Gram positive

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 as a probe, it was shown that this increase was mediated at the level of transcriptional initiation . The start point of the induced beta-lactamase transcript was determined, and the nucleotide sequence of the promoter region was analysed . No noticeable homology was found to control regions of inducible beta-lactamase genes of other bacteria . A striking feature was the presence of six direct repeats (ten base pairs each) upstream of the promoter region . Thus, an example of an inducible regulatory gene system in this Gram-positive microorganism is presented . Also, the primary structure of the beta-lactamase was deduced, showing a high degree of homology with class A beta-lactamases.

FEMS Microbiol Lett, 1989 Oct 1, 52(1-2), 195 - 8
Selenate reduction by a Pseudomonas species: a new mode of anaerobic respiration; Macy JM et al.; The high levels of selenium (selenate, selenite) in agricultural drainage water in the San Joaquin Valley of California, which have led to environmental problems, might be lowered if the selenate/selenite could be reduced to elemental insoluble selenium . Two organisms have been newly isolated which do this in anaerobic coculture . One, a strictly anaerobic, Gram-positive rod, reduces selenite to elemental selenium . The other, a Pseudomonas species, was shown to respire selenate to selenite . Cells grown anaerobically in Minimal Medium on acetate plus selenate oxidized 14C-acetate to 14CO2 with concomitant reduction of selenate to selenite and small amounts of elemental selenium.

Clin Ter, 1989 Sep 15, 130(5), 239 - 44
{Aztreonam and oxacillin in the treatment of febrile neutropenic patients with solid tumors}; Natali M et al.; 22 consecutive febrile episodes in 21 neutropenic (PMN less than 1000/mmc) cancer patients, were treated with aztreonam and oxacillin . Nineteen patients were severely neutropenic (PMN less than 500/mmc) . Cure was obtained in 86% of the febrile episodes, including 6/7 bacteriologically documented gram negative infections . No major side effects were observed . These results seem to indicate that aztreonam is effective as empiric treatment of gram negative infections in neutropenic patients . However, it must be used in combination with another antibiotic to ensure gram positive coverage.

Acta Chir Belg, 1989 Sep-Oct, 89(5), 247 - 52
Surgical management of left heart endocarditis; Defraigne JO et al.; Between 1981 and 1987, 29 patients (20 men and 9 women, mean age 46 +/- 15) underwent a valvular replacement for endocarditis (19 aortic and 10 mitral) . There were 25 native and 4 prosthetic valves . In 85% of cases, underlying valvular lesions were present . The oropharyngeal and the respiratory tracts were the most common sources of infection . In 81%, the infecting microorganism was gram-positive . In 21% of cases, a gram-negative was detected, always mixed with a gram-positive . One infection was caused by a Candida . Indications for surgery were severe valvular insufficiency or cardiac failure (90%), refractory sepsis (21%), thromboembolic events (11%) . In 22%, multiple factors were present . A biologic valve was chosen in 12 cases (40%) . Simultaneously with the valvular replacement, 4 ventricular septal perforations were occluded and 3 valvular annulus abscesses debrided . The operative mortality was 10% (3/29) . The one-year survival is 96% . Two patients required reoperation at 6 months and 2 years, for partial dehiscence, with good subsequent evolution . The authors concluded that surgical operation is the most suitable treatment for unstable or complicated endocarditis, in case of cardiac failure, iterative thromboembolic events or refractory sepsis.

J Parenter Sci Technol, 1989 Sep-Oct, 43(5), 208 - 12
Microbial growth in small-volume pharmaceuticals; Whyte W et al.; The ability of aseptically filled pharmaceuticals to support microbial growth was tested on 43 small-volume products (mainly parenterals) . These were inoculated with a variety of microorganisms which were known to be associated with contamination of pharmaceutical products . In general, Gram-negative bacteria were found to be much more likely to grow than Gram-positive . It was possible for an inoculum of a few cells to multiply to levels up to 10(7)/mL . The presence of preservatives also influenced the likelihood of growth, 12 out of 19 (63%) of the pharmaceuticals without preservatives supporting growth of one or more microorganisms; only 3 out of 24 (12%) of those with preservatives supported growth . The importance of these observations is discussed with reference to formulation of aseptically filled products, environmental sampling and the quality of cleanroom conditions necessary for production . It is suggested that those pharmaceuticals which are designed to be sterile but not to be terminally sterilized, should be tested before production begins, for their ability to support microbial growth . In this way, the risks involved in aseptically filling can be ascertained . A test is proposed in which "indicator" microorganisms would predict the likelihood of pharmaceutical formulations supporting growth.

Mt Sinai J Med, 1989 Sep, 56(4), 300 - 3
Pulmonary actinomycosis in a patient with HIV infection; Klapholz A et al.; Pulmonary actinomycosis is a rare clinical entity . It may arise primarily from aspiration of infected oropharyngeal material or secondarily from contiguous spread of cervicofacial or abdominal infection . We report the case of an HIV-seropositive patient with a two-week history of fever, a productive cough, and pleuritic chest pain . Chest x-ray revealed bilateral patchy alveolar infiltrates . Histological examination of transbronchial biopsy specimens revealed acute inflammation and granules with radiating gram-positive filaments with clubbed ends consistent with actinomycosis . The patient responded to intravenous penicillin and is currently well on long-term enteral antibiotic therapy.

Eur J Epidemiol, 1989 Sep, 5(3), 303 - 10
Biotyping of bacterial isolates using the yeast killer system; Morace G et al.; Forty-four presumptive killer yeasts were tested against bacterial isolates, including rapid-growing gram-positive and gram-negative bacteria, as well as slow-growing bacteria, such as the mycobacteria . A killer system, based on the patterns of bacterial susceptibility to the action of nine selected killer yeasts, was developed for epidemiological purposes . The killer system, previously standardized for yeasts and hyphomycetes, was adapted to the specific growth conditions of the bacterial isolates . The results obtained confirm that susceptibility to the yeast killer phenomenon is widespread among microorganisms unrelated to yeasts and that it could form the basis for a convenient and adaptable biotyping method in microbiological laboratories.

Oral Microbiol Immunol, 1989 Sep, 4(3), 135 - 40
Comparison of two methods for the small-scale extraction of DNA from subgingival microorganisms; Smith GL et al.; Two methods were compared for the extraction of DNA from small numbers of bacterial cells . The first method involved lysis of cells with SDS in the presence of proteinase K, treatment with hexadecyltrimethyl ammonium bromide (CTAB) and precipitation of DNA with isopropanol . In the second method, DNA was extracted by treatment of the cells with guanidine hydrochloride (GHCl) and precipitated with ethanol . Thirty strains of representative gram positive and gram negative species were included in the study . Preparations derived from confluent growth on one-quarter of the surface of agar plates and from 10(8) cells were subjected to each extraction procedure and analyzed for their content of DNA, RNA and protein . The suitabilities of the resultant DNA for restriction enzyme digestion and biotin-labelling by a random primer technique were also assessed . In general, the CTAB method yielded greater amounts of DNA than the GHCl procedure . RNA was present in most preparations of both types, but in amounts detectable only by agarose gel electrophoresis . The latter technique also revealed that DNA was not excessively sheared by either procedure . Protein was detected in some CTAB and GHCl preparations, but was not consistently associated with one or the other method . DNA obtained by both methods could be digested by the restriction enzyme EcoR I . In addition, biotin-labelled DNA probes prepared from CTAB and GHCl preparations were capable of hybridizing with homologous target DNA fixed to nitrocellulose . Since the CTAB method was consistently successful in recovering DNA from preparations containing 10(8) cells, it may be more suitable for the direct treatment of single colonies taken from primary isolation plates or plaque samples.

Vet Pathol, 1989 Sep, 26(5), 409 - 19
Ultrastructure and lectin histochemistry of equine cutaneous histiolymphocytic lymphosarcomas; Detilleux PG et al.; Tissues from subcutaneous lymphosarcomas and regional lymph nodes were examined by light and electron microscopy and by lectin histochemistry . Tumors were composed of two major cell types: small lymphocytes with few organelles and pleomorphic histiocytic cells with undulant surfaces, large numbers of cytoplasmic vacuoles, and many mitochondria with large crystalline inclusions . A large gram-positive coryneform bacterium was isolated from tumor nodules but was not identified morphologically in tumor tissues . Evaluation of sections of tumors with lectins as histochemical probes revealed three staining patterns: 1) lectin labeling histiocytic cells only (wheat germ, succinylated-wheat germ, Phaseolus vulgaris and soybean agglutinins); 2) lectins labeling histiocytic, interstitial and some lymphoid cells (concanavalin A, and Pisum sativum, Lens culinaris, and Ricinus communis I agglutinins); and 3) lectins failing to label any cell (peanut, Sophora japonica, and Ulex europaeus I agglutinins) . In the lymph node, macrophages were labeled by lectins of groups 1 and 2; interdigitating reticular cells were labeled by group 2 lectins . Lectin staining of histiocytic cells in tumor tissues suggested that these were reactive cells and that lymphoid cells were the primary neoplastic component.

Biochimie, 1989 Sep-Oct, 71(9-10), 989 - 96
Metabolite-sensitive, ATP-dependent, protein kinase-catalyzed phosphorylation of HPr, a phosphocarrier protein of the phosphotransferase system in gram-positive bacteria; Reizer J et al.; In this review article we summarize the recent information available concerning important mechanistic and physiological aspects of the protein kinase-mediated phosphorylation of seryl residue-46 in HPr, a phosphocarrier protein of the phosphoenolpyruvate: sugar phosphotransferase system in Gram-positive bacteria . Emphasis is placed upon the information recently obtained in two laboratories through the use of site-specific mutants of the HPr protein . The results show that (i) in contrast to eukaryotic protein kinases, the HPr(ser) kinase recognizes the tertiary structure of HPr rather than a restricted part of the primary sequence of the protein; (ii) like seryl protein kinases of eukaryotes, the HPr(ser) kinase can phosphorylate a threonyl residue, but not a tyrosyl residue when such a residue replaces the regulatory seryl residue in position-46 of the protein; (iii) the regulatory consequences of seryl phosphorylation are due to the introduction of a negative charge at position-46 in the protein rather than the bulky phosphate group; and (iv) PTS protein-HPr interactions influence the conformation of HPr, thereby retarding or stimulating the rate of kinase-catalyzed seryl-46 phosphorylation . The physiological consequences of HPr(ser) phosphorylation in vivo are still a matter of debate.

Arch Ital Urol Nefrol Androl, 1989 Sep, 61(3), 235 - 41
{Treatment of male genital infections with enoxacin}; Giorgi PM et al.; Inflammatory disease such as prostatitis and prostatovesiculitis, can affect the fertility potential of the male population . In this study, the Authors tested the therapeutical efficacy of a second generation quinolone, enoxacin, in patients suffering from vesicular and/or prostatic inflammations . This drug has been shown to diffuse into the prostatic fluid, achieving therapeutical concentrations either in acute or chronic pathological conditions . Thirty infertile patients referring to our Andrology Center and showing seminal signs (leukocytes, abnormal sperm forms, chemical and physical alterations, etc) of genital tract inflammations were found to have positive sperm culture for enoxacin-sensitive strains . Further investigations (echotomography) showed that they were affected by prostatic and/or vesicular subacute chronic inflammations . The mean age was 32.2 (range 20-36) ys . All the patients discontinued any previous treatment for at least 90 days . Enoxacin was administered at the dose of 300 mg b.i.d . for two cycles of 10 days each, with intervals of 20 days . At the beginning and at the end of the treatment (days 0 and 60), semen analysis and culture were performed . A paired-T test was employed for the statistical evaluation of data . 26.6% of patients ad an altered fluidification before treatment . Only 10.0% of them showed the same sign after treatment . A condition of hyperviscosity was present in 50% and 16.6% of patients before and after treatment respectively . Likewise, an elevated number of leukocytes (greater than 10(6)/ml) occurred in the ejaculates of 43.3% of patients and in 23.3% after enoxacin treatment . Enoxacin treatment was efficacious in 89.2% of cases, in presence of either Gram positive or Gram negative bacteria.(ABSTRACT TRUNCATED AT 250 WORDS)

Am J Clin Pathol, 1989 Sep, 92(3), 352 - 6
A case of Encephalitozoon cuniculi peritonitis in a patient with AIDS; Zender HO et al.; A 45-year-old man with acquired immune deficiency syndrome (AIDS) presented with an unusual peritonitis resulting from a microsporidian infection . An inflammatory mass formed by the omentum magnum was revealed at partial autopsy . This mass was infested with parasites measuring 2.5-2.6 microns by 1.2-1.5 microns, which appeared gram positive and stained dark blue with Giemsa stain . These organisms were pale pink with Kinyoun stain, and occasionally one of their poles was periodic acid-Schiff positive . Sporoblasts and spores contained in parasitophorous vacuoles were revealed by electron microscopic examination . These spores were mononucleated, without mitochondria, and had a polar filament with four or five coils . They were identified as Encephalitozoon cuniculi . Peritonitis resulting from this parasite has not been reported previously, however, it should be suspected among rare infections resulting from unusual parasites in patients with AIDS.

Transfusion, 1989 Sep, 29(7), 596 - 9
Growth of gram-positive and gram-negative bacteria in platelet concentrates; Punsalang A et al.; In 1986 the allowable platelet storage time was reduced from 7 to 5 days because of a recent increase in septic deaths associated with platelet transfusion . In this study, the growth curves of two gram-positive and two gram-negative organisms in platelets stored for 7 days in CLX and PL-732 bags were evaluated . Platelets in CLX bags were inoculated with 10(1), 10(2), and 10(3) organisms and 10(2) organisms were introduced into PL-732 bags . Test organisms were inoculated into trypticase soy broth as a control . All four bacteria grew rapidly in trypticase soy broth, reaching 10(9) organisms per mL within 48 hours . In both CLX and PL-732 bags, the growth pattern of gram-positive organisms was generally logarithmic during the first few days of storage . A concentration of 10(8) organisms per mL was present by Day 3 or 4, after which further proliferation was inhibited by the high density of bacteria in the platelets . In PL-732 bags, the proliferation of gram-negative organisms followed a pattern similar to that of the gram-positive bacteria . However, gram-negative organisms grew less well in CLX bags.(ABSTRACT TRUNCATED AT 250 WORDS)

Nippon Shishubyo Gakkai Kaishi, 1989 Sep, 31(3), 960 - 9
{Studies on bacterial contamination of chlorhexidine coated filaments of the toothbrush}; Yokosuka N et al.; The purpose of the present investigation was to determine bacterial contamination of chlorhexidine coated and uncoated (normal) nylon filaments of toothbrushes . Ten healthy subjects were employed in this study and the test toothbrush of four lines and thirty-eight tufts were used twice a day . Test periods were 1, 8, and 20 days for each filaments of toothbrush and after they brushed the used toothbrush was kept at the constant condition (20 degrees C, 65% RH) . After each test period, those toothbrushes were immediately collected and kept at the same condition for drying . After 0, 3, 6, 9, and 24 hours of drying, two tufts of filaments were pulled out from the toothbrush and cutted into two parts (end- and root-side of tufts) by sterile scissors . Each cutted part of filaments was washed with PBS and the aliquots was incubated on Brucella blood agar plate at 37 degrees C for 48 hours . The number of bacteria attached to filaments was enumerated . The results were as follows: 1 . The number of bacteria attached to both end- and root-sides of chlorhexidine coated filaments decreased with the time of drying . 2 . At the root-side of the normal filaments, the number of contaminated bacteria increased with the test periods . 3 . The isolated bacteria from tested toothbrushes were mainly gram positive at shorter period, however, gram negative rods were also found at longer period . 4 . The anti-bacterial activity of the end-side of chlorhexidine coated filaments diminished at eight days of the use, however, their activity at the root-side still remained even at twenty days . From these results, it was clear that the bacterial contamination of toothbrush was affected by several factors such as the condition of drying, the site of tufts, the using period of toothbrush and so on . To prevent this problem, it is important to keep it at good storage condition and to change it periodically . The developed chlorhexidine coated filaments of the toothbrush also indicates to be one of the useful way for prevention of bacterial contamination of toothbrush.

Hepatology, 1989 Sep, 10(3), 370 - 4
Antimitochondrial antibodies in primary biliary cirrhosis recognize both specific peptides and shared epitopes of the M2 family of antigens; Flannery GR et al.; Sera from patients with primary biliary cirrhosis exhibit variable autoantibody reactivity against mitochondria, the commonest antigen (designated M2) including three structures of approximate M.W . 70, 50 and 40 kD . The nature of these antigens has only recently been established; the 70 and 50 kD are the transacetylase E2 and component X, respectively, of the pyruvate dehydrogenase complex and are distinct polypeptides . We have demonstrated, by immunoblotting, elution and rebinding of antibodies, unequivocal cross-reactivity between the major bands of the M2 antigen . In addition, cross-reactivity has been shown between antibodies binding to each of the three M2 bands of mitochondria and two major antigenic bands of both Gram-negative and Gram-positive bacteria . Conversely, antibodies eluted from these two bands of Escherichia coli were found to bind all three M2 bands of mitochondria . These results suggest that the antibodies of primary biliary cirrhosis contain both peptide-specific and cross-reacting antibodies, the latter recognizing a common "M2 epitope" that might include nonprotein components of the peptides . However, direct and competitive enzyme-linked immunosorbent assays failed to implicate the coenzyme of the pyruvate dehydrogenase complex, lipoic acid or its amide, as the common antigenic moiety.

FEBS Lett, 1989 Aug 14, 253(1-2), 108 - 12
Cloning of a DNA region of Actinoplanes teichomyceticus conferring teicoplanin resistance; Moroni MC et al.; Teicoplanin is a glycopeptide antibiotic, produced by Actinoplanes teichomyceticus, active against Gram positive bacteria and recently introduced into clinical practice . It blocks cell wall biosynthesis by inhibiting peptidoglycan polymerization . The mechanism(s) of resistance of the producer strains of this class of antibiotics have not yet been characterized . We have constructed a genomic bank of A . teichomyceticus in Streptomyces lividans . A clone from this bank, PTR168, was able to confer resistance to teicoplanin on its sensitive host . The restriction map of plasmid pTR168 and the hybridization pattern to A . teichomyceticus DNA were determined; we have also studied the mechanism of this resistance which seems correlated with a reduced binding of the antibiotic to the cell wall.

Jpn J Antibiot, 1989 Aug, 42(8), 1780 - 90
{A clinical study on cefteram pivoxil in pediatrics}; Satoh Y et al.; Clinical evaluations of cefteram pivoxil (CFTM-PI, T-2588) were carried out . The obtained results are summarized as follows . 1 . Clinical responses to CFTM-PI of 39 patients with pediatric infections were excellent in 16, good in 21, fair in 1 and poor in 1 . The overall efficacy rate was 94.9% . 2 . Bacteriologically, eradication rates for 39 isolates presumed to be pathogens were evaluated . The eradication rates obtained were 94.1% in 17 strains of Gram-positive cocci, 90.9% in 22 strains of Gram-negative rods . 3 . Side effects observed were diarrhea in 2 patients, diarrhea and abdominal pain in 1, erythema and edema in 1 . The incidence was 8.7% . An abnormal value found in clinical laboratory tests was eosinophilia in 1 patient . The results suggested that CFTM-PI might be a very useful and safe drug for the treatment of pediatric infections.

