Gram positive

Prog Clin Biol Res, 1988, 272, 237 - 46
Endotoxaemia in multiple organ failure due to sepsis; Ramsay G et al.; Patients with multiple organ failure secondary to intraabdominal sepsis are often blood culture negative despite exhibiting the features of septic shock . This study examined the possible central role of endotoxin in such patients . In 15 consecutive intensive care patients with the above clinical picture endotoxin was measured by a chromogenic limulus (LAL) assay; on admission and thereafter 4 hourly . Regular blood cultures and cultures of any primary septic focus were also performed and liver function was assessed by measurement of indocyanine-green clearance from plasma (ICGC) . All 15 patients had significant endotoxaemia at least intermittently . No significant difference was observed between survivors (n = 5) and non-survivors (n = 10) in either initial or peak endotoxin levels, although the pattern of endotoxaemia differed with non-survivors exhibiting consistently high or steadily increasing levels . Of 5 patients with an intra-abdominal (I/A) septic focus only one had a positive blood culture while 5 of 10 patients with extra-abdominal (E/A) infection had positive cultures . Despite this the I/A group had higher initial and peak endotoxin levels . 3 patients with Gram-positive septicaemia had significant endotoxaemia in the absence of any gram-negative infection . Changes in ICGC appeared to be of useful prognostic significance . ICGC was significantly lower in the I/A group and in both groups there was a significant negative correlation between ICGC and the level of endotoxaemia . These results suggest that endotoxin may play a central role in the syndrome of multiple organ failure and further suggest that the endotoxin is endogenous (gut-derived) secondary to failure of hepatic filtration.

Ann Inst Pasteur Microbiol, 1988 Jan-Feb, 139(1), 33 - 44
Contribution of new cryomethods to a better knowledge of bacterial anatomy; Ryter A; Electron microscopy has largely contributed to the study of bacterial anatomy . However, as varied alterations can occur during cell preparation, at the level of cell structure and at the molecular level, it is difficult to know to what extent electron micrographs correspond to the true appearance of the living state . The recent development of cryomethods which avoid some of the alterations which may occur during conventional fixation and embedding procedures, has shed new light on bacterial anatomy . These have definitively proved that mesosomes do not exist, but are artefactual structures induced by the fixative . New features of the bacterial "nucleus" relating to its shape and fine structure appeared in thin sections of Gram-positive and Gram-negative bacteria prepared by cryosubstitution . New information has also been obtained on the cell wall structure of different bacterial species.

Am J Kidney Dis, 1988 Jan, 11(1), 63 - 5
Evaluation of an outpatient culture device in continuous ambulatory peritoneal dialysis; Rubin J et al.; From August 1983 through August 1986, we used a dipstick culture device for outpatient dialysate cultures among patients undergoing continuous ambulatory peritoneal dialysis . The device was used in 42% of 531 peritonitis episodes . In 21% of the peritonitis episodes, patients elected to be hospitalized for treatment and, therefore, did not obtain a dialysate culture . The frequency of noncompliance was 18% . All samples were received within four days of mailing . Forty percent of isolates were gram-positive organisms, 30% were gram-negative, 3% were fungal organisms, and 27% of the cultures failed to yield a growth . Aside from a greater incidence of failure to define a bacterial growth responsible for peritonitis, the spectrum of organisms was similar to culture results obtained from the patients who elected, during this same period, to be hospitalized . We believe the dipstick device may be used effectively for outpatient dialysate cultures.

Chemotherapy, 1988, 34(4), 332 - 40
Sensitivity of clinical isolates from German hospitals to amoxicillin/clavulanic acid (Augmentin) compared with other antibiotics; Focht J et al.; 17,244 pathogens isolated from clinical specimens of 24 hospitals in the Moers area (North-Rhine Westphalia, FRG) were tested in regard to their susceptibility to Augmentin (amoxicillin and clavulanic acid) . For this purpose, minimal inhibitory concentrations were determined by use of microbroth dilution technique . 80% of Gram-negative, 98% of Gram-positive and 97% of anaerobic isolates were susceptible to Augmentin (breakpoint 4 mg/l amoxicillin in the presence of 2.5 mg/l clavulanic acid) . In a second part of the study the susceptibility to Augmentin of 4.137 Gram-negative and 10.958 Gram-positive pathogens was compared to their sensitivity against benzylpenicillin, flucloxacillin, mezlocillin, erythromycin, clindamycin, fusidic acid, ampicillin, cefaclor and doxycyclin.

Br J Ophthalmol, 1988 Jan, 72(1), 55 - 61
Nocardial endophthalmitis: report of two cases studied histopathologically; Ferry AP et al.; We report two cases of nocardial endophthalmitis . Case 1 is a 66-year-old man whose left eye was enucleated about one month after onset of decreased vision . Ophthalmoscopic examination disclosed multiple choroidal masses . Six weeks before the onset of ocular manifestations he had undergone a prolonged carotid endarterectomy with intraoperative complications . The source of the ocular infection was probably exogenous . Case 2 is a 49-year-old woman who had systemic sclerosis (scleroderma) with severe pulmonary insufficiency . She had received moderate doses of corticosteroids . Seventeen months after initiation of therapy she developed ocular manifestations leading to enucleation of the eye one month later . Histopathologically, the enucleated eyes in both cases showed numerous branching, Gram-positive, filamentous organisms involving mainly the plane of Bruch's membrane and the subretinal space . The nosological and microbiological aspects of nocardiosis are reviewed.

Microbios, 1988, 55(223), 115 - 25
Ability of bacteria isolated from the hospital environment to proliferate in infusion fluids; Lamikanra A et al.; The ability of some bacteria isolated from environmental sources to grow in commonly administered infusion fluids was investigated . Infusion fluids may become contaminated with bacteria present in the environment in which they are being administered and the ability of such bacteria to proliferate within commonly used infusion fluids is therefore clinically significant . Bacteria present in the air and sink drains in wards at the Ife State Hospital were isolated, identified, and comprised fifteen Gram-positive and five Gram-negative organisms . Fourteen of the organisms obtained were introduced into sterile distilled water and five different infusion fluid preparations and were monitored over a 48 h period . It was found that, in general, Gram-positive organisms did not grow in the fluids used, while Gram-negative organisms were able to proliferate in the same fluids . Some Gram-positive organisms showed remarkable ability to remain viable in infusion fluids for more than 48 h.

Ann Rech Vet, 1988, 19(3), 175 - 80
{Aerobic and aero-anaerobic bacterial flora of the nasal cavities of lambs}; Menoueri N et al.; On the basis of bacteriological examinations carried out on 415 intranasal swabs, aerobic and aero-anaerobic respiratory microbes were studied in lambs . A great diversity of bacteria has been found (in total 35 bacterial species and genus have been identified) . This flora is characterised by the presence of gram positive cocci with a gram negative strain included in genus Moraxella and connected with Moraxella bovis species.

APMIS Suppl, 1988, 3, 101 - 3
Incidence of peritonitis, distribution of causative bacteria and outcome in continuous ambulatory peritoneal dialysis (CAPD) in Kuwait; al-Hilali N et al.; In 28 CAPD patients in Kuwait, 69 peritonitis episodes occurred in an observation period of 311 patient treatment months (1 episode per 4.5 PTM) . Microorganisms were isolated 53 times (gram-positive 34, gram-negative 17, fungi 2) . Peritonitis was the principal cause for stopping CAPD, i.e . on 9 occasions . Gram-negative and fungal peritonitis had particularly high failure rates.

Arthroscopy, 1988, 4(3), 182 - 6
Arthroscopic irrigation and debridement of infected total knee arthroplasty: report of two cases; Flood JN et al.; Various methods have been described for the treatment of the acutely infected total knee arthroplasty . These include antibiotic suppression, open debridement and irrigation, exchange arthroplasty, resection arthroplasty, arthrodesis, and amputation . A method not frequently reported is arthroscopic irrigation and debridement . Two cases of acutely infected total knee arthroplasty treated with arthroscopic irrigation and debridement are presented . In both cases there was a benign postoperative course averaging five months . Both infections were secondary to hematogenous seeding from a distant focus of infection . The patients presented within approximately 12 h after the onset of knee symptoms and were taken for arthroscopic irrigation and debridement within 12 h after presentation . Gram-positive organisms sensitive to the antibiotics being used were cultured in both . Postoperative knee function and range of motion returned rapidly and disability was minimal . At average 30-month follow-up both patients were pain free, had full activity of daily living, and had no clinical or radiographic evidence of infection . Arthroscopic irrigation and debridement appears to be an effective method of treatment in select cases of infected total knee arthroplasty.

Curr Med Res Opin, 1988, 11(2), 142 - 8
A comparison of sodium fusidate ointment and mupirocin ointment in superficial skin sepsis; Morley PA et al.; Sodium fusidate ointment and mupirocin ointment were compared in 354 patients with superficial skin sepsis . The ointments were applied 3-times daily, or once daily when covered by a dressing, and the response assessed after 6 to 8 days . Both preparations proved effective clinically with 86% of patients responding . There was no difference between the two preparations in cases of primary infection (85% to both ointments), including a sub-group with impetigo (sodium fusidate 88% and mupirocin 84%), or secondary infection (sodium fusidate 81% and mupirocin 89%) . Sodium fusidate ointment (98%) was significantly better (p less than 0.05) than mupirocin (82%) in patients with other superficial infections . Both ointments were equally effective in cases where Gram-positive, Gram-negative or mixed Gram-positive/Gram-negative bacteria were isolated . Adverse effects were reported in 1.0% of patients using sodium fusidate ointment and in 7.4% of patients using mupirocin ointment . The majority of complaints concerned the greasiness of mupirocin ointment.

Microb Pathog, 1988 Jan, 4(1), 71 - 83
Antigenic relatedness of a strongly immunogenic 65 kDA mycobacterial protein antigen with a similarly sized ubiquitous bacterial common antigen; Thole JE et al.; In gene libraries of Mycobacterium bovis BCG, Mycobacterium tuberculosis and Mycobacterium leprae recombinants were frequently found expressing an immunodominant 65 kDa protein antigen . In this study polyclonal and monoclonal antibodies against the 65 kDa antigen were found to react with a variety of different bacteria . Furthermore it is shown that the 65 kDa mycobacterial protein belongs to the family of antigens previously designated 'common antigen' due to their presence in a large variety of bacterial species . The molecular weight of this common antigen in 17 bacterial species was determined and it varied from 59 to 65 kDa . These bacteria included Gram-negative, Gram-positive and archae-bacteria, indicating that this antigen consists of members of an evolutionary well-conserved protein family . The 65 kDa protein was located in the cytoplasmic fraction of both Escherichia coli K12 and M . bovis BCG . Its function for the bacterial cell is presently unknown . The immunological relatedness of this common antigen to the MbaA protein might indicate a role in the etiology of rheumatoid arthritis, as was recently suggested for the mycobacterial 65 kDa antigen.

Infection, 1988, 16 Suppl 1, S65 - 8
Haemostasis during treatment with ciprofloxacin; Ziemen M et al.; The effects of ciprofloxacin, a new quinolone derivative with high activity on gram-negative aerobic bacteria and gram-positive cocci, on haemostasis were investigated in 11 healthy volunteers . No influence on platelet function was detectable . In some cases a slight reduction in antithrombin III activity was observed at the end of the therapy . No other changes were evident in the plasma coagulation parameters.

Folia Microbiol (Praha), 1988, 33(2), 81 - 7
Molecular properties of elongation factor Tu from Streptomyces aureofaciens and Escherichia coli; Weiser J et al.; Some molecular properties of the elongation factor Tu of protein synthesis purified in an aggregated state from gram-positive Streptomyces aureofaciens were studied and compared with those of Tu from gram-negative Escherichia coli . Electrofocussing under reducing conditions showed that the molecule of EF-Tu from S . aureofaciens has an isoelectric point shifted more to the acidic side compared with EF-Tu from E . coli . A comparison of amino acid composition revealed minor differences in the content of several amino acids in the two factors and showed that EF-Tu from S . aureofaciens contains four half-cystines per molecule . Under denaturing conditions only two mercapto groups reacted with 5,5'-dithiobis(2-nitrobenzoic acid) . Limited tryptic digestion of aggregated EF-Tu from S . aureofaciens yields six fragments: the four main fragments are of a similar size as those of the E . coli factor . All fragments detected after trypsin digestion of S . aureofaciens EF-Tu were immunologically cross-reactive with antibodies against E . coli EF-Tu . However, even after 2 h of the reaction there still remains a small part of streptomycete factor uncleaved, which documents high resistance of aggregated EF-Tu towards trypsin.

J Antimicrob Chemother, 1988 Jan, 21 Suppl A, 105 - 11
Teicoplanin in empirical combined antibiotic therapy of bacteraemias in bone marrow transplant patients; Menichetti F et al.; Teicoplanin in combination with amikacin and ceftazidime was used as empirical therapy in treating 46 febrile episodes in 34 consecutive patients undergoing allogenic bone marrow transplantation . All but four of these febrile episodes occurred in neutropenic patients and 50% of them proved to be bacteraemias (23/46) . Cure was achieved in 90% of Gram-positive bacteraemias (18/20) and in six of them teicoplanin was the only antibiotic with activity in vitro against the infecting strain . All (3/3) Gram-negative bacteraemias were cured . Central venous catheter removal was required in five patients (three tunnel infections, one exit-site infection and one thrombophlebitis) . Two failures occurred among Gram-positive bacteraemias and in one case the patient died of infection . Four instances of side effects were documented but only one was severe (hearing loss).

Dermatologica, 1988, 176(1), 29 - 38
Teicoplanin, a new antibiotic effective against gram-positive bacterial infections of the skin and soft tissues; Bochud-Gabellon I et al.; Teicoplanin is a new glycopeptide antibiotic chemically related to vancomycin with a similar bactericidal activity against aerobic and anaerobic Gram-positive bacteria but with a longer plasma elimination half-life of 40-100 h allowing a once daily parenteral administration . In an open prospective study, we treated 20 patients with skin and soft tissue infections such as erysipelas, cellulitis, folliculitis and furunculosis with a a success rate of 84% . The peak and trough serum levels of teicoplanin were above the minimal inhibitory concentrations of the bacteria isolated and the therapeutic index measured at the plateau level was between 24 and 146 . We observed a moderate increase of the transaminases in 3 patients which returned to normal at the end of treatment . We conclude that this new antibiotic, teicoplanin, is safe and effective in the treatment of skin and soft tissue infections . It can be administered once daily and is well tolerated even in long-term therapy.

J Periodontol, 1987 Dec, 58(12), 847 - 55
Bacterial penetration of the pocket tissues in juvenile/postjuvenile periodontitis after the presurgical oral hygiene phase; Liakoni H et al.; Previous ultrastructural investigations of untreated sites of both adult and juvenile periodontitis have shown bacteria within the periodontal soft tissues . In the present study biopsies of the soft tissue walls of deep pockets from seven patients with juvenile (JP) or postjuvenile periodontitis (PJP) were removed at the end of the presurgical oral hygiene phase of treatment and examined in the transmission electron microscope . Bacteria were sparse, regardless of the level of tissue breakdown, both on the surface and within the superficial layers of the epithelium, deep to the basement membrane and throughout the underlying connective tissue . Of the 140 blocks from 20 biopsies, only two revealed intratissue accumulations of microorganisms . The organisms observed were gram-positive or gram-negative and appeared to be exclusively coccoid or rod-shaped . It is suggested that the reduced tissue content of bacteria reflects the establishment of adequate oral hygiene . Evidently either the tissue content of bacteria is less than has been reported previously or the host response is able to cope with residual bacteria that have penetrated the soft tissue.

Br J Ophthalmol, 1987 Dec, 71(12), 933 - 7
Spontaneous hyphaema and corneal haemorrhage as complications of microbial keratitis; Ormerod LD et al.; Hyphaema developed spontaneously in 16 of 458 patients with microbial keratitis treated at two centres on the East and West Coasts of the United States . Chronic corneal conditions were often present, and three cases had rubeosis iridis . Inflamed iris vessels were assumed to be the source of the haemorrhage . The hyphaemas tended to persist longer than is usual, particularly when coincident with a hypopyon . Recurrent hyphaemas are reported in two patients from outside this series . Spontaneous corneal haemorrhage was seen in three cases . Subepithelial bleeding settled rapidly, but a combined midstromal and pre-Descemet's haematoma cleared more slowly . Anterior segment bleeding was significantly associated with advanced age, female sex, infection with Gram-positive organisms, and hypopyon.

Am J Surg, 1987 Dec, 154(6), 602 - 7
Peritoneal dialysis catheter sepsis: a medical and surgical dilemma; Smith JL et al.; Peritoneal dialysis remains a viable and valuable alternative to hemodialysis in selected patients; however, the development of intraperitoneal sepsis should raise serious questions as to whether a particular patient should remain with this particular mode of dialysis . Six conclusions can be drawn from this retrospective review . (1) Vancomycin appears to be the first single drug of choice, especially in cases of gram-positive peritonitis . (2) In our experience, the dialysis catheter should be removed in patients who do not demonstrate major resolution of their peritoneal sepsis by 3 to 4 days . (3) If removal of the dialysis catheter does not resolve the issue within 2 to 3 days, exploratory laparotomy should be seriously considered . (4) If fungal organisms are present, exploration and debridement of the peritoneal cavity should be carried out and the patient should be aggressively treated with systemic amphotericin . This should be undertaken early in the course of the peritonitis . (5) Patients with polycystic kidney disease may be better served by hemodialysis . (6) Patients who experience multiple septic episodes should be, when feasible, electively converted to hemodialysis or should undergo transplantation.

Chemioterapia, 1987 Dec, 6(6), 440 - 4
Amikacin plus ceftazidime versus amikacin plus piperacillin versus amikacin plus aztreonam in infections in neoplastic patients with granulocytopenia; Casali A et al.; Sixty granulocytopenic patients (granulocytes less than 1000/mm3) affected with solid tumors, previously submitted to antiblastic therapy and with infections, were treated with three antibiotic combinations: amikacin + ceftazidime, amikacin + piperacillin or amikacin + aztreonam . In 68% of the cases the infections were due to gram-negative and in the remaining 32% to gram-positive microorganisms . The results obtained with the three treatments show a slight but significant statistical difference (p less than 0.05), due to the greater efficacy of the amikacin + ceftazidime combination on gram-positive and amikacin + aztreonam on gram-negative bacteria.

J Appl Bacteriol, 1987 Dec, 63(6), 545 - 50
Use of the direct epifluorescent filter technique for the enumeration of bacterial spores; Kelly AF et al.; Heat treatment at 80 degrees C for 10 min effectively destroyed all vegetative cells (except for Gram-positive cocci) and made easier the counting of bacterial spores, which stained orange, green or rarely transparent/black with a dull green halo, in the direct epifluorescent filter technique . The numbers of both orange- or green-staining spores were lower than the plate count . A variety of physiological conditions were used to investigate the relationship of the different staining patterns with germination status . It was concluded that orange-staining spores had germinated and their number agreed with the plate count after incubation in yeast glucose broth at 30 degrees C for 4 h . This observation was unreliable, however, but it was found that a total spore count in the DEFT gave a good agreement with the plate count.

J Thorac Cardiovasc Surg, 1987 Dec, 94(6), 874 - 80
Proper donor selection for heart-lung transplantation . The Stanford experience; Harjula A et al.; Clinical cardiopulmonary transplantation is currently limited by the availability of suitable heart-lung donors . Distant graft procurement, with pretreatment, of the donor by intravenous prostaglandin E1 and cooling of the graft with pulmonary artery perfusion, is now clinically established and should increase the number of available donors . Between March 1981 and September 1986, 40 heart-lung transplantations were performed . The characteristics of the donor pool were analyzed . Gram stain of the donor tracheal aspirate revealed gram-positive bacteria in 80% and gram-negative organisms in 35% . Yeast was present on stain in 25% of the patients . Donor arterial oxygen tension was less than 100 torr inspired oxygen concentration 40%) repeatedly in one patient; this recipient died of lung failure at operation . Severe deterioration of allograft lung function was seen in 11 (27.5%) recipients . The causes of deterioration were substantial postoperative bleeding in six patients, sepsis in two, and acute rejection, poor lung function, and allograft heart failure in one patient each . HLA-A locus mismatch, poor donor alveolar-capillary gas exchange, tracheal colonization with heavy polymorphonuclear cells, and heavy bacteria and fungus resulted in increased operative mortality . Donor pretreatment with prostaglandin E1 was associated with improved survival . Recipient selection, emphasizing adequate liver function and absence of previous thoracic operation, careful surgical technique with minimal bleeding, and brief perfusion time were factors associated with improved survival . Early morbidity and mortality were principally related to recipient risk factors, and the strict criteria observed for selection of heart-lung donors were valid . The importance of appropriate recipient selection is underscored.

Scanning Microsc, 1987 Dec, 1(4), 1983 - 9
Scanning electron microscopy of black stain on human permanent teeth; Theilade J et al.; Black stain may develop on the coronal surfaces of human teeth, and this type of stain is common in the Hong Kong Chinese population . The present study was undertaken to ascertain if the deposit conforms in composition to the black stain found elsewhere, and to describe its ultrastructure using the scanning electron microscope . Gram-stained smears were made from black stain on the teeth of 11 adult Hong Kong Chinese and studied microscopically . From another 15 persons extracted teeth exhibiting black stain were obtained and fixed . Two ground sections were made from each tooth, one was stained with toluidine blue, the other was dried and prepared for scanning electron microscopy . The gram-stained smears demonstrated predominantly gram-positive filamentous microorganisms with an admixture of gram-positive cocci and rods . The ground sections revealed a deposit on the outer surface of the enamel, which was clearly divided into two distinctly different layers: an inner yellow opaque layer, and an outer layer of microorganisms . Scanning electron microscopy demonstrated that the deposit consisted entirely of microorganisms, and that in portions close to the enamel they were often obscured by a substance indicative of calcification . Thus the black stain found on the teeth of Hong Kong Chinese is similar in composition and structure to that reported to occur in other populations . The black stain is a special type of dental plaque characterized by its simple flora and its tendency to calcify.

J Infect, 1987 Nov, 15(3), 201 - 6
Endotoxaemia, fever and clinical status in immunosuppressed patients: a preliminary study; McCartney AC et al.; A prospective study was performed in order to find out whether endotoxaemia assays are clinically relevant in neutropenic patients . In a group of 10 immunocompromised patients, serial haematological, bacteriological and clinical investigations were done in parallel with serial plasma endotoxin assays . The chromogenic modification of the Limulus amoebocyte lysate (LAL) assay for endotoxin used in this study had a sensitivity of less than 10 pg endotoxin per ml plasma . It was found that endotoxaemia was associated with Gram-negative bacteraemia but infection with Gram-negative bacteria did not always produce endotoxaemia . Furthermore, infections with Gram-positive bacteria and administration of blood products may lead to raised endotoxin values . Endotoxin assays may be of value for elucidating mechanisms of fever in immunocompromised patients but it seems unlikely that routine assays of endotoxin will help in the clinical management of these patients.

J Antibiot (Tokyo), 1987 Nov, 40(11), 1530 - 40
The structure of manumycin . I . Characterization, structure elucidation and biological activity; Zeeck A et al.; Manumycin (1), produced by Streptomyces parvulus (strain Tu 64), was isolated from the mycelium by extraction with acetone and could easily be purified chromatographically . Chemical degradation of 1 (C31H38N2O7) gave 2-acetamino-3-hydroxycyclopent-2-enone (2) by acetolysis, 2,4,6-trimethyl-2,4-decadienoic acid (3) by alkaline hydrolysis, and 2-(2,4,6-trimethyl-2,4-decadienoylamino)-5,6-epoxy-1,4-benzoquinon e (5) by chromic acid oxidation . In connection with a detailed spectroscopic analysis, the structure of 1 could be elucidated and the (E)-configuration of the double bonds in the triene and diene chain was established . Manumycin exhibits biological activity against Gram-positive bacteria and fungi and furthermore, an inhibition of the developmental processes of some insects.

J Bacteriol, 1987 Nov, 169(11), 4972 - 9
Bacterial metabolism of alpha-pinene: pathway from alpha-pinene oxide to acyclic metabolites in Nocardia sp . strain P18.3; Griffiths ET et al.; Over 20 gram-positive bacteria were isolated by elective culture with (+/-)-alpha-pinene as the sole carbon source . One of these strains, Nocardia sp . strain P18.3, was selected for detailed study . alpha-Pinene-grown cells oxidized, without lag, alpha-pinene, alpha-pinene oxide (epoxide), and the cis and trans isomers of 2-methyl-5-isopropylhexa-2,5-dienal . No other tested terpene was oxidized at a significant rate . alpha-Pinene was not metabolized by cell extracts in the presence or absence of NADH or NADPH . Cell extracts catalyzed a rapid decyclization of alpha-pinene oxide, in the absence of added cofactors, with the formation of cis-2-methyl-5-isopropylhexa-2,5-dienal . Further oxidation of the aldehyde to the corresponding acid occurred in the presence of NAD . Both activities were induced by growth with alpha-pinene . A rapid, nonenzymic transformation of the cis aldehyde into the trans isomer occurred in glycine buffer . The trans isomer was also a substrate for the NAD-linked aldehyde dehydrogenase . The distribution of the alpha-pinene oxide lyase in alpha-pinene-utilizing Pseudomonas spp . was also investigated and was compatible with the two alternative ring-cleavage sequences that have been proposed on the basis of accumulated metabolites.

Clin Orthop, 1987 Nov, (224), 138 - 46
Postoperative discitis . Diagnosis and management; Dall BE et al.; Postoperative discitis (POD) continues to be a diagnostic challenge and its management remains variable . This article raises the following questions and presents new observations . What is the current role of the CT scan in POD? Is a uniform pathogen involved and is there a basis for the duration of intravenous antibiotics? What is the expected long-term functional result? In a retrospective analysis of 12 consecutive patients with POD followed for an average of 29 months (17-42 months), the CT scan was extremely sensitive in showing a pathogen was present . The CT scan was misread in over one-third of the cases . Gram-positive cocci were the only organisms cultured (10 of 13 cultures, 8 of 12 patients) . The erythrocyte sedimentation rate (ESR) invariably fell predictably to normal within 90 days when patients were treated with IV antibiotics for more than 40 days . Most patients were clinically improved and subjectively better at follow-up examination . No correlation existed between the patient's subjective result and preexisting medical conditions, the type of antibiotic, or the length of treatment, the ESR, or the follow-up roentgenograms.

