Crit Care Med, 1990 Aug, 18(8), 801 - 6 Impact of encephalopathy on mortality in the sepsis syndrome . The Veterans Administration Systemic Sepsis Cooperative Study Group; Sprung CL et al.; Sepsis, an important cause of hospital mortality, continues to be a diagnostic and therapeutic challenge . To define more clearly the impact of encephalopathy on the course of sepsis, the various clinical signs of sepsis, blood culture results, and mortality rates were examined in relation to mental status in septic patients . Patients were classified as having an acutely altered mental status due to sepsis (AAMS), preexisting altered mental status (PAMS), or normal mental status (NMS) . Twenty-three (307/1333) percent of the study patients had an acutely altered sensorium secondary to sepsis . Patients with AAMS had a higher mortality (49%) than patients with PAMS (41%) or patients with NMS (26%) (p less than .000001) . Multivariate analysis disclosed that altered mental status, hypothermia, hypotension, thrombocytopenia, and the absence of shaking chills were independent predictors of increased mortality in the sepsis syndrome . Patients with Gram-negative bacteremia (28%) were as likely to have AAMS as patients with Gram-positive bacteremia (25%) or patients with negative blood cultures (23%) . In summary, alterations in mental status are common in septic patients, and are associated with significantly higher mortality. Antimicrob Agents Chemother, 1990 Aug, 34(8), 1501 - 4 Novel beta-lactamase from Capnocytophaga sp; Foweraker JE et al.; A novel beta-lactamase activity which confers resistance to expanded-spectrum cephalosporins and penicillins has been found in strain IC 5/21 of Capnocytophaga spp . Enzyme activity migrated at a molecular size of 38,000 daltons and at an isoelectric point of 3.6, with a minor band at 4.1 . Kinetic studies suggested that it belonged to Richmond and Sykes beta-lactamase class 1c . Isoelectric focusing could be achieved only if a nonionic detergent was added to the gel, suggesting the presence of a hydrophobic enzyme akin to a membrane-bound beta-lactamase of gram-positive bacteria . The location of the gene coding for this beta-lactamase is not yet known. Am J Surg, 1990 Aug, 160(2), 148 - 50 Fate of the exposed saphenous vein graft; Ouriel K et al.; Patients with functioning vein grafts may present with wound problems resulting in exposure of the graft . We reviewed the courses of 16 patients presenting with this problem to determine the causative factors and the most appropriate management of this therapeutic dilemma . Diabetes mellitus (11 of 16, 68.7%) and wound infection (12 of 16, 75%) were frequent pre-existing conditions associated with exposed venous grafts . All patients with exposed vein grafts were initially treated conservatively with regular application of moist sterile dressings, followed by split-thickness skin graft coverage of the wounds when clean . The wounds healed in 7 patients, whereas 9 patients developed complications of hemorrhage (7 patients) and graft thrombosis (2 patients) . The outcome of therapy was highly dependent on the type of organism originally cultured from the wounds . The incidence of vein graft disruption was lowest when the wounds were sterile (25%) or when gram-positive bacteria grew (25%) . Gram-negative infection uniformly resulted in disruption of the exposed venous graft . When a new graft was placed, the secondary graft became reinfected in all patients with gram-negative primary graft infection . There were no instances of secondary graft reinfection when gram-negative bacteria were not present . These data suggest that the outcome of patients presenting with exposed vein grafts is highly dependent on the bacterial flora of the process . Vein graft disruption is frequent in patients with gram-negative infection, suggesting that these patients should be treated with distant graft ligation and extra-anatomic bypass . By contrast, patients without gram-negative infection may be successfully managed with local wound care. Transplantation, 1990 Aug, 50(2), 301 - 9 Induction and regulation of monocyte procoagulant activity; Szabo G et al.; Monocyte (MO) procoagulant activity (PCA) is induced by various stimuli including allogeneic stimulation, immunocomplexes, and bacterial products . Antigen-antibody complex stimulation therefore represents a pathway for MO PCA induction . Activation of MO PCA has been demonstrated in immunocomplex disease and could represent a major pathology in transplanted immunocomplex disease patients . Stimulation of monocytes via their FcRI receptor has been demonstrated to induce TNF and PGE2 . This report demonstrates that stimulation of the high-density FcRI receptor-bearing (FcRI+) MO by resetting with anti-Rh coated erythrocytes also induces significant PCA levels (P less than 0.001) . Muramyl dipeptide (MDP), a Gram-positive bacterial cell wall analogue, further increased PCA levels in the FcRI stimulated MO subpopulation (P less than 0.003) . Although increased PCA levels were also induced in the FcRI- MO subpopulation by MDP (P less than 0.003), the FcRI+ MO responded with much greater levels of PCA and PGE2 (P less than 0.001) . Greater PCA levels in the FcRI-positive MO subpopulation may indicate that stimulation of MO through their FcRI represents a different pathway from allogenic PCA activation, which can be augmented by subsequent bacterial challenge . A novel inhibitory effect of IL-4 on MO PCA induction is also demonstrated . IL-4 downregulated MO PCA levels either after isolation stimulation (55 +/- 19%), FcRI stimulation (57 +/- 12%), or FcRI plus MDP stimulation (60 +/- 13%) . PCA and PGE2 levels were concomitantly downregulated by IL-4 both in the FcRI-stimulated, FcRI+ and in the MDP-stimulated FcRI- MO subpopulations . Since indomethacin blocked MDP induced MO PGE2 production without affecting MO PCA levels, PGE2 production is not required for FcRI-stimulated PCA induction. J Antibiot (Tokyo), 1990 Jul, 43(7), 739 - 47 Isolation, characterization and structures of PA-46101 A and B; Matsumoto M et al.; New antibiotics, PA-46101 A and B, were isolated from the culture broth of a Streptomycete . The molecular formulae of A and B were determined to be C52H70O18 and C61H86O22, respectively, by elemental analyses, NMR and mass spectrometry . Their structures were elucidated by X-ray crystallography and NMR spectroscopy . These antibiotics are active in vitro against anaerobic Gram-positive and Gram-negative bacteria and also against a limited number of aerobic Gram-positive bacteria. J Cardiovasc Surg (Torino), 1990 Jul-Aug, 31(4), 469 - 73 Selection of antibiotic coverage in vascular patients undergoing cystoscopy; Wooster DL et al.; Bacteremic seeding of prosthetic vascular grafts represents a cause for graft infection; transurethral procedures account for one source of bacteremia . Therefore, a prospective study of 200 patients undergoing cystoscopy was conducted to identify the incidence of bacteruria and factors associated with it, organisms involved and their antibiotic sensitivities . Positive cultures were found in 21% . The incidence was 64% in in-patients and 8% in out-patients . Positive cultures were found in 12% of patients who received antibiotics and 29% who did not . Four percent showed signs of bacteremia . The cultures identified both Gram positive and negative organisms; multiple organisms grew in 22% . Gram negative organisms were more common in in-patients . Candida grew in 8% . The Gram positive organisms were sensitive to ampicillin (92%), sulfatrimethoprim (75%) and cefazolin (60%); Gram negative to aminoglycosides (100%) and cefazolin (92%) . In view of the unpredictable and multiple organisms, it is recommended that pre-cystoscopy cultures be performed and specific antibiotic coverage be based on the sensitivities. J Bacteriol, 1990 Jul, 172(7), 4002 - 7 Prey-derived signals regulating duration of the developmental growth phase of Bdellovibrio bacteriovorus; Gray KM et al.; The filamentous elongation typical of growth-phase cells of the predatory bacterium Bdellovibrio bacteriovorus is mediated by regulatory signals that are derived from the prey cell itself . These signals regulate the differentiation of growth-phase cells into the attack phase and appear to be required for continued filamentous growth by prey-dependent wild-type bdellovibrios and their prey-independent mutant derivatives alike . Using a prey-independent bdellovibrio strain, we have developed an assay for the detection and quantification of the growth-extending signal activity present in extracts of prey cells . This prey-derived regulatory activity was shown to be independent of its nutritional contribution to the bdellovibrios and was found to occur in heat-stable, proteinlike compounds of a variety of native molecular weights within the soluble fraction of extracts from both gram-negative and gram-positive bacteria. Gastrointest Endosc, 1990 Jul-Aug, 36(4), 364 - 8 Microbiological analysis of sepsis complicating non-surgical biliary drainage in malignant obstruction; Levine JG et al.; Cholangitis with sepsis is a common complication of non-surgical biliary drainage and represents a difficult management problem . Microbiological data for 18 septic episodes in 15 patients following endoscopic biliary drainage (EBD) and 14 septic episodes in 14 patients following percutaneous transhepatic drainage (PTD) were reviewed . In the EBD group, all 18 patient episodes of sepsis had blood cultures and 10 had bile cultures obtained . In total, 17 gram-negative isolates and 5 gram-positive isolates were grown in the EBD sepsis group . All of the 14 PTD patients had bile cultures and 13 had blood cultures . In total, 23 gram-negative isolates and 26 gram-positive isolates were grown in the PTD sepsis group . When PTD cultures were compared with EBD cultures, there were significantly more gram-positive cultures (26 vs . 5) associated with PTD sepsis than EBD sepsis (p less than 0.0005) . Analysis of the antibiotic sensitivities revealed that a combination of ticarcillin clavulanate with gentamicin covered 20 of the 22 (91%) EBD organisms and 38 of the 49 (78%) PTD organisms . Based on this data, ticarcillin clavulanate with gentamicin is the therapy of choice for EBD and PTD sepsis at our institution. J Struct Biol, 1990 Jul-Sep, 104(1-3), 169 - 77 New aspects of bacterial ultrastructure as revealed by modern acrylics for electron microscopy; Hobot JA; Modern acrylics can be used over a wide temperature range (+60 degrees C to -80 degrees C) for infiltration, embedding, and polymerization . They can be used in procedures involving chemical fixation or rapid freezing . This flexibility allows for studies to be carried out upon the effects that different parameters involved in preparing biological tissue for microscopy have upon structure and retention of immunoreactivity . With most preparative methods contributions have been made to our knowledge on bacterial structure in gram-negative and gram-positive cells . The future should lie in integrating the advantages of the various methods for the purpose of advancing our understanding of bacterial structure/function. Appl Environ Microbiol, 1990 Jul, 56(7), 2186 - 92 Transport and deamination of amino acids by a gram-positive, monensin-sensitive ruminal bacterium; Chen G et al.; Strain F, a recently isolated ruminal bacterium, grew rapidly with glutamate or glutamine as an energy source in the presence but not the absence of Na . Monensin, a Na+/H+ antiporter, completely inhibited bacterial growth and significantly reduced ammonia production (85%), but 3,3',4',5-tetrachlorosalicylanide (a protonophore) and valinomycin had little effect on growth or ammonia production . Dicyclohexylcarbodiimide, a H(+)-ATPase, inhibitor had no effect . The kinetics of glutamate and glutamine transport were biphasic, showing unusually high rates at high substrate concentrations . On the basis of low substrate concentrations (less than 100 microM), the Km values for glutamate and glutamine were 4 and 11 microM, respectively . Strain F had separate carriers for glutamate and glutamine which could be driven by a chemical gradient of Na . An artificial delta psi was unable to drive transport even when Na was present . The glutamate carrier had a single binding site for Na with a Km of 21 mM; the glutamine carrier appeared to have more than one binding site, and the Km was 2.8 mM . Neither carrier could use Li instead of Na . Histidine and serine were also rapidly transported by Na-dependent systems, but serine alone did not allow growth even when Na was present . Because exponentially growing cells at pH 6.9 had little delta psi (-3 mV) and a slightly reversed Z delta pH (+17 mV), it appeared that the membrane bioenergetics of strain F were solely dependent on Na circulation. Appl Environ Microbiol, 1990 Jul, 56(7), 2245 - 7 Alternate gram staining technique using a fluorescent lectin; Sizemore RK et al.; Fluorescence-labeled wheat germ agglutinin binds specifically to N-acetylglucosamine in the outer peptidoglycan layer of gram-positive bacteria . The peptidoglycan layer of gram-negative bacteria is covered by a membrane and is not labeled by the lectin . By exploiting this phenomenon, an alternative Gram staining technique has been developed. J Am Acad Dermatol, 1990 Jun, 22(6 Pt 1), 1088 - 90 Janeway lesions and Osler's nodes: a review of histopathologic findings; Cardullo AC et al.; The histologic findings in Osler's nodes and Janeway lesions have been reported rarely; we found descriptions of only 10 such cases, mostly from the late nineteenth- and twentieth-century French literature . We found gram-positive coccobacilli in the dermal abscess of a Janeway lesion from a patient with bacterial endocarditis . This finding suggests that septic microemboli are the cause. Ann Thorac Surg, 1990 Jun, 49(6), 979 - 83 Life-threatening acute posterior mediastinitis due to esophageal perforation; Burnett CM et al.; We analyzed the treatment of a recent group of patients with life-threatening acute posterior mediastinitis due to esophageal perforation to elucidate common factors in successful treatment . Life-threatening acute posterior mediastinitis due to esophageal perforation was diagnosed in 16 patients over the past 12 years . Esophageal perforation resulted from endoscopy in 11 