Antimicrob Agents Chemother, 1989 Aug, 33(8), 1188 - 92
Cefotiam disposition in markedly obese athlete patients, Japanese sumo wrestlers; Chiba K et al.; Markedly obese athletes like Japanese sumo wrestlers may frequently suffer various traumas which result in the prophylaxis or treatment of posttraumatic infection with antibiotics . However, appropriate dosage regimens in this group of patients have not been fully known for many antibiotics . Therefore, we studied the kinetic disposition of cefotiam, a parenteral, broad-spectrum cephalosporin with activity against gram-positive and -negative bacteria, after an intravenous dose (2 g) infused over 30 min into 15 sumo wrestler patients with an excess body weight (130 to 220% of ideal body weight) and 10 control patients with a normal weight (90 to 102% of ideal body weight) . Mean (+/- standard deviation) clearance and steady-state volume of distribution were significantly greater in the sumo wrestler than in the control group (38.3 +/- 9.4 versus 23.5 +/- 6.0 liters/h, P less than 0.001, and 30.2 +/- 8.0 versus 17.9 +/- 6.1 liters, P less than 0.001) . Mean elimination half-life was slightly but significantly longer in the sumo wrestler than in the control group (0.91 +/- 0.14 versus 0.74 +/- 0.20 h, P less than 0.05) . However, mean residence time did not differ between the two groups (0.79 +/- 0.10 versus 0.75 +/- 0.14 h) . The statistical differences in clearance and volume of distribution between the two groups disappeared when these kinetic parameters were corrected for body surface area, but not for total body weight or ideal body weight . The results suggest that the dosage calculation of cefotiam, a hydrophilic antibiotic, should be made on the basis of body surface area in morbidly obese athlete or sumo wrestler patients . However, whether this recommendation should extend to other nonathlete obese subjects remains to be determined.

J Cutan Pathol, 1989 Aug, 16(4), 183 - 93
Infection-induced panniculitis; Patterson JW et al.; We evaluated the histopathologic findings in 15 cases of panniculitis due to infection . Organisms were identified by special staining in 14 cases, and in 6 of these the etiologic agent was confirmed by culture studies . In one additional case, lesional culture was positive despite negative special staining . Eight cases were caused by gram positive or gram negative bacteria, 2 by atypical mycobacteria, 2 by Nocardia, and 3 by fungi (Candida and Fusarium species) . Most patients had conditions or were receiving therapies predisposing to immunosuppression, but at least 2 individuals had no other major medical problems . There were some variability in microscopic findings and overlap with established forms of panniculitis; 3 cases (2 due to bacteria and 1 to Fusarium) resembled acute, "neutrophilic" erythema nodosum, and evidence of vasculitis was seen in septicemias due to Pseudomonas, Nocardia, and Fusarium . Nevertheless, several distinctive features associated with infectious panniculitis of diverse etiologies included: epidermal alterations such as acanthosis and parakeratosis; dermal edema with a diffuse or perivascular neutrophilic infiltrate; and mixed septal-lobular panniculitis with neutrophilic infiltration, vascular proliferation and hemorrhage, and necrosis . Infection should be suspected in virtually any case of panniculitis, particularly when occurring in an immunosuppressed patients, but the microscopic features enumerated above should arouse particular suspicion of an infectious process.

J Clin Periodontol, 1989 Aug, 16(7), 434 - 42
Reproducibility of microscopic and cultural data in repeated subgingival plaque samples; Mombelli A et al.; In association studies, micro-organisms can only be recognized as suspects for playing a major role in the development of a pathological environment, if their destructive action goes along with a marked proportional increase of their numbers or if their first detection can be related to the clinical onset of the disease . Limitations in the reproducibility of repeated samples have to be taken into account, when changes of the microbial composition of subgingival environments are to be studied, and when local clinical changes are to be related to shifts in the composition of the pertaining microbiological compartment . To study reproducibility, a total of 109 sites was sampled repeatedly with sterile paperpoints at an interval of 7 to 10 days in 24 patients suffering from periodontal disease and 12 edentulous patients wearing successful and failing osseointegrated titanium implants . Using continuous anaerobic techniques, the samples were cultured on nonselective and selective media and were studied by darkfield microscopy . Both the intertest-agreements of frequencies of detection (kappa-statistics) as well as the discrepancies of proportions of bacterial groups and selected bacterial species were determined . The standard deviation of proportional differences between first and second samples ranged between 6.4% (fusiform organisms) and 17.2% (coccoid cells) for darkfield parameters, between 4.3% (B . melaninogenicus on ETSA/Kana.) and 14.0% (B . gingivalis on ETSA/Kana.) for selected bacterial species and between 6.9% (gram-negative anaerobic cocci) and 24.0% (gram-positive facultative cocci) for bacterial groups classified according to gram stain characteristics and atmospheric growth conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Am J Kidney Dis, 1989 Aug, 14(2), 92 - 5
Peritonitis secondary to dialysis tubing contamination among patients undergoing continuous ambulatory peritoneal dialysis; Rubin J et al.; Patients were asked to report all dialysis system contaminations occurring from December 1985 through May 1988 to the home training facility . There were 74 instances of peritoneal dialysis system contamination, 20 of which resulted in peritonitis . Prophylactic antibiotics were used in 48 of 54 episodes not resulting in peritonitis . Three cultures yielded gram-positive organisms without clinical peritonitis becoming evident . Fourteen of the 20 episodes of peritonitis had received antibiotics prophylactically . System contaminations were classified into tears or holes of the catheter at the adapter on the Tenckhoff catheter or at the tubing connection to the dialysate bag and breaks of the connecting devices from either dialysis catheter to dialysis tubing or dialysis tubing to dialysate bag . System contaminations accounted for 20 of the 333 episodes of peritonitis that occurred during this time . Identifying system contamination is useful because prophylactic antibiotic therapy may prevent peritonitis.

Ophthalmology, 1989 Aug, 96(8), 1171 - 5
Bacterial keratitis after radial keratotomy; Matoba AY et al.; The authors identified nine patients with culture-proven keratitis after radial keratotomy (RK) . Three patients became infected in the immediate post-operative period, and six patients had delayed-onset keratitis . Gram-negative rods were the predominant pathogens in late-onset keratitis (4 of 6 infections) . Gram-positive cocci were implicated in all three postoperative infections . The inferior corneal quadrants were involved in seven of nine patients . Two episodes of late-onset keratitis were associated with contact lens wear . Five of these patients had transverse incisions or greater than eight radial cuts . All six patients regained visual acuity of 20/40 or better . Two additional cases of early-onset and six cases of late-onset keratitis with many features similar to these cases have been reported previously.

EMBO J, 1989 Aug, 8(8), 2425 - 33
Molecular characterization of two proteins involved in the excision of the conjugative transposon Tn1545: homologies with other site-specific recombinases; Poyart-Salmeron C et al.; Excision is probably the initial and rate-limiting step of the movements of conjugative transposons of Gram-positive bacteria such as Tn916 and Tn1545 . We have shown, by molecular cloning and DNA sequencing, that a 2058 bp Sau3A right-junction fragment of transposon Tn1545 specifies two gene products that are involved in the excision of the element . The DNA sequence of these genes, designated orf1 and orf2, has been determined and the corresponding proteins, ORF1 and ORF2, have been identified in a bacterial cell-free coupled transcription-translation system . These proteins are freely diffusible since they are able to trans-complement in vivo a deletion derivative of Tn1545 defective for excision . Using an in vivo complementation assay, we have demonstrated that ORF2 alone is able to catalyse excision and that ORF1 strongly stimulates the activity of ORF2 . We also found that ORF1 and ORF2 display local homology with, respectively, proteins Xis and Int from lamboid phages, which suggests that these excision systems have a common origin . Based on the functional properties of the integrase of bacteriophage lambda, on the analysis of the nucleotide sequence of the junction fragments and of the target before insertion and after excision, a model is proposed for ORF2-catalysed excision of Tn1545 and related conjugative transposons.

Fortschr Med, 1989 Jul 30, 107(22), 477 - 80
{Infection caused by gram-positive and gram-negative bacteria . A comparative study}; Ruhnke-Trautmann M et al.; The clinical symptomatology of bacterial septicemias was analysed in 417 patients of a University Hospital in West Berlin . Sepsis was caused by Gram-negative organisms in 229 cases, and by Gram-positive bacteria in 177 cases; 11 cases presented with a mixed type sepsis involving both Gram-positive and Gram-negative pathogens . With the exception of a drop in blood pressure, observed appreciably more often in Gram-negative infections (42.4% of the cases as compared with only 25.4% in the case of septicemia due to Gram-positive organisms, (p less than 0.01), no significant clinical differences were seen between Gram-negative and Gram-positive sepsis . Pathophysiological changes (thrombopenia, leukopenia, coagulopathies) that are considered classical reactions to endotoxin, were also observed in Gram-positive infections . The overall prognosis of septicemia was determined largely by the severity of the underlying pathological condition.

J Med Microbiol, 1989 Jul, 29(3), 229 - 35
Gardnerella vaginalis has a gram-positive cell-wall ultrastructure and lacks classical cell-wall lipopolysaccharide; Sadhu K et al.; Gardnerella vaginalis has a very thin cell wall with a characteristic gram-negative staining pattern and an apparent lamellar structure when viewed at an oblique angle by electronmicroscopy . Examination at right angles to the cell-wall plane and by freeze-etching showed absence of an outer membrane or any other lamellar structure . Cell-wall extracts made by methods specific for lipopolysaccharide (LPS) gave negative reactions by silver staining and for endotoxin in the limulus amoebocyte lysate assay . 2-Keto-3-deoxy-D-manno-2-octonoic acid (KDO), heptose and hydroxy fatty acids specific for LPS were not detected in the extracts . G . vaginalis cell walls are unequivocally gram-positive in their ultrastructural characteristics and chemical composition.

Infect Immun, 1989 Jul, 57(7), 1890 - 3
Production of interleukin-1 but not tumor necrosis factor by human monocytes stimulated with pneumococcal cell surface components; Riesenfeld-Orn I et al.; While there is considerable evidence that both interleukin-1 (IL-1) and tumor necrosis factor (TNF) are central mediators of inflammation caused by gram-negative bacteria and endotoxin, the roles of these two mediators in gram-positive infection are unknown . Pneumococcal infections are characterized by an intense inflammatory reaction in infected tissues . Current evidence suggests that the component of the pneumococcus which causes this inflammation in many body sites is the cell wall . We determined the ability of native pneumococcal cell wall, lipoteichoic acid, and cell wall subcomponents to stimulate secretion of IL-1 and TNF from human monocytes . Each pneumococcal cell surface component was found to have a different specific activity for induction of IL-1 . Teichoication was an important determinant of this activity: teichoicated species were at least 10,000-fold more potent than endotoxin and 100-fold more potent than teichoic acid-free peptidoglycan . IL-1-inducing activity was greatly reduced by chemical alteration of the teichoic acid . In contrast to endotoxin, cell wall did not induce production of TNF . This dissociation of the production of IL-1 and TNF during the response of the human monocyte to pneumococcal surface components suggests that, in at least some circumstances, the mechanisms for generation of an inflammatory response to infection may be fundamentally different between gram-positive and gram-negative disease.

J Reprod Immunol, 1989 Jul, 15(3), 217 - 27
Background (spontaneous) immunoglobulin production in the murine small intestine before and after weaning; van der Heijden PJ et al.; The ontogeny of the murine intestinal B-cell compartment before and after weaning was studied by quantitative analysis of immunoglobulin-secreting cells (Ig-SC) in the small intestine (SI) . Before weaning, few Ig-SC were detected in the SI, whereas spleen and bone marrow already contained many Ig-SC . The number of Ig-SC in the SI started to increase immediately after weaning . Comparing early-weaned mice with non-weaned mice of the same age clearly demonstrated that weaning brought on the development of Ig-SC in the SI . The influence of a gut flora on the number of Ig-SC in the SI was examined by comparing the number of Ig-SC in the SI of conventionally housed, specific pathogen free (SPF) and germ-free mice . A bacterial flora was apparently needed for the normal development of Ig-SC in the SI . Comparing mice containing an aerobic Gram-negative bacterial flora with mice containing only an anaerobic Gram-positive bacterial flora demonstrated that the type of bacterial flora is relatively unimportant . No evidence was found that circulating maternal antibodies suppressed the development of the "spontaneous" intestinal and systemic B cell response . The results show that bacterial colonization of the intestine plays a pivotal role in the development of the Ig-SC compartment in the SI.

Am J Kidney Dis, 1989 Jul, 14(1), 44 - 9
Timing and characteristics of multiple peritonitis episodes: a report of the National CAPD Registry; Stablein DM et al.; Patterns of recurrent peritonitis episodes were examined in 6,335 new continuous ambulatory peritoneal dialysis (CAPD) patients entered into the National CAPD Registry . Forty-six percent of all peritonitis episodes were initial occurrences, with 8% of the patients reporting four or more episodes . The proportion of gram-positive and gram-negative infections was constant across episodes . In patients with multiple infections, negative organisms were found to have increased risk of recurring as gram-negative infection . A similar observation was made for fungal infections . Of patients with multiple peritonitis episodes, more than 40% of those who transferred to other maintenance renal replacement therapy identified peritonitis as the reason for transfer . A discrete time logistic model was used to estimate peritonitis risk in 4-month follow-up periods . Patients like those on the registry are estimated to have a 22% risk of developing peritonitis during any 4-month period . This risk was increased 4% for patients aged less than 21 years, 7% for nonwhite patients, and 19% in the period following a peritoneal infection.

Vet Microbiol, 1989 Jul, 20(3), 267 - 74
Endotoxin levels in milk and plasma of mastitis-affected cows measured with a chromogenic limulus test; Hakogi E et al.; A chromogenic limulus test ("Toxicolor") was applied to cow's milk and plasma after treatment with perchloric acid to remove interfering factors . The endotoxin levels in normal cow's milk and plasma were all less than 10 pg ml-1 . In acute mastitis, the milk endotoxin level averaged (1.1 +/- 0.7) X 10(3) pg ml-1 in the cases where Gram-negative bacteria were isolated, while the plasma endotoxin concentration was normal . The endotoxin levels in the quarters infected with Gram-positive bacteria were all normal, both in milk and plasma . In gangrenous mastitis due to Gram-negative bacteria, the endotoxin concentration was very high in both milk {(9.3 +/- 5.3) X 10(6) pg ml-1} and plasma (85.2 +/- 68.2 pg ml-1) . In similar cases due to Gram-positive bacteria, endotoxin levels were all normal, both in milk and plasma, resembling the acute mastitis due to Gram-positive bacteria . The test was considered suitable for the diagnosis of mastitis due to Gram-negative organisms and the levels of endotoxin detected would aid in assessing the prognosis.

EMBO J, 1989 Jul, 8(7), 2111 - 20
Mechanistic and physiological consequences of HPr(ser) phosphorylation on the activities of the phosphoenolpyruvate:sugar phosphotransferase system in gram-positive bacteria: studies with site-specific mutants of HPr; Reizer J et al.; The bacterial phosphotransferase system (PTS) catalyzes the transport and phosphorylation of its sugar substrates . The protein-kinase-catalyzed phosphorylation of serine 46 in the phosphocarrier protein, HPr, inhibits PTS activity, but neither the mechanism of this inhibition nor its physiological significance is known . Site-specific HPr mutants were constructed in which serine 46 was replaced by alanine (S46A), threonine (S46T), tyrosine (S46Y) or aspartate (S46D) . The purified S46D protein exhibited markedly lower Vmax and higher Km values than the wild-type, S46T or S46A protein for the phosphoryl transfer reactions involving HPr(His approximately P) . Interactions of HPr with the enzymes catalyzing phosphoryl transfer to and from HPr regulated the kinase-catalyzed reaction . These results establish the inhibitory effect of a negative charge at position 46 on PTS-mediated phosphoryl transfer and suggest that HPr is phosphorylated on both histidyl and seryl residues by enzymes that recognize its tertiary rather than its primary structure . In vivo studies showed that a negative charge on residue 46 of HPr strongly inhibits PTS-mediated sugar uptake, but that competition of two PTS permeases for HPr(His approximately P) is quantitatively more important to the regulation of PTS function than serine 46 phosphorylation.

Circ Shock, 1989 Jun, 28(2), 101 - 8
Cardiovascular reaction pattern during endotoxin or peptidoglycan application in awake sheep; Redl H et al.; Peptidoglycans (PG) and lipopolysaccharides (LPS) are cell wall constituents of bacteria . The relative contents vary significantly between gram-negative and gram-positive strains . Since both strains take part in clinical septicemia, we compared hemodynamic and permeability properties in a sheep model with chronic instrumentation and lung lymph drainage . The cardiovascular reaction patterns of PG and LPS were comparable at very different dose levels, with LPS being 10,000-fold more potent . Continuous infusion produced an increase in lung permeability (only with LPS) and cardiac output, as well as fever, to mimic the hyperdynamic situation in early septicemia.

Am J Med, 1989 Jun, 86(6 Pt 2), 787 - 90
Pseudomonal and candidal peritonitis as a complication of continuous ambulatory peritoneal dialysis in human immunodeficiency virus-infected patients; Dressler R et al.; PURPOSE: To our knowledge, there has been no report documenting the spectrum of peritonitis in human immunodeficiency virus (HIV)-infected persons . We therefore analyzed our records to confirm our previous observation of a higher incidence of pseudomonal and fungal peritonitis in a group of HIV antibody-positive (HIV+) patients undergoing continuous ambulatory peritoneal dialysis (CAPD) . PATIENTS AND METHODS: During a 22-month period, we retrospectively studied 71 patients with end-stage renal disease undergoing CAPD . Of these, seven were HIV+, five were at high risk for HIV infection but antibody-negative, and 59 were at low risk for HIV infection . Organisms isolated in episodes of peritonitis were classified microbiologically as one of the following: gram-positive, non-pseudomonal gram-negative, pseudomonal, fungal, or culture-negative . RESULTS: The total peritonitis rate was higher in both the high-risk (p less than or equal to 0.01) and the HIV+ (p less than or equal to 0.02) groups when compared with that in the low-risk population . These differences were attributable to the following: (1) the high-risk group's two-fold increase in gram-positive infections (p less than or equal to 0.01), and (2) a 24-fold increase in pseudomonal (p less than 0.001) infections and seven-fold increase in fungal (p less than 0.005) infections in the HIV+ group . These infections were invariably associated with catheter loss and frequently resulted in conversion to hemodialysis . CONCLUSION: We believe that the use of CAPD in HIV+ patients may be limited by this increased occurrence of pseudomonal and fungal peritonitis.

J Bacteriol, 1989 Jun, 171(6), 3366 - 72
Replication origins of single-stranded-DNA plasmid pUB110; Boe L et al.; The two replication origins of plasmid pUB110 have been characterized . The site of initiation of DNA replication at the plus origin was mapped to within an 8-base-pair sequence . DNA synthesis initiated at the origin was made to terminate precociously in an inserted sequence of 18 base pairs that is homologous to a sequence in the origin . This suggests that pUB110 replicates as a rolling circle . The minus origin of plasmid pUB110 has been characterized, and the minimal sequence required for function has been determined . As with other minus origins, activity is orientation specific with respect to the direction of replication . Its activity is sensitive to rifampin in vivo, suggesting that RNA polymerase catalyzes single-strand to double-strand conversion . Unlike all other plasmids of gram-positive bacteria thus far described, the pUB110 minus origin is functional in more than one host.

Microbiol Rev, 1989 Jun, 53(2), 231 - 41
The family of highly interrelated single-stranded deoxyribonucleic acid plasmids; Gruss A et al.; Many plasmids from gram-positive bacteria replicate via a single-stranded deoxyribonucleic acid (ssDNA) intermediate, most probably by a rolling-circle mechanism (these plasmids are referred to in this paper as ssDNA plasmids) . Their plus and minus origins are physically separated, and replicative initiations are not simultaneous; it is this feature that allows visualization of ssDNA replication intermediates . The insertion of foreign DNA into an ssDNA plasmid may provoke a high frequency of deletions, changes of replicative products to high-molecular-weight forms, segregational loss, and decreased plasmid copy numbers . When an ssDNA plasmid is inserted into the chromosome, both deletions and amplifications may be induced . Both the mode of replication and the copy control mechanism affect the fate of inserted foreign material, usually selecting for its loss . Thus, after having tasted various morsels of DNA, the resulting plasmid stays trim . The features of the ssDNA plasmids seem to be beneficial for their viability and propagation, but not for their use as cloning vectors . However, plasmids replicating via ssDNA intermediates are being exploited to yield insights into the mechanisms of recombination and amplification.

