Biophys Chem, 1996 Jun 11, 60(3), 99 - 110 Simulation of voltage-dependent interactions of alpha-helical peptides with lipid bilayers; Biggin PC et al.; Pore formation in lipid bilayers by channel-forming peptides and toxins is thought to follow voltage-dependent insertion of amphipathic alpha-helices into lipid bilayers . We have developed an approximate potential for use within the CHARMm molecular mechanics program which enables one to simulate voltage-dependent interaction of such helices with a lipid bilayer . Two classes of helical peptides which interact with lipid bilayers have been studied: (a) delta-toxin, a 26 residue channel-forming peptide from Staphylococcus aureus; and (b) synthetic peptides corresponding to the alpha 5 and alpha 7 helices of the pore-forming domain of Bacillus thuringiensis CryIIIA delta-endotoxin . Analysis of delta-toxin molecular dynamics (MD) simulations suggested that the presence of a transbilayer voltage stabilized the inserted location of delta-toxin helices, but did not cause insertion per se . A series of simulations for the alpha 5 and alpha 7 peptides revealed dynamic switching of the alpha 5 helix between a membrane-associated and a membrane-inserted state in response to a transbilayer voltage . In contrast the alpha 7 helix did not exhibit such switching but instead retained a membrane associated state . These results are in agreement with recent experimental studies of the interactions of synthetic alpha 5 and alpha 7 peptides with lipid bilayers. Ugeskr Laeger, 1996 Jun 10, 158(24), 3471 - 2 {Spread of an imported multiresistant Staphylococcus aureus to other hospitals via secondary colonized patients}; Haahr V et al.; A secondary spread of an imported methicillin-resistant Staphylococcus aureus strain (MRSA) to two other patients occurred within a Danish surgical ward in spite of isolation of a multitraumatized index-patient immediately after arrival from a hospital in the Mediterranean area . The two other colonized patients were later transferred to other hospitals in Denmark where it became apparent that they had developed serious infections with the MRSA strain . In conclusion: to prevent spread of imported MRSA within Danish hospitals, strict adherence to isolation procedures and a high level of general hygiene is essential not only when patients are transferred from hospitals situated in endemic areas of MRSA abroad, but also when admitted from Danish hospital wards where known cases of colonisation or infection with MRSA exist. Clin Exp Immunol, 1996 Jun, 104(3), 432 - 8 IL-10-driven immunoglobulin production by B lymphocytes from IgA-deficient individuals correlates to infection proneness; Friman V et al.; In search for a possible explanation of the phenotypic heterogeneity in IgA deficiency, we studied the function of B cells from IgA-deficient (IgAd) individuals . Two groups of IgAd individuals, one frequently infected and one clinically apparently healthy, as well as normal controls, were studied . Peripheral blood mononuclear cells (PBMC) and B cells from IgAd individuals and controls were cultured with Staphylococcus aureus Cowan I strain and with anti-CD40 MoAb presented on the CD32-transfected fibroblast cell line in the presence of IL-10 . In this experimental system PBMC and B cells from the infection-prone IgAd individuals produced only minute amounts of IgA . In contrast, PBMC and B cells from healthy IgAd subjects secreted significantly more IgA1 and IgA2 in comparison with infection-prone IgAd patients (P < 0.05) . These data suggest that the abnormalities of B cell differentiation in IgAd could be of heterogeneous origin . Thus, whereas in healthy IgAd subjects IgA production may be efficiently up-regulated in vitro by addition of IL-10 to CD40-activated B cell culture, the corresponding B cell differentiation does not occur in infection-prone IgAd patients . These observations provide a conceptual framework for phenotypic heterogeneity in IgAd subjects. In Vitro Cell Dev Biol Anim, 1996 Jun, 32(6), 372 - 7 Efficient production of IgG human monoclonal antibodies by lymphocytes stimulated by lipopolysaccharide, pokeweed mitogen, and interleukin 4; Yoshinari K et al.; Extensive screening of the mitogens lipopolysaccharide (LPS), pokeweed mitogen (PWM), and Staphylococcus aureus Cowan I (SAC I), alone and in combination and with and without interleukin (IL) was performed for in vitro activation of regional lymph node lymphocytes from lung cancer patients for the production of human IgG, IgM, and IgA . As assessed by electrofusion of the lymphocytes following their exposure to these agents with mouse myeloma cells and incubation of the fused hybridoma, a remarkable stimulatory effect was shown by LPS and particularly by LPS plus IL-4, which was substantially greater than that of either SAC I or PWM with or without various IL . Optimization studies indicated that the addition of PWM to LPS and IL-4 in the culture medium further stimulated the human antibody (Ab) production, and that the optimal formulation for stimulation of human IgG production was a culture medium containing 20 micrograms/ml of LPS, 1/500 of PWM, and 100 u/ml of IL-4. Eur J Clin Microbiol Infect Dis, 1996 Jun, 15(6), 499 - 503 Staphylococcal scalded skin syndrome in an immunocompromised adult; Roeb E et al.; Staphylococcal scalded skin syndrome, a generalized exfoliative dermatitis complicating infections by exfoliative toxin-producing strains of Staphylococcus aureus, is rarely observed in adults . In contrast to mortality in infants, mortality in adults is usually high . A case of generalized staphylococcal scalded skin syndrome in an immunocompromised woman is reported . Culture of skin biopsy and pleural fluid yielded identical strains of staphylococcus aureus belonging to phage group II . Exfoliative toxins A and B were detected in both isolates . As far as can be determined, this is the first reported case of generalized staphylococcal scalded skin syndrome in an adult with detection of exfoliate toxins A and B in which the patient was treated successfully. Eur J Clin Microbiol Infect Dis, 1996 Jun, 15(6), 437 - 45 Clinical spectrum of ventilator-associated pneumonia caused by methicillin-sensitive Staphylococcus aureus; Bergmans D et al.; The incidence of tracheal colonization and its association with ventilator-associated pneumonia caused by methicillin-sensitive Staphylococcus aureus (MSSA) was studied prospectively in 530 consecutively admitted mechanically ventilated patients in a general intensive care unit . Furthermore, the clinical spectrum, outcome, and microbiological results of 27 cases of staphylococcal ventilator-associated pneumonia (SVAP) were examined . Ventilator-associated pneumonia was diagnosed by protected specimen brush and/or bronchoalveolar lavage . On admission, 7% of the patients were colonized with MSSA in the trachea . Acquired tracheal colonization was demonstrated in 10% of the patients and occurred less frequently in patients with a hospital stay of > 48 h before ICU admission compared to patients admitted directly to the ICU (6% vs . 15%, p < 0.001) . Moreover, colonization was acquired more frequently among trauma and neurological/neurosurgical patients (22%) as compared to surgical and medical patients (7%) (p < 0.0001) . Twenty-one patients (4%) developed SVAP, the incident being higher in patients colonized in the trachea with MSSA than in those not colonized (21% vs . 1%), p < 0.00001) . Staphylococcal ventilator-associated pneumonia developed more often in trauma and neurological/neurosurgical patients as compared to surgical and medical patients (8% vs . 3%, p < 0.05) . Moreover, patients with a hospital stay of < 48 h before admission to the ICU had a higher incidence of SVAP as compared to those with a longer hospital stay before ICU admission (7% vs . 2%, p < 0.01) . Crude infection-related mortality was 26% . Preceding colonization with MSSA in the trachea appears to be an important risk factor for the development of SVAP, and patients with a short duration of hospitalization before intensive care unit admission have the highest incidence of ventilator-associated pneumonia caused by MSSA. Zentralbl Bakteriol, 1996 Jun, 284(1), 58 - 66 Selection of subpopulations resistnat to amikacin and netilmicin of gentamicin-resistant clinical strains of Staphylococcus aureus and Staphylococcus epidermidis; Torres Garcia M et al.; Recently we have found several strains of Staphylococcus aureus and Staphylococcus epidermidis, which in spite of containing aminoglycoside-modifying enzymes (AMEs) remained susceptible to antibiotics such as netilmicin (NET) and amikacin (AN) . Assuming an interest in this agent from a clinical point of view, the aim of this study was to determine if these strains became resistant after prolonged contact with such antibiotics . We found that minimal inhibitory concentrations (MICs) of the bacterial strains not only increased when using these two agents, but also when using other aminoglycosides such as gentamicin (GM), tobramycin (TM), amikacin (AN) and isepamicin (ISE) . In order to see the effect of prolonged use of NET on enzyme production, three strains containing AMEs were selected and we could observe an increase in the enzyme levels after successive passages through media containing NET. J Antimicrob Chemother, 1996 Jun, 37(6), 1171 - 5 Activity of glycylcyclines CL 329998 and CL 331002 against minocycline-resistant and other strains of methicillin-resistant Staphylococcus aureus; Hamilton-Miller JM et al.; Two glycylcyclines have been tested against 191 strains of methicillin-resistant Staphylococcus aureus, 72 of which were resistant to minocycline, isolated from many parts of the world . MICs of CL 329998 ranged from 0.06 to 4 mg/L, with MIC50 and MIC90 0.5 and 2 mg/L, respectively . CL 331002 was slightly less potent, having an MIC range 0.12-16 mg/L and MIC50 and MIC90 values of 1 and 4 mg/L, respectively. J Antimicrob Chemother, 1996 Jun, 37(6), 1077 - 89 Antimicrobial activity of cecropins; Moore AJ et al.; The lytic peptides, cecropins, were originally isolated from the haemolymph of the giant silk moth, Hyalophora cecropia and possess antibacterial and anticancer activity in vitro . This study investigated the antimicrobial activity of these peptides against human pathogens using standardised assay techniques, and the activity of cecropin B on outer and inner bacterial membranes . From a panel of 15 organisms, Gram-negative bacteria were generally more sensitive to cecropins than Gram-positive organisms, especially the lipopolysaccharide defective mutant, Escherichia coli BUE55 . Cecropins B and P1 shared similar MIC values whereas Shiva-1, a cecropin B analogue, was less active . Through combination studies with hydrophobic antibiotics and electron microscopy, cecropin B was shown to disrupt the bacterial outer membrane . Protoplasts of Staphylococcus aureus and Staphylococcus epidermidis were resistant to cecropin B, suggesting that the cytoplasmic membranes of Gram-positive organisms were inherently more resistant to the peptide. J Dairy Sci, 1996 Jun, 79(6), 1021 - 6 Staphylococcus aureus invasion of bovine mammary epithelial cells; Almeida RA et al.; Staphylococcus aureus is a frequent cause of mastitis in dairy cows . However, pathogenesis of the infection has not been completely defined . We report the invasion of two strains of S . aureus into a bovine mammary epithelial cell line and a bovine mammary epithelial cell primary culture . Invasion of S . aureus into bovine mammary cells was time-dependent . Transmission electron microscopy of bovine mammary cells invaded by S . aureus showed intracellular replication of the bacterium within membrane-bound vacuoles . Invasion was reduced significantly when bovine mammary epithelial cells were treated with inhibitors of F-actin microfilament polymerization but not when these cells were treated with inhibitors of microtubule formation . Results indicated that S . aureus is capable of invading and replicating inside bovine mammary epithelial cells . Data also suggested that S . aureus invasion of bovine mammary epithelial cells requires active participation of specific components of the cytoskeleton of the epithelial cell. J Neurosci Nurs, 1996 Jun, 28(3), 155 - 62 Shunt infections in children: presentation and management; Williams DG et al.; Since the earliest attempt at surgical management of hydrocephalus, infection has been a significant complication . For better assessment and care the neuroscience nurse needs to be aware of the signs and management of this condition . A retrospective review of 68 infections in 61 children was undertaken . Results showed an increased incidence of infection in the first nine months after surgery . Gram positive organisms (Staphylococcus epidermidis and Staphylococcus aureus) were most frequent; Propionobacter acnes was a significant pathogen in adolescence . Presenting symptoms included fever (26%), abdominal pain (19%), wound changes (22%) and indicators of shunt malfunction (33%) . Elevated white blood cells (WBCs) in spinal fluid from shunt tap and positive cultures were most reliable laboratory data . Culturing of causative organism was sometimes difficult . A value regulated system for ventricular drainage which allows greater mobility for the patient is described. J Antimicrob Chemother, 1996 Jun, 37 Suppl C, 21 - 35 Influence of immunosuppression on the pharmacokinetics and pharmacodynamics of azithromycin in infected mouse tissues; Girard D et al.; Azithromycin has been shown to preferentially distribute to infection loci . Due to the potential contribution of phagocytes as transporters of drug to these sites, there has been some concern that immunosuppression of the cellular arm of the host defence system would greatly reduce the delivery of azithromycin to sites of infection and hence impair efficacy . Therefore, we evaluated the pharmacokinetics and pharmacodynamics of azithromycin in a Staphylococcus aureus