patients, retching in 4, and blunt trauma in 1 patient . Preoperative serum albumin levels were higher in patients who survived . Fourteen of 16 patients (88%) underwent exploration: mediastinal drainage in 14 (10 survived), esophageal repair in 9 (7 survived) with diversion in 3 (3 survived), and stent placement in 2 (1 survived) . Six of 16 patients (38%) died, always of polymicrobial sepsis . Female patients and those with cancer, endoscopic perforations, delayed diagnosis, persistent mediastinal contamination, mediastinal suppuration or necrotizing cellulitis, and postoperative complications did poorly . Antibiotics must be effective against both gram-positive and gram-negative bacteria, and against both anaerobic and aerobic bacteria . Early surgical intervention is key, particularly elimination of ongoing mediastinal soilage . Thorough mediastinal debridement and wide mediastinal drainage appear to be important in improving survival of patients with life-threatening acute posterior mediastinitis due to esophageal perforation. Clin Pharmacokinet, 1990 Jun, 18(6), 485 - 90 Clearance from dialysate and equilibration of intraperitoneal vancomycin in continuous ambulatory peritoneal dialysis; Neal D et al.; This article reports on a study of the disposition of loading doses (1g and 15 mg/kg) of vancomycin given intraperitoneally to 6 patients on continuous ambulatory peritoneal dialysis with Gram-positive peritonitis . Dialysate samples were collected every 30 minutes during the first dwell, and serum samples were collected after the first 5 exchanges and after 7 or 14 days . The dialysate concentration/time data were fitted to a monoexponential curve for 4 patients and to a biexponential curve for 2 others . Dialysis clearance was 0.73 +/- 0.04 L/h (1g dose) and 0.70 +/- 0.23 L/h (15 mg/kg dose) . Total body clearance was 0.51 +/- 0.36 L/h . Serum concentrations reached 14 to 18 mg/L (15 mg/kg dose) and 6.75 to 24 mg/L (1g dose) at the end of the first dwell . The half-life of equilibration of vancomycin across the peritoneal membrane was 2.5 +/- 2.3 hours . Intraperitoneal loading doses of vancomycin produce concomitant serum concentrations in excess of the minimum inhibitory concentrations for susceptible organisms . Administration on a milligram per kilogram basis produces more consistent serum concentrations than using a standard loading dose which is not based on bodyweight. Res Microbiol, 1990 Jun, 141(5), 529 - 41 Additional arguments for the key role of "smart" autolysins in the enlargement of the wall of gram-negative bacteria; Koch AL; Because the wall of Gram-negative bacteria is thin, the mechanism for safe enlargement of the cell is subject to strong constraints . Several models for wall growth have been proposed; in the order that they have been proposed, these include: 1) an "allosteric" model in which the critical autolysin is only functional if the bond to be cleaved is near a covalently cross-linked, but unstretched oligopeptide; 2) a model in which the cell wall is thick enough to enlarge by the "inside-to-outside" mode characteristic of Gram-positive rods; 3) a "patches" model, recently proposed by Holtje, in which only parts of the cell wall are thickened at any one time; 4) a new multienzyme model in which the transpeptidase/autolysin complex cleaves one cross-linked oligopeptidoglycan chain for every two nascent chains covalently polymerized to the sacculus . These models are considered and contrasted . While none can be rigourously excluded, no . 4 is favoured . All models as applied to the Gram-negative rod-shaped bacteria require special, extraordinary features for their autolysins . These features have not been found with any other class of enzymes, but are essential to permit safe cell expansion. J Gen Microbiol, 1990 Jun, 136 ( Pt 6), 1145 - 51 Hydrogen autotrophy of Nocardia opaca strains is encoded by linear megaplasmids; Kalkus J et al.; Several linear megaplasmids were detected in the facultatively lithoautotrophic Gram-positive bacterium Nocardia opaca . The wild-type strain MR11 contains, in addition to the cccDNA plasmids pHG31-a and pHG31-b, the linear plasmids pHG201 (270 kb), pHG202 (400 kb) and pHG203 (420 kb) . The wild-type strain MR22 contains, in addition to the cccDNA plasmid pHG33, the linear plasmids pHG204 (180 kb), pHG205 (280 kb) and pHG206 (510 kb) . After preparation of DNA from cells embedded in agarose, the linear plasmids were demonstrated by pulsed-field electrophoresis . By means of DNA probes for genes of soluble hydrogenase and ribulose-bisphosphate carboxylase, the conjugative plasmids pHG201 and pHG205 were shown to be the carriers of the genetic information for these enzymes . A restriction map of pHG201 for the enzymes AsnI, SpeI, XbaI is presented. Appl Environ Microbiol, 1990 Jun, 56(6), 1695 - 701 Genes encoding mercuric reductases from selected gram-negative aquatic bacteria have a low degree of homology with merA of transposon Tn501; Barkay T et al.; An investigation of the Hg2+ resistance mechanism of four freshwater and four coastal marine bacteria that did not hybridize with a mer operonic probe was conducted (T . Barkay, C . Liebert, and M . Gillman, Appl . Environ . Microbiol . 55:1196-1202, 1989) . Hybridization with a merA probe, the gene encoding the mercuric reductase polypeptide, at a stringency of hybridization permitting hybrid formation between evolutionarily distant merA genes (as exists between gram-positive and -negative bacteria), detected merA sequences in the genomes of all tested strains . Inducible Hg2+ volatilization was demonstrated for all eight organisms, and NADPH-dependent mercuric reductase activities were detected in crude cell extracts of six of the strains . Because these strains represented random selections of bacteria from three aquatic environments, it is concluded that merA encodes a common molecular mechanism for Hg2+ resistance and volatilization in aerobic heterotrophic aquatic communities. J Antimicrob Chemother, 1990 Jun, 25(6), 985 - 93 Teicoplanin as modification of initial empirical therapy in febrile granulocytopenic patients; Novakova IR et al.; Teicoplanin at a dose of 400 mg per day was added to the initial empirical therapy of 65 of 202 febrile granulocytopenic episodes . Of 53 cases evaluable for outcome 23 (43%) responded . Responders and nonresponders were comparable in terms of time of starting teicoplanin treatment, duration of therapy and of granulocytopenia, number of granulocytopenic days after therapy was stopped and peak and through concentrations of the drug . Teicoplanin was given most often because of persistent fever or initial Gram-positive bacteraemia and only one-third of these cases responded . However, when teicoplanin was given because of proven or presumed Gram-positive infection 67% of cases were treated successfully . Patients with skin and soft tissue infections achieved a 78% response rate . The development of a lung infiltrate was the most common reason for failure to respond, although in most instances the aetiology was not determined . Serum concentrations of teicoplanin were predictable; peak and trough concentrations on the fourth day were 30.4 +/- 5.0 mg/l and 9.8 +/- 1.7 mg/l, respectively . Concentrations achieved in individual patients did not correspond to outcome . Hearing loss of 20 dB at 800 Hz was noted in one of 15 cases and transient liver or kidney disturbances attributable to the drug were observed in 4% of cases . Teicoplanin therapy was safe but only effective when used to treat infective episodes with a high probability of being due to Gram-positive bacteria. Res Microbiol, 1990 Jun, 141(5), 585 - 97 {Isolation, morphological and biochemical characteristics of gram-positive bacteria metabolizing beta-caryophyllene}; Pichinoty F et al.; Eleven strains of coryneform bacteria were isolated from soil samples by enrichment culture in a mineral medium containing beta-caryophyllene as the sole energy and carbon source . Ten of them could also metabolize longifolene . Numerical taxonomy, based on the use of 147 characteristics, revealed a large diversity . The DNA G + C content was found to be in the range of 62.5-68.3 mol% . Three strains were placed in "The National Collection of Industrial and Marine Bacteria". FEMS Microbiol Lett, 1990 Jun 1, 57(3), 293 - 7 ADP-ribosylation of membrane proteins of Streptomyces griseus strain 52-1; Penyige A et al.; Membranes purified from cells of Streptomyces griseus strain 52-1 possess an ADP-ribosyltransferase activity . The enzyme transfers the ADP-ribose moiety of NAD to one major membrane protein of Mr 32,000 and 2-3 minor proteins of larger molecular weights . The effects of inhibitors on the ADP-ribosyltransferase activity proves that the reaction is enzymatic and suggests that the enzyme ADP-ribosylates the guanidine group of arginine . The kinetics of liberation of ADP-ribose during alkaline hydrolysis of the modified proteins is consistent with the arginine-ADP-ribose bond . This is the first report of ADP-ribosylation of proteins in a Gram-positive bacterium. Aust N Z J Ophthalmol, 1990 May, 18(2), 155 - 7 An unusual case of crystalline keratopathy; Pararajasegaram P et al.; A 48-year-old woman developed a crystalline stromal lesion four years after a penetrating corneal graft, with few signs of ocular inflammation . An initial diagnosis of fungal keratitis was made because of the appearance of the lesion . An excisional biopsy revealed the presence of Gram-positive cocci lying between the stromal lamellae in the posterior third of the cornea . Large numbers of Gram-positive cocci were observed on light and transmission electron microscopy but no organism could be cultured from the biopsy . The replacement graft has remained clear over the subsequent two years. Physiol Behav, 1990 May, 47(5), 805 - 13 Comparison of the effects of bacterial lipopolysaccharide and muramyl dipeptide on food intake; Langhans W et al.; For further characterization of the mechanism involved in the anorexia during bacterial infection, we investigated whether muramyl dipeptide (MDP), the minimal immunologically active structure of gram-positive bacterial cell walls, affects rats' food intake in the same way as lipopolysaccharide (LPS) from E . coli . MDP (1.6 mg/kg body weight = b.wt.) injected intraperitoneally (IP) reduced food intake by decreasing meal frequency without affecting meal size . Indomethacin (2.5 mg/kg b.wt., IP) but not verapamil (5 mg/kg b.wt., IP) attenuated the hypophagic effect of MDP . In further experiments, MDP and LPS (100 micrograms/kg b.wt., IP) both inhibited gastric emptying and indomethacin failed to block this effect of LPS . Hepatic vagotomy did not attenuate the hypophagic effects of MDP or LPS . LPS reduced water intake only when food was available, but reduced food intake also during water deprivation . MDP did not affect water intake . MDP and LPS both had an aversive effect, but LiCl, which was also aversive, failed to reduce feeding under the conditions tested . This questions the role of a conditioned taste aversion in the hypophagia induced by MDP or LPS . The results suggest that a stimulation of eicosanoid synthesis contributes to MDP-induced hypophagia and may therefore also contribute to the anorexia during infection . In contrast, an inhibition of gastric emptying, an activation of hepatic satiety signals or a reduction of water intake, does not seem to be crucial for the hypophagic effects of MDP or LPS. J Antibiot (Tokyo), 1990 May, 43(5), 456 - 61 MK4588, a new antibiotic related to xanthocillin; Itoh J et al.; A new antibiotic, MK4588, structurally related to xanthocillin, was isolated from the culture broth of Leptosphaeria sp . L-179 . Antibiotic MK4588 exhibited inhibitory activity against a limited range of Gram-positive and Gram-negative bacteria . The antibiotic was degraded by alkali to a more active product . The structures of MK4588 and the degradation product were determined to be (1R*,6S*,7S*)-7-(Z)-(1-isocyano-2-(4-methoxyphenyl}ethenyl-1-hydro xy-7- isocyanobicyclo{4,2,0}oct-2-en-4-one and (Z)-2,3-diisocyano-1-(4-methoxyphenyl)buta-1,3-diene, respectively, by NMR spectral analyses coupled with X-ray crystallographic analysis of MK4588. Orthopedics, 1990 May, 13(5), 521 - 4 Vancomycin vs tobramycin elution from polymethylmethacrylate: an in vitro study; Lawson KJ et al.; We fabricated batches of cement containing 0.5 gm, 1.0 gm, and 2.0 gm vancomycin and one with 1.0 gm tobramycin and shaped them into cylinders . They were immersed into 0.5 L of normal saline and the fluid volume was changed daily . Samples of fluid were obtained on days 1, 2, 3, 5, 7, 14, and 28 . All fluid samples had antibiotic assays performed to quantitate the amount of elution for vancomycin or tobramycin . Vancomycin elution from PMMA occurred under our study conditions in similar quantities to that measured for tobramycin controls . Vancomycin-loaded PMMA cement may have a clinical role in the treatment of musculoskeletal sepsis caused by gram-positive bacteria, particularly if organisms resistant to the usual antibiotic agents are identified. J Dent Res, 1990 May, 69(5), 1118 - 25 An ultrastructural study of bacterial invasion and tissue breakdown in human experimental root-surface caries; Nyvad B et al.; This study describes the structural features of the interface between microbial deposits and root cementum in actively progressing root-surface caries lesions developed experimentally in six elderly individuals . A total of 18 specimens was examined by microradiography, and a further 18 by light and transmission electron microscopy after intra-oral periods of one, two, and three months . All specimens showed various degrees of subsurface dissolution of mineral and bacterial invasion of the cementum . Although the microradiographic pattern of mineral loss was subsurface in nature, transmission electron microscopy showed dissolution of crystals in the outermost layers of the cementum, with a distinct gradient inward . Bacterial invasion occurred along the borders between bundles of relatively well-mineralized extrinsic collagen fibers in which the characteristic cross-banding remained intact . The pattern of bacterial invasion was influenced by the incremental lines and the cemento-dentinal junction . The invading bacteria were almost exclusively Gram-positive, of various shapes, and