered in this communication was as follows: Does the immunogenicity of the vaccine decreased during the gastrointestinal passage under influence of acid and enzymes? We allowed the vaccine to react with simulated gastric juice and/or pepsin at pH = 3 and 37 C/60 min on the one hand and with simulated intestinal juice and/or pancreatin at pH = 7 and 37 degrees C/180 min on the other hand either individually or in combination . The vaccinal preparations produced this way were examined for their immunogenicity in the mouse protection test . The mice were orally immunized with the aid of a probang for ten times (total dose = 3.75 x 10(10) germs) and intraperitoneally infected with the virulent enteropathogenic strain of E . coli 2,380 being contained in the twelvefold vaccine on the 10 . day after the last oral vaccination . In the main test, 70.4% of 351 non-vaccinated control animals died . 277 mice were immunized with the vaccine having been treated in the strongest way (gastric juice + pepsin + intestinal juice + pancreatin); 4.0% of those died which is an index of efficacy of 94.3 . The mice immunized with untreated vaccine served as positive controls and were protected in the same way; 3.1% of 255 mice died (index of efficacy = 95.6) . The results show that the simulated gastro-intestinal passage did not have a negative influence upon the immunogenicity of the polyvalent vaccine.

Am J Med Sci, 1980 Nov-Dec, 280(3), 151 - 6
Radioimmunoassay for detection of IgG antibodies against enterobacterial antigens; Zeckel M et al.; The rough mutant of Salmonella minnesota (Re 595) contains several broad reacting antigens including a core LPS common to many aerobic gram-negative bacteria without sugars that confer serotype specificity to most gram-negative bacteria . Therefore, antibodies against this organism can be evoked by a large number of gram-negative bacteria . Using radioimmunoassay methods, sera from 59 patients with bacteremia due to enterobacteriaceae had higher concentrations of IgG antibodies against the rough mutant of Salmonella minnesota (Re 595) than control subjects . There was a significant correlation between concentrations of antibodies against Salmonella minnesota and concentrations of antibodies against a single strain of E coli . Sera from patients with bacteremia due to E coli or Klebsiella were tested against one strain of E coli and one strain of Klebsiella . The concentrations of antibodies against the homologous antigen were not higher than the concentrations of antibodies against the heterologous antigen . Sera from patients infected with S aureus or Pseudomonas aeruginosa did not have high concentrations of antibodies against S minnesota . Antibodies against common antigen(s) in Salmonella minnesota (Re 595) are useful in diagnosis of enterobacterial infections.

Antimicrob Agents Chemother, 1980 Nov, 18(5), 680 - 6
Effect of beta-lactamase and salt on mecillinam susceptibility of enterobacterial strains; Bongaerts GP et al.; Out of 15 selected enterobacterial strains resistant to ampicillin, 12 were able to transfer resistance to mecillinam to Escherichia coli K-12 . This resistance to mecillinam was found to be coupled to the presence of beta-lactamase . One strain contained a beta-lactamase characterized as a class IV beta-lactamase, whereas the other 14 strains possessed a class III (TEM-like) beta-lactamase . The specific activity of the class IV beta-lactamase against mecillinam was 55%, and those of the class III beta-lactamase sensitivity of mecillinam, the minimal inhibitory concentrations were lower than might be expected . However, after enzymatic hydrolysis of mecillinam, no antibacterial activity was found . At increasing salt or buffer concentrations the minimal inhibitory concentrations of mecillinam increase to a varying extent for all strains, independently of beta-lactamase production . This study indicates that the increase in minimal inhibitory concentration is dependent on the salt concentration . The study also shows that this increase is not due to salt-mediated hydrolysis or to stimulation either of beta-lactamase activity or of beta-lactamase production . To explain the difference between ampicillin and mecillnam resistance in the beta-lactamase-positive strains, a hypothetical model is presented and discussed.