intramuscular infection model in normal and immunosuppressed mice, employing therapeutic and prophylactic regimens . Immunosuppression was induced by daily doses of cyclophosphamide that culminated in leucopenia with an underlying granulocytopenic condition, with circulating peripheral granulocytes numbering from < or = 0.1-0.3 x 10(9)/L . Azithromycin tissue levels were not reduced in infection loci in granulocytopenic mice but moderate increases in Cmax and AUC values were observed, relative to similar tissues from normal mice . The tissue half-life of azithromycin in infected tissues in a therapeutic mode (75 h) was three-fold longer than in a prophylactic mode (25 h); this correlated with the degree of inflammation (therapy was withheld until inflammation was evident; i.e., prophylaxis reduced inflammation) . Histological examination of infected tissues from normal and leucopenic mice was indistinguishable despite a 70%-85% reduction in circulating granulocytes . Compared with untreated infected controls, bactericidal activity was noted following prophylaxis with azithromycin and bacteraemia was suppressed in mice receiving azithromycin therapeutically . In summary, these data indicate that azithromycin delivery and efficacy in a moderately immunosuppressed animal model are unimpaired. J Dermatol Sci, 1996 Jun, 12(2), 132 - 9 Adhesion of Staphylococcus aureus to horny layer: role of fibrinogen; Kanzaki H et al.; Staphylococcus aureus cells attach to and invade the epidermis more easily under conditions of abrasion or occlusion or in the presence of irritant dermatitis than when the epidermis is intact . This fact strongly suggests that exuded plasma components may play an important role in the adherence of S . aureus cells to the horny layer . S . aureus cells (Cowan 1 strain, Wood 46 strain, and the protein A-deficient mutant, C7 strain, which was isolated from the Cowan 1 strain) were epicutaneously inoculated on the backs of mice . Biopsy specimens were taken from the mice at 1 h, 3 h, and 6 h after inoculation and examined using immunoelectron microscopy . Gold particles for fibrinogen gathered in a time-dependent manner at the interfaces of S . aureus cells and horny material in the lesions inoculated with the Cowan 1 and C7 strains but not in the lesions inoculated with the Wood 46 strain . These results suggest that fibrinogen plays a role in the binding of S . aureus cells to the horny layer. Acta Med Okayama, 1996 Jun, 50(3), 131 - 7 Purification and characterization of a 39kDa apurinic/apyrimidinic endonuclease from mouse ascites sarcoma cells; Wakabayashi H et al.; We purified an apurinic/apyrimidinic (AP) endonuclease from mouse ascites sarcoma (SR-C3H/He) cells . The enzyme showed nicking activity on acid-depurinated DNA but not on untreated, intact DNA . It also showed priming activity for DNA polymerase on both acid-depurinated and bleomycin-damaged DNA . The priming activity on bleomycin-damaged DNA was two times higher than that on an acid-depurinated DNA . The enzymatic properties indicate that the enzyme is a class II AP endonuclease having DNA 3' repair diesterase activity . The purified enzyme has a molecular weight of 39,000 as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . The optimal pH for AP endonuclease activity was 8.0 in 50 mM Tris-HCl buffer . The AP endonuclease activity depended on divalent cation such as Mg2+ and Co2+ ions, and was inhibited by 2 mM EDTA with no addition of the divalent cation . An appropriate concentration of sodium or potassium salt stimulated the activity . Partial digestion of the AP endonuclease with Staphylococcus aureus V8 protease produced 4 major peptide fragments which may be used for protein sequencing. Infect Control Hosp Epidemiol, 1996 Jun, 17(6), 372 - 4 Trends in the prevalence of methicillin-resistant Staphylococcus aureus associated with discontinuation of an isolation policy; Fazal BA et al.; The number of patients with methicillin-resistant Staphylococcus aureus (MRSA) before and after discontinuing placement of patients into private rooms was determined . The mean monthly number of patients with MRSA decreased from 34 to 22, and the proportion of S aureus isolates that were MRSA decreased from 34% to 20% . We found no evidence that failure to isolate patients with MRSA resulted in an increased prevalence of MRSA. J Epidemiol, 1996 Jun, 6(2), 69 - 73 Incidence of methicillin-resistant Staphylococcus aureus (MRSA) isolation in a skilled nursing home: a third report on the risk factors for the occurrence of MRSA infection in the elderly; Washio M et al.; A case control study was carried out in order to evaluate the various factors which may influence the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) infections in a skilled nursing home . From April 1991 to March 1994, bacterial cultures were performed in 55 out of 102 residents in a nursing home based on various clinical aspects . We divided 102 residents into following three groups; (1) the MRSA group (n = 10), residents whose materials for bacterial culture were positive for MRSA, (2) the non-MRSA group (n = 45), residents whose specimens were negative for MRSA but positive for other bacteria, (3) the control group (n = 47), residents who did not have to undergo a bacterial culture because they were free from moderate and severe infectious diseases . Compared with the control group, the activities of daily living score and the serum albumin level were significantly lower in the MRSA group and the non-MRSA group at the beginning of the study . In contrast, the number of antibiotics used prior to the bacterial culture and the proportion of hospitalization within 6 months prior to the bacterial culture were significantly larger in the MRSA group than in either the non-MRSA group, or the control group . These results thus suggest that a low activities of daily living score, the use of many kinds of antibiotics and a recent previous hospitalization may be risk factors of MRSA infection in a nursing home environment. Appl Environ Microbiol, 1996 Jun, 62(6), 2006 - 12 Investigation of the effect of combined variations in temperature, pH, and NaCl concentration on nisin inhibition of Listeria monocytogenes and Staphylococcus aureus; Thomas LV et al.; Gradient plates were used to investigate the effects of varying temperature, pH, and sodium chloride (NaCl) concentration on nisin inhibition of Staphylococcus aureus and Listeria monocytogenes, Nisin was incorporated into the plates of 0, 50, 100, 250, and 500 IU ml -1 . Gradients of pH (3.7 to 7.92) at right angles to NaCl concentration (2.1 to 7% {wt/vol}) were used for the plates, which were incubated at 20, 25, 30 and 35 degrees C . Growth on the plates were recorded by eye and by image analysis . The presence of viable but nongrowing cells was revealed by transfer to nongradient plates . Lower temperatures and greater NaCl concentrations increased the nisin inhibition of S . aureus synergistically . Increasing the NaCl concentration potentiated the nisin action against L . monocytogenes; the effect of temperature difference was not so apparent . Between pH 7.92 and ca . pH 5, a fall pH appeared to increase nisin's effectiveness against both organisms . At more acid pH values (ca . pH 4.5 to 5), the organisms showed resistance to both nisin and NaCl at 20 and 25 degrees C . Similar results were obtained with one-dimensional liquid cultures. Cardiovasc Surg, 1996 Jun, 4(3), 389 - 92 Prophylaxis against Staphylococcus epidermidis vascular graft infection with rifampicin-soaked, gelatin-sealed Dacron; Sardelic F et al.; An animal model was used to assess the efficacy of rifampicin-impregnated, gelatin-sealed Dacron in the prevention of vascular graft infections caused by Staphylococcus epidermidis . Under a general anaesthetic an interposition graft was placed into sheep carotid artery . On completion of the operation 1 ml of normal saline containing 10(8) colony forming units (cfu) of a slime-producing S . epidermidis was inoculated directly onto the graft . After 3 weeks the graft was harvested . Swabs were taken of perigraft tissues, and of external and internal aspects of the graft . A 3-5-mm segment of the graft was incubated in broth medium and a second segment was ground for 5 min and incubated in broth medium . The presence of abscess formation and anastomotic disruption was assessed . Ten sheep received a gelatin-sealed Dacron graft (control), while nine received the same graft impregnated with rifampicin at a concentration of 1.2 mg/ml (treated) . Eight of 10 control grafts were infected, with 30 of 50 possible cultures positive, compared with four of nine treatment grafts infected (P = 0.13) and 13 of 45 cultures positive (P = 0.004) . The control group had four abscesses and two anastomotic disruptions; the treatment group had no abscesses (P = 0.05) or anastomotic disruptions (P = 0.26) . Other organisms were isolated from nine of the 12 infected grafts, most commonly Staphylococcus aureus . There was no development of resistance to rifampicin . Rifampicin-impregnated, gelatin-sealed Dacron is successful at reducing the incidence of S . epidermidis vascular graft infection. Burns, 1996 Jun, 22(4), 283 - 6 Effective control of methicillin-resistant Staphylococcus aureus in a burn unit; Matsumura H et al.; Methicillin-resistant Staph, aureus (MRSA) colonization and infection was studied in 231 patients who were admitted to our burn unit and remained for 3 days or more between 1986 and 1994 (patients with inhalation injury only and no burn wound were excluded) . The study was divided into two periods: from 1988 to 1989 and from 1990 to 1994 . MRSA was found in 80 patients . They increased from 1986 to 1988, slightly decreasing thereafter . In 1994 the incidence of MRSA was 4.3 per cent . The number of strains of MRSA isolated from burn wounds was significantly reduced in the later period . Comparing the two periods, isolation of patients from MRSA, prevention of contamination during care, and reduction in the number of patients initially given second- or third-generation cephem antibiotics were performed more strictly in the later period . The effectiveness of these measures was confirmed . Moreover, the first operation was carried out significantly earlier in the later period . Early excision and early closure of the wound was more effective in preventing and controlling MRSA colonization and infection. Jpn J Antibiot, 1996 Jun, 49(6), 658 - 62 {Studies on cerebrospinal fluid penetration of cefpirome in adult with meningitis}; Munemoto S et al.; A patient with intracerebral hematoma suffered from postoperative bacterial meningitis . Staphylococcus aureus was found from CSF . The organism was multiple drug resistant and refractory to antibiotics including piperacillin (PIPC), cephalexin (CEX), cefotaxime (CTX), ceftazidime (CAZ) and latamoxef (LMOX) . It was susceptible to cefpirome (CPR) . Treatment with CPR resulted in clinical improvement associated with clearing of the organism from CSF . Serum level of CPR was high enough and CPR penetration into the CSF was satisfactory . The results suggest that CPR is an extremely effective antibiotic for meningitis caused by CPR-susceptible bacteria . Evaluation of the CPR penetration into the CSF of adult meningitis was rarely reported . The result we obtained was important in the treatment for the adult meningitis. J Formos Med Assoc, 1996 Jun, 95(6), 458 - 63 Infectious spondylitis: MRI characteristics; Huang YC et al.; Magnetic resonance imaging (MRI) scans of 24 patients with clinically proven infectious spondylitis were retrospectively evaluated . Evaluation was made of abnormal signal and enhancement patterns within vertebral bodies, intervening disks, and epidural and paraspinal abscesses . The causative organisms included Mycobacterium tuberculosis, fungi and pyogenic bacteria . Staphylococcus aureus was the predominant causative organism among pyogentic bacteria . Decreased signal intensity of vertebral marrow on T1-weighted images was more extensive in pyogenic infections . Multilevel involvement (more than two) was observed in six of the 24 patients . Contiguous multilevel involvement was observed only in patients with tuberculous spondylitis . Noninvolvement of the intervertebral disk space was observed in two patients with pyogenic spondylitis . Epidural abscess was found in 15 patients, most of whom had dense, homogeneous enhancement . Paraspinal abscess was found in 18 patients . Diffuse patchy enhancement without obvious abscess formation in the paraspinal compartment was found in those patients with pyogenic infections . "Rice bodies" were found in paraspinal abscesses in only three patients with tuberculous spondylitis . It was difficult to differentiate candidal from tuberculous spondylitis on MRI . Compared with pyogenic infection, tuberculous spondylitis had a predilection for spinal deformity, subligamentous spread, contiguous multilevel involvement, presence of signal voids in paraspinal abscesses on T2WT and a lesser extent of marrow edema. Am J Physiol, 1996 Jun, 270(6 Pt 1), G962 - 8 Differential effects of GTP gamma S on acid and pepsinogen secretion by permeable gastric glands; Miller MD et al.; Gastric glands isolated from rabbit stomach were permeabilized with Staphylococcus aureus alpha-toxin . Acid secretion by parietal cells, as measured by the accumulation of weak base, was inhibited by incubation with alpha-toxin but could be restored by addition of exogenous ATP (1 mM) . The permeable glands were found to retain acid secretory responses to receptor-linked secretagogues, histamine and carbachol, as well as to intracellular mediators, forskolin and 8-bromoadenosine 3',5'-cyclic monophosphate, indicating the presence of intact, functional intracellular coupling mechanisms . Both basal and stimulated acid secretion by the permeable glands were blocked by the Mg2+ chelator, trans-1,2-diaminocyclohexane-N,N,N',N'-tetraacetic acid (CDTA; 5 mM), whereas CDTA had no