Bioessays, 1989 Jun, 10(6), 207 - 10
Bacterial cell walls and membranes . Discovery of the teichoic acids; Baddiley J; Teichoic acids are major wall components of most Gram-positive bacteria . Their discovery followed that of their nucleotide precursors . Lipoteichoic acids associated with the cell membrane were discovered at the same time . Events leading to these discoveries and the probable function of teichoic acids in cation control are described.

Antimicrob Agents Chemother, 1989 Jun, 33(6), 965 - 7
In vitro activity of SK&F 104662, a new glycopeptide antibiotic; Yao JD et al.; The in vitro activity of SK&F 104662, a new glycopeptide antibiotic, against gram-positive bacteria was evaluated . Activity was comparable to those of teicoplanin and vancomycin against most organisms . SK&F 104662 inhibited diphtheroids at concentrations of less than or equal to 0.5 microgram/ml . Addition of human serum to the test medium lowered the inhibitory activity of this glycopeptide against some organisms by as much as eightfold.

Inflammation, 1989 Jun, 13(3), 341 - 57
Modulation of functional activity of human polymorphonuclear and mononuclear phagocytes by intravenous gamma globulin; Pruzanski W et al.; Intravenous gamma-globulin was tested in a range of concentrations compatible with the increments obtained after therapeutic infusions for modulation of phagocytic functions of human polymorphonuclears (PMNs) and monocytes . Intravenous gammaglobulin in concentrations of 3.0 mg/ml or more increased adhesiveness and suppressed chemotaxis of PMNs . There was marked dose-dependent enhancement of opsonization of gram-positive and gram-negative microorganisms . Preincubation of PMNs with intravenous gamma-globulin caused enhancement of the total bacteria ingested, total bacteria killed, phagocytosis, and phagocytic index, when gram-positive and gram-negative bacteria were tested . During phagocytosis, there was no release of LDH or lysozyme; however, there was release of beta-glucuronidase . No significant difference in phagocytic enhancement was found when filtered and native intravenous gamma-globulin preparations were compared . There was marked enhancement of the superoxide anion generation by intravenous gamma-globulin above the concentration of 0.01 mg/ml . Intravenous gamma-globulin also markedly enhanced phagocytic activity of monocytes . Therefore, intravenous gamma-globulin modulates not only opsonization-related phenomena, but also exerts a complex influence on other aspects of phagocytic activity.

Eur J Clin Microbiol Infect Dis, 1989 Jun, 8(6), 499 - 504
Bacterial infections after liver transplantation; Paya CV et al.; Infection is a common complication of orthotopic liver transplantations and a major cause of mortality . Of the different types of infection, severe bacterial infections are the most common . The majority (81%) of bacterial infections occur within the first two months after liver transplantation . The most frequent site of infection is the abdomen (intrahepatic or extrahepatic abscesses, cholangitis, and peritonitis) . Bacteremia is a marker of mortality, and the majority of bacteremia cases are secondary to another bacterial infection site . The causative organisms vary among different centers . In some, gram-negative organisms are more common (66%); in one center, however, gram-positive microorganisms predominate (66%) . In the latter center, the use of nonabsorbable antibiotics, which eradicate gastrointestinal aerobic gram-negative microorganisms, may explain this microbiologic difference . The main risk factor predisposing to bacterial infection appears to be the duration of the transplantation operation, especially beyond 12 hours . Of the deaths resulting from infection, 81% were caused by bacterial infection.

Br J Urol, 1989 May, 63(5), 503 - 7
Long-term antibiotic treatment of chronic bacterial prostatitis . Effect on bacterial flora; Bergman B et al.; The bacterial flora in patients referred with chronic bacterial prostatitis were studied . Only 13% had Gram-negative bacteria in significant numbers but 43% had Gram-positives using the same criteria . Half of the patients were symptom-free by the end of a 12-week course of antibiotics and remained so after 6 months; in one-third the symptoms were unchanged 6 months after completing treatment . The relief of symptoms correlated with the disappearance of white blood cells in the expressed prostatic secretion (EPS) and with a lowered pH in the EPS . Thus only 1 of the 14 patients without symptoms at 6 months had a significant growth of bacteria at the prostatic level, whereas 7 of 10 patients with unchanged symptoms had a significant bacterial colonisation . Although the initially infecting organism was eliminated in about half of the patients, new Gram-positive bacteria were isolated after treatment in 13 of 29 patients; 12 of these resolved spontaneously within 6 months . Five patients with Gram-positive bacteria were colonised with new Gram-negatives at the end of treatment . Two healed spontaneously but 3 remained colonised with Gram-negatives at the end of the follow-up period . These findings make it likely that many patients infected with Gram-positive bacteria benefit from antibiotic treatment . However, disturbances in the bacterial flora by antibiotic treatment may facilitate invasion by new types of bacteria.

Pathol Biol (Paris), 1989 May, 37(5), 472 - 6
{Antibiotic prophylaxis in cardiac surgery in France}; Levy M et al.; Prophylactic administration of antibiotics in patients undergoing cardiac surgery is now an established procedure . The interest of a short prophylaxis (less then 48 h), directed mainly against Gram positive cocci has been demonstrated . However, there is no general agreement as to the agent to be used . We thus conducted a survey of the current practice of antibiotic prophylaxis (ABP) by sending a detailed questionnaire to each of the 51 centers performing cardiac surgery in France . 48 replies (94%) were received . Monotherapy was used in 42 centers, with cephalosporins in 41 (cefamandole: 22, cefazolin: 10, cefuroxime: 4, cephalothin: 3, cefotiam: 2) and with minocycline in one center . Six centers used a combination including aminoglycoside . Mean duration of ABP was 1.8 +/- 1.2 d . First dose of antibiotic was given before cardiopulmonary (C-P) bypass intravenously . In 29 centers, AB was injected into the C-P pump . Mean dosage of cephalosporin before surgery was 25 mg/kg and total dosage was 70 mg/kg/24 h . We conclude that cephalosporins are almost exclusively chosen in France contrasting with other european countries such as the United Kingdom where the most used regimen is a combination of penicillinase-resistant penicillin and an aminoglycoside.

J Antimicrob Chemother, 1989 May, 23(5), 759 - 71
A comparison of double beta-lactam combinations with netilmicin/ureidopenicillin regimens in the empirical therapy of febrile neutropenic patients; Kibbler CC et al.; In a randomized trial ceftazidime plus piperacillin or azlocillin, and netilmicin plus piperacillin or azlocillin were used as initial empirical therapy in 202 febrile neutropenic episodes . Netilmicin plus azlocillin was the most effective combination with a clinical response rate of 81% in clinically and microbiologically documented infections compared with 63% for ceftazidime plus piperacillin . All of the episodes of Gram-negative bacteraemia treated with azlocillin responded compared with 43% of those treated with piperacillin . Gram-positive organisms accounted for 52% of all bacteriologically documented infections and 40% of the febrile episodes were treated with vancomycin for presumptive or documented Gram-positive infection . Patients treated with netilmicin had significantly more nephrotoxicity than those given the double beta-lactam combinations (14.8% vs 3.5%; P less than 0.05) . However, this difference was not shown in those patients who did not receive concurrent vancomycin or amphotericin . The double beta-lactam combinations were associated with more hypokalaemia (58.2% vs . 37.7%; P less than 0.05) and more colonization with yeasts (24% vs . 10.4%; P less than 0.05) but there was no evidence that their use was associated with prolongation of neutropenia . These results indicate that ceftazidime plus a ureidopenicillin would be adequate empirical therapy in situations where the concomitant use of nephrotoxic agents precludes the use of aminoglycoside containing combinations.

J Clin Lab Immunol, 1989 May, 29(1), 25 - 32
A 180-kilodalton protein from Mycobacterium tuberculosis defined by a human T cell clone; Wadee AA et al.; A high molecular weight protein from Mycobacterium tuberculosis (M . tuberculosis) has been identified, that is recognized by peripheral blood mononuclear cells from several tuberculous patients and by a T cell clone derived from a patient with tuberculous pleurisy . Purification of this fraction demonstrated biological activity to reside in a 180-kDa protein component . This mycobacterial protein appears to exist in some, but not all mycobacteria as the clone reacts to M . tuberculosis, BCG M . kansasii, M . flavescens and M . fortuitum, but not to M . intracellulare, M . scrofulaceum or a variety of gram-positive or gram-negative bacteria, or to PPD . Specific anti-genic challenge of the T cell clone in the presence of irradiated antigen presenting cells results in proliferation and interleukin-2 (IL-2) production . Proliferation is restricted to HLA Class II antigens as antigenic recognition occurs only in the presence of either one of the two parental DR haplotypes . Peripheral blood mononuclear cells from several other patients with pulmonary tuberculosis also proliferate in response to this antigen, emphasizing the relevance of T cell cloning techniques in identifying important mycobacterial antigens.

Pharm Weekbl Sci, 1989 Apr 28, 11(2), 33 - 43
Developments in quinolones . Bacteriology, pharmacokinetics and initial clinical experience of several investigational quinolone derivatives; Janknegt R et al.; The properties of several new, investigational quinolones are reviewed . Desirable characteristics of new quinolones are improved activity against especially Gram-positive bacteria, longer elimination half-life, slower development of resistance, fewer side effects etc . Fleroxacin and lomefloxacin have entered phase III trials: their main advantage lies in improved pharmacokinetics . AM-1091, AT-4140 and T-3262 are still in early phases of development and show improved activity against Gram-positive bacteria . They also show a reduced penetration of the blood-brain barrier, probably resulting in fewer side effects in the central nervous system . AM-1091 shows incomplete cross-resistance with ciprofloxacin.

FEBS Lett, 1989 Apr 24, 247(2), 333 - 6
Two structural types of mercury reductases and possible ways of their evolution; Bogdanova ES et al.; Structural differences have been revealed among mercury reductases of immunologically unrelated types from Gram-positive bacteria: enzymes of one immunological type have a molecular mass of 62-69 kDa and seem to contain an N-terminal extension of 5-15 kDa, which is easily cleaved by trypsin and chymotrypsin; enzymes of the other immunological type have a molecular mass of 52-57 kDa and are resistant to proteolysis . The existence of at least two different lines in the evolution of mercury reductases is surmised.

J Biochem (Tokyo), 1989 Apr, 105(4), 648 - 52
Physical and chemical characterization of glutamine synthetase purified from Mycobacterium phlei; Kimura K et al.; Glutamine synthetase (L-glutamate: ammonia ligase {ADP forming}) {EC 6.3.1.2} has been purified from a Gram-positive, acid-fast bacterium, Mycobacterium phlei, by simple procedures with 57% recovery . The enzyme resembled that from Mycobacterium smegmatis in the subunit size (56,000), molecular weight (670,000), amino acid composition, the amino acid sequence of the NH2-terminal, and the secondary structure . The enzyme activity was regulated by adenylylation of each subunit in the dodecameric molecule . M . phlei glutamine synthetase possesses two useful characteristics: high thermostability and resistance to protease digestion . The enzyme was not inactivated on exposure to 60 degrees C for 2 h or 37 degrees C for 72 h, or after incubation with 1% trypsin or chymotrypsin at 37 degrees C for 12 h, pH 7.8 . With saturating substrate levels, the Arrhenius plot was nonlinear and concave downward with an intersection point at 45 degrees C, and the activation energies were calculated to be 3.2 and 9.6 cal/mol from the slopes . The specific activity of the highly adenylylated enzyme (E10.7) was remarkably lower than that of the slightly adenylylated enzyme (E2.5); however, both enzymes show similar profiles of the Arrhenius plot . These results indicate that the adenylylation of the enzyme does not affect its activation energies.

Wien Klin Wochenschr, 1989 Mar 31, 101(7), 244 - 9
{Epidemiology of autopsy verified infection}; Mikuz G et al.; In a retrospective study of 35,220 autopsies performed from 1950 to 1984 in our department, septicaemia was found in 707 cases (2% of all autopsies) . The incidence of pyaemia decreased after 1960, whereas that of septicaemia increased significantly . This increase was observed in surgical and medical departments due to patients suffering from neoplastic disease who died of septicaemia (40% of our cases) . In the paediatric departments, however, mortality from septicaemia decreased slowly, but continuously . Age distribution revealed two peaks, one in infancy and one in patients older than 60 years . Over the past decade the mean age increased significantly (15 years on average) . In blood cultures gram negative bacteria were found more often than gram positive strains.

Acta Cytol, 1989 Mar-Apr, 33(2), 259 - 62
Inflammatory pseudotumor of the liver . Report of the fine needle aspiration cytologic findings in a case initially misdiagnosed as malignant; Lupovitch A et al.; The fine needle aspiration (FNA) cytologic features are described in a case of inflammatory pseudotumor of the liver (xanthogranuloma), a disease generally regarded as of unknown etiology . The initial FNA findings were those of an acute exudative process, with atypical biliary duct epithelium and hepatocytes . These were interpreted as verifying the radiologic impression of a malignancy . Histologic study of subsequently resected nodules revealed the true nature of the case . As the lesion evolved, granulomatous inflammation supervened, characterized by numerous foamy histiocytes and lesser populations of plasma cells and lymphocytes . Numerous gram-positive cocci were readily demonstrated, suggesting that the lesion was an unusual tissue response to an intrahepatic bacterial infection . The lesion eventually resolved with prolonged antibiotic therapy.

J Vasc Surg, 1989 Mar, 9(3), 472 - 8
Rotational muscle flaps: a new technique for covering infected vascular grafts; Mixter RC et al.; Twenty-one patients with established localized infection of vascular bypass grafts were treated with aggressive debridement and rotational muscle flap coverage to control graft infection . There were six gram-positive, six gram-negative, four mixed, and three fungal graft infections . Graft material included Dacron, Gore-Tex (registered trademark of W . L . Gore Associates Inc., Elkton, Md.), Dacron and Gore-Tex in combination, and saphenous vein . Twenty of 21 patients had successful preservation of graft function, local wound healing, and control of infection . There were no amputations or deaths . The one failure was caused by incomplete debridement of an infected graft segment . Aggressive debridement and rotational muscle flap coverage is an effective means of treating locally infected vascular bypass grafts.

Diagn Microbiol Infect Dis, 1989 Mar-Apr, 12(2), 143 - 7
In vitro activity of Ro 23-9424, ceftazidime, and eight other newer beta-lactams against 100 gram-positive blood culture isolates; Jones RN et al.; One hundred Gram-positive bacteremia organisms from five important genus groups were tested against 10 newer beta-lactams . Ceftazidime was significantly less active (50% of strains at less than or equal to 8 micrograms/ml) compared to other cephalosporins . The penems (FCE-22101 and HRE-664) and imipenem were each superior to the cephalosporins with 92-93% inhibition of strains . A novel fused co-drug of fleroxacin and desacetyl-cefotaxime, Ro 23-9424, was 100% effective against these Gram-positive pathogens at less than or equal to 8 micrograms/ml . Several of these compounds should receive consideration for clinical trials for empiric therapy among neutropenic patient infections where Gram-positive pathogens may be more prevalent.

Microbiol Rev, 1989 Mar, 53(1), 109 - 20
Protein phosphorylation and allosteric control of inducer exclusion and catabolite repression by the bacterial phosphoenolpyruvate: sugar phosphotransferase system; Saier MH Jr; The bacterial phosphotransferase system (PTS) functions in a variety of regulatory capacities . One of the best characterized of these is the process by which the PTS regulates inducer uptake and catabolite repression . Early genetic and physiological evidence supported a mechanism whereby the phosphorylation state of an enzyme of the PTS, the enzyme III specific for glucose (IIIGlc), allosterically inhibits the activities of a number of permeases and catabolic enzymes, the lactose, galactose, melibiose, and maltose permeases, as well as glycerol kinase . Extensive biochemical evidence now supports this model . Evidence is also available showing that substrate binding to those target proteins enhances their affinities for IIIGlc . In the case of the lactose permease, this positively cooperative interaction represents a well documented example of transmembrane signaling, demonstrated both in vivo and in vitro . Although the PTS-mediated regulation of cyclic AMP synthesis (catabolite repression) is not as well defined from a mechanistic standpoint, a model involving allosteric activation of adenylate cyclase by phospho-IIIGlc, together with the evidence supporting it, is presented . These regulatory mechanisms may prove to be operative in gram-positive as well as gram-negative bacteria, but the former organisms may have introduced variations on the theme by covalently attaching IIIGlc-like moieties to some of the target permeases and catabolic enzymes . It appears likely that the general process of PTS-catalyzed protein phosphorylation-dephosphorylation will prove to be important to the regulation of numerous bacterial physiological processes, including chemotaxis, intermediary metabolism, gene transcription, and virulence.

Oral Microbiol Immunol, 1989 Mar, 4(1), 47 - 51
Rapid method for the purification of DNA from subgingival microorganisms; Smith GL et al.; A method is described which facilitates the rapid purification of high molecular weight chromosomal DNA from gram positive and gram negative bacteria grown on solid media . A total of 32 reference strains and fresh isolates were examined in this study . The purification procedure involved lysis of cells with SDS in the presence of proteinase K, followed by removal of cellular polysaccharides and proteins with hexadecyltrimethyl ammonium bromide (CTAB) and phenol:chloroform:isoamyl alcohol . Preparations were incubated with RNase and, after removal of the enzyme, DNA was precipitated with ethanol . Several hundred micrograms of DNA could be prepared within 5 h from cells grown on 1-2 agar plates . None of the final preparations contained RNA; protein was detected in 12/32 preparations . The resultant DNA proved suitable for restriction enzyme digestion and biotin-labelling by a random primer technique . DNA probes constructed from these preparations were capable of detecting 100 pg of homologous target DNA fixed to nitrocellulose . Cross reactions between closely related species displayed weaker signal intensities than, and, thus, were easily distinguished from, true positive reactions between homologous species . DNA obtained by this procedure may also be suitable for DNA-DNA homology studies, recombinant DNA experiments and molecular fingerprinting.

Boll Chim Farm, 1989 Feb, 128(2), 71 - 3
Synthesis and biological properties of 1-methyl-2-{(4-aminophenyl)-sulfonyl-}amino-5-nitro imidazole; Bertolini A et al.; The synthesis of 1-methyl-2-{(4-aminophenyl)sulfonyl} amino-5-nitroimidazole 5 is described . The new sulfonamide 5 shows a good activity against aerobic and anaerobic Gram-positive and Gram-negative bacteria . Compound 5 is well absorbed in rats after oral administration but the plasma levels are inferior to those of sulfadiazine and sulfamethoxazole.

Can J Microbiol, 1989 Feb, 35(2), 274 - 82
The characterization and ultrastructure of two new strains of Butyrivibrio; Cheng KJ et al.; Strains B-385-1 and 2-33 are numerically important components rumen bacterial populations , but they have remained (taxonomically) undefined . In spite of some resemblance to Selenomonas ruminantium in their cell size and in their formation of tufts of flagella, they more closely resemble Butyrivibrio fibrisolvens in the subpolar location of their flagella, in their guanine + cytosine content, and in most biochemical characteristics, including butyrate formation . Cells of these strains stain Gram negative, as do both Selenomonas and Butyrivibrio, but their cell walls closely resemble those of Butyrivibrio in their Gram-positive type of molecular architecture and in their cleavage pattern in freeze-etching . Cells of these strains and of B . fibrisolvens have a very thin (ca . 12 nm) peptidoglycan cell wall; thus, they fail to retain the crystal violet complex of the Gram stain and stain Gram negative . This important structural characteristic of their cell walls places strains B-385-1 and 2-33 within the genus Butyrivibrio and certain morphological and biochemical characteristics distinguish them from B . fibrisolvens.