Can J Microbiol, 1980 Oct, 26(10), 1232 - 40
Yersinia enterocolitica: observations on some growth characteristics and response to selective agents; Schiemann DA; A broth medium which provided for optimum growth of Yersinia enterocolitica was formulated . In this medium Y . enterocolitica grew best at pH 7.6-7.9 and 32 degrees C with a generation time of 33-39 min depending upon the strain . Examination of various chemicals as potential selective agents in an agar medium showed a high tolerance for surface-active agents, but cetrimide, 4-nitrophenol, potassium tellurite, and sodium azide were inhibitory at very low concentrations . Irgasan was tolerated at concentrations inhibitory to some other Enterobacteriaceae . Minimum inhibitory concentrations for 57 antibacterial agents tested against 18 strains suggested that carbenicillin, novobiocin, and SCE-129 (cefsulodin) might serve as useful agents for selective isolation of Y . enterocolitica.

J Antibiot (Tokyo), 1980 Oct, 33(10), 1138 - 45
PS-6 and PS-7, new beta-lactam antibiotics . In vitro and in vivo evaluation; Sakamoto M et al.; Biological properties of two new beta-lactam antibiotics, PS-6 and PS-7, containing the carbapenem nucleus were studied . The in vitro activities of PS-6 and PS-7 were tested against clinical isolates of Gram-positive and Gram-negative bacteria in comparison with those of cefazolin, ampicillin and PS-5 . In general, the antibacterial spectra of PS-6 and PS-7 were similar to that of PS-5 . PS-7 was slightly less active than PS-5 and ABPC against Staphylococcus aureus . Clinical isolates of Gram-negative bacteria were found to be 2- to 8-fold more resistant to PS-6 than to PS-5, while PS-7 was 2-fold more active than PS-5 against Enterobacter, Klebsiella, Proteus, Serratia and Escherichia coli . The therapeutic effect of PS-6 seemed slightly less than that of PS-5 in an experimental infection with Staph . aureus Smith in mice.

Pediatrics, 1980 Oct, 66(4), 573 - 8
Disposition of chloramphenicol in low birth weight infants; Glazer JP et al.; Although infrequently an antibiotic of first choice for neonates, chloramphenicol (CL) may be indicated in selected instances of infection caused by aminoglycoside-resistant enterobacteriaciae, anaerobes, and ampicillin-resistant Haemophilus influenzae . Use of CL in neonates has been limited since the recognition that vascular collapse may occur as a consequence of dosage regimens tolerated by adults . With an assay that detects only active CL, we studied drug disposition in 13 low birth weight infants, eight between 1 and 8 days of age (group I), and five between 11 days and 8 weeks of age (group II) . Peak serum CL concentrations ranged from 11.2 to 36.2 microgram/ml in group I and from 10.0 to 36.2 microgram/ml in group II, at doses ranging from 15 to 50 mg/kg/day, and 25 to 50 mg/kg/day, in groups I and II, respectively . Serum CL half-lives (T1/2) ranged from 10 to 36 hours in four of the eight group I patients; three of the remaining patients had T1/2 greater than 48 hours and the fourth patient accumulated CL in the interval between doses . T1/2 in group II ranged from 5.5 to 15.7 hours . Observed differences in T1/2 between groups I and II were statistically significant (P = .05) and could not be accounted for by factors other than postnatal age . These preliminary data suggest that although there appears to be an inverse relationship between CL T1/2 and postnatal age, there is sufficient variability in serum levels that monitoring must be performed in low birth weight infants treated with this drug.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Bacteriol Virusol Parazitol Epidemiol, 1980 Oct-Dec, 25(4), 237 - 50
{Recent proposals for nomenclature and classification of Enterobacteriaceae}; Negut M; The authors review recent proposals concerning the taxonomy and nomenclature of Enterobacteriaceae, underlining the differences with respect to the classification in Bergey's Manual of Determinative Bacteriology, 8th edition . The comments are accompanied by tables showing the various more practical tests used for differentiating the taxonomic groups up to species levels.