Mol Gen Genet, 1987 Nov, 210(1), 23 - 32
Chromogenic identification of promoters in Streptomyces lividans by using an ampC beta-lactamase promoter-probe vector; Forsman M et al.; A promoter-probe system, based on the ampC beta-lactamase gene of Escherichia coli, has been developed for the isolation and characterization of transcriptional signals in the gram-positive bacterium Streptomyces lividans . The promoter-probe vector, denoted pJAS14, has the SLP1.2 replicon with a copy number of four-five plasmids per cell . It contains a unique BamHI site just in front of the ampC ribosome-binding site, and upstream of this BamHI site a transcriptional terminator signal that prevents readthrough transcription from plasmid-borne promoters has been inserted . Using pJAS14, we have shot-gun cloned chromosomal DNA from S . lividans and S . lavendulae into the BamHI site, and isolated a number of promoter containing DNA fragments by the use of the chromogenic cephalosporin nitrocefin . On plates, we identified promoters of varying strengths and also with differences in nutritional and temporal expression . Using liquid cultures of S . lividans, it has been demonstrated that one promoter, denoted P1 (SEP8), as well as the ampC gene of E . coli, show activity corresponding to the vegetative growth of the cells . The P1 (SEP8) promoter was shown to be expressed also in E . coli, and it initiates RNA synthesis at exactly the same nucleotides in both S . lividans and E . coli . The promoter shows good homology to the E . coli promoter consensus sequence in both the -35 and -10 regions . Thus, this promoter is a representative of the SEP (Streptomyces E . coli-type promoter) class of promoters recently described (Jaurin and Cohen 1985) . This indicates that an S . lividans RNA polymerase recognizes the same sequence determinants and chooses the point of initiation of RNA synthesis in the same way as the corresponding E . coli enzyme.

Plasmid, 1987 Nov, 18(3), 193 - 204
Nucleotide sequence of the kanamycin resistance determinant of plasmid RP4: homology to other aminoglycoside 3'-phosphotransferases; Pansegrau W et al.; The kanamycin resistance determinant of the broad-host-range plasmid RP4 encodes an aminoglycoside 3'-phosphotransferase of type I . The nucleotide sequence of the kanamycin resistance gene (Kmr) and the right end of the insertion element IS8 of plasmid RP4 has been determined . The gene (816 bp) is located between IS8 and the region (Tra 1) encoding plasmid factors mediating bacterial conjugation . Kmr and Tra 1 are transcribed toward each other . The nucleotide sequence has been compared to five related aphA genes originating from gram-negative and gram-positive organisms and from antibiotic producers . Among these that of Tn903 shares the highest degree of similarity (60%) with the RP4 gene . Significant similarities were also detected between the amino acid sequences of the six enzymes . The C-terminal domains of six different aminoglycoside 3'-phosphotransferases (APH(3'} are highly conserved . They are substantially similar to segments of a variety of enzymes using ATP as cofactor . The role of the C-terminal sequences of APH(3') as potential domains for ATP recognition and binding is discussed.

Antibiot Med Biotekhnol, 1987 Nov, 32(11), 811 - 4
{Kafamycin--a new pyrrol ether antibiotic}; Murenets NV et al.; Cafamycin is a novel polyether antibiotic active against gram-positive bacteria . It was isolated from the culture fluid of Streptomyces sp., an organism producing the anthracycline antibiotic galtamycin . The structure of cafamycin was assessed by spectral analysis: UV, PMR, mass spectroscopy and CD . Physico-chemical and biological properties of the antibiotic are described . Cafamycin was shown to be an analog of indanomycin (X-14547A), a pyrrol ether antibiotic.

J Clin Pathol, 1987 Oct, 40(10), 1235 - 9
Activation of the alternative complement pathway: clinical application of a new technique to measure fragment Ba; Senaldi G et al.; A new laser nephelometric technique for the measurement of the alternative complement pathway fragment Ba has been developed . Activation of the alternative complement pathway was assessed in 16 patients with Gram negative bacteraemia, six with Gram positive bacteraemia, 20 with rheumatoid arthritis, and 18 healthy subjects . Patients with Gram negative bacteraemia had significantly higher values of Ba (median 14.8%) than controls (9.3%) (p less than 0.01), while patients with Gram positive bacteraemia and rheumatoid arthritis had values similar to those of controls (10.1% and 9.5%) . The technique proved sensitive and precise, and is suitable for the routine laboratory evaluation of complement activation through the alternative pathway.

Am J Kidney Dis, 1987 Oct, 10(4), 300 - 5
Once weekly intraperitoneal therapy for gram-positive peritonitis; Morse GD et al.; The pharmacokinetics and clinical outcome following a 30 mg/kg/2 L intraperitoneal (IP) dose of vancomycin, which was administered once a week for 3 weeks, was studied in ten continuous ambulatory peritoneal dialysis patients with peritonitis . Vancomycin was 91% absorbed following the first dose and rapidly achieved therapeutic serum concentrations, 19 +/- 8 mcg/mL at 1 hour and a peak of 37 +/- 8 mcg/mL at 6 hours . Vancomycin was eliminated slowly with a mean total clearance of 7 +/- 3 mL/min/70 kg and a distribution volume of 1.2 +/- 0.3 L/kg . The resultant mean serum t1/2 over the first week was 184 hours and the mean serum concentration at 168 hours was 10 +/- 4 mcg/mL . Based on the positive clinical outcome (100% cure) among patients with uncomplicated gram-positive peritonitis, the potential use of this alternative vancomycin dosing regimen is proposed.

Br J Urol, 1987 Oct, 60(4), 345 - 8
Double-blind study comparing aztreonam with placebo for prophylaxis of infection following prostatic surgery; Millar MR et al.; In a prospective, randomised, double-blind study, 179 patients undergoing retropubic or transurethral prostatectomy were given pre-operatively either 1 g aztreonam or a placebo . In patients treated with aztreonam there was a significant reduction in the number with post-operative bacteriuria and in the number requiring treatment of post-operative bacteriuria . Other differences were not significant . The mean duration of post-operative hospital stay for patients receiving aztreonam was 7.1 days compared with 6.9 days for those receiving placebo . In patients treated with aztreonam there was no increase in the frequency of infections due to Gram-positive bacterial species.

Antimicrob Agents Chemother, 1987 Oct, 31(10), 1600 - 4
Pharmacokinetics of teicoplanin in critically ill patients with various degrees of renal impairment; Domart Y et al.; The pharmacokinetics of teicoplanin were studied in 15 adult patients in the acute phase of severe infections caused by gram-positive cocci . All the subjects were given a daily intravenous bolus dose of 6 mg of teicoplanin kg-1 (body weight) . The pharmacokinetic study was performed over a 48-h period after injection 4 . The subjects were categorized according to their mean creatinine clearances (ml.min-1.kg-1) during the study period: group 1 (n = 3), greater than 1.6; group 2 (n = 6), 0.8 to 1.6; and group 3 (n = 6), 0.15 to 0.8 . Mean concentrations of teicoplanin in serum at 1, 24, and 48 h were 33 +/- 8, 9 +/- 3, and 6 +/- 2.5 micrograms.ml-1, respectively . The mean half-lives of the concentration-time curve from 12 to 48 h were 28 +/- 4, 44 +/- 24, and 48 +/- 14 h in groups 1, 2, and 3, respectively (group 3 versus group 1: P less than 0.05) . The mean area under the serum concentration-time curve from time zero to 24 h was 344 +/- 92 mg.h.liter-1, and the mean hybrid volume of distribution was 1.09 +/- 0.46 liter.kg-1 . These values were similar for the three groups, with a trend for larger areas under the curve in group 3 . Creatinine clearance correlated directly with the total body clearance of teicoplanin (r = 0.70) and with the renal clearance of teicoplanin (r = 0.82) . However, in critically ill patients, the wide interindividual variations in pharmacokinetic parameters are more relevant than those related to the variations in renal function when creatinine clearance is above 0.30 ml.min-1.kg-1 . We concluded that, in such conditions, monitoring of concentrations of teicoplanin in serum is mandatory.

N Engl J Med, 1987 Sep 10, 317(11), 659 - 65
Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis . The Veterans Administration Systemic Sepsis Cooperative Study Group; Infectious crystalline keratopathy; Eye Hospital, RotterdamIn seven patients white branched crystalline opacities, which grew very slowly, were seen in the corneal stroma . They were associated with very little inflammatory activity, so that the clinical picture at first did not suggest an infectious etiology . Pathological examination, however, demonstrated colonies of bacteria between intact corneal lamellae . On bacterial examination gram-positive commensals were mainly found . All the patients described so far were found to be taking corticosteroids regularly, sometimes in combination with antibiotics . The immunosuppression brought about by corticosteroids is probably an important factor in the development of these crystalline opacities . The therapy for this infectious crystalline keratopathy is difficult and lengthy . It consists of local bactericidal antibiotics and the lowest possible dosage of corticosteroids, if necessary combined with a partial lamellar keratectomy and removal of the affected corneal tissue by fraising.

Antibiot Med Biotekhnol, 1987 Aug, 32(8), 571 - 6
{Eremomycin--a new antibiotic from the cyclic glycopeptide group}; Gauze GF et al.; Eremomycin, a novel antibiotic belonging to the group of cyclic glycopeptides is produced by an actinomycete designated INA-238 . Biosynthesis, isolation, physico-chemical and biological properties of the antibiotic are described . Eremomycin is shown to be close to vancomycin . However, by its chromatographic and electrophoretic mobility, presence of chlorine in the antibiotic molecule and optic characteristics eremomycin differs from vancomycin . Eremomycin is less toxic than vancomycin whereas its chemotherapeutic activity in treatment of infections caused by gram-positive organisms is higher.

Br J Ophthalmol, 1987 Aug, 71(8), 598 - 601
Corneal and intraocular penetration of topical and subconjunctival fusidic acid; Taylor PB et al.; Corneal tissue absorption and intraocular penetration of fusidic acid were assessed in the rabbit after topical or subconjunctival application . Corneal tissue levels of fusidic acid one hour after the last topical application of the drug were well above the minimum inhibitory concentrations (MICs) for most Gram-positive and many Gram-negative organisms . Adequate levels were achieved in the aqueous at one hour following the last topical application, but no significant levels were detected in the vitreous . The corneal tissue and aqueous levels declined at 12 and 24 hours following the last drug application, however, corneal tissue levels at 24 hours were considered to be above the MICs for most Gram-positive organisms . A single subconjunctival injection of 100 mg of fusidic acid produced levels above the MICs of most organisms in the cornea, aqueous, and vitreous which persisted over 24 hours, but subconjunctival injection of fusidic acid at this concentration resulted in conjunctival necrosis and corneal decompensation . Fusidic acid penetrates well into avascular tissue and fully penetrates corneas with both intact and debrided epithelium, as evidenced by the intracameral drug levels . Good corneal penetration and absence of known topical toxicity make fusidic acid suitable for the treatment of microbial keratitis caused by susceptible organisms.

Scand J Dent Res, 1987 Aug, 95(4), 297 - 307
Transmission electron microscopy of early microbial colonization of human enamel and root surfaces in vivo; Nyvad B et al.; This study describes the early microbial colonization of teeth by the use of light- and transmission electron microscopy . Six dental students carried a total of 60 test pieces of unerupted enamel and root surface in intraoral acrylic appliances for 4, 8, 12, 24 and 48 h, during which periods oral hygiene was abandoned . Pronounced variations were recorded in structure and thickness of the pellicle across the individual surfaces of both dental tissues . Bacterial single-cell colonization increased the electron density of the adjoining pellicle . Micro-colonies of bacteria were observed in relation to enamel surface irregularities such as perikymata, while the distribution on root surfaces appeared incidental . Root surfaces were generally colonized by thicker deposits than homologous enamel surfaces although the structural composition of the microbiota was similar . Gram-positive bacteria with thick cell walls appeared in coccoid or rod-shaped configurations depending on the age of the bacterial deposit . These bacteria were further characterized by selective invasion between collagen fibers . After 48 h the complexity of the microbiota was increased by the establishment of new bacterial species in the superficial layer . It is concluded that the pattern and composition of the early microbiota on teeth is more complex and variable than hitherto assumed.

J Gen Microbiol, 1987 Aug, 133 ( Pt 8), 2147 - 54
Enzymological features of aromatic amino acid biosynthesis reflect the phylogeny of mycoplasmas; Berry A et al.; Acholeplasma laidlawii possesses a biochemical pathway for tyrosine and phenylalanine biosynthesis, while Mycoplasma iowae and Mycoplasma gallinarum do not . The detection of 7-phospho-2-dehydro-3-deoxy-D-arabino-heptonate (DAHP) synthase (EC 4.1.2.15), dehydro-shikimate reductase (EC 1.1.1.25) and 3-enol-pyruvoylshikimate-5-phosphate synthase (EC 2.5.1.19) activities in cell-free extracts established the presence in A . laidlawii of a functional shikimate pathway . L-Phenylalanine synthesis occurs solely through the phenylpyruvate route via prephenate dehydratase (EC 4.2.1.51), no arogenate dehydratase activity being found . Although arogenate dehydrogenase was detected, L-tyrosine synthesis appears to occur mainly through the 4-hydroxyphenylpyruvate route, via prephenate dehydrogenase (EC 1.3.1.12), which utilized NAD+ as a preferred coenzyme substrate . L-Tyrosine was found to be the key regulatory molecule governing aromatic biosynthesis . DAHP synthase was feedback inhibited by L-tyrosine, but not by L-phenylalanine or L-tryptophan; L-tyrosine was a potent feedback inhibitor of prephenate dehydrogenase and an allosteric activator of prephenate dehydratase . Chorismate mutase (EC 5.4.99.5) was sensitive to product inhibition by prephenate . Prephenate dehydratase was feedback inhibited by L-phenylalanine . It was also activated by hydrophobic amino acids (L-valine, L-isoleucine and L-methionine), similar to results previously found in a number of other genera that share the Gram-positive line of phylogenetic descent . Aromatic-pathway-encoded cistrons present in saprophytic large-genome mycoplasmas may have been eliminated in the parasitic small-genome mycoplasmas.

J Int Med Res, 1987 Jul-Aug, 15(4), 245 - 50
Effects of intravenous erythromycin lactobionate in respiratory infections; Di Sciacca A et al.; The antibiotic erythromycin lactobionate given intravenously acts almost exclusively on Gram-positive bacteria . Even at high plasma and tissue concentrations there is an almost total absence of side-effects . It could be considered, therefore, as first choice in the treatment of patients with infectious respiratory diseases . Most of the 40 patients admitted to the present study were elderly and all had either acute or chronic and becoming acute respiratory disease . Their clinical symptoms and levels of phlogosis improved on treatment with erythromycin lactobionate without any interruption of therapy due to side-effects and toxicity . The absence of unfavourable pharmacological interactions further enhances the usefulness of the drug . In view of the excellent response to monotherapy with erythromycin lactobionate and the few groups of resistant bacteria found in those cases when it was possible to check, it was not considered necessary to investigate any synergistic association with other antibiotics . It can be concluded, therefore, that therapy with erythromycin lactobionate in patients with infective respiratory disease is favourable and patients show excellent tolerability.

J Antibiot (Tokyo), 1987 Jul, 40(7), 991 - 1005
Synthesis and structure-activity relationships of a new oral cephalosporin, BMY-28100 and related compounds; Naito T et al.; The synthesis and structure-activity relationships of 7-{D-alpha-amino-alpha-(4-hydroxyphenyl)-acetamido}-3-{(Z)-1-propenyl}- 3-cephem-4-carboxylic acid (BMY-28100) and its analogs in the 3- and 7-side chains are described . The 3-(substituted-propenyl) groups were introduced by the Wittig reaction of the 3-phosphoniomethyl cephems which were derived from the 3-chloromethyl derivatives . The reaction gave predominantly the cis isomer regarding the 3-side chain . The cis and trans isomers showed characteristic UV and 1H NMR spectra . Most of cephems of this series were well-absorbed orally and more active both in vitro and in vivo than cephalexin and cefaclor against Gram-positive organisms . Their Gram-negative activity varied depending on the 3- and 7-substituents . Compounds with a cis-propenyl group showed the best Gram-negative activity among the 3-alkenyl analogs prepared, whereas the D-4-hydroxyphenylglycyl and D-4-hydroxy-3-methoxyphenylglycyl substitutions in the 7-side chain were found suitable to improve the Gram-negative activity of 3-cis-propenyl series of cephalosporins to the level favorably compared with that of cefaclor . The 3,4-dihydroxyphenyl analog was found to be metabolized in vivo to the 4-hydroxy-3-methoxyphenyl derivative and, therefore, showed nearly the same in vivo activity as that of the latter . BMY-28100 was selected for further evaluation and the results will be reported in the subsequent paper.

Antimicrob Agents Chemother, 1987 Jul, 31(7), 1126 - 9
Prospective randomized clinical trial of teicoplanin for empiric combined antibiotic therapy in febrile, granulocytopenic acute leukemia patients; Del Favero A et al.; The increasing prevalence of bacteremia caused by gram-positive bacteria in granulocytopenic acute leukemia patients prompted us to evaluate, in a prospective randomized trial, the role of teicoplanin, a new glycopeptide antibiotic, when it was added to amikacin plus ceftazidime, as an empiric therapy of fever in these patients . Of 47 evaluable episodes, 22 were treated with the teicoplanin regimen and 25 were treated with the combination of amikacin and ceftazidime . The overall response to therapy of patients treated with teicoplanin was slightly better (82% improvement) than that obtained with amikacin plus ceftazidime (52%) . The response rate of patients with gram-positive bacteremias was 80% (4 of 5) to the regimen that included teicoplanin; 25% (1 of 4) of the patients treated with amikacin plus ceftazidime responded to treatment; and for patients with gram-negative bacteremias, the response rates were, respectively, 100% (4 of 4) and 70% (7 of 10) . The better results obtained with amikacin-ceftazidime-teicoplanin treatment were most evident in patients with profound (less than 100/mm3) and persistent neutropenia (83 versus 30% improvement) . Furthermore, a good response rate of patients with gram-positive bacteremias (seven of eight; 87% improvement) was achieved in a small group of bone marrow transplant patients who were all treated with amikacin-ceftazidime-teicoplanin . No severe side effects were documented in any patient . Teicoplanin, as a drug administered as a single daily dose, seems to be a safe and useful anti-gram-positive agent when used in combination with amikacin-ceftazidime as an empiric therapy of febrile episodes in granulocytopenic acute leukemia patients.

Life Sci, 1987 Jun 29, 40(26), 2543 - 50
Radiation induced gram negative bacteremia and endotoxemia in rabbits: modification by anti-lipopolysaccharide hyperimmune equine plasma; Wells MT et al.; Lethal whole body irradiation damages the gut mucosa and leads to leakage of endotoxin or lipopolysaccharides (LPS) into the systemic circulation . Sixteen rabbits, irradiated with 900 rads 60Co, were randomly divided on day 4 into 2 groups, one of which received an intraperitoneal injection of normal saline (control) and the other (experimental) an equal volume of anti-LPS hyperimmune plasma . The time course of endotoxemia and bacteremia were determined for the duration of the experiment . While rabbits in both groups died within 13 days after irradiation, rabbits given saline died on average 2 days earlier, than rabbits given anti-LPS plasma . Plasma LPS concentrations rose to a small peak on day 2 prior to treatment . Thereafter plasma LPS in rabbits given saline increased forty fold by day 9 . In contrast, in rabbits given anti-LPS plasma, LPS concentrations in the plasma remained within pretreatment limits (p 0.01) . By day 12 after irradiation, plasma anti-LPS IgG had declined to 5.8% of pretreatment levels in rabbits given saline as compared to 46% in rabbits given anti-LPS plasma (p 0.005) . Whilst both groups developed gram-positive bacteremia, rabbits given saline in addition also developed gram-negative bacteremia . No rabbits treated with Anti-LPS showed gram-negative bacteremia . Treatment with Anti-LPS plasma thus significantly protects radiated rabbits from the incidence of gram-negative bacteremia, development of high plasma LPS levels and hence endotoxemia, and prolongs survival to a certain extent.

Am J Med, 1987 Jun 26, 82(6B), 40 - 6
Norfloxacin for prevention of bacterial infections in granulocytopenic patients; Winston DJ et al.; The efficacy and safety of norfloxacin were compared with those of placebo, vancomycin-polymyxin, and trimethoprim-sulfamethoxazole (TMP/SMX) for prophylaxis of bacterial infections in granulocytopenic patients . The study results showed that norfloxacin treatment, which was well tolerated and not associated with any serious systemic adverse effects, prevented acquisition of gram-negative bacillary organisms . Fewer norfloxacin-treated patients (38 of 108 patients, or 35 percent) experienced microbiologically documented infections compared with patients receiving placebo (27 of 40 patients, or 68 percent), vancomycin-polymyxin (16 of 30 patients, or 53 percent), or TMP/SMX (14 of 28 patients, or 50 percent) . Gram-negative bacteremia developed in five of 108 norfloxacin-treated patients (5 percent), compared with 17 of 40 placebo-treated patients (43 percent), five of 30 treated with vancomycin-polymyxin (17 percent), and one of 28 patients treated with TMP/SMX (4 percent) . The incidence of gram-positive bacteremia was similar in all study groups and was not affected by norfloxacin or any other oral prophylactic antibiotics . These results suggest that norfloxacin is both safe and effective for the prevention of serious gram-negative bacillary infections in granulocytopenic patients . More effective prophylaxis of gram-positive bacterial infections, however, is needed.

J Antibiot (Tokyo), 1987 Jun, 40(6), 750 - 60
Arginomycin: production, isolation, characterization and structure; Argoudelis AD et al.; Arginomycin is a new nucleoside antibiotic produced by Streptomyces arginesis . Arginomycin, C18H28N8O5, which inhibits the growth of Gram-positive bacteria and fungi in vitro, is structurally related to blasticidin S and found to be relatively non-toxic.

J Clin Microbiol, 1987 Jun, 25(6), 996 - 1001
Rapid identification of obligately anaerobic gram-positive cocci using high-performance liquid chromatography; Harpold DJ et al.; High-performance liquid chromatography was evaluated as a rapid means of identifying obligately anaerobic gram-positive cocci of medical interest . Isolates were inoculated into a defined chemical medium consisting primarily of amino acids and were incubated aerobically for 1 h at 35 degrees C . After removal of organisms, the supernatant fluids were derivatized for 1 min at room temperature by the addition of o-phthalaldehyde . The total time required to run a chromatogram was approximately 50 min . Standardized peak heights for each medium component and any new peaks formed were calculated for each isolate and compared with those for uninoculated control medium . Multiple isolates of various species of anaerobic gram-positive cocci gave consistent patterns of medium utilization that could be used for identification purposes . This method can easily be adapted for laboratory use and has the potential for automated microbial identification.

Arch Ophthalmol, 1987 Jun, 105(6), 831 - 7
Intravitreal vancomycin . Retinal toxicity, clearance, and interaction with gentamicin; Pflugfelder SC et al.; Some of the gram-positive isolates from exogenous bacterial endophthalmitis cases treated at our institution have been found to be resistant to either cefazolin sodium, gentamicin sulfate, or both . However, all of these isolates have been sensitive to vancomycin . These findings prompted us to reevaluate the retinal toxicity and clearance of intravitreal vancomycin in pigmented rabbits . Doses up to 2 mg were found to be nontoxic in phakic and aphakic-vitrectomized eyes . Clearance was determined in phakic and aphakic-vitrectomized rabbit eyes with or without intact lens capsules . The antibiotic was cleared most slowly in phakic eyes . Aphakic-vitrectomized eyes without an intact lens capsule cleared antibiotic most rapidly, while aphakic-vitrectomized eyes with intact capsules exhibited an intermediate clearance rate . In addition, the interaction between vancomycin and gentamicin on gram-positive endophthalmitis isolates was found to be additive or synergistic depending on the bacterial species . Based on these data, we recommend the combination of vancomycin and an aminoglycoside as the initial antibiotic therapy for exogenous bacterial endophthalmitis.

Infect Control, 1987 Jun, 8(6), 260 - 3
Nocardia; Chazen G; N asteroides is an aerobic, gram-positive, partially acid-fast, branching rod . Cell-mediated immunity via both macrophage activation and direct cytotoxicity represents the main host defense . While clinical infection most commonly occurs in immunocompromised hosts, Nocardia can infect and exist as a saprophyte in normal hosts . Diligence on the part of the treating physician is necessary to confirm the diagnosis . A combination of trimethoprim and sulfamethoxazole is the mainstay of treatment . With an aggressive approach to diagnosis and therapy, the prognosis in patients with nocardiosis appears to be dependent on their underlying disease process.

Eur J Biochem, 1987 Jun 1, 165(2), 267 - 73
Metabolism of glyphosate in an Arthrobacter sp . GLP-1; Pipke R et al.; The metabolism of glyphosate {N-(phosphonomethyl)glycine} in a bacterium tentatively identified as an Arthrobacter sp., capable of growth on this herbicide as its sole phosphorus source, has been investigated using solid-state NMR techniques as well as radiotracer analysis . The pathway involves the conversion of glyphosate to glycine, a C1 unit and phosphate . The phosphonomethyl carbon is specifically incorporated into the amino acids serine, cysteine, methionine, and histidine, as well as into purine bases and thymine, indicating the involvement of tetrahydrofolate in single-carbon transfer reactions . Glycine derived from glyphosate is utilized in purine and protein biosynthesis . This pathway for glyphosate degradation in a gram-positive bacterium is similar to that previously reported for Pseudomonas sp . PG2982 {Jacob et al . (1985) J . Biol . Chem . 260, 5899-5905} and is distinct from that reported for soil metabolism of glyphosate where aminomethylphosphonic acid has been shown to be a major metabolite . Preliminary evidence is presented which indicates that the conversion of glyphosate to glycine and the C1 unit involves the intermediate formation of sarcosine . Thus, the primary event in glyphosate degradation by Arthrobacter sp . GLP-1 is the cleavage of its C-P bound . This report constitutes the first demonstration of the metabolism of glyphosate in a gram-positive bacterium.