DICP, 1989 Feb, 23(2), 162 - 70
A clinical pharmacy-oriented drug surveillance network: results of a nationwide antibiotic utilization review of bacterial pneumonia--1987; Grasela TH Jr et al.; One hundred eighteen pharmacists enrolled in the Drug Surveillance Network completed a survey of antibiotic prescribing patterns for bacterial infections . A total of 319 hospitalized patients being treated for suspected or documented bacterial pneumonia were monitored, and this paper summarizes the data collected on this specific subpopulation . Two hundred three patients (64 percent) were treated for community-acquired pneumonia and 116 patients (36 percent) were treated for nosocomial pneumonia . Seventy-three percent of the nosocomial pneumonias were culture-positive, with a gram-negative microorganism as the predominant isolate . Forty-eight percent of the community-acquired pneumonias were culture-positive with a mixture of gram-positive and gram-negative organisms . Fifty percent of patients were treated with a single agent, 33 percent with two antibiotics, and the remaining 17 percent with a combination of three or more antibiotics . A satisfactory response was noted for 62 and 76 percent of the patients with nosocomial and community-acquired pneumonias, respectively . Twenty percent of the pneumonia patients were switched to oral drug after an average of five days of therapy and discharged from the hospital . Twenty-five adverse events that were possibly or probably related to the antibiotic regimen were reported in 23 of the 350 patients for an overall incidence of 6.5 percent . The results of this survey provide a cross-sectional view of antibiotic prescribing patterns for the treatment of bacterial pneumonia and the outcome of therapy under actual clinical conditions of use.

FEMS Microbiol Lett, 1989 Feb, 48(3), 259 - 63
Streptomycetes can grow through small filter capillaries; Wolf H et al.; Streptomycetes are Gram-positive bacteria growing as branching filaments . The filaments are able to deform . This ability allows the cells to squeeze through capillaries as small as 0.2 micron in diameter . After passage through the capillaries, numerous hyphae are morphologically altered to a helical structure.

Eur J Clin Microbiol Infect Dis, 1989 Feb, 8(2), 150 - 3
Comparative evaluation of the BCB Roche and Oxoid Signal blood culture systems; Rohner P et al.; The agar-slide blood culture system BCB Roche was compared with the Oxoid Signal blood culture system using 2,266 paired blood cultures . A total of 271 (12%) paired sets were culture-positive, including 222 (9.8%) yielding pathogens associated with septicemia and 50 (2.2%) yielding likely contaminants . In the recovery of the total 235 isolates considered as pathogens, the BCB Roche system yielded 202 (85.9%), the Oxoid Signal 211 (89.8%); 178 (75.7%) were cultured by both systems . There was no statistically significant difference between the two systems in their sensitivity, contamination-rate and detection time, except for gram-positive organisms, which were detected earlier by the Oxoid Signal system . Both systems performed well and were easy to handle.

Arch Pathol Lab Med, 1989 Feb, 113(2), 181 - 3
A modified Brown and Hopps stain for identification of gram-positive and gram-negative microorganisms in glycol methacrylate-embedded tissues; Schwartz DA et al.; Plastic embedding is a recently developed technique that has been shown to be superior to conventional paraffin embedding in the histopathologic identification of microorganisms in tissue specimens . This report describes a modification of the Brown and Hopps stain for the differentiation of gram-positive and gram-negative microorganisms in 3-micron-thick plastic sections . This technique is easily performed and has a rapid turnaround time . This staining method permits a more precise histopathologic diagnosis of infectious agents than is possible in paraffin-embedded tissues.

Ned Tijdschr Geneeskd, 1989 Jan 21, 133(3), 126 - 8
{Transient bone marrow inhibition caused by aminoglutethimide}; Tel W et al.; A 53-year-old woman with reversible bone marrow insufficiency caused by aminoglutethimide (AGT) treatment of metastatic breast carcinoma is described . The clinical picture included moderate thrombocytopenia and severe granulocytopenia complicated by Gram-positive septicaemia and skin infections, and by oral candidiasis . Withdrawal of AGT and antibiotic therapy resulted in clinical and haematological recovery, but the patient died suddenly, probably from a cardiac cause . Autopsy revealed widespread bone metastases, but no bone marrow infiltration of breast carcinoma . The haematological hazards caused by application of AGT are discussed.

Am Ind Hyg Assoc J, 1989 Jan, 50(1), 44 - 50
Investigation of organic aerosols generated during sugar beet slicing; Forster HW et al.; A description is given of a hygiene investigation made to determine workers' exposure to airborne microorganisms and antigen in the slicing area of a sugar beet refinery following complaints by the workers of work-related respiratory symptoms . Dust concentrations in the slicing area were not high (up to 3.5 mg/m3), but there were many airborne microorganisms (200,000 colony forming units/m3), mostly gram-positive bacteria . Of 15 workers, 7 had precipitins to a sugar beet extract . Of these 7, there were 5 who also had precipitins to an extract of dust collected on a 'Staplex' filter . There was a line of identity between the beet and dust extracts, indicating the dust contained appreciable quantities of beet antigen . As a result of these findings, local exhaust ventilation was installed before the next slicing season . Further investigations were made near the beginning and end of this second season . The results showed lower dust concentrations and markedly fewer numbers of airborne bacteria . Although total numbers of bacteria fell, numbers of gram-negative bacteria increased and, at the end of the season, comprised 20% of the total bacterial numbers . Specific immunoglobulin G (IgG) concentration in the workers' serums fell between the two slicing seasons and then remained constant through the next slicing season . This reflected the environmental measurements that showed lower dust concentrations after the installation of exhaust ventilation equipment.

J Bacteriol, 1989 Jan, 171(1), 498 - 502
Peptidoglycan-polysaccharide complex in the cell wall of the filamentous prochlorophyte Prochlorothrix hollandica; Jurgens UJ et al.; A peptidoglycan-polysaccharide complex composed of N-acetylglucosamine, N-acetylmuramic acid, muramic acid 6-phosphate, L-alanine, D-alanine, D-glutamic acid, meso-diaminopimelic acid, N-acetylmannosamine, mannose, galactose, glucose, and phosphate was isolated from cell walls of the filamentous prochlorophyte Prochlorothrix hollandica; this complex was similar in chemical composition and structure to that found in cyanobacteria . Peptide patterns of partial acid hydrolysates of the isolated peptidoglycan revealed an A1 gamma structure with direct cross-linkage (m-diaminopimelic acid-D-alanine) of the peptide side chains . The degree of cross-linkage (63%) was found to be in the range of values obtained for gram-positive bacteria and cyanobacteria.

Clin Orthop, 1989 Jan, (238), 159 - 66
Revision of septic total knee arthroplasty; Jacobs MA et al.; Nine patients with septic total knee arthroplasties (TKA) were treated between 1980 and 1984; six were gram-positive infections and three were gram-negative . Initial treatment included the maintenance of all solidly fixed components . Patients with loose components were treated with removal of all prosthetic material and subsequent reimplantation after a six-week course of antibiotics . At follow-up examination six of nine patients had satisfactory results . One patient maintained his original femoral and tibial components and one patient required a knee fusion to treat his recurrent gram-negative infection . Overall, complications were associated with chronic infection, gram-negative infection, and abnormalities of the extensor mechanism.

Caries Res, 1989, 23(4), 209 - 17
Ultrastructural study on human root caries; Frank RM et al.; Superficial root caries lesions of incisors and premolars of 24 patients aged 52-60 years were studied by scanning electron microscopy and transmission electron microscopy . In the predominantly gram-positive bacteria of the root dental plaque, a great number of corncob configurations were observed . Bacterial infiltration into cementum occurred without any gradient of demineralization and mainly followed the borders between calcified cementum bundles as well as incremental lines . The narrow channels which were filled initially by a single row of gram-positive bacteria broadened progressively with simultaneous destruction of the apatite minerals and the collagenous matrix . Root dentin invasion showed great similarities to coronal dentin with an important gradient of demineralization . In the deep layers, sclerosed tubules contained sometimes rhombohedral crystals . In more superficial layers, bacterial invasion occurred initially in still partially sclerosed tubules . Tubular lumens as well as lateral side branches which had lost their peritubular dentin were filled with gram-positive microorganisms . An important diffuse destruction of the apatite minerals was observed at this stage in the intertubular dentin which still presented typical cross-banded collagen fibrils . The confluence of enlarged dentinal tubules filled by numerous microorganisms led to large bacterial zones with complete destruction of root dentin.

APMIS Suppl, 1989, 5, 9 - 16
Inactivation of beta-lactamases by sulbactam and enhanced clinical activity due to target-site binding of the combination of sulbactam and ampicillin; Yokota T; In addition to the beta-lactamase-inactivation activity of sulbactam, a stronger bactericidal activity has been confirmed with sulbactam/ampicillin than with either antibiotic alone . To clarify this latter mechanism, binding affinities of the combination drug were compared with those of ampicillin and sulbactam alone against the PBPs of E . coli, S . aureus, P . vulgaris and H . influenzae . Ampicillin showed the highest binding activity to the PBP fraction essential for septum formation such as PBP3 of E . coli, whereas sulbactam manifested the strongest affinity for the PBP fraction necessary for cell elongation such as PBP1a of E . coli . Sulbactam/ampicillin bound strongly to both PBP fractions . Light microscopy and scanning electronmicroscopy of these bacteria grown in the presence of the antibiotics revealed that more rapid formation of bulge or spheroplast forms of the cells are seen in the presence of small amounts of sulbactam/ampicillin compared to larger amounts of each drug alone . It is concluded that sulbactam/ampicillin, by synergistic inhibition of PBP fractions essential for bacterial cell division, can manifest a stronger bactericidal effect on Gram-positive and Gram-negative bacteria than each drug alone, not only in beta-lactamase-producing strains but also in ampicillin-sensitive strains.

Chemotherapy, 1989, 35(3), 208 - 20
Integrated complex combinations for the treatment of opportunistic infections in AIDS; Freerksen E et al.; In the present paper the 'serial combinations' (components of the combination offered separately), as used in conventional combination therapy, are compared with the 'integrated complex combination' (offered as fixed combinations) . So far, three combinations have been worked out on the basis of this concept (RMP + SMZ + TMP + INH; RMP + SMZ + TMP + PTH; RMP + INH + PTH + DDS) . They allow successful treatment of almost all mycobacterial infections and diseases (including tuberculosis and leprosy) and a number of infections caused by gram-negative and gram-positive microorganisms and by Pneumocystis carinii.

Ther Drug Monit, 1989, 11(4), 450 - 4
Individualizing vancomycin dosage regimens: one- versus two-compartment Bayesian models; Pryka RD et al.; The absolute and relative predictive performances of one- and two-compartment Bayesian forecasting models were evaluated and compared . Initial population parameters were derived from 25 adult patients with stable renal function and who were being treated for presumed or documented gram-positive infections . The performance of each model was compared using these population parameters with and without steady-state or non-steady-state feedback concentrations to predict future peak and trough concentrations in an additional 20 patients . Both models tended to underpredict vancomycin peak and trough concentrations obtained at steady state . The use of a two-compartment model resulted in statistically less bias and more precise predictions of vancomycin peak concentrations when either population parameters or non-steady-state concentrations were used for future predictions . No difference in model performance was observed when steady-state concentrations were used to predict future steady-state concentrations . The results of this evaluation demonstrate that the two-compartment Bayesian model is less biased and more precise in determining future vancomycin serum concentrations given only population parameters or non-steady-state feedback information . No difference in model performance could be discerned when steady-state concentrations were used as feedback information.

Caries Res, 1989, 23(3), 151 - 8
Structure of dental plaque and the plaque-enamel interface in human experimental caries; Nyvad B et al.; This study describes the ultrastructure of dental plaque and the plaque-enamel interface after 2 and 3 weeks' exposure to a cariogenic challenge . Five dental students carried a total of 25 specimens of smooth surface enamel in intraoral acrylic appliances . During the initial 3 days the volunteers refrained from oral hygiene and performed nine daily mouthrinses with 10% (w/v) solutions of sucrose . After the 3rd day the volunteers cleaned their natural teeth, whereas the experimental sites were left undisturbed except for nine daily extraoral 5-min immersions in 5% (w/v) solutions of sucrose . Clinically, three patterns of colonization were observed after 3 days . At the histological level the experimental bacterial deposits also exhibited three distinctly different structural patterns after 2 and 3 weeks . Individual patterns consistently differed with regard to the microbial composition, the structural organization of the deposits, and the presence or absence of crystal-like material . However, in all individuals a layer of densely packed gram-positive bacteria resembling Actinomyces was consistently present close to the enamel surface . In 1 individual the microbial deposits were dominated by large bacteria, the ultrastructure of which conformed to the description of Stomatococcus mucilaginosus . These findings may partly explain pronounced individual variations in the rate of caries lesion development and progression in vivo.

Complement Inflamm, 1989, 6(1), 27 - 35
Measurement of complement proteins C2 and B in systemic lupus erythematosus and septic shock; Oglesby TJ et al.; We developed sensitive radioassays to quantitate the homologous complement proteins C2 and B, in intact form, in sera from patients with diseases associated with hypocomplementemia . In a study of systemic lupus erythematosus (SLE) patients, we found a subset of patients (6/40) with low C2 concentrations, though overall, C2 concentration was not related to disease activity . Protein B concentration was increased in 23/40 SLE patients, apparently not due to a generalized acute phase response . Among patients with both gram-negative and gram-positive septic shock, C2 and B concentrations were low in a subset of patients with pre-existing cirrhosis, suggesting hepatic hyposynthesis of these proteins may be important in their prognosis and predisposition to severe infections.

Scand J Infect Dis, 1989, 21(4), 359 - 66
Fiberoptic bronchoscopy for diagnosis of opportunistic pulmonary infections after bone marrow transplantation; Heurlin N et al.; As a part of the diagnostic procedure for 16 suspected pulmonary infections in 15 marrow transplant recipients fiberoptic bronchoscopy with bronchoalveolar lavage (BAL), transbronchial lung biopsy (TBB) and brushing were performed . Cytomegalovirus (CMV) was the most common microorganism and CMV pneumonia was diagnosed in 8/16 (50%) episodes of pulmonary disease studied . Pneumonias were diagnosed as caused by Candida or Aspergillus species in 6 episodes and by gram-positive cocci in 2 cases . Adenovirus and Pneumocystis carinii was also isolated in 1 patient each . Three noninfectious diseases (pulmonary oedema, idiopathic pneumonia and pulmonary embolism) were diagnosed by methods other than bronchoscopy . The use of fiberoptic bronchoscopy with BAL and TBB allowed correct identification of 14/18 microorganisms involved . Brushing was less useful . Four patients' pneumonias had a multiple etiology . The bronchoscopy methods used were well tolerated even by patients whose condition was poor.

Acta Neurochir (Wien), 1989, 100(1-2), 67 - 9
Infected ventriculostomy: bacteriology and treatment; Ohrstrom JK et al.; During a period of 6 years 256 patients underwent ventriculostomy as their first operative procedure . Twenty-seven patients (11%) developed CSF-infections, in almost 90% caused by Gram-positive cocci compatible with normal skin flora . The incidence of infection was distributed evenly in the postoperative period . All patients received intravenous and intrathecal antibiotic treatment simultaneously according to the sensitivity test . The treatment was highly effective, and without serious adverse effects.

Indian J Chest Dis Allied Sci, 1989 Jan-Mar, 31(1), 15 - 20
Review of one hundred cases of empyema thoracis; Gupta SK et al.; One hundred cases of empyema thoracic have been reviewed . Aetiology of empyema was tubercular in 21 per cent cases and non-tubercular in 79 per cent cases . Gram negative organisms were cultured in 84.6% cases, whereas gram positive organisms were cultured only in 15.4% cases . It was observed that management of cases of empyema differed considerably with the presence or absence of BPF, thick or thin pus and size of empyema . It was concluded that all cases of simple empyema with thin pus and only those cases of simple empyema with thick pus where size of empyema is small should be managed by aspiration/s . Cases failed by above method, all cases of simple empyema with thick pus and with moderate to large size of empyema and all cases of empyema with BPF should be straightway managed by intercostal drainage tube connected to water seal . On the whole, cases of empyema with BPF were difficult to manage and needed major surgery in 45.8 per cent cases in comparison to only 2.9 per cent cases of simple empyema.

Chemotherapy, 1989, 35 Suppl 1, 49 - 57
Comparison of aztreonam plus clindamycin with tobramycin plus clindamycin in the treatment of intra-abdominal infections; Birolini D et al.; The activity of aztreonam (a beta-lactam antibiotic with specific activity against gram-negative bacteria) was evaluated and compared with that of tobramycin in hospitalized patients with severe intra-abdominal infections due to gram-negative pathogens, either alone or in association with other bacteria . Of a total study population of 156 patients, 76 were assigned to treatment with aztreonam + clindamycin, and the remaining 80 were treated with tobramycin + clindamycin . Patients underwent a variety of surgical procedures involving the peritoneal cavity . The final clinical evaluation revealed similar percentages of satisfactory results: 86.8% for the patients in the aztreonam-treated group and 86.2% for the tobramycin-treated patients . Among the patients who had a poor therapeutic result, gram-negative bacteria, either alone or associated with gram-positive pathogens, were considered responsible for 50% of the infections in the aztreonam group; the percentage increased to 82% among those treated with tobramycin . The incidence of side effects and laboratory alterations was not significant and was similar in both groups . The results of this study suggest that aztreonam may be an effective and safe drug for the treatment of bacterial infections due to gram-negative pathogens.

Arch Microbiol, 1989, 151(2), 183 - 5
Photokilling of bacteria by the natural dye curcumin; Dahl TA et al.; Curcumin is a yellow-orange compound derived from the root of Curcuma longa (Zingiberaceae family), that has been used as a medicine, spice and coloring agent . Curcumin has proved nontoxic in a number of cell culture and whole animal studies . Curcumin has, however, been reported to have bactericidal effects at very high concentrations . When illuminated, curcumin exerted potent phototoxic effects in micromolar amounts . Gram-negative bacteria displayed greater resistance to curcumin phototoxicity relative to Gram-positive bacteria . Oxygen was required for curcumin phototoxicity . Curcumin binding to cells was not required for photokilling; the reactive intermediate therefore must be relatively long-lived . The mechanism(s) of curcumin phototoxicity may involve hydrogen peroxide production . Singlet excited oxygen was not detected.

J Orthop Trauma, 1989, 3(1), 1 - 5
Adjunctive use of laser Doppler flowmetry for debridement of osteomyelitis; Swiontkowski MF et al.; Laser Doppler flowmetry was used intraoperatively to differentiate viable from nonviable bone during the debridement of 12 cases of chronic osteomyelitis and three cases of acute bone infection following trauma . Six weeks of i.v . antibiotic therapy were directed against two cases of gram-positive and 13 cases of gram-negative bone infection . In cases of chronic infection, free muscle flaps were added for soft tissue coverage in five cases and rotational muscle flaps in four cases . At follow-up observation, of 1 to 3 years, no recurrences were seen . Laser Doppler flowmetry is an easy-to-use adjunct to the surgical debridement of bone infection.

J Med, 1989, 20(1), 97 - 105
The effect of pentoxifylline in septic shock--new pharmacologic aspects of an established drug; Schonharting MM et al.; Pentoxifylline (Trental) is a well-known vasoactive drug with proven clinical efficacy in various circulatory disorders . It improves the microcirculation due to its rheologic effects on red blood cells, platelets, and plasmatic components, resulting in a decrease of whole blood viscosity . Surprisingly, it has been found that pentoxifylline will also be of great benefit in different models of animal sepsis, including both gram positive and gram negative bacteria . In these experiments, survival rates are significantly increased in the pentoxifylline group when compared with the controls, which is paralleled by a decrease in germ counts . By different experimental approaches it could be shown that this drug interferes with pathologic granulocyte-endothelium interactions which are closely related to septic symptoms, both downregulating intravasal granulocyte hyperreactivity as well as stimulating antiaggregatory activity of the vessel endothelium . Through this way, beneficial effects of pentoxifylline may be expected in various diseases related to infection, sepsis, and shock which, however, have still to be proven in detailed clinical studies.

