Adv Perit Dial, 1996, 12, 218 - 20 Does the response to hepatitis B vaccination predict CAPD-associated infections? Holley JL. Rates of peritoneal dialysis-associated catheter infections and peritonitis were compared in continuous ambulatory peritoneal dialysis patients grouped on the basis of their response to hepatitis B vaccination with Engerix to assess the usefulness of vaccination in predicting patients at risk for peritonitis and catheter infections . Engerix was given intramuscularly in a dose of 40 micrograms at 0, 1, 2, and 6 months . Sixty-three percent (20/32) of patients developed hepatitis B surface antibodies (converters) . Converters and nonconverters were not different in proportions of women, whites, diabetics, or Staphylococcus aureus nasal carriers; mean age and mean months on peritoneal dialysis were also not different . Overall, peritonitis (0.46/year vs 0.33/year) and catheter infection (0.53/year vs 0.54/year) rates were not different among converters and nonconverters, respectively . Nonconverters had higher S . aureus peritonitis rates (0.12/year vs 0.04/year, p < 0.05) but lower S . epidermidis peritonitis rates (0.03/year vs 0.18/year, p < 0.02) . However, when the patient with recurrent S . epidermidis peritonitis was excluded from analysis, S . epidermidis peritonitis rates among converters and nonconverters were not different (0.13/year vs 0.03/year, respectively, p < 0.09) . These data suggest that the development of surface antibodies with hepatitis B vaccination does not predict a reduced risk of S . epidermidis peritonitis . The possibility that nonconverters are more likely to be S . aureus nasal carriers and therefore at greater risk of S . aureus peritonitis deserves further study. Adv Perit Dial, 1996, 12, 209 - 10 Surgical treatment of persistent exit-site infections; Glickman JD et al.; Persistent exit-site infections and tunnel infections (ESI/TI) are a cause for removal of Swan neck catheters (SNC) . Previous studies report variable success in the treatment of these infections by surgical exposure and removal of the subcutaneous external cuff . We report our experience with this technique . All 5 patients with persistent ESI/TI were successfully treated with antibiotics and surgical intervention . All cultures grew Staphylococcus aureus . Average time to complete healing after surgical exposure was 39.4 days . Mean follow-up after complete healing was 164.8 days . There were no subsequent episodes of ESI/TI in these patients . None of the catheters subsequently malfunctioned or developed leaks . Persistent ESI/TI in Swan neck catheters can be successfully treated with surgical exposure and removal of the subcutaneous external cuff. J Biomed Mater Res, 1996 Fall, 33(3), 139 - 43 A self-setting TTCP-DCPD apatite cement for release of vancomycin; Hamanishi C et al.; Vancomycin (VCM), a methiciline-cefem resistant Staphylococcus aureus (MRSA)-specific antibiotic, was incorporated in a self-setting tetracalcium phosphate (TTCP)-dicalcium phosphate dihydrate (DCPD) apatite cement that hardened isothermally into a hydroxyapatite (HAP) phase with crystallinity similar to that of host bone . Effective release of VCM into PBS lasted for 2 weeks from cements containing 1% VCM and for longer than 9 weeks from cements containing 5% VCM . The rate of release of VCM differed between cements with different crystallinities as well as between the two dissolution media, PBS and simulated body fluid . Mean concentration of VCM in the bone marrow tissue released from cements containing 5% VCM was 20 times the minimum inhibitory concentration 3 weeks after implantation in bone . Direct contact with new bone was observed with the cements containing 1% VCM . Slow delivery of VCM from a self-setting TTCP-DCPD apatite cement with low crystallinity could be used to treat MRSA osteomyelitis. Perit Dial Int, 1996, 16 Suppl 3, S51 - S70 Exit-site healing post catheter implantation; Twardowski ZJ et al.; The study goals were (1) to describe the natural healing process post peritoneal dialysis catheter implantation; (2) to discern factors that predispose to exit infection; (3) to recognize signs of early exit-site infection; and (4) to ascertain the influence, if any, of the healing process on subsequent peritonitis rates and final catheter outcomes . There were 226 evaluations of 43 exits {range 3-6 per exit, mean 5.2 + or - 1.1 (SD)} in 41 patients . Eleven exits were in the parasternal area and 32 exits were in the abdomen . Exit sites and sinus tracts were examined weekly for 6 weeks with a magnifying loupe and macro-photographed . Cultures were taken from sterile saline sinus washouts, periexit smears, and nares . Exit sites were categorized into four types: (1) fast-healing exits had no drainage or minimal moisture deep inside by the third week; epidermis started to enter into the sinus within 2-3 weeks, progressed steadily, and covered at least half the visible sinus tract 4-6 weeks after implantation; (2) in slow-healing exits without infection, epidermis started to enter into the sinus after 3 weeks or progressed slowly and did not cover half the visible sinus by 5 weeks; the sinus might have had serous or serosanguineous, but never purulent, drainage persistent up to 4 weeks; (3) healing interrupted by infection initially looked identical to the fast-healing exit, but within 6 weeks the epidermis did not progress or regress, granulation tissue became soft or frankly fleshy; drainage increased and/or became purulent; (4) in slow-healing exits due to early infection, granulation tissue became soft or fleshy and/or drainage became puru lent by 2-3 weeks; sinus epidermization was delayed or progressed slowly, only after infection was appropriately treated . Compared with patients with fast-healing exits, patients with early infected exits were more likely (although not significantly) to be diabetics, to have an abdominal catheter, wound hematoma, higher body mass index, and higher percentage of positive cultures for Staphylococcus aureus in nares . Early colonization of the exit was the most significant factor in determining the healing pattern: the later the colonization, the better the healing . Positive culture from either washout or periexit smear one week after implantation was associated with early exit infection, a higher peritonitis rate, and a high probability of catheter loss due to an exit/tunnel infection, and higher peritonitis rate; however, the time to the first peritonitis episode was not shorter than in the groups with later exit colonization . We postulate that exit infections and peritonitis rates may be decreased by delaying exit colonization using prophylactic antibiotics for at least 2 weeks after implantation and sterile exit dressing procedure for the entire healing time of approximately 6 weeks. Nippon Jinzo Gakkai Shi, 1996 Jan, 38(1), 27 - 32 {A case of toxic shock syndrome (TSS) induced by methicillin-resistant staphylococcus aureus (MRSA) presenting as acute renal failure with disseminated intravascular coagulation}; Fukuuchi F et al.; A case of a 73-year-old woman with acute renal failure due to toxic shock syndrome (TSS) is reported . The patient was admitted to our hospital with the complaints of high fever, disturbance of consciousness and shock . Laboratory findings on admission were; CRP 25.11 mg/dl, WBC 35000/ microl, Plt 1.6 x 10(4)/ microl, GOT 155 U/l, GPT 65 U/l, CPK 4202 U/l (CPK-MM 96%), BUN 123 mg/dl and SCr 7.0 mg/dl . Because of anuria, hemodialysis was performed . This patient was treated with dopamine, methyl prednisolone (MP), frozen fresh plasma, AT III, antibiotics, and platelet transfusion . The bacterial cultures of blood and cerebrospinal fluid were negative, but MRSA was isolated subsequently from the pharynx and vagina . We investigated the production of toxic shock syndrome toxin 1 (TSST-1) and staphylococcal enterotoxins (SE) . The isolated MRSA produced TSST-1, SEB and SEC . Accordingly, we made the diagnosis of TSS . After improvement of acute renal failure and the patient's general condition, MRSA persisted and TSST-1 was still found in the patient's blood . Finally we eradicated the MRSA and TSST-1 after administration of ciprofloxacin hydrochloride (CPFX) and Rifampicin (RFP). Biotechnol Prog, 1996 Jan-Feb, 12(1), 77 - 83 Applications of perfluorocarbon affinity emulsions for the rapid isolation of Staphylococcus aureus; McCreath GE et al.; Human immunoglobulin G (IgG) has been immobilized to poly(vinyl alcohol)-stabilized liquid perfluorocarbon droplets . This affinity emulsion has been shown to adsorb Staphylococcus aureus cells from solutions with adsorption capacities of 32 x 10(9) and 48 x 10(9) cells/mL for affinity emulsions with immobilized IgG densities of 1.15 and 2.45 mg/mL, respectively . The kinetics of cell binding from solution were found to be rapid with clearance of S . aureus cells from a suspension (8 x 10(8) cell/mL) achievable in under 5 min . S . aureus cells (1.3 x 10(9) cells) could also be rapidly depleted from a suspension of Saccharomyces cerevisiae (3.4 x 10(10) cell/mL) in under 18 min with no cross-reactivity being observed . The affinity emulsion was stable for at least five cycles of operation with little loss in adsorption capacity when removal of adsorbed cells was carried out at pH 2.5. Drugs Exp Clin Res, 1996, 22(1), 9 - 15 Potentiation of human polymorphonuclear leukocyte phagocytosis and intracellular bactericidal activity by amoxycillin/clavulanic acid; Cuffini AM et al.; The use of broad spectrum beta-lactamase inhibitors in association with beta-lactam agents provides one strategy to overcome the enzymatic resistance . Clavulanic acid is a potent inhibitor of a wide range of bacterial beta-lactamases and its potentiating effect on amoxycillin has been established both in vitro and in clinical trials . Since the efficacy of an antimicrobial agent in the therapy of infections depends on the interaction of bacteria, antibiotic and phagocytes, we investigated the effect of amoxycillin/clavulanic acid on the in vitro interaction between human polymorphonuclear cells (PMNs) and beta-lactamase producing strains of Klebsiella pneumoniae and Staphylococcus aureus . Clavulanic acid did not have any significant influence upon the PMN phagocytosis and killing against intracellular bacteria . Interestingly, the presence of the suicide inhibitor, with its beta-lactamase inhibitory properties, potentiated the activity of amoxycillin against the beta-lactamase producing strains of K . pneumoniae and S . aureus in such a manner that bacteria became significantly more susceptible to either phagocytosis or microbicidal activities of human phagocytes, compared to both the control and amoxycillin systems. J Biomater Sci Polym Ed, 1996, 7(10), 905 - 15 Biological activities of new poly(N-1-adamantylmaleimide) and poly(N-1-diamantylmaleimide); Wang JJ et al.; N-1-Diamantylmaleimide was synthesized by reaction of maleic anhydride with 1-aminodiamantane, followed by dehydration with acetic anhydride and sodium acetate . Poly(N-1-adamantylmaleimide) (IIa) and poly(N-1-diamantylmaleimide) (IIb) were synthesized by free radical polymerization . N-1-Adamanlylmaleimide (Ia) and N-1-diamantylmaleimide (Ib), exhibited strong activities in vitro antitumor activities . Interestingly, poly(N-1-adamantylmaleimide) exhibited growth inhibitory values against Colo 205, Hep G2, and SK-BR-3, similar to 5-Fluorouracil . It was noted that poly(N-1-adamantylmaleimide) showed relatively lower cytotoxicity against Molt-4 cells than against Colo 205, Hep G2, and SK-BR-3 cells . The decreasing antitumor activities against individual tumor cell line were in the order Ia > Ib > IIa > IIb . This result shows that N-substituents of maleimides play an important role in their antitumor activity . Additionally, Ia and Ib show good in vitro activity against staphylococcus aureus ATCC 25923 while polymers IIa and IIb exhibited weak activity against S . aureus ATCC 25923. Eur Spine J, 1996, 5(3), 201 - 3 Spinal epidural abscess: an unusual cause of sciatica; Kotilainen E et al.; A previously healthy patient was admitted to our hospital because of low back pain and sciatica . For 4 weeks preceding the admission, he had been treated with nonsteroidal antiinflammatory analgetics and bed rest with a clinical diagnosis of lumbar disc herniation . On admission, the patient was subfebrile but developed general symptoms of septic infection by the next day . Computed tomography and magnetic resonance imaging of the lumbar spine revealed a spinal epidural abscess and spondylodiscitis at the L5-S1 level . During an emergency laminotomy, gross pus in abundance was evacuated from the epidural space; microbiological cultures from the pus and blood yielded Staphylococcus aureus . The unique clinical presentation of our patient combined with merely indolent symptoms of infection delayed the correct diagnosis . We are not aware of any similar reports of patients with lower spinal epidural abscess whose primary presentation was sciatic pain. Dermatology, 1996, 192(2), 110 - 5 B-cell chronic lymphocytic leukemia associated with high serum IGE levels and pruriginous skin lesions: successful therapy with IFN-alpha 2b after failure on IFN-gamma; Neuber K et al.; BACKGROUND . Chronic lymphocytic leukemia of the B-cell type (B-CLL) associated with highly elevated serum IgE levels and skin involvement has rarely been observed . Furthermore, not much is known about therapeutic strategies in such diseases . OBJECTIVE . We describe a 56-year-old male patient with a 5-year history of chronic and relapsing pruritic skin lesions as well as recurrent Staphylococcus aureus infections of the skin . RESULTS . Histologically, a lymphocytic and eosinophilic skin infiltrate was seen . Laboratory analysis revealed lymphocytosis (46.5%), eosinophilia (11.9%) as well as markedly elevated serum IgE levels (140,000 IU/ml) . Immunohistology showed dermal B cells with intracytoplasmic IgE . Bone marrow biopsy showed a diffuse infiltrate of small lymphoplasmacytic