Am J Med Technol, 1980 Oct, 46(10), 776 - 8
Rapid identification of Enterobacteriaceae associated with bacteremia: a preliminary report; Hicock PI et al.; A preliminary report of a method to rapidly identify Enterobacteriaceae associated with bacteremia is described . When both bottles of a blood culture set revealed gram-negative rods on the Gram stain, an aliquot of the positive culture sample was repeatedly washed in sterile deionized water to remove RBCs and culture media . The concentrated suspension of organisms was used to inoculate API 20ETM identification strips which were generally read within 6-8 hr . Samples were also processed using conventional techniques . Ten episodes of bacteremia associated with Enterobacteriaceae were correctly identified using this rapid system . One Klebsiella pneumoniae with growth only in the aerobic bottle was excluded from the study, but was identified by conventional methods . Further advantages of this protocol are described.

Appl Environ Microbiol, 1980 Oct, 40(4), 794 - 7
Survival of two enterobacteria in feces buried in soil under field conditions; Temple KL et al.; Feces samples, inoculated with 10(6) Escherichia coli resistant to streptomycin and nalidixic acid and with 10(5) Salmonella typhimurium per g, were buried at five mountain field sites ranging from 2,005 to 2,730 m in elevation . Counts of each bacterium rose initially and then declined to 10(3) or 10(4) per g of feces in 8 weeks . The survival pattern was similar at all sites regardless of marked differences in elevation, soil, moisture, exposure, and vegetation . S . typhimurium numbers were consistently higher than E . coli numbers after week 3 . The test encompassed most of the time that the area is snow-free and accessible for hiking . The results were judged to discredit the recommendation for shallow burial of feces and to indicate a potential health hazard under intensive use.

J Clin Microbiol, 1980 Oct, 12(4), 550 - 3
Single-disk diffusion testing (Kirby-Bauer) of susceptibility of Proteus mirabilis to chloramphenicol: significance of the intermediate category; Furtado GL et al.; The significance of the intermediate category of the single-disk diffusion test (Kirby-Bauer) of antibiotic susceptibility has never been clearly defined . Thirty-two percent of 756 clinical isolates of Proteus mirabilis were of intermediate susceptibility to chloramphenicol, a higher percentage than for any other species . The breakpoint separating susceptible and intermediate isolates nearly bisected the frequency distribution of zone diameters of P . mirabilis but not that of the other species . The breakpoint separating susceptible and intermediate isolates nearly bisected the frequency distribution of zone diameters of P . mirabillis but not that of the other species tested . By serial broth dilution testing, the minimal inhibitory concentrations (MICs) of chloramphenicol of 50 individual isolates of P . mirabilis were 3.9 to 22.1 micrograms/ml (geometric mean, 8.0), whereas the MICs of susceptible Escherichia coli, Klebsiella, and Enterobacter strains were 2.0 to 3.9 micrograms/ml (geometric mean, 2.9) . Seventy percent of isolates of P . mirabilis with MICs of 7.8 to 15.6 micrograms/ml were classified as susceptible by disk testing . We conclude that existing Kirby-Bauer breakpoints do not accurately discriminate P . mirabilis isolates that are marginally susceptible to chloramphenicol . These data underscore the difficulty of applying a single set of breakpoints to all species and suggest that species-specific breakpoints would more accurately predict the MIC equivalent of given zone diameters.