possessed thick, moderately electron-dense cell walls and electron-lucent "vacuoles" in the cytoplasm . It is concluded that because of pronounced mineral loss of the outermost cementum, accompanied by bacterial invasion, the surface of an active cementum caries lesion, as observed by transmission electron microscopy, is not identical to that seen in microradiograms. Vet Clin North Am Small Anim Pract, 1990 May, 20(3), 615 - 25 Microbiology of the canine and feline eye; Gerding PA Jr et al.; Knowledge of the microbiology of the canine and feline eye in normal and pathologic states is an important aspect of the clinician's assessment of external ocular disease . Gram-positive bacteria predominate in surveys of microbial flora in normal and diseased eyes . These same organisms are routinely isolated from skin and the upper respiratory tract . Injury to the eye may result in proliferation and potential pathogenicity of normal ocular flora . A variety of bacterial, fungal, viral, and other microbial isolates affect the diagnosis and treatment of external ocular disease. J Bacteriol, 1990 May, 172(5), 2462 - 8 Sequence homology between the subunits of two immunologically and functionally distinct types of fimbriae of Actinomyces spp; Yeung MK et al.; Nucleotide sequencing of the type 1 fimbrial subunit gene of Actinomyces viscosus T14V revealed a consensus ribosome-binding site followed by an open reading frame of 1,599 nucleotides . The encoded protein of 533 amino acids (Mr = 56,899) was predominantly hydrophilic except for an amino-terminal signal peptide and a carboxy-terminal region identified as a potential membrane-spanning segment . Edman degradation of the cloned protein expressed in Escherichia coli and the type 1 fimbriae of A . viscosus T14V showed that both began with alanine at position 31 of the deduced amino acid sequence . The amino acid compositions of the cloned protein and fimbriae also were comparable and in close agreement with the composition of the deduced protein . The amino acid sequence of the A . viscosus T14V type 1 fimbrial subunit showed no significant global homology with various other proteins, including the pilins of gram-negative bacteria . However, 34% amino acid sequence identity was noted between the type 1 fimbrial subunit of strain T14V and the type 2 fimbrial subunit of Actinomyces naeslundii WVU45 (M . K . Yeung and J . O . Cisar, J . Bacteriol . 170:3803-3809, 1988) . This homology included several different conserved sequences of up to eight identical amino acids that were distributed in both the amino- and carboxy-terminal thirds of each Actinomyces fimbrial subunit . These findings indicate that the different types of fimbriae on these gram-positive bacteria share a common ancestry. Klin Wochenschr, 1990 Apr 2, 68(7), 372 - 9 {Pneumonia in immunocompromised patients: the value of non-biopsy bronchoscopic examination procedures in the diagnosis of pathogens}; von Eiff M et al.; Bronchoscopy was performed on 101 immunocompromised patients with fever and pulmonary infiltrates . Underlying diseases were mainly hematological malignancies . In 71% of cases, etiology of pneumonia was clarified by nonbioptic bronchoscopic methods (bronchoalveolar lavage, bronchial secretions, protected specimen brush) . In 51% of cases, empirical antibiotic treatment was modified following bronchoscopy . In patients with early bronchoscopy a better prognosis regarding healing and survival was observed than in those cases, where bronchoscopy was performed later during pneumonia . Bronchoalveolar lavage was particularly suited for diagnosis of Pneumocystis carinii and pneumonia due to viruses or Legionella . Sensitivity and specificity of bronchoscopy were lower for diagnosis of mycotic pneumonia and of Gram-negative or Gram-positive bacteria. Kanho Hakhoe Chi, 1990 Apr, 20(1), 38 - 49 {A study of incidence of bacteriuria according to bladder irrigation in patients with indwelling catheters}; Koh KO; The Purpose of this study is for clinical nurses to be aware of the significance of prevention against bacteriuria caused form foley catheterization, through probing variables related to the occurrence of bacteriuria which appears as the most frequent occurring infection, and try to lower bacteriuria by applying to nursing care at the clinical . For this study 46 patients with catheterization and the closed drainage system were sampled and investigated from among patients at Intensive Care Unit in Two hospitals affiliated to K University in Seoul . Those patients sampled had not shown bacteriuria before foley catheterization . The research design is to explore the effectiveness of prevention against bacteriuria in accordance with bladder irrigation and no bladder irrigation . Especially, the frequency of occurrence of bacteriuria examined so as to compare the effectiveness of bladder irrigation depending on the type of foley catheter between 2-lumen foley catheter and 3-lumen foley catheter . The results Were as follows . 1 . The occurrence of bacteriuria in patient with bladder irrigation was 21.7%, while in patient without bladder irrigation 26.1% . 2 . The occurrence of bacteriuria in patient without bladder irrigation according to duration of indwelling catheter, was 4.3% after 48 h, 8.7% after 72 h and 21.7% after 96 h . 3 . In case of 2-lumen foley catheter the occurrence of bacteriuria in patient with bladder irrigation was 0% after 72 h, and 4.35% after 96 h . In case of 3-lumen foley catheter, the occurrence of bacteriuria in patient with bladder irrigation was 13% after 48 h, 8.7% after 72 h and 4.3% after 96 h . 4 . The occurrence of bacteriuria according to duration of catheterization was 8.7% after 48h, 8.7% after 72 h and 15.2% after 96 h . In sex, female was 35% and male 15.4% . 5 . The occurrence of bacteriuria according to mental state was 15% in clear state, while 29.6% in mental disorder . 6 . In regard to a kind of microorganism induced bacteriuria, Gram negative bacteria was 63.7%, Gram positive bacteria 36.3%. Planta Med, 1990 Apr, 56(2), 198 - 201 Armillaric acid, a new antibiotic produced by Armillaria mellea; Obuchi T et al.; A new antibiotic armillaric acid (2), has been isolated from the cultured mycelia of Armillaria mella (Vahl . ex Fr.) Quel (Trichlometaceae) . Its structure was elucidated on the basis of the spectral data . Compound 2 exhibits inhibitory activity against gram-positive bacteria and yeast. Int J Syst Bacteriol, 1990 Apr, 40(2), 194 - 204 Amycolatopsis methanolica sp . nov., a facultatively methylotrophic actinomycete; de Boer L et al.; The generic position of a gram-positive, facultatively methylotrophic actinomycete known as Nocardia sp . strain 239 was determined by comparing reverse transcriptase sequences of 16S rRNA . The assignment of the organism to the genus Amycolatopsis was strongly supported by chemotaxonomic and morphological data . A comparison with the type strains of validly described Amycolatopsis species showed that the organism formed the nucleus of a new species . The name proposed for this new species is Amycolatopsis methanolica . The organism has been deposited in the National Collection of Industrial Bacteria as NCIB 11946. Nihon Kyobu Shikkan Gakkai Zasshi, 1990 Apr, 28(4), 651 - 5 {A case of pulmonary nocardiosis diagnosed by percutaneous aspiration}; Nakahara Y et al.; A 71-year-old man complained of mild dyspnea, and his chest X-ray showed a cavitating lesion accompanied by infiltrative changes in the right middle lobe . Percutaneous aspiration revealed numerous gram-positive and acid-fast branching rods . Morphological examination and biochemical tests of the colonies confirmed the diagnosis of pulmonary nocardiosis caused by nocardia asteroides . The patient was treated successfully with sulfamethoxazole-trimethoprim . It has been reported that approximately half of the patients with pulmonary nocardiosis have immunodeficiency, but our patient had no underlying disease . This disease has no characteristic clinical features, so diagnosis is difficult . As nocardia may involve the central nervous system leading to a poor prognosis, early diagnosis and prompt treatment are required to improve survival. Jpn J Antibiot, 1990 Apr, 43(4), 736 - 53 {Pharmacokinetics and clinical evaluations on aztreonam in perinatal infections in obstetrics and gynecology . A study of aztreonam in the perinatal co-research group}; Matsuda S et al.; Pharmacokinetics and clinical studies on an injectable monobactam antibiotic aztreonam (AZT), were carried out in perinatal infections in obstetrics and gynecology and the obtained results are summarized as follows . 1 . Pharmacokinetic study (1) Upon one-shot intravenous injection of AZT 1 g before delivery, maternal serum concentration of AZT was 89.0 micrograms/ml immediately after the injection and a half-life (T 1/2) of 0.96 hour was observed . Umbilical-cord serum concentration showed a peak value of 16.5 micrograms/ml at 1.26 hours after the injection and gradually decreased with a T 1/2 of 1.91 hours . The transfer into amniotic fluid was observed and the peak value of AZT in amniotic fluid reached 12.9 micrograms/ml at 5.57 hours after the injection and slowly decreased thereafter with a T 1/2 of 4.42 hours . Transfer and disappearance in one-shot 2 g intravenous injection and 1 g intravenous drip infusion (1 hour) of AZT were very similar to the results obtained with the one-shot 1 g intravenous injection . (2) The residual serum concentration in neonates after one-shot 1 g intravenous injection of AZT to the mother was almost below the detectable limit . Transfer of AZT into milk was scarcely recognized . 2 . Clinical studies (1) AZT was injected to 47 cases with various perinatal infections and it was more than "effective" in 45 cases with an efficacy rate of 95.7% . Also, all the 12 cases to which AZT was administered for prophylaxis of infections showed prophylactic effect . Bacterial eradication was obtained with 25 strains out of 29 aerobic Gram-negative bacteria, but 1 strain "persisted" and for 3 strains results were "unknown", hence an eradication rate of 96.2% was obtained . However, AZT treatment resulted in a little lower eradication rate against Gram-positive bacteria . (2) One case (1.3%) of minor degree of urticaria was found as a side effect, and one case each of eosinophilia and elevation of GOT, GPT and Al-P was observed as abnormal laboratory value . From the above results of pharmacokinetics and clinical evaluation, it has been concluded that AZT is a useful and highly safe drug in various perinatal infections and prophylaxis. J Antimicrob Chemother, 1990 Apr, 25(4), 689 - 95 Incidence of gallbladder lithiasis after ceftriaxone treatment; Cometta A et al.; Ceftriaxone has potent activity against a broad range of Gram-positive and Gram-negative bacteria . While it is eliminated mainly by the kidney, 10-20% of the drug is eliminated in the bile and ceftriaxone salt precipitates have been described in the gallbladder of animals dosed with ceftriaxone . The purpose of the present study was to investigate the incidence of biliary lithiasis 6 and 12 months after treatment with ceftriaxone and to compare it with that in patients treated with amoxycillin/clavulanate . Biliary ultrasonography was performed at the start of treatment, at 6 months and at 12 months after the beginning of the study . One hundred patients were randomized and 74 were evaluable: 34 were given amoxycillin/clavulanate, 40 ceftriaxone . Gallbladder lithiasis developed in one patient 12 months after the amoxycillin/clavulanate treatment and in none in the ceftriaxone treatment arm . Biliary precipitate during ceftriaxone treatment was not looked for because this phenomenon was not known at the beginning of the study, but gallbladder precipitation that was seen in two patients given ceftriaxone during and at the end of treatment, respectively, resolved spontaneously . In conclusion, ceftriaxone treatment does not appear to lead to gallstone formation more often than an antibiotic that is not eliminated through the bile. Antimicrob Agents Chemother, 1990 Mar, 34(3), 496 - 7 Influence of N substitution on antimycobacterial activity of ciprofloxacin; Haemers A et al.; Ciprofloxacin analogs with various substitutions on the piperazine nitrogen were tested against several mycobacteria . In contrast to what has been found with other gram-positive and gram-negative bacteria, alkyl analogs such as N-isopropylciprofloxacin were shown to be significantly more active than ciprofloxacin . MICs of 0.125 microgram/ml against Mycobacterium tuberculosis were found. J Antibiot (Tokyo), 1990 Mar, 43(3), 259 - 66 SF2487, a new polyether antibiotic produced by Actinomadura; Hatsu M et al.; A new antibiotic SF2487 has been isolated from the culture broth of Actinomadura sp . SF2487 . The structure of antibiotic SF2487 was determined by spectroscopic analyses of the sodium salt and X-ray diffraction analysis of the silver salt . The antibiotic represents a new member of polyether group antibiotics known as the acyltetronic acid type 4 . The antibiotic is weakly active against Gram-positive bacteria and exhibits antiviral activity against influenza virus in vitro. Crit Care Med, 1990 Mar, 18(3), 259 - 63 Plasma cortisol levels in patients with septic shock; Schein RM et al.; To investigate the endogenous adrenocortical response to sepsis, plasma cortisol concentrations were measured in 37 patients (53 +/- 3 yr of age) with septic shock . Patients were studied 11 +/- 2 h after shock commenced . Vasopressor therapy was required in 35 of 37 patients (median dopamine infusion rate of 11 micrograms/kg.min, range 3 to 74) . Plasma cortisol concentrations were increased markedly (median 50.7 micrograms/dl, range 15.6 to 400) above normal values (10 to 20 micrograms/dl) in patients with septic shock . Neither patients who reversed their shock nor those who survived to hospital discharge had significantly different plasma cortisol concentrations from those who did not . Patients with Gram-positive infections had increased cortisol levels compared with those who had Gram-negative infections (median 83 micrograms/dl, range 32 to 400 vs . median 44 micrograms/dl, range 16 to 81, respectively; p less than .05) . The source of infection, amount of vasopressors infused, and severity of shock were not associated with differences in cortisol concentrations . The length of time in shock before collection of the blood sample for measurements of cortisol and mean arterial pressure at the time of blood collection had significant but weak negative correlations with cortisol concentrations (p less than .05, rs = .37 and p less than .05, rs = -.40, respectively) . We conclude that plasma cortisol concentrations are increased in patients with septic shock, but that the degree of increase is variable . This variability may, in part, be related to type of infection, length of time in shock, and BP at the time of blood sampling.