lymphocytes . Over 80% of blood and bone marrow lymphocytes were CD5 +, CD19 +, CD20 +, CD23 + and CD38 + . Based on these findings, the diagnosis of B-CLL was made . The strong pruritus was resistant to antihistamines and steroids . Therefore, a trial with interferon (IFN) gamma 50 micrograms s.c . daily was started in order to suppress elevated serum IgE but failed . After 1.5 million units s.c . of IFN-alpha 2b every second day for 2 weeks, pruritus and serum IgE levels diminished markedly (48,000 IU/ml) . Skin lesions, pruritus as well as skin infection and serum IgE level improved under continuing IFN-alpha 2b therapy for 2 years . CONCLUSION . In cases with suspected hyper-IgE syndrome, hematological neoplasias have to be excluded . The results argue for a benefical effect of IFN-alpha 2b in suppressing IgE production and symptoms of pruritus in an early-stage B-CLL. Clin Infect Dis, 1996 Jan, 22(1), 86 - 90 Use of restriction endonuclease analysis of plasmids and pulsed-field gel electrophoresis to investigate outbreaks of methicillin-resistant Staphylococcus aureus infection; Liu PY et al.; We used restriction endonuclease analysis of plasmids (REAP) and pulsed-field gel electrophoresis (PFGE) to investigate clusterings of methicillin-resistant Staphylococcus aureus (MRSA) infections in our orthopedic unit, neurosurgery unit, intensive care unit, and burn unit . Fourteen different strain types were identified by REAP and 10 different strain types were identified by PFGE among 25 MRSA isolates collected during these incidents of infection . Though neither technique was clearly superior to the other for typing MRSA isolates, REAP is recommended as a relatively simple and reproducible technique for the preliminary investigation of MRSA infection outbreaks in clinical settings. Clin Infect Dis, 1996 Jan, 22(1), 40 - 5 Infective endocarditis in injection drug users: importance of human immunodeficiency virus serostatus and degree of immunosuppression; Pulvirenti JJ et al.; Human immunodeficiency virus (HIV)-infected patients are at increased risk for serious and recurrent bacterial infections . We hypothesized that the degree of immunosuppression may play an important role in outcomes for HIV-seropositive patients with infective endocarditis (IE) . To test our hypothesis, we retrospectively reviewed 144 cases of IE in injection drug users . One hundred two patients with documented HIV status (45 HIV-seropositive patients and 57 HIV-seronegative patients) were included in the analysis . Eleven patients (6 HIV-seropositive patients and 5 HIV-seronegative patients) died in the hospital . Staphylococcus aureus, the most common etiologic pathogen causing IE in our series, was isolated from 32 HIV-seropositive patients (71.1%) and 32 HIV-seronegative patients (56.1%) . A clear inverse correlation between mortality rate and CD4 cell count was demonstrated (r = -.625; P < .001) . Both univariate and multivariate analyses supported the finding of significantly higher mortality rates among patients with CD4 cell counts of < 200/mm3 than among patients with CD4 cell counts of > 500/mm3 (OR, 14.7; 95% CI, 2.64-81.9). Peptides, 1996, 17(1), 13 - 6 Hydrolysis of N-formylmethionyl chemotactic peptides by endopeptidase 24.11 and endopeptidase 24.15; Lesser M et al.; Endopeptidase 24.11 (EP 24.11), a membrane-bound cell surface enzyme, modulates chemotactic responsiveness of neutrophils to f-Met-Leu-Phe . It is unknown if the enzyme degrades potent formylmethionyl tetrapeptides or if an enzyme with similar activities, endopeptidase 24.15 (EP 24.15), degrades formylated chemotactic peptides . In a study of five formylmethionyl tetrapeptides and f-Met-Leu-Phe, we found that EP 24.11 had high affinity for all peptides evaluated, although it did not effectively degrade f-Met-Ile-Leu-Phe . EP 24.15 had high affinity for three of the tetrapeptides, and for f-Met-Leu-Phe, although, for unclear reasons, it did not degrade f-Met-Ile-Leu-Phe or f-Met-Leu-Phe, the apparent natural products of Staphylococcus aureus and Escherichia coli, respectively. Zh Mikrobiol Epidemiol Immunobiol, 1996 Jan-Feb, (1), 27 - 30 {The relationship of the indices of solar-geomagnetic activity and the autofluctuations in the biological properties of Staphylococcus aureus 209 subcultures in vitro}; Polikarpov NA; The in vitro study of effect of such factors as solar activity and the magnetic field of the Earth revealed their influence on the autofluctuations of the biological activity of S.aureus 209 subcultures . Differences in the activity of the synthesis of DNAase, RNAase and delatinase could increase two-- to tenfold during the year . Relationships between heliogeophysical characteristics and the biological activity of bacteria could be both direct and reverse . The study also revealed that at the periods of increased solar and geomagnetic activity S.aureus may spontaneously dissociate in the soil, forming subcultures with greater biological activity than the initial strains. Acta Otolaryngol, 1996 Jan, 116(1), 104 - 11 Interaction and immunological effect of very late antigen-4, 5, and fibronectin in tonsillar lymphocytes and their relation to age; Ohguro S et al.; We examined the expressions of alpha-subunits of very late antigen (VLA)-4 (alpha4) and VLA-5 (alpha5) on tonsillar lymphocytes and the interaction between these integrin receptors and their ligand, fibronectin (FN) . Immunohistological and flow cytometric analyses showed that alpha4 and alpha5 were expressed in the lymphoid follicle and were positive on about 10% each of T cells and on 55% and 35% of B cells . When tonsillar B cells were separated by a discontinuous Percoll gradient, the number of alpha4- and 5-positive cells decreased as the cell density went down, while the number of activated cells went up . After in vitro activation of tonsillar B cells by Staphylococcus aureus Cowan I strain (SAC), the expression of alpha5 and the adhesiveness to FN decreased . The increased proliferation of B cells was observed when tonsillar B cells were cultured with immobilized FN . The expressions of alpha-subunits of VLA-4 and VLA-5 on tonsillar T and B lymphocytes increased with age . These results suggest that: i) B cell activation may cause decreased expressions of VLA-4 and -5, which gives a costimulatory effect on B cell activation itself again in cooperation with FN, ii) Increased expressions of VLA-4 and -5 on tonsillar lymphocytes with age may be related to regional immune response of the palatine tonsils. Auris Nasus Larynx, 1996, 23, 111 - 20 Expressions of very late antigen-6 and vitronectin receptor, and their interactions to laminin and vitronectin during tonsillar B-cell activation; Ohguro S et al.; This study examined the expressions of a-subunits of very late antigen-6 (VLA-6; alpha 6) and vitronectin receptor (VNR; alpha V) on tonsillar B cells and interactions between those integrins and their respective ligands, laminin (LM) and vitronectin (VN) . alpha 6 and alpha V were expressed on about 30 to 40% of tonsillar B cells . When purified tonsillar B cells were separated by a discontinuous Percoll gradient, the number of alpha 6- and alpha V-positive cells decreased as the cell density went down, while the number of activated cells went up . After in vitro activation of tonsillar B cells by Staphylococcus aureus Cowan I strain (SAC), the expressions of alpha 6 and alpha V and their adhesiveness to LM or VN decreased significantly . Increased proliferation of B cells was observed when tonsillar B cells were cultured with immobilized LM or VN . The results of immunohistological staining showed VLA-6, VNR, LM and VN in the follicular area . These results suggest that the expressions of VLA-6 and VNR on tonsillar B cells may be decreased during B cell activation, and the interaction between VLA-6, VNR, and LM, VN may give a costimulatory effect on B cell activation in the follicular area of the tonsil. Infect Control Hosp Epidemiol, 1996 Jan, 17(1), 20 - 8 Colonization and infection with methicillin-resistant Staphylococcus aureus: associated factors and eradication; Asensio A et al.; OBJECTIVES: To identify characteristics associated with methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection, and to evaluate the efficacy of systemic and topical antimicrobials in the eradication of MRSA carriage among hospitalized patients . DESIGN: A case-control study was done to identify associations . Odds ratios were estimated by unconditional multiple logistic regression . Cohort study was done to evaluate MRSA decolonization efficacy by an oral regimen . Patients infected or colonized with MRSA received a 5-day course of oral (160 mg/800 mg) trimethoprim-sulfametroxazole twice daily and 600 mg of rifampin once daily as decolonization treatment . The proportion of MRSA-free patients after decolonization treatment was determined . Persistence of clearing was estimated by the Kaplan-Meier method . SETTING: Ramon y Cajal Hospital, a 1,249-bed, tertiary-care teaching hospital in Madrid, Spain . PATIENTS: One hundred ninety-two patients with hospital-acquired MRSA infection/colonization and 195 MRSA-free random controls . RESULTS: Six factors were associated independently with MRSA infection/colonization: age (every 10 years of age, odds ratio {OR} = 1.3); ward (surgical, OR = 1; medical, OR = 3.1; intensive care unit, OR = 60); previous hospitalization (OR = 6.9); coma (OR = 25.3); invasive procedures (each, OR = 1.7); 3 or more weeks of hospitalization (OR = 3.8) . We failed to show antibiotic therapy to be an independent risk factor for MRSA hospital infection/colonization . Overall, MRSA eradication was 64.2% by day 2 to 9 after completion of treatment . Kaplan-Meier product limit survival analysis showed that the probability of remaining MRSA-free was 65.3% (SE = 0.09) at 32 days after completion of treatment . CONCLUSIONS: The results offer a rationale for reduction of MRSA infection/colonization in the hospital by interventions aimed at early identification of patients at higher risk, at prompt discharge of patients, and at preventing dissemination while performing invasive procedures . They also provide estimates of antibiotic treatment efficacy to reduce the reservoir of MRSA in the hospital. Antimicrob Agents Chemother, 1996 Jan, 40(1), 166 - 72 Overproduction of a 37-kilodalton cytoplasmic protein homologous to NAD+-linked D-lactate dehydrogenase associated with vancomycin resistance in Staphylococcus aureus; Milewski WM et al.; We previously reported the isolation of a laboratory-derived Staphylococcus aureus mutant, 523k, that has constitutive low-level resistance to vancomycin (MIC = 5 micrograms/ml) and teicoplanin (MIC = 5 micrograms/ml) and elaborates a ca . 39-kDa cytoplasmic protein that was not detected in the parent strain 523 (MIC = 1 micrograms/ml) . We have now detected the protein in strain 523 by immunoblotting with antiserum raised against the protein . Consistent with our initial observations, densitometric analysis of the immunoblots revealed an increased production of the protein in 523k compared with that of the susceptible parent 523 . The 5' region of the gene encoding the protein of interest was identified by nucleotide sequencing a PCR product amplified from the genome of 523k with degenerate primers designed to encode the amino acid sequence of proteolytic peptides obtained from the protein . The remainder of the gene was identified by library screening, PCR, and nucleotide sequencing . The gene encodes a 36.7-kDa protein with homology to a family of bacterial NAD+-dependent, D-specific 2-hydroxyacid dehydrogenases which includes both D-lactate dehydrogenase and the enterococcal vancomycin resistance protein VanH and is therefore designated ddh . Increased production of the product of ddh, Ddh, was associated with increased D-lactate dehydrogenase activity in 523k, a finding which suggested that Ddh is likely to be the D-lactate dehydrogenase previously identified in S . aureus . The increased D-lactate dehydrogenase activity in strain 523k and the structural similarities among Ddh, D-lactate dehydrogenase, and VanH suggest that overproduction of Ddh might play a role in vancomycin resistance in this strain. Neurol Med Chir (Tokyo), 1996 Jan, 36(1), 40 - 4 Cervical discitis associated with spinal epidural abscess caused by methicillin-resistant staphylococcus aureus; Sawada M et al.; A 53-year-old male developed fever, nuchalgia, shoulder pain, and sore throat after a partial sigmoidectomy . He suffered sudden onset of quadriplegia about 5 days later . Magnetic resonance (MR) imaging indicated the characteristic appearance of C5-6 intervertebral disc herniation . However, anterior discectomy showed that he had cervical discitis associated with spinal epidural abscess . Continuous pus drainage from the abscess and vigorous antibiotic therapy were undertaken after surgery . He improved and could walk with assistance . MR imaging with gadolinium can be useful in diagnosing pyogenic spinal infection (epidural abscess, osteomyelitis, and discitis), but care should be taken in MR image interpretation since spinal epidural abscess associated with discitis may mimic disc herniation . Axial MR images are important to distinguish this rare disease from other cervical disorders. J Ethnopharmacol, 1996 Jan, 50(1), 27 - 34 Comparative study on the antibacterial activity of phytochemical flavanones against methicillin-resistant Staphylococcus aureus; Tsuchiya H et al.; Differently substituted flavanones were isolated from Leguminosae and their antibacterial activity was comparatively studied against methicillin-resistant Staphylococcus aureus (MRSA) . The minimum inhibitory concentrations (MICs) of phytochemical flavanones to clinical isolates of MRSA were determined by a serial agar dilution method . The structure-activity relationship has indicated that 2',4'- or 2',6'-dihydroxylation of the B ring and 5,7-dihydroxylation of the A ring in the flavanone structure are important for significant anti-MRSA activity and that substitution with