J Clin Microbiol, 1980 Oct, 12(4), 546 - 9
Evaluation of cefamandole susceptibility testing of Enterobacteriacea by the autobac 1 system; de Girolami PC et al.; A total of 509 clinical isolates of Enterobacteriaceae were tested for susceptibility to cefamandole by Autobac 1 and Bauer-Kirby disk diffusion methods, using commercially available 30-micrograms cefamandole disks . Minimal inhibitory concentrations were determined for all organisms showing major or very major discrepancies . Overall agreement between Autobac 1 and disk diffusion was 89.8%, with 5.1% major or very major and 5.1% minor discrepancies . When considering only the genera for which 20 or more isolates were tested, overall agreement was 90.8% . Discrepancies for Escherichia coli showed a trend toward resistance by Autobac 1, with minimal inhibitory concentrations generally in agreement with disk diffusion results . No trends were detected for other genera . The rate of agreement was lower for Enterobacter species (75.4%), but minimal inhibitory concentrations, determined for all discrepancies in this genus, agreed with Autobafc 1 as often a with disk diffusion results.

J Clin Microbiol, 1980 Oct, 12(4), 517 - 20
Role of a cefoxitin-inducible beta-lactamase in a case of breakthrough bacteremia; Beckwith DG et al.; Development of resistance during therapy with cefamandole contributes to treatment failure . A simple cefoxitin disk test was recently described which detects a cefamandole-active inducible beta-lactamase not otherwise detectable with cefamandole as the inducer . A case of breakthrough Enterobacter bacteremia due to selection of a resistant subpopulation is reported in an immunocompromised patient . The use of this simple disk test in selected clinical cases is advocated.

Antimicrob Agents Chemother, 1980 Oct, 18(4), 574 - 8
In vitro evaluation of Ro 13-9904; Hinkle AM et al.; The in vitro activity of a new investigational cephalosporin, Ro 13-9904, was compared with those of four cephalosporins (cephalothin, cefamandole, cefoxitin, and moxalactam), five semisynthetic penicillins (mezlocillin, piperacillin, carbenicillin, ticarcillin, and azlocillin), and the aminoglycoside tobramycin . Ro 13-9904 inhibited 75% of all isolates of Enterobacteriaceae at a concentration of 6.25 micrograms/ml, including Enterobacter spp., Serratia marcescens, and indole-positive Proteus spp . Ro 13-9904 was only minimally active against Pseudomonas aeruginosa and enterococci . There was no significant change (greater than or equal to 2 dilutions) in drug activity when tested in various pH and media . A significant inoculum effect occurred when the size of the inoculum was increased from a concentration of 10(5) to 10(7) organisms per ml.

Antimicrob Agents Chemother, 1980 Oct, 18(4), 582 - 5
Synergistic activity of piperacillin in combination with beta-lactamase inhibitors; Neu HC et al.; Clavulanic acid and a penicillanic acid sulfone, when combined individually with piperacillin, synergistically inhibited various Enterobacteriaceae, Staphylococcus aureus, and Bacteroides fragilis . Clavulanic acid and piperacillin synergistically inhibited 91 of 170 (55%) isolates tested . Synergy was most often found against piperacillin-resistant bacteria: 65 of 69 isolates (94%) . Although the penicillanic acid sulfone acted synergistically with piperacillin, inhibiting 62 of 170 strains (33%), the concentration of clavulanic acid required for synergy generally was less than that of penicillanic acid sulfone . Combination of piperacillin and cefotaxime, an inhibitor of type 1 beta-lactamases, rarely was synergistic and was antagonistic for several species . The combination of piperacillin with potent beta-lactamase inhibitors made piperacillin active against those isolates of Escherichia coli and Klebsiella and Bacteroides species, as well as selected other species, that are resistant to piperacillin by virtue of their production of beta-lactamases.

J Antibiot (Tokyo), 1980 Sep, 33(9), 1022 - 30
Synthesis and structure-activity relationships of 7 beta-{2-(2-aminothiazol-4-yl)acetamido}-cephalosporin derivatives . III . Synthesis and antibacterial activity of 7 beta-{2-amino-2-(2-aminothiazol-4-yl)acetamido}cephalosporins; Ochiai M et al.; New derivatives of 7 beta-{2-(2-aminothiazol-4-yl)acetamido}cephalosporins having amino group at the 2-position of the 7-acyl moiety were synthesized in the hope that they would show improved antibacterial activity . Some of these compounds (XXa, XXd, XVb) showed improved activity against Enterobacter cloacae . Replacement of the annular amino group by a methyl group caused loss of activity.