Acta Vet Scand, 1989, 30(2), 165 - 74
Studies on microaerophilic cocci (Stuart-Schwan cocci) isolated from summer mastitis and other pyogenic infections of cattle; Madsen M; Forty-nine strains of microaerophilic gram-positive cocci (Stuart-Schwan cocci) isolated from summer mastitis, "pyogenes"-mastitis, other pyogenic conditions of Danish cattle and swine, and from the sheep headfly Hydrotaea irritans were biochemically characterized with the API 50 CH and API ZYM test kit systems, and screened for production of a variety of extracellular enzymes by agar plate methods . For comparison 4 strains isolated from Swedish cases of heifer and dry cow mastitis were included in the study . Similarity calculations indicated a high degree of homogeneity within the strains studied (similarity level 92%; group mean similarity 87%) . The strains probably represent one species, although the taxonomic position of the organism remains unclear . The biochemical feature of the strains studied were very similar for strains isolated from cases of summer mastitis and strains from other sources of origin . It is suggested that the Stuart-Schwan coccus occurs as a natural cohabitant to Actinomyces pyogenes, Peptostreptococcus indolicus and the anaerobic organism characteristic of the bacterial complex isolated from summer mastitis and similar pyogenic conditions in ruminants and swine.

Nephrol Dial Transplant, 1989, 4(7), 635 - 9
Pharmacokinetics of vancomycin in patients undergoing haemodialysis and haemofiltration; De Bock V et al.; Vancomycin is widely used for the treatment of infections with Gram-positive bacteria in patients with end-stage renal disease . The concentration of vancomycin in serum, in ultrafiltrate, and in dialysate was measured during nine haemofiltration and seven haemodialysis procedures with high-permeability membranes . The t1/2 of vancomycin was 101 +/- 19 h in the interdialytic and interhaemofiltration period . There was no significant difference between the haemodialysis clearance (55.2 +/- 18.5 ml/min) and the haemofiltration clearance (66.8 +/- 13.6 ml/min) . The redistribution phenomenon was about 25% in the post haemofiltration period and only 10% in the post haemodialysis period . Approximately 270 mg of vancomycin was recovered in dialysate or ultrafiltrate . With high-permeability membranes more commonly used in patients with end-stage renal disease, continuous monitoring of vancomycin therapy is recommended.

Arch Microbiol, 1989, 151(5), 399 - 406
Enrichment and isolation of Acetitomaculum ruminis, gen . nov., sp . nov.: acetogenic bacteria from the bovine rumen; Greening RC et al.; Five strains of acetogenic bacteria were isolated by selective enrichment from the rumen of a mature Hereford crossbred steer fed a typical high forage diet . Suspensions of rumen bacteria, prepared from contents collected 7 h postfeeding, blended and strained through cheesecloth, were incubated in a minimal medium containing 10% clarified rumen fluid under either H2:CO2 (80:20) or N2:CO2 (80:20) headspace atmosphere . The selection criterion was an increment of acetate in the enrichments incubated under H2:CO2 . Periodically, the enrichment broths were plated onto agar media and presumed acetogenic bacteria subsequently were screened for acetate production . Selected acetogenic bacteria utilized a pressurized atmosphere of H2:CO2 to form acetate in quantities 2 to 8-fold higher than when grown under N2:CO2 . All presumptive acetogenic isolates were derived from either the 10(-7) or 10(-8) dilutions of rumen contents . All 5 strains were Gram-positive rods, and all utilized formate, glucose and CO . One strain required, and all were stimulated by, rumen fluid . No spores were observed with phase-contrast microscopy and two strains were motile . No methane was detected in the headspace of pure cultures grown under either gas phase . The isolation of these bacteria indicates that acetogenic bacteria are inhabitants of the rumen of the bovine fed a typical diet and suggests that they may be participants in the utilization of hydrogen in the rumen ecosystem . Strain 139B (= ATCC 43876) is named Acetitomaculum ruminis gen . nov., sp . nov . and is the type strain of this new species.

J Med Chem, 1989 Jan, 32(1), 151 - 60
Synthesis and activity of nonhydrolyzable pseudomonic acid analogues; Klein LL et al.; Several series of pseudomonic acid analogues have been prepared that incorporate modified functionalities in place of the C1-C3 alpha,beta-unsaturated ester group . The inhibition of isoleucyl-tRNA synthetase and the in vitro activity of these compounds against various Gram-positive and Gram-negative strains are described . Several derivatives showed enzyme inhibition equivalent to or better than that of methyl pseudomonate (3), while lacking the hydrolyzable ester group at C1 . These analogues include the corresponding phenyl ketone and the ether 12 . The long-chain ketone 24 exhibited similar in vitro activity as the parent ester.

Jpn J Antibiot, 1988 Dec, 41(12), 1863 - 73
{Clinical studies in sultamicillin fine granule in the field of pediatrics}; Sato Y et al.; Clinical studies were carried out on sultamicillin (SBTPC) fine granule in the field of pediatrics . The results obtained are summarized below . 1 . Thirty children with bacterial infections were treated with SBTPC fine granule . The clinical results were excellent in 24 and good in 5, with an efficacy rate of 96.7% . 2 . Bacteriological screening identified 26 pathogenic organisms of which 14 were Gram-positive cocci and 12 Gram-negative rods . Eradication rates were 91.7% in Gram-positive cocci and 66.7% in Gram-negative rods . 3 . As side effects, diarrhea was observed in 12.9%, loose stool in 16.1% and eosinophilia in 3.2% of the patients . From the above results, it appeared that SBTPC fine granule was a useful drug for treating bacterial infections in the field of pediatrics.

Chemioterapia, 1988 Dec, 7(6), 382 - 6
Effects of orally administered activated charcoal on ciprofloxacin pharmacokinetics in healthy volunteers; Torre D et al.; Ciprofloxacin is a broad-spectrum antibiotic orally active against both gram-positive and gram-negative bacteria . Recent literature indicates that orally administered activated charcoal can alter the bioavailability of many drugs and in vitro studies have demonstrated an interaction with ciprofloxacin . To evaluate in vivo the effects of activated charcoal on ciprofloxacin pharmacokinetics, six healthy volunteers received, according to a cross-over design, either ciprofloxacin 500 mg alone or concomitantly 1 g activated charcoal . The coadministration of the latter drug did not influence any of the considered pharmacokinetic parameters . Activated charcoal at a clinically effective dose, therapeutically used in gaseousness, does not alter ciprofloxacin pharmacokinetics.

Artif Organs, 1988 Dec, 12(6), 482 - 3
Cefoperazone in the treatment of peritonitis in continuous ambulatory peritoneal dialysis patients; Leehey DJ et al.; Cefoperazone is a third-generation cephalosporin that is active against a broad spectrum of gram-positive and gram-negative bacteria . We added this antibiotic to peritoneal dialysis solution at a concentration of 62.5 mg/L to treat peritonitis in six continuous ambulatory peritoneal dialysis (CAPD) patients . Serum drug concentrations were obtained at 0, 0.5, 1, 2, 4, and 24 h after instituting antibiotic therapy . Rapid uptake by blood of the antibiotic across the peritoneal membrane occurred when the latter was inflamed . Adequate bactericidal serum levels for many bacteria were obtained in less than 4 h . Cefoperazone effectively eradicated peritonitis in all patients.

EMBO J, 1988 Dec 1, 7(12), 3963 - 70
A mycoplasma high-affinity transport system and the in vitro invasiveness of mouse sarcoma cells; Dudler R et al.; FS9 mouse sarcoma cells were previously shown to be highly invasive when confronted with chicken heart fibroblasts using Abercrombie's confronted explant technique . This invasion could be inhibited by addition to the assay of Fab fragments of a monoclonal antibody directed against p37, a protein associated with the surface of FS9 cells . We have cloned and sequenced the gene for p37 . We show that it originates from Mycoplasma hyorhinis and that UGA is a tryptophan codon in this organism . We present evidence that the p37 gene is part of an operon encoding two additional proteins which are highly similar to components of the periplasmic binding-protein-dependent transport systems of Gram-negative bacteria, and we suggest that p37 is part of a homologous, high-affinity transport system in M . hyorhinis, a Gram-positive bacterium . We discuss the influence of p37 and M . hyorhinis on contact inhibition of locomotion of mammalian cells.

Am J Surg, 1988 Dec, 156(6), 529 - 32
Management of refractory empyema with early decortication; Muskett A et al.; One hundred consecutive patients underwent surgical procedures for empyema . Sixty-six patient acquired empyema from pneumonia, 16 from trauma, 11 from abdominal sepsis, and 7 from other causes . If tube thoracostomy failed, computerized tomography and ultrasonography were used to demonstrate a loculated empyema . After a median observation period of 11 days, 91 patients underwent thoracotomy and decortication and 9 patients underwent either rib resection, an Eloesser flap procedure, or both . The mortality rate was 6 percent 30 days postoperatively, the in-hospital mortality rate was 9 percent, and the overall morbidity rate was 17 percent . An excellent result was achieved in 85 percent of the patients with a recurrence rate of 4 percent . Gram-positive aerobes were the most common organisms cultured, but several opportunistic infections were encountered . We have concluded that early thoracotomy and decortication of empyema results in eradication of difficult pleural infections with hospital stays of an acceptable length and reasonably low morbidity and mortality rates.

Eur J Clin Microbiol Infect Dis, 1988 Dec, 7(6), 753 - 7
Mouse model for evaluation of antibiotic treatment of acute and chronic infections; Renneberg J et al.; A thread model is presented which enables the simultaneous evaluation of bactericidal rate and antibiotic concentration at the site of infection in mice . Ampicillin and netilmicin were tested against both gram-positive and gram-negative bacteria . With the doses tested there was substantial drug penetration into the site of infection immediately after initiation of infection (day 0), whereas the drug penetration on days 2 and 6 of infection was delayed and reduced . On day 0 of infection there was significant bactericidal effect, but little or no effect could be demonstrated on days 2 and 6 of infection, even though drug concentrations close to the MBC values for several drug/bacteria combinations were reached . The model reflects the treatment situations for the acute and the chronic infection and may be of help in evaluating the efficacy of the drug at the site of infection.

Z Hautkr, 1988 Nov 15, 63(11), 958 - 65
{Etiology of pathogen-induced changes between the toes in patients working under moist conditions}; Grunder K et al.; Referring to recent studies, we discuss the epidemiology of tinea pedis and its position within the range of polyetiological foot infections caused by microbial agents . 201 industrial workers used to wear rubber boots because of moist working conditions were examined with regard to their feet . 107 of them showed clinically altered toe web; in 45 cases, we found ringworm infection (22.4%), in correlation to increased daily wearing time of rubber boots . 85 workers showed colonization of pathogenic bacteria (42.4%), especially gram-negative species (25.8%) . Frequently, mixed infections were found . The clinical picture not always allows definite conclusions as to the causal agents . The symptom "maceration" is seen in each of the 3 pathogenic groups of germs (fungi, gram-positive pathogenic cocci, gram-negative bacteria), frequently in bacterial foot infections, especially gram-negative infections . Marked clinical symptoms involve increased infection rates . The predisposing factors to foot infection such as interdigital maceration and the promoting role of rubber boots have been confirmed . The final diagnosis is to be reassured by cultural investigations, in order to set up a specific treatment.

J Forensic Sci, 1988 Nov, 33(6), 1369 - 78
Development of a radioimmunoassay technique for the detection of human hemoglobin in dried bloodstains; Quarino L et al.; A sensitive radioimmunoassay for the detection of human hemoglobin in dried bloodstains for the purpose of forensic science species identification has been developed . Bloodstains from 13 animal species were tested and found to be negative for human blood . A minimum volume of 0.8 microL of fresh blood is required to produce sufficient stain for successful testing . Bloodstains prepared from newborn and sickle-cell bloods were determined to be human . Bloodstains ranging in age from 1 month to 6 years which had been maintained desiccated at 20 to 25 degrees C were also successfully tested . Positive results were obtained on human bloodstains stored at 24 degrees C with relative humidity ranging from 0 to 98% for a period of 3 weeks . Absolute counts per minute (CPM) decreased with increased humidity . Human bloodstains exposed to bacterial contamination (gram positive or negative species) under humid conditions for 2 weeks also tested positive . Bacterial contamination caused a decrease in CPM, but insufficient to result in an erroneous conclusion as to species of origin . Positive results were also obtained on human bloodstains stored for 6 weeks at various temperatures ranging from -16 to 37 degrees C . No significant decreases in CPM were noted for any of the temperature conditions described.

J Antibiot (Tokyo), 1988 Nov, 41(11), 1552 - 60
Metabolites of microorganisms . 248 . Synthetic analogs of saphenamycin; Bahnmuller U et al.; A synthesis of racemie saphenic acid is described . From this acid 9 ester derivatives of saphenamycin were prepared . Those with aromatic acid components showed high activity against many Gram-positive and some Gram-negative bacteria . Of the esters with aliphatic acid moieties only the acetate and, to a lesser extent, the butyrate showed considerable anti-bacterial activities, whereas esters with higher fatty acids showed strongly reduced, if any, activities against some test organisms . Similar results were obtained with ID50 values against the eucaryotic tumor cell line CCRF/CEM . The salicylate, which is structurally similar to saphenamycin, was most active.

Am J Dis Child, 1988 Nov, 142(11), 1158 - 60
Polymicrobial bacteremia in children . An 11-year experience; Bonadio WA; The clinical records of all patients with blood cultures positive for a bacterial pathogen were retrospectively examined during an 11-year period to determine the rate of and clinical features associated with polymicrobial bacteremia . During this period, bacteria were isolated in 6302 blood cultures . Of these cultures, 38 instances (0.6%) of polymicrobial bacteremia occurred in 38 patients . In 37 patients (97%), an underlying condition was identified that was considered a predisposing factor for polymicrobial bacteremia--18 patients (42%) had lesions of the gastrointestinal tract, 13 patients (34%) had an indwelling central venous catheter, nine patients (24%) had a malignant neoplasm or were receiving chemotherapy, and nine patients (24%) had neutropenia . A total of 98 pathogenic organisms were isolated; 52 were gram-negative and 46 were gram-positive, and 18 patients (47%) had more than two organisms isolated . Polymicrobial bacteremia was usually clinically indistinguishable from monomicrobial septicemia . Overall mortality was 32% . Polymicrobial bacteremia continues to be a rare, but serious, infectious disease that usually affects children with underlying medical problems and is associated with a high rate of mortality.

Vet Clin North Am Small Anim Pract, 1988 Nov, 18(6), 1267 - 85
Therapy of gram-positive bacterial infections; Papich MG; This article considers the important features of gram-positive bacteria that relate to chemotherapy and the clinical pharmacology of the drugs of choice for treating these infections.

Presse Med, 1988 Oct 26, 17(37), 1971 - 3
{Ceftazidime after bone marrow graft . Current aspects}; Blaise D et al.; The aplasia which follows bone marrow transplantation is extremely deep and characterized by disruption of all cutaneous and mucosal barriers and by major immunodepression . It is complicated in 30 to 40 per cent of the cases by septicaemia usually caused by Gram-positive organisms . Because the natural defence mechanisms have been suppressed an empirical broad-spectrum antibiotic therapy is usually instituted before microbiological results are available, and this has proved effective in reducing the immediate mortality due to infection . However, nephrotoxic drugs such as cyclosporin A and amphotericin B are also used in this context, and clinicians are looking for antibiotics that have minimal noxious effect on the kidneys . Ceftazidime administered alone or combined with another antibiotic is currently being investigated from this point of view in several clinical trials.

Presse Med, 1988 Oct 26, 17(37), 1964 - 7
{Prospective and comparative study of 2 antibiotic therapy protocols in 66 febrile neutropenic patients . Ceftazidime-vancomycin versus ticarcillin-vancomycin-amikacin}; Brion JP et al.; Out of 66 febrile neutropenic patients, 33 were treated with a ceftazidime-vancomycin combination (group A) and 33 with a ticarcillin-vancomycin-amikacin combination (group B) . There was no significant difference in satisfactory results between the two groups (group A 79 per cent, group B 88 per cent), and both regimens were equally active in all febrile episodes . Reversible side-effects (renal and cutaneous toxicity) were observed in 15 per cent of the cases . Two cases of superinfection and one case of resistance occurring during treatment were noted in group B patients . At a time when Gram-positive infections are increasingly frequent among febrile neutropenic patients, the ceftazidime-vancomycin combination seems to be as effective as the ticarcillin-vancomycin-amikacin triple drug combination.

J Theor Biol, 1988 Oct 21, 134(4), 463 - 72
Partition of autolysins between the medium, the internal part of the wall, and the surface of the wall of gram-positive rods; Koch AL; Autolysins are exoenzymes formed by bacteria to aid in wall expansion and in cell division . For the Gram-positive rod, these enzymes function predominately on the periphery of the wall . As they destroy their substrate they rebind to peptidoglycan when the cell density is high . Only then is the concentration of autolysins high enough on the external surface to favor cell division and prevent the formation of chains of cells (filaments) . It is suggesting that circumstance is important for the kinetics of turnover of the wall and the splitting of the septum.

N Engl J Med, 1988 Oct 20, 319(16), 1053 - 8
Vancomycin, ticarcillin, and amikacin compared with ticarcillin-clavulanate and amikacin in the empirical treatment of febrile, neutropenic children with cancer; Shenep JL et al.; We assessed two antibiotic regimens--vancomycin, ticarcillin, and amikacin, as compared with a vancomycin placebo, ticarcillin-clavulanate, and amikacin--as initial empirical therapy for febrile, neutropenic children with cancer . In a randomized, double-blind clinical trial, the planned 10-day treatment was unsuccessful in 15 percent of the vancomycin, ticarcillin, and amikacin group (n = 53), as compared with 38 percent of the group receiving ticarcillin-clavulanate and amikacin (n = 48) (P = 0.010) . Of 10 episodes of breakthrough bacteremia, 9 (1 fatal) occurred in patients treated with ticarcillin-clavulanate and amikacin (P = 0.006) . Each of the 10 microbial isolates was a gram-positive bacterium with similar susceptibilities to vancomycin and ticarcillin-clavulanate in vitro . Both regimens were well tolerated . None of the patients had detectable renal dysfunction, but those receiving vancomycin, ticarcillin, and amikacin were more likely to have twofold increases in serum hepatic-enzyme activity . Rashes consistent with the "red-man" syndrome occurred in three patients upon the infusion of vancomycin and in three others who received a placebo . We conclude that the combination of vancomycin, ticarcillin, and amikacin is more effective than ticarcillin-clavulanate and amikacin as empirical antibiotic therapy in clinical settings in which gram-positive bacteremias are a serious problem.

Appl Environ Microbiol, 1988 Oct, 54(10), 2549 - 55
Microbial metabolism of polycyclic aromatic hydrocarbons: isolation and characterization of a pyrene-degrading bacterium; Heitkamp MA et al.; Microbiological analyses of sediments located near a point source for petrogenic chemicals resulted in the isolation of a pyrene-mineralizing bacterium . This isolate was identified as a Mycobacterium sp . on the basis of its cellular and colony morphology, gram-positive and strong acid-fast reactions, diagnostic biochemical tests, 66.6% G + C content of the DNA, and high-molecular-weight mycolic acids (C58 to C64) . The mycobacterium mineralized pyrene when grown in a mineral salts medium supplemented with nutrients but was unable to utilize pyrene as a sole source of carbon and energy . The mycobacterium grew well at 24 and 30 degrees C and minimally at 35 degrees C . No growth was observed at 5 or 42 degrees C . The mycobacterium grew well at salt concentrations up to 4% . Pyrene-induced Mycobacterium cultures mineralized 5% of the pyrene after 6 h and reached a maximum of 48% mineralization within 72 h . Treatment of induced and noninduced cultures with chloramphenicol showed that pyrene-degrading enzymes were inducible in this Mycobacterium sp . This bacterium could also mineralize other polycyclic aromatic hydrocarbons and alkyl- and nitro-substituted polycyclic aromatic hydrocarbons including naphthalene, phenanthrene, fluoranthene, 3-methylcholanthrene, 1-nitropyrene, and 6-nitrochrysene . This is the first report of a bacterium able to extensively mineralize pyrene and other polycyclic aromatic hydrocarbons containing four aromatic rings.