a certain aliphatic group at the 6- or 8-position also enhances the activity . Among the thirteen flavanones tested, tetrahydroxyflavanones with these structural characteristics isolated from Sophora exigua and Echinosophora koreensis showed intensive activity to inhibit the growth of all MRSA strains at 3.13-6.25 micrograms/ml . The present hydroxyflavanones would be useful in the phytotherapeutic strategy against MRSA infections. J Biomater Sci Polym Ed, 1996, 7(9), 769 - 80 Bacterial adhesion to polyurethane surfaces in the presence of pre-adsorbed high molecular weight kininogen; Nagel JA et al.; The factors which affect the adherence of a bacteria cell to the surface of a biomaterial include the surface chemistry of the cell and material, as well as the composition of the adsorbed protein layer when the biomaterial is exposed to circulating blood . In an effort to better understand the mechanisms by which bacteria adhere to such surfaces, and specifically to determine the effects of high molecular weight kininogen on bacterial adhesion, experiments were performed in which the attachment of Staphylococcus aureus was directly observed on glass and on a series of functionalized polyurethanes . These surfaces had been pre-adsorbed with various concentrations of high molecular weight kininogen and fibrinogen . Attachment was observed using a radial flow chamber, in which shear stress varied inversely with radial distance . Protein adsorption studies were also performed using 125I labeled fibrinogen to investigate the relationship between surface chemistry, protein adsorption, and bacterial attachment . Bacterial attachment was significantly decreased when the glass surface was pre-adsorbed with high molecular weight kininogen--either alone, or following adsorption of fibrinogen . High molecular weight kininogen thus exhibited anti-adhesive effects . On polyurethane surfaces pre-adsorbed with fibrinogen, kininogen, and albumin, the highest bacterial attachment was found on the base polyurethane, while significant decreases were seen on the hydrophilic polyurethanes . In addition, it was found that the surface with the least bacterial attachment and fibrinogen deposition was the polyurethane with pendant phosphonate groups. Antibiot Khimioter, 1996 Jan, 41(1), 22 - 6 {Antibioticograms of microorganisms isolated from foci of local infections in infants}; Sentsova TB et al.; Microbiological tests were performed in regard to 474 newborns within 1985-1995 . It was shown that gram-positive microflora (Staphylococcus epidermidis and Staphylococcus aureus) predominated in the etiological structure of omphalitis and conjunctivitis . Among gram-negative isolates in the cases with omphalitis there predominated Klebsiella pneumonia . The antibioticograms were of great practical value for the adequate therapy. Rev Med Interne, 1996, 17(4), 300 - 4 {Pyomyositis in adults in central Tunisia . Apropos of 10 cases}; Chekir T et al.; Ten adult patients treated for pyomyositis between 1988 and 1994 in Sousse's university hospital (Tunisia) were retrospectively reviewed . Due to the non specific symptoms, the diagnosis was often delayed (mean = 17 days) and other primary diagnoses were considered, mainly including synovitis . The muscles around hip and thigh were most commonly involved (ten patients), and Staphylococcus aureus was the most common pathogen (nine patients) . Ultrasonography was very helpful in the accurate diagnosis of the infection . Incision, drainage, and antibiotic therapy eradicated the infection in all patients . No residual functional limitations and no residual symptoms were noted . Our study showed that pyomyositis is present in central Tunisia and not associated with HIV infection . Clinical features and prognosis are similar to those previously described in the literature. Chemotherapy, 1996 Jan-Feb, 42(1), 21 - 36 Gentamicin- and methicillin-resistant Staphylococcus aureus: phenotypic and genotypic characterization of three putative nosocomial outbreak strains; Traub WH et al.; Nineteen representative isolates of gentamicin- and methicillin-resistant Staphylococcus aureus (MRSA) were found to comprise three phenotypes; these differed with regard to hydrolysis of nitrocefin and production of staphylococcal enterotoxin A or/and toxic shock syndrome toxin-1 . All MRSA isolates produced a capsule and were susceptible to coumermycin, nitrofurantoin, novobiocin, trimethoprim, trimethoprim-sulfamethoxazole, teicoplanin and vancomycin . All MRSA isolates were resistant to co-amoxiclav, ciprofloxacin, clarithromycin, gentamicin, methicillin, norfloxacin, ofloxacin, oxacillin and polymyxin B. J Clin Microbiol, 1996 Jan, 34(1), 20 - 4 Clinical comparison of difco ESP, Wampole isolator, and Becton Dickinson Septi-Chek aerobic blood culturing systems; Cockerill FR 3rd et al.; The ESP 80A aerobic blood culture of the ESP automated blood culture system (Difco Laboratories . Detroit, Mich.) was compared with two manual aerobic blood culture systems, the Isolator (Wampole Laboratories, Cranbury, N.J.) and the Septi-Chek (Becton Dickinson, Cockeysville, Md.) systems, for the detection of bloodstream microorganisms from 5,845 blood samples for culture collected from adult patients with suspected septicemia . The bottles were incubated for 7 days, and the sediment from the Isolator tube was inoculated onto solid medium and this medium was incubated for 72 h . A total of 609 microorganisms were recovered from 546 blood cultures . There was no statistically significant difference in the total recovery of microorganisms for the ESP 80A system when compared with that for the Septi-Chek system (P = 0.083); however, the Isolator system recovered significantly more microorganisms overall than either the ESP 80A (P < 0.001) or the Septi-Chek (P < 0.001) system . When assessing individual probable pathogens, the Isolator system detected statistically significantly more Staphylococcus aureus and Candida spp . than either the ESP 80A or the Septi-Chek system (P < 0.05) . Similarly, the Isolator system detected statistically significantly more bloodstream infections (septic episodes) caused by S . aureus and Candida spp . than either the ESP 80A or the Septi-Chek system (P < 0.05) . In blood culture sets which produced growth of the same probable pathogens in the ESP 80A and the Isolator systems, there was no statistically significant difference in the median times to detection for all pathogens combined (P = 0.067) . However, a similar comparison showed the Isolator and the ESP 80A systems to have statistically significantly shorter median detection times for all pathogens combined (P < 0.001) when they were independently compared with the Septi-Chek system . The ESP 80A system had 29 (0.5%) false-positive signals . The ESP system required less processing time than the Isolator system and eliminates the hands-on time for the detection of positive cultures required by the manual systems. J Laryngol Otol, 1996 Jan, 110(1), 78 - 80 Staphylococcus aureus peritonsillar abscess in an 11-week old infant; Akhtar MJ et al.; A case of Staphylococcus aureus peritonsillar abscess in an 11-week-old infant is described . The importance of peritonsillar abscess culture and its changing management is discussed. Mem Inst Oswaldo Cruz, 1996 Jan-Feb, 91(1), 101 - 5 Analysis of the clonal diversity of Staphylococcus aureus methicillin-resistant strains isolated at João Pessoa, state of Paraíba . Brazil; Santos Filho L et al.; To investigate the clonal diversity of Staphylococcus aureus strains isolated at Joao Pessoa, State of Paraiba, Brazil, digested genomic DNA were studied by pulsed-field gel electrophoresis (PFGE) in nine methicillin-resistant strains (MRSA) and three methicillin-sensitive strains (MSSA), selected among 67 isolates based on their antimicrobial susceptibility and epidemiology . The isolates were obtained between April and November 1992 from the Hospital of the Federal University of Paraiba, located in Joao Pessoa . Two MRAS isolates from the Oswaldo Cruz Hospital, Sao Paulo, Brazil, including an epidemic strain previously detected from different hospitals at the country were used as control . Five different patterns, were demonstrated by MRSA isolated in Joao Pessoa and these patterns were described in several epidemiologically unrelated hospitals in Sao Paulo . Our results suggest the interstate dissemination of a MRSA clone in Joao Pessoa which is similar to that described in other cities of Brazil. Perit Dial Int, 1996, 16 Suppl 1, S362 - 7 Impaired initial cell reaction in CAPD-related peritonitis; Koopmans JG et al.; Our objective was to determine the incidence of peritonitis episodes with an impaired initial cell reaction (IICR:neutrophil number < 100 x 10(6)/L) over a period of ten years, and to find possible explanations for this unusual presentation of peritonitis . A retrospective review of the files of continuous ambulatory peritoneal dialysis (CAPD) patients included in the CAPD program 1984 and 1993 was done . Analysis of cytokine and prostanoid patterns during four peritonitis episodes with an IICR was compared to 12 episodes with a normal initial cell reaction (NICR) . Dialysate cell numbers and immunoeffector characteristics of peritoneal cells were compared in 7 IICR patients in a stable situation and a control group of 70 stable CAPD patients . The setting was a CAPD unit in the Academic Medical Center in Amsterdam . Thirty-five CAPD patients who had one or more peritonitis episodes with an IICR and a control group of 249 CAPD patients were included in the study . The incidence of peritonitis with an IICR was 6% . These episodes occurred more than once in 51% of the patients who presented with IICR . In 72% the cell reaction was only delayed: a cell number exceeding 100 x 10(6)/L was reached later . Staphylococcus aureus was significantly more frequently the causative microorganism compared to all peritonitis episodes (PE) that occurred during the study period . Patients with IICR had lower dialysate cell counts in a stable situation, compared to a control group (p < 0.01) . This was caused by a lower number of macrophages and CD4 positive lymphocytes . The phagocytosis capacity of the macrophages appeared to be normal . In a comparison of four PE with an IICR and 12 episodes with an NICR, the tumor necrosis factor-alpha (TNF-alpha) response was similar and occurred on day 1, also pointing to normally functioning macrophages . However, the maximal appearance rates of interleukin-6 (IL-6) and IL-8 occurred later in the episodes with IICR compared to NICR (day 2 vs day 1, p < 0.05) . No differences were found in vasodilating prostaglandins, mesothelial cell markers (cancer antigen 125, phospholipids, hyaluronan), and mesothelial cell numbers in the stable situation nor during peritonitis . Peritonitis can present as abdominal pain in the absence of a cloudy dialysate . In some of the patients this presentation occurred more than once . This impaired, most often delayed, cell reaction was associated with a delayed secondary cytokine response . As IL-6 and IL-8 can be synthesized by mesothelial cells, this suggests an impaired functioning mesothelium . This could not be confirmed, however, by a lower number of mesothelial cells in effluent or lower dialysate levels of mesothelial cell markers. Enferm Infecc Microbiol Clin, 1996 Jan, 14(1), 27 - 30 {Pyomyositis in Zamora}; Montserrat Chimeno M et al.; BACKGROUND: Pyomyositis is a purulent infection involving the skeletal muscle . Although it was initially described in tropical countries, is it ever more frequently found in warm climates . METHODS: A review of the clinical histories of the admission of patients in the Internal and Infectious Medicine Units over the period from May 1992 to April 1994 (1818 admissions) was carried out analyzing those in whom the diagnosis was of pyomyositis . This diagnosis was performed by clinical data and radiologic and microbiologic confirmation . RESULTS: Five patients diagnosed with pyomyositis were found . Of the five cases, four were men with ages ranging from 27 to 64 years . In most of the cases more than one muscle group was involved and only two cases showed predisposing factors (history of injury and DM) . The existence of abscesses was shown by echography in 3 cases and by CAT in 2 cases . Staphylococcus aureus was the most frequently isolated microorganism . The five patients underwent medical treatment and surgical treatment was also performed in 2 achieving satisfactory evolution . CONCLUSIONS: Imaging techniques (echography and CAT) effectively contribute to the diagnosis of pyomyositis . Medical treatment, associated with surgery in some cases, achieved satisfactory evolution . The incidence of pyomyositis is probably greater than what has been recognized to date. J Mal Vasc, 1996, 21 Suppl A, 139 - 45 {Antibiotic-impregnated prostheses: eclectic indications}; Melliere D et al.; OBJECTIVE: Infection is a major complication in vascular stents . Stents impregnated with gelatine and dipped in Rifampicin have been shown to resist methicillin-resistant Staphylococcus aureus in both animal experiments and in man . It has been suggested that all aorto-ilio-femoral stents should be treated . To evaluate this method, we reassessed all stent infections observed in our patients who had undergone revascularization of the lower limbs from January 1985 to 1994 . We excluded stents implanted for ruptured aneurysms or implanted in patients with a past history of local infection on vascular stents . RESULTS: The rate of septic complications observed during the first year was 1% for all patients in the series, 0% for aorto-aortic and aorto-biiliac stents and 0.7% for aorto- bifemoral stents . These rates are similar to those reported in the multicentric study directed by Goeau Brissoniere using antibiotic impregnated stents . The extra cost involved in using such stents for aorto-ilio-femoral revascularization was estimated in this series at 2,180,000 Francs . The costs resulting from the three infections was