J Antibiot (Tokyo), 1980 Sep, 33(9), 1005 - 13
Synthesis and structure-activity relationships of 7 beta-{2-(2-aminothiazol-4-yl)acetamido}-cephalosporin derivatives . I . Synthesis and antibacterial activity of 7 beta-{2-alkyl- and 2-hydroxy-2-(2-aminothiazol-4-yl)-acetamido}cephalosporins; Ochiai M et al.; 2-Alkyl- and 2-hydroxy derivatives of 7 beta-{2-aminothiazol-4-yl)acetamido}cephalosporins were synthesized to improve the antibacterial activity of the parent compounds especially against beta-lactamase-producing organisms . Some of these compounds showed an increase in activity against Serratia marcescens (Xb, XXIIIa) and Enterobacter cloacae (Xb, XIV) . The 2,2-dimethyl derivative (XXVIIIb) showed a definite loss of activity.

J Gen Microbiol, 1980 Sep, 120(1), 117 - 29
Numerical and DNA: DNA reassociation analyses of Erwinia rubrifaciens and other members of the Enterobacteriaceae; Azad HR et al.; Phenetic data on 75 strains of Erwinia and other representative genera of the Enterobacteriaceae were collected and analysed using two numerical taxonomic methods . In both methods the same subclusters were recovered . The subclusters, however, were defined at different similarity levels and were classified into clusters of different composition . Erwinia rubrifaciens strains formed a very tight, homogeneous subcluster, completely distinct and readily distinguishable from other Erwinia and enterobacteria species studied . DNA: DNA hybridization between E . rubrifaciens and Erwinia and Shigella species were analysed to corroborate the numerical classifications . A good correlation between the numerical and DNA: DNA hybridization analyses was found and provided sufficient evidence for not supporting the previously proposed subspecific taxonomic position of E . rubrifaciens . The data clearly showed that E . rubrifaciens is a separate species in its own right . Based on the existence of very high genetic relatedness and high similarities in phenetic characters among E . rubrifaciens strains and the confinement of the pathogen to the state of California, the hypothesis is offered that E . rubrifaciens originated from a single source.

Eur J Biochem, 1980 Sep, 110(1), 247 - 54
Antigenic relationships between pore proteins of Escherichia coli K12; Overbeeke N et al.; Antisera were raised against the purified Escherichia coli K12 outer membrane proteins ompA-, ompC- and ompF proteins and protein e . Several immunological methods were used to investigate the specificity of the antisera and the immunological relationship between the major outer membrane proteins . Although the antisera had been raised against highly purified proteins, several of them contained activity against lipopolysaccharide and lipoprotein due to minor impurities in the immunogens . The three general porins ompF protein, ompC protein and protein e were shown to be cross-reactive . Anti-(ompA protein) serum only reacted with the homologous protein . None of these antisera reacted with the phage lambda receptor protein or with protein III . Pore protein preparations isolated from Salmonella typhimurium, Klebsiella aerogenes, Enterobacter cloaceae and Proteus mirabilis were found to be structurally related to the E . coli K12 porins as they reacted with the antisera raised against E . coli K12 porins.

Antimicrob Agents Chemother, 1980 Sep, 18(3), 382 - 5
Induction of beta-lactamase by various beta-lactam antibiotics in Enterobacter cloacae; Minami S et al.; The induction of beta-lactamase in Enterobacter cloacae GN5797 was studied by using 23 beta-lactam antiobiotics, including newly introduced drugs, as inducers . the beta-lactam antibiotics can be classified into three groups on the basis of their inducer activity . Among the tested cephalosporins, cephamycin derivatives such as cefoxitin, cefmetazole, and YM09330 had high inducer activity even at low drug concentrations . On the other hand, cefoperazone, cefsulodin, piperacillin, and apalcillin showed low inducer activity when compared with the other cephalosporins.