effect on nonpermeabilized glands . These results are interpreted to show that alpha-toxin permeabilizes parietal cells to moderate sized molecules without causing a loss of critical intracellular components . The acid secretory responses to histamine and carbachol persisted in media containing low ( < 50 nM) levels of free Ca2+ buffered by 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid (0.5 mM), indicating that changes in bulk Ca2+ are not required for these responses . Inclusion of the nonhydrolyzable analogue of GTP, guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S; 100 microM), resulted in inhibition of spontaneous acid secretion, blocked responses to all agents tested, and inhibited stimulated acid secretion . GTP gamma S had no effect on nonpermeabilized glands . No effects on acid secretion by either permeable or nonpermeable glands were observed with GTP, guanosine diphosphate, or guanosine 5'-O-(2-thiodiphosphate) . GTP gamma S had no effect on H+ gradient formation by gastric membrane vesicles, showing that it does not inhibit the gastric H(+)-K(+)-adenosinetriphosphatase directly . These results are interpreted to show that GTP gamma S interacts at a postreceptor site to inhibit or reverse a critical step in stimulus-secretion coupling in parietal cells . In contrast to the effect on parietal cells, GTP gamma S was found to stimulate pepsinogen secretion by alpha-toxin-permeabilized chief cells . The differential effects of GTP gamma S on acid and pepsinogen secretions suggest unique roles for GTP binding proteins in these two secretory processes . The use of alpha-toxin-permeabilized gastric glands should prove useful in defining the stimulus-secretion coupling mechanisms involved in both acid and pepsinogen secretions. J Laryngol Otol, 1996 Jun, 110(6), 547 - 50 Evaluation of the microbiology of chronic sinusitis; Sener B et al.; Chronic sinusitis is one of the most common diseases treated in outpatient centres . In this prospective study, 49 patients with the diagnosis of chronic maxillary sinusitis were evaluated microbiologically by using sinus swab, irrigation fluid and sinus mucosal tissue specimens obtained during endoscopic sinus surgery . There was no bacterial growth in seven cases . In the remaining 42 cases a total of 89 bacteria were isolated, 28 of them being classical pathogens and 61 being non-classical pathogens . Among the classical pathogens Staphylococcus aureus was the most common one . The correlation between the isolates obtained from maxillary sinus and isolates obtained from throat, nose and nasopharynx did not have a predictive value . Since the overall rate of classical pathogen isolation from patients with chronic sinusitis was not significantly high, the possible role of factors other than bacterial growth should be identified in the pathogenesis of chronic sinusitis. J R Coll Surg Edinb, 1996 Jun, 41(3), 182 - 3 Pyomyositis: an unusual infection due to staphylococcus aureus; Das I et al.; Pyomyositis is a primary pyogenic infection of skeletal muscle, leading to the formation of intramuscular abscesses . Although common in tropical climates, it is infrequent in temperate zones . We report a patient who developed the condition without travelling to tropical areas. Nippon Kyobu Geka Gakkai Zasshi, 1996 Jun, 44(6), 814 - 9 {A case report of mediastinitis due to methicillin resistant Staphylococcus aureus after total aortic arch replacement}; Asano S et al.; A 78-year-old man underwent total aortic arch replacement for ruptured aortic arch aneurysm . Two weeks after the surgery, high fever and leucocytosis developed . He was placed on a regimen of antibiotics . However, mediastinitis eventually ensued five weeks later with the pus draining from the sternotomy wound . The culture revealed a Methicillin resistant staphylococcus aureus . The infected tissue was debrided from the mediastinal cavity 40 days postoperatively . The cavity was kept open and was intermittently irrigated with 2% Providone-iodine for three days . Subsequently, an omental graft was placed . The infection successfully subsided gradually and the patient has been well for a year and a half after the initial surgery . The procedure is considered to be extremely effective for the management of a drastic infection involving thoracic aortic prosthesis. J Clin Microbiol, 1996 Jun, 34(6), 1502 - 5 Typing of Staphylococcus aureus by PCR for DNA sequences flanked by transposon Tn916 target region and ribosomal binding site; Cuny C et al.; The continuous intra- and interhospital spread of multiresistant Staphylococcus aureus demands a rapid molecular typing system . This study describes the fingerprinting of S . aureus by PCR amplification of DNA sequences flanked by the target site for transposon Tn916 and the ribosomal binding site and neighboring nucleotides (target 916-Shine-Dalgarno PCR {tar 916-shida PCR}) . Both starting points for PCR are known to be randomly distributed on the S . aureus chromosome . By use of SmaI-macrorestriction patterns as the reference method it was shown that this PCR genotyping discriminates among strains of the major clonal groups of the species S . aureus (strains with phage patterns 29, +, 94, 96, and 95 as well as group II and group III patterns) and identifies the six epidemic methicillin-resistant S . aureus strains prevalent in German hospitals . All of the investigated strains including methicillin-sensitive . S . aureus were typeable . Tar 916-shida patterns are stable during the dissemination of epidemic methicillin-resistant S . aureus among different hospitals. J Clin Microbiol, 1996 Jun, 34(6), 1364 - 72 Genomic fingerprinting for epidemiological differentiation of Staphylococcus aureus clinical isolates; Smeltzer MS et al.; We used genomic fingerprinting to investigate an outbreak of methicillin-resistant Staphylococcus aureus in the neonatal intensive care units (NICUs) of two hospitals . The hospitals are located in the same city and are part of the same medical care system . Fingerprinting was done by Southern blot hybridization with DNA probes for the genes encoding the S . aureus collagen adhesin (cna), fibronectin-binding proteins (fnbA and fnbB), and beta-toxin (hlb) . Genomic DNA was digested with HaeIII (cna and fnbA-fnbB probes) or HindIII (hlb probe) . Hybridization patterns could be distinguished on the basis of (i) the presence or absence of cna, (ii) the size of the restriction fragment containing the cna gene, (iii) restriction fragment length polymorphisms within fnbA and fnbB, (iv) the presence of a lysogenic phage within hlb, and (v) the sizes of the restriction fragments containing the phage-bacterial DNA junction fragments . Over a period of 4 months we examined a total of 46 isolates obtained from various wards within each hospital . Among these 46 isolates, we observed a total of 4 cna patterns, 11 fnbA-fnbB patterns, and 11 hlb patterns . Southern blots with HaeIII-digested genomic DNA and a combination of all three gene probes revealed a total of 16 clearly distinguishable patterns . A total of 22 of the 46 isolates were identical with respect to every genomic marker examined . A total of 21 of these 22 isolates were obtained from patients within an NICU . Nineteen of 21 isolates also exhibited identical antibiotic resistance profiles (antibiogram) . Although 5 of the remaining 24 strains exhibited an antibiogram identical to those of the NICU isolates, all 24 strains could be distinguished from the NICU isolates by at least one genomic marker . These results suggest that the NICU isolates had a common origin and that genomic fingerprinting with the cna, fnbA, fnbB, and hlb gene probes can provide an important epidemiological tool for the identification of clinical isolates of S . aureus. Ophthal Plast Reconstr Surg, 1996 Jun, 12(2), 131 - 5 Draining cutaneous fistula associated with infection of hydroxyapatite orbital implant; Glasgow BJ et al.; The implantation of an orbital hydroxyapatite implant was complicated by conjunctival dehiscence, cutaneous fistula formation, and infection with Staphylococcus aureus . Pathologic examination of the sphere 2 years after its implantation revealed reduction in the size of the implant, peripheral lamellar bone formation and central necrosis . This is the first report of this constellation of complications with hydroxyapatite spheres positioned in the orbit . The 2-year interval between implantation and removal of the sphere is the longest reported in a case with histopathologic analysis. Ophthal Plast Reconstr Surg, 1996 Jun, 12(2), 121 - 6 Adverse effects of bone wax in surgery of the orbit; Katz SE et al.; The goal of this article is to establish the incidence and scope of adverse reactions to bone wax in a large orbital surgical series . We report two patients with bone wax granulomas of the orbit as a remote surgical complication . These are the first reported cases of adverse reactions to bone wax in the ophthalmic literature . A chart review was conducted on all patients from the University of British Columbia Orbit Clinic that had surgery with temporary or permanent removal of orbital bone . Two patients with bone wax granulomas were identified . In one case, intraoperative cultures grew Staphylococcus aureus, confirming that the wax may indeed act as a nidus for infection . No cases of pseudoarthrosis have occurred . This syndrome of chronic granulomatous giant cell foreign body inflammation has characteristic clinical, radiologic, and histopathologic features . The literature regarding adverse reactions to bone wax is reviewed, and specific implications for orbital surgery are discussed. Antimicrob Agents Chemother, 1996 Jun, 40(6), 1534 - 5 Vancomycin-gentamicin synergism revisited: effect of gentamicin susceptibility of methicillin-resistant Staphylococcus aureus; Mulazimoglu L et al.; Vancomycin monotherapy of deep-seated staphylococcal infection may be associated with poor bacteriological response . We evaluated 24 unique patient isolates of methicillin-resistant Staphylococcus aureus (MRSA) for vancomycin-gentamicin synergism by determining time-kill curves for vancomycin at 10 micrograms/ml and gentamicin at 1 microgram/ml . Nine MRSA strains showed high-level gentamicin resistance (HLGR) (MIC, > 500 micrograms/ml), and 15 did not . Vancomycin-gentamicin demonstrated synergism against none of the HLGR strains . For the non-HLGR strains, gentamicin agar dilution MICs ranged from 0.5 to > 128 micrograms/ml . Vancomycin-gentamicin demonstrated synergism against six of these strains and indifference against nine of them . There was no relationship between the agar dilution MIC of gentamicin and the occurrence of synergism against non-HLGR strains . We conclude that a gentamicin MIC of > 500 micrograms/ml predicts a lack of vancomycin-gentamicin synergism for strains of MRSA . For non-HLGR strains, synergism is not predictable from the gentamicin MIC. Antimicrob Agents Chemother, 1996 Jun, 40(6), 1498 - 503 Effect of exogenous glycine on peptidoglycan composition and resistance in a methicillin-resistant Staphylococcus aureus strain; de Jonge BL et al.; A highly homogeneously methicillin-resistant Staphylococcus aureus strain was grown in the presence of various concentrations of exogenous glycine . Increasing concentrations of glycine in the medium resulted in a decrease in methicillin resistance and the appearance of a heterogeneous resistance phenotype . Parallel to the gradual changes in resistance was an alteration in the muropeptide composition of peptidoglycan . Increasing concentrations of glycine in the medium resulted in peptidoglycan in which muropeptides with a D-alanyl-D-alanine terminus were replaced with D-alanyl-glycine-terminating muropeptides . The disappearance of D-alanyl-D-alanine-terminating muropeptides in peptidoglycan and the concomitant decrease in resistance indicate a central role for D-alanyl-D-alanine-terminating precursors in methicillin resistance. Antimicrob Agents Chemother, 1996 Jun, 40(6), 1432 - 7 Antibiotic-impregnated heart valve sewing rings for treatment and prophylaxis of bacterial endocarditis; Cimbollek M et al.; Prosthetic heart valve sewing rings were impregnated with gentamicin crobefat (EMD 46217), a poorly soluble gentamicin salt, gentamicin sulfate, and clindamycin palmitate to prevent early prosthetic endocarditis . MICs and MBCs of gentamicin and/or clindamycin were tested against several pathogens of early prosthetic endocarditis . The combination of gentamicin and clindamycin was found to be effective against most relevant bacterial pathogens . With an in vitro pharmacokinetic model, the antibacterial activity of gentamicin and clindamycin was tested against Staphylococcus aureus and Escherichia coli . High gentamicin levels over the first 24 h were required for a strong reduction of bacterial counts of both strains . Equal amounts of gentamicin and clindamycin sustained the antibacterial effect and prevented regrowth . The most effective release curves of gentamicin and clindamycin found with an in vitro model were used for monitoring release profiles of these antibiotics from impregnated sewing rings by investigating combinations of gentamicin sulfate, gentamicin crobefat, and clindamycin palmitate . Sewing rings impregnated with 4 mg of gentamicin sulfate, 14 mg of gentamicin crobefat, and 20 mg of clindamycin palmitate gave an initial gentamicin burst and afterwards yielded a lower sustained release of gentamicin and clindamycin palmitate . These in vitro release kinetics were confirmed in vivo by pharmacokinetic analysis after intramuscular implantation of impregnated sewing ring segments . Gentamicin and active clindamycin palmitate metabolites were obtained at the implantation site for at least 2 weeks in concentrations of 3 and 5 micrograms per g of muscle, respectively . The investigated method of impregnation holds promise for revision implants after prosthetic valve endocarditis . It may also serve as a prophylactic tool for