Am J Kidney Dis, 1988 Oct, 12(4), 304 - 6
Intraperitoneal (IP) vancomycin therapy for CAPD peritonitis--a prospective, randomized comparison of intermittent v continuous therapy; Boyce NW et al.; The use of intraperitoneal (IP) vancomycin as initial, single agent therapy for gram positive and "no organism" continuous ambulatory peritoneal dialysis (CAPD) peritonitis is described, comparing continuous and intermittent administration schedules . "Continuous" therapy consisted of an IP 1-g loading dose of vancomycin followed by 30 mg/L dialysate effluent . "Intermittent" therapy consisted of 2 IP doses of 30 mg vancomycin/kg body weight--the initial dose delivered at diagnosis and the second dose 1 week later . All patients presenting with peritonitis (n = 90) were randomized to receive either continuous or intermittent vancomycin therapy . Patients in whom gram negative organisms and fungi were identified by microscopy and culture were transferred to therapy with a more appropriate antibiotic (n = 39) . In the remainder (n = 51), CAPD peritonitis was treated solely with vancomycin (continuous, n = 21; intermittent, n = 30) . Clinical resolution was seen in all patients, requiring a mean of 3.2 days for macroscopic clearing of dialysate effluent . Recurrence of peritonitis within 1 month of cessation of therapy was unusual and did not vary between treatment protocols (4/21 v 3/30; P = NS) . There were no differences in observed side effects . Thus, IP vancomycin proved to be a useful single agent therapy for gram positive and no organism CAPD peritonitis . Therapy with two IP doses was effective and as safe as continuous IP vancomycin therapy, and therefore should replace other vancomycin administration schedules in the treatment of CAPD peritonitis.

J Med Chem, 1988 Oct, 31(10), 1993 - 7
Oral absorption of cephalosporin antibiotics . 2 . Expanded structure-activity relationships of 7-(arylacetamido)-3-substituted cephalosporins; Pfeil-Doyle J et al.; The structure-activity relationship for 7-arylacetamido cephalosporins has been extended . Modifications of the 7-aryl group led to improvements in microbiological activity against Gram-positive organisms . However, Gram-negative activity was generally much poorer than that of the lead compound 7-{(2-aminothiazol-4-yl)acetamido}-3-chloro-cephalosporanic acid (A) . Modifications of the 3-position did not significantly change the microbiological activity or spectrum . Of the compounds selected for mouse protection studies (ED50's), 7-{(benzothien-3-yl)acetamido}-3-chloro cephalosporin and A showed the best per oral to subcutaneous ED50 ratios.

Chemioterapia, 1988 Oct, 7(5), 323 - 6
Treatment of febrile episodes in neutropenic leukemic patients with the antibiotic combinations piperacillin or ceftazidime plus amikacin: results of a randomized study; Fenu S et al.; Seventy-six consecutive neutropenic patients with hematologic malignancies, admitted to the "Department of Hematology" of Rome between March and September 1986, were randomly assigned to receive either piperacillin (300 mg/kg in four divided doses) or ceftazidime (100 mg/kg in four divided doses) plus amikacin (15 mg/kg in two divided doses) whenever they developed a febrile episode (temperature greater than 38 degrees C thrice over 12 hours, not related to drugs or transfusions, or else temperature greater than 38.5 degrees C) . After 72 hours of antibiotic therapy, in case of persistent fever, piperacillin or ceftazidime was added to the ceftazidime + amikacin or piperacillin + amikacin combination, respectively . The antibiotic treatment was, however, modified according to in vitro susceptibility if a positive culture was present . Success without regimen modification was observed in both antibiotic combinations in 52.6% of cases . Considering the empiric cross of antibiotics, the response rate reached 78% . Neither toxicity nor side effects were observed in the reported groups . Considering blood isolates, we observed a greater incidence of gram-positive organisms compared with gram-negatives (28 cases vs 5 cases, 84.7% vs 15.3% respectively) . Fungal infections were documented in four cases, two in each group . Even though no statistical difference was found between the two groups as far as patients not responding to the first antibiotic combination are concerned, piperacillin seems to have had more efficacy (twelve patients responding to the addition of piperacillin vs seven patients responding to the addition of ceftazidime) . Piperacillin + amikacin seems to be as effective as ceftazidime + amikacin in the empirical therapy of febrile episodes in neutropenic patients.

J Chromatogr, 1988 Sep 23, 431(1), 1 - 15
Determination of environmental levels of peptidoglycan and lipopolysaccharide using gas chromatography with negative-ion chemical-ionization mass spectrometry utilizing bacterial amino acids and hydroxy fatty acids as biomarkers; Sonesson A et al.; D-Alanine and diaminopimelic acid originating from bacterial peptidoglycans and hydroxy fatty acids from lipopolysaccharides (endotoxins) were analysed by gas chromatography using a chiral column (Chirasil-Val as stationary phase) and selected-ion monitoring detection with negative-ion chemical-ionization mass spectrometry . The amino acids were analysed as N-heptafluorobutyryl isobutyl esters after rapid hydrolysis of peptidoglycan followed by isolation of the amino acids with disposable ion-exchange columns . Racemization of amino acid enantiomers was controlled by using deuterium chloride in the hydrolysis . The hydroxy acids were analysed as O-pentafluorobenzoyl methyl esters . Most of the bacteria present in airborne dust from a poultry confinement building were found to be Gram-positive according to the analytical chemical method whereas the Limulus amoebocyte lysate test suggested the presence of appreciable amounts of lipopolysaccharides of Gram-negative bacteria . Further studies are required to compare the utility of these two methods for determining endotoxins in complex environments.

J Antibiot (Tokyo), 1988 Sep, 41(9), 1178 - 85
Metabolic products of microorganisms . 244 . Colabomycins, new antibiotics of the manumycin group from Streptomyces griseoflavus . I . Isolation, characterization and biological properties; Grote R et al.; The yellow colabomycins A to C, three new antibiotics of the manumycin group produced by Streptomyces griseoflavus (strain Tu 2880), were detected by chemical screening . They were isolated from mycelium extracts by column chromatography on various adsorbents, followed by preparative reversed phase HPLC . The main compound, colabomycin A (1), was characterized and shown to be chiefly biologically active against Gram-positive bacteria and stem cells of murine L1210 leukemia.

J Bacteriol, 1988 Sep, 170(9), 3817 - 26
Cloning and expression in Escherichia coli of isopenicillin N synthetase genes from Streptomyces lipmanii and Aspergillus nidulans; Weigel BJ et al.; beta-Lactam antibiotics such as penicillins and cephalosporins are synthesized by a wide variety of microbes, including procaryotes and eucaryotes . Isopenicillin N synthetase catalyzes a key reaction in the biosynthetic pathway of penicillins and cephalosporins . The genes encoding this protein have previously been cloned from the filamentous fungi Cephalosporium acremonium and Penicillium chrysogenum and characterized . We have extended our analysis to the isopenicillin N synthetase genes from the fungus Aspergillus nidulans and the gram-positive procaryote Streptomyces lipmanii . The isopenicillin N synthetase genes from these organisms have been cloned and sequenced, and the proteins encoded by the open reading frames were expressed in Escherichia coli . Active isopenicillin N synthetase enzyme was recovered from extracts of E . coli cells prepared from cells containing each of the genes in expression vectors . The four isopenicillin N synthetase genes studied are closely related . Pairwise comparison of the DNA sequences showed between 62.5 and 75.7% identity; comparison of the predicted amino acid sequences showed between 53.9 and 80.6% identity . The close homology of the procaryotic and eucaryotic isopenicillin N synthetase genes suggests horizontal transfer of the genes during evolution.

J Clin Microbiol, 1988 Sep, 26(9), 1791 - 4
Semiquantitation of bacteria in sputum gram stains; Valenstein PN; In many clinical laboratories, bacteria seen in Gram-stained sputum smears are reported semiquantitatively, using a three- or four-category scale consisting of ratings such as numerous, moderate, rare, and none seen . The consistency with which these categories are assigned was evaluated by repeatedly presenting coded smears to seven experienced microbiology technologists . Technologists rated the same smear twice, pairs of smears prepared from the same specimen, and smears prepared after specimen refrigeration . Agreement was assessed with the weighted kappa test . Semiquantitation of gram-negative rods, gram-positive diplococci, and gram-positive cocci in clusters all showed poor reproducibility (kappa = 0.32, 0.34, and 0.17, respectively) . Twenty-four percent of paired ratings differed by two or more categories . Lack of reproducibility was due mainly to the inability of the technologists to render a consistent rating when viewing the same slide on separate occasions (P less than 0.001) . Variation in the rating styles of different technologists, differences between smears prepared from the same specimen, and specimen refrigeration tended to further decrease the consistency of ratings, but the reductions were not statistically significant . The quantity of potentially pathogenic bacteria in sputum smears is not estimated consistently with standard microscopy procedures and should not be reported.

Science, 1988 Aug 19, 241(4868), 959 - 61
Chromosomal gene transfer in Spiroplasma citri; Barroso G et al.; The study of resistance marker rearrangement in Spiroplasma citri mutants provides evidence of transfer of chromosomal information followed by recombination . This is the first report of such a transfer in vivo in the mollicutes--that is, in the smallest self-replicating organisms . The double-resistant phenotypes obtained are stable even without selection pressure . The mechanism of gene transfer is insensitive to deoxyribonuclease, requires contact, and possibly, areas of fusion of the cell membranes; it shares properties with the transfer by protoplast fusion in Gram-positive bacteria . The extensive degenerative evolution of mollicutes has retained, in S . citri, bacterial functions of chromosomal transfer and recombination.

Gene, 1988 Aug 15, 68(1), 119 - 38
A versatile class of positive-selection vectors based on the nonviability of palindrome-containing plasmids that allows cloning into long polylinkers; Elhai J et al.; Several families of positive-selection cloning vectors were constructed, based on the principle of palindrome nonviability first used by Hagan and Warren {Gene 19 (1982) 147-151} . Each vector, derived from either pBR322 or RSF1010 (a broad-host-range plasmid), contains a long inverted repeat (2 x 366 to 2 x 1008 bp) ending in a symmetrical polylinker . Plasmids with long palindromes are not viable in most strains of Escherichia coli and in at least one Gram-positive bacterium . These palindrome-containing vectors therefore transform such strains at a very low frequency unless a DNA fragment is cloned within the polylinker at the center of the palindrome . Transformation by plasmids lacking an insert is reduced by two to four orders of magnitude . Such vectors can be propagated in a palindrome-tolerant strain; however, long symmetrical deletions then occur within the palindrome . To suppress the resulting deletion derivatives, vectors have been constructed so that an extensive deletion would remove the selectable marker . Alternatively, the vectors can be propagated in any strain of E . coli so long as the palindrome is interrupted by a nonpalindromic DNA fragment . We also present several symmetrical polylinkers and drug-resistance cassettes within the vectors . These components can be interchanged to make new positive-selection vectors as needed, and the cassettes are useful in insertional mutagenesis as well . A general method is described to convert virtually any small or medium-sized plasmid into a positive-selection vector.

Br J Anaesth, 1988 Aug, 61(2), 231 - 2
Incidence of sinusitis in patients with nasotracheal intubation; Hansen M et al.; Sinusitis is a complication known to accompany nasotracheal intubation, but its frequency has not been well documented . Twelve patients suffering from cerebral haemorrhage or from cranial trauma and treated with mechanical ventilation were examined for radiological and bacteriological signs of sinusitis with CT-scanning, and cultures of nasal pus discharge . All patients showed radiological signs of sinusitis within 3 days after intubation . They all developed fever, six with a known focus outside the sinuses . There was an even distribution of Gram-negative and Gram-positive bacteria . It is concluded that sinusitis should be considered where fever occurs without known focus in patients with nasotracheal intubation.

J Antibiot (Tokyo), 1988 Aug, 41(8), 1085 - 92
Deacylation of A21978C, an acidic lipopeptide antibiotic complex, by Actinoplanes utahensis; Boeck LD et al.; A21978C, produced by Streptomyces roseosporus NRRL 11379, is an acidic lipopeptide antibiotic complex that inhibits Gram-positive bacteria . Individual factors of the complex possess an identical peptide core or "nucleus", and are differentiated by the distinctive fatty acid acyl group attached to the N-terminus of the nucleus . Certain members of the family Actinoplanaceae deacylated A21978C to yield the unaltered nucleus, which was then reacylated to form new analogs . Actinoplanes utahensis NRRL 12052 was the most efficient of these cultures, producing up to 500 micrograms of nucleus per ml of culture broth per hour . Eacylation was also accomplished with semi-pure and tert-butoxycarbonyl (tert-BOC)-A21978C . In the latter, the ornithine amino group was blocked to prevent formation of diacyl analogs during reacylation . The acylase was an endoenzyme present in submerged cultures of A . utahensis from less than 18 to greater than 168 hours of incubation . Whole cells suspended in phosphate buffer or entrapped in polyacrylamide gel also deacylated A21978C efficiently.

Eur J Clin Microbiol Infect Dis, 1988 Aug, 7(4), 549 - 51
In vitro activity and beta-lactamase stability of LY163892; Pelosi E et al.; Susceptibility testing of clinical isolates of several gram-negative and gram-positive species showed LY163892 to be more active than cefaclor and cephalexin . OXA-2, TEM-1, TEM-2, PSE-1, CEP-1, CARB-3 and SHV-1 beta-lactamases showed similar activity against LY163892 and cefaclor, whereas OXA-1 hydrolyzed the latter more rapidly . Organisms producing these beta-lactamases, but not TEM-2 and CEP-1, appeared to be more susceptible to LY163892 than cephalexin, although cephalexin proved to be more resistant to beta-lactamase activity . Strains producing TEM-2 and CEP-1 were resistant to LY163892, cefaclor and cephalexin.

J Hosp Infect, 1988 Aug, 12 Suppl D, 67 - 73
Treatment of human immunodeficiency virus antibody positive children with intravenous immunoglobulin; Williams PE et al.; Five human immunodeficiency virus (HIV) antibody positive children developed recurrent infections requiring multiple hospital admissions . These comprised mainly upper respiratory tract infections, otitis media, pneumonia and diarrhoea, and there was failure to thrive despite adequate antibiotic therapy . They were commenced on iv immunoglobulin (IVIG) therapy and are now relatively free of serious infections and are gaining weight . This therapy was associated with a major reduction in the hospitalization required . In HIV antibody positive children the onset of serious infections, particularly with encapsulated gram-positive organisms, should be taken as an indication for the commencement of regular iv infusions of immunoglobulin.

FEBS Lett, 1988 Jul 18, 234(2), 280 - 2
The diversity of mercury reductases among mercury-resistant bacteria; Bogdanova ES et al.; Two immunologically non-cross-reactive types of mercury reductases were found among Gram-negative and two among Gram-positive mercury-resistant environmental bacteria . Mercury reductases were further discriminated by 'spur' formation immunodiffusion tests . Immunologically indistinguishable mercury reductases were found among strains belonging to phylogenetically distant genera . This suggests a horizontal transfer of mercury resistance genes between these strains.

J Antibiot (Tokyo), 1988 Jul, 41(7), 849 - 54
BMY-28190, a novel antiviral antibiotic complex; Ohkuma H et al.; BMY-28190, an antibiotic complex active against herpes simplex virus type 1 (HSV-1) was produced by the cultured broth of Streptoalloteichus hindustanus sp . nov., a producing strain of tallysomycins A and B . The antibiotic complex was recovered from the broth with Amberlite IRC-50 resin and separated from the coproduced tallysomycins and nebramycins by a series of chromatographies . BMY-28190 exhibited weak inhibitory activity toward Gram-positive and Gram-negative bacteria and strong inhibitory activity toward HSV-1 . Structural studies disclosed that BMY-28190 is a novel complex of gamma-poly-D-alpha, gamma-diaminobutyric acids with an average MW of 5,130.

J Antibiot (Tokyo), 1988 Jul, 41(7), 835 - 42
New antibiotics SF2315A and B produced by an Excellospora sp . I . Taxonomy of the strain, isolation and characterization of antibiotics; Sasaki T et al.; Two new antibiotics SF2315A and B have been isolated from culture filtrate of an actinomycete strain, Excellospora viridilutea SF2315 . They are weakly active against Gram-positive bacteria and inhibited reverse transcriptase of avian myeloblastosis virus . Empirical molecular formula of antibiotics SF2315A and B were determined to be C19H16O5 and C19H20O6, respectively.

J Exp Med, 1988 Jul 1, 168(1), 443 - 8
C5a stimulates secretion of tumor necrosis factor from human mononuclear cells in vitro . Comparison with secretion of interleukin 1 beta and interleukin 1 alpha; Okusawa S et al.; We have demonstrated that purified C5a is a potent stimulus to human PBMC secretion of TNF-alpha, IL-1 beta, and IL-1 alpha, which proceeds in a dose-dependent fashion . At a given concentration of C5a, TNF-alpha and IL-1 beta secretion did not differ significantly; both were secreted in significantly greater quantity than IL-1 alpha . Clinical conditions such as Gram-positive and Gram-negative bacterial infections, trauma, and immune complex diseases activate complement . Through the mediation of TNF and IL-1 secreted in response to C5a, these diverse disorders can share common features of fever, coagulopathy, acute phase protein production, and disordered metabolism.

Vet Immunol Immunopathol, 1988 Jul, 19(1), 67 - 77
Immunologic aspects of German shepherd dog pyoderma (GSP); Wisselink MA et al.; In 21 dogs with clinical features of German Shepherd dog Pyoderma (GSP) parameters of the specific and aspecific immune system have been examined . Chemotaxis and killing capacities of neutrophilic leucocytes were undisturbed, whereas in skin biopsies no specific immunoglobulin or complement deposits were found with immunofluorescence . With double immunodiffusion, antibodies against Gram-positive bacteria were found . In a laser nephelometric assay significantly elevated levels of IgG, IgGab, IgGd, IgM and bacterial components, associated and non-associated with circulating immune complexes, were detected . However, no relation was found with the disease state . It is concluded that dogs with GSP are immunologically normal reactors . A bacterial hypersensitivity reaction is hypothesized as a possible initiating factor in the pathogenesis of GSP.

J Antimicrob Chemother, 1988 Jul, 22 Suppl A, 23 - 35
Activity of beta-lactamases against beta-lactams; Stratton CW; Resistance mediated by beta-lactamases is an important mechanism which has evolved in both Gram-positive and Gram-negative bacteria . There are a large number of different beta-lactamases produced by micro-organisms . Synthesis can be mediated by chromosomes, plasmids, or transposons . Enzyme kinetics for these different beta-lactamases are expressed as affinity of the enzyme for the substrate (1/Km) and rate of hydrolysis of the substrate by the enzyme (Vmax) . Such kinetics at physiological concentrations of the enzyme and substrate are important factors in determining the activity of beta-lactam agents . Other factors include the cellular location and amount of enzyme . The clinical importance of subtle differences in beta-lactamase-mediated resistance for both Gram-positive and Gram-negative bacteria is becoming apparent . Antagonism of beta-lactams by beta-lactamases becomes increasingly more important as a resistance mechanism as our knowledge and understanding of this phenomenon grows.

Br J Urol, 1988 Jul, 62(1), 85 - 7
Ureteric obstruction secondary to pelvic actinomycosis; Jackson AE et al.; PIP: With only 7 other cases reported throughout history, the incidence of ureteric obstruction is a rare complication of actinomycosis . Diagnosis of pelvic actinomycosis is generally difficult and only confirmed after histological examination . In the case of a 45-year-old caucasian woman who had been complaining of night sweats, epigastric and back pain and constipation, histological examination demonstrated the presence of actinomycosis in both the endometrium and the myometrium . Actinomyces israelli is a gram positive anaerobic parasite that alternates in form between a true bacterium and a complex fungus . The disease is often connected with the presence of a foreign body . It has been theorized that the presence of a foreign body combined with heavy anaerobic vaginal flora provides the perfect setting for actinomycotic growth . This growth is possible with all types of IUDs . Antibiotic therapy initially at a high dosage followed by prolonged oral therapy is generally recommended . However, laparotomy is needed for diagnosis and for the debulking procedure .