Farmaco {Sci}, 1987 May, 42(5), 341 - 6
alpha-(1H-imidazol-1-ylmethylene)ketones with antimycotic activity; Mosti L et al.; A series of title compounds were synthesized starting from heterocyclic alpha-hydroxymethyleneketones and 1,1'-carbonyldiimidazole and tested against gram-positive and gram-negative bacteria, as well as fungi . 7,8-Dihydro-6-(1H-imidazol-1-ylmethylene)-2-phenylquinazolin -5(6H)-one showed a remarkable activity against Candida krusei.

Rev Infect Dis, 1987 May-Jun, 9(3), 581 - 9
Primary actinomycosis of an extremity: a case report and review; Reiner SL et al.; Primary infection of an extremity is an uncommon feature of actinomycosis and can readily be confused with actinomycetoma caused by aerobic actinomycetes such as Nocardia and Streptomyces . A case of primary actinomycosis of the leg is reported, and 35 cases published in the English-language literature are reviewed . There were 14 cases of upper extremity infections and 22 cases of lower extremity infections . Antecedent trauma had occurred in 21 cases . Lesions began in the skin, subcutaneous tissue, muscle, bone, and joint space . Spread to contiguous structures was characteristic, and most lesions eventually involved all of the aforementioned structures . The lesions were typical of actinomycosis with sinus formation and granules in the pus . Cultures were positive in 17 cases . Surgical therapy was necessary in most instances; penicillin remains the drug of choice . Pending results of culturing, a lesion with granules of branching gram-positive bacteria would best be treated empirically with penicillin and a sulfonamide . Prognosis is excellent.

J Neurosurg, 1987 May, 66(5), 701 - 5
Perioperative antibiotic prophylaxis for prevention of postoperative neurosurgical infections . A randomized clinical trial; Young RF et al.; The authors report the results of a randomized, prospective study to assess the effectiveness of perioperative antibiotic prophylaxis in preventing postoperative infections following clean neurosurgical operations . The study group comprised 846 patients treated between October, 1979, and June, 1984 . Antibiotics, including cefazolin and gentamicin, were administered only in the immediate preoperative and intraoperative periods . Sixteen patients, none of whom developed infections, were excluded from final statistical analysis because they had inadvertently been entered into the study while failing to meet entry criteria . Fifteen wound infections (3.64%) developed in the group of 412 patients who did not receive antibiotics, whereas only four infections (0.96%) were identified among the 418 patients who received antibiotics . The difference is statistically significant (p = 0.008) and represents a 74% reduction in infection rate with antibiotics . An analysis of subgroups of surgical procedures revealed a dramatic decrease in craniotomy infections from 6.77% to 0% (p = 0.003) . Of the four infections that occurred among the antibiotic-treated patients, three were in cases where foreign bodies had been implanted . No complications of antibiotic usage were identified . The rates of infection in areas of the body other than the surgical wound were no different in the antibiotic-treated and nontreated groups . All wound infections in both antibiotic-treated and nontreated patients involved similar types of Gram-positive organisms, suggesting that antibiotic prophylaxis did not produce infections with resistant or unusual organisms . This study, combined with other recently published analyses, suggests that routine perioperative antibiotic prophylaxis can significantly reduce the incidence of postoperative neurosurgical infections.

J Clin Microbiol, 1987 May, 25(5), 889 - 92
Role of interleukin-1 in augmenting serum neutralization of bacterial lipopolysaccharide; Riveau GR et al.; We have previously described an assay to quantify the serum neutralization of bacterial lipopolysaccharide which is based on a spectrophotometric Limulus amoebocyte lysate test (T.J . Novitsky, P.F . Roslansky, G.R . Siber, and H.S . Warren, J . Clin . Microbiol . 21:211-216, 1985) . Studies since have shown that serum samples drawn from patients with leukemia and fever, gram-negative or gram-positive bacterial infections, or shock caused by gram-negative bacteria neutralize approximately 10-fold more lipopolysaccharide than do samples from normal controls . These findings suggested that the increased neutralization might reflect an acute-phase response and raised the question of whether it might be under the control of interleukin-1 . To answer this question, we studied the neutralization of lipopolysaccharide in serum samples drawn from rabbits before and after the administration of crude interleukin-1, prepared from activated macrophage supernatants, and recombinant human interleukin-1 . Crude interleukin-1 induced a 5.7-fold increase in serum neutralization 24 h after intravenous injection, and cloned interleukin-1 induced a 3.0-fold increase (P less than or equal to 0.01 and 0.05, respectively) . In individual rabbits given identical doses of crude interleukin-1 on a weight basis, the serum-neutralizing ability correlated significantly with three activities of interleukin-1: rise in temperature (r2 = 0.558; P less than or equal to 0.01), decrease in serum iron (r2 = 0.534; P less than or equal to 0.01), and increase in serum copper (r2 = 0.323; P less than or equal to 0.05) . We conclude that the increase in neutralization of bacterial lipopolysaccharide by serum samples drawn from patients with inflammatory states is mediated, at least in part, by interleukin-1, presumably through the induction of acute-phase serum proteins.

Arthritis Rheum, 1987 Apr, 30(4), 443 - 7
Infective complications of plasma exchange: a prospective study; Singer DR et al.; We examined the incidence and types of infective complications which occurred in 41 patients whose medical management included plasma exchange (PX) by intermittent cannulation; femoral, subclavian, or internal jugular catheter; or arteriovenous shunt . A high incidence of positive cultures from vascular access catheters was demonstrated . Of 23 patients for whom data were available, 13 had positive cultures, and results on 3 of these showed greater than 1 species . Gram-positive cocci were typically found . Of the 34 patients who received drug immunosuppression with PX, 1 patient developed severe shunt-site infection, and an additional 4 developed bacteremia . Seven patients were given PX alone, and none of these developed clinically significant infection; however, this difference in infection rate did not reach statistical significance . Clinically significant access-related infection remains an infrequent but potentially important hazard of therapeutic PX.

Orthop Rev, 1987 Apr, 16(4), 255 - 8
Overview of osteomyelitis; Gentry LO; Osteomyelitis is becoming a more common infection . This increase has been associated with an increase in the number of orthopaedic surgical procedures and with severe bone trauma . The etiology of osteomyelitis is also changing, with more gram-negative and more polymicrobial infections due to both gram-positive and gram-negative pathogens . Underlying diseases such as diabetes mellitus, peripheral vascular and sickle cell disease are associated with a poor cure rate when treated with antibiotics . The emergence of resistant strains of bacteria during the long-term treatment necessary for osteomyelitis has been documented, and continues to be a concern, as are the other side effects.

Can J Vet Res, 1987 Apr, 51(2), 181 - 4
The resemblance of clinical attributes between mastitic cows with no growth on bacterial milk cultures and those with gram-positive bacteria cultured; White ME et al.; The clinical attributes of 40 dairy cows which had mastitis but no growth of bacteria from the milk were analyzed and compared to the attributes in 102 cows with only gram-positive and 61 cows with only gram-negative bacteria cultured from the milk . Cows with no bacteria cultured from the milk did not differ significantly from cows with gram-positive bacteria cultured, but 9 of 12 attributes were significantly different between cows with no bacteria cultured and cows with gram-negative bacteria cultured . Discriminant analysis was used to classify cows as members of the gram-positive or gram-negative culture groups . The discriminant equation was then applied to the cows with no bacteria cultured, and 78% of cows with no bacteria cultured were classified as members of the gram-positive group . Most mastitis in cows with no bacteria grown from the milk was probably due to gram-positive bacteria . If antibiotic therapy is used in cows with persistent mastitis and a negative culture in the belief that the culture is a false negative, treatment with antibiotics effective only against gram-negative organisms would not be appropriate.

Ophthalmic Surg, 1987 Apr, 18(4), 268 - 71
Antibiotic resistance of crystalline bacterial ingrowth in a corneal graft; Kincaid MC et al.; Four recent reports have described the clinical appearance of fine needle-like opacities in the corneal stroma of six patients . In five of these patients these developed in a corneal graft . Histologically, all the corneal buttons had bacterial ingrowth between the stromal lamellae, with a striking lack of inflammatory response . We report a patient in whom this process occurred following penetrating keratoplasty . Intensive topical antibiotic treatment failed, and she underwent a second, successful, penetrating keratoplasty . Postoperatively, this patient has maintained good vision with no recurrence for over three years . Histologic and ultrastructural study of the corneal button revealed viable and nonviable gram-positive cocci with a marked paucity of inflammatory infiltrate.

Infect Immun, 1987 Apr, 55(4), 848 - 55
Cloning and functional expression of the Coxiella burnetii citrate synthase gene in Escherichia coli; Heinzen RA et al.; The citrate synthase gene from the obligate intracellular rickettsial parasite Coxiella burnetii was cloned and expressed in Escherichia coli . Transduction into E . coli with a C . burnetii gene library constructed in the cosmid vector pHK17 resulted in the functional complementation of the gltA mutation of E . coli MOB154 . A GltA+ clone carrying 16.4 kilobase pairs of C . burnetii DNA and designated pJCC959 was isolated and characterized . Southern hybridization analysis confirmed that the pJCC959 cloned insert consists of C . burnetii DNA and that homology exists with the Rickettsia prowazekii citrate synthase gene . Subcloning analysis with the multicopy expression vector pUC8 revealed that citrate synthase expression was under control of a C . burnetti promoter . In vitro transcription-translation of subclones pLPM20 and pLPM30 established a molecular weight of ca . 46,000 for the monomer form of the cloned enzyme . Transposon Tn5 mutagenesis of pLPM30 defined the coding region to approximately 1.2 kilobase pairs of C . burnetii DNA . Maxicell analysis of selected pLPM30::Tn5 insertion derivatives identified the direction of transcription and the relative translational start and stop sites and substantiated the molecular weight value calculated from the in vitro analysis . Inhibition studies showed that citrate synthase activity in crude cell extracts obtained from strain MOB154 transformed with the cloned C . burnetii gene was markedly inhibited by 4 mM ATP, while 4 mM alpha-ketoglutarate had virtually no effect . These data indicate that the C . burnetii enzyme displays regulatory behavior characteristic of the small gram-positive bacterial and eucaryotic enzyme.

Arch Pathol Lab Med, 1987 Mar, 111(3), 246 - 9
Botryomycosis in acquired immunodeficiency syndrome; Toth IR et al.; The first case, to our knowledge, of an integumentary form of botryomycosis is reported in a homosexual man with acquired immunodeficiency syndrome . Anal fistula and ischiorectal and gluteal abscesses developed following severe cryptosporidial diarrhea . Grains composed of gram-positive cocci were identified in the suppurative exudate . The grains had attached to multinucleated macrophages, many of which contained clusters of cocci in their cytoplasm . It is postulated that the cocci were able to survive and probably replicate in the cytoplasm of multinucleated macrophages, and were subsequently extruded as grains . These observations suggest a defect in intracellular killing of cocci by the monocyte-macrophage system . This may relate to failure in induction of control of macrophage activity by T4-inducer subsets.

Mikrobiologiia, 1987 Mar-Apr, 56(2), 294 - 302
{Proposed neotype Streptomyces ruber (Krainsky, 1914) Waksman et Henrici, 1948}; Kuznetsov VD et al.; Culture 78 was proposed as a neotype of Streptomyces ruber . It was isolated from the soils of the Baikal region and was closest, in its taxonomic properties, to the original description of the species {13} whose representative had been lost . Cultures from different microbial collections designated as S . ruber were shown to be unlike the original description . The neotype had the following taxononic properties: the cell wall of type I; spiral sporophores with extended spirals having 2-3 coils; oval spores with a smooth envelope; greyish pink aerial and dark-red substrate mycelia; a red pigment not passing into the medium; slow gelatin liquefaction and milk peptonization; weak starch hydrolysis; assimilation of glucose, xylose, rammose, fructose, and inositol; weak growth on arabinose, raffinose and mannitol, but not on sucrose; no formation of melanoid pigments; synthesis of riboflavin and prodigiosin pigments; inhibition of Gram-positive bacterial and acid-resistant mycobacterial growth; no inhibition of yeast and fungal growth . The culture was sensitive to streptomycin, neomycin, gentamycin, monomycin, tetracycline,erythromycin, oleandomycin, lincomycin, ristomycin, levomycetin, polymyxin and fusidin, but resistant in penicillin . The population was composed of six variants {3}: main, faded, asporogenic red, asporogenic yellow, asporogenic white and nocardia-like . The latter two were not capable of riboflavin and prodigiosin formation . The asporogenic yellow variant was a monosynthetic organism: it formed riboflavin, but could not synthesize prodigiosin . The neotype of S . ruber 78 is deposited withthe national Collection of Microorganisms (the reference number is VKM A-611).

J Appl Bacteriol, 1987 Mar, 62(3), 223 - 6
A note on the use of the Catalasemetre in assessing the quality of milk; Phillips JD et al.; The Catalasemetre, for assessing the quality of raw and pasteurized milk, has been studied . No correlation was found between catalase activity and bacterial counts for farm bulk tank milks within the range 5.2 X 10(2)-5.4 X 10(5) cfu/ml . Similarly, no relation was observed between catalase activity and somatic cell counts of milk (range of counts from 0.08 to 3.5) . However, the catalase activity and bacterial count of pasteurized milks which had been pre-incubated at 21 degrees C for 25 h in the presence of crystal violet-penicillin-nisin to inhibit Gram-positive bacterial growth were significantly related . Thus, the use of this pre-incubation procedure coupled with the Catalasemetre to estimate bacterial growth, has potential in assessing the keeping quality of pasteurized milk samples within 25.5 h of production . Results on the thermostability of native milk catalase are also presented.

Rev Infect Dis, 1987 Mar-Apr, 9 Suppl 2, S160 - 7
Potential role of trimethoprim-sulfamethoxazole in the treatment of serious hospital-acquired bacterial infections; Quintiliani R et al.; Although trimethoprim-sulfamethoxazole (TMP-SMZ) has become a standard agent for the treatment of a broad range of infections, it may often be overlooked as a choice for treatment of serious hospital-acquired infections . A review of the literature shows that a number of common and uncommon gram-negative and gram-positive organisms susceptible to TMP-SMZ are frequently resistant to cephalosporins . TMP-SMZ has, in addition to its exceptional microbiologic activity, pharmacokinetic characteristics that make it a potentially cost-effective alternative to third-generation cephalosporins in the treatment of serious hospital-acquired infections caused by susceptible organisms.

J Antibiot (Tokyo), 1987 Mar, 40(3), 258 - 65
The aurachins, new quinoline antibiotics from myxobacteria: production, physico-chemical and biological properties; Kunze B et al.; The aurachins, new quinoline alkaloids, were extracted with acetone from the biomass of the myxobacterium, Stigmatella aurantiaca strain Sg a15 and purified by column chromatography . The four described aurachins A, B, C and D, were inhibitory for Gram-positive bacteria and a few yeasts and molds . They blocked NADH oxidation in beef heart submitochondrial particles.

Antimicrob Agents Chemother, 1987 Mar, 31(3), 455 - 7
In vitro activity of a new cyclic lipopeptide antibiotic, LY146032, against gram-positive clinical bacteria; Huovinen P et al.; The in vitro activity of LY146032, a novel cyclic lipopeptide antibiotic, was tested against different gram-positive clinical isolates . The activity of LY146032 was clearly higher than that of vancomycin against all isolates tested . However, in some instances rifampin and imipenem showed higher activity than did LY146032.

Arch Intern Med, 1987 Feb, 147(2), 337 - 40
The Limulus amebocyte lysate assay . A rapid and sensitive method for diagnosing early gram-negative peritonitis in patients undergoing continuous ambulatory peritoneal dialysis; Clayman MD et al.; The Limulus amebocyte lysate (LAL) assay was used in a blinded, prospective fashion to analyze peritoneal fluids from 35 consecutive patients undergoing continuous ambulatory peritoneal dialysis (CAPD), who presented with clinical peritonitis . The results were correlated with standard microbiologic culture results . The LAL assay was positive in all three patients with gram-negative peritonitis, was appropriately negative in 24 of 28 gram-positive infections (sensitivity, 100%; specificity, 86%) and was positive in two of five cases in which there was no microbiologic growth . One of the two patients in this last group yielded a gram-negative organism two days later . It was then demonstrated that therapeutic concentrations of a variety of antibiotics (cefazolin sodium, gentamicin sulfate, tobramycin sulfate, ticarcillin disodium, penicillin G potassium, vancomycin hydrochloride, metronidazole hydrochloride, piperacillin sodium, and trimethoprim/sulfamethoxazole) did not interfere with the LAL assay . Together, these data indicate that the LAL assay is useful for identifying patients at high risk for gram-negative peritonitis and for excluding from possible aminoglycoside exposure the majority of patients with peritonitis undergoing CAPD, most of whom will have gram-positive infections . Furthermore, lack of antibiotic interference allows the possibility of monitoring treatment efficacy.

Acta Pathol Microbiol Immunol Scand {B}, 1987 Feb, 95(1), 75 - 8
Can decreased phagocytosis and killing of autologous gram-positive bacteria explain the finding of gram-positive bacteria in "non-bacterial prostatitis"?
Wedren H, Holm SE, Bergman B.
Immunological deficiency is seldom considered in the pathogenesis of chronic prostatitis, despite clinical symptoms of prostatic inflammation and occasionally also in other tissues . Investigations in three patients with severe bacterial prostatitis with Gram-positive bacteria in the prostatic secretion revealed a decreased phagocytotic activity of the polymorphonuclear leukocytes (PMN-cells) derived from patients' sera towards the autologous Gram-positive bacteria from their own prostatic secretions but not towards heterologous Gram-positive bacteria from other patients or controls . These observations indicate a hitherto unobserved, altered host-parasite interaction in patients with prostatitis possibly caused by Gram-positive bacteria.

Int J Clin Pharmacol Ther Toxicol, 1987 Feb, 25(2), 113 - 20
Combination of amikacin and ceftazidime as empiric treatment of febrile leukopenic patients affected by solid tumors; Gasparini G et al.; A combination of amikacin and ceftazidime was used as initial empiric therapy for the treatment of 25 evaluable febrile episodes (temperature greater than or equal to 38.5 degrees C) in leukopenic adult patients (wbc less than or equal to 1,000/mm3) with solid tumors, characterized by poor prognosis because of low performance status (median Karnofsky score: 50) and progressive disease (76% of cases) . Nineteen (76%) of the 25 episodes responded to the initial empiric antibiotic combination . In the microbiologically documented infections, there was no significant difference in the response rate between bacteremia (67%) and localized infections (81%) . The response in localized infections caused by gram-negative organisms (81%) was similar to that obtained in gram-positive organisms (82%), whereas gram-positive bacteremia responded better than gram-negative (100 vs 50%) . No serious side effects were observed . Reversible nephrotoxicity occurred in 12% and hypokalemia in 20% of the patients treated . This antibiotic combination is a safe and efficacious empiric therapy for infections in leukopenic patients with solid neoplasia.

Arch Intern Med, 1987 Feb, 147(2), 232 - 6
Bacteremic hypocalcemia . A comparison between the calcium levels of bacteremic and nonbacteremic patients with infection; Aderka D et al.; Hypocalcemia has been documented in critically ill patients, including those with sepsis and shock . However, its incidence and significance in bacteremic patients without shock has not been established . In the present study the presence of hypocalcemia was evaluated in a group of 67 consecutive bacteremic patients, as compared with 64 infected but nonbacteremic patients . After correction of serum calcium level for serum protein, 25 of the bacteremic patients (37.3%) had "corrected" hypocalcemia (less than 8.5 mg/dL {2.12 mmol/L}), compared with only three in the nonbacteremic group (4.5%) . The incidence and magnitude of hypocalcemia in gram-positive and gram-negative infections was similar . In hypocalcemic patients, the "corrected" calcium level was found to be inversely correlated with day of disease and attained a nadir on day 6 to 8 of bacteremia . This nadir was significantly lower in male than in female subjects . Hypocalcemic patients had a significantly higher maximal temperature than normocalcemic ones, but hypocalcemia was unrelated to serum levels of albumin, transaminase, and creatinine.

Am Surg, 1987 Jan, 53(1), 29 - 33
Early diagnosis and outcome of pancreatic abscesses in pancreatitis; Hurley JE et al.; During the past 3.5 years the authors have evaluated 191 patients, both retrospectively and prospectively, to establish factors which might help to identify those patients at higher risk of developing pancreatic abscesses . Those factors included etiology of pancreatitis, number of severity indices present, and specific indices present . Once an abscess developed, severity indices, etiology, and bacteriology were examined as factors in mortality . Six specific severity indices occurred more often (P less than 0.05) in patients developing abscesses . These indices were lactate dehydrogenase evaluation, leukocytosis, metabolic acidosis, hypoxemia, hypocalcemia, and fluid sequestration . In addition, seven of 18 abscess patients had six or more indices present as opposed to five of 161 pancreatitis patients . This was significant at P less than 0.05 level . The etiology of the pancreatitis was not a significant factor . Once an abscess developed, gram-negative infections were polymicrobial (8 of 9 patients) and were associated with a 56 per cent mortality . The gram-positive abscesses (6 patients) were all monomicrobial and none of these patients died . In addition, age greater than 55 years, serum glucose greater than 200 mg%, hematocrit decrease of 10 per cent, and fluid sequestration greater than 6 L were associated with a 50 per cent or greater mortality . The authors believe that patients presenting initially with six or more severity indices, especially the six mentioned above, are at significantly increased risk for developing a pancreatic abscess and those abscess patients with gram-negative abscesses, as well as having any of the four severity indices previously mentioned, have a much worse prognosis.

Nephron, 1987, 46(3), 316 - 8
Intravenous or intraperitoneal vancomycin for the treatment of continuous ambulatory peritoneal dialysis associated gram-positive peritonitis?
Bailie GR, Morton R, Ganguli L, Keaney M, Waldek S.
A clinical and pharmacokinetic study was carried out to determine whether an intraperitoneal (IP) loading dose of vancomycin was as effective as an intravenous (IV) load in the treatment of continuous ambulatory peritoneal dialysis (CAPD)-associated gram-positive peritonitis . Each patient continued a 14-day treatment on IP maintenance doses . All cases of peritonitis (10 in each group) were eradicated . Side effects occurred in 3 patients following IV vancomycin and in none following IP vancomycin . Serum and peritoneal vancomycin concentrations equilibrated fully and rapidly with each route . It is concluded that an IP loading dose of vancomycin, followed by IP maintenance doses, is as effective as and produces fewer side effects than an IV loading dose in the treatment of CAPD peritonitis.

Nephron, 1987, 45(4), 283 - 5
Treatment of gram-positive peritonitis with two intraperitoneal doses of vancomycin in continuous ambulatory peritoneal dialysis patients; Bastani B et al.; Eight patients with end-stage renal failure on continuous ambulatory peritoneal dialysis (CAPD), who developed peritonitis, received an intraperitoneal dose of vancomycin (30 mg/kg body weight) with 6 h of peritoneal dwell and then resumed their routine CAPD schedule . Vancomycin concentration in serum, peritoneal dialysate (PD) from an overnight dwell and 1, 2 and 3 h after a new exchange was measured at 48 h (in 5 patients) and 7 days (in 6 patients) . Except for an occasional 1-hour peritoneal fluid sample on the 7th day, all samples had satisfactory vancomycin levels . Five of the 8 patients who had gram-positive peritonitis and 1 with 'sterile' peritonitis received another similar intraperitoneal dose of vancomycin at the 7th day . All of these patients had good therapeutic response with a negative PD culture 3 weeks after the cessation of therapy and no relapse of infection in at least 1 month of follow-up . We conclude that 2 intraperitoneal doses of vancomycin (30 mg/kg body weight) given 1 week apart with 6 h of intraperitoneal dwell is an effective and adequate treatment for gram-positive and 'sterile' peritonitis in CAPD patients.

Anaesthesist, 1987 Jan, 36(1), 9 - 18
{The effect of stress ulcer prevention on the incidence of pneumonia in artificial respiration}; Daschner F et al.; The role of stress ulcer prophylaxis in increasing the risk of pneumonia in ventilator patients was analyzed prospectively in 142 artificially ventilated patients at a medical and surgical intensive care unit (104 males, 38 females, mean time of ventilation 7.9 days, mean age 46.5 years) . The pH of gastric aspirate and bacterial counts in gastric fluid and tracheal secretions were investigated daily . Identical isolates from gastric aspirates and tracheal secretions were typed by agglutination, bacteriocin, or phage typing . An average of 2.1 bacterial species were isolated in 80.5% of all gastric aspirates . Bacterial counts increased with rising gastric aspirate pH, which was especially true for Gram-negative and less so for Gram-positive organisms; colony counts of Candida sp . decreased slightly . In 31.6% of patients identical bacterial species were first isolated from gastric aspirates and 1 to 2 days later from tracheal secretions . Of these microbes that were first isolated from gastric aspirate and later from tracheal secretions, 50.3% were Gram-negative, 37.5% Gram-positive, and only 4.2% Candida sp . One-half of all bacterial aspirations occurred between the 2nd and 7th day of ventilation; 80% occurred within 11 days of ventilation . Only 20% of all migrations of Gram-positive organisms from stomach to respiratory tract lead to pneumonia, as compared with 60% of Gram-negatives . At a gastric pH below 3.4 the incidence of ventilation pneumonia was 40.6%; above pH 5.0 the incidence was 69.2% (P less than or equal to 0.05) . As pH increased, the organism causing pneumonia was significantly more often isolated first from the gastric aspirate and 1 to 2 days later from the tracheal secretion of the same patient.

Chemotherapy, 1987, 33(2), 93 - 6
Kinetics of cefatrizine penetration into gynaecological tissues after oral administration; Fraschini F et al.; Twenty-four patients, hospitalized in order to undergo radical gynaecological surgery, were orally administered cefatrizine in a single dose of 1 g at different times before surgery . The tissue levels determined in the organs considered (uterus, ovary, tubae, vagina) proved that cefatrizine possesses good absorption in the genital tract, reaching concentrations near to the MICs of most gram-negative and gram-positive sensitive bacteria lasting even 12 h after administration.

Can J Vet Res, 1987 Jan, 51(1), 27 - 31
In vitro growth inhibition of mastitis pathogens by bovine teat skin normal flora; Woodward WD et al.; One factor contributing to differences in the susceptibility of cows to mastitis may be differences in the teat skin normal flora, which could inhibit or enhance the growth of pathogenic bacteria . Using in vitro cross-streaking methods, we found that 25% of the isolates of teat normal flora of non-lactating heifers inhibited the growth of selected mastitis pathogens, but enhancers were not detected . Gram-positive pathogens were inhibited to a greater extent than Gram-negative pathogens . Inhibition was not a characteristic of specific genera or species of normal flora, but rather a property of certain variants within a species . This phenomenon of inhibition of mastitis pathogens in vitro by normal flora may be useful as an in vivo biological control method to reduce the incidence of mastitis.

Ann Intern Med, 1987 Jan, 106(1), 1 - 7
Oral norfloxacin for prevention of gram-negative bacterial infections in patients with acute leukemia and granulocytopenia . A randomized, double-blind, placebo-controlled trial; Karp JE et al.; We evaluated the effect of norfloxacin, 400 mg given orally every 12 hours, on the prevention of bacterial infections in 68 adult patients who had acute leukemia throughout prolonged courses of granulocytopenia (median, 32 days) . Gram-negative infections were documented in 13 of the 33 patients receiving placebo, but only in 4 of the 35 patients receiving norfloxacin; no effect on the frequency of gram-positive or fungal infections was noted . Norfloxacin administration resulted in the suppression of gastrointestinal tract colonization by aerobic bacteria without the development of norfloxacin resistance . Patients receiving norfloxacin developed first infectious fevers later than did those receiving placebo, had more rapid resolution of that fever after systemic antibiotic treatment, and spent less time febrile . Therefore, although no difference was seen in survival duration, we found that the prophylactic administration of oral norfloxacin led to decreases in overall morbidity and gram-negative infections, was well tolerated, and did not predispose to the development of multiply drug-resistant bacteria.

Int J Clin Pharmacol Res, 1987, 7(3), 199 - 201
A comparative study of ofloxacin versus cefazolin in lower respiratory tract infections; Bariffi F et al.; An open study was conducted in 40 randomized patients to evaluate the efficacy of ofloxacin in comparison with cefazolin in the treatment of acute, chronic and recurrent lower respiratory tract infections . The therapeutic efficacy of the two drugs was evaluated on the basis of bacteriological and clinical examinations . Bacteriological assays revealed that ofloxacin eliminated bacterial flora from sputum in 20/21 cases (14 Gram-negative and 7 Gram-positive), while cefazolin eradicated the pathogens in 12/19 cases (16 Gram-negative and 3 Gram-positive) . In clinical terms, 20/21 (95.2%) infections were cured and 1/21 (4.8%) improved in the ofloxacin group as against 12/19 (63.2%) cured, 5/19 (26.3%) improved and 2/19 (10.5%) unchanged in the cefazolin group . The results of this study confirm the efficacy and excellent tolerance of ofloxacin in the treatment of lower respiratory tract infections.

Arkh Patol, 1987, 49(11), 44 - 9
{Morphology of infectious endocarditis affecting bioprostheses of the cardiac valves}; Iaroshinskii IuN et al.; Four varieties of infectious endocarditis were identified after cardiac valve bioprostheses: early acute, early subacute, late acute, and late subacute forms . Any of these forms may be of bacterial, fungal, or mixed (bacterial and fungal) origin . In the early forms, the infection was of exogenous origin, with a predominance of Gram-positive organisms, whereas in the late forms it was endogenous with a preponderance of Gram-negative flora . The hallmarks of fungal thromboendocarditis were an early massive thrombosis of the bioprosthesis, multiple thromboembolism, and an absence of cellular reaction in the cuspal tissue . In the subacute bacterial endocarditis, progressive dysfunction of the bioprosthesis resulting from calcination of bacteria-containing cusps and thrombi was noted.

Microbiol Immunol, 1987, 31(10), 1017 - 23
A simple method for quantitative determination of bacterial adherence to human and animal epithelial cells; Valentin-Weigand P et al.; A simple quantitative method for determining bacterial adherence to epithelial cells was devised . The method involved incubation of fluorescein-labeled bacteria with oral epithelial cells . Non-adherent bacteria were subsequently removed by Percoll density centrifugation . The degree of bacterial adherence was then determined fluorospectrophotometrically by measuring the fluorescein extracted from the adherent bacteria . The degree of adherence corresponded well with the microscopic counts of adherent bacteria . The method proved to be suitable for assaying adherence of both gram-positive and gram-negative bacteria to human as well as animal epithelial cells.

Scand J Rheumatol Suppl, 1987, 64, 49 - 54
Intestinal bacteria and rheumatic disease; Midtvedt T; The striking clinical and pathological similarities between certain naturally occurring infectious diseases in animal species and those of some human rheumatic diseases, such as rheumatoid arthritis (RA), have stimulated the search for a microbial etiology of the latter syndrome . A long series of microbial species, including aerobic and anaerobic intestinal bacteria, mycoplasma and several viruses have been put into focus . Most often, however, an initially positive report has been followed by several reports denying an etiological role of the microbial species in focus . However, the concept of a microbial trigger in the etiology and symptomatology of RA is still a subject of intense debate . Recent results have indicated a reversed effect of gram-positive vs . gram-negative intestinal bacteria on adjuvant-induced arthritis in germfree rats and microbial peptidoglycans have been shown to play a major role in this experimental model . It has been shown that the intestinal flora may include bacteria containing antigenic determinant(s) cross-reacting with some markers within the HLA-system . The intestinal flora may also influence upon several digestive and absorptive functions and thereby acting upon parameters of importance in the development of rheumatic disease.

Toxicol Pathol, 1987, 15(4), 388 - 400
2,2,2-Trifluoroethanol-induced enteropathy in rats: chemically or bacterially mediated effects; Kim JC et al.; The lethal effects of the fluorinated ether anesthetic, fluroxene, in rats are a consequence of its metabolism, which is catalyzed by cytochrome P-450 to the toxic metabolite 2,2,2-trifluoroethanol (TFE) . The anesthetic or TFE (0.21 g/kg) caused decreased white blood cell counts, necrosis of bone marrow and lymphocytes, and decreased small intestine dry weight and was associated with septicemia . To elucidate the mechanism of TFE toxicity in rats we undertook histopathologic, ultrastructural and bacteriologic studies . TFE produced severe edema of intestinal lamina propria and submucosae, dilatation of crypts, loss of surface epithelium, vacuolation and necrosis of intestinal epithelial cells, and infiltration of polymorphonuclear leukocytes into the edematous lamina propria . Intestinal epithelial villi lost their cellular tissue integrity . Coccobacillary organisms were numerous in the ulcerated intestine . Hemolytic E . coli were isolated from intestinal tissue at a two-log increase in concentration relative to controls . Hemograms from TFE-treated rats exhibited marked leukopenia and morphologic differences . The platelets lost their discoid shape, extended pseudopods, and centralizing granules . Hemoglobin precipitation as Heinz bodies and crystalloid structures was observed in TFE-treated rats . Together the data suggest that TFE-induced enteropathy was most probably due to E . coli precipitated from TFE-mediated alterations in the population of small intestinal microbes . The antibiotics erythromycin, active against gram-positive bacteria, and streptomycin, active against gram-negative bacteria, and the antiendotoxin, polymyxin B, were administered to rats prior to TFE in an effort to differentiate between these mechanisms by altering the intestinal bacteria populations . The results indicate that the TFE-induced small intestinal lesions are initiated by the direct focal necrotic effect of TFE or its metabolites on the small intestinal epithelium . The focal coagulation necrosis produced by TFE predisposes the animals to lethal enteritis and systemic bacteremia.

Drugs, 1987, 34 Suppl 2, 205 - 15
Use of cephalosporins in the immunologically compromised patient; Newland AC et al.; Infection is a major threat to patients with neutropenia, particularly those with haematological malignancies who are undergoing chemotherapy . Early use of an empirical antibiotic regimen with the broadest possible spectrum of activity is recommended until culture data can guide the choice . A standard combination in many centres is an amino-glycoside and a semisynthetic penicillin with antipseudomonal activity or a cephalosporin . However, no regimen can adequately cover all potential pathogens and in these patients, who are exposed to many toxic insults, the choice of antibiotics may significantly increase the incidence of side effects, particularly nephrotoxicity . There has, therefore, been considerable interest in simpler, less toxic (and less expensive) regimens and the concept of monotherapy has been explored . Although recent studies using ceftazidime alone have supported this as an effective approach, there remain several issues to resolve; and on a more cautionary note preliminary results from the latest EORTC study, which recruited more than 1200 patients, suggest that in Gram-negative bacteraemia, conventional combination therapy remains the treatment of choice in neutropenia . While monotherapy is attractive in an environment of low drug resistance when exposure to third generation cephalosporins is infrequent, this is rarely the case . In addition, the widespread use of tunnelled catheters for venous access had led to an increase in Gram-positive infections, and the more intensive immunosuppression to the emergence of fungal infections . Although these tend not to be rapidly fatal, their presence must be considered in designing treatment strategies . The influence of the host and treatment on the type of infection and the relative merits of the differing concepts in therapy are explored in detail in this article.

Acta Med Austriaca, 1987, 14(1), 21 - 4
{Clinical value of endotoxin determination in infection . Comparison of the Limulus amebocyte lysate test with detection of bacterial pathogens}; Watzke H et al.; To evaluate usefulness of Limulus amoebocyte lysate test and blood culture in the diagnosis of septicemia both tests were performed in 27 intensive care patients . Test results were compared with a clinical sepsis score . Ten (62%) out of 16 patients with clinical diagnosis of septicemia showed a positive endotoxin test and 11 (69%) a positive blood culture . In 14 patients (87%) either endotoxin test or blood culture revealed a positive result . Two out of 11 patients (20%) classified by the sepsis score as non-septic showed positive blood cultures as well as positive endotoxin tests . 4 patients with gram-positive bacteria in the blood cultures showed a positive endotoxin test . Due to lack of sensitivity and specificity the Limulus amoebocyte lysate test is of rather low value in the diagnosis of septicemia . Simultaneous performance of Limulus amoebocyte lysate test and blood culture is able to improve the sensitivity, which then over-rules the one obtained when only blood cultures are performed.

Helv Paediatr Acta, 1987, 42(4), 297 - 303
Preliminary experience with ceftazidime monotherapy in perinatal infection; Amato M et al.; Ceftazidime, a new cephalosporin antibiotic, was used as monotherapy to treat 75 term neonates with suspected perinatal bacterial infection . Septicemia was documented in ten patients (13%) . Ceftazidime was administered as 25 mg/kg doses intravenously every 12 h . Peak serum concentrations at 0.5 h after dose ranged from 57 to 115 micrograms/ml and trough serum concentrations prior to next dose from 2 to 15 micrograms/ml . The overall clinical, bacteriological and laboratory response to ceftazidime was satisfactory and the drug was well tolerated . However, reservations with regard to study design, limited gram-positive drug activity and potential emergence of drug resistance require further well-controlled clinical evaluations of ceftazidime in neonatal intensive care units, before definite recommendations for the use of this antibiotic in perinatal infection can be formulated.

Lung, 1987, 165(5), 279 - 82
Rothia dentocariosa pneumonia in an immunocompromised patient; Schiff MJ et al.; An 84-year-old woman with acute myelocytic leukemia presented with fever and a left upper lobe infiltrate on chest x-ray . She failed to respond to initial broad spectrum antibiotic therapy . Bronchoalveolar lavage fluid and a transthoracic needle aspirate subsequently both grew Rothia dentocariosa, a gram-positive branching rod . The pneumonia resolved after prolonged treatment with Clindamycin . Rothia dentocariosa must be considered a cause of opportunistic pulmonary infection.

Comp Biochem Physiol A, 1987, 87(4), 911 - 4
Pyrogens fail to produce fever in the snakes Psammophis phillipsii and Lamprophis fuliginosus; Zurovsky Y et al.; 1 . Preferred body temperature of five diurnal, Psammophis philipsii and three nocturnal, Lamprophis fuliginosus, snakes was measured in a thermal gradient chamber by indwelling colonic thermocouples, before and after injection of a variety of pyrogens . 2 . The snakes achieved their preferred body temperature by moving up and down in the gradient chamber; it was about 33 degrees C for P . phillipsii and 25 degrees C for L . fuliginosus . 3 . The snakes did not develop fever in response to any of the pyrogens, whether gram-negative or gram-positive in origin, either on the day of injection or on the subsequent day . 4 . We believe that fever is rare amongst reptiles.

Microbiol Immunol, 1987, 31(2), 113 - 21
A simple metachromatic and fluorescent staining method for microorganisms using carbocyanine dye; Umeda M; The cationic carbocyanine dye, 1-ethyl-2-{3-(1-ethylnaphtho{1, 2d}-thiazolin-2-ylidene)-2-methylpropenyl}-naphtho{1, 2d}thiazolium bromide, interacts with several classes of anionic polymers, exhibiting metachromasia . We were able to stain various kinds of microorganisms with this dye . Gram-negative bacteria were stained reddish purple, while Gram-positive bacteria were stained violet or bluish purple . Stains of molds were of various colors . Yeast vegetative cells were stained reddish purple, but zygotic asci were bluish . Chlamydia trachomatis inclusions, which are surrounded by cytoplasmic membranes, were also stained red . Microorganism and cell stains have different features and can be identified also by use of fluorescent microscopy . The new staining method we report here is rapid and simple enough for routine microscopical examinations of smears of clinical specimens including microorganisms.

J Antibiot (Tokyo), 1986 Dec, 39(12), 1657 - 69
Metabolic products of microorganisms . 234 . Urdamycins, new angucycline antibiotics from Streptomyces fradiae . I . Isolation, characterization and biological properties; Drautz H et al.; The colored urdamycins A to F, six new angucycline antibiotics produced by Streptomyces fradiae strain Tu 2717, were detected by chemical screening . They are biologically active against Gram-positive bacteria and stem cells of murine L1210 leukemia . The urdamycins are glycosides and differ in their aglycones, which can be liberated by acidic hydrolysis besides the sugars D-olivose and L-rhodinose . The structure of the main compound, urdamycin A, follows from the spectroscopic and chemical data in connection with an X-ray analysis . The aglycone urdamycinone A is identical with aquayamycin . The structures of urdamycin B, E, F and partial structures of urdamycin C and D, will be presented in a subsequent paper . The new term "angucycline/angucyclinone" is used for an increasing group of related antibiotics.

Minerva Med, 1986 Nov 30, 77(45-46), 2163 - 82
{Cefotiam, a new cephalosporin . Microbiological research, preliminary evaluation of its effect on phagocytosis and clinical multicenter research}; Di Nola F et al.; After a brief review of the data on cefotiam in the literature the report presents the results of microbiological research, a preliminary study into the drug's possible actions on phagocytosis and a polycentric clinical study of 93 cases of broncho-pleuro-pulmonary pathology and one sinusitis of the jaw . In vitro cefotiam was found to have an excellent inhibitory effect on gram positive and gram negative bacteria with MICs50 and 90 respectively 0.2 and 0.8 mcg/ml V . Staph . aureus, Str . pyogenes . E . Coli, K . pneumoniae and Pr . mirabilis . A dose-dependent increase in phagocytosis was noted . The clinical response was excellent with 90.43% (88/94) of the cases achieving clinical and radiological cure or very much improved . Cefotiam was very well tolerated with the appearance of 2/94 skin rashes (2.12%) . The liver and kidney parameters showed no change at the end of treatment . No increase in enzymuria was noted during treatment with cefotiam.

Jpn J Antibiot, 1986 Nov, 39(11), 2938 - 44
{Clinical evaluation of astromicin administered by intravenous drip infusion . Report II . Bacterial infections in the field of surgery}; Sakai K et al.; A clinical evaluation of astromicin (ASTM) administered by intravenous drip infusion against infections in the surgical field was made, and the results were summarized as follows . Excellent effect was observed in 19 out of a total of 44 cases, good effect in 19, fair in 1 and poor in 5 . The efficacy rate calculated from the 38 cases of "excellent" and "good" was 86% . In stratification by disease, the efficacy rate was 91% in localized peritonitis (31/34 cases) and 63% in diffuse peritonitis (5/8 cases); the overall efficacy rate in peritonitis was 86% . The efficacy rate in 2 cases infected by Gram-positive bacteria was 50%, and that in 16 cases by Gram-negative bacteria was 94% . The disappearance rate of Gram-negative bacteria was 93%, and this drug was especially effective against E . coli . There were no subjective or objective side effects and no abnormal laboratory test values that were related to the administration of ASTM.

Rev Infect Dis, 1986 Nov-Dec, 8 Suppl 5, S470 - 81
Classification of beta-lactamases; Bauernfeind A; Traditionally, the classification of beta-lactamases has followed the general principles of describing enzymes by the characterization of their activity against substrates . New types of beta-lactam structures with therapeutic relevance have emerged, necessitating more specific substrate profiles . Biophysical characterization, i.e., primarily isoelectric focusing, has greatly improved classification, particularly of nonchromosomal beta-lactamases . The classification of beta-lactamases of both gram-positive and gram-negative organisms is reviewed and updated by adding data on recently discovered enzymes . Data on amino acid sequence and molecular structure that are available for an increasing number of beta-lactamases will gradually be incorporated into the established system . In addition, the introduction of evolutionary aspects should serve to modify the existing system, which to date has been based on arbitrarily selected characteristics.

J Bacteriol, 1986 Nov, 168(2), 917 - 22
Diglycosyl diacylglycerol of Mycobacterium tuberculosis; Hunter SW et al.; A diglycosyl diacylglycerol was isolated from Mycobacterium tuberculosis, and its structure was established by a combination of methylation analysis, 1H nuclear magnetic resonance, and fast atom bombardment-mass spectrometry . It is a 1,2-diacyl-{beta-D-glucopyranosyl(1"----6')-beta-D-glucopyranosyl(1'---- 3)}- sn-glycerol and exists in at least five molecular species differing in fatty acyl substituents . The major constituent fatty acids were identified as iso- and anteisopentadecanoate, iso- and n-hexadecanoate, and iso- and anteisoheptadecanoate . Although glycosyl diacylglycerols are common membrane components of gram-positive bacteria, this report represents the first substantial evidence for the presence of a glycosyl diacylglycerol within a member of the Mycobacterium genus . Although the glycolipid is not a major component of M . tuberculosis, it reacts readily in enzyme-linked immunosorbent assay against rabbit antibodies raised against whole bacteria and thus may be useful for the serodiagnosis of tuberculosis.

Experientia, 1986 Oct 15, 42(10), 1167 - 70
Two sulfur-containing ansamycin antibiotics from Streptomyces albolongus; Tanida S et al.; Two sulfur-containing ansamycin antibiotics were isolated from the culture broth of Streptomyces albolongus C-46366; the major one was identical with awamycin and the minor one was a new ansamycin antibiotic, ansathiazin . Their structures were elucidated from their reactions and spectroscopic analyses . These antibiotics were active against gram-positive bacteria, acid-fast bacteria and a protozoan.

Antibiot Med Biotekhnol, 1986 Oct, 31(10), 741 - 3
{Formation of a new polyene antibiotic octamycin by a culture of Actinoplanes ianthinogenes subsp . octamycini}; Lysenkova LN et al.; A culture of Actinoplanes ianthinogenes subsp . octamycini producing a polyenic antibiotic with the UV spectrum characteristic of octaens was isolated . Optimal conditions for biosynthesis of the antibiotic were developed and an active variant 4041-6 producing 2 mg of octamycin per 100 ml of the medium was selected . A procedure for recovery of the antibiotic with the use of Sefadex LH-20 was used . Certain physicochemical characteristics of octamycin were defined . The data on the UV and IR spectra suggested the presence of an alkyl substituent in the octamycin chromophore . The antibiotic showed antitumor activity, sufficient activity against gram-positive bacteria and low activity against fungi and yeasts.

Acta Pathol Microbiol Immunol Scand {B}, 1986 Oct, 94(5), 293 - 300
Isolation and characterization of a mucin-degrading strain of Peptostreptococcus from rat intestinal tract; Carlstedt-Duke B et al.; A mucin-degrading microorganism was isolated from the intestinal tract by serial sectioning from the serosal side of the caecum wall from a conventional rat . The ability of degrading the intestinal water-soluble mucin was present both in vivo after monocontamination of germ-free rats and in vitro, when adding the microbe to Mucin medium . The morphology, Gram-positive cocci single or in short chains and the very weak biochemical activities allow us to place this strain in the species Peptostreptococcus micros.

Clin Orthop, 1986 Oct, (211), 122 - 7
Significance of operative cultures in total hip arthroplasty; Dupont JA; The significance of operative cultures to the development of deep infections in total hip arthroplasties performed for failures of previous surgeries was studied . Four hundred fifty conversion total hips were followed for three or more years . Twenty-nine percent had had more than one prior surgery . One hundred twenty-one organisms in 81 hips (18%) were found . Gram-positive cultures were increased in rheumatoid arthritis . Twenty (4.4%) of the hips became infected . Nine (11%) of the hips with positive cultures and 11 (3%) of the hips with no growth at conversion later developed infections . Failed total hip arthroplasties with a positive culture had a 40% rate of reinfection . Rheumatoid hips had a two-times higher infection rate, and 80% were caused by gram-negative organisms . Hips with a gram-negative growth at the time of conversion had a higher infection rate than hips infected with gram-positive organisms.

J Antimicrob Chemother, 1986 Oct, 18 Suppl C, 13 - 23
R plasmid transfer; Thompson R; This paper is a brief survey of the systems of genetic exchange in bacteria relevant to the spread of antibiotic resistance genes . Emphasis is given to those systems most likely to be important in nature, particularly conjugation . Several recently described examples of conjugation in Gram-positive bacteria are discussed and contrasted with the better studied examples in Gram-negative bacteria.

J Antimicrob Chemother, 1986 Oct, 18(4), 521 - 9
Comparative multicentre evaluation of the safety and efficacy of ceftazidime versus cefamandole for pneumonia; Yangco BG et al.; Ceftazidime and cefamandole were compared in a randomized multicentre trial in hospitalized patients with pneumonia . Of 290 patients enrolled, 92 patients in the ceftazidime group and 71 patients in the cefamandole group were evaluable . Geometric mean MICs of organisms isolated and tested to ceftazidime were within achievable therapeutic serum concentrations of ceftazidime . Satisfactory clinical responses were observed in 91% (84/92) of ceftazidime-treated patients and 83% (59/71) of cefamandole-treated patients (P greater than 0.05) . Superinfection occurred in one (1%) ceftazidime-treated patient and in five (7%) cefamandole-treated patients . Side effects were infrequent with either treatment . Ceftazidime is as safe and effective as cefamandole for the treatment of pneumonia due to a variety of Gram-positive and Gram-negative pathogens.

Blut, 1986 Oct, 53(4), 333 - 9
Ceftazidime does not enhance cyclosporin-A nephrotoxicity in febrile bone marrow transplantation patients; Verhagen C et al.; Ceftazidime was used as monotherapy for 30 febrile episodes in 28 patients, who underwent allogeneic bone marrow transplantation and who were treated concomitantly with the immunosuppressive agent cyclosporin-A . Ceftazidime did not enhance the well established nephrotoxicity of cyclosporin-A as measured by serum creatinine levels or creatinine clearance . Although an increasing number of Gram-positive infections in these patients warrants vigilance, ceftazidime as initial empirical monotherapy proved to be successful in 95% of all febrile post-transplantation patients . All Gram-negative and 69% of the Gram-positive infections were cured with ceftazidime alone . The overall clinical cure rate was 72%, with microbiological clearance in 63% . This compares favourably with aminoglycoside containing schedules and avoids the aminoglycoside associated nephrotoxicity.

J Ethnopharmacol, 1986 Sep, 17(3), 205 - 11
Investigation of Grewia bicolor Juss; Jaspers MW et al.; Grewia bicolor is a small tree, parts of which are used in Sudanese traditional medicine for treating pustulent skin lesions, internally on indication of a delayed afterbirth and sometimes as a tranquilizer . A phytochemical investigation of Grewia bicolor gave the following results: the petroleum ether extract afforded beta-sitosterol and beta-sitosterol- and triterpene esters, and the triterpenes lupeol and betulin . The methanol extract afforded: beta-sitosterol-glucoside and three alkaloids, harman, 6-methoxyharman and 6-hydroxyharman . The latter is the main alkaloid . The methanol extract shows activity against gram-positive and gram-negative organisms and causes a strong contraction of the isolated rat uterus which can be blocked by methysergide.

Arch Environ Health, 1986 Sep-Oct, 41(5), 306 - 11
Airborne microbial contaminants in indoor environments . Naturally ventilated and air-conditioned homes; Kodama AM et al.; The atmospheric burden of viable particulates in the interiors of condominium homes with central air conditioning was compared with that of the typically more open-type of naturally ventilated Hawaiian homes . Andersen microbial air samplers were used to enumerate the numbers and kinds of respirable fungi and bacteria inside the residences . The results were compared with that obtained outside the homes to evaluate the impact of the air conditioning systems on indoor air quality . There were no significant differences in microbial air contaminants between the outdoors and the air inside naturally ventilated residences . The air inside air conditioned homes were found to have fewer fungi, including a significantly smaller number of Cladosporium sp., but had a significantly greater number of Aspergillus sp . when compared to the outdoors . The total number of bacteria and the number of Gram positive (+) cocci were significantly larger inside air-conditioned residences than outside . A preliminary health status survey revealed occupants of centrally air-conditioned homes had more complaints of eye irritation, sneezing, nasal congestion, and cough.

Am J Med, 1986 Sep, 81(3), 405 - 11
Transfusion-related sepsis after prolonged platelet storage; Anderson KC et al.; The antecubital fossa venipuncture site in frequent blood donors can become scarred or "dimpled" and colonized with surface and deep bacteria that are not sterilized by standard iodophor preparation techniques . These microorganisms can be introduced into blood or platelets at the time of donation . Recent advances that permit the prolonged storage of platelets at room temperature before transfusion allow proliferation of these contaminating bacteria, particularly gram-positive microorganisms . Documented are three episodes of platelet contamination with gram-positive organisms and four cases of sepsis in recipients of these platelets, which were obtained through the "dimpled" site of a single donor and stored for at least 80 hours at 22 degrees C before transfusion . In contrast, platelets harvested from this donor's "dimpled" site and stored for not more than 50 hours were transfused to 25 patients without complication . Therefore, the extended storage of platelets at 22 degrees C prior to transfusion demands strict awareness of any possible sources of extrinsic contamination, since gram-positive bacteria can proliferate under these conditions and result in infectious complications in recipients.