estimated at 960,000 Francs . CONCLUSION: Based on the findings in this series, antibiotic impregnated stents should be indicated only in selected patients due to the extra cost: past history of local infection, ruptured aneurysms, femoro-tibial stents, cross or axillo-femoral revascularization for which the rate of stent infection is 6.3 - 3.2 and 1.4%, immunodeficient patients, multiple reoperations, post-irradiation arteritis and situations known to involve major risk of infection. Microbiol Immunol, 1996, 40(4), 247 - 54 Isolation and characterization of teichoic acid-lake substance as an adhesin of Staphylococcus aureus to HeLa cells; Matsuura T et al.; A cell wall component that bound to HeLa cells (HeLa cell-binding CWC) was isolated from a clinical isolate of Staphylococcus aureus . The HeLa cell-binding CWC was resistant to heat (100 C, 1 hr) and proteases, did not stain with Coomassie Brilliant Blue R-250 on SDS-PAGE but stained as a broad band with antiserum against the strain on Western blots . These data suggest that the HeLa cell-binding CWC is not a protein, and may be teichoic acid . Purified teichoic acid bound to HeLa cells, whereas fractions without teichoic acid did not . In Western blots, HeLa cell-binding CWC appeared as a broad band of less than 35 kDa, similar to that of purified teichoic acid . These data suggest that the HeLa cell-binding CWC obtained in this study is teichoic acid . Teichoic acid inhibited S . aureus adherence to HeLa cells and bound to the cells time and dose dependently, in a saturable and reversible manner, and therefore appears to be an adhesin of S . aureus to HeLa cells. Lab Anim, 1996 Jan, 30(1), 28 - 34 Lung, ileum and heart are predilection sites for AApoAII amyloid deposition in CD-1 Swiss mice used for toxicity studies . Pulmonary amyloid indicates AApoAII; Gruys E et al.; Amyloid deposits represent frequent histological findings in SPF strains of mice mainly used for toxicological studies . Usually, these are deposits of reactive amyloid (AA-amyloid) derived from the acute phase protein serum amyloid A (SAA) . The SAA is an apoprotein of high density lipoprotein (apoSAA) . Senescence-accelerated amyloid (ASsam) occurs in a special strain of mice . This type of amyloid is derived from apolipoprotein-AII and, therefore, is called AApoAII . Recently, C57B1/Ka control mice not treated for long duration with immunosuppressive agents, were found to have developed AApoAII-amyloidosis with a predilection for the deposits in the ileum (HogenEsch et al . 1993) . In the present study, SPF CD-1 Swiss outbred mice, used for chronic toxicity experiments, were investigated . Amyloidosis was diagnosed by haematoxylin and eosin staining . The tissue localization of amyloid was recorded and confirmed by Congo red staining . The chemical type of amyloid was investigated by peroxidase antiperoxidase (PAP)-immunostaining using anti-murine AA and anti-murine AApoAII antibodies . Those animals which died during the study and the mice killed at end of the experiment, aged 18 months, from treated as well as non-treated control groups, showed AApoAII-amyloid deposits with similar prevalence . The AApoAII amyloid had organ predilection for gut, heart and lung tissue . A group of animals was euthanazed intercurrently at a young age, since they suffered from spontaneous dermatitis associated with Staphylococcus aureus infection . Sixty-eight percent had reactive amyloid deposits found primarily in spleen, liver, kidney and gut . From these findings and literature data on various other mouse strains, it is concluded that in mice used for toxicity studies, AA and AApoAII types of amyloidosis may be expected . The deposition patterns of these types of amyloid are slightly different . AA-amyloid has a predilection for spleen, liver, gut and kidney, and is often associated with inflammatory lesions of the skin, whereas masses of amyloid in lung, heart and ileum suggest AApoAII . Pulmonary amyloid appears to represent the most reliable deposition criterion for discriminating between both types of amyloidosis. Vet Microbiol, 1996 Jan, 48(1-2), 51 - 5 Genotyping by PCR, of Staphylococcus aureus strains, isolated from mammary glands of cows; Lipman LJ et al.; A total of 71 Staphylococcus aureus strains isolated from bovine mammary glands were identified and subtyped . The methods used to differentiate between the S . aureus isolates were the DNA polymorphism pattern after amplification with a Polymerase Chain Reaction using several primer combinations and phage typing . The DNA fingerprinting technique using RAPD, ERIC1R and ERIC primers proved to be useful in differentiating isolates of S . aureus . Differentiation of isolates using phage typing gave no additional information compared to the DNA technique . The outbreak of S . aureus in the herd studied was mainly caused by one S . aureus strain . Other strains were only found on three occasions, twice in subclinical infections and once from a case of clinical mastitis . In the latter case the dominant strain was isolated from a different quarter of the same cow . Four of the ten cows studied suffered from clinical mastitis . From those four cows, three remained infected with the same S . aureus strain despite antibiotic treatment. Arch Med Res, 1996 Summer, 27(2), 165 - 70 Clinical stage, age and treatment in tropical pyomyositis: a retrospective study including forty cases; Martinez-de Jesus FR et al.; A comparative and retrospective trial of 40 patients with tropical pyomyositis covering studies done between January 1, 1987 and November 31, 1990, at the General Hospital at Cosamaloapan, Veracruz, IMSS, was undertaken . The objectives were to compare predisposing factors, clinical data, morbidity, mortaity and hospital stay among 1) medical (group I) and surgical treatment (II), 2) adult and pediatric populations and 3) the clinical stage of the disease (invasive, suppurative and late) . In group I, the family history of diabetes (56%), fever (66%) and hospital stay (6.5 +/- 1.8 days) were significantly different from group II (19%, 100% and 12.8 +/- 5.5 days), respectively . The mean age in adult and pediatric populations was 38 and 8 years, respectively . Pediatric patients had lowest hemoglobin levels (9.7 +/- 1.3) . Upper respiratory antecedent was highest in suppurative stage (65%) . In the late stage eosinophilia (5.9 +/- 6.9), fluctuance muscles (100%), complication rate of 57%, surgical drainage (100%) and mortality of 29% were found . Cultures were performed in 20 cases with negative results in 55% and the remaining 45% were positive to Staphylococcus aureus . Pyomyositis appears to be multifactorial in origin, the antecedents of trauma and upper respiratory infection were the major predisposing factors . Septicemia caused high morbidity and mortality in the late stage . Surgical treatment was frequently needed, increasing costs. J Dairy Sci, 1996 Jan, 79(1), 62 - 70 Mathematical modeling to estimate efficacy of postmilking teat disinfection in split-udder trials of dairy cows; Lam TJ et al.; A mathematical model was used to estimate the efficacy of postmilking teat disinfection from observations in split-udder trials with natural exposure . Data were studied from an outbreak of Staphylococcus aureus IMI during a split-udder trial in a commercial herd with low SCC . The efficacy of postmilking teat disinfection was similar when calculated based on incidence density rates or on transmission rates of IMI in dipped and control quarters . If, however, first and subsequent S . aureus IMI in a cow were not assumed to be independent and were therefore treated separately in the models, the efficacy of post-milking teat disinfection was calculated as being higher with the modeling procedure . The analysis using mathematical modeling, which includes the effect of the number of existing IMI on the number of new IMI, is presented and discussed . This analysis also allows estimation of the basic reproduction ratio . The impact of postmilking teat disinfection on transmission of pathogens is quantified, and proposals for additional preventive measures can be generated . We concluded that efficacy estimations from split-udder trials, assuming quarters to be independent observations, might underestimate the effect of postmilking teat disinfectants on udder pathogens. J Int Med Res, 1996 Jan-Feb, 24(1), 12 - 6 Activity of nadifloxacin against methicillin-resistant Staphylococcus aureus isolated from skin infections: comparative study with seven other fluoroquinolones; Nishijima S et al.; The in vitro susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) to nadifloxacin and seven other fluoroquinolones (norfloxacin, ofloxacin, enoxacin, ciprofloxacin, lomefloxacin, tosufloxacin and sparfloxacin) was evaluated . The MRSA isolates were isolated from 114 skin infections between 1991 and 1994 . Nadifloxacin exhibited the lowest minimum inhibitory concentration and there were no MRSA isolates resistant to nadifloxacin, while there were some resistant to all of the other seven fluoroquinolones . The minimum concentrations of these drugs needed to cause 50% inhibition of the isolates increased dramatically from 1991 to 1992, but has hardly changed since 1992. Hum Immunol, 1996 Jan, 45(1), 42 - 5 The toxic shock syndrome toxin-1 induces anergy in human T cells in vivo; Mahlknecht U et al.; TSST-1 is a Staphylococcus aureus-derived superantigen which has been implicated in the pathogenesis of toxic shock syndrome . In mice, superantigen-induced proliferation is followed by deletion or anergy of reactive T cells . So far, superantigen-induced T-cell anergy has not been observed in humans . We therefore examined PBMCs derived from a 15-year-old patient suffering from severe toxic shock syndrome . Markedly elevated levels of circulating TSST-1-reactive T cells were found by cytofluorometric analysis . Upon in vitro restimulation with TSST-1, hyporesponsiveness of TSST-1-responsive V beta 2+ T cells was detected, thus confirming results obtained in the murine system. J Antimicrob Chemother, 1996 Jan, 37(1), 65 - 75 Bleomycin resistance in Staphylococcus aureus clinical isolates; Gennimata D et al.; Among clinical isolates of Staphylococcus aureus tested for resistance to the antibiotic bleomycin, 197 were found to be resistant; most of them were also resistant to tobramycin and contained plasmids . DNA dot-blot hybridization analysis of the bleomycin resistant isolates with an 171 bp probe derived from the plasmid pUB110 indicated that 43 strains (22%) carried pUB110-like bleomycin resistance DNA sequences . Analysis of bacterial cell lysates derived from the bleomycin resistant isolates indicated that many contained bleomycin-binding properties (BBP), that prevent DNA damage by the antibiotic . Of 13 strains that were analysed by DNA gel electrophoresis and Southern blot DNA hybridization, six were found to carry pUB110-like bleomycin resistance DNA sequences . These studies indicate that there may be more than one genetic determinant for bleomycin resistance in S . aureus whose DNA is protected. J Antimicrob Chemother, 1996 Jan, 37(1), 53 - 63 Detection of the mec-A gene and phenotypic detection of resistance in Staphylococcus aureus isolates with borderline or low-level methicillinresistance; Bignardi GE et al.; Eighty-three isolates of Staphylococcus aureus for which MICs of methicillin of 4-16 mg/L had previously been recorded were tested for the presence of the mecA gene with a DNA probe and a PCR assay . There was complete agreement between the results obtained by these methods; 39 isolates were mecA-positive and 44 were mecA-negative . Using the presence of mecA as the defining standard, several phenotypic methods for determining resistance to methicillin were evaluated and a high-inoculum, agar-incorporation breakpoint test was found to offer the best combination of high sensitivity and high specificity . However twenty-seven of the 44 mecA-negative strains were methicillin-resistant according to agar dilution MICs (MIC > 4 mg/L on at least one of the four media used) but none had MICs exceeding 32 mg/L . One of the mecA-positive strains had a methicillin MIC of only 8 mg/L and did not appear to be heteroresistant . The clinical significance of these two groups of 'atypical' isolates may need further investigation . This study highlights the problems of detecting reliably S . aureus with low level methicillin resistance by phenotype methods and the usefulness of direct detection of the mecA gene. Eur J Clin Microbiol Infect Dis, 1996 Jan, 15(1), 60 - 4 Molecular typing of methicillin-resistant Staphylococcus aureus on the basis of protein A gene polymorphism; Frenay HM et al.; The polymorphic X-region of the protein A gene (spa) was used for molecular typing of methicillin-resistant Staphylococcus aureus (MRSA) strains . The X-region is characterized by a variable number (between 3 and 15) of small repeats . DNA sequencing of MRSA strains revealed 25 distinct repeats . Analysis of MRSA strains grown in vitro and in vivo revealed that the X-region was sufficiently stable for epidemiologic typing of MRSA strains . Spa typing of MRSA strains was compared to phage typing and, in general, concordance was found between the two methods . However, spa typing was more sensitive, allowing differentiation of strains within a particular phage type . Results obtained with spa typing suggest that hospital outbreaks may be caused by two or more MRSA strains . Spa typing may be an important tool in unravelling the spread of MRSA strains within and between hospitals. J Interferon Cytokine Res, 1996 Jan, 16(1), 7 - 16 Stimulation of natural interferon-alpha/beta-producing cells by Staphylococcus aureus; Svensson H et al.; Human peripheral blood mononuclear cells (PBMCs) produced high levels of antiviral activity, as determined by bioassay, when stimulated by Staphylococcus aureus Cowan I (SAC) and E . coli . Specific immunoassays demonstrated the presence of both IFN-alpha and gamma and, for SAC, also low levels of IFN-beta . The frequencies