routine use against this disease. Antimicrob Agents Chemother, 1996 Jun, 40(6), 1403 - 7 Variation in postantibiotic effect of clindamycin against clinical isolates of Staphylococcus aureus and implications for dosing of patients with osteomyelitis; Xue IB et al.; Initial measurements of postantibiotic effect (PAE) were made by a standard laboratory method (exposure to 1 mg of clindamycin per liter for 1 h) . The range of PAE for 21 strains of Staphylococcus aureus isolated from osteomyelitis patients was 0.4 to 3.9 h, which markedly exceeded the coefficient of variation for the method (6 to 19%) . Exposure of S . aureus to three doses of clindamycin at 8-h intervals had no consistent effect on either PAE or MIC . The PAE was dependent on both concentration and duration of exposure to clindamycin: for example, the PAEs for one strain were 1.7 h after exposure to 1 mg/liter for 1 h, 2.4 h after exposure to 4 mg/liter for 1 h, and 5.9 h after exposure to 4 mg/liter for 3 h . Pharmacokinetic simulations showed that the dose required to maintain free serum clindamycin concentrations above the MIC was 300 mg 6 hourly after oral administration (95% confidence interval, 243 to 301 mg) and 1.2 g 6 hourly (95% confidence interval, 305 to 1,145 mg) after intravenous (i.v.) administration . The duration of PAE would have to be at least 2.4 h to allow an increase in the oral dose interval to 8 h or to allow i.v . administration of 300 mg 6 hourly . Additional PAE experiments were performed with the three strains for which PAEs are the shortest after exposure to 1 mg/liter for 1 h (0.4 to 1.2 h) . The PAE for these three strains increased markedly to 4.4 to 6.7 h following exposure to 2 mg/liter for 6 h (to mimic the area under the concentration-time curve from 0 to 6 h after a 300-mg dose) . These data suggest that oral clindamycin could be administered at 300 mg 8 hourly in the treatment of S . aureus infection, whereas the i.v . dose interval should be 6 h . These suggestions should be confirmed by performing clinical trials. Microbiology, 1996 Jun, 142 ( Pt 6), 1491 - 7 Proline is biosynthesized from arginine in Staphylococcus aureus; Townsend DE et al.; Staphylococcus aureus NCTC 8325 exhibited a long lag phase (11 h) when inoculated into defined medium lacking proline, that could be shortened by increasing the concentration of arginine in the medium, or by supplying ornithine . Radioactivity from L-{14C}arginine, but not L-{14C}glutamate was incorporated into a spot with the chromatographic mobility of {14C}proline in the pool metabolites fraction . Selection for transposon Tn917-lacZ mutants impaired in arginine catabolism yielded four proline auxotrophs . Enzyme assays and precursor feeding experiments suggested that the major pathway for proline biosynthesis in S . aureus was from arginine via ornithine and delta'-pyrroline 5-carboxylate, rather than from glutamate . Strain 8325 Pro+, a proline prototrophic variant obtained by cultivation of 8325 in the absence of proline, accumulated L-{14C}arginine from the medium at about eight times the rate of strain 8325, suggesting its response to proline starvation was to increase arginine uptake. J Appl Bacteriol, 1996 Jun, 80(6), 577 - 82 Quantification of Staphylococcus aureus and Escherichia coli in the liquid medium by fluorimetry and its use in phagocytosis assay; Fang W; A fluorimetric technique was compared with the plate counting method for quantification of viable cells of Staphylococcus aureus and Escherichia coli in the liquid medium . The fluorimetric assay measures the release of fluorogenic 4-methylumbelliferone (4-MU) from 4-methylumbelliferyl phosphate by the bacterial phosphatases . The increase in fluorescence was dependent on the size of bacterial inocula . Setting the fluorescence threshold at the middle of the logarithmic growth phase resulted in good linear relationship between bacterial counts and fluorescence (r = 0.99 for both Staph . aureus and E . coli) . There was also an excellent correlation between the fluorimetric assay and the plate counting method in quantifying viable bacteria in saline (r = 0.99) . Both methods were further compared for evaluation of extracellular bacteria following phagocytosis . The fluorimetric technique, in general, gave a higher percentage of phagocytosis than the plate counting method with statistical significance for E . coli. J Leukoc Biol, 1996 Jun, 59(6), 902 - 7 Killing of phagocytosed Staphylococcus aureus by human neutrophils requires intracellular free calcium; Wilsson A et al.; The mobilization of intracellular calcium plays an important role in regulating neutrophil activation . With this in mind we investigated the effect of intra- and extracellular calcium on the ability of human neutrophils to kill complement-opsonized Staphylococcus aureus . We found that a rise in intracellular calcium is necessary for efficient killing of phagocytosed S . aureus . In the presence of extracellular calcium, killing of ingested bacteria in calcium-buffered neutrophils compared with normal cells was slightly reduced . Calcium buffering had no effect on phagocytic uptake by the neutrophils, but did decrease the generation of toxic oxygen metabolites, measured as chemiluminescence (CL) . In nondepleted and calcium-depleted cells, removal of extracellular calcium did not affect ingestion but did cause a marked decrease in the ability to kill the bacteria . In parallel, the CL response was substantially reduced or completely blocked . These data show that calcium is not a prerequisite for phagocytosis of S . aureus by human neutrophils, but does play a vital role in the post-ingestion killing of the bacteria by regulating the generation of toxic oxygen metabolites. J Exp Med, 1996 Jun 1, 183(6), 2675 - 80 Protection against lethal toxic shock by targeted disruption of the CD28 gene; Saha B et al.; Toxic shock syndrome (TSS) is a multi system disorder resulting from superantigen-mediated cytokine production . Nearly 90% of the clinical cases of TSS arise due to an exotoxin, toxic shock syndrome toxin-1 (TSST-1), elaborated by toxigenic strains of Staphylococcus aureus . It is clearly established that besides antigen-specific signals a variety of costimulatory signals are required for full T cell activation . However, the nature and potential redundancy of costimulatory signals are incompletely understood, particularly with regards to superantigen-mediated T cell activation in vivo . Here we report that CD28-deficient mice (CD28-/-) are completely resistant to TSST-1-induced lethal TSS while CD28 (+/-) littermate mice were partially resistant to TSST-1 . The mechanism for the resistance of the CD28 (-/-) mice was a complete abrogation of TNF-alpha accumulation in the serum and a nearly complete (90%) impairment of IFN-gamma secretion in response to TSST-1 injection . In contrast, the serum level of IL-2 was only moderately influenced by the variation of CD28 expression . CD28 (-/-) mice retained sensitivity to TNF-alpha as demonstrated by equivalent lethality after cytokine injection . These findings establish an essential requirement for CD28 costimulatory signals in TSST-1-induced TSS . The hierarchy of TSST-1 resistance among CD28 wild-type (CD28+/+), CD28 heterozygous (CD28+/-), and CD28-/- mice suggests a gene-dose effect, implying that the levels of T cell surface CD28 expression critically regulate superantigen-mediated costimulation . Finally, as these results demonstrate the primary and non-redundant role of CD28 receptors in the initiation of the in vivo cytokine cascade, they suggest therapeutic approaches for superantigen-mediated immunopathology. J Immunol, 1996 Jun 1, 156(11), 4107 - 13 Inability to produce IL-6 is a functional feature of human germinal center B lymphocytes; Burdin N et al.; In response to Ag encounter, B lymphocytes undergo a complex maturation process yielding phenotypically distinct subpopulations that are located in highly organized compartments of secondary lymphoid organs . This study describes the patterns of cytokine secretion of naive, memory, and germinal center (GC) human tonsillar B lymphocytes, activated either through CD40 or B cell receptor or with Staphylococcus aureus Cowan I particles . The three B cell subpopulations produced comparable levels of IL-10 and TNF-alpha, regardless of the stimulation pathway . Interestingly, activated GC B lymphocytes fail to express IL-6, as determined both at mRNA and at protein levels, whereas both naive and memory B cells can be induced to secrete IL-6 . Likewise, naive B lymphocytes undergoing dual ligation of CD40 and B cell receptor fail to express IL-6, since they acquire a GC-like phenotype . IL-6 receptors are up-regulated on both ex vivo-purified GC B lymphocytes and in vitro generated GC-like B cells, following CD40 activation . Consistent with this, addition of exogenous IL-6 sustains growth of CD40-stimulated GC B lymphocytes . Taken together, these results demonstrate that loss of IL-6 secretion is a functional characteristic of human GC B lymphocytes . The swap from an autocrine to a paracrine IL-6 response may permit a better control of B cell growth and differentiation during the germinal center reaction. Epidemiol Infect, 1996 Jun, 116(3), 319 - 22 Nasal carriage of enterotoxin-producing Staphylococcus aureus among restaurant workers in Kuwait City; al Bustan MA et al.; Enterotoxin-producing Staphylococcus aureus is a common cause of staphylococcal food poisoning . To determine the incidence of carriage of enterotoxin-producing S . aureus in a sample of the healthy population in Kuwait city, restaurant workers in the city were screened for nasal carriage of S . aureus . 26.6% of 500 workers studied carried S . aureus and 86.6% of the S . aureus produced staphylococcal enterotoxins . 28% produced enterotoxin A, 28.5% produced enterotoxin B, 16.4% produced enterotoxin C and 3.5% produced enterotoxin D . Ten isolates produced both enterotoxins A and B or A and C . 73% of the isolates were untypeable with standard phages . However, 17.1%, 3% and 6% belonged to phage groups I, II and III respectively . The results demonstrated a high level of enterotoxigenic S . aureus carriage among restaurant workers which although lower than that reported for the general population and hospital workers may be important in the restaurant industry. World J Surg, 1996 Jun, 20(5), 613 - 7 Tropical pyomyositis; Ansaloni L; Tropical pyomyositis (TP), a suppurative disease caused predominantly by Staphylococcus aureus, is responsible for 3% to 4% of surgical admissions in some hospitals in certain tropical countries . This study describes the clinical features of 35 patients with TP (20 males, 15 females; mean +/- SD age 28.3 +/- 14.1 years) admitted to our hospital during a 1-year period and analyzes the causal association between ancylostomiasis, human immunodeficiency virus (HIV) infection, and TP . Concerning the supposed etiologic association between Ancylostoma duodenale infection and TP, among the 35 patients with TP the stool examination of 22 (62.8%) revealed the presence of eggs of A . duodenale . In a control group of 100 asymptomatic subjects the prevalence of ancylostomiasis was 55% . The Odds ration between the two groups is 1.38 (exact 95% confidence limits = 0.59 < OR < 3.34) . Furthermore, the pus from all TP abscesses (41 in 35 patients) was carefully collected and examined microscopically, but nematode larvae were not detected in any of the specimens . Hence these results do not support an association between ancylostomiasis and TP . With the aim of correlating TP with HIV infection, I carried out a case-control comparison of HIV seroprevalence among the patients affected by TP and an age- and sex-matched control group of healthy subjects . Eleven patients with TP were HIV antibody-positive (seroprevalence 31.42%), as were two controls (seroprevalence 5.71%) . The matched analysis produced a Mantel-Haenszel matched Odds ratio of 5.50 and a maximum likelihood estimate of OR (MLE) of 5.50 (exact 95% confidence limits for MLE: 1.20 < OR < 51.07) . Among the 11 patients HIV-seropositive, 9 (81.8%) fulfilled the World Health Organization clinical case definition (CCD) for AIDS, compared with 1 of 24 (4.1%) HIV-negative subjects . The chi-square test for difference in fulfilling the CCD for AIDS between patients with TP seropositive and seronegative result was statistically significant (p < 0.0001) . It is concluded that TP is a bacterial infection highly significantly associated with HIV infection and thus must be considered a strong sign of stage III-IV of HIV disease. J Bacteriol, 1996 Jun, 178(11), 3362 - 4 Identification and characterization of the pckA gene from Staphylococcus aureus; Scovill WH et al.; The Staphylococcus aureus pckA gene was identified and characterized . A pckA mutant lacked detectable phosphoenolpyruvate carboxykinase activity and grew poorly in the absence of glucose . Both enzymatic activity and pckA promoter activity in wild-type cells grown in the absence of glucose were at least 22-fold greater than activities in cells grown in the presence of glucose. Arthritis Rheum, 1996 Jun, 39(6), 959 - 67 In situ hybridization analysis of synovial and systemic cytokine messenger RNA expression in superantigen-mediated Staphylococcus aureus arthritis; Zhao YX et al.; OBJECTIVE: To investigate patterns of synovial and systemic cytokine messenger RNA (mRNA) expression in mice with superantigen-mediated Staphylococcus aureus arthritis . METHODS: Mice were inoculated intravenously with 1 x 10(7) colony-forming units of toxic shock syndrome toxin-1-producing S aureus LS-1 . Synovial tissues and spleens were obtained at varying time intervals after bacterial inoculation, and examined for mRNA expression of interleukin-1beta (IL-1beta), IL-4, IL-10, IL-12, tumor necrosis factor alpha (TNFalpha), TNFbeta, interferon-gamma (IFN-gamma), transforming growth factor beta, and perforin, by an in situ hybridization technique . RESULTS: In situ hybridization revealed early synovial up-regulation of TNFalpha and IL-1 beta mRNA expression . Peak frequencies of these proinflammatory cytokines were observed at the second and third week of the infection . Expression of T cell-derived cytokine mRNAs was detected later, and in a relatively low frequency . Notably, induction and peak numbers of Th2 cytokine (IL-4 and IL-10) mRNA expression preceded Th1 cytokine (IFNgamma and TNFbeta) mRNAs . In comparison with synovial tissues, peak spleen cytokine mRNA expression of IL-1beta, TNFalpha, TNFbeta, IL-12, and IFNgamma occurred earlier, but displayed a clearly lower magnitude of expression . CONCLUSION: These findings demonstrate synovial and systemic up-regulation of cytokine mRNA expression during S aureus arthritis, indicating that both monocyte/macrophage and T cell-derived products are involved in the pathogenesis of this disease. Ann Otol Rhinol Laryngol, 1996 Jun, 105(6), 476 - 80 Effect of SC-41930, a potent selective leukotriene B4 receptor antagonist, in the guinea pig model of middle ear inflammation; Sutbeyaz Y et al.; Arachidonic acid metabolites such as prostaglandins and leukotrienes have been shown to play an important role in the pathogenesis of otitis media (OM) . Among these mediators, leukotriene B4 (LTB4) is one of the most potent inducers of inflammatory processes . SC-41930 has been shown to be a specific LTB4 receptor antagonist both in vitro and in vivo . In this study, anti-inflammatory effects of SC-41930 were investigated in a guinea pig model of OM induced by middle ear (ME) inoculation of killed Staphylococcus aureus . Outcome of treatment was determined by measurement of myeloperoxidase activity in the samples of ME mucosa, evaluation of temporal bone histopathology, and presence of ME fluids . Myeloperoxidase activity in the SC-41930-treated group was found to be significantly lower than that in the control group . Histopathology of temporal bones indicated decreased inflammation in the treated group as compared to the controls . In addition, ME fluids were absent in four out of six treated animals . These results demonstrate that SC-41930 can produce significant anti-inflammatory effects in this model of OM. J Med Microbiol, 1996 Jun, 44(6), 496 - 9 True identity of control Staphylococcus aureus strains and their performance in the tube coagulase test; Wilcox MH et al.; One hundred laboratories were asked to submit their control Staphylococcus aureus strains to determine the true identity of strains presumed to be S . aureus NCTC 6571, and also to evaluate the performance of those strains being used as controls in the tube coagulase test (TCT) . Of the 60 who replied, 55 laboratories sent at least one strain labelled as S . aureus NCTC 6571 (total of 64 strains) . Of these, 84% were identified as S . aureus, and were indistinguishable from a fresh type strain by a combination of phenotypic methods including biotyping, antibiotic susceptibility testing and phage typing . Six-to-ten strains (9-16%), depending on the degree of stringency, were not identifiable as S . aureus NCTC 6571 . The time since last retrieval from storage ranged from daily to > or = 3 years, but there was no correlation between this duration and the likelihood of differing from S . aureus NCTC 6571 . Forty-seven laboratories submitted 51 strains used as controls in the TCT; these included 31 strains labelled as S . aureus NCTC 6571, eight wild strains, three other NCTC strains and nine strains of uncertain origin . Generally, the S . aureus NCTC 6571 strains produced weaker clots than the remainder . None of the S . aureus NCTC 6571 strains was found to be inoculum dependent but four of the other control strains were . The study demonstrates that some laboratories must improve procedures for ensuring that control S . aureus strains retain their true identity, particularly by avoiding repeated subcultures . Laboratories are divided in their use of strong or weak (S . aureus NCTC 6571) positive controls for the TCT . S . aureus NCTC 6571 is a more stringent control for the TCT than other control strains presently being used and is, therefore, to be preferred. Biochim Biophys Acta, 1996 May 31, 1301(1-2), 127 - 32 Differential effects of glycero- and sphingo-phospholipolysis on human high-density lipoprotein fluidity; Lottin H et al.; This study investigates the effect of enzymatic modifications of the HDL(3) surface lipid composition on their physical properties . Human HDL(3) (d: 1.125-1.21 g/ml) was treated either by an exogenous phospholipase A(2) from Crotalus adamanteus or by a sphingomyelinase from Staphylococcus aureus in the presence of albumin for various periods of time in order to obtain several degrees of hydrolysis . Glycerophospholipid hydrolysis ranged from 13 to 81% and sphingomyelinase action led to a 31-92% sphingophospholipid degradation . Physical properties of the surface of HDL(3) were examined by two spectroscopic methods: fluorescence polarisation and electron spin resonance . Glycerophospholipolysis treatment of HDL(3) enhanced the fluorescence anisotropy values (6-18%) and both relaxation correlation time (30-100%) and degree of order . All these results indicated a more rigid environment, a decreased mobility and an increased order of the surface lipids . Conversely, treatment of the HDL(3) with sphingophospholipase induced a progressive fluidization: fluorescence polarisation and degree of order decreasing down to 10% and relaxation correlation time down to 35% compared to native HDL(3) . Taken together, all these observations suggest the relative importance of the two major phospholipids to modulate the fluidity and order of the surface of HDL(3) and could account for several recent physiological observations. J Am Vet Med Assoc, 1996 May 15, 208(10), 1705 - 8 Use of composite milk samples for diagnosis of Staphylococcus aureus mastitis in dairy cattle; Lam TJ et al.; OBJECTIVE--To measure relative sensitivity and relative specificity for use of composite milk samples, compared with that of individual gland milk samples, for diagnosis of Staphylococcus aureus mastitis . ANIMALS--505 cows suspected of having subclinical mastitis . Of these cows, 172 were considered infected with Sta aureus, based on the results from individual gland samples . PROCEDURE--Composite and individual gland milk samples were collected from cows suspected of having subclinical mastitis, and results of bacteriologic culturing of samples from the same cow were compared . Results were interpreted at the cow level . Relative sensitivity and relative specificity for composite samples were computed from 2 x 2 tables, using results from individual gland samples as references . RESULTS--Relative sensitivity for use of composite milk samples in diagnosing Sta aureus mastitis was 0.63 . The relative specificity was 0.98 . Factors influencing the relative sensitivity for composite samples were the number of infected glands per cow, the amount of Sta aureus shedding from infected glands, and the proportion of the composite milk obtained from each gland . CLINICAL IMPLICATIONS--Collecting composite instead of individual gland milk samples increases the number of false-negative results in diagnosing Sta aureus mastitis . By collecting consecutive samples from the same cow or by increasing the inoculum volume at culturing, this problem can be diminished. J Immunol, 1996 May 15, 156(10), 3932 - 8 Induction of IL-12 p40 messenger RNA expression and IL-12 production of macrophages via CD40-CD40 ligand interaction; Kato T et al.; The mechanism of IL-12 production has been studied by stimulating macrophages or B cell lines with LPS, Staphylococcus aureus, or phorbol diester . However, since IL-12 plays an important role in the activation of T cells interacting with APC, it is important to study the mechanism of IL-12 production induced by T helper cell-APC interaction . We and others have demonstrated that IL-12 is produced in cultures where Th1 cells are stimulated with Ag or APC . In the present experiments, we studied a role of CD40-CD40 ligand (CD40L) interaction in IL-12 production and obtained the following results: 1) incubation of normal Th1 clone with APC in the presence of Ag induced IL-12 p40 and p35 mRNA accumulation and IL-12 production, and the addition of anti-CD40L blocked the p40 mRNA accumulation and IL-12 production but not p35 mRNA accumulation; 2) when Th1 clone from a CD40L-deficient mouse was used in the incubation, p35 mRNA accumulation was induced, but neither p40 mRNA accumulation nor IL-12 production was induced; 3) CD40L+ Th1 clone, or insect cell membrane expressing mouse CD40L, induced p40 mRNA accumulation and IL-12 production but not p35 mRNA accumulation . These results indicate that the CD40-CD40L interaction plays a critical role in IL-12 p40 mRNA accumulation and bioactive IL-12 production and that p35 mRNA accumulation was regulated via a different mechanism than CD40-CD40L interaction . Most of the cells producing IL-12 were Mac-1+ macrophages. Cancer Lett, 1996 May 15, 103(1), 41 - 7 Antitumour activity of protein A in a mouse skin model of two-stage carcinogenesis; Shukla Y et al.; Protein A (PA) is an immunostimulating glycoprotein (mol . wt . 43,000 kDa) obtained from Staphylococcus aureus cowan I . The antitumour property of PA is well documented in the literature in various transplantable tumours of rats and mice . In the present set of investigations, the antitumour property of PA was tested in Swiss albino mice in a two-stage initiation-promotion mouse skin carcinogenesis model . The animals were initiated topically with a single subcarcinogenic dose (52 microgram) of 7,12-dimethylbenzanthracene (DMBA) . PA was administered intraperitoneally (1 microgram/animal), twice weekly for 2 weeks . Promotion was performed by twice weekly applications of 12-O- tetradecanoyl phorbol-13-acetate (TPA) at a dose of 5 microgram/animal for 32 weeks . The result showed that the treatment schedule can effectively check the onset of tumorigenesis, the cumulative number of tumours and the average number of tumours per mouse . In the PA administered group, 30% of the animals remained tumour free until the termination of the experiments (i.e . 32 weeks of promotion) . Thus the present study proves that protein A can effectively inhibit DMBA initiated and TPA promoted mouse skin carcinogenesis. J Biol Chem, 1996 May 3, 271(18), 10853 - 8 Molecular expression of the alpha-chemokine rabbit GRO in Escherichia coli and characterization of its production by lung cells in vitro and in vivo; Johnson MC 2nd et al.; GRO proteins are alpha-chemokine cytokines that attract neutrophils and stimulate the growth of a variety of cells . Previously, we observed that rabbit alveolar macrophages transcribe the genes for at least two GRO homologues . In order to study the role of GRO cytokines in lung inflammation, we cloned the predominant rabbit GRO cDNA (RabGRO) from alveolar macrophages, expressed bioactive recombinant protein (rRabGRO) in Escherichia coli, and developed a sensitive and specific enzyme-linked immunosorbent assay for RabGRO protein . We found that rabbit AM express and secrete GRO in vitro in response to both exogenous (e.g . lipopolysaccharide, heat-killed Staphylococcus aureus, and crystalline silica) and endogenous inflammatory stimuli (e.g . tumor necrosis factor-alpha) as determined by both radioimmunoprecipitation and enzyme-linked immunosorbent assay . Biologically significant amounts of GRO are present in vivo in the bronchoalveolar lavage fluid of rabbits with E . coli pneumonia; by in situ hybridization, GRO mRNA is detectable in infiltrating pulmonary leukocytes and bronchial epithelial cells . These results indicate that GRO chemokines are likely to be important mediators of the inflammatory response that accompanies acute infectious processes in the lungs. Antibiot Khimioter, 1996 May, 41(5), 13 - 8 {Absorption of various actinomycins by Staphylococcus aureus cells}; Polin AN et al.; The absorption of actinomycin D by the cell suspension of Staphylococcus aureus via diffusion linearly depended on the antibiotic concentration in the suspension within the ranges of 2 to 15 micrograms/ml . The absorption of active actinomycins C2, C3 and Au6 was the same as that of actinomycin D . The Staphylococcus intact membranes limited the inlet of the actinomycins to the cells since the membranotropic substances such as gramicidin S and its derivatives and thyrocidin increased their absorption by 30-70 per cent . The absorption of a low active actinomycin D0 and inactive actinomycinic acid even after the exposure to the membranotropic substances was not detectable . These compounds did not form any complexes with DNA . The level of the absorption of the actinomycins by the cells was likely defined by their ability to complex with DNA. J Nucl Med, 1996 May, 37(5), 863 - 8 Functional upregulation of granulocytes labeled with technetium-99m-HMPAO and indium-111-oxinate; Bertrand-Caix J et al.; Indium-111-oxinate-labeled granulocytes have been used in vivo for several years for the detection of abscesses . Technetium-99-m-hexamethylpropyleneamine oxime (99mTc-HMPAO) labeling has more recently been described . METHODS: The influence of radiolabeling by both radiotracers on adhesion glycoprotein CD11b quantification was studied in quiescent and formyl-methionylleucylphenylalanine (fMLP)-activated neutrophils (PMN) . Adhesion was assessed on human umbilical endothelial cells (HUVEC) as well as the repercussion of the granulocyte labeling on HUVEC viability (neutral red) and metabolic activity (MTT) . Chemotaxis of PMN was evaluated by measuring migration under agarose with fMLP as chemoattractant . We also measured phagocytosis and the production of hydrogen peroxide induced by staphylococcus aureus . RESULTS: Whereas whole functional integrity is maintained after labeling, most of the functions (CD11b expression, adhesion, HUVEC metabolic activity) are up-regulated while chemotaxis