Arch Surg, 1986 Sep, 121(9), 1027 - 31
Association of burn mortality and bacteremia . A 25-year review; Mason AD Jr et al.; The relationship between bacteremia and mortality was studied in 5882 burn patients consecutively admitted to one burn center between 1959 and 1983 . Among 5877 patients with adequate data, 1481 had one or more positive blood cultures; 1529 patients died . A predictor of mortality was developed, based on data from the 4396 patients without positive blood cultures, and used to assign a discrete probability of death in the absence of bacteremia to all the patients . Comparisons were then made between observed and predicted mortality in subsets of patients with bacteremia due to enteric organisms, Pseudomonas species, gram-positive organisms, or yeastlike organisms, or without bacteremia . These comparisons indicate significantly increased mortality in patients with gram-negative bacteremia, an equivocal increase in patients with blood cultures positive for yeastlike organisms, and no increase attributable to gram-positive bacteremia.

Jpn J Antibiot, 1986 Sep, 39(9), 2534 - 42
{Study on cefotiam in the perinatal period}; Takase Z et al.; Cefotiam (CTM), a new cephem antibiotic with high activity against Gram-positive and Gram-negative bacteria, has been investigated for use in 60 mothers in perinatal period, and following results were obtained . The concentration of CTM in maternal serum was 38 micrograms/ml at 0.5 hour after an intravenous administration of 1 g . A good transport of CTM into umbilical cord serum and amniotic fluid was observed after the intravenous administration into the mother . No adverse effect appeared in the neonates . The CTM is highly useful antibiotic in perinatal infections, and the safe dose of CTM to the mother in perinatal period is considered to be 1-2 g per day.

Mikrobiologiia, 1986 Sep-Oct, 55(5), 831 - 5
{New species of bacteria in the genus Kurthia--Kurthia sibirica sp . nov.}; Belikova VA et al.; Six aerobic gram-positive nonspore-forming bacterial strains belonging to the Kurthia genus were isolated from the Magadan (Susuman) mammoth found in the permafrost of the East Siberia . The strains are a phenotypically homogeneous group different from the two known species (K . zopfii and K . gibsonii) in requiring more vitamins, the absence of growth in a medium with 7% NaCl, and a low level of DNA-DNA hybridization (not more than 45%) . Moreover, the strains differ from K . zopfii in the synthesis of a yellow pigment, the activity of phosphatase, and the absence of coccoid forms; the bacteria differ from K . gibsonii in the absence of growth at a temperature above 40 degrees C . The organisms are referred to as Kurthia sibirica sp . nov . The type strain 13-2 has been deposited in the All-Union Collection of Microorganisms as strain VKB B-1549.

J Biol Buccale, 1986 Sep, 14(3), 223 - 8
Inorganic pyrophosphatase activity in a plaque calcifying microorganism: Bacterionema matruchotii; Pellat BP et al.; The presence and activity of an alcaline pyrophosphatase of Bacterionema matruchotii, a Gram positive filamentous organism present in the bacterial plaque and calculus was studied . A strong enzymatic activity was demonstrated . The optimal conditions for this activity (alcaline pH, magnesium cofactor) have to be related to the pyrophosphatase conditions found in other calcifiable structures . The activity was shown in intact bacteria as well as in the culture medium devoid of micro-organisms . The strongest activity having been demonstrated in broken cells, it can be postulated that the enzyme is active inside the cell . The hypothesis of a contribution of Bacterionema matruchotii to the mineral phase formation is proposed; it is possible that the pyrophosphatase produced by this microorganism contributes to the mineralization process involved in dental calculus formation.

Appl Environ Microbiol, 1986 Sep, 52(3), 450 - 9
Mechanism of inactivation of enteric viruses in fresh water; Ward RL et al.; Fresh water obtained from nine sources was shown to cause inactivation of poliovirus . Further testing with four of these water samples showed that enteric viruses from different genera were consistently inactivated in these freshwater samples . Studies on the cause of inactivation were conducted with echovirus type 12 as the model virus . The results revealed that the virucidal agents in the waters tested could not be separated from microorganisms . Any treatment that removed or inactivated microorganisms caused loss of virucidal activity . Microbial growth in a sterilized creek water seeded with a small amount of stream water resulted in concomitant production of virucidal activity . When individual bacterial isolates obtained from a stream were grown in this sterilized creek water, most (22 of 27) produced a large amount of virucidal activity, although the amount varied from one isolate to the next . Active and inactive isolates were represented by both gram-positive and gram-negative organisms . Examination of echoviruses inactivated in stream water revealed that loss of infectivity first correlated with a slight decrease in the sedimentation coefficient of virus particles . The cause appeared to be cleavage of viral proteins, most notably, VP-4 and, to a lesser extent, VP-1 . Viral RNA associated with particles was also cleaved but the rate was slower than loss of infectivity . These results suggest that proteolytic bacterial enzymes inactivate echovirus particles in fresh water by cleavage of viral proteins, thus exposing the viral RNA to nuclease digestion.

Ann Inst Pasteur Microbiol, 1986 Sep-Oct, 137B(2), 165 - 75
Ribosomal ribonucleic acid gene restriction patterns as potential taxonomic tools; Grimont F et al.; Deoxyribonucleic acid from 41 different bacterial species (including Gram-negative and Gram-positive species) were cleaved by different restriction endonucleases, electrophoresed in agarose and transferred to nylon filters . The DNA fragments carrying rRNA genes (rDNA) were localized by hybridization with a 32P-labelled Escherichia coli 16 + 23S rRNA probe . A pattern of hybridized fragments was obtained for each DNA tested . Within a bacterial species (defined as a DNA hybridization group), one or several rDNA restriction patterns were observed . When DNA hybridization data were available, strains showing identical patterns were highly related with insignificant divergence . In a species, different patterns corresponded to significant divergence, as evaluated by thermal stability studies of DNA/DNA hybrids . Sets of rDNA restriction fragment sizes might constitute useful data for inclusion in species and type strain descriptions . Such data might later prove useful in identification of bacteria when biochemical characteristics are poor or atypical.

Am J Med, 1986 Aug, 81(2), 243 - 8
Aztreonam therapy in neutropenic patients with cancer; Jones PG et al.; Combinations of aztreonam/vancomycin, aztreonam/vancomycin/amikacin, and moxalactam/ticarcillin were compared in a prospective randomized trial as empiric therapy for febrile neutropenic cancer patients . Vancomycin was added to aztreonam to provide coverage against gram-positive organisms . Of 535 febrile episodes included in the study, 455 were evaluable . The aztreonam/vancomycin and aztreonam/vancomycin/amikacin combinations were both more effective than the moxalactam/ticarcillin combination in a total of 244 episodes of documented infection . The difference was due to the fact that both aztreonam-containing combinations were more effective than the moxalactam/ticarcillin combination in documented gram-positive infections . The three regimens were equally effective in 67 documented infections due to a single gram-negative bacterial species . (The response rates were 87, 86 and 94 percent for the aztreonam/vancomycin, aztreonam/vancomycin/amikacin, and moxalactam/ticarcillin combinations, respectively.) Aztreonam was effective as the single active antibiotic in the treatment of gram-negative infections in neutropenic patients; however, it must be used in combination with another antibiotic to provide gram-positive coverage.

Acta Pathol Microbiol Immunol Scand {C}, 1986 Aug, 94(4), 131 - 6
Bacteria are polyclonal T-dependent stimulants of immunoglobulin formation; Rasanen L et al.; Various gram-positive and gram-negative bacteria were tested for their ability to induce antibody secretion in human blood cell cultures . Total and specific immunoglobulin levels in the culture supernatants were quantitated with enzyme-linked immunosorbent assays (ELISA) . All the twelve strains used stimulated IgM and IgG secretion in adult mononuclear cell cultures . With the four strains tested, also umbilical cord blood cells produced IgM . Specific antibodies directed against two bacteria were sought in adult and newborn cell culture but none were found . Bacterium-induced antibody synthesis thus seemed to be polyclonal . Experiments with purified T and B lymphocytes showed that bacterium-driven antibody formation was T-cell dependent.

Hinyokika Kiyo, 1986 Aug, 32(8), 1203 - 12
{Therapeutic studies on male non-gonorrheal urethritis--use of AT-2266--Sapporo Clinical Research Group for STD}; Kumamoto Y et al.; AT-2266 tablets were administered orally in a daily dosage of 600 mg for 7 consecutive days as treatment of non-gonorrheal urethritis in 106 cases . The therapeutic results in 90 cases were investigated, and a detailed analysis of various background factors was also performed . Most of the patients were between 15 and 35 years old; 11.3% of the patients were between 15 and 19 years old . The source of infection was a "professional" woman such as a prostitute in 37 cases, and a non-professional woman in 53 cases . This is noteworthy because the source is more often a "professional" women in the case of gonorrhea . Bacterial isolates were obtained by culture of the urethral secretions . Most were gram-positive cocci, especially S . epidermidis, but, in 51.7% of the patients, no bacteria could be cultured . The urethral secretion was purulent in 51.9% of the patients, and serous in the remaining 48.1% . The efficacy rates obtained when AT-2266 was administered in a daily dosage of 600 mg (in 3 divided oral doses) for 7 days were as follows . In the purulent secretion group, the 3-day and 7-day therapeutic efficacy (elimination of the secretion) rates were 24.2% and 61.2% . In the serous secretion group, the corresponding efficacy rates were 36% and 71.4% . Thus the therapeutic efficacy was slightly inferior in the purulent secretion group . Oral administration of AT-2266 resulted in side effects in 5 of the patients (5.5%) . These side effects consisted primarily of mild gastrointestinal disturbances, which did not require discontinued drug administration.

Biochim Biophys Acta, 1986 Jul 24, 859(2), 219 - 26
The role of acyl chain character and other determinants on the bilayer activity of A21978C an acidic lipopeptide antibiotic; Lakey JH et al.; An acidic lipopeptide A21978C has previously been shown to have a powerful antibiotic activity against Gram-positive organisms . Due to its ability to increase the K+ permeability of bacterial cells and its specific calcium requirement, which is similar to a previously described ionophore CDA, its effect on planar bilayer membranes has been studied . Although it produces significant increases in the conductivity of lipid bilayers it is shown that this alone cannot account for its in vivo activity . Similarly, unlike the in vivo results, the Ca2+-induced increases in bilayer conductivity can be mimicked by Mg2+ and charged lipids . Results from a series of homologues differing in the length of the acyl moiety show a close similarity between bilayer conductance and LD50 trends from in vivo studies . A complex activity is proposed which depends upon incorporation in, rather than disruption of, the bilayer membrane.

Sex Transm Dis, 1986 Jul-Sep, 13(3 Suppl), 189 - 91
Advances in the diagnosis and management of chancroid; D'Costa LJ et al.; PIP: Physicians paid little attention to chancroid and its causative agent Hemophilus ducreyi until the late 1970s and early 1980s . Therefore diagnoses are insufficient . In addition, physicians do not manage chancroid well and public health officials cannot control its spread . Chancroid is endemic in developing countries, but periodically chancroid epidemics do occur in developed countries . Gram positive cocci which also flourish in chancroid ulcers often overgrow H . ducreyi (a gram negative rod) making it hard to diagnose infection . Besides, for optimal chance of H . ducreyi isolation, a health worker must directly inoculate pus from the ulcer onto either gonococcal or Mueller-Hinton agar in the Petri dish . To further complicate diagnosis, clinical and epidemiological characteristics of patients who are H . ducreyi culture negative are like those of patients who are H . ducreyi culture positive . Moreover genital ulceration varies like it does with Treponema pallidum or herpes simplex virus . In fact, only about 40% of men and 29% of women have an ulcer . Nevertheless a chancroid lesion starts out as papule that soon turns into an ulcer . Around 33% of all patients experience lymphadenopathy . If chancroid is not treated, the lymph nodes swell and exude pus . They eventually burst and drain chronically . Prostitutes and other sexually active females with ulcers tend to be reservoirs of H . ducreyi . As of late 1990, researchers could not culture H . ducreyi from asymptomatic males . Another exacerbation of the problems with chancroid is that H . ducreyi is resistant to most antibiotics . Yet erythromycin, ceftriaxone, and cefotaxime treatment yield positive results . A study in Kenya shows that treatments with 1000 mg, 500 mg, and 250 mg ceftriaxone cured 97% of men with genital ulcer disease . Since diagnosis is difficult; anyone with chancroid and his/her contacts should be treated immediately .

J Gen Microbiol, 1986 Jun, 132 ( Pt 6), 1591 - 7
Analysis of EDTA-soluble cell surface components of gram-positive anaerobic cocci; Smith GL et al.; The protein content of EDTA extracts from 76 strains of Gram-positive anaerobic cocci was examined using SDS-PAGE . Strains of Peptostreptococcus anaerobius produced almost identical profiles; greater heterogeneity was observed within the species Peptococcus magnus, Peptococcus prevotii and Peptococcus asaccharolyticus, but several strains within each biotype produced similar patterns . Serological investigation of these extracts by ELISA revealed numerous cross-reactions among the different biotypes . Immunoblot transfers from polyacrylamide gels demonstrated two common antigens within strains of the species, Ps . anaerobius, but these were not species-specific.

Pathol Res Pract, 1986 Jun, 181(3), 320 - 6
Actinomycosis and nocardiosis . A morphologic study of 17 cases; Oddo D et al.; Actinomycosis and nocardiosis are bacterial infectious diseases with distinct morphologic features, that can be diagnosed in tissue sections . The clinico-pathologic features of 17 cases are reported with emphasis on their histopathologic diagnosis by using a simple combination of common tissue stains . Actinomycosis was frequently observed as a secondary and localized infection often with lung involvement, especially in residual cavities or bronchiectasis; in these cases numerous actinomycotic granules and only occasionally individual bacterial filaments within the suppurative foci and/or granulomas with suppurative centers were identified . Nocardiosis was observed as an opportunistic infection in the three cases studied; in these, isolated filaments of acid-fast and Gram-positive bacteria were observed . The morphologic features and the differential diagnosis in tissue sections of both infections are discussed with emphasis on their identification by the general pathologist in the routine material.

J Appl Bacteriol, 1986 Jun, 60(6), 491 - 500
Estimation of gram-negative bacteria in milk: a comparison of inhibitor systems for preventing gram-positive bacterial growth; Phillips JD et al.; A number of inhibitor systems which have been reported to allow selection of Gram-negative bacteria were tested against Gram-positive and Gram-negative isolates of dairy origin . No one system worked perfectly . A mixture of crystal violet-penicillin-nisin or monensin had least inhibitory effect on Gram-negative isolates whereas Selectocult (a commercially available mixture of Benzalkon A 50% and crystal violet) and sodium deoxycholate were the most effective inhibitors of Gram-positive bacteria . Cetrimide-fucidin-cephaloridine solutions, which have been reported as allowing selective growth of pseudomonads, were not so specific when applied to milk systems.

Chem Phys Lipids, 1986 Jun-Jul, 40(2-4), 303 - 14
Antibodies to liposomes, phospholipids and phosphate esters; Alving CR; Polyclonal and monoclonal antibodies to liposomes having various phospholipid compositions have been produced . Binding of the anti-lipid bilayer antibodies is influenced both by the chemical composition and the physical state of the liposomal lipids . The antibodies to liposomes have a 'subsite' in the binding site that recognizes small soluble phosphorylated haptens such as nucleotides (e.g., ATP) . The capacity of anti-liposome antibodies to bind to phosphate is also shared by antibodies to numerous other substances, including lipid A from Gram-negative bacterial lipopolysaccharide, cardiolipin, DNA, polynucleotides, and lipoteichoic acids from Gram-positive bacteria . Because of similarities of chemical structures between all of these molecules widespread immunological cross-reactivities are observed.

J Antibiot (Tokyo), 1986 Jun, 39(6), 773 - 9
Studies on a new antibiotic SF-2330 . I . Taxonomy, isolation and characterization; Itoh J et al.; A new antibiotic SF-2330 active against Gram-positive bacteria has been isolated from the culture broth of Streptomyces sp . SF-2330 . The antibiotic was obtained as orange needle crystals and its molecular formula was C22H14O7 . This is a new member of the pluramycin group antibiotics.

Chemioterapia, 1986 Jun, 5(3), 213 - 6
Miocamycin and theophylline blood levels; Rimoldi R et al.; Two groups of patients were studied in order to evaluate the possible interference of miocamycin with theophylline blood levels . One group was treated with i.v . theophylline and another one was treated with slow-release theophylline . Both groups did not show any changes in theophylline blood levels . Therefore we can draw the conclusion that miocamycin, a new macrolide, is active on gram-positive and some gram-negative bacteria besides mycoplasma, legionella and chlamydia and it can be used in association with theophyllinic compounds without interaction on theophylline blood concentrations.

Jpn J Antibiot, 1986 Jun, 39(6), 1514 - 8
{Fundamental study of imipenem/cilastatin sodium in obstetrics and gynecology}; Taguchi K et al.; Following results were obtained from drip intravenous administration of imipenem/cilastatin sodium (MK-0787/MK-0791) (500 mg/500 mg) by measuring concentration of MK-0787 in uterine arterial plasma, cubital venous plasma, oviduct, ovary and several sites in uterine tissue in cases of simple hysterectomy, and pelvic cavity fluid in cases of radical operation . Cervix uteri, portio vaginalis, myometrium showed higher concentration among various uterine tissues in any time after the end of administration . In cases of radical operation, the pelvic cavity fluid showed 6.6 approximately 7.8 micrograms/ml at 5 hours after the end of administration . In the field of obstetrics and gynecology, it was considered that MK-0787/MK-0791 has good efficacy in infections especially caused by Gram-positive aerobic bacteria.

J Biol Buccale, 1986 Jun, 14(2), 115 - 24
Ultrastructural development of dated plaque in case of denture stomatitis; Walter B et al.; Using special acrylic discs glued into the palatal surface of a denture the development of denture plaque in a case of denture stomatitis as well as the relationships between the denture surface, pellicle, plaque and palatal epithelium were studied with transmission electron microscopy after 30 mn, 1 h, 4 h, 8 h, 24 h, 48 h, 9 days and 29 days . A thin pellicle which increased in thickness from 9 hours to 28 days was visible at the surface of the acrylic denture . It appeared that bacteria retained in the palatal epithelial intercellular spaces were the source of the plaque which developed at the surface of the acrylic denture . Initially loosely packed cocci-like and a few rod-shaped Gram positive bacteria appeared in 8 hours samples at the denture-epithelium interface . An important increase in denture plaque thickness was noted between 24 and 48 hours . In 9 and 28 days samples, coccoid and rod-shaped Gram positive and Gram negative bacteria were present and filamentous bacteria began to be apparent . In all the samples studied, Candida was rare.

Infusionsther Klin Ernahr, 1986 Jun, 13(3), 152 - 7
{Clinical study of the bacterial contamination of 2 differently prepared enteral feeding solutions}; Pfenninger E et al.; The incidence of bacterial contamination under ICU-conditions of two solutions designed for enteral feeding; the oligopeptide mixture Peptisorb and the nutrient defined diet Biosorb, were investigated . 54% of the specimens taken prior to use from the oligopeptide mixture, which is marketed as a powder and brought into solution before application, were found to be bacterially contaminated . At the end of the 6-12 h application period this percentage has risen to 79% . Prior to use the sterile packed prepared nutrient defined diet was found to be free of bacterial contamination in 97% of cases, while at the end of the period of application 21% of the samples taken contained bacteria . In most instances the solutions prepared on ICU were contaminated with gram positive spore forming bacteria and typical gram negative hospital flora . Based on the results of this investigation, only those enteral feeds which are marketed as sterile solutions should be used, in order to protect ICU patients from potential sources of contamination.

Int J Clin Pharmacol Ther Toxicol, 1986 Jun, 24(6), 333 - 6
Ceftazidime in pediatric infections unsuccessfully treated with other antibiotics: an evaluation of its efficacy and tolerability in compromised host; Boner AL et al.; Ceftazidime (C) is a cephalosporine active against Gram-positive and especially negative bacteria . The aim of the study was to evaluate efficacy and tolerance of C in the treatment of children suffering from infections previously treated unsuccessfully with different antibiotics . We examined 20 children, administering a dosage of C 30 to 100 mg/kg intravenously or intramuscularly for a mean treatment duration of 8.6 days . A favorable response was observed in all the children: of the 20 patients 13 were cured and 7 improved . A transient elevation of liver enzymes was noted in three children . The study confirms the efficacy of C in the treatment of severe infections . Since 9 of the 20 patients were neonates, we suggest the possible role of C in the newborns' infections.

J Theor Biol, 1986 May 7, 120(1), 73 - 84
The pH in the neighborhood of membranes generating a protonmotive force; Koch AL; The chemiosmotic mechanism provides a way whereby energy inherent in a chemical combustion process is extracted and transduced: first into the energy of electron X volts of the electron redox system and second into proton X volts as protons are forced to leave the interior of the cell, creating an electro-chemical protonic potential (the protonmotive force) . Here we consider the distribution of potential and pH across the membrane and the phases bathing the membrane in more detail . The distribution of hydrogen ions parallel to the surface is also described . It is shown that the voltage and pH gradients due to the proton extrusion occur near to the membrane (approximately 2 nm) . This implies that the pH is much lower immediately outside the membrane than in the cytoplasm or in usual neutral growth or isotonic media . It provides a link between the points of view of Mitchell and Williams . It requires that literature models for the role of the protonmotive force in the maintenance of wall thickness in Gram-positive organisms, the adhesion of microbes to surfaces, and the transport of auxin in plants be modified.

Thorax, 1986 May, 41(5), 396 - 400
Antibiotic prophylaxis in cardiothoracic surgery in the United Kingdom: current practice; Wilson AP et al.; A survey was conducted of the current practice of antibiotic prophylaxis in cardiac surgery throughout the United Kingdom . Most surgeons (84%) use a regimen covering a broad spectrum of bacterial species that is continued for two to three days after the operation . The most used regimens are a combination of beta lactamase resistant penicillin with an aminoglycoside (44%) or a single broad spectrum cephalosporin (30%) . Just 16% of surgeons preferred a narrow spectrum regimen effective against only the Gram positive organisms commonly responsible for postoperative infection in these patients . Antibiotic prophylaxis has been adopted by all cardiac surgeons in the United Kingdom but is sometimes continued longer than is indicated by the clinical or experimental evidence.

J Antibiot (Tokyo), 1986 May, 39(5), 624 - 8
DC-86-M, a novel antitumor antibiotic . II . Structure determination and biological activities; Takahashi K et al.; A novel antibiotic, DC-86-M was isolated from the culture broth of Streptomyces luteogriseus DO-86 . The antibiotic has the molecular formula of C17H14N2O5 and belongs to the phenazine antibiotics . Its structure has been elucidated by mass and NMR spectra . It is active against Gram-positive and Gram-negative bacteria and experimental murine sarcoma 180.

Antimicrob Agents Chemother, 1986 May, 29(5), 774 - 80
Lack of relevance of kinetic parameters for exocellular DD-peptidases to cephalosporin MICs; Boyd DB et al.; MICs of a set of cephalosporins against a variety of gram-positive and gram-negative pathogens showed no strong correlations with the rate at which these inhibitors acylate or are deacylated by beta-lactam-sensitive DD-peptidases excreted by Streptomyces sp . strain R61 and Actinomadura sp . strain R39.

CMAJ, 1986 May 1, 134(9), 1019 - 22
Peritonitis during continuous ambulatory peritoneal dialysis in children; Watson AR et al.; The use of continuous ambulatory peritoneal dialysis (CAPD) in children has proved beneficial . However, peritonitis remains the major complication . A review of the incidence of peritonitis in 55 children (mean age 9.6 years) who underwent CAPD between 1978 and 1984 showed that there were 67 episodes of peritonitis (1 per 9.4 patient-months) in 33 of the 55 . Three patients accounted for 22 of the episodes . In all cases, treatment with antibiotics, given intraperitoneally, was successful . Cephalothin was routinely given for infections due to gram-positive organisms, tobramycin for infections due to gram-negative organisms . Peritonitis recurred in seven patients, of whom five had to have their catheters replaced because of associated chronic infections of the deep peritoneal cuff, the exit site or the catheter tunnel . Although peritonitis was a common complication of CAPD in this population, it did not affect the success of the technique.

J Clin Invest, 1986 May, 77(5), 1533 - 8
Bacterial lipoteichoic acid sensitizes host cells for destruction by autologous complement; Hummell DS et al.; Lipoteichoic acids (LTA) released by gram-positive bacteria can spontaneously bind to mammalian cell surfaces . In the present study, erythrocytes (E) sensitized with pneumococcal LTA (LTA-E) were used as a model system to determine if LTA could render host cells susceptible to damage by autologous complement . Complement (C)-mediated lysis of LTA-E from normal rats and normal humans occurred when these cells were incubated in their respective autologous sera in vitro . In addition, when LTA-E from a C2-deficient human and from C4-deficient guinea pigs were incubated in their autologous sera, there was significant lysis in vitro, demonstrating a role for the alternative pathway . The in vivo survival of 51Cr-labeled autologous LTA-E was also studied . Only 2.9% of autologous LTA-E remained in the circulation of normal rats after 90 min . In contrast, 31.2% of autologous LTA-E remained in the circulation of rats depleted of C3 . Intravascular hemolysis accounted for the clearance of LTA-E in the normal rats, whereas liver sequestration was responsible for clearance in the C3-depleted rats . These results demonstrate that LTA can render the host's cells susceptible to damage by its own complement system, establishing this as a possible mechanism of tissue damage in natural bacterial infections.

Am J Ophthalmol, 1986 Apr 15, 101(4), 429 - 33
Ulcerative keratitis associated with contact lens wear; Alfonso E et al.; A review of 573 cases of ulcerative keratitis cultured at the Bascom Palmer Eye Institute from January 1977 through September 1982 showed that 118 cases (21%) were associated with contact lens wear; of these, 64 were culture-positive . Of these culture-positive cases, 50 (78%) were caused by gram-negative bacteria, nine (14%) by gram-positive organisms, and two (3%) by fungal organisms . Of the 264 culture-positive ulcers not associated with contact lens wear, 119 (45%) were caused by gram-negative bacteria, 74 (28%) by gram-positive organisms, and 63 (24%) by fungal organisms . These statistically significant differences suggested that the organisms associated with ulcerative keratitis within our geographic region are modified by contact lens use . Pseudomonas was the organism most frequently isolated from ulcers associated with contact lenses and was responsible for nearly two thirds of the culture-positive cases.