of SAC-induced IF N-alpha-producing cells (IPCs) were up to 1-2 per 10(3) PBMCs . These IPCs expressed the HLA-DR and CD4 antigens but not CD3, CD14, or CD19, thus resembling the natural IFN-alpha-producing cells (NIPC) . The SAC was more efficient as IFN inducer when heat killed than when streptomycin inhibited . The SAC was inhibitory to virally induced IFN-alpha responses, in particular when streptomycin inhibited . Both pronase treatment and mechanical disruption of SAC cells abolished their capacity to induce IFN-alpha production . Staphylococcal strains lacking or expressing low levels of protein A (SpA) showed a decreased ability to induce IFN-alpha production . However, purified SpA did not itself induce IFN-alpha . Possibly, SpA together with other bacterial surface proteins is important for the capacity of SAC to induce IFN-alpha production in NIPC. J Formos Med Assoc, 1996 Jan, 95(1), 45 - 50 Home parenteral nutrition in children; Huang FC et al.; From 1985 to 1994, home parenteral nutrition (HPN) was used as the method of feeding nine pediatric patients . Indications for HPN included congenital or acquired short bowel syndrome . Crohn's disease, chronic intractable diarrhea, chronic idiopathic intestinal pseudo-obstruction and Hirschsprung's disease . During the period, two patients died; one of sepsis and the other from hepatic failure . Three of the remaining patients have since moved on to oral feeding, but four patients continued on HPN . The majority of these patients have attained a normal weight and height for age while receiving HPN . All patients were fed via an implanted silicone catheter . Catheters were removed and replaced due to complications including nine episodes of infection, four episodes of occlusion, three episodes of breakage and two episodes of dislodgement . Catheter-related sepsis was the most common cause of morbidity and hospital readmission in patients receiving HPN, but was acceptably rare . Staphylococcus aureus was the most frequently cultured organism from either the catheter tip or the blood . HPN is a relatively safe feeding method for patients who would otherwise remain hospitalized for prolonged periods on parenteral nutrition for permanent or prolonged intestinal failure. J Clin Periodontol, 1996 Jan, 23(1), 38 - 44 Increased release of free oxygen radicals from peripheral neutrophils in adult periodontitis after Fc delta-receptor stimulation; Gustafsson A et al.; The release of free oxygen radicals and degranulation was studied in neutrophils from 14 patients with adult periodontitis and 14 age- and sex-matched healthy controls . The neutrophils were activated by Fc gamma-receptor stimulation, using Staphylococcus aureus opsonized with gamma globulin . Release of oxygen radicals was measured as luminol-enhanced chemiluminescence . Degranulation was assessed as release of elastase, measured with a specific substrate and as release of lactoferrin measured with ELISA . The neutrophils from the patients showed a significantly higher chemiluminescence and a slightly higher release of elastase, whereas the release of lactoferrin was the same in both groups . In contrast, the ratio between the 2 degranulation products, elastase and lactoferrin, was significantly higher in the group with periodontitis . A flow cytometric analysis of the membrane expression of the adhesion molecules CD 11a, CD 11b, CD 15, CD 16, CD 35 and Mel 14 showed no differences in the median immunofluorescence between the 2 groups . This study showed a more than 2-fold higher release of free oxygen radicals from Fc-gamma-receptor stimulated neutrophils compared with healthy controls, which indicates a specific neutrophil-associated host response in adult periodontitis. Am J Med, 1996 Jan, 100(1), 24 - 31 Contrasting methicillin-resistant Staphylococcus aureus colonization in Veterans Affairs and community nursing homes; Mulhausen PL et al.; PURPOSE: To compare the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nares colonization, the patterns of MRSA acquisition, and the risk for subsequent MRSA infection between a hospital-based, Department of Veterans Affairs (VA) nursing home care unit (NHCU) and community-based nursing homes . PATIENTS and METHODS: In this prospective study, 148 residents of three community nursing homes and 55 residents of a VA NHCU had their anterior nares swabbed; repeat cultures were obtained from hospitalized patients and/or individuals colonized with MRSA . Subjects were followed up prospectively for 1 year to note hospitalizations and the development of MRSA infections . RESULTS: The prevalence of MRSA colonization was significantly higher in the VA NHCU than in the community nursing homes (mean +/- SD 30.3% +/- 11% versus 9.9% +/- 4%) . The rate of MRSA nares colonization was similar in the two settings . Acquisition of MRSA took place in both the long-term care facilities and hospitals, with 23.8% of incident cases occurring during a hospitalization . Only 3 of the 27 individuals colonized at baseline developed an MRSA infection . A trend toward an increased rate of infection was seen in colonized individuals residing in the community nursing homes versus those in the VA NHCU (relative risk 4.67; 95% Cl 0.55 to 39.9) . Forty-seven percent of the 55 subjects hospitalized were colonized at some point during the study . In contrast to residents of the VA NHCU, MRSA colonization in the community facilities was a marker for high mortality . CONCLUSIONS: Outcomes from colonization may be different in the VA NHCU population and the community nursing home population. Ann Emerg Med, 1996 Jan, 27(1), 43 - 8 Contaminated wounds: infection rates with subcutaneous sutures; Mehta PH et al.; STUDY OBJECTIVE: To determine whether buried absorbable subcutaneous sutures (BASS) increase the infection rate in irrigated contaminated wounds . METHODS: This was a randomized, prospective trial in a rat model, with the histologist blinded to treatment group . A single 2-cm dorsal incision was made on each of 30 anesthetized 250-g Sprague-Dawley rats and inoculated with approximately 10(8) organisms of Staphylococcus aureus . After irrigation, 15 wounds were closed with running 4-0 nylon transdermal sutures, and 15 were closed with three interrupted 4-0 coated polyglactin 910 (Vicryl) subcuticular sutures (BASS) and running 4-0 nylon transdermal sutures . On day 7, wounds were scored on a scale of 0 to 3 in six categories: inflammatory infiltrates, fibroplasia and capillary proliferation, necrosis, exudates, giant cells, and edema . The possible range for the cumulative wound score was 0 (no inflammation) to 18 (severe inflammation and infection) . RESULTS: The median total wound score in wounds closed with BASS was 14 (range, 7 to 16); it was 8 (range, 5 to 15) for wounds closed without BASS (P = .0004) . The subscores for inflammation, necrosis, exudate, and edema were also significantly higher in wounds closed with BASS . CONCLUSION: BASS increase the infection rate and the degree of inflammation in contaminated wounds, despite through irrigation. Scand J Immunol, 1996 Jan, 43(1), 64 - 72 Effect of 12 neutralizing anti-cytokine antibodies on in vitro activation of B-cells . Interleukin-12 is required by B1a but not B2 cells; Jones BM; Normal human peripheral blood mononuclear cells, depleted of most monocytes and virtually all CD8-positive cells, were stimulated in vitro with pokeweed mitogen plus Staphylococcus aureus Cowan I in the presence or absence of various neutralizing anti-cytokine antibodies . Numbers of CD5+ and CD5- immunoglobulin-secreting cells were determined using the protein A haemolytic plaque assay after labelling B1a cells with anti-CD5-coated beads . Antibodies against IL-2, IL-5 and IL-10 had little or no effect on plaque-forming cell (PFC) induction; anti-IL-6, -TNF alpha and -TGF beta enhanced PFC induction; anti-IL-1 alpha, -IL-1 beta, -IL-4, -IFN gamma and -IL-13 suppressed PFC induction . B1a and B2 cells were equally affected by cytokine deprivation using these 11 neutralizing antibodies . In contrast, neutralizing anti-IL-12 suppressed induction of CD5+ but not CD5- PFC . Furthermore, recombinant IL-12, if added during the first 48 h of culture, enhanced CD5+ PFC induction while marginally suppressing (IgG-) or not affecting (IgA-, IgM-) induction of CD5- PFC . IL-12 did not preferentially increase survival in culture of B1a cells nor induce expression of CD5 on B2-cells . Further studies are required to determine whether manipulation of B1a and B2 subsets in vivo using IL-12 could be achieved in clinical situations where imbalances in the two populations have been observed. Scand J Immunol, 1996 Jan, 43(1), 23 - 30 The influence of follicular dendritic cells on B-cell proliferation depends on the activation of B cells and the mitogen used; Bosseloir A et al.; Follicular dendritic cells (FDC) are unique non-lymphoid cells found only in lymph follicles . They play a part in the survival, proliferation and differentiation of B cells . To analyse the influence of FDC on B-lymphocyte proliferation, we isolated them from human tonsils on albumin gradients and treated them with mitomycin C to prevent the multiplication of lymphoid cells harboured in their cytoplasmic evaginations . FDC cultured for 12-16 h remained attached to the substrate; non-adherent cells were carefully eliminated by washing . Purified B cells cultured alone or with contaminant-cleared FDC were maintained for 2 days in the presence or absence of various stimulants, after which tritiated thymidine uptake by these cells was measured . In the absence of activators, FDC did not induce B-cell multiplication . B cells cultured in the presence of FDC exhibited increased 3H-TdR uptake when activated with anti-CD40 MoAb, anti-immunoglobulin MoAb or transferrin, but not when stimulated with Staphylococcus aureus strain Cowan I (SAC) at a given concentration . In the latter case, B-cell proliferation clearly decreased . In control cocultures where mitomycin-C-treated non-adherent cells were used instead of FDC in the presence of the different stimulants, no increase in B-cell proliferation was observed . The results suggest that, inside the germinal centres, FDC modulation of B-cell proliferation depends on the activation state of the B cells and on the stimulant encountered. Infect Immun, 1996 Jan, 64(1), 310 - 8 Staphylococcus aureus binding to human nasal mucin; Shuter J et al.; Colonization of human nasal mucosa with Staphylococcus aureus sets the stage for subsequent systemic infection . This study characterizes S . aureus adhesion to nasal mucosa in vitro and investigates the interaction of S . aureus with human nasal mucin . S . aureus binding to cell-associated and cell-free mucus was greater than to nonmucin-coated epithelial cells . Scanning electron microscopy of S . aureus incubated with human nasal mucosal tissue showed minimal binding to ciliated respiratory epithelium . In a solid-phase assay, S . aureus bound to purified human nasal mucin-coated wells significantly more than to bovine serum albumin-coated microtiter wells . Binding to mucin was saturable in a dose- and time-dependent fashion . Staphylococcal adherence to human nasal mucin was inhibited by bovine submaxillary mucin but not by fibrinogen . Pretreatment of mucin with periodate but not with pronase reduced adherence . Trypsin treatment of the bacteria significantly reduced adherence to mucin . 125I-labelled nasal mucin bound to two surface proteins (138 and 127 kDa) of lysostaphin-solubilized S . aureus . Binding to human nasal mucin occurs in part via specific adhesin-receptor interactions involving bacterial proteins and the carbohydrate moiety in mucin . These experiments suggest that S . aureus binding to mucin may be critical for colonization of the nasopharyngeal mucosa. J Clin Invest, 1996 Jan 1, 97(1), 250 - 7 The potent anti-Staphylococcus aureus activity of a sterile rabbit inflammatory fluid is due to a 14-kD phospholipase A2; Weinrauch Y et al.; The cell-free fluid (ascitic fluid, AF) of a sterile inflammatory peritoneal exudate elicited in rabbits is potently bactericidal for complement-resistant gram-negative as well as gram-positive bacterial species . This activity is absent in plasma . We now show that essentially all activity in AF against Staphylococcus aureus is attributable to a group II 14-kD phospholipase A2 (PLA2), previously purified from AF in this laboratory . Antistaphylococcal activity of purified PLA2 and of whole AF containing a corresponding amount of PLA2 was comparable and blocked by anti-AF-PLA2 serum . At concentrations present in AF (approximately 10 nM), AF PLA2 kills > 2 logs of 10(6) S . aureus/ml, including methicillin-resistant clinical isolates, and other species of gram-positive bacteria . Human group II PLA2 displays similar bactericidal activity toward S . aureus (LD90 approximately 1-5 nM), whereas 14-kD PLA2 from pig pancreas and snake venom are inactive even at micromolar doses . Bacterial killing by PLA2 requires Ca2+ and catalytic activity and is accompanied by bacterial phospholipolysis and disruption of the bacterial cell membrane and cell wall . These findings reveal that group II extracellular PLA2, the function of which at inflammatory sites has been unclear, is an extraordinarily potent endogenous antibiotic against S . aureus and other gram-positive bacteria. J Bacteriol, 1996 Jan, 178(2), 441 - 6 Cell wall sorting of lipoproteins in Staphylococcus aureus; Navarre WW et al.; Many surface proteins are thought to be anchored to the cell wall of gram-positive organisms via their C termini, while the N-terminal domains of these molecules are displayed on the bacterial surface . Cell wall anchoring of surface proteins in Staphylococcus aureus requires both an N-terminal leader peptide and a C-terminal cell wall sorting signal . By fusing the cell wall sorting of protein A to the C terminus of staphylococcal beta-lactamase, we demonstrate here that lipoproteins can also be anchored to the cell wall of S . aureus . The topology of cell wall-anchored beta-lactamase is reminiscent of that described for Braun's murein lipoprotein in that the N terminus of the polypeptide chain is membrane anchored whereas the C-terminal end is tethered to the bacterial cell wall. J Bacteriol, 1996 Jan, 178(2), 418 - 23 Characterization of the sar locus and its interaction with agr in Staphylococcus aureus; Heinrichs JH et al.; The expression of cell wall and extracellular proteins in Staphylococcus aureus is controlled by global regulatory systems, including sar and agr . We have previously shown that a transposon insertion into the 372-bp sarA gene within the sar locus resulted in decreased expression of several extracellular and cell wall proteins (A . L . Cheung and S . J . Projan, J . Bacteriol . 