(ABSTRACT TRUNCATED AT 250 WORDS) Minerva Anestesiol, 1990 Mar, 56(3), 49 - 55 {Microbiologic flora in two different periods in intensive care units}; Capuzzo M et al.; Bacterial examinations performed in two periods (Nov . 1985-Feb . 1986) and Nov . 1988-Feb . 1989) on materials taken from patients admitted into two similar Intensive Care Units (ICU) of the same hospital were evaluated . Excluding oropharyngeal swab cultures, which were performed only in the second period, Gram positive bacteria were 45.3% in 1985-1986 and 62.3% in 1988-1989 and Gram negative fell from 41.9% to 29% . The percentage of fungi remained unchanged . Microorganisms did not grow in 33.3% of tracheal aspirate specimens in 1985-1986 and in 54.3% in 1988-1989, probably depending on the larger number of patients with decompensated chronic respiratory failure treated in the second period . Usually the microorganisms found in the trachea was also in the oropharynx; Gram negative were only 5.1% of the microorganism collected in the oropharinx . The authors emphasize the increase of Gram positive bacteria in ICUs and suggest that the low rate of pneumonia observed in this study depends mostly on the good neurologic state of their patients. Semin Respir Infect, 1990 Mar, 5(1), 74 - 9 Nocardiosis in transplant recipients; Chapman SW et al.; Nocardia is an increasingly important opportunistic pathogen in immunosuppressed patients, especially solid organ transplant recipients . Infection is most often caused by Nocardia asteroides and presents as lung disease in 80% to 90% of infected transplant patients . Radiographic findings are nonspecific and include nodular infiltrates, cavitation, and pleural effusion . Dissemination to other organs, especially to the central nervous system (CNS) and skin, occurs in up to 40% of transplant recipients . A presumptive diagnosis is most rapidly made by the direct visualization in tissue, lower respiratory secretions, or wound drainage of filamentous, gram-positive, beaded rods that are partially acid fast . Specimens for culture should be held for at least 3 weeks when the diagnosis is suspected . The prognosis of nocardial infection is related to the site of disease, rapidity of diagnosis, and extended treatment with a sulfonamide . Mortality is highest in patients with CNS involvement . Prophylactic trimethoprim-sulfamethoxazole should be considered in transplant centers with excess rates of nocardial infection . Hopefully, future refinement of immunosuppressive regimens will be accompanied by a reduction in frequency of Nocardia infections in transplant recipients. Microbiol Rev, 1990 Mar, 54(1), 1 - 17 Anion-exchange mechanisms in bacteria; Maloney PC et al.; This article discusses the physiological, biochemical, and molecular properties of bacterial anion-exchange reactions, with a particular focus on a family of phosphate (Pi)-linked antiporters that accept as their primary substrates sugar phosphates such as glucose 6-phosphate (G6P), mannose 6-phosphate, or glycerol 3-phosphate . Pi-linked antiporters may be found in both gram-positive and gram-negative cells . As their name suggests, these exchange proteins accept both inorganic and organic phosphates, but the two classes of substrate interact very differently with the protein . Thus, Pi is always accepted with a relatively low affinity, and when it participates in exchange, it is always taken as the monovalent anion . By contrast, when the high-affinity organic phosphates are used, these same systems fail to discriminate between monovalent and divalent forms . Tests of heterologous exchange (e.g., Pi: G6P) indicate that these proteins have a bifunctional active site that accepts a pair of negative charges, whether as two monovalent anions or as a single divalent anion . For this reason, exchange stoichiometry moves between limits of 2:1 and 2:2, according to the ratio of mono- and divalent substrates at either membrane surface . Since G6P has a pK2 within the physiological range (pK of 6.1), this predicts a novel reaction sequence in vivo because internal pH is more alkaline than external pH . Accordingly, one expects an asymmetric exchange as two monovalent G6P anions from the relatively acidic exterior move against a single divalent G6P from the alkaline interior . In this way an otherwise futile self-exchange of G6P can be biased towards a net inward flux driven (indirectly) by the pH gradient . Despite the biochemical complexity exhibited by Pi-linked antiporters, they resemble all other secondary carriers at a molecular level and show a likely topology in which two sets of six transmembrane alpha-helices are connected by a central hydrophilic loop . Speculations on the derivation of this common form suggest a limited number of structural models to accommodate such proteins . Three such models are presented. Antimicrob Agents Chemother, 1990 Mar, 34(3), 426 - 31 Role of protonated and neutral forms of macrolides in binding to ribosomes from gram-positive and gram-negative bacteria; Goldman RC et al.; Erythromycin binds to a single site on the bacterial 50S ribosomal subunit and perturbs protein synthesis . However, erythromycin contains desosamine and thus exists in both protonated (greater than 96%) and neutral (less than 4%) forms at physiological pH because of the pKa of the dimethylamino group . We therefore examined the relative roles of both forms in binding to ribosomes isolated from two species each of gram-positive and gram-negative bacteria . We developed a system to directly measure the forward (association) rate constant of formation of the macrolide-ribosome complex, and we have measured both the forward and reverse (dissociation) rate constants as a function of pH . Forward rate constants and binding affinity did not correlate with pH when the interaction of erythromycin with ribosomes from both gram-positive and gram-negative bacteria was examined, demonstrating that the protonated form of this macrolide binds to ribosomes . Conversely, the neutral form of macrolide cannot be the sole binding species and appears to bind with the same kinetics as the protonated form . Forward rate constants were 3- to 4-fold greater at physiological pH, and binding affinity calculated from rate constants was 5- to 10-fold greater than previously estimated . Similar results were obtained with azithromycin, a novel 15-membered macrolide that contains an additional tertiary amine in the macrolide ring . Ribosome- and macrolide-specific kinetic parameters were demonstrated at neutral pH and may be related to the potency of the two macrolides against gram-positive and gram-negative bacteria. DICP, 1990 Mar, 24(3), 255 - 6 Clinical pharmacokinetics of daptomycin; Pryka RD et al.; Daptomycin is a new lipopeptide antibiotic for which preliminary pharmacokinetic data in adults have been limited to normal healthy volunteers and patients with renal insufficiency . We report the clinical pharmacokinetics of the first and fifth doses of iv daptomycin 150 mg (2 mg/kg) q24h in a 29-year-old man being treated for a gram-positive cellulitis and thrombophlebitis . Individual pharmacokinetic parameters yielded similar results during doses one and five . The pharmacokinetic profile observed in our patient did not markedly differ from data obtained from healthy volunteers. Clin Pharmacokinet, 1990 Mar, 18(3), 184 - 209 Clinical pharmacokinetics of teicoplanin; Rowland M; Teicoplanin is a recently introduced glycopeptide antibiotic for the treatment of a variety of aerobic and anaerobic Gram-positive infections . It is a mixture of 5 closely related components, of similar polarity and biological activity, and 1 or more polar hydrolysis products . Teicoplanin is rapidly and extensively absorbed from muscle and the peritoneal cavity but very poorly absorbed from the gastrointestinal tract . Following intravenous administration, the disposition kinetics are best described by a tri-exponential equation, and the majority of drug is excreted unchanged, by glomerular filtration . In patients with normal renal function, the half-lives of the first, second and terminal phases are 35 minutes, 10 hours and 87 hours, respectively . The initial volume of distribution is 0.089 L/kg, the volume of distribution at steady-state is 0.86 L/kg, clearance is 0.0114 L/h/kg and renal clearance is 0.0083 L/h/kg . Teicoplanin is highly bound in plasma to albumin (fraction unbound = 0.1) and in tissues . The pharmacokinetics are linear over a wide dose range (2 to 26 mg/kg) . The minor differences in the pharmacokinetics of the components of teicoplanin can be accounted for by differences in lipophilicity . The events following multiple dosing are predicted from single dose data; renal clearance decreases in patients with renal insufficiency in a predictable manner . Negligible drug is lost during haemodialysis . As expected, clearance per kilogram is higher in children than in adults, and lower in the elderly, associated with a decrease in glomerular filtration rate with advancing years . Tissue distribution data are limited . Concentrations, relative to those in plasma, are high in lung and bone tissue and low in fat . Animal data show high concentrations in most tissues, and particularly high in liver and kidneys . Teicoplanin penetrates slowly and poorly into cerebrospinal fluid, but relatively rapidly and effectively in synovial and pleural fluids and in soft tissue . The manufacturer's recommended intravenous or intramuscular dosage regimens rapidly achieve and maintain adequate plasma concentrations of teicoplanin; the dosing interval is usually 1 day . The maintenance dosing rate, but not the loading dose (if needed), must be reduced in patients with poor renal function and in the elderly . For those patients on continuous ambulatory peritoneal dialysis, the peritoneal cavity offers a convenient alternative route of drug administration. J Appl Bacteriol, 1990 Mar, 68(3), 271 - 8 The survival and transfer of microbial contamination via cloths, hands and utensils; Scott E et al.; Survival and transfer of bacteria from laminated surfaces and cleaning cloths were investigated under laboratory conditions . Drying produced substantial reductions in numbers of recoverable organisms and achieved satisfactory decontamination of clean laminate surfaces . On soiled surfaces and on clean and soiled cloths, Gram-positive and some Gram-negative species survived for up to 4 h, and in some cases up to 24 h . Where contaminated surfaces or cloths came into contact with the fingers, a stainless steel bowl, or a clean laminate surface, organisms were transferred in sufficient numbers to represent a potential hazard if in contact with food. Appl Environ Microbiol, 1990 Mar, 56(3), 583 - 9 Size-selective grazing on bacteria by natural assemblages of estuarine flagellates and ciliates; Gonzalez JM et al.; The small average cell size of in situ bacterioplankton, relative to cultured cells, has been suggested to be at least partly a result of selection of larger-sized cells by bacterivorous protozoa . In this study, we determined the relative rates of uptake of fluorescence-labeled bacteria (FLB), of various cell sizes and cell types, by natural assemblages of flagellates and ciliates in estuarine water . Calculated clearance rates of bacterivorous flagellates had a highly significant, positive relationship with size of FLB, over a range of average biovolume of FLB of 0.03 to 0.08 microns3 . Bacterial cell type or cell shape per se did not appear to affect flagellate clearance rates . The dominant size classes of flagellates which ingested all types of FLB were 3- to 4-microns cells . Ciliates also showed a general preference for larger-sized bacteria . However, ciliates ingested a gram-positive enteric bacterium and a marine bacterial isolate at higher rates than they did a similarly sized, gram-negative enteric bacterium or natural bacterioplankton, respectively . From the results of an experiment designed to test whether the addition of a preferentially grazed bacterial strain stimulated clearance rates of natural bacterioplankton FLB by the ciliates, we hypothesized that measured differences in rates of FLB uptake were due instead to differences in effective retention of bacteria by the ciliates . In general, clearance rates for different FLB varied by a factor of 2 to 4 . Selective grazing by protozoa of larger bacterioplankton cells, which are generally the cells actively growing or dividing, may in part explain the small average cell size, low frequency of dividing cells, and low growth rates generally observed for assemblages of suspended bacteria. Stomatol Glas Srb, 1990 Mar-Apr, 37(2), 101 - 6 {Lipoproteins and lipids of human dental plaque}; Stefanovic G; Host-derived lipoproteins have not yet-been detected in human dental plaque . In this microarea only lipids and lipoprotein polysaccharides known to derive from gram-positive and gram-negative bacterias, were detected . The results of this work show that in human dental plaque there are some components analogous to human serum lipoproteins . The presence of alpha-lipoproteins was established, while beta-lipoproteins could not be detected . The studies of lipids in plaque show that plaque samples contain lipid components similar of serum free cholesterol, free fatty acids, three glycerides and cholesterol esters . Phospholipids were present in extremely small amounts . The results were discussed from the aspect of the possible origin of these lipoprotein constituents as well as from the aspect of specificity and sensitivity of procedures applied in their detection. Appl Environ Microbiol, 1990 Mar, 56(3), 601 - 6 Gram staining apparatus for space station applications; Molina TC et al.; A self-contained, portable Gram staining apparatus (GSA) has