J Bacteriol, 1986 Apr, 166(1), 72 - 7
Critical micelle concentrations of lipoteichoic acids; Wicken AJ et al.; Purified lipoteichoic acids (LTAs) from several gram-positive organisms have been shown, by methods involving spectral changes of an added merocyanine dye probe, to have critical micelle concentrations in the range of 1 to 10 micrograms/ml, suggesting that acylated LTAs in their monomer forms may represent the major configuration of extracellular LTAs in bacterial culture fluids . The critical micelle concentrations obtained did not differ markedly with degree of carbohydrate substitution of the polymers . The significance of these findings in relation to the biological properties of LTA is discussed.

Acta Chir Scand, 1986 Apr, 152, 317 - 8
Spontaneous peritonitis and rheumatoid arthritis--a case report; Skau T et al.; An unusual case in which an adult patient with rheumatoid arthritis developed a fulminant spontaneous gram-positive bacterial peritonitis and underwent emergency laparotomy for this condition is presented . Spontaneous peritonitis in adult patients was previously seen only in patients with liver disease, nephrotic syndrome or systemic lupus erythematosus.

Sci Sin {B}, 1986 Apr, 29(4), 379 - 88
Studies on glutamine synthetase from Streptomyces hygroscopicus var . jinggangensis; Xia TH et al.; Streptomyces hygroscopicus var . jinggangensis produces validamycin, an important antibiotic used in agriculture . It was found that there was a positive correlation between the specific activity of mycelial glutamine synthetase (GS) and validamycin biosynthesis in our laboratory . So, in this paper, the purification, characteristics and regulatory properties of GS are reported . The native enzyme had a molecular weight of approximately 530,000 and was composed of 12 identical subunits, each 43,000 . Electronic microscopic examination of preparations negatively stained disclosed that the subunits were arranged in two hexagonal rings that lay one on top of the other in a face-to-face fashion . Mg2+ or Mn2+ was absolutely needed as cofactor for GS activity . The enzyme activity was regulated by feedback inhibition and cumulative feedback inhibition . In addition, it was also regulated through a covalent modification, adenylylation and deadenylylation, suggesting that the covalent modification of GS exists not only in Gram-negative bacteria but also in some Gram-positive bacteria.

Eur J Biochem, 1986 Mar 17, 155(3), 557 - 63
Molecular and functional properties of protein SS1 from small ribosomal subunits of Streptomyces aureofaciens; Mikulik K et al.; Small ribosomal subunits of gram-positive cells of Streptomyces aureofaciens contain an acidic protein designated SS1 . Purified protein SS1 has the same mobility in sodium dodecyl sulfate/polyacrylamide gel as ribosomal protein S1 of Escherichia coli (apparent Mr 68 000) . Protein SS1 was dissected under mild conditions with trypsin and generated fragments were compared with well-characterized fragments of protein S1 . The protein SS1 contains a structure homologous with the C-terminal fragment of protein S1 . The affinity of protein SS1 to poly(U) is virtually identical with that of E . coli protein S1 . In contrast to protein S1, the addition of SS1 to partially S1-depleted ribosomes of E . coli had no stimulatory effect on poly(U)-directed synthesis of polyphenylalanine . At molar excess of SS1 over ribosomes, the protein had comparable inhibitory effect on polypeptide synthesis as had S1 of E . coli . Ribosomes of S . aureofaciens required about one order of magnitude higher concentration of poly(U) for maximum synthetic activity than did ribosomes of E . coli . The addition of proteins SS1 or S1 to ribosomes of S . aureofaciens had no stimulatory effect on translation of poly(U) . Our data indicate that the high-molecular-mass acidic protein SS1 of small ribosomal subunits of S . aureofaciens exhibits only a part of the functional properties of E . coli protein S1.

Mycopathologia, 1986 Mar, 93(3), 185 - 7
The second case of mycetoma due to Nocardia caviae in Israel; Alteras I et al.; A second case of actinomycetoma due to Nocardia caviae contracted in Israel is reported . A 39-year-old female of Yemenite origin, resident in Israel for more than 15 years, presented with a sclerotic tumor mass on the dorsum of the right foot which discharged an oily purulent fluid containing minute yellowish granules . Seen in the microscopic examination of smears were thin Gram-positive filaments and bacillary elements . Culture of the crushed granules yielded small pale colonies identified as Nocardia caviae . In vitro testing of the isolate to various antibiotics, isoniaside and sulphonamides showed the organism to be more sensitive to isoniaside and tetracycline . Isoniaside was administered for one year with marked improvement and was then replaced by tetracycline due to side effects, this treatment still being continued.

Infection, 1986 Mar-Apr, 14(2), 68 - 70
Bacteremia in patients suffering from cirrhosis; Almdal T et al.; In a five-year retrospective study, there were 57 episodes of bacteremia among 1623 admissions (3.5%) of patients suffering from cirrhosis . Gram-positive bacteria were found in 70% of the episodes, gram-negative bacteria in 30% . All of the gram-positive bacteria found were fully sensitive to methicillin and to gentamicin . The gram-negative bacteria found were all sensitive to gentamicin, but only 50% were sensitive to ampicillin . The distribution between gram-positive and gram-negative bacteria was the same, irrespective of whether the patients acquired the infection inside or outside the hospital . More than 50% of the patients suffered from one or more of the following complications of cirrhosis: ascites, encephalopathy and haematemesis . Twenty-one patients died within seven days after the bacteremia was diagnosed . Bacteremia is a serious complication of advanced cirrhosis, and it is recommended that adequate antibiotic treatment is started when septicemia is suspected.

No Shinkei Geka, 1986 Mar, 14(3 Suppl), 340 - 4
{Nocardia brain abscess and ventriculitis--resistance of Nocardia to sulfonamides and susceptibility to beta-lactams}; Oda Y et al.; A 31-year-old man had been healthy until the end of August, 1984 when he developed a sore throat, rhinorrhea, and high fever (39 degrees C) . He was found to have hematuria and leukocytosis, though his complaints were not severe, and was not absent from his work . From the September 30, he experienced continuous pains on both temple regions and the neck . On October 6, he visited our hospital without any inflammatory signs . A screening CT scan demonstrated a ring-like enhancing mass with remarkable perifocal edema in the right temporal lobe . On emergency admission on October 9, a low grade fever (37.4 degrees C) and slight leukocytosis were noted, but not other primary lesions were present . He had normal immunological function of both humoral and cellular types . A provisional diagnosis of malignant brain tumor was made, but a possibility of brain abscess was not completely ruled out . He was initially treated with antidiuretics and steroid with prophylactic antibiotics, and underwent follow-up CT scanning . After a 10-day period with no obvious changes in CT scan, he suddenly complained of severe headache and fever, and became stuporous . A subsequent CT scan showed signs of ventriculitis, and contrast-enhancing multiloculated capsules . A lumber puncture revealed an increased number of cells, and concentration of protein in the CSF . An emergency trephination and drainage of an abscess was performed . Gram positive, acid fast, and branching fungi were found in both the smear of pus, and the samples from surrounding brain tissues . These were later identified as Nocardia asteroides in bacteriological studies.(ABSTRACT TRUNCATED AT 250 WORDS)

J Antibiot (Tokyo), 1986 Mar, 39(3), 430 - 6
Structural studies on rhodilunancins A and B; Li M et al.; Antitumor antibiotics rhodilunancins A and B were isolated from a culture of Streptomyces violaceus var . lunanensis var . n . No . 1289 by acidic acetone extraction of mycelia and purified by silica gel chromatography . Rhodilunancin A is identical to cosmomycin A . Rhodilunancin B is identical to cosmomycin B (= rhodomycin Y) . Both antibiotics exhibited activities against Gram-positive bacteria and inhibition on DNA synthesis of P388 leukemia cell in vitro.

J Antibiot (Tokyo), 1986 Mar, 39(3), 345 - 53
Isolation and structure determination of crisamicin A, a new antibiotic from Micromonospora purpureochromogenes subsp . halotolerans; Ling D et al.; A new antibiotic, crisamicin A, with in vitro activity against Gram-positive bacteria, B16 murine melanoma cells, and herpes simplex, vaccinia, and vesicular stomatitis viruses, has been isolated from Micromonospora purpureochromogenes subsp . halotolerans . On the basis of 1H and 13C NMR spectroscopic, high resolution field desorption mass spectrometric, and circular dichroism studies of the antibiotic and several of its derivatives, the structure of crisamicin A has been assigned.

Jpn J Antibiot, 1986 Mar, 39(3), 761 - 71
{Augmentation by serrapeptase of tissue permeation by cefotiam}; Koyama A et al.; Cefotiam (CTM) is a new cephalosporin with a broad spectrum of activity against both Gram-positive and Gram-negative microorganisms . Cephalosporins are widely used for prophylaxis of infections in patients undergoing thoracotomy . Augmentation by serrapeptase on tissue permeation of CTM was examined in 35 thoracotomy patients with lung cancer . The subjects were divided into two groups according to the method of the administration of CTM . Group I consisted of 17 subjects, each of whom received a single dose of 2 g of CTM alone by an instillation for 30 minutes . Group II consisted of 18 subjects, each of whom received a combination of CTM and serrapeptase; serrapeptase was given 2 tablets (10 mg) each time for three times/day until the day before surgery, and then CTM was administered by the same procedure . The following results were obtained: Individual difference was observed for the permeation of CTM into tissues . Pathologic differences also affected the permeation . Nevertheless, the CTM levels in pulmonary tissues reached about a half of those in the blood in both the single dose group and the combination group, hence sufficient concentrations exceeding MIC80 for main microorganisms that caused infections in the lung were obtained . The concentrations of CTM in inflammatory tissues have showed lower levels than those of normal tissues in both CTM single dose and the combination groups . Decrease of blood flow volume may have contributed to the reduction in levels of CTM in the inflammatory tissues . The ratio of the concentration of the drug in pulmonary tissues to that in the blood was 29.1 +/- 2.5% in the single dose group, and 44.2 +/- 6.0% in the combination group, the latter showing quite a significant increase (P less than 0.05) . Combined administrations of CTM and serrapeptase deserves more trials in the case when surgical treatments of the lung are performed . An antiinflammatory effect of serrapeptase in the respiratory system is expected, and in addition, the combined use of CTM and serrapeptase should stimulate permeation of the antibiotic into tissues.

Afr J Med Med Sci, 1986 Mar-Jun, 15(1-2), 1 - 5
Detection of bacterial spoilage in some fruit flavoured ultra-high temperature milks in Nigeria; Acheampong YB; Statistical analyses of pH measurements and microbiological methods have been employed to monitor microbial activity (spoilage) in a brand of non-refrigerated mango and vanilla flavoured ultra-high temperature (UHT) milk drinks in Nigeria . The mango flavoured milks were more sensitive to changes in storage conditions than was the vanilla flavoured milks . The aerobic bacterial flora in the spoiled flavoured milks was dominated by Gram-positive cocci, both catalase-positive and catalase-negative types . Coliforms and pseudomonads were also detected . The importance of this study to the methods for detecting spoilage in quality control and to the storage conditions of such products in the tropics is discussed.

J Antibiot (Tokyo), 1986 Feb, 39(2), 205 - 14
New metabolites of Fusarium martii related to dihydrofusarubin; Kurobane I et al.; Six strains of Fusarium martii produced fusarubin and dihydrofusarubins A and B . Further examination of strains, T-77 and T-127, showed that four additional metabolites were produced . By 1H and 13C NMR spectral analyses, these additional metabolites have been identified as 3-O-methyl and 3-O-ethyl ethers of fusarubin and dihydrofusarubin A . The methyl ethers are new compounds and showed moderate cytostatic activity against mouse leukemia L1210 culture cells as well as moderate antibiotic activity against leukemia L1210 culture cells as well as moderate antibiotic activity against Gram-positive bacteria and fungi . 3-O-Methyl and 3-O-ethyl ethers of dihydrofusarubin A were converted non-enzymically to the respective ethers of fusarubin under alkaline conditions . Since in addition, only dihydrofusarubin derivatives were formed when an acidic pH was maintained in the culture, it can be concluded that only these are true metabolites of Fusarium martii.

Diagn Microbiol Infect Dis, 1986 Feb, 4(2), 109 - 17
Peptococcaceae bacteremia; Topiel MS et al.; Bacteremia with Peptococcaceae is an uncommon clinical manifestation of infection with this family of microorganisms . A 20-month review of 12 patients with bacteremic infections due to anaerobic gram-positive cocci revealed that obstetrical patients during the peripartum period constitute the group at greatest risk for the development of such infections . Eight of the 12 patients were young women hospitalized on the obstetrical service . Seven patients had postpartum endometritis and one patient had chorioamnionitis . The remaining four patients include a single patient each with pylephlebitis and microabscesses of the liver, ascending cholangitis, thoracic empyema, and necrotizing soft-tissue infection . Bacteriologic identification of the microorganisms revealed the following: Peptostreptococcus micros (5 patients), Peptostreptococcus asaccharolyticus (5 patients), Peptostreptococcus magnus (1 patient), and Peptococcus species (1 patient) . Eleven of the 12 patients received appropriate antibiotic therapy . All patients did well and there were no major sequelae.

J Antibiot (Tokyo), 1986 Feb, 39(2), 184 - 91
Isolation and properties of valanimycin, a new azoxy antibiotic; Yamato M et al.; Valanimycin, a new azoxy antibiotic, was isolated from culture broths of a streptomycete . Valanimycin is an unstable oil at room temperature and active against some Gram-positive and Gram-negative bacteria, mouse leukemia L1210 cells in cultures, and prolongs the life span of mice inoculated with Ehrlich carcinoma or L1210.

J Immunol, 1986 Feb 1, 136(3), 860 - 6
Subpopulations of neutrophils with increased oxidative product formation in blood of patients with infection; Bass DA et al.; Stimulated human polymorphonuclear leukocytes (PMNL) have a marked increase in oxidative metabolism, producing reduced oxygen species (e.g., H2O2) that mediate bacterial killing . Previously, quantitation of metabolic responses of PMNL from patients with acute infections employed assays that measure mean activity of the entire PMNL population; such studies reported a modest and highly variable increase in oxidative metabolic responses of such "toxic" PMNL compared with normal cells . To assess metabolic capability of PMNL from 51 patients with acute bacterial infection, we employed a quantitative flow cytometric assay of H2O2-dependent oxidative product formation, the intracellular oxidation of 2',7'-dichlorofluorescin (DCFH) . After stimulation by phorbol myristate acetate, the PMNL of patients demonstrated an increase in mean DCFH oxidation (315 +/- 14 and 180 +/- 4.5 amol/cell, patients and controls) . Hexose monophosphate shunt activation was similarly increased in stimulated PMNL from bacteremic patients . These data are comparable with previous studies of mean metabolic activities of toxic PMNL . However, these mean values underestimate the quantitative responses of the hyperresponsive ("primed") PMNL within a mixture of normal and primed PMNL in the patients' blood . The flow cytometric assay demonstrated that the PMNL of the patients were composed of two populations . One population of PMNL had normal oxidative responses; the other "primed" population had up to 4.6 times the oxidative product formation of normal cells . Similar priming of circulating PMNL was caused by infection with gram-positive or gram-negative staining bacteria or by Candida species . The proportion and oxidative ability of the primed PMNL occurred independently of the number of juvenile neutrophil forms and independently of "toxic" morphologic changes of Wright's-stained PMNL . On the average, 40% of the PMNL of patients were primed, but the size of the primed PMNL population varied widely between patients (range 0 to 80%) . This variable subpopulation may explain the variability of mean responsiveness of the PMNL of patients reported previously . Moreover, the marked increase in oxidative metabolic capability of the primed PMNL may be a significant component of the host response to acute infection . It could also contribute to the damage to host tissues such as pulmonary vascular endothelium during bacteremia.

J Clin Pathol, 1986 Jan, 39(1), 93 - 8
Survival of gram positive anaerobic cocci on swabs and their isolation from the mouth and vagina; Smith GL et al.; The survival of Gram positive anaerobic cocci on plain cotton wool and albumin coated swabs held in various transport media was investigated . Results suggested that in most cases Amies', Stuart's and VMGII media do not offer any more protection to the bacteria than storing swabs dry in their containers . A technique was developed for the isolation and identification of Gram positive anaerobic cocci from the mouth and vagina, incorporating bicozamycin in the medium as a selective agent . Few strains were recovered from the oral cavity, but larger numbers were isolated from the vagina . Using a minimum number of antibiotic sensitivity and biochemical tests, including analysis of end products by gas-liquid chromatography, most isolates were identified to species level.

Pediatr Infect Dis, 1986 Jan-Feb, 5(1), 6 - 11
Perspective on the management of catheter-related infections in cancer patients; Hiemenz J et al.; The risk of infectious complications ranges from 9 to 80% depending on patient population and definition of catheter-related infection . In the vast majority of these patients, those infections can be treated successfully without catheter removal . The major exceptions to this guideline are patients with significant exit site or tunnel infections or with fungal isolates . Because the majority of those infections are caused by Gram-positive organisms such as S . epidermidis or S . aureus that have variable sensitivities to the antistaphylococcal penicillins, intravenous vancomycin along with gentamicin should be administered empirically until culture results are available . It appears to be unnecessary to remove the Silastic catheter automatically just because the patient is febrile, particularly if there is no microbiological evidence that the catheter is the source of the fever . Quantitative blood cultures drawn through the catheter and from a peripheral vein may lead to a better understanding of the role the catheter plays in the septic episodes in these patients but has yet to be definitive in identifying patients who absolutely require catheter removal to cure their infection . Surveillance cultures have not proved helpful in defining an "at risk" group for catheter-related infection and, due to cost and possible added risk of inducing an infectious complication, should not be routinely performed outside of an investigational setting . Instruction of patients in proper catheter care both before and after placement is of critical importance . To date there is no proved standard of catheter care and maintenance . There is a need for careful investigation in this area . We recommend that routine handling of the catheter be done with aseptic technique, which usually requires use of Betadine swabs when manipulating the catheter tip and use of a sterile dressing (e.g . E . Med IV Strip) or Op-Site (a transparent occlusive dressing) at the exit site . Continued dressings with either daily, every other day or biweekly changes may protect the catheter from gross contamination but do not protect it from catheter-associated infections . Controlled studies are needed to compare the numerous methods of postplacement catheter management and to determine the rate of infectious complications with the recently available double and triple lumen Silastic catheters and the subcutaneous implantable port-type catheters . We are presently pursuing such an investigation.

J Int Med Res, 1986, 14(6), 325 - 9
Clinical epidemiological survey of Legionella pneumophila infections in Italy; Andreoni G et al.; A clinical epidemiological survey of Legionella pneumophila infections occurring in Italy between 1 December 1985 and 31 May 1986 was carried out to evaluate the incidence of sporadic, epidemic and nosocomial L . pneumophila pneumonia . A total of 355 cases of pneumonia were studied of which 11.5% were due to Gram positive bacteria, 11% were due to Gram negative bacteria, 7.9% were due to Mycoplasma pneumoniae, 4.5% were due to L . pneumophila and 8.5% were due to sundry aetiological agents . The remainder (45.6%) could not be diagnosed accurately . In addition, the anti L . pneumophila antibody titres were assessed . The results are discussed in terms of the occurrence of the disease in Italy and regarding the importance of considering the possibility of legionellosic aetiology when diagnosing pneumonia.

J Antibiot (Tokyo), 1986 Jan, 39(1), 17 - 25
Microbial products . VIII . Azinothricin, a novel hexadepsipeptide antibiotic; Maehr H et al.; Azinothricin was isolated from the culture filtrate of Streptomyces sp . X-14950 in crystalline form . It represents a new type of hexadepsipeptide antibiotic as it contains a 19-membered cyclodepsipeptide ring composed of six unusual amino acids and bearing a novel C21 side chain . Azinothricin was identified as {(3S,4S,7R(S*),10S,17R,20S,23R){2S(2'R*,5'S*, 6'S*)3S*}}-alpha-ethyl-6-(3-ethyl-1, 5-dimethyl-4-oxo-1,5-heptadienyl)- N-(1,8, 14,15,18,21,27-heptaaza-21-hydroxy-7-(1-hydroxyethyl)-2,6,9,16,19, 22-hexaoxo-4-isopropyl-20-(methoxy-methyl)-17,18-dimethyl-5-oxa tricyclo {21.4.0.0(10,15)}heptacosan-3-yl)tetrahydro-alpha, 2-dihydroxy-5-methyl-2H-pyran-2-acetamide and is primarily active against Gram-positive microorganisms.

J Antibiot (Tokyo), 1986 Jan, 39(1), 1 - 5
Lactoquinomycin B, a novel antibiotic; Okabe T et al.; Streptomyces tanashiensis IM8442T was found to produce lactoquinomycin B, a novel antibiotic, together with lactoquinomycin A . Lactoquinomycin B was purified, and the physico-chemical and biological characteristics were studied . Lactoquinomycin B, C24H27NO9, mp 149-152 degrees C (dec), FD-MS m/z 473 (M+), is a basic substance, showing UV lambda MeOHmax (epsilon) 239 (15,100), 287 (3,450) and 369 nm (5,300), and IR nu CHCl3max 1790 (gamma-lactone), and 1700 and 1650 (quinone) cm-1 . The structure of lactoquinomycin B was elucidated by 1H NMR and 13C NMR in comparison with those of lactoquinomycin A, indicating that B is a 4a,10a-epoxide derivative of A . Lactoquinomycin B displayed inhibitory activity against bacteria, particularly Gram-positive organisms, and cytotoxicity against human and murine tumor cell lines . LD50 for mice was ca . 40 mg/kg by iv route.

Nephron, 1986, 43(2), 105 - 9
Peritonitis in continuous ambulatory peritoneal dialysis: analysis of an 8-year experience; Prowant B et al.; Experiences with peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) program at a single center over 8 years were reviewed . Home-acquired peritonitis rates have been less than 1 episode per patient year since 1982 . Gram-positive organisms continue to account for most episodes in a similar proportion . Actual known contamination could be pinpointed in only 7.4% of cases, but was strongly suspected in 35.8% of episodes . Exit site and/or tunnel infections were thought to have caused 20% of the cases . Intrinsic peritonitis probably accounted for 10.5% . Recurrence of peritonitis with the same organisms following cessation of antibiotics represented only 2.1% of cases.

Graefes Arch Clin Exp Ophthalmol, 1986, 224(3), 251 - 5
Intracorneal bacterial colonization in a crystalline pattern; Nanda M et al.; We report the case of a 78-year-old woman who developed an intrastromal bacterial colonization 22 months after penetrating keratoplasty . Slit-lamp examination revealed discrete, finely branched, fernlike stromal opacities, which were histopathologically found to be large intrastromal aggregates of gram-positive cocci with almost no inflammatory cell response.

Infection, 1986, 14 Suppl 1, S89 - 92
{Effectiveness of ofloxacin in the treatment of wound infections}; Roekaerts F et al.; Ofloxacin (OFX) and doxycycline (D) were compared in an open randomized study in the treatment of wound infections, including soft tissue, traumatic and postoperative wound infections caused by gram-positive as well as gram-negative pathogens . Doses were 2 X 200 mg/day of OFX (n = 21) and 2 X 100 mg/day of D (n = 20) . In three cases from the OFX group, the daily dose was successfully increased to 2 X 300 mg . Clinical cure was observed in 20 of 21 patients on OFX and in 12 of 20 patients on D . One patient who failed to respond clinically in the OFX group showed moderately severe gastric pain (possibly drug-related), but by the time this adverse effect became evident, the wound exudate had already cleared bacteriologically . In this study OFX proved to be highly effective in the treatment of wound infections, and it was also well tolerated . Not only did symptoms disappear more frequently under OFX than under D, but they also disappeared more quickly.

Infection, 1986, 14 Suppl 3, S213 - 6
Efficacy of enoxacin in the treatment of bacterial infections of the skin with regards to photosensitization; Petri H et al.; Thirty-four patients suffering from various skin infections caused by gram-positive and gram-negative pathogens were treated with enoxacin (400 to 800 mg/day) for 8 to 14 days . A marked abatement of clinical symptoms, accompanied by eradication of the causative pathogens was observed in all 34 patients . Enoxacin was well tolerated . The minimal erythema dose of UVA light was reduced by a mean of 45% in three of the twenty patients receiving the 800 mg daily dosage of enoxacin . No positive reactions could be provoked in a subsequently applied photopatch test, allergic reactions were not observed . These mild reactions seen in a small percentage of patients appear to indicate further specific tests to determine a possible photosensitization effect of enoxacin.

Rev Stomatol Chir Maxillofac, 1986, 87(1), 60 - 4
{Cat-scratch disease or benign inoculation lymphoreticulosis . A continuous quest for the etiological agent}; Champsaur H; This infection usually results from transmission to humans by the scratch of a cat, but may also follow spine stings or cuts from fresh bones of various animals, this explaining the ubiquity of the causative agent and its resistance to various physical agents . The primary lesion develops in the skin at the inoculation site, to be followed by the appearance of one or several satellite adenopathies, of regional distribution and evolving towards suppuration . Apart from some rare nervous manifestations the prognosis is usually good, but regression of the adenopathy is a slow process . Histology shows tumefaction of massed reticular cells with central necrosis, leucocyte diapedesis and ultimate abscess formation . Diagnosis is by evidence of allergy to a specific antigen formed of the pus from infected glands after sterilization . The responsibility of a gram-positive bacterium of the genus Rothia has just been demonstrated.

Appl Environ Microbiol, 1985 Dec, 50(6), 1439 - 43
Nitrogen utilization in bacterial isolates from the equine cecum; Maczulak AE et al.; A total of 114 bacterial isolates were obtained from the cecal contents of two mature cecally fistulated horses on a habitat-simulating medium containing 40% energy-depleted cecal fluid . Of these isolates, 108 were maintained in pure cultures and were tentatively grouped on the basis of cell morphology and physiological characteristics . Gram-negative rods (50.9%), gram-positive rods (22.8%), and gram-positive cocci (21.9%) represented the largest groups isolated from these animals . Fifty isolates were tested for their ability to grow in media containing urea, ammonia, peptones, or amino acids as sole nitrogen sources . None of the isolates had a unique requirement for urea or ammonia since nitrogen derived from peptones, amino acids, or both supported growth as well as did ammonia or urea in a low nitrogen medium . Of the cecal isolates, 18% were able to use urea for growth, and 20.5% were able to grow with ammonia as the sole nitrogen source . All organisms grew in the experimental media containing peptones as the sole nitrogen source . Urease activity was detected in only 2 of 114 isolates tested . The inability of isolates to use urea or ammonia as nitrogen sources may have been a reflection of growth conditions in the habitat-stimulating medium used for isolation, but it could also suggest that many cecal bacteria require nitrogen sources other then ammonia or urea for growth.