176:4168-4172, 1994) . In this study, Northern (RNA blot) analysis with a 732-bp sarA probe indicated that two major transcripts (0.56 and 1.2 kb) were absent in the sar mutant compared with the parental strain RN6390 . Additional transcriptional studies revealed that the sarA gene is encoded within the 0.56-kg transcript . Notably, a plasmid carrying the sarA gene together with a 1.2-kb upstream fragment (1.7 kb total) was able to reestablish the 1.2-kb transcript in the mutant . Although reconstitution of the parental phenotype by the sarA gene was incomplete, the introduction of a plasmid carrying the 1.7-kb fragment to the mutant restored the parental phenotype . Transcription of RNAII and RNAIII, which encode the structural and regulatory genes of agr, respectively, was diminished in the mutant but restored to wild-type levels by complementation with the 1.7-kb fragment . In gel shift assays, cell extracts of this clone were able to retard the mobility of a labeled RNAII promoter probe but not an RNAIII promoter element . These data suggest that sarA and the adjacent upstream DNA are essential to the expression of a DNA-binding protein(s) with specificity for the RNAII promoter, thereby controlling agr-related transcription. Arch Dermatol, 1996 Jan, 132(1), 27 - 33 Staphylococcal enterotoxin B applied on intact normal and intact atopic skin induces dermatitis; Strange P et al.; BACKGROUND AND DESIGN: Colonization of inflammatory skin diseases with Staphylococcus aureus is a frequent phenomenon and may cause exacerbation of the skin disease . Staphylococcus aureus strains present on atopic dermatitis are capable of releasing staphylococcal enterotoxins, a group of superantigens that are very potent T-cell activators . To determine whether the superantigen staphylococcal enterotoxin B can induce inflammation when applied on the skin, staphylococcal enterotoxin B was applied with and without occlusion on the volar aspect of the skin on the forearm of 10 subjects without skin disease and six subjects with atopic dermatitis of minimal activity and no eczema on the volar aspect of the skin on their forearm . The main outcome measures were clinical rating; determination of the increase of the thickness of the skin-fold; and determination of skin blood flow . RESULTS: Clinically, staphylococcal enterotoxin B induced skin changes of erythema and induration in 10 of 10 healthy volunteer subjects and six of six subjects suffering from atopic dermatitis, while the vehicle induced clinically evident skin changes in only one of 10 healthy subjects and none of six subjects with atopic dermatitis . On day 3 after the application of an occluded patch containing 10 micrograms/cm2 of staphylococcal enterotoxin B in the healthy subjects, the thickness of the skinfold increased 0.47 +/- 0.49 mm (mean +/- SD) (n = 9; P < .02) relative to the increase in the thickness of the skinfold following application of the vehicle . The Doppler laser-measured skin blood flow index had increased from 1.0 +/- 0.4 to 5.3 +/- 3.7 (mean +/- SD) (n = 10; P < .002) . On day 3 after the application of occluded patchs containing 10 micrograms/cm2 of staphylococcal enterotoxin B in the subjects suffering from atopic dermatitis, the increase in the thickness of the skinfold increased 0.20 +/- 0.24 mm (n = 6; P, not significant) relative to the increased thickness in the skinfold following application of the vehicle . The Doppler laser-measured skin blood flow index had increased from 1.1 +/- 0.4 to 3.7 +/- 2.2 (n = 6, P, not significant) . Three of six subjects suffering from atopic dermatitis experienced a flare of their disease in the elbow flexure ipsilaterally to where the staphylococcal enterotoxin B patch was applied . CONCLUSIONS: The superantigen staphylococcal enterotoxin B applied on intact skin from both normal subjects and patients with atopic dermatitis induces an inflammatory reaction . This finding suggests that superantigens released from S aureus present on the skin in inflammatory skin diseases may exacerbate and sustain the inflammation. Am J Kidney Dis, 1996 Jan, 27(1), 75 - 83 Spinal epidural abscess in hemodialysis patients: report of three cases and review of the literature; Obrador GT et al.; Spinal epidural abscess (SEA) is a rare infection that can evolve to severe permanent neurologic deficit or death if the diagnosis is delayed . We report three cases of SEA in hemodialysis patients and summarize nine previously reported cases occurring in hemodialysis patients, with detailed comparisons to series of SEA from the general medical literature . Among these 12 patients, hemodialysis catheters and arteriovenous grafts were the major source of infection, in contrast to the usual skin source . Staphylococcus aureus was implicated in all cases, but in one patient Bacteroides fragilis also was isolated from both the resected arteriovenous fistula and the SEA, and Escherichia coli was isolated from the arteriovenous fistula . The classic syndrome of SEA includes fever, backache, and local spinal tenderness, followed by progressive radicular and cord compression signs and symptoms . In this series, back pain and radicular pain were common at presentation, but only a minority had fever, back tenderness, weakness, or leukocytosis . Cerebrospinal fluid was typically abnormal but culture negative, whereas blood and epidural abscess cultures were frequently positive . Plain x-ray films, bone scans, and plain computed tomography scans had low diagnostic yield, and magnetic resonance imaging with gadolinium had a sensitivity of 80% . Only myelography or computed tomography-myelography gave consistently correct diagnoses . The clinical outcome was poor, with one patient deceased and seven with severe weakness or paralysis . Early intervention provided a higher likelihood of good outcome, whereas late intervention and preoperative neurologic deficits portended a poor functional result . Because of the high incidence of bacteremia in hemodialysis patients, we recommend that symptoms of fever, backache, and spinal tenderness be promptly evaluated for SEA before signs or symptoms of cord compression develop . Early recognition and treatment with antibiotics and decompressive laminectomy is generally associated with a better outcome. J Infect Dis, 1996 Jan, 173(1), 98 - 103 Effect of tampon composition on production of toxic shock syndrome toxin-1 by Staphylococcus aureus in vitro; Parsonnet J et al.; To determine whether tampons composed of cotton or rayon differ in their effects on production of TSST-1 in vitro, two methods of bacterial cultivation, with and without agitation, were used to study the effects of 16 commercially available and experimental tampons on production of TSST-1 . Experiments were done in blinded fashion . TSST-1 was produced in medium alone in the absence of a tampon by both methods . Neither cotton nor rayon tampons consistently increased toxin production, nor were there significant differences between them in their effects on TSST-1 . In contrast, a tampon composed of carboxymethylcellulose and polyester foam increased production of TSST-1 to a large degree in both culture systems . Thus, neither cotton nor rayon amplifies production of TSST-1 in vitro, and cotton tampons cannot be claimed to be inherently safer on the basis of such data. J Infect Dis, 1996 Jan, 173(1), 203 - 11 Treatment of experimental gram-negative and gram-positive bacterial sepsis with the hematoregulatory peptide SK&F 107647; DeMarsh PL et al.; SK&F 107647, a novel synthetic low-molecular-weight peptide, has demonstrated potent antiinfective activities in murine models of fungal and viral infection . To determine if the hematoregulatory activities of SK&F 107647 could offer protection over conventional antibiotic therapy or as a single agent in animal models of bacterial sepsis, rats were implanted intraperitoneally with a live bacteria-containing fibrin-thrombin clot . Rats pretreated subcutaneously or orally with SK&F 107647 and then infected with either a gram-negative (Escherichia coli) or a gram-positive (Staphylococcus aureus) bacteria-containing clot demonstrated significantly improved survival over control formulation-treated animals . Treated animals showed increased effector cell activation, measured by CD11b expression on neutrophils and monocytes, and up to 1000-fold reduction in the number of E . coli recovered from blood . Thus, the hematoregulatory activities of SK&F 107647 can increase natural host resistance to infections caused by both gram-negative and gram-positive bacteria. Gene, 1995 Dec 29, 167(1-2), 115 - 9 Association of staphylococcal type-1 capsule-encoding genes with a discrete genetic element; Lee CY; Previous studies have shown that 13 genes located in a 14.6-kb region of the chromosome of Staphylococcus aureus (Sa) M are required for type-1 capsular polysaccharide (CP1) biosynthesis . In this report, a total of 17 Sa strains producing different CP serotypes were analyzed by Southern hybridization using DNA probes from the cap1 coding region and the flanking sequences . The results showed that the sequence encoding cap1 genes was specific to CP1-producing strains . In addition, DNA regions of at least 18 kb flanking the cap1 genes were absent in most of the non-type-1 strains . These data suggest that the cap1 genes are associated with a chromosomally located discrete genetic element . One end of the element, referred to as the cap1 element, is located in a 1.7-kb fragment about 11.1 kb upstream from the first gene of the cap1 locus and the other end is located in a 0.8-kb region about 7.6 kb downstream from the last gene of the cap1 locus . Thus, the size of the cap1 element is between 33.3 and 35.8 kb. Gene, 1995 Dec 29, 167(1-2), 111 - 3 Analysis of Staphylococcus aureus genes encoding penicillin-binding protein 4 and an ABC-type transporter; Domanski TL et al.; A region of the Staphylococcus aureus chromosome has been isolated that contains the gene encoding penicillin-binding protein 4 (PBP4), as well as abcA, a gene that encodes a protein with strong sequence similarity to the ABC transporter family of proteins . A disruption in abcA by Campbell-type integration results in cells that display an increased resistance to methicillin and cefoxitin, two antibiotics known to interact with low-molecular-weight PBPs . Based on these observations, a potential regulatory link between these two genes is discussed. Proc Natl Acad Sci U S A, 1995 Dec 19, 92(26), 12055 - 9 Cell density control of staphylococcal virulence mediated by an octapeptide pheromone; Ji G et al.; Some bacterial pathogens elaborate and secrete virulence factors in response to environmental signals, others in response to a specific host product, and still others in response to no discernible cue . In this study, we have demonstrated that the synthesis of Staphylococcus aureus virulence factors is controlled by a density-sensing system that utilizes an octapeptide produced by the organism itself . The octapeptide activates expression of the agr locus, a global regulator of the virulence response . This response involves the reciprocal regulation of genes encoding surface proteins and those encoding secreted virulence factors . As cells enter the postexponential phase, surface protein genes are repressed by agr and secretory protein genes are subsequently activated . The intracellular agr effector is a regulatory RNA, RNAIII, whose transcription is activated by an agr-encoded signal transduction system for which the octapeptide is the ligand. FEMS Microbiol Lett, 1995 Dec 15, 134(2-3), 209 - 12 Triton X-100 alters the resistance level of methicillin-resistant Staphylococcus aureus to oxacillin; Komatsuzawa H et al.; We used population analysis to examine the effects of Triton X-100 on the level of resistance to oxacillin of 18 methicillin-resistant Staphylococcus aureus . In the presence of 0.02% Triton-X-100, 17 formerly methicillin-resistant strains exhibited enhanced sensitivity to oxacillin . One homogenous isolate, KSAF1 was barely affected by the Triton X-100 . Sensitivities of lysostaphin, 51 kDa N-acetylglucosaminidase and 62 kDa N-acetylmuramoyl-L- alanine amidase to heat-inactivated cells were not affected when the bacteria were grown in 0.02% Triton X-100 . Our data, together with those of a previous study, suggested that Triton X-100 alters the resistance level of methicillin-resistant S . aureus influencing a factor (s) other than PBPs, bacteriolytic enzymes, or femAB products. J Biol Chem, 1995 Dec 15, 270(50), 29923 - 7 Moricin, a novel type of antibacterial peptide isolated from the silkworm, Bombyx mori; Hara S et al.; A novel antibacterial peptide that shows antibacterial activity against Staphylococcus aureus was isolated from the hemolymph of the silkworm, Bombyx mori . The novel peptide consisted of 42 amino acids and was highly basic . This peptide indicated no significant similarity with other antibacterial peptides . The peptide showed antibacterial activity against several Gram-negative and -positive bacteria and had a higher activity against Gram-positive bacteria than cecropin B1, a major antibacterial peptide of B . mori . The novel peptide was inducible by bacterial injection . These results suggest that the peptide is responsible for the antibacterial activity