Am J Ophthalmol, 1980 Sep, 90(3), 388 - 93
Cefoxitin levels in human aqueous humor; Axelrod JL et al.; We administered 2 g of cefoxitin to 25 patients before cataract surgery . An additional 23 patients received 500 mg of probenecid 30 minutes before the 2-g doses of cefoxitin . Average aqueous humor levels of 1.54, 3.16, 2.46, 1.22, and 0.82 microgram/ml were achieved at 30 minutes and one, two, four, and six hours, respectively, after the 2-g dose . The addition of probenecid prolonged significant aqueous humor levels . Therapeutic levels against common gram-positive pathogens were consistently achieved at two hours after injection without probenecid and from two to four hours after injection with probenecid . Therapeutic levels effective against Enterobacteriaceae were inconsistent.

J Bacteriol, 1980 Sep, 143(3), 1444 - 9
Generalized transduction in the enterobacterial phytopathogen Erwinia chrysanthemi; Chatterjee AK et al.; Bacteriophages induced by mitomycin treatment of Erwinia chrysanthemi KS612 produced plaques on lawns of E . chrysanthemi EC183 and KS605 . Bacteriophage Erch-12, purified from one such plaque, transferred an array of chromosomal genes (arg, leu, his, ser, thr, trp, ura) to appropriate recipient strains derived from E . chrysanthemi EC 183 . Recombinants were formed in the absence of cellular contact between donor and recipient bacteria and in the presence of deoxyribonuclease . Ultraviolet irradiation of the bacteriophage stimulated transductional frequency . Linkage was detected in two-factor crosses between the loci thr and ser and between rif and ade; several closely linked mutations in ser were mapped with respect to thr.

J Clin Microbiol, 1980 Sep, 12(3), 375 - 90
Clinical laboratory evaluation of the Abbott MS-2 automated antimicrobial susceptibility testing system: report of a collaborative study; Thornsberry C et al.; The MS-2 system (Abbott Diagnostics, Division of Abbott Laboratories, Dallas, Tex.) was evaluated for its efficacy in determining the susceptibilities of both clinical and selected challenge (nonfastidious, facultative, and aerobic) isolates . The MS-2 results were compared with standard Kirby-Bauer disk diffusion and microdilution results by using fresh clinical isolates . For gram-positive isolates other than enterococci, overall agreement between MS-2 and reference results was 93 to 98% . With enterococci, MS-2 agreement with disk diffusion was 68% but with microdilution was 86% (agreement between disk diffusion and microdilution was 73%) . The main discrepancies with enterococci were with cephalothin, penicillin, gentamicin, and kanamycin . With clinical gram-negative isolates, the overall agreement was 91 to 93%, with most discrepancies occurring with Enterobacter spp . and beta-lactam antibiotics (MS-2 versus disk diffusion, 84%; MS-2 versus microdilution, 84%; disk diffusion versus microdilution, 87%) and with Serratia spp . and colistin (false-susceptible results) . The agreement of MS-2 results with established reference antibiograms of a special collection of challenge strains was 91 to 97% for the gram-positive cocci and 86 to 98% for the gram-negative strains . (With Enterobacter spp., agreement was 86%, but was greater than 90% for all other organism groups.) Of the 98 finite MS-2 minimum inhibitory concentrations (MICs) that could be directly compared with microdilution MICs, 77 (79%) were within +/- 1 well of the geometric mean microdilution MIC . MS-2 analysis time ranged from 2.8 to 6.5 h (mean, 4.2 h) . On the basis of these results, we conclude that the MS-2 can be expected to yield rapid and accurate results with most nonfastidious, facultative, and aerobic pathogens.