is decreased in the presence of both radiotracers . Indium-111-oxinate induces larger alterations than 99mTc-HMPAO . CONCLUSION: These data were obtained in normal volunteers . In patients, alterations due to the in vitro labeling procedure, in addition to potential functional alterations caused by the underlying pathology, should be taken into account during image interpretation. Head Neck, 1996 May-Jun, 18(3), 292 - 4 Wide reconstruction of the anterior cranial base with bipedicled galeopericranial flap; Terashi H et al.; BACKGROUND . Reconstruction of facial bone fractures complicated by frontal sinus destruction must seal off the cranial cavity from the upper respiratory tract to avoid ascending infections of the intracranial contents . METHODS . We used a bipedicled galeopericranial flap for reconstruction of the extradural and subcutaneous spaces of the frontal region, which were infected with methicillin-resistant Staphylococcus aureus (MRSA) following unsuccessful coverage of the anterior cranial base with an anteriorly based pericranial flap . RESULTS . The patient healed uneventfully without infection . CONCLUSION . Because a bipedicled galeopericranial flap has abundant blood supply, it can be used to cover a wide segment of the anterior cranial base . This is the first report of the application of a bipedicled galeopericranial flap for wide reconstruction of the anterior cranial base. Curr Microbiol, 1996 May, 32(5), 286 - 90 A phage-mediated transfer of chromosomally integrated tetracycline resistance plasmid in Staphylococcus aureus; Udo EE et al.; The ability of a Staphylococcus aureus isolate WBG7416 to transfer its resistance determinants was studied in conjugation and mixed-culture transfer experiments . It carried plasmid-borne resistance to kanamycin, trimethoprim, chloramphenicol, cadmium, propamidine isethionate, and chromosomal resistance to methicillin, gentamicin, streptomycin, erythromycin, clindamycin, tetracycline, and minocycline . It transferred tetracycline resistance in mixed-culture transfer but not in conjugation experiments . DNA-DNA hybridization of genomic DNA from the tetracycline-resistant transferrants against a labeled tetracycline resistance plasmid, pWBG3, probe revealed the presence of an integrated plasmid in their chromosomes . In contrast, no homology to the probe was detected in the chromosome of a tetracycline-resistant mutant of the recipient strain . The results established a role for a bacteriophage in the transfer of chromosomal tetracycline resistance in WBG7416 besides demonstrating the presence of an integrated tetracycline resistance plasmid in the transferrants . It also offered an insight into the nature of the integrated plasmid. Plasmid, 1996 May, 35(3), 174 - 88 Characterization of a Staphylococcus aureus transposon, Tn5405, located within Tn5404 and carrying the aminoglycoside resistance genes, aphA-3 and aadE; Derbise A et al.; A new staphylococcal composite transposon, designated Tn5405, carrying the genes aphA-3 and aadE, which encode resistance to aminoglycosides, was partially characterized . The transposon is 12 kb long and is flanked by inverted repeated sequences displaying the characteristic features of an insertion sequence, named IS1182 . This insertion sequence is 1864 bp long and has 23/33-bp imperfect inverted repeats at its ends . One of the IS1182 copies delimiting Tn5405 contains a copy of IS1181 flanked by 8-bp direct repeats . Tn5405 was found in the chromosome of MRSA clinical isolate BM3121, within a Tn552-related transposon, Tn5404 . Tn5404 was previously characterized following its transposition onto a beta-lactamase plasmid harbored by BM3121 . Two forms of the recombinant beta-lactamase-encoding plasmid generated by the inversion of Tn5405 within Tn5404 were detected . IS1182 was not detected in the DNA of 4 of the 17 tested MRSA isolates containing aphA-3 and resistant to streptomycin . Thus, aphA-3 and aadE genes are not disseminated only by Tn5405 or related transposons delimited by IS1182. FEMS Immunol Med Microbiol, 1996 May, 14(1), 45 - 51 Intramammary immunization with live-attenuated Staphylococcus aureus: microbiological and immunological studies in a mouse mastitis model; Garcia V et al.; Mammary infection was induced in lactating mice by intramammary injection of Staphylococcus aureus . Histopathological analysis revealed infiltration and lesions of varying magnitude that were still apparent 21 days after the challenge . Concomitantly, viable S . aureus was recovered from infected mammary glands . Mice were immunized by the intramammary route with 5 x 10(6) colony forming units of a temperature-sensitive mutant of S . aureus and subsequently received a boosting injection seven days later . On day 14 mice were challenged by the intramammary route with the wild-type strain . Intramammary immunization induced a significant increase in milk IgA (P < 0.05), serum IgG (P < 0.05) and serum IgA (P < 0.05) on the day of the challenge, when compared with non-immunized mice . Immunization decreased significantly (P < 0.01) the number of S . aureus colony forming units recovered 96 h after intramammary challenge . In conclusion, the feasibility of immunizing locally with temperature-sensitive S . aureus to induce immunity in the mouse mammary gland was demonstrated . The mouse model of mastitis is proposed as a useful system for screening temperature-sensitive S . aureus strains to be utilized in the development of a vaccine. Ger J Ophthalmol, 1996 May, 5(3), 176 - 81 Oculomucocutaneous changes as paraneoplastic syndromes; Kreutzer B et al.; Bullous dermatoses such as erythema exsudativum multiform major (EEMM) and bullous pemphigoid can lead to severe ocular involvement . In rare cases, both diseases develop as paraneoplastic syndromes . The immunopathologic mechanisms are discussed . A 69-year-old woman with non-Hodgkin's lymphoma (NHL) of grade IIIb developed EEMM while under systemic treatment with Fluconazole, Ofloxacin, and/or a combination of sulfamethoxazole and trimethoprim after polychemotherapy . In the eye, conjunctival necrosis with sicca syndrome led to Staphylococcus aureus-induced corneal superinfection, perforation, and consecutive keratoplasty a chaud . The patient died 6 weeks after the first presentation . A 44-year-old man with NHL of grade IVa after polychemotherapy developed a bullous pemphigoid affecting the skin, mucous membranes, and both eyes while under systemic treatment with sulfamethoxazole and trimethoprim . Although the underlying malignancy responded well to chemotherapy, the ocular manifestations of the paraneoplastic systemic syndrome slowed down only on treatment with cyclosporin A but not following therapy with azathioprine and cyclophosphamide . Therapy could not stop cicatrization and keratinization of the conjunctiva and cornea . An occult malignancy should be excluded in acute and chronic oculomucocutaneous syndromes . The prognosis for the eye seems to be poor because of the rapid course and the ineffectiveness of therapy as demonstrated in the present cases. Acta Derm Venereol, 1996 May, 76(3), 214 - 8 Preferential expression of T-cell receptor V beta-chains in atopic eczema; Neuber K et al.; Chronic skin colonization with Staphylococcus aureus is a characteristic feature of atopic eczema, and about 60% of S . aureus strains isolated from the skin of patients with atopic eczema secrete enterotoxins . T-cell stimulation by staphylococcal enterotoxins is restricted to the V beta-chain of the T-cell receptor . Therefore, the expression of different V beta-chains (V beta 3, 5 a,b,c, 6, 8, 12) on peripheral blood T-cells (CD4+) from patients with atopic eczema was measured by flowcytometry before and after stimulation with staphylococcal enterotoxin B . Lymphocytes from healthy donors served as controls . Additionally, the expression of V beta-chains in normal skin and in lesional skin of patients with atopic eczema was determined by immunofluorescence histology . In atopic eczema, higher numbers of CD4+ T-cells expressed V beta 3, V beta 8 and V beta 12 compared to the control group . No correlation between S . aureus enterotoxin B-stimulated V beta-expression and HLA-haplotypes was found . In lesional skin of patients with atopic eczema most of the infiltrating T-cells were V beta 3+, whereas in normal skin only very few T-cell receptor-expressing cells were detected . To evaluate the significance of these T-cell clones for allergic inflammation, T-cells from patients with atopic eczema and normal donors were stimulated with monoclonal antibodies against V beta 3, 5(c) and 8 . Afterwards, the proliferative response of lymphocytes as well as IL-5 and IFN gamma synthesis were measured . T-cells from patients with atopic eczema showed a significantly higher proliferation and IL-5 secretion than normal donors after stimulation with monoclonal antibodies against V beta 3 and V beta 8 . In contrast, the monoclonal antibodies directed to V beta 5(c) induced a markedly elevated proliferation and IFN gamma production of normal lymphocytes compared to patients with atopic eczema . Our results suggest a preferential expression of certain V beta-subgroups during inflammation in atopic eczema; this may be explained by a selective stimulation of TH2-cells via S . aureus-derived enterotoxins. Vet Immunol Immunopathol, 1996 May, 51(1-2), 67 - 78 Effects of in vitro supplementation with alpha-tocopherol and selenium on bovine neutrophil functions: implications for resistance to mastitis; Ndiweni N et al.; A low vitamin E/selenium status has been associated with increased vulnerability of dairy cattle to mastitis . Since polymorphonuclear leucocytes (PMN) provide the major cellular defence mechanism within the mammary gland, the effect of in vitro supplementation with vitamin E and selenium on the function of these cells was investigated . Both vitamin E and selenium enhanced the chemotactic and random migration of PMN and increased the production of superoxide following stimulation with phorbol myristate acetate . Vitamin E, but not sodium selenite, was also found to enhance the phagocytosis of opsonised Staphylococcus aureus by PMN . No synergistic effects of the two nutrients were observed . These results obtained in vitro may indicate the potential benefits of in vivo supplementation of dairy cows with vitamin E and selenium in terms of enhancing their natural resistance to mastitis. Harefuah, 1996 May 1, 130(9), 602 - 3, 655 {Purulent pericarditis}; Evron E et al.; Purulent pericarditis is diagnosed when pus is drained from the pericardial space or when bacteria are cultured from the pericardial fluid . This rare disease is often diagnosed late, when severe hemodynamic compromise develops due to pericardial tamponade . It is usually a complication of pneumonia, especially if there is empyema as well, and often follows chest surgery or chest wall infections . It sometimes appears in patients with septicemia, especially when they are debilitated or immuno-compromised . Diagnosis is aided by echocardiography . Pericardiocentesis and drainage of the pus, as well as prolonged antibiotic treatment, are mandatory . Delay in diagnosis and treatment often results in death . Some surviving patients may develop constrictive pericarditis and require pericardiectomy . We report a 73-year-old man with pulmonary lymphoma who suffered from purulent pericarditis secondary to sepsis with methicillin-resistant Staphylococcus aureus . Pericardial drainage and appropriate antibiotic treatment eventually resulted in complete recovery. J Dairy Sci, 1996 May, 79(5), 846 - 50 A method for measuring specific antibodies in bovine lacteal secretions during the nonlactating period; Guidry AJ et al.; A large portion of new IMI in dairy cattle occurs during the nonlactating period . Because antibiotic infusions at the beginning of the nonlactating period are only partially effective, attempts have been made to stimulate the production of protective antibodies in lacteal secretions during this period . However, measurement of antibodies in mammary secretions during the nonlactating period has been hampered by the complex, viscous nature of these secretions . This report describes the use of caprylic acid to clarify secretions from the bovine mammary gland during the nonlactating period to provide a more accurate measurement of specific antibody . Six healthy Jersey cows were injected in the area of the supramammary lymph node with an encapsulated strain of Staphylococcus aureus in dextran sulfate at the beginning of the nonlactating period and 15 and 30 d later . Seven healthy unimmunized Jersey cows served as controls . Lacteal secretions taken at the beginning of the nonlactating period; at 15, 30, and 45 d into the nonlactating period; and at calving were treated with caprylic acid prior to assay for specific antibodies using ELISA . Purified S . aureus capsule was used as the antigen in the ELISA . Caprylic acid lowered non-specific binding of IgG1 and IgM in secretions during the dry period from unimmunized control cows and lowered IgM from immunized cows . The most pronounced effect of caprylic acid was an increase in IgG2 binding in secretions from immunized cows . Treatment with caprylic acid more accurately measured specific activity of Ig in mammary secretions during the nonlactating period. Zh Mikrobiol Epidemiol Immunobiol, 1996 May-Jun, (3), 74 - 7 {The role of the persistent characteristics of a causative agent in determining the protracted course of a suppurative-inflammatory course}; Deriabin DB et al.; An important role of the complex of biological properties of Staphylococcus aureus, including anticomplementary and antilysozyme activity, capacity for the inactivation of the bactericidal component of interferon and the Fc-reception of immunoglobins, in the prolonged character of the purulent inflammatory process induced by this infective agent . The system permitting the prognosis of the unfavorable course of post-injection abscesses, based on the analysis of known informative properties of the infective agent, was developed with the use of the heterogeneous consecutive procedure of sample recognition. Z Orthop Ihre Grenzgeb, 1996 May-Jun, 134(3), 273 - 82 {Outbreak of infection with methicillin-resistant Staphylococcus aureus (MRSA) in an orthopedic septic care unit--measures for eradication and subsequent colonization studies}; Fruhauf G et al.; An outbreak due to a methicillin-resistant S . aureus (MRSA) strain in an orthopaedic septic care unit was observed . 