Am J Med Sci, 1988 Jul, 296(1), 1 - 10
Respiratory complications of cardiac transplantation; Schulman LL et al.; The authors evaluated all respiratory complications of cardiac transplantation in a 10-year study of 94 consecutive recipients . Mean follow-up time was 20 +/- 17 months . The initial 20 patients were treated with azathioprine and prednisone, while the subsequent 74 patients received cyclosporine and prednisone . In the azathioprine group, respiratory infections accounted for 24 of 60 (40%) infections . Two-thirds of the respiratory infections occurred in the first 3 postoperative months and were generally localized processes (focal pneumonitis, nodule(s), abscess, or empyema) . Gram-positive and gram-negative bacteria (8/30) and aspergillus (8/30) were the predominant pathogens . Respiratory failure occurred in 29% of infectious episodes . In the cyclosporine group, there were significantly fewer respiratory infections . There was also a reduction in the number of nonrespiratory infections; hence, the percentage of total infections due to respiratory causes, 26 of 50 (52%), was not significantly different . In contrast, however, nearly two-thirds of the respiratory infections in cyclosporine-treated patients occurred after the first 3 postoperative months, and were usually diffuse processes . Despite diffuse disease, respiratory failure was observed with similar frequency (19%) . Pneumocystis carinii (9/31) and cytomegalovirus (CMV) (7/31) were the predominant pathogens . CMV pneumonitis tended to occur earlier than that due to P . carinii (2.9 +/- 1.9 mo vs . 9.8 +/- 11.2 mo, respectively), but there was considerable overlap . In comparison with infectious processes, there were 50% fewer noninfectious respiratory complications in both groups . These were primarily pleural (46%) or thromboembolic (18%) disorders . Four of five pulmonary emboli occurred in patients with intercurrent cardiorespiratory illness, and were detected only at autopsy . The authors conclude that respiratory infections account for one-half of all infections observed in cardiac transplant recipients, despite the reduced infection rate associated with the use of cyclosporine . Furthermore, respiratory infections in cyclosporine-treated patients exhibit different clinical and etiologic features than those seen in azathioprine-treated patients . Finally, occult thromboemboli may be difficult to recognize in cardiac transplant recipients because of the high incidence of coexisting cardiorespiratory disease.

J Antibiot (Tokyo), 1988 Jul, 41(7), 908 - 15
Microbial transformation of 6-O-methylerythromycin derivatives; Sasaki J et al.; Mucor circinelloides f . griseo-cyanus IFO 4563 was found to convert 6-O-methylerythromycin A (TE-031, A-56268) to (14R)-14-hydroxy-6-O-methylerythromycin A {14R)-14-hydroxy TE-031) . The TLC and spectral data of the conversion product were perfectly identical with those of an active major metabolite of TE-031 in humans (M-5) . A related antibiotic, 6-O-methylerythromycin B (TB-010), was able to be similarly transformed to its C-14 hydroxy analogue {14R)-14-hydroxy-6-O-methylerythromycin B, (14R)-14-hydroxy TB-010) . The MICs of (14R)-14-hydroxy-6-O-methylerythromycin B against some Gram-positive bacteria were almost equal to those of 6-O-methylerythromycin B . It is suggested that the hydroxylation at C-14 of 6-O-methylerythromycins A and B scarcely reduces their in vitro activity.

Plasmid, 1988 Jul, 20(1), 33 - 41
Transformation of Mycoplasma pulmonis and Mycoplasma hyorhinis: transposition of Tn916 and formation of cointegrate structures; Dybvig K et al.; A procedure for transformation of the murine pathogen Mycoplasma pulmonis with plasmid pAM120 was developed . This plasmid replicates in Escherichia coli and contains the gram-positive transposon Tn916 . The transformation protocol also proved effective for the swine pathogen Mycoplasma hyorhinis . The tetracycline resistance determinant of Tn916 was expressed in transformed myocoplasma cells, and Tn916 was found inserted into numerous sites in the recipient chromosomes of M . pulmonis and M . hyorhinis, indicating that transposition had occurred . Interestingly, some transformants of M . pulmonis and M . hyorhinis contained cointegrate structures which apparently had a complete copy of the entire donor plasmid (pAM120) inserted into the recipient chromosome . Subsequent transposition of inserted Tn916 was observed in passaged clones of transformed M . pulmonis.

J Immunol, 1988 Jun 15, 140(12), 4180 - 6
Human monoclonal rheumatoid factor-like antibodies from CD5 (Leu-1)+ B cells are polyreactive; Nakamura M et al.; CD5+ lymphocytes constitute a major subset of the normal human B cell repertoire . We found here, by transformation with EBV and limiting dilution analysis, that the majority of CD5+ B cells from healthy subjects are committed to the production of antibodies with rheumatoid factor-like activity . By fusing the EBV-transformed cells generated from CD5+ B lymphocytes with human-mouse heterohybrid cells, we constructed continuous cell lines producing mAb . These mAb bound not only to the Fc fragment of IgG but also at varying degrees to other self-Ag, such as ssDNA, thyroglobulin, and insulin, as well as to exogenous Ag, such as tetanus toxoid, LPS from Gram-negative and polysaccharides from Gram-positive bacteria . Competitive inhibition studies revealed that although each of the mAb reacted with the Fc fragment of IgG, their functional affinities for other Ag varied by as much as 1000-fold . Our studies argue that broad polyreactivity is an inherent property of the antibodies produced by CD5+ B lymphocytes and that these antibodies may be what has been referred to as the "natural antibodies" of the serum.

Appl Environ Microbiol, 1988 Jun, 54(6), 1612 - 4
Mineralization of polycyclic aromatic hydrocarbons by a bacterium isolated from sediment below an oil field; Heitkamp MA et al.; Microbiological analyses of sediments chronically exposed to petrogenic hydrocarbons resulted in the isolation of a gram-positive, rod-shaped bacterium which mineralized naphthalene (59.5% of the original amount), phenanthrene (50.9%), fluoranthene (89.7%), pyrene (63.0%), 1-nitropyrene (12.3%), 3-methylcholanthrene (1.6%), and 6-nitrochrysene (2.0%) to carbon dioxide when grown for 2 weeks in pure culture with organic nutrients . The bacterium tolerated salt concentrations up to 4% and grew well at 24 to 30 degrees C . The use of this bacterium may be an attractive alternative to existing physicochemical methods for the remediation of polycyclic aromatic hydrocarbons in the environment.

J Antibiot (Tokyo), 1988 Jun, 41(6), 726 - 33
A83586C, a new depsipeptide antibiotic; Smitka TA et al.; A culture identified as Streptomyces karnatakensis was found to produce a novel cyclic hexadepsipeptide antibiotic designated A83586C . The structure was elucidated by X-ray crystallography, and full 1H and 13C NMR assignments are reported . The absolute configuration was confirmed by the detection of D-threonine in the acid hydrolysate of A83586C . A83586C had potent Gram-positive activity in vitro but lacked in vivo efficacy in mice.

J Antibiot (Tokyo), 1988 Jun, 41(6), 713 - 8
Isolation and characterization of katanosins A and B; Shoji J et al.; Two peptide antibiotics katanosins A and B were isolated from the culture broth of a strain related to the genus Cytophaga . These antibiotics are basic peptides soluble in aqueous alcohols . The molecular formulae C57H95N15O17 for A and C58H97N15O17 for B were indicated . The constituent amino acids of katanosin A are suggested to be Thr (1), Ser (1), Val (1), Leu (3), Arg (1) and three unusual amino acids . In katanosin B, the Val residue is replaced by Ile . Katanosins A and B are active against Gram-positive bacteria in vitro and in vivo.

Hinyokika Kiyo, 1988 Jun, 34(6), 1105 - 8
{Prostatic tissue levels of cefpiramide (CPM)}; Takata K et al.; The concentration of CPM in prostatic tissue and serum in 12 patients with benign prostatic hypertrophy was measured . One gram of CPM was injected intravenously prior to prostatectomy . One, 2, 3 and 5 hours following the administration of CPM, the mean serum level of CPM was 142, 88.2, 87.4 and 61.2 micrograms/ml, respectively, while the mean level in the prostatic tissue was 48.3, 15.1, 15.6 and 8.3 micrograms/g, respectively . The prostatic tissue level of CPM was thought to be enough to eradicate gram-negative and gram-positive bacteria in the prostate . It is presumed from our study that clinical effectiveness of CPM might be expected in the case of acute or chronic bacterial prostatitis.

Burns Incl Therm Inj, 1988 Jun, 14(3), 180 - 4
Rapid quantification of bacterial and fungal growth in burn wounds: biopsy homogenate Gram stain versus microbial culture results; Taddonio TE et al.; A prospective analysis of 370 burn wound biopsies was done to correlate Gram-stain results from biopsy homogenates with quantitative culture results . The number of bacteria seen in a total of 10 oil immersion microscope fields of Gram-stained homogenates was correlated with significant microbial growth (1 x 10(5) organisms/gram of tissue) of the same biopsy homogenate plated on trypticase soy agar . Of the biopsies examined, Gram-negative rods were present in 36.8 per cent, Gram-positive cocci in 49.7 per cent and yeast in 15.9 per cent . Mixtures of organisms were present in 24.3 per cent . When Gram stains showed one or more organisms per oil immersion microscope field, the correlation with significant microbial growth was 94.5 per cent or more . When five or more organisms were seen per field, the correlation with significant growth became 97 per cent or greater . When no organism was seen on Gram stain, the cultures grew significant numbers of organisms 19.1 per cent of the time or less . This false-negative rate was considered to be high . It is believed, however, that this method of early detection of significant burn wound microbial growth may prove to be valuable in the management of severely burned patients.

Am J Ophthalmol, 1988 May 15, 105(5), 512 - 8
Corneal infection in mucosal scarring disorders and Sjögren's syndrome; Ormerod LD et al.; We reviewed 69 episodes of microbial keratitis occurring over an 11-year period in 56 patients with a mucosal scarring disorder or Sjogren's syndrome . Gram-positive bacterial isolates were the most common cause of infection, and accounted for almost all cases in patients with Sjogren's syndrome . Trichiasis (cicatricial pemphigoid), topical corticosteroids, bandage contact lenses, and corneal surgery were the main predisposing factors in the development of the corneal infection . In patients with ocular cicatricial pemphigoid, infection was much less common after chemotherapeutic control had been achieved . Recurrent infections were relatively frequent . There was a high rate of major complications, particularly in microbial keratitis complicating Sjogren's syndrome.

J Protozool, 1988 May, 35(2), 300 - 15
Fine structure and taxonomic position of the giant amoeboid flagellate Pelomyxa palustris; Griffin JL; Specimens of Pelomyxa palustris from five collecting sites had numerous nonmotile flagella . The structures are called flagella because of morphological similarities to flagella and because P . palustris has affinities with amoeboid flagellates . Flagella were photographed on living cells and studied by transmission and scanning electron microscopy . From 64 to 742 flagella per cell were estimated from scanning electron microscopy of ten cells 204 to 1269 micron in length . The nonmotile flagella arise from basal granules which were, in one strain, surrounded by radiating electron-dense microtubules . This strain also had excess axonemal microtubules . Abundant cytoplasmic microtubules were arranged in several different patterns . In about half of the P . palustris cells in which nuclei were studied, microtubules were either apposed to the nuclear membrane in a parallel alignment (with some also radiating) or radiating from the nuclear membrane (with none parallel) . Bacteria associated with nuclei were of three characteristic types: Gram-negative rods, Gram-positive rods, and large rods . All nuclei within a given trophozoite had similar perinuclear features . Recent proposals for separation of Pelomyxa to its own phylum (based on its proposed primitive, unique nature) can not be justified . Pelomyxa is a complex, highly specialized organism adapted to live in a specific fresh-water environment . Mastigamoebid amoeboid flagellates of the genera Mastigamoeba, Mastigella, Mastigina, and possibly Dinamoeba are placed with Pelomyxa within the order Pelobiontida Page, 1976, emend., containing two families . Pelomyxidae Schulze, 1877, and Mastigamoebidae Goldschmidt, 1907.

J Antimicrob Chemother, 1988 May, 21(5), 647 - 55
A clinical, microbiological and pharmacokinetic study of ciprofloxacin plus vancomycin as initial therapy of febrile episodes in neutropenic patients; Smith GM et al.; Forty-six episodes of fever in 34 patients with neutropenia and haematological malignancy were treated empirically with a combination of ciprofloxacin and vancomycin . Improvement or temporary improvement was seen in 86% of evaluable episodes, and 75% of bacteraemias improved . There was no difference in the response rate between infections due to Gram-negative and those due to Gram-positive organisms, despite the fact that MICs for ciprofloxacin for Gram-negative organisms were generally much lower . Pharmacokinetic data were obtained from five patients while receiving iv ciprofloxacin and after conversion to the oral form of the drug . The mean plasma half life on 200 mg iv was 5.7 +/- 1.7 h and mean plasma clearance 389 ml/min . The peak serum level after 750 mg orally was 3.6 +/- 2.2 mg/l and occurred between 1 and 3 h.

J Antibiot (Tokyo), 1988 May, 41(5), 589 - 94
Isolation of a new phenazine antibiotic, DOB-41, from Pseudomonas species; Shoji J et al.; A new phenazine antibiotic, DOB-41, was isolated from the culture broth of a Pseudomonas strain . The antibiotic obtained as yellow crystals showed UV maxima at 255 nm and 370 nm . A molecular formula, C19H18N2O6, was indicated by elemental analysis and mass spectrometry . The structure was elucidated by X-ray diffraction analysis . The antibiotic exhibited inhibitory activity against Gram-positive bacteria, and antitumor effect against leukemia P388 in mice.

Pediatr Infect Dis J, 1988 May, 7(5 Suppl), S22 - 9
Infections and immunodeficiency in bone marrow transplantation; Tutschka PJ; After allogeneic bone marrow transplantation certain patterns of infectious complications emerge that follow the clinical course, are correlated to the immunobiology of transplantation and are almost predictable in their character and expression . The preparative regimen, designed to generate complete aplasia, will be associated with severe and sometimes life-threatening bacterial infections, predominantly with Gram-negative organisms derived from bowel flora, but also Gram-positive skin saprophytes . In this early aplastic phase, life-threatening viral infections are less common, consisting mainly of herpes simplex and possibly Epstein-Barr stomatitis and BK papovavirus cystitis . Systemic infections with invasive filamentous fungi are rare and are seen only when the induced aplasia is markedly prolonged . Once early marrow recovery has been achieved, systemic infections will generally disappear unless acute graft-vs.-host disease develops . This complication, which will lead to the breakdown of natural barriers such as skin and gastrointestinal epithelium and the marked impairment of all systemic defense mechanisms, can cause polymicrobial infections as well as set the stage for life-threatening viral infections . Such opportunistic viral infections, leading to either interstitial pneumonia or hemorrhagic gastroenteritis, are the major threat in the early recovery phase after engraftment has taken place . Usually caused by cytomegalovirus and rotavirus, respectively, these infections are the primary expression of the severe combined immunodeficiency post transplant, statistically associated with the presence of acute graft-vs.-host disease and amenable to immunologic manipulations . With the recovery of cellular and humoral immune function derived from transplanted donor lymphoid cells, the third phase of infectious complications is reached, covering 3 months to 2 years post grafting.(ABSTRACT TRUNCATED AT 250 WORDS)

Pathol Biol (Paris), 1988 May, 36(5), 531 - 5
{Efficacy of teicoplanin in 25 cases of severe infections caused by gram-positive cocci}; Potel G et al.; Teicoplanin was evaluated in 25 severe infections caused by Gram-positive bacteria alone {13}, in combination {9}, alone then in combination {3}, in an open study . Of 22 infections that could be evaluated, there were 18 cures and improvements (81.8%), 2 recurrence and 2 failures . Serum concentrations are unpredictable and steady after 5 days i.v . teicoplanin . Trough and peak concentrations are respectively less than 5 mg/l and less than 20 mg/l in 13 infections and higher in 9, unrelated with success or failure . A trough concentration greater than CMI and kind of infection seem deciding . The choice of the antibiotic combined with teicoplanin warrant more data.

Biochemistry, 1988 Apr 5, 27(7), 2624 - 9
A soluble enzyme activity that attaches free diaminopimelic acid to bdelloplast peptidoglycan; Araki Y et al.; An enzyme activity, responsible for the attachment of diaminopimelic acid (DAP) to bdelloplast wall peptidoglycan, was studied in an in vitro, cell-free system . Most of the activity was found in the high-speed (20000g) supernatant fraction of homogenates of bdelloplasts prepared from a culture of the intracellular bacterium Bdellovibrio bacteriovorus 109J, growing synchronously within cells of Escherichia coli . Peptidoglycan preparations obtained either from E . coli ML35 or from the walls of bdelloplasts synchronously cultured for 40 or 90 min served as the acceptors in this reaction, whereas cell wall or peptidoglycan preparations obtained from Gram-positive bacteria could not function as acceptors of DAP . The attachment activity had an apparent Km value for DAP of 10 microM; for bdelloplast peptidoglycan, it was approximately 0.43 mg/mL, which is 13 microM with respect to peptidoglycan disaccharide peptide units . DAP attachment was partially inhibited by the structural analogues lanthionine, L-ornithine, beta-aminobutyric acid, and D-serine, as well as the cell wall synthesis inhibitors penicillin G, ampicillin, and cephalexin . This enzyme activity is present only during the intracellular stage of the bdellovibrio's developmental growth cycle and may serve a stage-specific function of biochemically modifying the cell in which it grows.

Jpn J Antibiot, 1988 Apr, 41(4), 460 - 6
{A study of transfer of cefbuperazone into postoperative exudates in patients with cancer mastectomy or thyroidectomy}; Sasaki F et al.; Cefbuperazone (CBPZ) at a dose of 2 g was administered postoperatively by intravenous drip infusion to 9 patients subjected to radical mastectomy and 10 others subjected to thyroidectomy then levels of CBPZ in postoperative exudates were measured and its prophylactic effect on postoperative infections was determined . 1 . Serum CBPZ levels in the patients after cancer mastectomy and thyroidectomy on postoperative day 1 were similar to those in healthy adults . 2 . Levels of CBPZ in the postoperative exudates in patients subjected to cancer mastectomy reached a mean peak value of 66.3 micrograms/ml (range: 26.0-99.6 micrograms/ml) in 0-3 hours after administration, and the mean CBPZ level at 6 hours after administration was 33.3 micrograms/ml (range: 19.1-54.1 micrograms/ml) . 3 . As compared to the cases of cancer mastectomy, levels of CBPZ in postoperative exudates in patients subjected to thyroidectomy varied considerably from a patient to another: a mean peak level of 76.4 micrograms/ml (range: 31.3-128 micrograms/ml) appeared in 0 to 6 hours after administration . 4 . There was no correlation between CBPZ levels in the exudate and hemoglobin levels or hematocrit values . 5 . Likely because of the CBPZ administration at 4 g/day for 2 to 6 days postoperatively to 19 patients, postoperative infection was absent and no side effect attributable to this drug occurred in any of the patients . Because levels of CBPZ in postoperative exudates in patients subjected to cancer mastectomy or thyroidectomy were greater than MICs for principal Gram-positive and Gram-negative bacteria, it is likely that this drug is a useful agent for prophylaxis against postoperative infections in patients undergoing cancer mastectomy or thyroidectomy.

J Med Microbiol, 1988 Apr, 25(4), 289 - 93
Identification of gram-positive anaerobic cocci by use of systems for detecting pre-formed enzymes; Murdoch DA et al.; Two systems for detecting pre-formed enzymes, RapID ANA and a prototype system from API, were compared in a blind study for their ability to identify 69 gram-positive anaerobic cocci isolated from clinical specimens . Both systems were able to identify Peptostreptococcus anaerobius, Ps . asaccharolyticus and Ps . micros accurately without the need for further tests . The prototype API system identified all isolates of Ps . magnus correctly, but the RapId ANA system misidentified several isolates as Ps . micros . Numerous different enzyme patterns were found with the indole-negative, butyrate-producing cocci (Ps . prevotii and Ps . tetradius), suggesting that this group of organisms may be heterogeneous . We conclude that kits for detecting preformed enzymes are of considerable potential for the identification of gram-positive anaerobic cocci in clinical laboratories.