been developed for use in the microgravity environment on board the Space Station Freedom . Accuracy and reproducibility of this apparatus compared with the conventional Gram staining method were evaluated by using gram-negative and gram-positive controls and different species of bacteria grown in pure cultures . A subsequent study was designed to assess the performance of the GSA with actual specimens . A set of 60 human and environmental specimens was evaluated with the GSA and the conventional Gram staining procedure . Data obtained from these studies indicated that the GSA will provide the Gram staining capability needed for the microgravity environment of space. Agric Biol Chem, 1990 Mar, 54(3), 791 - 4 A new depsipeptide antibiotic, variapeptin; Nakagawa M et al.; A culture similar to Streptomyces variabilis was found to produce a novel cyclic hexadepsipeptide antibiotic named variapeptin . Variapeptin is structurally related to azinothricin, A83586C, and citropeptin . The antibiotic was active against Gram-positive bacteria and showed cytotoxic activity against mammalian cells. J Exp Med, 1990 Feb 1, 171(2), 439 - 48 The role of cytokines in the generation of inflammation and tissue damage in experimental gram-positive meningitis; Saukkonen K et al.; Cytokines mediate many host responses to bacterial infections . We determined the inflammatory activities of five cytokines in the central nervous system: TNF-alpha, IL-1 alpha, IL-1 beta, macrophage inflammatory protein 1 (MIP-1), and macrophage inflammatory protein 2 (MIP-2) . Using a rabbit model of meningeal inflammation, each cytokine (except IL-1 beta) induced enhanced blood brain barrier permeability, leukocytosis in cerebrospinal fluid, and brain edema . Homologous antibodies to each mediator inhibited leukocytosis and brain edema, and moderately decreased blood brain barrier permeability . In rabbits treated with anti-CD-18 antibody to render neutrophils dysfunctional for adhesion, each cytokine studied lost the ability to cause leukocytosis and brain edema . After intracisternal challenge with pneumococci, antibodies to TNF or IL-1 prevented inflammation, while anti-MIP-1 or anti-MIP-2 caused only a 2-h delay in the onset of inflammation . We suggest these cytokines have multiple inflammatory activities in the central nervous system and contribute to tissue damage during pneumococcal meningitis. Surg Gynecol Obstet, 1990 Feb, 170(2), 137 - 40 Controlled comparison of cefmetazole with cefoxitin for prophylaxis in elective cholecystectomy; Berne TV et al.; Prophylactic antibiotics are given routinely to patients undergoing surgical treatment of the biliary tract to prevent postoperative infection if risk factors for postoperative sepsis are present . Cefmetazole (CM) is a new broad spectrum parenteral cephamycin antibiotic . This drug possesses a spectrum of activity against a wide range of gram-negative and gram-positive bacteria that is similar to cefoxitin (CX), an antibiotic widely used for prophylaxis with operations upon the abdomen . In this study, there was a random selection of two patients to receive CM to every one patient to receive CX . The dose of CM was 1 gram given intravenously every eight hours for three doses beginning 30 minutes before the operation; three doses of CX were given intravenously, 2 grams every six hours . Fifty-two evaluable patients comprised the CM group and 26, the CX group . The risk factors for postoperative infection were acute cholecystitis (CM, seven patients; CX, one patient), evidence from imaging procedure suggesting need for exploration of the common duct (CM, six; CX, one), hyperbilirubinemia (CM, eight; CX, four), hyperamylasemia (CM, 17; CX, seven); age of 60 years or more (CM, six; CX, one), obesity (CM, 36; CX, 14) and diabetes mellitus (CM, four; CX, five) . Operative bactibilia and the organisms were comparable in both groups . Postoperative days of fever greater than or equal to 38 degrees C . (oral) (CM, 0.83 +/- 1.20; CX, 0.58 +/- 0.96) and hospitalization (CM, 6.59 +/- 2.20; CX, 5.04 +/- 1.26) were similar . Postoperative septic complications at the operative site occurred in two patients in the CM group (4 per cent) and in none of the patients in the CX group (p = 0.4; N.S., Fischer exact test) . These two antibiotics had similar efficiency in preventing postoperative infections. J Bacteriol, 1990 Feb, 172(2), 659 - 69 RcsB and RcsC: a two-component regulator of capsule synthesis in Escherichia coli; Stout V et al.; Colanic acid capsule synthesis in Escherichia coli K-12 is regulated by RcsB and RcsC . The amino acid sequences of these two proteins, deduced from the nucleotide sequence reported here, demonstrate their homology to environmentally responsive two-component regulators that have been reported in both gram-positive and gram-negative bacteria . In our model, RcsC acts as the sensor and RcsB acts as the receiver or effector to stimulate capsule synthesis from cps genes . In addition, RcsC shows limited homology to the other effectors in its C terminus . Fusions of rcsC to phoA that resulted in PhoA+ strains demonstrated that RcsC is a transmembrane protein with a periplasmic N-terminal domain and cytoplasmic C-terminal domain . Additional control of this regulatory network is provided by the dependence on the alternate sigma factor, RpoN, for the synthesis of RcsB . The rcsB and rcsC genes, which are oriented convergently with their stop codons 196 base pairs apart, are separated by a long direct repeat including two repetitive extragenic palindromic sequences. Infect Immun, 1990 Feb, 58(2), 384 - 92 The 34-kilodalton membrane immunogen of Treponema pallidum is a lipoprotein; Swancutt MA et al.; Treponema pallidum subsp . pallidum and Escherichia coli incorporated exogenous {3H}palmitate into the 34-kilodalton (kDa) pathogen-specific antigen of T . pallidum . Radiolabeled fatty acid remained associated with the protein upon immunoprecipitation and after boiling in sodium dodecyl sulfate, acetone precipitation, and extensive extractions in organic solvents, suggesting that the fatty acid was covalently bound to the protein . Detection of {3H}palmitate after alkaline and acid hydrolyses confirmed the identity of the incorporated label . Globomycin inhibited maturation of the recombinant 34-kDa antigen, suggesting that E . coli uses the lipoprotein-specific signal peptidase II to process the treponemal antigen . Globomycin also inhibited processing of the 34-kDa antigen, as well as the 44.5- and 15-kDa antigens, in T . pallidum, implying that T . pallidum also possesses the lipoprotein export pathway common to both gram-negative and gram-positive bacteria . Ethanol inhibited processing of the 34-kDa antigen in minicells, suggesting that the 34-kDa antigen normally is translocated through the cytoplasmic membrane . Comparison of the Triton X-114 phase partitioning behavior of the 34-kDa antigen produced either by minicells or by a cell-free translation system indicated that the covalent attachment of fatty acid conferred hydrophobic biochemical properties to the 34-kDa antigen, consistent with the hypothesis that the attached lipid anchors the 34-kDa antigen into the membrane. J Chemother, 1990 Feb, 2(1), 45 - 50 Microbiological patterns of four new imidazole derivatives; Dubini F et al.; The authors present an in vitro experimental study concerning the microbiological properties of four imidazole derivatives, with a piperazine group between two benzene rings . Seventy strains of Gram-positive and Gram-negative bacteria, 30 of yeasts, 14 of filamentous fungi and 10 strains of Trichomonas vaginalis were tested . The new compounds revealed a good inhibitory activity against Gram-positive bacteria, yeasts and dermatophytes . These results compare well with those obtained with the other known imidazoles . Moreover any mutagenic activity is absent. Antimicrob Agents Chemother, 1990 Feb, 34(2), 215 - 8 Ofloxacin versus co-trimoxazole for prevention of infection in neutropenic patients following cytotoxic chemotherapy; Liang RH et al.; The efficacy of ofloxacin in preventing infection in neutropenic patients following cytotoxic chemotherapy was evaluated and was compared with that of co-trimoxazole . A total of 102 patients with hematological malignancies were randomly selected to receive either co-trimoxazole or ofloxacin . All patients were monitored for compliance, occurrence of infection, and drug-related side effects . A surveillance culture of a rectal swab was performed regularly . A total of 25 of the 52 patients (48%) who received co-trimoxazole and 11 of the 50 patients (22%) who received ofloxacin developed fever during the study period (P less than 0.025) . Gram-negative bacteremia occurred in nine patients in the co-trimoxazole group (17%) but in only one patient (2%) in the ofloxacin group (P less than 0.05) . No patient in either group had documented gram-positive bacterial or Pneumocystis carinii infection . Poor performance status was the only identifiable factor associated with an increased incidence of bacteremia . The surveillance study showed that significantly fewer bacterial strains were resistant to ofloxacin than to co-trimoxazole and that acquisition of resistance to co-trimoxazole was more commonly observed than was acquisition of resistance to ofloxacin . Significantly more patients had skin rashes following co-trimoxazole than ofloxacin treatment (P less than 0.05) . Ofloxacin was superior to co-trimoxazole in preventing infection in this population of neutropenic patients. Exp Eye Res, 1990 Feb, 50(2), 189 - 95 Modulation of the blood-aqueous barrier by gram positive and gram negative bacterial cell wall components in the rat and rabbit; Kufoy EA et al.; Acute anterior uveitis in man is related to Gram negative bacterial infection occurring at sites distant to the eye . This could involve intraocular localization of inflammatory bacterial cell wall constituents . Modulation of the blood-aqueous barrier in rabbit and rat, by muramyl dipeptide (the monomer of peptidoglycan) and lipopolysaccharide (and its monomer lipid A) was studied . The rabbit eye was found to be highly susceptible to MDP and LPS, although without cellular infiltration . In contrast the rat eye was demonstrated to be totally refractory to MDP . The response to LPS in the rat was modest, required high dosages and ocular changes were slow to occur, but cellular infiltration was readily apparent . Since MDP is found in Gram positive (as well as Gram negative) bacterial cell walls it is hypothesized that Gram positive bacteria might also play a role in causing uveitis in man. J Dent Res, 1990 Feb, 69 Spec No, 559 - 66; discussion 634-6 Structural events in the caries process in enamel, cementum, and dentin; Frank RM; The structural events observed in enamel, cementum, and dentin during the caries process have been reviewed . In incipient enamel lesions, the prevailing concept of an almost intact surface layer has been seriously challenged by SEM and TEM observations demonstrating structural pathways (such as enlarged prism junctions or sheaths) from the enamel surface to the sub-surface lesion . The destruction in this latter location consisted of (1) enlarged prism junctions, (2) diffuse mineral destruction in the prism cores, and (3) destruction of the interprismatic substance . In root caries, the destruction of cementum started along junctions between calcified layers of extrinsic (Sharpey) and intrinsic collagen fibers as well as along incremental lines . Invasion of Gram-positive micro-organisms followed these enlarged junctions . Dentin caries was similar in coronal and root caries . It consisted of sclerosis of the lumens of the dentinal tubules, followed by an important gradient of demineralization of intertubular dentin and destruction of occluded tubular lumens and peritubular dentin . Bacterial penetration occurred initially in the dentinal tubules and was followed by bacterial invasion and destruction of the intertubular dentin . Various phenomena of crystalline remineralization were described in enamel and dentin . Whereas in enamel and dentin caries, an important gradient of demineralization was observed before bacterial invasion, a simultaneous destruction of the mineral and organic components seemed to occur in cementum. Philos Trans R Soc Lond B Biol Sci, 1990 Jan 30, 326(1236), 489 - 504 Structures and homologies of carbohydrate: phosphotransferase system (PTS) proteins; Lengeler JW et al.; The bacterial phosphotransferase system (PTS) is the major transport system for many carbohydrates that are phosphorylated concomitantly with the translocation step through the membrane (group translocation) . It consists of two general proteins, enzyme I and histidine protein (HPr), and a series of more than 15 substrate-specific enzymes II (EII) . The sequences of several of these derived from Gram-positive and Gram-negative bacteria were compared, which allowed the possible identification of the following functional domains: membrane-bound pore, substrate-binding site, linker domains, transphosphorylation domain and primary phosphorylation site . Several EIIs have been analysed in the meantime, also by topological tests, by sequential deletion of the corresponding structural genes, and by construction of intergenic hybrids between different domains of several EIIs . These data suggest evolutionary relationships between different EIIs; they also enable a general model to be constructed of EIIs as carbohydrate transport systems, phosphotransferases, chemoreceptors in chemotaxis and as part of a global regulatory network. Philos Trans R Soc Lond B Biol Sci, 1990 Jan 30, 326(1236), 353 - 64; discussion 364-5 Periplasmic binding protein-dependent transport systems: the membrane-associated components; Higgins CF et al.; Periplasmic binding protein-dependent transport systems are multicomponent, consisting of several inner membrane-associated proteins and a periplasmic component . The membrane-associated components of different systems are related in organization and function suggesting that, despite different substrate specificities, each transport system functions by a common mechanism . Current understanding of these components is reviewed . The nature of energy coupling to periplasmic transport systems has long been debated . Recent data now demonstrate that ATP hydrolysis is the primary source of energy for transport . The ATP-binding transport components are the best characterized of a family of closely related ATP-binding proteins believed to couple ATP hydrolysis to a variety of different biological processes . Intriguingly, systems closely related to periplasmic binding protein-dependent transport systems have recently been identified in several Gram-positive organisms (which lack a periplasm) and in eukaryotic cells . This class of transport system appears to be widespread in nature, serving a variety of important and diverse functions. FEMS Microbiol Lett, 1990 Jan 15, 55(1-2), 127 - 30 Rapid procedure to determine the DNA base composition from small amounts of gram-positive bacteria; Ezaki T et al.; A universal rapid procedure to determine the DNA base composition (mol% guanine + cytosine) of Gram-positive bacteria is described . Cells of Gram-positive bacteria were lysed with achromo-peptidase and the mol% G + C of their DNAs were determined by using high performance liquid chromatography . One ml of a Gram-positive bacterial suspension which matched MacFarland No . 