in B . mori against Gram-positive bacteria . The effects of the peptide on bacterial and liposomal membranes showed that a target of the peptide is the bacterial cytoplasmic membrane . The results also suggest that the N-terminal portion of the peptide, containing a predicted alpha-helix, is responsible for an increase in the membrane permeability . We propose the name "moricin" for this novel antibacterial peptide isolated from B . mori. J Biol Chem, 1995 Dec 15, 270(50), 29854 - 61 Molecular cloning, expression, and partial characterization of two novel members of the ovalbumin family of serine proteinase inhibitors; Sprecher CA et al.; A human placental lambda gt11 cDNA library was screened for sequences encoding proteins related to human proteinase inhibitor 6 (PI6), and two plaques were identified that displayed weak hybridization at high stringency . Isolation and characterization of the DNA inserts revealed two novel sequences encoding proteins composed of 376 and 374 amino acids with predicted molecular masses of approximately 42 kDa . The novel proteins displayed all of the structural features unique to the ovalbumin family of intracellular serpins including the apparent absence of a cleavable N-terminal signal sequence . The degree of amino acid sequence identity between the novel serpins and PI6 (63-68%) significantly exceeds that of any other combination of known intracellular serpins . The two novel serpins encoded by the two novel cDNA sequences have been designated as proteinase inhibitor 8 (PI8) and proteinase inhibitor 9 (PI9) . The putative reactive center P1-P1' residues for PI8 and PI9 were identified as Arg339-Cys340 and Glu340-Cys341, respectively . PI9 appears to be unique in that it is the first human serpin identified with an acidic residue in the reactive center P1 position . In addition, the reactive center loop of PI9 exhibits 54% identity with residues found in the reactive center loop of the cowpox virus CrmA serpin . Two PI8 transcripts of 1.4 kilobases (kb) and 3.8 kb were detected by Northern analysis in equal and greatest abundance in liver and lung, while the 1.4-kb mRNA was in excess over the 3.8-kb mRNA in skeletal muscle and heart . Two PI9 transcripts of 3.4 and 4.4 kb were detected in equal and greatest abundance in lung and placenta and were weakly detected in all other tissues . PI8 and PI9 were expressed in baby hamster kidney and yeast cells, respectively . Immunoblot analyses using rabbit anti-PI6 IgG indicated the presence of PI8 in the cytosolic fraction of stably transfected cells that formed an SDS-stable 67-kDa complex with human thrombin . PI9 was purified to homogeneity from the yeast cell lysate by a combination of heparin-agarose chromatography and Mono Q fast protein liquid chromatography and migrated as a single band in SDS-polyacrylamide gel electrophoresis with an apparent molecular mass of 42 kDa . Purified recombinant PI9 failed to inhibit the amidolytic activities of trypsin, papain, thrombin, or Staphylococcus aureus endoproteinase Glu-C and did not form an SDS-stable complex when incubated with thrombin . The cognate intracellular proteinases that interact with PI8 and PI9 are unknown. J Immunol, 1995 Dec 15, 155(12), 5795 - 802 Collagen-like complement component C1q is a membrane protein of human monocyte-derived macrophages that mediates endocytosis; Kaul M et al.; The collagen-like C1q molecule, a subcomponent of the first component of complement, C1, is synthesized by macrophages (M phi) . Previously, we have demonstrated that C1q is a membrane protein of guinea pig peritoneal macrophages (M phi) . To extend this observation as a general biologic characteristic of M phi, we investigated human (hu) monocyte-derived M phi . Interestingly, surface labeling with the biotin derivative sulfosuccinimidyl-6-(biotinamido)-hexanoate of M phi, freshly isolated monocytes, lymphocytes, granulocytes, and myelomonocytic U937 cells revealed that C1q occurs only on the surface of M phi and not on the surface of the other cells types . Therefore, C1q appears to be a marker for differentiation into M phi . FITC-labeled, fixed Staphylococcus aureus coupled to membrane C1q via a monoclonal alpha-hu-C1q Ab were used to demonstrate that membrane C1q is capable of mediating phagocytosis . Various detergents (Nonidet P-40, digitonin, lubrol, and Triton X-114) were used to solubilize membrane C1q . Membrane C1q of hu M phi is tightly bound to or located in the intact membrane, since treatment of cells with acidic buffers ("acid strip") failed to remove C1q from the cell surface . However, repeated freezing and thawing of cells and washing of segregated membranes with buffer containing 1 M KCl and 3 M urea brought about a marked release of membrane C1q. Br J Nurs, 1995 Dec 14-1996 Jan 11, 4(22), 1345 - 9 Methicillin-resistant Staphylococcus aureus and wound management; Phillips E et al.; The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing in the UK . MRSA is mainly transmitted via the hands of health-care workers . MRSA can cause colonization or infections . MRSA infections can be fatal. FEBS Lett, 1995 Dec 4, 376(3), 135 - 40 Characterisation of a synergohymenotropic toxin produced by Staphylococcus intermedius; Prevost G et al.; Staphylococcal synergohymenotropic (SHT) toxins damage membranes of host defence cells and erythrocytes by the synergy of two secreted and non-associated proteins: class S and class F components . Whereas Panton-Valentine leucocidin (PVL), gamma-hemolysin and Luk-M from Staphylococcus aureus are members of this toxin family, a new bi-component toxin (LukS-I + LukF-I) from Staphylococcus intermedius, a pathogen for small animals, was characterised and sequenced . It is encoded as a luk-I operon by two cotranscribed genes, like PVL, LukS-I + LukF-I shares a strong leukotoxicity of various PMNs, but only slight haemolytic properties on rabbit erythrocytes . When intradermally injected into rabbit skin, a 100 ng dose caused acute inflammatory reaction leading to tissue necrosis . The new SHT seemed to be largely distributed among various Staphylococcus intermedius strains. J Gastroenterol, 1995 Dec, 30(6), 718 - 24 The order of ward rounds influences nosocomial infection . A 2-year study in gastroenterologic surgery patients; Yoshida J et al.; We studied the effect of the order of ward rounds on nosocomial infection in gastroenterologic surgery patients . The subjects were patients with gastrointestinal diseases admitted between September 1992 and August 1994 . During the 1st year, the round proceeded indiscriminately among recovery rooms and rooms with stable patients and isolated patients with methicillin-resistant Staphylococcus aureus (MRSA) . In the subsequent year, the round started in the recovery rooms and moved into the general rooms with stable patients and finally into the isolation rooms . Against the time course, piecewise linear regression analyses were made with the number of culture-positive patients and the quantities of antibiotics and disinfectants used . Of a total of 1894 strains from 264 patients, isolates of MRSA (n = 200) decreased from 150 in the 1st year to 50 in the 2nd year . The number of MRSA-positive patients showed the point of inflexion in the analysis at the change of round order, with a later decrease . The trend was similar for Candida (n = 99) and Enterococcal (n = 225) species . The amount of antibiotics was unchanged while the amount of disinfectants used decreased in the 2nd year . Thus, the round re-ordering appeared to help prevent nosocomial infection . Ward rounds for patients who have had gastroenterologic surgery should proceed from compromised hosts to stable patients, and then isolated patients. J Hosp Infect, 1995 Dec, 31(4), 253 - 60 Molecular epidemiology of a multiple strain outbreak of methicillin-resistant Staphylococcus aureus amongst patients and staff; Lessing MP et al.; Since methicillin-resistant Staphylococcus aureus (MRSA) isolates are not endemic in our hospital, which is a tertiary referral centre, the finding of 13 MRSA isolates from 12 patients associated with an acute vascular surgery ward between October 1993 and December 1993 prompted further epidemiological and laboratory investigations . Two strains were distinguished by antibiogram and phage-typing . One strain, resembling EMRSA-16, colonized six patients and was probably introduced from another hospital in the Oxford Region . Five other patients were colonized by a second strain, gentamicin-resistant and non-typable by phage-typing, probably introduced into the hospital 12 months previously by a patient from Nairobi, Kenya . A 12th patient was colonized by both strains simultaneously . Of 46 staff members screened three were colonized--one by an EMRSA-16 strain, a second by the gentamicin-resistant 'Nairobi'-strain and a third member carried yet a further distinct MRSA strain . The healthcare worker colonized by the 'Nairobi'-strain had been carrying the isolate 12 months previously and was the likely source of this strain . These isolates were also characterized by the repetitive extragenic palindromic-polymerase chain reaction (REP-PCR), a novel PCR-based methodology which has not been previously used in characterizing Staphylococcus aureus in an outbreak . This method corroborated the strain classifications provided by the traditional methods, confirming that there had been spread of two strains simultaneously . Our study demonstrates that multiple strains of MRSA may circulate amongst patients and staff during an outbreak, patients may be colonized by more than one strain simultaneously and long-term staff carriage (> 12 months) may be an important source of colonization in patients . REP-PCR is a rapid and effective molecular typing method for MRSA. Rev Esp Fisiol, 1995 Dec, 51(4), 213 - 8 Serum hemolytic and bactericidal activity in breast and formula-fed infants; Barriga C et al.; Whether formula or breast feeding influences the functional activity of the complement system from birth to three months of age has been studied . The classical pathway was evaluated by assessing hemolytic activity, based on the capacity of the intact complement system to lyse sheep erythrocytes when coated with specific antibodies . The bactericidal activity of the serum against Staphylococcus aureus and Escherichia coli was used to evaluate the alternative complement pathway . Sera were obtained from neonates (40 +/- 2 weeks of gestation), and one-month or three-month old infants, fed either breast or formula . Control serum was obtained from healthy adults between 22 and 30 years of age . The hemolytic capacity of serum from breast-fed infants of one month and three months of age was significantly greater than that of the serum from infants which had been fed formula milk. Protein Eng, 1995 Dec, 8(12), 1275 - 85 An engineered Staphylococcus aureus PC1 beta-lactamase that hydrolyses third-generation cephalosporins; Zawadzke LE et al.; The beta-lactamase from Staphylococcus aureus PC1 has been cloned into an Escherichia coli vector for site-directed mutagenesis and high-level protein expression . A mutant enzyme has been produced in which Ala238 is replaced by a serine, and Ile239 is deleted (A238S:I239del) . The engineered enzyme hydrolyses third-generation cephalosporins substantially more rapidly than the parental enzyme does, while hydrolysis of benzylpenicillin is slower with the mutant than with the wild-type and native enzymes . The mutant beta-lactamase has been crystallized and the structure determined and refined at 2.8 A resolution . The disposition of the beta-strand which forms the side of the active site is altered in comparison with the native S . aureus beta-lactamase structure, widening the active site cleft and providing space to accommodate the bulky side-chains of the third-generation cephalosporins. Microb Pathog, 1995 Dec, 19(6), 409 - 19 Internalization of Staphylococcus aureus by cultured osteoblasts; Hudson MC et al.; Staphylococcus aureus is the most common cause of both acute and chronic osteomyelitis; however, the pathogenesis of osteomyelitis is poorly understood . We investigated the ability of S . aureus to associate with chick osteoblasts in culture and have demonstrated internalization of bacteria by the osteoblasts . Two strains of S . aureus were examined that were ingested by osteoblasts to different extents, suggesting strain differences in uptake . Initial association of S . aureus strains with osteoblasts was independent of the presence of matrix collagen produced by the osteoblasts . Internalization of bacteria required live osteoblasts, but not live S . aureus, indicating osteoblasts are active in ingesting the organisms . The bacteria were not killed by the osteoblasts, since viable bacteria were cultured several hours after ingestion. Planta Med, 1995 Dec, 61(6), 497 - 501 Inhibitory effects of bisbenzylisoquinoline alkaloids on induction of proinflammatory cytokines, interleukin-1 and tumor necrosis factor-alpha; Onai N et al.; Bisbenzylisoquinoline alkaloids are known to affect immune responses as well as inflammatory responses, and have been used for the treatment of inflammatory symptoms in China . This study is aimed at elucidating the inhibitory effects of two alkaloids, fangchinoline and isotetrandrine, on the induction of the proinflammatory cytokines, interleukin-1 (IL-1), and tumor necrosis factor-alpha (TNF-alpha), by Staphylococcus aureus Cowan 1 (SAC)-stimulated human peripheral blood mononuclear cells . These two alkaloids inhibited cytokine production in a dose-dependent manner, and they inhibited it by more than 90% at 10 micrograms/ml at every time point examined . Of note was that these two alkaloids appeared to inhibit IL-1 beta production more effectively than IL-1 alpha production . When the levels of cytokine mRNA were measured by semiquantitative RT-PCR, these alkaloids reduced the levels of the mRNAs of IL-1 beta and TNF-alpha, but not that of beta 2-microglobulin, suggesting that these alkaloids may suppress cytokine transcription