Br J Hosp Med, 1988 Apr, 39(4), 308 - 12
Vancomycin; Smyth EG et al.; Vancomycin is an important antibiotic for the treatment of severe Gram-positive infection, especially in cases with resistant organisms or when the patient is allergic to penicillin . Because of its mode of action, pharmacokinetics and side effects, close liaison with the medical microbiologist is necessary.

Ann Vasc Surg, 1988 Apr, 2(2), 193 - 5
Aneurysm of the abdominal aorta in an eighteen-month-old child; Defraigne JO et al.; We report the case of an infected aneurysm of the abdominal aorta in a 18 month-old child, discovered by routine palpation of the abdomen during hospitalization for pneumonia . Ultrasonography and arteriography showed a 6 cm aneurysm of the abdominal aorta beginning distal to the renal arteries which occluded the right common iliac artery . The aneurysm was treated by interposing a 6 mm Gore-Tex graft between the infrarenal aorta and the aortic bifurcation . Pathologic examination of the aneurysmal wall demonstrated a leukocytic infiltrate and the presence of encapsulated Gram positive organisms . Arterial aneurysms are exceedingly rare in children . Their etiology is varied: infection, connective tissue disease, trauma, inflammatory arterial disease or other rare diseases such as tuberous sclerosis, neurofibromatosis, or Behcet's disease.

J Periodontol, 1988 Apr, 59(4), 266 - 9
The in vitro effects of amine fluorides on plaque bacteria; Kay HM et al.; Forty strains of bacteria which may be isolated from subgingival plaque were tested for their in vitro susceptibility to several amine fluorides and a commercial formulation (Elmex gel) containing these compounds . The amine fluorides were active against a wide range of plaque bacteria with gram-positive strains tending to be more sensitive than gram-negatives . The minimum inhibitory concentrations ranged from 45 to 1440 micrograms/ml with approximately half of the strains being inhibited at a concentration of 130 micrograms/ml of amine fluoride . The Elmex gel had a bactericidal effect on all of the strains tested and exhibited a rapid killing action at high dilutions . These in vitro findings suggest that amine fluorides may be useful in the treatment or prophylaxis of plaque-related diseases.

Can J Microbiol, 1988 Apr, 34(4), 526 - 35
Aspects of plasmid F maintenance in Escherichia coli; Kline BC; A major class of replicons in procaryotes is typified by low copy number, nonrandom intracellular distribution, and stable inheritance . Included in this class are chromosomes of gram-positive and gram-negative bacteria as well as a number of plasmids from these organisms . Replicons in this major class have remarkable structural and functional similarities in the genes that effect and control replication . In the present work a review of plasmid F is presented as a paradigm for many aspects of this group's maintenance features.

Biochim Biophys Acta, 1988 Mar 31, 949(3), 288 - 96
Beta-lactamase genes of Streptomyces badius, Streptomyces cacaoi and Streptomyces fradiae: cloning and expression in Streptomyces lividans; Jaurin B et al.; Genes encoding extracellular beta-lactamases (EC 3.5.2.6) of Gram-positive Streptomyces badius, Streptomyces cacaoi and Streptomyces fradiae have been cloned into Streptomyces lividans . The beta-lactamase gene of S . badius was initially isolated on a 7 kb BamHI fragment and further located on a 1300 bp DNA segment . An 11 kb BamHI fragment was isolated encompassing the S . cacaoi beta-lactamase gene, which was subcloned to a 1250 bp DNA fragment . The beta-lactamase gene of S . fradiae was cloned on an 8 kb BamHI fragment and mapped to a 4 kb DNA segment . Each of the three BamHI fragments encompassing the beta-lactamase genes hybridized to a BamHI fragment of the corresponding size in chromosomal DNA from the respective strain used for cloning . The activities of the three beta-lactamases were predominantly found to be extracellular in the S . lividans recombinants . The S . badius and S . cacaoi beta-lactamases exhibited a 10-100-times lower activity in S . lividans, whereas the S . fradiae beta-lactamase showed an approximately 10-fold higher activity in the cloned state, compared with the activities found in the original strains.

Vestn Khir Im I I Grek, 1988 Mar, 140(3), 71 - 3
{Use of urea in the treatment of patients with suppurative diseases of the lungs and pleura}; Kolos AI et al.; Under analysis were results of treatment of 96 patients with suppurative diseases of the lungs and pleura . The 30% solution of urea was locally used in 59 patients as pleural punctures, introduction of the solution through drains into the purulent cavity by dropping irrigation of bronchi and tamponage of open purulent cavities . Gram-positive microorganisms were found to die in the 30% solution of urea within 30 min.--3 h, gram-negative ones--within 30 min.--1 h . The introduction of urea directly into the purulent infection focus against the background of general therapy allowed to quickly block the acute phase of the suppurative process, to prepare the patients to planned operations and to reduce the amount of postoperative complications as compared with a control group of patients who were treated by routine local antiseptic drugs.

Appl Environ Microbiol, 1988 Mar, 54(3), 822 - 3
Lactic acid concentration as an indicator of acceptability in refrigerated or freeze-thawed ground beef; Nassos PS et al.; Lactic acid concentrations increased in refrigerated and freeze-thawed anaerobically stored ground beef . Bacterial counts were higher in refrigerated samples, but the ratios of gram-positive bacteria in refrigerated and freeze-thawed samples were the same . No differences in appearance or odor between refrigerated and freeze-thawed samples were noted after 2 days of aerobic storage . Initial lactic acid concentration can be used to predict the shelf life of frozen beef.

J Antibiot (Tokyo), 1988 Mar, 41(3), 316 - 31
cis-Halovinylthioacetamido side chain, a new effective structural element for 7 beta-substitution in cephem and oxacephem antibiotics . I . 7 beta-cis-Chlorovinylthioacetamino-7 alpha-methoxy-1-oxacephems; Nishitani Y et al.; The synthesis and in vitro activity of 7 beta-(substituted vinylthioacetamido)-1-oxacephem antibiotics are described . The compounds having a cis-chlorovinylthioacetamido group at C-7 showed high activity against Gram-positive as well as Gram-negative bacteria . The most interesting compound of the series was 51 I because of its high activity and high plasma level in mice.

Int J Dermatol, 1988 Mar, 27(2), 131 - 3
Treatment of cutaneous infections . Worldwide experience with ciprofloxacin; Parish LC et al.; Oral ciprofloxacin, a new fluorinated 4-quinolone, was evaluated in 795 patients with skin and skin structure infections . Ninety-four point one percent of the patients treated had clinical success with eradication of almost all of the offending bacteria . Ciprofloxacin has good activity against gram-positive organisms and excellent activity against gram-negative organisms . Side effects were few and not considered significant.

Ann Clin Lab Sci, 1988 Mar-Apr, 18(2), 102 - 8
Review of selected bacterial enterotoxins and their role in gastroenteritis; Harris RC; The study of enterotoxins began in earnest approximately 30 years ago with characterization of the cholera toxin . So far, more enterotoxins have been associated with Gram-negative rather than Gram-positive bacteria . These substances can be roughly divided into the cytotonic variety, which primarily interfere with intestinal cell metabolism, and those which are cytotoxic, responsible for cell destruction . Most cytotonic enterotoxins activate cyclic adenosine monophosphate (cAMP) or cyclic guanosine monophosphate (cGMP) producing watery diarrhea, resulting from fluid and electrolyte flux . This typically results after binding to a toxin-specific receptor site on the small intestinal epithelium . Cytotoxic enterotoxins may interfere with protein synthesis in cells of the colonic epithelium and cause bloody, sometimes fatal dysentery . As more enterotoxins are discovered, it is becoming apparent that such variables as anatomic site and mode of action may not, in fact, be definitive criteria for classifying these substances . As a result, no universally acceptable classification scheme has yet been devised . Moreover, the biochemical and physiological characteristics of many enterotoxins and their role in gastroenteritis and other disorders remain speculative.

Pediatr Infect Dis J, 1988 Mar, 7(3), 165 - 70
Ceftazidime with or without vancomycin vs . cephalothin, carbenicillin and gentamicin as the initial therapy of the febrile neutropenic pediatric cancer patient; Granowetter L et al.; In a 28-month randomized trial we compared ceftazidime (CAZ), an extended spectrum cephalosporin, with cephalothin, carbenicillin and gentamicin (KCG) as empiric therapy for febrile neutropenic pediatric cancer patients . Because of the occurrence of ceftazidime-resistant Gram-positive primary infections, vancomycin was added to CAZ after the first year of study . Of 206 evaluable episodes 76 (37%) were documented infections including 20 bacteremias; 130 (63%) episodes were caused by fever of unknown origin . The number of complete responses to initial therapy in patients with documented infections did not differ among regimens: 26 of 43 (61%) for KCG, 9 of 16 (56%) for ceftazidime and 8 of 16 (50%) for CAZ + vancomycin (not significant) . In patients with fever of unknown origin, response without modification of the initial regimen was 52 of 62 (84%) in the KCG arm, 32 of 40 (80%) on CAZ and 23 of 29 (80%) in patients treated with CAZ + vancomycin (not significant) . Modifications of the regimen were similar among all three groups and were due primarily to the use of empiric antifungal or antiviral therapy and to empiric treatment of interstitial pneumonia . Hypokalemia occurred in 25 of 105 patients treated with KCG and in 4 of 101 treated with CAZ or CAZ + vancomycin (P less than 0.001) . No differences between the efficacy of KCG, CAZ and CAZ + vancomycin as initial empiric therapy were demonstrated.

Appl Environ Microbiol, 1988 Mar, 54(3), 768 - 71
Isolation and characterization of "Methanosphaera cuniculi" sp . nov; Biavati B et al.; A nonmotile, gram-positive, spherical organism was isolated from the intestinal tracts of rabbits . Both hydrogen and methanol were required for growth . No methane was produced from hydrogen-carbon dioxide, formate, acetate, methylamines, ethanol, or isopropanol . The optimum pH was 6.8, and the optimum temperature was 35 to 40 degrees C . The DNA G+C content is 23 mol% . The pseudomurein cell wall contained serine . These characteristics and the immunological fingerprinting results are consistent with its placement in the genus Methanosphaera as a new species.

Drug Intell Clin Pharm, 1988 Mar, 22(3), 218 - 26
Teicoplanin: a new glycopeptide antibiotic complex; Babul N et al.; The chemistry, microbiology, pharmacokinetics, clinical efficacy, and adverse effect profile of teicoplanin are reviewed and, where appropriate, compared with vancomycin . Teicoplanin is a glycopeptide antibiotic with potent bactericidal activity against a wide variety of aerobic and anaerobic gram-positive bacteria . In contrast to the structurally related vancomycin, teicoplanin has a prolonged elimination half-life of approximately 60 hours and it may be safely administered by the intramuscular route . Adverse effects of teicoplanin include ototoxicity, nephrotoxicity, skin rash, eosinophilia, neutropenia, and transient elevation of serum aminotransferases . Teicoplanin may be beneficial as an alternative to vancomycin for patients with poor vascular access and in those requiring long-term outpatient therapy . The role of teicoplanin in the treatment and prophylaxis of gram-positive infections will ultimately depend on its unfolding safety and efficacy profile.

Can J Microbiol, 1988 Feb, 34(2), 101 - 6
Isolation and partial characterization of a bacteriophage active on Hyphomicrobium sp . WI-926; Preissner WC et al.; Isolation of a Hyphomicrobium phage from raw sewage from Athens, Ohio, was achieved by a combination of differential centrifugation, filtration, enrichment in mixed Hyphomicrobium cultures, and purification on individual host strains by subculturing single plaques in soft agar overlayers . Enrichments with water from Lake Erie and Lake Beechwood (Ohio) were unsuccessful . Out of 21 Hyphomicrobium strains and 22 other Gram-negative and Gram-positive bacteria tested, only Hyphomicrobium WI-926 (isolated from a German forest pond) was susceptible . This phage had an isometric head (diameter between opposite apices, 67 nm) and a short (12 nm), noncontractile tail and belongs thus to the morphogroup C1 . It contained double-stranded DNA . The single-step growth curve showed a latent period of 9 h, a rise period of 6 h, and a burst size of 35 . The various differentiation stages in the host development exhibited different affinities for phage adsorption and development . While all stages allowed phage adsorption, the daughter cells were most efficient . Phage multiplication was limited to daughter cells, and the development of infected swarmer cells was arrested permanently at this stage.

Pharmazie, 1988 Feb, 43(2), 80 - 1
Synthesis and reactions of some delta beta,gamma-butenolides with a study of their biological activity; el-Kousy SM et al.; alpha-(2-Thienylidene)-gamma-aryl-delta beta,gamma-butenolides 1 are prepared by condensing thiophene-2-aldehyde with beta-aroylpropionic acids in sodium acetate-acetic anhydride mixture . The butenolides react with ammonia in ethanol to give the corresponding 5-oxo-2-pyrrolines 2 . Hydrazine hydrate reacts with the butenolides 1 with the formation of the corresponding acrylic acid hydrazides 3 . Ring closure of the latter hydrazides with hydrochloric/acetic acid mixture gives the pyridazinones 4 . The biological activity of the synthesized compounds is tested against bacterial and yeast strains . The butenolides 1 and the oxopyrrolines 2 inhibit the growth of yeast and gram-negative strain . The hydrazides 3 and the pyridazinones 4 are effective on gram-positive strains.

Jpn J Antibiot, 1988 Feb, 41(2), 210 - 5
{A study on ceftriaxone in the perinatal period}; Takase Z et al.; Ceftriaxone (CTRX), a new cephem antibiotic with high activity against Gram-positive and Gram-negative bacteria, was investigated pharmacokinetically in 30 mothers in the perinatal period . The obtained results are summarized below . 1 . The maximum CTRX level in the maternal serum was 135 micrograms/ml between 20 and 25 minutes after an intravenous administration of 1 g of CTRX . 2 . The transfer of CTRX into the umbilical cord serum and the amniotic fluid was very good . CTRX levels in these fluids were about 20% and 10% of the maternal serum level, respectively . 3 . No side effect was observed in mothers or neonates . 4 . CTRX is a useful antibiotic for perinatal infections.

Appl Environ Microbiol, 1988 Feb, 54(2), 619 - 21
Isolation and identification of a morpholine-degrading bacterium; Cech JS et al.; A gram-positive, slowly growing rod effectively utilizing morpholine as the sole source of organic carbon, nitrogen, and energy was isolated from a mixed culture in a laboratory reactor . The strain was tentatively identified as Mycobacterium aurum . Its growth characteristics at 20 degrees C and pH 6.5 were as follows: maximum specific growth rate, 0.052 h-1; half-velocity constant, 1.3 mg/liter; and yield, 0.37 g/g . The optimum temperature and pH were 31 degrees C and 6.0, respectively.

Chemioterapia, 1988 Feb, 7(1), 29 - 32
Post-antibiotic effect induced by ofloxacin in both gram-positive and gram-negative bacteria; Reina S et al.; We estimated the relationship of Post Antibiotic Effect (PAE) induced by ofloxacin in both gram-positive and gram-negative bacteria, with the Percent Growth Rate Average (PGRA) considered on an increase of 1 log (CFUs/ml) . The results showed a good correlation between parameters (0.84, p less than 0.001), and enabled us to find out that the drug-induced effect persisted after the period of time considered in the standard procedure . Where the values of PAE are much greater, the growth curve rates were faster after the apparent termination of the phenomenon.

J Antimicrob Chemother, 1988 Feb, 21(2), 201 - 12
Antibiotic prophylaxis in cardiac surgery: serum and tissue levels of teicoplanin, flucloxacillin and tobramycin; Wilson AP et al.; In this study, the pharmacokinetics of teicoplanin have been studied in serum, fat and bone during and after cardiac surgery with two dose (400 and 200 mg) and three dose (400 mg each) regimens in a total of 49 patients . For comparison, 20 other patients, who had received a regimen of flucloxacillin (500 mg qds for five days) and tobramycin (1.5 mg/kg initially then 80 mg tds for three days), were similarly investigated . The lowest mean serum level of teicoplanin during operation was 6.9 mg/l in the two dose regimen and 9.7 mg/l with the three dose regimen . Mean serum levels of flucloxacillin and tobramycin fell to 7 and 1.4 mg/l respectively by the end of operation . At the end of bypass, fat washings contained a mean of 1.2 mg/l of teicoplanin and bone washings a mean of 6.3 mg/l . Mean tobramycin levels were 0.4 and 0.9 mg/l respectively and flucloxacillin less than 1 mg/l in washings from both tissues . The low levels of teicoplanin in fat may explain an excess of Gram-positive sternal infections in the accompanying clinical trial.

Mycopathologia, 1988 Feb, 101(2), 95 - 8
Upper respiratory tract infection in mouse and rats; Nyska A et al.; Spontaneous aspergilloma in the para-nasal cavities of 2 rats, and a chronic granuloma with grains, caused by Gram-positive cocci in the maxillary sinus of a mouse, are reported.

Am J Ophthalmol, 1988 Jan 15, 105(1), 70 - 4
Postkeratoplasty crystalline deposits mimicking bacterial infectious crystalline keratopathy; Weisenthal RW et al.; Three corneal transplant patients developed white, crystalline, anterior stromal lesions in their grafts while receiving long-term topical corticosteroid therapy . A presumed diagnosis of infectious crystalline keratopathy was made in each case . However, histologic examination of the lesions failed to show gram-positive cocci . A fungal infiltrate was present in the first two patients, and calcium deposits produced the lesion in the third patient.

Nature, 1988 Jan 14, 331(6152), 187 - 90
Protein biosynthesis in organelles requires misaminoacylation of tRNA; Schon A et al.; In the course of our studies on transfer RNA involvement in chlorophyll biosynthesis, we have determined the structure of chloroplast glutamate tRNA species . Barley chloroplasts contain in addition to a tRNA(Glu) species at least two other glutamate-accepting tRNAs . We now show that the sequences of these tRNAs differ significantly: they are differentially modified forms of tRNA(Gln) (as judged by their UUG anticodon) . These mischarged Glu-tRNA(Gln) species can be converted in crude chloroplast extracts to Gln-tRNA(Gln) . This reaction requires a specific amidotransferase and glutamine or asparagine as amide donors . Aminoacylation studies show that chloroplasts, plant and animal mitochondria, as well as cyanobacteria, lack any detectable glutaminyl-tRNA synthetase activity . Therefore, the requirement for glutamine in protein synthesis in these cells and organelles is provided by the conversion of glutamate attached to an 'incorrectly' charged tRNA . A similar situation has been described for several species of Gram-positive bacteria . Thus, it appears that the occurrence of this pathway of Gln-tRNA(Gln) formation is widespread among organisms and is a function conserved during evolution . These findings raise questions about the origin of organelles and about the evolution of the mechanisms maintaining accuracy in protein biosynthesis.

Toxicon, 1988, 26(3), 293 - 300
The effects of peptidoglycan, a pyrogenic constituent of gram-positive microorganisms, on the pharmacokinetics of rifampicin; Lavicky J et al.; Pharmacokinetics of rifampicin (20 mg/kg orally or i.v.) was determined in calves and rabbits . Seven days later a model pyrogen was administered i.v . to the same animals and 1 hr later the rifampicin administration was repeated . The pharmacokinetic analysis of oral rifampicin was performed using a one-compartment open model with absorption . Intravenously administered rifampicin was analysed by a two-compartment intravascular model . Injection of peptidoglycan in pyrogenic doses led to a significant increase of orally applied rifampicin serum levels in both animal species . The i.v . administration of rifampicin had the same parameters in the control and peptidoglycan experiments . Daily pretreatment of rabbits with small doses of peptidoglycan induced tolerance to the pyrogenic effect . In tolerant animals we did not observe any changes of rifampicin serum levels . Elevated temperature alone was not responsible for observed pharmacokinetic changes leading to the increase of bioavailability of oral rifampicin since another pyrogenic substance (endotoxin) had an opposite effect on pharmacokinetics of previously tested drugs.

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