17 patients developed wound infections . Stronger regime of hygiene and chemotherapy and new technics of operations controlled the outbreak within 5 months . Studies of colonisation were performed at the care unit in march, june and august 1992 . 618 isolates were investigated from patients, personnel and their environment . The frequencies of detected MRSA diminished from 30% in march only to 22% in august 1992 . The long time persistence of endemic MRSA in a care facility was evident from the presence of MRSA even 5 months after the last infection. Res Microbiol, 1996 May, 147(4), 279 - 86 Anionic properties of beta-lactam-enhancing factor on methicillin-resistant Staphylococcus aureus; Tajima Y et al.; We found a Factor (factor T) in aged mixtures of tungstate and phosphate which greatly enhanced the antibacterial effects of beta-lactams upon methicillin-resistant Staphylococcus aureus (MRSA) . Factor T suppressed penicillinase production and the amount of penicillin-binding protein-2' in the membrane fraction, thus sensitizing MRSA strains to beta-lactams . In addition, Factor T caused a metachromatic reaction and prolonged the blood coagulation time, indicating that it is a heparin-like polyanion . Since Factor T becomes ineffective in the presence of a polycation, a charge interaction may play an important role in the enhancing effect . One possibility is that Factor T non-specifically inhibits several anion-sensitive enzymes . Factor T inhibited several nucleotide-interacting enzymes, but not most serum enzymes. Res Microbiol, 1996 May, 147(4), 263 - 71 Phenotypic and genotypic (pulsed-field gel electrophoresis) characteristics of enterotoxin-A-producing Staphylococcus aureus strains; Gouloumes C et al.; The phenotypic (antibiotype, serotype, phagetype) and genotypic (SmaI restriction patterns using pulsed-field gel electrophoresis) characters of 162 Staphylococcus aureus epidemiologically unrelated strains were studied . Eighty-two of the isolates produced enterotoxin-A (SEA+), while 80 produced none (SEA-) . None of the phenotypic characters observed were characteristic of SEA+ strains . On the other hand, the electrophoretic profiles revealed a non-random distribution of the SEA+ strains (p < 0.01 in groups PI and PIII, and p < 0.03 in group PII) . It can therefore reasonably be assumed that the enterotoxin-A-producing strains did not constitute a single clone, but rather, seemed to belong to strains derived from at least three clones with distinct genetic organization. Trans R Soc Trop Med Hyg, 1996 May-Jun, 90(3), 280 - 3 Pyogenic liver abscesses and acute schistosomiasis mansoni: report on 3 cases and experimental study; Teixeira R et al.; Three children with acute schistosomiasis mansoni developed pyogenic liver abscesses . The abscesses were diagnosed by ultrasonography and confirmed during laparotomy . Staphylococcus aureus were the sole bacteria isolated from the abscesses . An experimental study was carried out in mice to establish whether schistosomiasis is a predisposing cause for pyogenic liver abscesses . Seventeen mice (group 1) were infected with 40 Schistosoma mansoni cercariae (LE strain) and 60 d later inoculated intravenously with a strain of Staph . aureus, isolated from a patient with bacteraemia; 17 mice infected with Sch . mansoni (group 2), 19 infected with bacteria alone (group 3), and 18 uninfected mice (group 4), served as controls . Thirteen group 1 mice (77%) developed multiple liver abscesses while none was observed in the controls . These results indicate that acute schistosomiasis mansoni concurrent with Staph . aureus bacteraemia favours the colonization of the liver by bacteria and the development of pyogenic hepatic abscesses. Jpn J Antibiot, 1996 May, 49(5), 517 - 21 {Transferability of cefozopran to cerebrospinal fluid in rabbits with meningitis caused by Staphylococcus aureus}; Haruta T et al.; The transferability of cefozopran (CZOP) to cerebrospinal fluid (CSF) was studied employing rabbits with experimental meningitis caused by Staphylococcus aureus . The mean plasma concentration was 293 +/- 17.6 micrograms/ml at 15 minutes after intravenous administration of CZOP at a dose level of 100 mg/kg . The mean concentration in CSF reached its maximum, 16.5 +/- 2.74 micrograms/ml at 60 minutes after administration . Pharmacokinetic parameters calculated from these values were as follows: Cmax (CSF/plasma) 5.72%, AUC (CSF/plasma) 6.61% between 15 and 60 minutes, 9.38% between 15 and 120 minutes and 11.2% between 15 and 180 minutes, T 1/2 for CZOP in CSF: 138 minutes, T 1/2 (CSF/plasma): 2.81 . In comparison to those of beta-lactams that were obtained in the same way, the transferability of CZOP to CSF was moderate but concentration in CSF was high, hence, in consideration of the antimicrobial potency against the main pathogens of meningitis, it appears worthwhile of running clinical trials for CZOP. Reg Anesth, 1996 May-Jun, 21(3), 239 - 42 Bactericidal activity of clinically used local anesthetics on Staphylococcus aureus; Sakuragi T et al.; BACKGROUND AND OBJECTIVES . The rate of onset of antimicrobial activity of local anesthetics is unknown . Similarly, whether the activity is bactericidal or bacteriostatic is also unknown . The antimicrobial activity of local anesthetics with preservatives has not been studied . This study investigated the rate and potency of the antimicrobial activity of 0.125%, 0.25%, and 0.5% bupivacaine, 2.0% mepivacaine and 2.0% lidocaine with preservatives, and 2.0% lidocaine without preservatives on two strains of methicillin-resistant Staphylococcus aureus . METHODS . The pathogen was exposed to each local anesthetic for 1, 3, 6, 12, and 24 hours at room temperature . The inocula from these suspensions were diluted to 1:1,000 with physiological saline to inactivate the antimicrobial activity of the local anesthetics and then were cultured for 24 hours at 37 degrees C on agar plates . RESULTS . Lower colony counts were observed with a 3-hour or longer exposure to 0.5% bupivacaine in both strains of S . aureus (P < .05) . The 3-hour exposure reduced the count by approximately 60%, the 6-hour exposure by 70%, and the 24-hour exposure by more than 99% . The bactericidal activity was lowest with 0.125% bupivacaine and 2.0% mepivacaine . CONCLUSIONS . Antimicrobial activity was observed shortly after exposure of S . aureus to local anesthetics and appeared to be bactericidal rather than bacteriostatic . However, the observed bactericidal activity, although it developed rapidly, may be insufficient to account for the low incidence of epidural infection related to epidural cannulation. Biol Pharm Bull, 1996 May, 19(5), 672 - 7 Proteolysis of human tumor necrosis factor (TNF) by endo- and exopeptidases: process of proteolysis and formation of active fragments; Nakamura K et al.; Recombinant human tumor necrosis factor (TNF) was digested with endopeptidases under mild conditions . Incubation of the TNF (155-amino-acid TNF) with trypsin, Staphylococcus aureus V-8 protease or chymotrypsin initially released small peptides derived from the amino (N)-terminal region of TNF, but did not release peptides from the carboxyl (C)-terminal region . The TNF was resistant to carboxypeptidases A and Y under a non-denaturing condition, but in the presence of urea or sodium dodecyl sulfate the C-terminal amino acid was released quantitatively by these peptidases . These results indicate that the N-terminal region of the TNF molecule is accessible to protease, while the C-terminal region is not susceptible to degradation . When the TNF was incubated with seven kinds of endopeptidases, its activity rapidly disappeared . At an early stage of the degradation, one active fragment was detected among the fragments produced with trypsin or pronase P, but no active fragments were detected on the degradation with the other peptidases . The active fragment was a fragment lacking the four N-terminal amino acid residues of the TNF . These results suggest that TNF is initially degraded at the N-terminal region by an endopeptidase and loses its activity as the degradation proceeds. J Hosp Infect, 1996 May, 33(1), 49 - 53 Consecutive isolation of homologous strains of methicillin-resistant and methicillin-susceptible Staphylococcus aureus from a hospitalized child; Lawrence C et al.; A multiply resistant, methicillin-resistant Staphylococcus aureus was repeatedly isolated from the anterior nares of a premature neonate hospitalized in an intensive-care unit and treated with multiple courses of antibiotics . Two months following cessation of antibiotic therapy, a strain of S . aureus with a similar antibiotic resistance profile, but susceptible to methicillin, was isolated from three consecutive nasal swabs . Total DNA of the methicillin-susceptible and -resistant isolates was digested with SmaI and resolved by pulsed-field gel electrophoresis . The SmaI restriction profile of the susceptible isolate was similar to that of the resistant one except for the replacement of a 207-kb fragment by a 147-kb fragment . In Southern hybridization, a mecA-specific probe hybridized to the 207-kb SmaI fragment of the methicillin-resistant strain but not to DNA of the susceptible strain . These results suggest that loss of the mecA gene can occur in vivo when antibiotic selective pressure is removed. Nucl Med Commun, 1996 May, 17(5), 430 - 4 Accumulation of 99Tcm-polyclonal immunoglobulin in different stages of infection: an experimental study; Burak Z et al.; In this experimental study, the utility of 99Tc(m)-polyclonal human immunoglobulin (99Tcm-HIG) for localizing acute and chronic phases of inflammatory lesions was investigated . Three groups of rats were inoculated with Staphylococcus aureus in the right thigh . Then, 24 h (group I, n = 12), 48 h (group II, n = 12) and 72 h (group III, n = 12) post-inoculation, the rats received 40 MBq 99Tcm-HIG into the jugular vein . In addition, two control rats were studied at 24 h after inoculation of sterile saline . Both visual and quantitative evaluations were undertaken . The acute and chronic stages of inflammation were determined by pathological examination . The mean ( +/- S.D.) lesion/contralateral uptake ratios at 4 and 24 h after 99Tcm-HIG injection were: group I, 1.22 +/- 0.1 and 2.12 +/- 0.16; group II, 1.15 +/- 0.08 and 2.25 +/- 0.16; group III, 1.06 +/- 0.09 and 2.08 +/- 0.14 . In conclusion, the acute and chronic phases of infection showed non-significant differences in 99Tcm-HIG uptake ratios. Br J Dermatol, 1996 May, 134(5), 962 - 5 Staphylococcal scalded skin syndrome in an HIV-1 seropositive man; Farrell AM et al.; The staphylococcal scalded skin syndrome (SSSS) is very rare in adults . Renal impairment and immunocompromise are predisposing causes . We report a 38-year-old HIV-1 seropositive intravenous drug abuser who developed SSSS due to staphylococcal pneumonia . An exfoliating toxin-releasing Staphylococcus aureus, phage type II type 3C, was isolated from the sputum and from blood cultures . This is the third case of adult SSSS to be reported in the context of HIV disease. J Clin Immunol, 1996 May, 16(3), 171 - 9 The effects of retinoic acid on immunoglobulin synthesis: role of interleukin 6; Ballow M et al.; Retinoic acid (RA) and its parent compound, retinol (ROH, vitamin A), have been recognized as important immunopotentiating agents . Previous studies from our laboratory have demonstrated that RA can augment formalin-treated Staphylococcus aureus (SAC)-stimulated immunoglobulin (Ig) synthesis of cord blood mononuclear cells (CBMC) . To determine the mechanism(s) by which RA modulates Ig synthesis, we studied the effects of RA on B cells and cytokine production . The addition of RA (10(-5) to 10(-10) M) to Epstein-Barr virus (EBV)-transformed B-cell clones derived from either adult or cord blood B cells augmented Ig secretion twofold . In contrast, cell proliferation was inhibited as measured by 3H-thymidine incorporation . We evaluated two cytokines known to be constitutively produced by EBV cell lines, IL-1 and IL-6 . While RA had no effect on IL-1 production, IL-6 synthesis was greatly enhanced (20- to 45-fold), which was also reflected by an increase in steady-state mRNA levels for IL-6 but not TNF-alpha or TGF-beta on Northern blot analysis . Polyclonal rabbit anti-IL-6 antibodies were used to block the augmenting effects of RA on Ig synthesis of adenoidal B cells . RA-induced augmentation in IgG and IgA synthesis was blocked 58 and 29%, respectively, by anti-IL-6 antibodies . These studies suggest that the enhancing effects of RA on Ig synthesis are mediated, at least in part, by the autocrine or paracrine effects of IL-6 on B-cell differentiation. Pediatr Res, 1996 May, 39(5), 835 - 42 Granulocyte functions in children with cancer are differentially sensitive to the toxic effect of chemotherapy; Lejeune M et al.; To analyze the toxicity associated to chemotherapy upon granulocytes, different functional assays were performed, within days of drug exposure and at time of bone marrow recovery, on polymorphonuclear neutrophils (PMN) from children with cancer . There were no significant postchemotherapy changes in the expression of the different receptors studied nor in the phagocytosis of Staphylococcus aureus 42D . By contrast, a significant decrease was observed in H2O2 production in PMN recently exposed to chemotherapy with both cytofluorometric and chemiluminescence assays . There was also