selectively. J Antimicrob Chemother, 1995 Dec, 36(6), 941 - 50 Azithromycin induces in vitro a time-dependent increase in the intracellular killing of Staphylococcus aureus by human polymorphonuclear leucocytes without damaging phagocytes; Silvestri M et al.; Despite its clinical efficacy on intracellular pathogens, the in-vitro intracellular antimicrobial activity of azithromycin, has been shown to be absent or lower than expected from the intracellular concentrations reached . To test the possibility that the high intracellular concentrations of the drug could damage phagocytes, the present study evaluated the effects of azithromycin on (a) the intracellular killing of Staphylococcus aureus by human blood neutrophils (PMNs) and (b) the viability and the respiratory burst of PMNs . Using a fluorochrome assay, we assessed the phagocytosis and intracellular killing of S . aureus by PMNs preloaded with azithromycin, or by PMNs unloaded but with the drug in the culture medium . In addition, possible drug-induced damage to PMNs was evaluated measuring: (a) hydrogen peroxide (H2O2) production and (b) the percentages of PMNs dead at the end of the phagocytosis process . Compared to control PMNs without drug, a time-dependent enhancement in the intracellular killing was observed which was statistically significant after 60 min incubation . The increased intracellular killing was higher in suspensions of unloaded PMNs and azithromycin (P < 0.01) that in suspensions of preloaded PMNs (P < 0.05) . This increased intracellular killing was not associated with increased proportions of dead phagocytes, either in preloaded or unloaded PMNs (P < 0.05, each comparison) . Similarly no changes in the production of H2O2 by PMNs were observed in the presence of azithromycin . Thus, azithromycin induces a time-dependent increase in the bactericidal activity of human PMNs, without increasing the phagocyte self-killing or modifying H2O2 production. Clin Exp Allergy, 1995 Dec, 25(12), 1218 - 27 Upregulation of IgE synthesis by staphylococcal toxic shock syndrome toxin-1 in peripheral blood mononuclear cells from patients with atopic dermatitis; Hofer MF et al.; BACKGROUND: Atopic dermatitis (AD) is a chronic skin disease associated with increased IgE synthesis and colonization with Staphylococcus aureus secreting exotoxins, such as Toxic Shock Syndrome Toxin-1 (TSST-1) . OBJECTIVES: In this study, we were interested in determining the in vitro effects of TSST-1 on IgE synthesis in peripheral blood mononuclear cells from patients with AD . METHODS: We stimulated peripheral blood mononuclear cells (PBMC) from AD patients with a wide range of TSST-1 concentrations and measured IgE synthesis by enzyme-linked immunosorbent assay (ELISA) after 14 days . RESULTS: We show herein that TSST-1 produced antagonistic effects on IgE synthesis by PBMC from AD patients, depending on the concentration used: IgE synthesis was inhibited at 1000 pg/mL (P < 0.05) and enhanced at 0.01 pg/mL (P < 0.01) of toxin . TSST-1 was found to induce the production of much higher amounts of interferon-gamma (IFN gamma) at 1000 pg/mL than at 0.01 pg/mL of toxin (P = 0.0001) . More importantly, immunoglobulin E (IgE) synthesis was enhanced by TSST-1 at 1 pg/mL in the presence of antibodies blocking IFN gamma activity . The other immunoglobulin (Ig) isotypes were also increased after TSST-1 stimulation suggesting that the enhanced IgE synthesis was secondary to a polyclonal B cell activation rather than an isotype switch . TSST-1-stimulated IgE synthesis was T cell-dependent because purified tonsil B cells were only able to synthesize increased amounts of IgE when small numbers of T cells were added to the cultures . Anti-HLA-DR and anti-LFA-1 monoclonal antibodies (MoAb) inhibited TSST-1-enhanced IgE synthesis, suggesting that the bridging of the T cell receptor (TCR) and major histocompatibility complex (MHC) class II on B cells was necessary for activation of B cell differentiation . CONCLUSION: These data indicate that staphylococcal superantigens are able, at concentrations inducing low amounts of IFN gamma, to stimulate IgE synthesis by PBMC from AD patients, and suggest that staphylococcal toxins may contribute to elevated IgE synthesis in AD. Jpn J Pharmacol, 1995 Dec, 69(4), 443 - 5 Effect of levofloxacin-albumin Dacron graft on graft infection; Fujimoto K et al.; The susceptibility of Dacron grafts to infection is compared with Dacron grafts applied with levofloxacin-bonded albumin (LVFX-ALB) following the inoculation of 10(7) cells Staphylococcus aureus in rats . Staphylococcus epidermidis was inoculated in the same manner . While the control grafts were infected at the time of removal, the LVFX-ALB Dacron grafts resisted infection, thus demonstrating their effectiveness. Diabetes Care, 1995 Dec, 18(12), 1588 - 91 Infected puncture wounds in diabetic and nondiabetic adults; Lavery LA et al.; OBJECTIVE: To evaluate bone and soft tissue pathogens resulting from puncture wounds among diabetic and nondiabetic adults . RESEARCH DESIGN AND METHODS: We used a case-control design to compare bacterial pathogens in diabetic and nondiabetic subjects with foot infections precipitated by puncture injuries . We used ICD-9-CM code E920.8 to identify 77 diabetic and 69 nondiabetic patients admitted to the hospital for infected puncture wounds . We identified surgical bone and soft tissue cultures and number and type of organisms per culture . RESULTS: Nondiabetic subjects had significantly less osteomyelitis (13 vs . 35%, P < 0.01) than diabetic subjects and were infected by fewer organisms . Pseudomonas was the most common cause of osteomyelitis among nondiabetic subjects (P < 0.001) . Staphylococcus aureus was more common in diabetic bone (P < 0.001) and soft tissue (P < 0.001) infections . Polymicrobial osteomyelitis was more common in diabetic subjects . There was a longer delay until diabetic subjects received medical treatment compared with nondiabetic subjects (8.7 vs . 5.3 days, P < 0.002) . Diabetic subjects were more likely to have neuropathy (P < 0.001) and to have sustained their injuries while barefoot (P < 0.006) . CONCLUSIONS: Puncture wounds in diabetic subjects were commonly associated with polymicrobial infections . Pseudomonas was the most common cause of nondiabetic osteomyelitis . These results have implications for differential emergent and chronic treatment of puncture wounds in diabetic versus nondiabetic subjects. Br J Pharmacol, 1995 Dec, 116(8), 3191 - 8 Role for intracellular platelet-activating factor in the circulatory failure in a model of gram-positive shock; De Kimpe SJ et al.; 1 . This study investigates the effects of two structurally different antagonists of platelet-activating factor (PAF), BN52021 and WEB2086, on the circulatory and renal failure elicited by lipoteichoic acid (LTA) from Staphylococcus aureus (an organism without endotoxin) in anaesthetized rats . 2 . Administration of LTA (10 mg kg-1, i.v.) caused hypotension and vascular hyporeactivity to noradrenaline (1 microgram kg-1, i.v.) WEB2086 (5 mg kg-1, i.v., 20 min before and 150 min after LTA) inhibited the delayed fall in mean arterial blood pressure (at 300 min: 99 +/- 6 mmHg vs . 75 +/- 6 mmHg, P < 0.01) and prevented the decrease in pressor response to noradrenaline (at 300 min: 36 +/- 5 mmHg min vs . 17 +/- 5 mmHg min, P < 0.01) . Surprisingly, BN52021 (20 mg kg-1, i.v., 20 min before and 150 min after LTA) neither prevented the hypotension (74 +/- 6 mmHg) nor the vascular hyporeactivity (21 +/- 5 mmHg min) . However, BN52021 inhibited the hypotension to injections of PAF as well as the circulatory failure elicited by lipopolysaccharides (10 mg kg-1, i.v.) . 3 . LTA caused an increase in plasma concentration of creatinine from 39 +/- 5 microM (sham-operated) to 70 +/- 8 microM and urea from 4.7 +/- 0.1 to 13.1 +/- 1.6 mM . The renal failure elicited by LTA was significantly inhibited by WEB2086 (creatinine: 45 +/- 4 microM and urea: 5.7 +/- 0.7 mM), but not by BN52021 . 4 . The induction of nitric oxide synthase activity in lungs by LTA was attenuated by WEB2086 from 98 +/- 17 to 40 +/- 15 pmol L-citrulline 30 min-1 mg-1 protein (P < 0.01), but not by BN52021 (148 +/- 21 pmol L-citrulline 30 min-1 mg-1 protein) . Similarly, WEB2086, but not BN52021, inhibited the increase in plasma nitrite concentration associated with the delayed circulatory failure caused by LTA . The release of tumour necrosis factor-alpha (TNF-alpha) after injection of LTA was not attenuated by WEB2086 . 5 . The induction of nitrite release by cultured macrophages activated with LTA (10 micrograms ml-1 for 24 h) was inhibited by 74 +/- 4% by WEB2086 (3 x 10(-4) M), but not by BN52021, indicating that only WEB2086 acts on intracellular PAF receptors . 6 . Thus, the intracellular release of PAF contributes to the circulatory and renal failure and induction of nitric oxide synthase elicited by LTA in anaesthetized rats . The difference between the two structurally different PAF antagonists in our septic shock models using either LTA or lipopolysaccharide (LPS), shows the importance of models for Gram-positive sepsis in the elucidation of the pathophysiology of septic shock and for the evaluation of potential drugs. Indian J Biochem Biophys, 1995 Dec, 32(6), 372 - 7 Designing of peptides with immuno-modulatory properties using protein A as a probe; Ray PK et al.; A series of reports from our laboratory have described the multifarious properties of protein A of Staphylococcus aureus Cowan I, apart from its IgG binding affinity . Original reports regarding its anti-tumor, anti-toxic, anti-carcinogenic and immunomodulatory properties published earlier by the authors have implicated some uniqueness of this bacterial protein . It was conceived that such diversified properties must lie in its specific peptide sequences, rendering it to act and behave as a multipotent "Biological Response Modifier" (BRM) . The high resolution X-ray structure of protein A-Fc complex has been delineated earlier, and has been the foundation of many protein engineering studies . This structure along with the amino acid sequence data of its four repetitive domains provided us the basis for designing an octapeptide . This octapeptide was synthesized by solid phase peptide synthesis considering it as the probable site through which PA binds IgG . This octapeptide (NH2-Gln-Asn-Ala-Phe-Tyr-Glu-Ile-Leu-COOH) is present in the first helical segment of B-domain of protein A, and also is a part of domain D, A and C . This octapeptide has been shown to bind IgG by the immunoblotting technique . The binding affinity of the octapeptide appears to be significantly higher than that of intact protein A, as was revealed by calculation of Ka (association constant) and Kd (dissociation constant) values . This octapeptide might serve as a good immunoadsorbant for IgG and/or immune complexes. Immunol Cell Biol, 1995 Dec, 73(6), 505 - 10 Characterization of immunorelated peptides to porcidin P1; Alberdi F Jr et al.; Porcidin P1, an antimicrobial peptide purified from the granules of porcine polymorphonuclear neutrophils (PMN) using ultrafiltration and reverse phase high performance liquid chromatography (RP-HPLC), was covalently conjugated to BSA and used to generate monospecific polyclonal ascites . Antibodies raised against porcidin P1 were covalently coupled to an Affi-gel Hz affinity column and used for immunoaffinity chromatography of peptides from porcine PMN cell extract . Eleven immunorelated peptides were eluted from the column from neutrophil cell extracts and purified to homogeneity by HPLC . The molecular weights of the immunorelated peptides were determined by mass spectral analysis and ranged in size from 1.91 to 10.65 kDa . Of the 11 immunorelated peptides which were bound to the affinity column, only six peptides were recognized by the anti-porcidin antibodies after HPLC purification . Three immunoreactive peptides displayed potent antibacterial activity towards Staphylococcus aureus and Escherichia coli, reducing viability by as much as 99.9% (> 3 log reduction in CFU) when 5 mu g/mL of each purified peptide was used . The polyclonal monospecific antibodies also reacted with proteins from ovine and human PMN, illustrating possible structural relationships between small antibacterial peptides from the different species. Int Angiol, 1995 Dec, 14(4), 381 - 4 The value of quantitative bacteriological investigations in the monitoring of treatment of ischaemic ulcerations of lower legs; Majewski W et al.; The quantitative and qualitative bacteriological investigations of 63 patients were done on ischaemic ulcerations before reconstructive vascular surgery and at 7 day intervals after the operation . Among the isolated bacteria the most common were Gram positive (62.9%), especially Staphylococcus aureus . Amputations due to non-healing ulcers were performed on 8 patients, who had ankle brachial index (ABI) lower than 0.47 . In 55 patients with ABI higher than 0.47 (with the exception of one case) free skin grafts were applied to reduce the time of the ulcers healing . Primary healing of ulcers covered with free-skin grafts was achieved in 44 out of 55 patients (80%) . In 11 patients, were free-skin grafts had failed, ulcerations were healed following the repetition of the free-skin grafts . The healing results of skin grafts statistically were significantly better in the group where the number of bacteria in 1 cm2 of ulceration was lower than 50.000 . The severity of infections in ulcers makes the healing process of skin grafts impossible . Quantitative bacteriology additionally helps in objective evaluation of granulating tissue and facilitates choice of proper skin grafting time . This study has shown the usefulness of quantitative bacteriology for the determination of the severity of infections in ulcers. Int J Pancreatol, 1995 Dec, 18(3), 265 - 70 CT-guided aspiration of suspected pancreatic infection: bacteriology and clinical outcome; Banks PA et al.; We have performed CT-guided percutaneous needle aspiration in 104