Zh Mikrobiol Epidemiol Immunobiol, 1980 Sep, (9), 70 - 4
{Enterobacterial sensitivity to colicins in the presence of enterochelin}; Nazaruk MI et al.; The correlation between the colicine resistance of the reference and isolated strains of enterobacteria and their capacity for the biosynthesis of enterocheline, as well as the influence of exogenous enterocheline on the colicine sensitivity of enterobacteria were studied . In the wild strains of enterobacteria sensitivity to colicines was shown to have no correlation with capacity for the accumulation of catechol-type sideriphores . In some cases exogenous enterocheline prevents the lethal effect of colicines on the cultures of microorganisms capable of the biosynthesis of enterocheline.

Acta Pathol Microbiol Scand {B}, 1980 Aug, 88(4), 243 - 8
Cross-reactions between Salmonella typhi and 24 other bacterial species; Espersen F et al.; Cross-reactions between antigens from S . typhi and 24 other bacterial species were studied by quantitative immunoelectrophoretic methods . A sonicated S . typhi antigen preparation and a corresponding pooled rabbit antiserum regularly presenting 86 immunoprecipitates were used as a reference system . Antigens from Enterobacteriaceae cross-reacted intensively with the S . typhi antigens . No cross-reactions between S . typhi and antigens from gram-positive bacteria were found, and only a few cross-reactions with antigens from gram-negative bacteria outside the Enterobacteriaceae . The taxonomic perspectives of the immunoelectrophoretic approach are stressed by results showing that the number of cross-reacting antigens between S . typhi and other Enterobacteriaceae was positively correlated to the number of identical reactions in a collection of 28 biochemical tests.

J Pediatr Surg, 1980 Aug, 15(4), 569 - 73
The microbial flora and antimicrobial therapy of neonatal peritonitis; Bell MJ et al.; Data from 31 infants with gastrointestinal perforation were analyzed to determine the microorganisms usually present in the peritoneum and blood, and the antibiotic susceptibility of those organisms . Multimicrobial contamination of the peritoneal cavity was present in over one-half of the patients and 23% were found to have mixed aerobic-anaerobic peritoneal flora . Most common organisms were E . coli and Bacteroides species . Blood cultures were positive in 32% of patients, most frequently growing E . coli . Among numerous antibiotics tested, only gentamicin was effective against all Enterobacteriaceae isolated . Clindamycin was 99% effective against Bacteroides species isolated and 90% against other anaerobes . Group D streptococcus was the most frequently isolated gram positive aerobe . Based on these findings, empiric therapy with ampicillin, gentamicin and clindamycin is recommended for neonates with gastrointestinal perforation . Adjustments in therapy for individual patients should be based upon culture and sensitivity data.

J Bacteriol, 1980 Aug, 143(2), 906 - 13
Major heat-modifiable outer membrane protein in gram-negative bacteria: comparison with the ompA protein of Escherichia coli; Beher MG et al.; The outer membranes of several strains of Escherichia coli, other enteric bacteria, and a variety of nonenteric gram-negative bacteria all contain a major heat-modifiable protein similar to the OmpA protein of E . coli K-12 . The heat-modifiable proteins from these bacteria resemble the K-12 protein in molecular weight, in preferential release from the outer membrane by sodium dodecyl sulfate in the presence of Mg2+, and in characteristic cleavage by proteases to yield a smaller fragment which remains membrane bound . Antiserum directed against the K-12 protein precipitated the heat-modifiable protein from all strains of Enterobacteriaceae, and chemical comparison by isoelectric focusing, cyanogen bromide cleavage profiles, and proteolytic peptide analysis indicated that the proteins from the various enteric bacteria were nearly identical in primary structure . The heat-modifiable proteins from bacteria phylogenically distant from E . coli shared many of the properties of the E . coli protein but were chemically distinct . Thus, it appears that the structure (and, presumably, the function) of the heat-modifiable protein of gram-negative bacteria is strongly conserved during evolution.

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