3 standard turbidity was sufficient to determine the mol% G + C within 3 h. Gastroenterol Clin Biol, 1990, 14(5), 474 - 82 {Complications in 52 liver transplantations excluding graft rejection}; Bresson-Hadni S et al.; We analyzed the postoperative complications excluding graft rejection in 52 consecutive orthotopic liver transplantations performed from March 1986 to November 1988 in 48 patients . Thirteen patients died: one intraoperatively, seven during the first 2 months, and five between 5 and 28 months . Complications were predominant during the first 3 months; infection was the most common complication . The main cause was viral agents . Cytomegalovirus was responsible for infection in 62 percent of cases, but was symptomatic in only 37 percent of patients and always had a favorable outcome . Six cases of disseminated candidiasis were observed with fatal outcome in 3 cases . Ten patients had septicemia due to Gram positive germs with a favorable course in all cases . Two patients required retransplantation on the 2nd postoperative day because of primary graft failure . Three patients had hepatic infarction which was fatal in one case . Technical complications were represented by intra-abdominal bleeding in 3 cases, perihepatic hematoma in 10 cases and stenosis of the biliary anastomosis in 8 cases; in one patient, partial portal vein thrombosis occurred; no hepatic arterial thrombosis occurred during the first postoperative days but this complication was diagnosed later in 3 instances by arteriography . Five out of 7 patients transplanted for malignant liver disease experienced recurrence which cause death in 4 cases . In 3 out of the 5 patients transplanted for postviral B cirrhosis, chronic active hepatitis occurred 6 months after transplantation and one of these patients had to be retransplanted at 13 months for recurrence of cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS) J Acquir Immune Defic Syndr, 1990, 3(4), 335 - 42 Indwelling central venous catheter infections in patients with acquired immune deficiency syndrome; Skoutelis AT et al.; Indwelling central venous catheters are increasingly useful in the clinical management of patients with acquired immune deficiency syndrome (AIDS) . To evaluate the risk of catheter infection in this group of patients, we reviewed the records of 299 patients with Hickman and Port-a-cath catheters . Patients were stratified into three groups: (a) AIDS (n = 54), (b) non-AIDS immunodeficiencies (n = 102), and (c) immunocompetent (n = 98) . The rate of infection per 1,000 catheter days was 2.02, 0.41 (p less than 0.002), and 0.23 (p less than 0.002), respectively . Gram-positive cocci were the predominant isolate . Previous catheter infection and advanced AIDS (as determined by positive p24 antigen and low CD4+ number) were associated with increased risk of infection . Exit, tunnel, and fungal infections required catheter removal . The risk of infection and management were similar in Hickman and Port-a-cath catheters . The mortality was extremely low in all groups . However, the risk of infection associated with indwelling catheters was significantly higher in AIDS patients compared to patients with other immunodeficiencies. Am Rev Respir Dis, 1990 Jan, 141(1), 94 - 7 Plasma tumor necrosis factor in patients with septic shock . Mortality rate, incidence of adult respiratory distress syndrome, and effects of methylprednisolone administration; Marks JD et al.; We assayed serial plasma samples from 86 patients, who were enrolled in a prospective randomized trial of the effects of methylprednisolone (MPSS) in septic shock, for the presence of cytokine tumor necrosis factor (TNF) using an enzyme-linked immunosorbent assay . TNF was present in the plasma of 27 of the 74 patients with septic shock, but in only 1 of the 12 patients with shock due to other causes . TNF was detected with equal frequency in patients with shock from gram-negative or from gram-positive bacillary sepsis . TNF levels were highest on the initial sample and decreased significantly over the subsequent 24 h in both the patients treated with MPSS and in those given placebo . Patients with detectable TNF had a higher incidence and severity of the adult respiratory distress syndrome and a higher mortality rate than did patients without detectable TNF. Ther Hung, 1990, 38(3), 125 - 8 Experiences in the Ebrimycin gel treatment of burns; Papp T et al.; Ebrimycin gel has been used for the local treatment of burns of 50 partly hospitalized patients, partly outpatients . According to the observations the product may be successfully used by the exposure method for the treatment of superficial facial burns and by the occlusive dressing method for the treatment of small burns which are infected by Gram-positive bacteria. Crit Rev Biotechnol, 1990, 10(3), 191 - 204 Autoregulatory factors of secondary metabolism and morphogenesis in actinomycetes; Horinouchi S et al.; The Gram-positive bacterial genus Streptomyces possesses interesting biological aspects, such as the ability to produce a wide variety of secondary metabolites and a mycelial form of growth that culminates in sporulation . A close relationship of secondary metabolism and cell differentiation has been well recognized; secondary metabolism might be a physiological expression of cell differentiation . A variety of diffusible low-molecular-weight chemical substances have been found to function in general as regulatory factors, like "hormones" in eukaryotes, for secondary metabolism and cell differentiation . Among these factors, A-factor has been most extensively studied . This review summarizes recent research on the chemical structures, functions, biosyntheses, and mode of action of these regulatory factors. Scand J Infect Dis, 1990, 22(4), 507 - 8 Are tumor necrosis factor (TNF) or cortisol of value for the diagnosis of acute septicemia? Rollof J, Akervall J, Rydberg J. Early diagnosis is of great importance to improve the prognosis of septicemia . Traditional laboratory tests are either delayed like blood cultures, or unspecific like WBC count or ESR . In this retrospective pilot study we have assayed plasma cortisol, blood sugar and serum tumor necrosis factor (TNF) from patients with verified septicemia . With the approach used in this study none of the tests were able to differentiate between septicemia and other infectious febrile illnesses, or to predict if the causing organism was gram-positive or gram-negative. Scand J Infect Dis Suppl, 1990, 72, 35 - 7 Teicoplanin therapy in children: a review; Bassetti D et al.; Teicoplanin has been investigated mainly in adults and to a lesser extent in children . Pharmacological studies in children aged 2-12 years showed that a daily dose of 3-6 mg/kg of teicoplanin was insufficient to maintain microbiologically effective trough serum levels, while a regimen of 10 mg/kg/day was sufficient to obtain effective serum concentrations . Teicoplanin has been administered, alone or in combination therapy, to neutropenic or non-neutropenic paediatric patients . Combinations of teicoplanin (10 mg/kg/day) plus beta-lactams or aminoglycosides have been found effective in the treatment of febrile episodes in neutropenic (less than 500 pmn/microliters) children . Teicoplanin, 3-10 mg/kg i.v., has been administered as the sole antibiotic agent as a daily dose to more than 100 children and newborns with documented or suspected Gram-positive infections . Overall, teicoplanin was found to be a very effective and well tolerated treatment for Gram-positive infections in pediatric patients . Further trials are required to confirm these observations. Lens Eye Toxic Res, 1990, 7(3-4), 685 - 91 Multifocal serous chorioretinitis in beagle dogs; von Landenberg F et al.; In the years 1988 and 1989, routine ophthalmological examinations of dogs from the company-owned beagle colony revealed a clinically inapparent chorioretinitis in 7.4 and 10% of the animals, respectively, as it has previously been described by Weisse et al . (1981) . The alterations were seen mainly in the non-tapetal fundus, and they appeared more frequently in both eyes than in just one eye . Infection tests as well as virologic, bacteriologic and histopathologic investigations were performed in order to clarify the origin . A direct evidence of virus particles from processed ocular material by electron microscopy was not possible . Tests for growth on MDCK cells were negative . In bacteriologic tests, a gram positive, filiform, branched microorganism was isolated . The histopathologic findings in the subacute stage were a focal atrophy of the first retinal neuron and a focal proliferation of glia cells. J Basic Microbiol, 1990, 30(8), 597 - 607 Ultrastructural features of microbial colony organization; Tetz VV et al.; The ultrastructure of microbial colonies was studied . Inside the colonies three types of intercellular contacts were demonstrated . In the colonies of Gram-negative bacteria, the cells were found to be connected by tight adhesions of outer membranes of the cell walls and membrane bridges . In the colonies of Gram-positive bacteria, the intercellular contacts were formed by fusion of peptidoglucan layers of the cell walls . Bacterial cells were differentiated by the presence of a capsule-like envelope . The obtained data indicate the existence of elements of cellular cooperation and specialization in microbial colonies. Adv Perit Dial, 1990, 6, 88 - 91 A multi-center study: clinical practices of HIV infected patients on CAPD/CCPD; Graham MM et al.; Our statistics reveal the average patient in our study to be a young black male with a history of IVDA with CAPD as the initial dialysis modality . He was most often trained on a mechanical assist device, but he still developed frequent peritonitis episodes, predominantly gram positive . His survival rate was less than 2 years, but he was able to remain independent until he died . Our fears about caring for the HIV infected individual cannot be denied . Even though we may never be truly comfortable when caring for someone with this disease, it is possible to train them to perform home peritoneal dialysis safely and effectively . By doing this, we can preserve the patients' independence and maintain their dignity while they cope with this overwhelming illness. Haematologica, 1990 Jan-Feb, 75 Suppl 1, 83 - 6 Infection after autologous blood-derived stem cell transplantation; D'Antonio D et al.; Ten patients who underwent autologous blood-derived stem cell transplantation (APBSCT) were studied retrospectively to determine the frequency and outcome of transplant associated infections during the hemopoietic reconstitution . Six patients developed an infection after transplant . Severe bacterial infections were unfrequent and mostly caused by gram-positive cocci . In no case pneumonia was observed and this scarce morbility of infection could be the result of early engraftment . None of them died for infection . The frequency of infections in APBSCT patients appears lower than the one observed in autologous bone marrow transplant patients. J Neural Transm Suppl, 1990, 32, 315 - 8 Methylamine oxidase from Arthrobacter P1 as a prototype of eukaryotic plasma amine oxidase and diamine oxidase; McIntire WS et al.; Methylamine oxidase (MAOx) from Gram-positive soil bacterium Arthrobacter P1 catalyzes the oxidation of CH3NH2 to H2C = O and NH4+ via reduction of O2 to H2O2 . Past work indicates that MAOx is similar to mammalian plasma amine oxidase (PAO) and diamine oxidase (DAO), plant DAO, and yeast peroxisomal amine oxidase (YAO) . All have Mr congruent to 170,000 and are composed of 2 identical subunits, each of which contains 1 atom of Cu(II) and one molecule of quinonoid cofactor . Herein, we report further evidence as to the striking similarity of these enzymes, and describe properties of MAOx which offer insights into understanding the eukaryotic oxidases . It is our belief that the structure of the quinone cofactor, and the Cu(II) site in MAOx are identical to these sites in PAO and DAO. Int J Syst Bacteriol, 1990 Jan, 40(1), 19 - 27 Taxonomic study of anaerobic, gram-negative, rod-shaped bacteria from breweries: emended description of Pectinatus cerevisiiphilus and description of Pectinatus frisingensis sp . nov., Selenomonas lacticifex sp . nov., Zymophilus raffinosivorans gen . nov., sp . nov., and Zymophilus paucivorans sp . nov; Schleifer KH et al.; A collection of 47 strains of obligately anaerobic, gram-negative, rod-shaped bacteria that were isolated mainly from spoiled beer and pitching yeast was studied to learn more about their taxonomic positions . A new species of the genus Pectinatus, Pectinatus frisingensis, a new species of the genus Selenomonas, Selenomonas lacticifex, and a new genus comprising two species, Zymophilus raffinosivorans and Zymophilus paucivorans, are described . All of the strains contained directly cross-linked meso-diaminopimelic acid-containing peptidoglycan and in addition the diamine cadaverine or (rarely) putrescine . The diamine was covalently linked to the alpha-carboxyl group of D-glutamic acid in the peptide subunit of peptidoglycan . Lipid F was also found as a characteristic cellular compound . The phylogenetic relationships of members of these new