J Antibiot (Tokyo), 1985 Dec, 38(12), 1649 - 54
Production, isolation, physico-chemical and biological properties of angiolam A, a new antibiotic from Angiococcus disciformis (Myxobacterales); Kunze B et al.; Angiolam A, a new lactone-lactam antibiotic, was isolated from the culture broth of the myxobacterium Angiococcus disciformis strain An d30 . It was active against a few Gram-positive bacteria and mutant strains of Escherichia coli with increased permeability . It appears to interfere with protein synthesis.

Antimicrob Agents Chemother, 1985 Dec, 28(6), 824 - 8
A randomized prospective study of ceftazidime versus ceftazidime plus flucloxacillin in the empiric treatment of febrile episodes in severely neutropenic patients; de Pauw B et al.; In a prospective, randomized study, ceftazidime monotherapy was compared with a combination of ceftazidime and flucloxacillin in 100 febrile neutropenic patients . Thirty-four bacteriologically documented infections, of which 26 were bacteremias, in 51 patients were treated with ceftazidime alone . Thirty-four bacteriologically proven infections, of which 29 were bacteremias, in 49 patients were treated with a combination of ceftazidime and flucloxacillin . The clinical response rate for ceftazidime monotherapy was 80%; the bacteriological cure rate was 90% . Efficacy against gram-negative pathogens appeared to be excellent, achieving a 100% cure rate . The clinical response and bacteriological cure rates for the combination were 76 and 86%, respectively . Three superinfections were registered in the ceftazidime group, and four, involving six pathogens, were registered in the combination group . Other side effects of ceftazidime were minimal . It is concluded that ceftazidime is an effective drug for the empiric treatment of febrile neutropenic patients . It offers the opportunity to avoid the aminoglycosides in first-line treatment . It may be appropriate to combine ceftazidime with cephalothin or vancomycin or to modify therapy if resistant gram-positive strains are encountered.

J Antibiot (Tokyo), 1985 Dec, 38(12), 1664 - 9
Isolation and characterization of terpentecin, a new antitumor antibiotic; Tamamura T et al.; A new antitumor antibiotic, terpentecin was isolated from the culture broth of strain MF730-N6 . Strain MF730-N6, isolated from soil, was found to belong to the genus Kitasatosporia . The antibiotic was extracted with chloroform, purified by column chromatography using silica gel and Diaion HP-20 successively, and finally purified by high performance reverse-phase thin layer chromatography . The molecular formula of terpentecin was determined to be C20H28O6 (molecular weight, 364) . The antibiotic inhibited the growth of Gram-positive and Gram-negative bacteria, and prolonged the survival period of mice bearing leukemia L-1210, P388 and Ehrlich ascites carcinoma.

Int J Pediatr Otorhinolaryngol, 1985 Dec, 10(3), 271 - 7
Bacterial tracheitis, diagnosis and treatment; Mahajan A et al.; During a 22-month period, 5 children, 6-13 months of age, presented with an acute obstructive upper airway infection which resembled both croup and epiglottitis . All 5 failed to respond to standard treatment for croup, including aerosolized racemic epinephrine . In all patients, direct laryngoscopy revealed minimal or no change in the epiglottis and aryepiglottic folds but severe subglottic swelling and copious purulent tracheal secretions . Gram stains of the purulent secretions revealed many polymorphonuclear leukocytes with gram-positive cocci (3 patients) and small gram-negative rods (2 patients) . Cultures subsequently confirmed the presence of S . Aureus and H . Influenzae . Initial therapy for all patients included endotracheal intubation, antibiotic therapy for both S . Aureus and H . Influenzae and frequent tracheal suctioning . Hospitalization varied from one to 3 weeks . We reported findings in these patients because: the initial diagnosis was unclear due to confusion caused by clinical features common to both croup and epiglottitis and bacterial tracheitis requires a prompt accurate diagnosis and aggressive antibiotic and airway management in order to prevent unnecessary morbidity and mortality.

J Appl Bacteriol, 1985 Dec, 59(6), 493 - 9
The direct epifluorescent filter technique (DEFT): increased selectivity, sensitivity and rapidity; Rodrigues UM et al.; With the direct epifluorescent filter technique (DEFT), differentiation of bacteria was achieved by a modified Gram-staining procedure using acridine orange as the counterstain . The method enumerated viable Gram-negative and all Gram-positive bacteria . Counts of clumps of orange fluorescent cells (Gram-negative DEFT count) correlated well with colony counts of Gram-negative bacteria in samples of raw milk (r = 0.94) . The use of stainless steel membrane filter supports and the addition of citrate-NaOH buffer (0.1 M, pH 3.0) during filtration enabled 10 ml samples of milk to be filtered, thereby increasing the sensitivity of the DEFT five-fold . The relationship between colony and DEFT counts with 10 ml samples was better (r = 0.90) than that using standard 2 ml samples (r = 0.88) . Alternatively, these modifications in procedure allowed the preincubation time for 2 ml milk samples to be reduced from 10 to 2 min . Sonication was successful in dispersing bacterial clumps in both pure cultures and in raw milk samples to yield a bacterial count by DEFT which should give a better indication of the hygienic status and keeping quality of a product, than counts of colony forming units.

Biochem Int, 1985 Nov, 11(5), 691 - 9
Comparison of ribosomes from gram-positive and gram-negative bacteria with respect to the presence of protein S1; Muralikrishna P et al.; Ribosomes from Gram-positive and Gram-negative bacteria have been analysed for the presence of ribosomal protein S1 by three methods, sodium dodecyl sulfate polyacrylamide gel electrophoresis, immunoreaction with E . coli anti-S1 and chromatography on poly (U)-Sepharose . We observed that protein S1 is predominantly present in Gram-negative bacteria in comparison with Gram-positive bacteria . Exceptions are noted in both species.

Jpn J Antibiot, 1985 Nov, 38(11), 3415 - 33
{Clinical study of aztreonam on respiratory tract infections caused by gram-negative pathogens}; Shimokata K et al.; Aztreonam (E-0734, AZT) was administered to pneumonia and chronic respiratory tract infections . The results were as follows: AZT was administered to 29 patients . Twenty-six cases were evaluable and 3 cases were excluded from evaluation of efficacy because 1 was Gram-positive infection, 2 were unclear symptom of infection . Pneumonia was 4 cases . Chronic respiratory tract infections were 22 cases . Clinical efficacy was judged as follows; excellent in 7 cases, good in 10 cases, fair in 5 cases and poor in 4 cases, then the efficacy rate was 65.4% . Efficacy rate in pneumonia, acute aggravation of diffuse panbronchiolitis and bronchiectasis with infection was 50%, 67% and 83%, respectively . Bacteriological response was judged on 21 cases with eradication rate was 66.7% . Bacteriological response classified by pathogen was as follows: All 6 isolates of H . influenzae, 2 in 6 isolates of P . aeruginosa, 4 in 5 isolates of H . parainfluenzae and all 3 isolates of K . pneumoniae were cleared . Total eradicated rate was 74.1% . Eruption was observed in 1 case as side effect . Abnormal laboratory findings were observed in 4 cases . Elevation of GOT and GPT was in 3 cases . Increase of eosinophil and basophil was in 1 case . AZT was considered to be a useful antibiotic for the treatment of respiratory tract infections, especially chronic respiratory tract infections, caused by Gram-negative pathogens.

Rev Infect Dis, 1985 Nov-Dec, 7 Suppl 4, S741 - 6
Aztreonam plus vancomycin (plus amikacin) vs . moxalactam plus ticarcillin for the empiric treatment of febrile episodes in neutropenic cancer patients; Jones P et al.; Aztreonam plus vancomycin (AV), aztreonam plus vancomycin and amikacin (AVA), and moxalactam plus ticarcillin (MT) were compared in an ongoing, randomized, prospective trial of the treatment of febrile episodes in neutropenic patients with cancer . Vancomycin was combined with aztreonam to provide coverage against gram-positive bacteria . Patients with gram-negative bacterial infections who were given AV in effect received single-agent therapy with aztreonam . Overall, AVA was more effective than MT and somewhat more effective than AV in the treatment of 170 documented infections . AV and AVA were each more effective than MT in the treatment of 29 gram-positive infections (response rates of 90%, 80%, and 43%, respectively) . The three regimens were equally effective in the treatment of 39 aerobic gram-negative infections (response rates of 88%, 100%, and 100% for AV, AVA, and MT, respectively) . Thus far, the addition of amikacin to the AV regimen appears to offer no advantage in the treatment of documented gram-negative infections.

Int J Clin Pharmacol Ther Toxicol, 1985 Nov, 23(11), 629 - 34
Evaluation of ceftazidime in the treatment of 80 infectious episodes in compromised children; Viscoli C et al.; The efficacy of ceftazidime in the treatment of infections in compromised children was evaluated in 80 such episodes occurring in 64 patients with various underlying diseases . Among the patients treated, 9 were newborns with severe neonatal distress, 21 were children with cancer and neutropenia, 8 were surgical patients, 22 had cystic fibrosis and 4 were suffering from meningitis . The following types of infections were treated: 19 bacteriologically documented and 8 possible septicemias (the latter only in newborns and neutropenic cancer patients); 2 severe upper respiratory tract infections in cancer patients; 8 soft tissue or skin infections; 1 cholangitis; 1 pneumonia; 1 osteomyelitis; 1 mediastinitis; 35 infectious exacerbations of underlying pulmonary disease in cystic fibrosis patients; and 4 meningitides . In almost all cases ceftazidime was administered intravenously in combination with an aminoglycoside . In 2 cases it was also given intrathecally or intraventricularly . Bacteriological documentation was achieved in 70 out of 80 episodes . A successful outcome was obtained in 79% of the cases with slight and statistically nonsignificant differences between groups of patients with different etiological patterns in terms of prevalence of gram-positive microorganisms . Tolerance of the treatment was uniformly good, only one patient showing a mild, transient transaminase elevation.

Clin Nephrol, 1985 Nov, 24(5), 256 - 60
Intravenous vancomycin as initial treatment for gram-positive peritonitis in patients on chronic peritoneal dialysis; Obermiller LE et al.; Fourteen episodes of peritonitis complicating chronic peritoneal dialysis were treated with intravenous injections of 1 gm of vancomycin weekly for 4 successive weeks . Peak (one hour after completion of injection) and trough (immediately before the next injection) serum and dialysate vancomycin levels were measured . Vancomycin treatment resulted in a cure in 12 episodes (85.7%) . Serum vancomycin levels were always above therapeutic range, but did not rise, with subsequent injections, to toxic range . Dialysate vancomycin levels were therapeutic for more than 85% of the measurements . One patient, who failed to respond to vancomycin plus cephalosporins, was cured with intraperitoneal streptokinase plus the same antibiotics . In another patient, a relapse was cured with vancomycin plus oral rifampin . Dialysate vancomycin levels were therapeutic in the last two patients . Peritoneal catheters were not removed . No significant side effects of vancomycin treatment were observed.

J Antibiot (Tokyo), 1985 Oct, 38(10), 1363 - 70
Demalonyl derivatives of guanidylfungin A and copiamycin: their synthesis and antifungal activity; Takesako K et al.; Guanidylfungin A was chemically modified by alkylation, reduction and/or demalonylation . Demalonylmethylguanidylfungin A became soluble in water and showed approximately eight-fold higher activity against fungi and Gram-positive bacteria than guanidylfungin A along with strongly fungicidal effect . Similarly, copiamycin was converted to demalonylmethylcopiamycin, which also showed higher antifungal activity than copiamycin itself.

J Antibiot (Tokyo), 1985 Oct, 38(10), 1359 - 62
Chemical modifications of the aliphatic bridge of ansamycins . 3 . Synthesis and activity of 21-epi-rifamycin S; Brufani M et al.; Rifamycins inhibit bacterial DNA-dependent RNA polymerase through the formation of non-covalent bonds by the oxygenated groups at C(1), C(8), C(21), and C(23) . These must be unhindered and underivatized, with the antibiotic in a proper overall molecular conformation . The present study shows that contrary to previous conclusions the availability of the hydroxyl group at C(21) is not as important as that of the other three groups . In support of this is the observation that 21-epi-rifamycin S is partially active, both on the isolated DNA-dependent RNA polymerase and on some Gram-positive bacterial strains.

Arch Dermatol, 1985 Oct, 121(10), 1332 - 4
Actinomycetoma caused by Nocardiopsis dassonvillei; Sindhuphak W et al.; We report a case of mycetoma caused by Nocardiopsis dassonvillei in a 39-year-old man . He had multiple nodules and draining sinuses on the anterior aspect of his right leg just below the knee . Few cream-colored granules were seen in the exudate . The biopsy specimen showed gram-positive, non-acid-fast granules with distinct borders . An aerobic actinomycete isolated from the lesion was identified as N dassonvillei . We think that this is the first reported case of mycetoma caused by N dassonvillei.

J Antibiot (Tokyo), 1985 Oct, 38(10), 1327 - 32
Lactoquinomycin, a novel anticancer antibiotic . I . Taxonomy, isolation and biological activity; Tanaka N et al.; Lactoquinomycin, a novel basic antibiotic, was isolated from the culture broth of a soil streptomyces by repeated solvent extraction and adsorption column chromatography . Morphological, cultural and physiological studies revealed that the organism belongs to the species Streptomyces tanashiensis . The antibiotic was active against bacteria, particularly Gram-positive organisms, and neoplastic cells in vitro . Antibiotic-resistant cell sublines of L5178Y lymphoblastoma were more significantly inhibited by lactoquinomycin than the parental cell line . Lactoquinomycin was effective against Ehrlich carcinoma in mice.

J Antibiot (Tokyo), 1985 Oct, 38(10), 1291 - 301
Metabolic products of microorganisms . 225 . Elloramycin, a new anthracycline-like antibiotic from Streptomyces olivaceus . Isolation, characterization, structure and biological properties; Drautz H et al.; Elloramycin (1), a new antibiotic produced by Streptomyces olivaceus strain Tu 2353, was detected by chemical screening . The dark yellow compound, molecular formula C32H36O15, is weakly active against a variety of Gram-positive bacteria, especially streptomycetes and against stem cells of L-1210 leukemia . Acidic hydrolysis of the antibiotic liberated elloramycinone (3) as aglycone and 2,3,4-tri-O-methyl-L-rhamnose, which was identified as methyl glycoside 5b . The structure of elloramycin was established by comparison of the spectra (UV, 1H NMR, 13C NMR) with those of the known tetracenomycin C (2), 3 and the fact that 2 and 3 gave the same tetramethyl ether after permethylation . Elloramycin is an anthracycline-like antibiotic, the aglycone resembles tetracenomycin C, the sugar is connected in a phenolic alpha-glycosidic linkage.

J Comput Assist Tomogr, 1985 Sep-Oct, 9(5), 976 - 8
Actinomycotic brain abscess: CT findings; Millan JM et al.; An unusual case of actinomycotic brain abscess with histologic documentation is reported . Commonly, a primary focus of actinomycosis in the cervicofacial, thoracic, or abdominal areas is found . In our particular case such a primary source of infection was not evident . Cranial CT showed a thick-walled ring enhancing lesion deeply located in the left parietal region . This CT finding was useful but not diagnostically pathognomonic . Correct diagnosis was made based on histologic findings . Sulfur granules and Gram-positive branching organisms were seen in the purulent material.

J Clin Microbiol, 1985 Sep, 22(3), 391 - 4
Total volume culture technique for the isolation of microorganisms from continuous ambulatory peritoneal dialysis patients with peritonitis; Dawson MS et al.; A total volume method of culturing dialysis fluid from continuous ambulatory peritoneal dialysis patients during episodes of peritonitis was developed . Concentrated culture media stored in small blood transfer bags were added directly to the drained dialysate exchange bags by the same technique used to carry out the dialysate exchange . The exchange bag with the added culture medium was incubated at 35 degrees C and observed for turbidity . Seventy-eight dialysis exchange bags from patients without clinical peritonitis (negative controls) and forty-eight dialysis exchange bags from patients with clinical peritonitis were cultured . Bacteria were recovered from all cultures of patients with clinical peritonitis (100% sensitivity) and from five cultures of negative control fluids (94% specificity) . Of these isolates, 86% were gram positive, and 14% were gram negative . This technique represents an advance over previously described culture techniques in its ability to isolate the causative organism(s) in cases of peritonitis in continuous ambulatory peritoneal dialysis patients.

Acta Paediatr Scand, 1985 Sep, 74(5), 687 - 90
Changes in the incidence and spectrum of neonatal septicemia during a fifteen-year period; Bennet R et al.; Over a period of 15 years the incidence of neonatal septicemia seen at St Goran's Children's Hospital has increased both per 1000 births and per 100 admitted neonates . The spectrum of causative organisms has changed towards more Gram-positive organisms and fewer Gram-negative organisms . In the initial antibiotic treatment an aminoglycoside and ampicillin derivate will still be needed to give full coverage.

J Antibiot (Tokyo), 1985 Sep, 38(9), 1171 - 81
Saquayamycins, new aquayamycin-group antibiotics; Uchida T et al.; From the culture broth of Streptomyces nodosus MH190-16F3, four new antibiotics have been isolated, and named saquayamycins A, B, C and D . The compounds are glycosides of aquayamycin, and among aquayamycin-group antibiotics they are most closely related to P-1894B (vineomycin A1) . All saquayamycins act on Gram-positive bacteria and inhibit the growth of adriamycin-sensitive and adriamycin-resistant P388 leukemia cells.

Neurosurgery, 1985 Aug, 17(2), 296 - 9
Paranasal sinusitis: a common complication of nasotracheal intubation in neurosurgical patients; Deutschman CS et al.; Sinusitis secondary to nasotracheal intubation has not been reported to occur in neurosurgical patients . Over a 1-year period, 11 patients admitted to the Intensive Care/Trauma Unit at St . Paul Ramsey Medical Center developed this entity . The mean age of these patients was 36 +/- 4 years; 7 were trauma victims, 3 had each had a subarachnoid hemorrhage, and 1 had suffered hypertensive hemorrhage . The patients presented with fever of unknown origin (FUO) and evidence of persistent hypermetabolism without an obvious cause . In 8 cases, the diagnosis was not suspected until mucopurulent nasal discharge was noted . Three additional cases were evaluated for suspected sinusitis before the occurrence of discharge . The mean duration of intubation before the diagnosis of sinusitis was 7.8 +/- 1.5 days . The diagnosis was confirmed by sinus films with a Waters view in 7 cases or by computed tomographic scanning in 4 cases and by bacteriological cultures . Two cases involved only the maxillary sinus on the side of intubation; the rest were polysinusites . The organisms involved included gram-positive and gram-negative species; all were polymicrobial with a single organism predominant . Secondary pulmonary involvement was common, and 4 patients revealed a bacteremia consistent with the major sinus organism . One patient developed septic shock . Treatment involved either orotracheal intubation or tracheostomy . This was curative in all cases . It is concluded that neurosurgical patients nasally intubated are at risk for sinusitis, which can have untoward effects such as septicemia or pulmonary infection . A high degree of suspicion will permit early diagnosis and treatment.

J Bacteriol, 1985 Aug, 163(2), 803 - 5
Glutathione-independent maleylacetoacetate isomerase in gram-positive bacteria; Hagedorn SR et al.; Nocardia globerula CL1 produced a glutathione-independent maleylacetoacetate isomerase after growth on L-tyrosine . Partial purification of this isomerase demonstrated its independence of low-molecular-weight cofactors such as glutathione . Similar glutathione-independent maleylacetoacetate isomerases were present in three other gram-positive bacteria grown on tyrosine.

Jpn J Antibiot, 1985 Jul, 38(7), 1750 - 60
{Clinical studies of S6472 in otorhinolaryngologic infections}; Baba S et al.; A multicenter cooperative clinical trial was carried out on S6472 (a long-acting preparation of cefaclor (CCL)) to evaluate its effectiveness and safety in the treatment of infectious diseases in the field of otorhinolaryngology . The results are as follows: The clinical efficacy of the drug could be evaluated in 114 patients . An efficacy rate of 65.8% was obtained . The efficacy rate for each disease was found to be 60.0% for acute suppurative otitis media, 12.5% for chronic suppurative otitis media and 44.4% for acute exacerbation of chronic suppurative otitis media . The overall efficacy rate for all cases of suppurative otitis media was 46.4% . The efficacy rate for acute tonsillitis was found to be 93.1% . In the treatment of acute exacerbation of chronic tonsillitis, the efficacy of the drug was rated as excellent or good in all cases . The overall efficacy rate for all cases of tonsillitis was found to be 93.9% . In the treatment of other infectious diseases, the efficacy was rated as excellent or good in all cases . When the cases by resistant organisms to CCL were excluded from the evaluation, the overall efficacy rate of the drug was found to be 74.2% . The bacteria could be identified in 106 cases . Regarding the bacteriological efficacy of single infections, its bacterial elimination rate was found to be 81.1% for Gram-positive bacteria including S . aureus, S . epidermidis, etc., while it was 42.9% for Gram-negative bacteria . The overall elimination rate of bacteria in single infections was 73.1% . The bacterial elimination rate for mixed infections was found to be 85.7%, whereas it was 76.8% when the single and mixed infections were combined . Regarding side effects, 1 case each of diarrhea, soft stool and rash, or 3 cases in total (2.4%), were recorded in a total of 123 patients . However, the severity of each side effect was mild . Regarding abnormal laboratory findings, there were 1 case each of an increase in S-GPT, leukopenia and complication of eosinophilia and thrombocytopenia, or 3 cases in total (7.0%) . Each of these adverse reactions was, however, transient in nature, and no serious cases were observed . On the basis of the above results, it was concluded that S6472 can provide sufficient clinical efficacy when it is administered at daily dosage of 750 mg or 1,500 mg in 2 divided doses after the breakfast and dinner.

Surgery, 1985 Jul, 98(1), 81 - 6
Vascular graft infection: an analysis of sixty-two graft infections in 2411 consecutively implanted synthetic vascular grafts; Lorentzen JE et al.; Among 2411 consecutive arterial reconstructions performed with synthetic prosthetic material in Denmark during a 4-year period, 62 patients (2.6%) developed graft infection . Graft infection occurred only when the groin had been incised . The incidence of infection and the spread of infection along the graft did not relate to the graft material used (Dacron velour, Dacron woven, polytetrafluoroethylene, and umbilical vein) . Retrospective analysis disclosed predisposing or precipitating factors in 50 of the 62 cases; the most important seemed to be unsatisfactory surgical technique . Fifty-three percent of the graft infections occurred within 30 days . Gram-positive cocci were the most common pathogen . The 62 patients had been in the hospital for a mean of 90 days and had undergone an average of 1.4 operations for graft infections . Of the patients, 25.8% died and 30.6% underwent amputations . Vascular graft infection is still one of the major problems in vascular surgery; greater care should be taken to improve antiseptics, improve surgical technique, and establish a rational prophylactic antibiotic regimen . A prophylactic antibiotic regimen of a combination of cephalosporin and ampicillin is recommended.

J Antimicrob Chemother, 1985 Jul, 16 Suppl A, 13 - 21
Structure activity relationships in lincosamide and streptogramin antibiotics; Le Goffic F; Lincomycin is a 6-amino, 6-deoxy-octopyraninose with strong antibiotic activity . To maintain or enhance this activity, one must have the configuration of the first five asymmetric carbons of the sugar residue with the thioglycolic moiety in the alpha-position . The nitrogen on carbon 6 with the R configuration is also a prerequisite for the activity . Substitutions at the level of C-7 as well as the pyrolidine moiety can dramatically enhance this activity . The streptogramin group is composed of a wide variety of structures which can be classified into two subgroups . Group A or M is composed of polyunsaturated cyclic peptolides, e.g . pristinamycin IIA; group B or S is composed of cyclic hexadepsipeptides . Separately, these molecules have a bacteriostatic activity on Gram-positive organisms, whereas in association they exhibit a strong and synergistic bactericidal effect . The 13-OH function of PIIA is essential for antibiotic activity to occur whereas the 15-carbonyl function can be reduced with the retention of the biological properties of the drug . The carbonyl function of PIA can be reduced and the pipecolic moiety can be replaced by other groups without a dramatic influence on the antibiotic activity . The macrocyclic lactone ring is necessary for antibiotic activity.

J Am Acad Dermatol, 1985 Jul, 13(1), 125 - 33
Cutaneous nocardiosis . Case reports and review; Kalb RE et al.; Two cases of cutaneous nocardial infection are reported . The Nocardia species are gram-positive, partially acid-fast bacteria . Cutaneous involvement may develop as one of four types: (1) mycetoma, (2) lymphocutaneous (sporotrichoid) infection, (3) superficial skin infection, or (4) systemic disease with cutaneous involvement . A review of each of these types of infection is included, as well as potential clues that may suggest the diagnosis of nocardiosis.

Am J Med, 1985 Jun 7, 78(6A), 100 - 3
Imipenem/cilastatin in the treatment of osteomyelitis; MacGregor RR et al.; Thirty-four patients with osteomyelitis were treated for a mean of 32.5 days with 2 to 4 g per day of imipenem/cilastatin . Twenty-six infections involving the lower extremities were associated with accidents and prosthesis implantation, and 19 of 34 patients had more than one organism isolated . Gram-positive and gram-negative organisms were equally represented, but follow-up bone culture samples showed only 11 percent of gram-positive organisms persisted versus 23 percent of gram-negative organisms . Seventy-four percent of patients were cured or improved, and failures were related to resistant organisms and the inability to perform adequate surgical debridement . Adverse drug side effects included nausea, diarrhea, liver enzyme elevations, and neutropenia, but discontinuation of treatment was required in only three patients . Imipenem/cilastatin holds promise as monotherapy in complicated polymicrobial osteomyelitis.