a decrease in the production of O2- and in chemotaxis; finally, the intracellular killing of S . aureus 42D and Escherichia coli was reduced . In patients having recovered from drug-induced bone marrow aplasia, PMN functions were found to be normal except for bactericidal activity which was still defective . The observations indicate that, in patients exposed to chemotherapy, some PMN functions are transiently altered, whereas microorganism cell killing is continuously impaired. Can J Anaesth, 1996 May, 43(5 Pt 1), 471 - 4 Bacterial meningitis and cauda equina syndrome after epidural steroid injections; Cooper AB et al.; PURPOSE: To describe a rare adverse outcome resulting from lumbar epidural steroid injections for the treatment of chronic lower back pain . CLINICAL FEATURES: We report a case of staphylococcus aureus meningitis and cauda equina syndrome following a series of epidural steroid injections for chronic back pain . Although rare, bacterial meningitis following epidural analgesia has been reported, but epidural steroid injections have not been associated with either bacterial meningitis or cauda equina syndrome . The causal relationship between epidural steroid injections, bacterial meningitis, and cauda equina syndrome is discussed . CONCLUSION: A through pre-procedure assessment with attention to the neurologic examination and signs/symptoms of infection is essential. Antimicrob Agents Chemother, 1996 May, 40(5), 1308 - 10 Treatment of Staphylococcus aureus catheter-related infection and infective endocarditis with granulocyte colony-stimulating factor in the experimental rabbit model; Frank U et al.; The role of granulocyte colony-stimulating factor with and without antibiotics in the treatment of catheter-related infection and infective endocarditis caused by methicillin-susceptible Staphylococcus aureus was assessed in the experimental rabbit model . Granulocyte colony-stimulating factor stimulated leukocytosis in infected animals but did not increase the clearance of methicillin-susceptible S . aureus from peripheral blood, subcutaneous port catheters, intravascular cardiac catheters, or aortic valve vegetations. Antimicrob Agents Chemother, 1996 May, 40(5), 1301 - 3 50S ribosomal subunit synthesis and translation are equivalent targets for erythromycin inhibition in Staphylococcus aureus; Champney WS et al.; Macrolide antibiotics like erythromycin can prevent the formation of the 50S ribosomal subunit in growing bacterial cells, in addition to their inhibitory effect on translation . The significance of this novel finding has been further investigated . The 50% inhibitory doses of erythromycin for the inhibition of translation and 50S subunit assembly in Staphylococcus aureus cells were measured and were found to be identical . Together they account quantitatively for the observed effects of erythromycin on cell growth rates . There is also a direct relationship between the loss of rRNA from the 50S subunit and its accumulation as oligoribonucleotides in cells . The importance of this second site for erythromycin inhibition of bacterial cell growth is discussed. Antimicrob Agents Chemother, 1996 May, 40(5), 1219 - 24 Importance of penicillinase production for activity of penicillin alone or in combination with sulbactam in experimental endocarditis due to methicillin-resistant Staphylococcus aureus; Fantin B et al.; The activity of penicillin, alone and in combination with sulbactam, against a heterogeneously methicillin-resistant, penicillinase-producing clinical isolate of Staphylococcus aureus and its penicillinase-negative derivative was investigated in vitro and in a rabbit experimental endocarditis model . Penicillin was significantly more effective than vancomycin against the penicillinase-negative derivative in vivo (P < 0.001), and it sterilized 25% of the vegetations . The combination of penicillin and sulbactam exhibited an in vivo synergistic effect on the penicillinase-producing strain (P < 0.01) but did not produce any advantage over treatment with vancomycin, even when a high dose of sulbactam was used (100 mg/kg of body weight every 6 h) . This combination was significantly less effective against the penicillinase-producing strain than was penicillin alone against the penicillinase-negative derivative (P < 0.03) . In addition, the most resistant subpopulation of the surviving bacteria, which grew on agar containing 16 micrograms of methicillin per ml, was detected in 5 of 6 animals treated with penicillin and a high dose of sulbactam against the penicillinase-producing strain compared with only 1 of 12 animals treated with penicillin alone against the penicillinase-negative derivative (P < 0.01) . We conclude that penicillin is highly effective against penicillinase-negative methicillin-resistant S . aureus and that penicillinase production, rather than methicillin resistance, appears to be the limiting factor for the activity of the penicillin-sulbactam combination against penicillinase-producing, methicillin-resistant S . aureus. Antimicrob Agents Chemother, 1996 May, 40(5), 1157 - 63 Alterations in the DNA topoisomerase IV grlA gene responsible for quinolone resistance in Staphylococcus aureus; Yamagishi J et al.; A 4.2-kb DNA fragment conferring quinolone resistance was cloned from a quinolone-resistant clinical isolate of Staphylococcus aureus and was shown to possess a part of the grlB gene and a mutated grlA gene . S-80-->F and E-84-->K mutations in the grlA gene product were responsible for the quinolone resistance . The mutated grlA genes responsible for quinolone resistance were dominant over the wild-type allele, irrespective of gene dosage in a transformation experiment with the grlA gene alone . However, dominance by mutated grlA genes depended on gene dosage when bacteria were transformed with the grlA and grlB genes in combination . Quinolone-resistant gyrA mutants were easily isolated from a strain, S . aureus RN4220, carrying a plasmid with the mutated grlA gene, though this was not the case for other S . aureus strains lacking the plasmid . The elimination of this plasmid from such quinolone-resistant gyrA mutants resulted in marked increases in quinolone susceptibility . These results suggest that both DNA gyrase and DNA topoisomerase IV may be targets of quinolones and that the quinolone susceptibility of organisms may be determined by which of these enzymes is most quinolone sensitive. Kansenshogaku Zasshi, 1996 May, 70(5), 490 - 5 {Two cases of gram-positive sepsis successfully treated with vancomycin in combination with imipenem or cilastatin}; Sakamoto M et al.; Against gram-positive sepsis, vancomycin (VCM) was administered in combination with imipenem or cilastatin (IPM/CS) . Its excellent efficacy was confirmed in 2 cases, one affected with methicillin resistant Staphylococcus aureus and another with Gemella morbillorum . By calculating the FIC index according to a checkerboard technique, the in vitro synergistic effect was also demonstrated . At the present state multi-drug resistant gram-positive infections prevailed, the combination of VCM with IPM/CS can be expected as an effective measure for treating these diseases. Vet Med (Praha), 1996 May, 41(5), 149 - 53 Survival of model bacterial strains and helminth eggs in the course of mesophilic anaerobic digestion of pig slurry; Juris P et al.; The effect of methanogenesis on the survival of model bacterial strains (Escherichia coli EC 5, Staphylococcus aureus SA 11, Enterococcus faecium CCM 4231) and non-embryonated helminth eggs (Ascaris suum) was investigated in pig slurry . Two pilot-plant experiments were carried out in two anaerobic digesters (800 and 1,000 litre) in a mesophilic thermal range (35-37 degrees C) . The mean hydraulic retention time of the digesters was 20 days . The methanogenesis process was monitored by determining the following chemical parameters: pH, N-NH3, total dry matter (kg/day), organic matter (kg/day) production of methane by supplied and degraded organic matter (m3/kg) . The results obtained allow us to state that the anaerobic stabilization of pig slurry in the mesophilic temperature range resulted in total devitalization of model bacterial strains E . coli EC 5 and Ent . faecium CCM 4231 . St . aureus SA 11 cells, exposed to the above mentioned conditions, were also reduced in their number from 10.04 to 3.27 and from 8.69 to 2.77 log cfu/ml . It is assumed that the longer retention time of excrements in the digester could also result in total devitalization of St . aureus SA 11 cells . From the microbiological point of view, the above mentioned facts indicate a sufficient hygienization effect of the anaerobic fermentation on the contaminated pig excrements . The survival of A . suum eggs was little affected by the 20-day anaerobic mesophilic digestion of pig slurry . Only 17 or 18% (F1, F2) of the non-embryonated A . suum eggs were damaged after the 20-day exposure. Pflugers Arch, 1996 May, 432(1), 66 - 74 Thermosensitivity is reduced during fever induced by Staphylococcus aureus cells walls in rabbits; Toien O et al.; Thermosensitivity (TS) and threshold core temperature for metabolic cold defence were determined in six conscious rabbits before, and at seven different times after i.v . injection of killed Staphylococcus aureus (8 x 10(7) or 2 x 10(7) cell walls x kg(-1)) by exposure to short periods (5-10 min) of body cooling . Heat was extracted with a chronically implanted intravascular heat exchanger . TS was calculated by regression of metabolic heat production (M) and core temperature, as indicated by hypothalamic temperature . Threshold for cold defence (shivering threshold) was calculated as the core temperature at which the thermosensitivity line crossed preinjection resting M . The shivering thresholds followed the shape of the fever response . TS was significantly reduced (up to 49%) during the time course of fever induced by the highest dose of pyrogen only . At both high and low doses of pyrogen TS correlated negatively with shivering threshold (r = 0.66 and 0.79 respectively) with similar slopes . The reduction in TS during fever was thus associated with the increase in shivering threshold resulting from the pyrogen injection and not by the dose of pyrogen . Model considerations indicate, however, that changes in sensitivity of the thermosensory input to the hypothalamic controller may affect threshold changes but cause negligible TS changes . It is more likely that the reduction in TS is effected in the specific hypothalamic effector pathways. Am J Med, 1996 May, 100(5), 509 - 16 Nosocomial Staphylococcus aureus bacteremia among nasal carriers of methicillin-resistant and methicillin-susceptible strains; Pujol M et al.; OBJECTIVES: To determine the relevance of nasal carriage of Staphylococcus aureus, either methicillin-sensitive (MSSA) or methicillin-resistant (MRSA), as a risk factor for the development of nosocomial S aureus bacteremia during an MRSA outbreak . PATIENTS AND METHODS: In this prospective cohort study, 488 patients admitted to an intensive care unit (ICU) during a 1-year period were screened with nasal swabs within 48 hours of admission and weekly thereafter in order to identify nasal S aureus carriage . Nasal staphylococcal carriers were observed until development of S aureus bacteremia, ICU discharge, or death . RESULTS: One hundred forty-seven (30.1%) of 488 patients were nasal S aureus carriers; 84 patients (17.2%) harbored methicillin-sensitive S aureus; and 63 patients (12.9%) methicillin-resistant S aureus . Nosocomial S aureus bacteremia was diagnosed in 38 (7.7%) of 488 patients . Rates of bacteremia were 24 (38%) of the MRSA carriers, eight (9.5%) of the MSSA carriers, and six (1.7%) of noncarriers . After adjusting for other predictors of bacteremia by means of a Cox proportional hazard regression model, the relative risk for S aureus bacteremia was 3.9 (95% confidence interval, 1.6-9.8; P = 0.002) for MRSA carriers compared with MSSA carriers . CONCLUSIONS: Among ICU patients, nasal carriers of S aureus are at higher risk for S aureus bacteremia than are noncarriers; in the setting of an MRSA outbreak, colonization by methicillin-resistant strains represents a greater risk than does colonization by MSSA and strongly predicts the occurrence of MRSA bacteremia. J AOAC Int, 1996 May-Jun, 79(3), 661 - 9 Efficacy of a latex agglutination test for rapid identification of Staphylococcus aureus: collaborative study; Chang TC et al.; Fifteen laboratories completed a collaborative study comparing the efficacy of a latex agglutination kit (Aureus Test) with that of AOAC Official Method 987.09 (coagulase test for identification of Staphylococcus aureus) . Each laboratory analyzed 240 strains of bacteria, including 160 isolates of S . aureus and 80 isolates of other bacteria . Upon receipt of cultures, collaborators subcultured each isolate on both tryptic soy agar (TSA) and Baird-Parker agar medium (BPA) to determine whether the growth medium has any effect on either method . For cultures grown on TSA, the latex test had sensitivity and specificity rates of 99.2 and 97.1%, respectively, whereas the coagulase test had respective rates of 98.4 and 92.5% . For cultures able to grow on BPA, the latex test had sensitivity and specificity rates of 99.2 and 96.6%, respectively, while the coagulase test had respective rates of 98.3 and 91.3% . By using the McNemar pairwise comparison test of the 2 methods, the false-positive and false-negative rates of the latex test were significantly lower (p < 0.01) than those of the coagulase test for strains grown either on TSA or BPA . The latex agglutination test for identification of S . aureus isolated from foods has been adopted by AOAC INTERNATIONAL. Aust N Z J Surg, 1996 May, 66(5), 287 - 90 Spinal epidural abscess: a report of nine cases and the use of intra-operative ultrasonography; Mak KH et al.; BACKGROUND: Spinal epidural abscess is an uncommon and dangerous lesion . Once neurological complications oc