species were examined by reverse transcriptase sequencing of 16S rRNA or by DNA-DNA hybridization studies or both . All of the organisms belong to the subdivision containing species with gram-negative cell walls within the phylum of gram-positive bacteria . This finding is in good agreement with the presence of a peptidoglycan that contains diamine. Clin Trials J, 1990, 27(1), 20 - 9 Disinfection and sterilization in dentistry . Use of potentiated glutaraldehyde (DIBA-GLAXO) in the water systems of dentistry units: analysis of microbiological activity, physico-chemical compatibility and residues in washing water; Urbani G et al.; Glutaraldehyde is a potent sterilizing agent with a very broad-spectrum of biocidal activity including Gram-positive and -negative bacteria, spores and viruses such as HBV and HIV (the aetiological agents responsible for hepatitis B and AIDS, respectively) . The aim of this study was to evaluate, in experimental conditions simulating the operative risk in dental practice, a 2% potentiated acid glutaraldehyde-based product (DIBA-GLAXO) not only in the disinfection and sterilization of the water circuits of dental units, but also with regard to physico-chemical compatibility, as well as from the toxicological viewpoint . DIBA, in the dental unit disinfection cycle, proved capable of destroying the bacterial cultures of all 16 pathogens used to contaminate artificially the water circuits of the unit handpieces . When the contamination was produced using bacterial spores, 5 hours of contact were sufficient to obtain sterility . The residual concentrations of glutaraldehyde in the circuit washing water, after optimization of the washing process, may be regarded as safe for the patient . Lastly, the product analysed was found to be compatible with the mechanical components of dental unit water circuits . No corrosion phenomena were observed even after total immersion in DIBA for a period equivalent to approximately 20,000 disinfection cycles. Mol Microbiol, 1989 Dec, 3(12), 1825 - 31 Secretion, processing and activation of bacterial extracellular proteases; Wandersman C; Many different bacteria secrete proteases into the culture medium . Extracellular proteases produced by Gram-positive bacteria are secreted by a signal-peptide-dependent pathway and have a propeptide located between the signal peptide and the mature protein . Many extracellular proteases synthesized by Gram-negative bacteria are also produced as precursors with a signal peptide . However, at least two species of Gram-negative bacteria secrete one or more proteases via a novel signal-peptide-independent route . Most proteases secreted by Gram-negative bacteria also have a propeptide whose length and location vary according to the protease . Specific features of protease secretion pathways and the mechanisms of protease activation are discussed with particular reference to some of the best-characterized extracellular proteases produced by Gram-positive and Gram-negative bacteria. Am Surg, 1989 Dec, 55(12), 710 - 3 Primary peritonitis . An unusual operative diagnosis; Murray L et al.; Primary peritonitis, or spontaneous bacterial peritonitis, is a highly morbid and often fatal complication of cirrhosis and other conditions associated with ascites . Prompt antibiotic therapy may be lifesaving, as may early surgical intervention in patients who have signs and symptoms of an acute abdomen . During a 5-year period, 12 patients had 14 episodes of primary peritonitis diagnosed in our hospital . Three patients had exploratory laparotomy, and gram-positive organisms were obtained from peritoneal fluid in two patients . The clinical features, patho-physiology, and natural courses of these patients are presented and the current literature reviewed. Antibiot Khimioter, 1989 Dec, 34(12), 883 - 5 {Antibiotics formed by Actinomadura fulvescens}; Zbarskii VB et al.; Novel antibiotics with in vitro activity against gram-positive bacteria were isolated from Actinomadura fulvescens INA 3321 and INA 3852 . Conditions for biosynthesis and isolation of antibiotics 3321 and 3852, as well as their physicochemical and biological properties were studied . Chromatographic analysis of the antibiotics revealed that each of them contained two biologically active components . The components were separated with preparative chromatography . Physicochemical properties of the components showed that antibiotics 3321 and 3852 were similar . UV and IR spectroscopy suggested that antibiotics 3321 and 3852 were original compounds not described earlier. J Antibiot (Tokyo), 1989 Dec, 42(12), 1763 - 7 Sandramycin, a novel antitumor antibiotic produced by a Nocardioides sp . Production, isolation, characterization and biological properties; Matson JA et al.; A new antitumor antibiotic, sandramycin, was isolated from cultured broth of a Nocardioides sp . (ATCC 39419) and purified by solvent partition and column chromatography . Sandramycin, a new depsipeptide, was moderately active in vitro against Gram-positive organisms and in vivo against leukemia P388 in mice. Am J Infect Control, 1989 Dec, 17(6), 340 - 4 Bacterial carriage by artificial versus natural nails; Pottinger J et al.; Although health care workers are following fashion trends when they wear artificial nails, the implications of these nails for infection control is unknown . Cultures were obtained before and after handwashing from the fingertips of 56 nurses with artificial nails and 56 nurses with natural nails . After handwashing there were higher numbers of colony-forming units of gram-negative rods cultured from the fingertips of nurses with artificial nails than from nurses with natural nails . There were no significant differences in carriage of gram-positive cocci or normal flora . Because of the number of nosocomial infections caused by gram-negative rods, health care workers who wear artificial nails should consider the potential risk of increased carriage of gram-negative rods. Otolaryngol Head Neck Surg, 1989 Dec, 101(6), 646 - 50 Effect of lipoteichoic acid on proliferation and differentiation of keratinocytes; Yabe T et al.; Bacterial infection is always found to be associated with cholesteatoma . Accumulation of keratin debris is one of the crucial factors for the growth of cholesteatoma . The effects of lipoteichoic acid, a cell wall component of gram-positive bacteria, on the proliferation and differentiation of keratinocytes were studied . Various concentrations of lipoteichoic acid (0 to 100 micrograms/ml) were added to keratinocytes . DNA synthesis and protein synthesis were inhibited by decreasing the incorporation of 3H-thymidine and 3H-leucine into keratinocytes . The effects of lipoteichoic acid on terminal differentiation were then studied by measuring the number of sodium dodecyl sulfate-insoluble cornified cell envelopes and the transglutaminase activity (a marker of terminal differentiation) determined by incorporation of 3H-putrescine into cornified envelopes . These studies showed that lipoteichoic acid stimulated the formation of cornified cell envelopes and transglutaminase activity . These findings suggest that lipoteichoic acid stimulated the terminal differentiation and accumulation of keratin debris and that lipoteichoic acid might have stimulatory effects on the development of cholesteatoma. Pract Odontol, 1989 Dec, 10(12), 35 - 7 {Immune response and dentobacterial plaque}; Angell Vazquez del Mercado M; The effects of bacterial plaque on the immunologic response are varied and complex, which is astounding considering the nature of the plaque . The large number of gram-positive and gram-negative bacteria and their products like lipopolysaccharides (LPS), lipoteicoic acids (LTA), dextrans and levanes, permit the activation of most immunologic mechanisms . Both the classical and alternate paths in the complement system are activated, as well as lymphocytes, macrophages, and lymphocyne liberation . Polyclonal mitogens evolving to B lymphocytes may perform an important function in lymphocyte stimulation . An immunogenetic control over the functions of T auxiliary cells has been suggested, with at least one antigen from plaque, and related to the HLA-DR . These reactions may be modulated through potentiating and suppressing effects of some plaque components, thus resulting in a chronic localized inflammatory response. Clin Orthop, 1989 Nov, (248), 15 - 9; discussion 19-20 Mechanisms of failure of the femoral and tibial components in total knee arthroplasty; Windsor RE et al.; From 1974 to 1986, 1430 cemented primary total knee arthroplasties were available for analysis . These included 224 total condylar prostheses with a polyethylene tibial component, 289 posterior stabilized prostheses with a polyethylene tibial component, and 917 posterior stabilized prostheses with a metal-backed tibial component . There were 12 failures in the total condylar series including three infections (one early and two late), five loose tibial components, two loose femoral and tibial components, and two unstable arthroplasties . The posterior stabilized prosthesis with the polyethylene tibia demonstrated six failures including two loose tibial components, two loose femoral components, and one supracondylar femur fracture . The posterior stabilized prosthesis with the metal-backed tibial component was associated with seven failures including six infections (three early and three late) and one femoral loosening . No metal-backed tibial components have been revised for loosening . The overall failure rate in this series was 1.7% for all prostheses . The incidence of tibial loosening was 0.53% with an average time to failure of 4.7 years . The incidence of femoral loosening was 0.35% with an average time to failure of 2.0 years . Tibial loosening was related to error in technique: postoperative varus tibiofemoral alignment, varus tibial component position, and excessive tibial resection . The overall infection rate was 0.63% for all total knee arthroplasties, and all were secondary to gram-positive organisms . Presently, the posterior stabilized prosthesis with a metal-backed tibia is the authors' implant of choice . Technical error and infection are the major causes of failure. J Antimicrob Chemother, 1989 Nov, 24 Suppl B, 185 - 93 Controlled prospective study of oral amoxycillin/clavulanate vs ciprofloxacin in acute exacerbations of chronic bronchitis; Schmidt EW et al.; This investigation compared the efficacy of oral formulations of amoxycillin/clavulanate and ciprofloxacin in acute exacerbations of chronic bronchitis . Forty patients were randomized to receive either Augmentin (1,000 mg amoxycillin +250 mg clavulanate) tds or ciprofloxacin (500 mg) bd . During and before therapy sputum samples were taken for bacteriology, sputum volume measurement and histamine determination . Lung function was also monitored . From sputum, 143 bacterial isolates and 15 yeast strains were obtained before therapy . During therapy with amoxycillin/clavulanate the incidence of Gram-positive isolates decreased significantly whereas ciprofloxacin left their frequency unchanged . On the other hand, ciprofloxacin more effectively diminished the incidence of Gram-negative isolates . Yeasts were grown from the sputum of several patients before and during therapy . Their number did not increase during amoxycillin/clavulanate therapy while it increased under ciprofloxacin . The groups showed no significant differences with regard to sputum production, histamine concentration or lung function . The majority of patients (28/40) acknowledged improvement of their symptoms . There was no significant difference between the groups . On the basis of these results both amoxycillin/clavulanate and ciprofloxacin appear of similar value for treatment of patients with exacerbations of chronic bronchitis. J Antimicrob Chemother, 1989 Nov, 24 Suppl B, 147 - 56 Comparison of the safety and efficacy of parenteral ticarcillin/clavulanate and clindamycin/gentamicin in serious intra-abdominal infections; Fink MP et al.; One hundred and twelve patients with proven or suspected serious intra-abdominal infections were randomized for treatment with either ticarcillin/clavulanate (3.1 g every 4 h) or gentamicin (dosage schedule adjusted according to serum concentrations) plus clindamycin (in most cases 900 mg every 8 h) . Positive intraperitoneal and/or blood cultures were available in 47 cases . Considering only fully evaluable cases, 15/20 (75%) were clinically cured or improved in the ticarcillin/clavulanate group and 16/25 (64%) in the gentamicin/clindamycin group, the difference not being significant (P greater than 0.05) . Bacteraemia was documented in nine of 45 fully evaluable cases . During the course of the study, the serum creatinine concentration increased by more than 5 mg/l in only one patient (ticarcillin/clavulanate group) . Two patients (one in each group) had apparent allergic reactions . No other drug-related adverse effects were noted . In-vitro sensitivity testing of anaerobic isolates revealed that, of those tested, 5/38, 1/38 and 2/37 were resistant to ticarcillin, ticarcillin/clavulanate and clindamycin, respectively . Among aerobic Gram-negative isolates, 34/78, 6/78 and 4/78 were resistant to ticarcillin, ticarcillin/clavulanate, and gentamicin, respectively . Among aerobic Gram-positive isolates, 2/32, 2/32, and 5/14 were resistant to ticarcillin, ticarcillin/clavulanate, and clindamycin, respectively . We conclude that ticarcillin/clavulanate is a safe and efficacious preparation for treating serious intra-abdominal infections. Taiwan Yi Xue Hui Za Zhi, 1989 Nov-Dec, 88(11-12), 1156 - 9 Cutaneous abscess caused by Nocardia brasiliensis: report of a case; Shih KC et al.; We report a case of cutaneous Nocardia brasiliensis infection . The patient had received radiotherapy and anti-neoplastic chemotherapy for epidermoid carcinoma of the left sphenoid sinus with bone destruction . He developed fever and an ulcer on the dorsal medial surface of the left hand after an intravenous infusion of chemotherapeutic agents in the same site 3 days earlier . Needle aspiration of the abscess disclosed polymorphonuclear leukocytes, and a partially acid-fast, gram-positive filamentous branching organism . Cultures of the aspirate grew N . brasiliensis 1 week later . The patient was treated successfully with a regimen of parenteral ceftazidime and amikacin with definite improvement 1 week later . Therapy was continued for 1 more week, and then the patient was switched to oral trimethoprim-sulfamethoxazole for 3 months with no recurrence . The diagnosis, clinical manifestations, treatment and prognosis of cutaneous abscesses cause by N . brasiliensis are discussed. Orthop Nurs, 1989 Nov-Dec, 8(6), 61 - 9 Disseminated intravascular coagulation: a nursing challenge; Suchak BA et al.; Altered clotting encompasses a wide spectrum of clinical conditions ranging from bleeding disorders to abnormal clot formation . DIC is an abnormal overstimulation of the normal coagulation process resulting from several clinical conditions that illustrate these extremes . In orthopaedic patients, DIC can develop following trauma (crush injuries), tissue necrosis, fat embolism, gram-negative or gram-positive sepsis, and venous stasis (bedrest) . Because of its occurrence as a secondary process and its subtle development, DIC can elude early recognition, diagnosis, and treatment. Kyobu Geka, 1989 Nov, 42(12), 991 - 4 {Prophylactic use of cefpiramide (CPM) in open heart surgery}; Koga M et al.; The concentration of cefpiramide (CPM) in serum and myocardial tissues was measured in 24 patients with open heart surgery . The regimen was given in bolus of 2 g intravenously before the commencement of cardiopulmonary bypass . Blood and tissues of the right atrial appendage and pericardium were surveyed for samples at an estimated interval after the administration of CPM . The concentration of CPM in the blood and the myocardial tissues were consistently efficacious for both gram positive and negative bacterium . The duration and dosage of CPM, selected in the study, were both satisfactory for prevention of infection in open heart surgery. J Antibiot (Tokyo), 1989 Nov, 42(11), 1653 - 60 C(3)-cyclopropyl cephems and carbacephems; Spry DO et al.; A series of C(3)-cyclopropyl cephems and carbacephems has been prepared by palladium catalyzed addition of diazomethane to the corresponding C(3)-vinyl derivatives . The phenylglycyl cyclopropyl cephem derivatives exhibit better Gram-positive activity than cephalexin or cefaclor, while the aminothiazole oxime cyclopropyl cephem derivatives were not as active as the corresponding C(3)-vinyl cephems. Enferm Infecc Microbiol Clin, 1989 Nov, 7(9), 471 - 7 {Spontaneous bacterial peritonitis: clinical, microbiological and clinical course study of 89 episodes}; Pascual J et al.; We have retrospectively studied 89 episodes of spontaneous bacterial peritonitis (SBP) attended at our service with the purpose of analyzing clinical features, microbiologic data and possible etiopathogenic factors, treatment and course . The most frequent symptoms were ascites, abdominal pain and fever . Only 3.3% of episodes were asymptomatic . Twenty-four episodes (26.96%) resulted in death of the patient and only the presence of septic shock and prothrombin time lower than 35% statistically correlated with a higher mortality (100% and 53.8%, respectively, p less than 0.01) of the possible factors analyzed . The culture of ascitic fluid (AF) was positive in 52.8% of the episodes and there were no clinical or time course differences between these cases and those who presented negative culture . The isolated microorganisms were the usual ones in this condition, outstanding 37.5% of gram-positive cocci in monomicrobial SBP . Treatment was initiated within the first 12 hours from admittance in 76.4% of cases, between 12 and 72 hours in 12.3% and after 72 hours in 11.2% . Cefotaxime was given to 47.1% of episodes and 52.9% of patients received ampicillin or cefoxitin plus aminoglycoside; the mortality was lower with the first schedule (11.9% versus 40.4%, p less than 0.01). Ann Ig, 1989 Nov-Dec, 1(6), 1419 - 26 {Evaluation of the microbial burden using rinsing of the oral cavity in patients undergoing bone marrow transplantation}; Pasquarella C et al.; We report the methodology and the results of our research on the total microbic charge of the oral cavity carried out in 35 (thirty-five) patients undergoing bone marrow transplant and selective decontamination at the Bone Marrow Transplant Unit Perugia, between July 1985 and December 1988 . The specimens, obtained by washing the oral cavity for 15 seconds with 10 ml of sterile distilled water, were taken from each patient during his stay in the Laminar Air Flow Room (from day -7 to day +28 of the transplant) . The first sample was taken before starting the selective decontamination and the microbiological controls were carried out weekly . The quantitative determination of the microbic charge was made by diluting and plating, while selective media for gram-positive and gram-negative microorganisms were used for the qualitative evaluation . The results obtained prove the effectiveness of the mouth-wash method as an instrument for the evaluation of microbial contamination of the "mouth"-area, since it determines the oral microbic flora by standardized counting and testing methods which are simple to use and give rapid and reliable results . Furthermore, this method has proved to be especially useful for studying the effectiveness of the decontamination and chemoprophylaxis treatments carried out on the patients undergoing bone marrow transplants. J Antibiot (Tokyo), 1989 Oct, 42(10), 1465 - 9 Isolation and characterization of thioxamycin; Matsumoto M et al.; A new peptide antibiotic named thioxamycin which contained thiazole and oxazole rings was isolated from the culture broth of Streptomyces sp . The antibiotic is acidic and lipophilic in nature . A molecular formula, C52H48N16O15S4, was indicated by elemental analysis and MS . One mol of threonine and three unusual amino acids were detected by amino acid analysis of the acid hydrolysate . The antibiotic is active in vitro against anaerobic Gram-positive and Gram-negative bacteria and also aerobic Gram-positive bacteria. Surgery, 1989 Oct, 106(4), 750 - 6; discussion 756-7 Antibiotic prophylaxis for surgery in morbidly obese patients; Forse RA et al.; The rate of wound infections in morbidly obese patients who underwent gastroplasty surgery at our institution was 16.5% compared with a rate of 2.5% in normal-weight patients who underwent clean-contaminated surgery . Both groups received 1 gm of cefazolin intramuscularly before surgery was performed . We hypothesized that this regimen of prophylaxis did not provide adequate tissue levels in the morbidly obese . Morbidly obese patients who were undergoing gastroplasty were randomly selected to receive 1 gm cefazolin in the buttock fat, buttock muscle, or by intravenous injection . A fourth group of morbidly obese patients received 2 gm of cefazolin intravenously . Normal-weight patients who were undergoing upper abdominal surgery received 1 gm of cefazolin intravenously . At incision and closure, both blood and tissue levels of cefazolin were significantly (p less than 0.001) lower for all morbidly obese patients who received 1 gm cefazolin when compared with the blood and tissue levels of the drug found in normal-weight patients . The cefazolin levels obtained were below the minimal inhibitory concentrations of greater than 2 micrograms/ml for gram-positive cocci and of greater than 4 micrograms/ml for gram-negative rods . Only when the morbidly obese patient received 2 gm cefazolin were both the serum and adipose tissue levels adequate . For a 4-month period, all morbidly obese patients received 2 gm cefazolin prophylaxis, and the wound infection rate dropped to 5.6% compared with the previous rate of 16.5% (p less than 0.03) . We conclude that antibiotic prophylaxis must be specially tailored to the needs of these obese patients. Rev Esp Enferm Apar Dig, 1989 Oct, 76(4), 325 - 30 {Septic complications following splenectomy after abdominal trauma}; Alvarez Perez JA et al.; We reviewed retrospectively the septic postsplenectomy complications after splenic rupture from abdominal trauma in 53 patients treated in the last five years (1984-1988) . We recorded a higher incidence of complications (pneumonia, subphrenic abscess) in these patients than in those who underwent clean surgery during the same period, but we did not demonstrate the same difference in other infectious processes (infection of the surgical wound) . Infections had a higher incidence in patients with splenic rupture with associated lesions (54.10%) than in those with only a splenic lesion (37.50%) (SD p less than 0.05) . The predominant agents usually isolated were aerobic Gram-positive . We remark the importance of open drainage systems (Penrose type) in the genesis of subphrenic abscesses. Aust N Z J Med, 1989 Oct, 19(5), 417 - 25 A randomised trial of empirical antibiotic therapy in febrile neutropenic patients with hematological disorders: ceftazidime versus azlocillin plus amikacin; Gibson J et al.; One hundred and two patients with neutropenia (less than 1 x 10(9)/L) secondary to primary hematological disorders or chemotherapy for hematological malignancies were prospectively randomised, upon the development of fever or other signs of infection, to receive empirical antibiotic treatment with either ceftazidime (+/- flucloxacillin) (n = 52) or azlocillin plus amikacin (+/- flucloxacillin) (A&A, n = 50) . The two groups were equivalent with respect to clinical and laboratory parameters prior to antibiotic therapy and flucloxacillin was added to approximately 25% of the patients in each group on the clinical suspicion of Gram positive infection . When assessed at 96 hours, the complete response rates were 59.6% for the ceftazidime treated patients and 44% for A&A treated patients . Partial response rates were 17% and 20% respectively . This difference was not statistically significant . Eight patients died whilst on the trial, three of those initially randomised to ceftazidime and five initially randomised to A&A . Moderate to severe hypokalemia was encountered significantly less often in the ceftazidime treated group (p less than 0.01), whilst other parameters of toxicity were equivalent . No primary or acquired resistance to ceftazidime was encountered . Separate analysis of those patients who did not receive flucloxacillin yielded identical results . We conclude that ceftazidime (+/- flucloxacillin) is as efficacious as azlocillin plus amikacin (+/- flucloxacillin) in the empirical antibiotic management of such patients and is associated with a lower incidence of moderate to severe hypokalemia. Clin Microbiol Rev, 1989 Oct, 2(4), 354 - 9 Erysipelothrix rhusiopathiae: an occupational pathogen; Reboli AC et al.; Erysipelothrix rhusiopathiae is a nonsporulating, gram-positive, rod-shaped bacterium which was identified more than 100 years ago as the etiologic agent of swine erysipelas . Since then, it has been found to cause infection in several dozen species of mammals and other animals . Humans become infected through exposure to infected or contaminated animals or animal products . By far the most common type of human infection is a localized, self-limited cutaneous lesion, erysipeloid . Diffuse cutaneous and systemic infections occur rarely . Approximately 50 cases of endocarditis have been reported; all but one recent case have involved native valves . The organism may be isolated from biopsy or blood specimens on standard culture media . It is identified by morphology, lack of motility, and biochemical characteristics; identification may be confirmed by the mouse protection test . It is susceptible to penicillins, cephalosporins, erythromycin, and clindamycin, but it is often resistant to many other antibiotics, including vancomycin, a drug frequently used in empiric therapy for infections due to gram-positive bacteria. J Bacteriol, 1989 Oct, 171(10), 5614 - 9 Cloning, characterization, and heterologous expression of the Saccharopolyspora erythraea (Streptomyces erythraeus) gene encoding an EF-hand calcium-binding protein; Swan DG et al.; The regulatory effects of Ca2+ in eucaryotic cells are mostly mediated by a superfamily of Ca2+-binding proteins (CABs) that contain one or more characteristic Ca2+-binding structural motifs, referred to as EF hands . We have cloned and sequenced the structural gene for an authentic EF-hand CAB from the spore-forming gram-positive bacterium Saccharopolyspora erythraea (formerly Streptomyces erythraeus) . When the gene was introduced into Streptomyces lividans on the high-copy plasmid vector pIJ702, CAB was found to be expressed at higher levels than in S . erythraea, with no apparent effects on either growth or sporulation . A more convenient expression system for CAB was obtained by introducing an NdeI site at the initiation codon by using oligonucleotide-directed mutagenesis and placing the gene in the expression vector pT7-7 in Escherichia coli . In this system, CAB was efficiently expressed at levels up to 20 to 30% of total cell protein . When purified to homogeneity from either E . coli or Streptomyces lividans, CAB was found to be identical to the protein previously obtained from S . erythraea. Antibiot Khimioter, 1989 Oct, 34(10), 723 - 6 {Production of lincomycin by Micromonospora halophytica culture}; Bibikova MV et al.; A Micromonospara culture designated as 991/78 with activity against gram-positive cocci and bacteria was isolated from samples of silt-covered substrates from the Amu-Darya . Directed screening on a selective medium supplemented with lincomycin in an amount of 50-100 micrograms/ml was used . Identification of the antibiotic produced by the culture showed it to be lincomycin . By its taxonomic features the culture was classified as belonging to Micromonospora (subgroup II, Cinnamomea) and in particular to M . halophytica (Weinstein, Luedemann, Oden, Wagman, 1968) . Up to now, it was known that lincomycin was produced only by Streptomyces cultures. Mol Microbiol, 1989 Oct, 3(10), 1425 - 32 Transcriptional induction of Streptomyces cacaoi beta-lactamase by a beta-lactam compound; Forsman M et al.; The soil bacterium Streptomyces cacaoi produces an extracellular beta-lactamase . The beta-lactamase expression could be induced by the beta-lactam compound 6-amino penicillinoic acid (6-APA) . In liquid cultures, a 50-fold increase in beta-lactamase expression was observed within the first three hours after addition of 6-APA . Using the cloned beta-lactamase gene a