Arch Intern Med, 1985 Jun, 145(6), 1083 - 8
A multicenter comparative trial of tobramycin and ticarcillin vs moxalactam and ticarcillin in febrile neutropenic patients; Feld R et al.; During a multicenter prospective randomized trial in febrile neutropenic patients (neutrophil count, less than 1,000/cu mm), 103 episodes were treated with tobramycin sulfate plus ticarcillin disodium (TT) while 117 were treated with moxalactam plus ticarcillin disodium (MT) . The majority of patients had an underlying diagnosis of leukemia (60%) and most (62.8%) had granulocyte counts of less than 100/cu mm at the start of therapy . The response rates for clinically or microbiologically documented episodes were 38 of 60 (55.1%) for TT and 38 of 64 (59.4%) for MT . The MT regimen appeared to be more effective for gram-positive infections (56% vs 33%) while TT appeared more effective for gram-negative infections (64% vs 40%) . Nephrotoxicity attributable to study drugs occurred in only 2.3% of cases (one on each treatment arm) . Prolongation of the prothrombin time was observed in only six of 78 (7.7%) in the TT arm as compared with 39 of 103 (38%) in the MT arm . Neither regimen was adequate for the unusually high frequency of gram-positive pathogens seen during this study.

J Antibiot (Tokyo), 1985 Jun, 38(6), 691 - 8
Lavendomycin, a new antibiotic . I . Taxonomy, isolation and characterization; Komori T et al.; Lavendomycin, a new basic peptide antibiotic containing novel amino acids, has been isolated from the culture broth of a streptomyces designated as Streptomyces lavendulae subsp . brasilicus . The antibiotic obtained as colorless crystals (C29H50N10O8, MW 666) is active against Gram-positive bacteria in vitro and in vivo, however, inactive against Gram-negative bacteria and fungi . An acute toxicity of the antibiotic in mice was LD50 greater than 2 g/kg by subcutaneous injection.

J Gen Microbiol, 1985 Jun, 131 ( Pt 6), 1289 - 98
Biochemical basis of resistance to hygromycin B in Streptomyces hygroscopicus--the producing organism; Pardo JM et al.; Hygromycin B, an aminocyclitol antibiotic that strongly inhibits both 70S and 80S ribosomes, is synthesized by Streptomyces hygroscopicus . Ribosomes from this Gram-positive mycelial bacterium are inhibited in vitro by the antibiotic . In contrast, the streptomycete is highly resistant to the drug in vivo since it possesses hygromycin B phosphotransferase activity . This enzyme has been shown by gel filtration to have a molecular weight of 42000, and to modify its antibiotic substrate to produce 7"-O-phosphoryl-hygromycin B which totally lacks biological activity both in vivo and in vitro.

Lancet, 1985 Jun 1, 1(8440), 1236 - 9
The aetiological agent of cat scratch disease; Gerber MA et al.; A highly pleomorphic, gram-positive bacterium was cultured from an excised lymph node of a patient with cat scratch disease (CSD) . The organism had morphological forms similar to those of the bacterium observed in Warthin-Starry stains of lymph node sections from CSD patients and may be the aetiological agent of this disease . Electron microscopic examination of lymph node sections from another patient with CSD showed organisms with morphological forms similar to those of the isolated bacterium . Biochemical and physiological analyses of this isolate suggested that it is not a commonly recognised contaminant or human pathogen and that it may be a member of the genus Rothia . This organism appears to resemble the bacterium that was identified as the aetiological agent of Parinaud's oculoglandular syndrome, a specific form of CSD, over 70 years ago.

N Engl J Med, 1985 May 2, 312(18), 1142 - 7
Rapid diagnosis of intravascular catheter-associated infection by direct Gram staining of catheter segments; Cooper GL et al.; We conducted a study to determine the usefulness of the Gram stain in the detection of intravascular catheter-associated infection . A total of 330 intravascular catheters were prospectively collected from adults and children suspected of having such an infection . Semiquantitative solid-agar cultures of the distal catheter tip were correlated with blood cultures . Catheter-associated bacteremia occurred in 34 per cent of cases in which catheter tips were colonized (greater than or equal to 15 colonies per agar plate) . There were no cases of catheter-associated bacteremia in patients with uncolonized catheters . Immediately after culture, whole catheter segments were stained by the Gram technique . Gram-negative and gram-positive bacteria and yeast were easily identifiable under oil immersion (X 1000), located predominantly on external catheter surfaces . Any catheter with at least one organism per 20 oil-immersion fields was designated as positive by Gram stain, but the majority of the 41 positive catheters had much larger numbers of organisms . The Gram stain of the catheter tip was 100 per cent sensitive and 96.9 per cent specific for the detection of catheter-tip colonization, with positive and negative predictive values of 83.9 and 100 per cent, respectively . We conclude that a Gram stain of the distal catheter tip is a simple, inexpensive, and accurate test for the rapid diagnosis of intravascular catheter-associated infection.

Am J Surg, 1985 May, 149(5), 627 - 8
Management of Hickman catheter sepsis; Schuman ES et al.; Hickman catheters have been shown to be efficacious and durable . We believe their performance can be safely prolonged with aggressive management of complications . One hundred sixty-five consecutive patients with catheters were followed prospectively and 28 episodes of sepsis in 24 patients were evaluated . At least 90 percent of septic catheters were salvaged with a combination of antibiotics and thrombolytic agents . When our protocol was followed, all episodes of sepsis were successfully treated . This included gram-positive and gram-negative organisms as well as one case of fungal sepsis . Since treatment can be handled mostly on an outpatient basis, there are benefits in regard to patient comfort as well as health care costs.

Microbiol Sci, 1985 May, 2(5), 144 - 7
Genetic analysis of gram-positive toxin determinants: the impact of new technologies; Dougan G et al.; Work is progressing rapidly on the genetic analysis of Gram-positive bacterial toxin determinants . Information is accumulating on the molecular structure of these determinants and how their expression is regulated and coordinated within the bacterial cell.

J Periodontol, 1985 May, 56(5), 273 - 80
The colonization and establishment of invading bacteria in periodontium of ligature-treated immunosuppressed rats; Sanavi F et al.; The morphologic features and pattern of bacterial invasion of the periodontal tissue in ligature-induced periodontal defects of immunosuppressed rats were studied . Silk ligatures were placed circumferentially on the maxillary left second molar of 24 Sprague-Dawley rats . The treatment group (14 rats) received Cytoxan (75 mg/kg) the day after ligature placement and at Day 4 . The control group (10 rats) received no medication . All animals were sacrificed on Day 8 and the maxillae processed for light and electron microscopy . Only ligated sites in immunosuppressed animals exhibited bacterial invasion . Invading bacteria consisted of microcolonies of Gram-negative and Gram-positive coccoid cells and rods located near the tissue surface . Each microcolony consisted of morphologically homogeneous microorganisms . The deeper sites revealed a diffuse invasion of Gram-negative rods which appeared morphologically similar . Other features associated with invasion were complete destruction of epithelial tissue next to the ligature and the lack of inflammatory cells in the gingival region . These findings, when compared to those of other reports of tissue penetration by bacteria, point to the necessity of differentiating between bacterial invasion of gingival tissues, associated with penetration of tissues by proliferating bacteria, and bacterial translocation, a situation in which bacteria are passively carried into the tissues, for example by mechanical manipulation immediately before or during biopsy taking, or possibly during processing for histology.

J Protozool, 1985 May, 32(2), 341 - 6
Chemotaxis by Entamoeba histolytica; Bailey GB et al.; A micropore membrane procedure to assay taxis by Entamoeba histolytica is described and the results of studies of responses to a variety of soluble substances, bacteria, an rat colon washings using this procedure are reported . Trophozoites migrated in blind well chambers through 8-micron pore size polycarbonate membranes but not nitrocellulose membranes up to 12 micron pore size . Amoebae were attracted toward fresh axenic culture medium (TYI-S), an enzymatic hydrolysate of casein (Trypticase), and a partially purified preparation of N-acetylneuraminic acid from egg mucin, but not purified N-acetylneuraminate or a variety of other low molecular weight metabolites . The response was verified as chemotaxis by checkerboard analysis . Amoebae migrated most dramatically toward suspensions of all of seven bacterial species tested, including motile and non-motile, gram-negative and gram-positive rods and cocci . This response was diminished when the bacteria concentration gradient was eliminated . The response to bacteria culture filtrates was less than 10% of that to bacterial suspensions . A response to clarified washings from the rat colon was detected; this was diminished but not eliminated by filter sterilization of the washings . We concluded that some soluble molecules, possibly of intermediate molecular size, whole bacteria, and both soluble and particulate components of the rat colon provide tactic stimuli for E . histolytica . Scanning electron micrographs of trophozoites migrating towards attractants through membranes showed narrow, extended pseudopodia entering the membrane pores, and enlarging spheres exiting as the cells proceeded through.

Surgery, 1985 Apr, 97(4), 420 - 7
Ventricular sepsis and abdominally related complications in children with cerebrospinal fluid shunts; Rush DS et al.; In a retrospective study of 300 children who underwent placement or revision of cerebrospinal fluid (CSF)-peritoneal shunts during a 10-year period, 15 (5%) developed shunt-related abdominal complications with ventricular sepsis and two developed acute perforated appendicitis . Abdominal complications and associated shunt infections suggested two potential modes of development: (1) descent of contaminated CSF from an infected shunt into the abdomen (CSF ascites--four patients, CSF pseudocysts--four patients, and shunt-induced abscess/peritonitis--five patients); and (2) ascent of bacteria into the shunt from an abdominal source (visceral perforation by the shunt catheter--two patients and acute perforated appendicitis--two patients) . Three types of shunt systems were placed during the study period; five of the seven (71%) most serious septic complications were associated with the use of Raimondi spring-reinforced catheters . Bacteria isolated in this series were associated with differing modes of sepsis: those involving descent of bacteria into the abdomen from an infected shunt were predominantly gram-positive, cutaneous microorganisms, whereas those associated with ascent of bacteria from the abdomen into the shunt were mixed, gram-negative intestinal microorganisms . Appendicitis did not result in shunt infections . Aggressive treatment resulted in no operative or complication-related deaths . Removal of the shunt catheter from the abdomen and intravenous antibiotics were essential for eradication of sepsis; laparatomy was required only for cases with suspected peritonitis . In eight of the 17 (47%) patients, reestablishment of CSF-peritoneal shunts was performed after resolution of shunt-related complications . In recent years improved shunting materials and supportive care have reduced the incidence of the most serious of these complications.

Immunology, 1985 Apr, 54(4), 643 - 53
Opsonization of Legionella pneumophila in human serum: key roles for specific antibodies and the classical complement pathway; Verbrugh HA et al.; Legionella pneumophila has previously been shown to require serum factors for efficient uptake by phagocytic cells . In this investigation, the roles of specific antibody and complement in phagocytosis of L . pneumophila by human polymorphonuclear leucocytes (PMN) and tissue macrophages were determined . Opsonization was assessed by quantitating the uptake of {3H}-labelled Legionellae . Compared to other Gram-negative and to Gram-positive bacterial species, L . pneumophila was highly resistant to the opsonic activity of normal pooled human serum (PHS) . Of 12 donor sera tested, only four promoted significant L . pneumophila uptake when used at full strength . Experiments with immune antibody, and with human sera deficient in immunoglobulins, or the complement components C2, C3, or C5, revealed that L . pneumophila opsonization was dependent on antibody-mediated activation of the classical complement pathway; activation of the alternative pathway could not be detected . At high concentrations, immune antibody alone could adequately opsonize L . pneumophila . Human alveolar and peritoneal macrophages required very similar amounts and types of opsonins for L . pneumophila phagocytosis as did human PMN . Heating L . pneumophila to temperatures greater than or equal to 80 degrees abolished its resistance to opsonization by diluted PHS; however, activation of complement via the alternative pathway or via other antibody-independent routes remained undetectable . These studies show that, in addition to immune antibody, the classical pathway of complement plays an important role in the opsonization of L . pneumophila . The limited ability of these bacteria to interact with human complement provides a likely explanation for their resistance to opsonization and may be partly based on heat-sensitive structures on the surface of L . pneumophila.

J Am Vet Med Assoc, 1985 Apr 1, 186(7), 700 - 2
Encephalitozoonosis in a parrot; Poonacha KB et al.; Encephalitozoon infection was diagnosed in a double yellow-headed Amazon parrot, Amazona ochrocephala . Illness was characterized by respiratory distress, decreased appetite, diarrhea, and weight loss . This gram-positive organism was present in renal tubules, intestine, and lungs . Ultrastructural features consisted of 5 polar filament coils and a single nucleus . Organisms were contained within parasitophorous vacuoles in cytoplasm of the renal tubular epithelium.

Appl Environ Microbiol, 1985 Apr, 49(4), 925 - 33
Monensin-based medium for determination of total gram-negative bacteria and Escherichia coli; Petzel JP et al.; Plate count-monensin-KCl (PMK) agar, for enumeration of both gram-negative bacteria and Escherichia coli, is composed of (per liter) 23.5 g of plate count agar, 35 mg of monensin, 7.5 g of KCl, and 75 mg of 4-methylumbelliferyl-beta-D-glucuronide (MUG) . Monensin was added after the medium was sterilized . The diluent of choice for use with PMK agar was 0.1% peptone (pH 6.8); other diluents were unsatisfactory . Gram-negative bacteria (selected for by the ionophore monensin) can be used to judge the general quality or sanitary history of a commodity . E . coli (differentiated by its ability to hydrolyze the fluorogenic compound MUG) can be used to assess the safety of a commodity in regard to the possible presence of enteric pathogens . Pure-culture studies demonstrated that monensin completely inhibited gram-positive bacteria and had little or no effect on gram-negative bacteria . When gram-negative bacteria were injured by one of several methods, a few species (including E . coli) became sensitive to monensin; this sensitivity was completely reversed in most instances by the inclusion of KCl in the medium . When PMK agar was tested with food and environmental samples, 96% of 535 isolates were gram negative; approximately 68% of colonies from nonselective medium were gram negative . PMK agar was more selective than two other media against gram-positive bacteria and was less inhibitory for gram-negative bacteria . However, with water samples, KCl had an inhibitory effect on gram-negative bacteria, and it should therefore be deleted from monensin-containing medium for water analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Scand J Dent Res, 1985 Apr, 93(2), 90 - 5
Formation and ecology of plaque at different locations in the mouth; Theilade E et al.; Some recent findings concerning microbial colonization of smooth surfaces of teeth, gingival crevices, occlusal fissures and removable dentures are reviewed considering the many ecologic factors of importance for the oral microbial communities . The oral microbiota is extremely complex comprising at least 200 taxa . In spite of interindividual and site-to-site variations, each oral habitat has a characteristic microbiota ranging from Gram-positive, facultatively anaerobic cocci and rods in occlusal fissures to predominance of Gram-negative, strictly anaerobic rods and spirochetes in deep periodontal pockets.

Br J Dermatol, 1985 Apr, 112(4), 415 - 22
The effects of a shampoo containing zinc pyrithione on the control of dandruff; Marks R et al.; Thirty-two subjects who suffered from dandruff participated in a study in which one-half of the head was washed with a shampoo containing 1% zinc pyrithione (ZPT) and the other half was washed with the same shampoo without ZPT . Four groups, eight subjects per group, were shampooed one, three, six or nine times (shampoo frequency twice per week) . Clinical dandruff gradings of each half of the head were made 4 days after the last shampoo in each group, when scalp biopsy samples were also taken from each half of the head . Measurements of labelling index (LI), mean epidermal thickness (MET), and assessment of the numbers of PAS- and Gram-positive micro-organisms were made on the biopsy samples . There was a progressive reduction in dandruff on the sides of the head treated with the ZPT shampoo, the differences relative to the placebo-treated areas being statistically significant after three, six and nine washes . There were no significant differences in LI between treatment groups and the MET was shown to vary according to the treatment and the number of washes . There was a significant reduction in the number of PAS-positive micro-organisms (but not Gram-positive micro-organisms) on the ZPT-treated areas.

Res Commun Chem Pathol Pharmacol, 1985 Apr, 48(1), 121 - 31
Plasma beta-endorphin-like-immunoreactivity levels and hemodynamics in patients with septic shock; Hughes GS Jr; Plasma beta-endorphin-like immunoreactivity (beta-ELIR) levels were measured during hyper and hypodynamic phases of septic shock in patients (n = 36) due to a variety of microorganisms . Plasma beta-ELIR levels were elevated in all groups, but were most marked in patients with hyperdynamic circulation due to gram-positive and gram-negative organisms, followed by hypodynamic circulation due to gram-negative organisms and were least elevated in hypodynamic shock due to gram-positive organisms . There was strong correlation between plasma beta-ELIR levels and cardiac index in patients with a hyperdynamic circulation (gram-negative organisms, rs = 0.79, p less than 0.01; gram-positive, rs = 0.85, p less than 0.01) but little to no correlation in patients with hypodynamic circulation (gram-negative, rs = 0.32, p = NS; gram-positive organisms rs = 0.04, p = NS) . These results imply that plasma beta-ELIR levels may be involved in the early phases of septic shock and may contribute to a hyperdynamic circulation, whereas plasma beta-ELIR levels may be normal or may not be related to hypodynamic circulation as seen in later phases of shock.

J Gen Microbiol, 1985 Apr, 131 ( Pt 4), 833 - 47
Properties of the germination inhibitor of Streptomyces viridochromogenes spores; Grund AD et al.; Germinating spores of Streptomyces viridochromogenes excreted a substance into the surrounding medium which inhibited germination of another sample of the spores . The germination inhibitor (GI) was produced during submerged culture after exponential growth had ceased . The GI was purified 51-fold following extraction from growth liquor with chloroform . It was soluble in alcohol and water and had a molecular weight of less than 1000 . The GI blocked growth and respiration of some Gram-positive bacteria and was an inhibitor of the membrane bound, but not solubilized, calcium-dependent ATPase of germinated spores and mycelia of the producing organism . Several sodium-potassium activated ATPases were also inhibited . All four activities (respiration, growth, germination inhibition, ATPase) co-purified during column and thin-layer chromatography . The GI activities released during germination and produced during growth were identical . A role for the GI antibiotic in regulation of dormancy of spores of the producing organism is discussed.

J Gen Virol, 1985 Apr, 66 ( Pt 4), 711 - 8
Continuous production of interferon in normal mice: effect of anti-interferon globulin, sex, age, strain and environment on the levels of 2-5A synthetase and p67K kinase; Galabru J et al.; Two interferon-mediated enzymes, a 2-5A synthetase and a kinase that phosphorylates a 67 000 mol . wt . (p67K) protein were found at variable levels in different organs of mice . Among the different strains of mice included in this study, germ-free mice had the lowest levels of these enzymes . The levels of 2-5A synthetase and p67K kinase were enhanced significantly in all mice following treatment with mouse (alpha + beta) interferon . Here, we show that the presence of 2-5A synthetase and p67K kinase in different organs of normal mice (untreated) was due, at least in part, to a constant production of interferon under different physiological conditions . Accordingly, injection of normal mice with anti-mouse interferon (alpha + beta) globulin led to a significant decrease in the level of 2-5A synthetase and p67K kinase . In conventional mice (C3H/He), the level of both of these enzymes was higher in female than in male animals and was decreased with age or when such animals were reared isolated in a pathogen-free protected unit . The levels of 2-5A synthetase and p67K kinase were also decreased in normal mice following injection with a powerful antibiotic against a very wide spectrum of Gram-positive and Gram-negative bacteria . These results suggest that the production of interferon was induced continuously in normal mice . Such induction was mediated by both internal and external agents.

Agents Actions, 1985 Apr, 16(3-4), 273 - 6
Bacteria-induced histamine release . Examination of the bacterial cell wall components peptidoglycan, teichoic acid and protein A; Norn S et al.; The histamine-releasing capability of whole bacteria was examined in leukocyte suspensions from normal individuals . Both gram-positive and gram-negative bacteria caused basophil histamine release . It is probably the bacterial cell wall which interacts with the basophil cell surface leading to release of histamine, since cell walls showed higher histamine releasing capability than the whole bacteria . The releasing effect of the bacterial cell wall components peptidoglycan, teichoic acid and protein A was examined . The peptidoglycan preparations were found to be more potent than the corresponding whole bacteria and cell walls . Since peptidoglycan is found in the cell wall of both gram-positive and gram-negative bacteria, it might be a common factor responsible for histamine release by different bacteria . No release was obtained by teichoic acid, whereas protein A caused histamine release in leukocytes from allergic patients, but only a poor release in normal individuals . The initial step in protein A-induced histamine release might be a binding of protein A to IgE on the cell surface, since removal of cell-bound IgE reduced the release and a high correlation was found between protein A- and anti-IgE-induced histamine release.

Hinyokika Kiyo, 1985 Mar, 31(3), 441 - 8
{The effectiveness of a combination of trimethoprim plus rifampicin and local injection of antibiotics into the prostate in chronic bacterial prostatitis}; Yamamoto M et al.; Seventy out-patients suffering from chronic bacterial prostatitis were treated with a combination of trimethoprim plus rifampicin or trimethoprim alone . A combination of 300 mg . rifampicin plus 160 mg . trimethoprim (rifaprim) was used . Forty-four patients were administered rifaprim at doses of 920 mg . (twice a day) for two months . Twenty-six patients were administered trimethoprim at doses of 320 mg . (twice a day) for two months . Cultures of the expressed prostatic secretions (EPS) yielded gram-positive bacteria in 61 patients and gram-negative bacteria in 9 . In rifaprim group, clinical responses were excellent in 9 cases, moderate in 23 cases and poor in 12 cases . The efficacy rate was 73% . In trimethoprim group, excellent in 1 case, moderate in 14 cases and poor in 11 cases . The efficacy rate was 60% . Seven patients of chronic bacterial prostatitis were treated by local injection of tobramycin into the prostate . The antibiotic level in the prostatic fluid twenty-four hours after injection was very high . The pain and discomfort experienced by the patients during injection into the prostate were minimal . Local necrosis was not found after histologic or electron microscopic studies of biopsied prostatic specimen after the injection . Results show that this simple method should be valuable in the treatment of the refractory group of chronic bacterial prostatitis.

Antibiot Med Biotekhnol, 1985 Mar, 30(3), 182 - 5
{Mechanisms of bacterial inactivation as affected by cation surface-active substances}; Pavlova IB et al.; The death kinetics and ultratructure of gram-positive and gram-negative bacteria exposed to alkyldimethylammonium chloride were studied . It was shown that at low concentrations (0.0001 per cent) the agent had a pronounced bactericidal effect, which was higher with respect to the gram-positive bacteria . Impairment of the intactness of the cytoplasmic membrane, a vitally important organoid of the bacterial cell, was the main factor in the mechanism of action of the cationic surface-active substance . Membrane structures of various configuration and localization not associated with the cell division were detected in the cytoplasm of the dead bacteria . These structures are probably the result of self-assembly of the membrane lipid components broken under the action of the detergent.

J Antimicrob Chemother, 1985 Mar, 15(3), 271 - 82
Characterization of aminoglycoside 6'-N-acetyltransferases {AAC(6')} from gram-negative bacteria and Streptomyces kanamyceticus; Meyer JF et al.; Aminoglycoside-6'-N-acetyltransferase {AAC(6') enzymes} from several Gram-negative bacteria and Streptomyces kanamyceticus were purified by affinity and ion exchange chromatography . The different enzymes were characterized by their biochemical properties including molecular weights, isoelectric points, substrate ranges, and pH-optima . These biochemical characteristics were compared to the data for 6'-N-acetyltransferases from other Gram-negative and Gram-positive bacteria . All data indicated that the group of AAC(6') enzymes is rather heterogeneous from the biochemical point of view and led us to a new proposal for classification of subgroups.

Arch Microbiol, 1985 Mar, 141(2), 116 - 22
Methanosphaera stadtmaniae gen . nov., sp . nov.: a species that forms methane by reducing methanol with hydrogen; Miller TL et al.; Methanosphaera stadtmaniae is a non-motile, Gram-positive spherical-shaped organism that obtains energy for growth by using hydrogen to reduce methanol to methane . It does not produce methane from hydrogen and carbon dioxide, formate, acetate or methylamines and cannot grow with hydrogen and carbon monoxide, nitrate, fumarate, sulfate or choline . Its pH optimum is 6.5 to 6.9 and its temperature optimum is 36 degrees to 40 degrees C . It is not inhibited by bile salts, inhibitors of the synthesis of folic acid coenzymes, cephalothin or clindamycin but is inhibited by metronidazole, bacitracin, monensin, lasalocid, or bromoethanesulfonate . It requires acetate, carbon dioxide, isoleucine, ammonium, and thiamin for growth and biotin is stimulatory . It does not contain cytochromes and the mol % G + C of its DNA is 25.8 . The composition of its cell wall and 16 S rRNA and its immunological fingerprint are consistent with characterization of the organism as a member of a new genus of the family Methanobacteriaceae . The habitat of the type strain is the human large intestine.

Appl Environ Microbiol, 1985 Mar, 49(3), 686 - 92
Preparation of a DNA gene probe for detection of mercury resistance genes in gram-negative bacterial communities; Barkay T et al.; A DNA gene probe was prepared to study genetic change mechanisms responsible for adaptation to mercury in natural bacterial communities . The probe was constructed from a 2.6-kilobase NcoI-EcoRI DNA restriction fragment which spans the majority of the mercury resistance operon (mer) in the R-factor R100 . The range of specificity of this gene probe was defined by hybridization to the DNA of a wide variety of mercury-resistant bacteria previously shown to possess the mercuric reductase enzyme . All of the tested gram-negative bacteria had DNA sequences homologous to the mer probe, whereas no such homologies were detected in DNA of the gram-positive strains . Thus, the mer probe can be utilized to study gene flow processes in gram-negative bacterial communities.

Jpn J Antibiot, 1985 Mar, 38(3), 553 - 74
{Clinical studies on TMS-19-Q.O tablet in respiratory tract infection}; Hara K et al.; A new macrolide antibiotic preparation, TMS-19-Q.O tablet, was used to investigate the efficacy in the treatment of patients with respiratory tract infection, and the results obtained were as follows: Three hundred and seven cases were included in this report, and overall efficacy rate was 76.2% . Especially high clinical effect (86.0%) was observed in the treatment of patients with pneumonia including mycoplasmal pneumonia . Bacteriological effect was 87.5% in 51 cases identified as single infection of Gram-positive cocci and was 48.0% in 34 cases Gram-negative rods infection . Side effects were observed in 11 cases (3.50%): gastrointestinal disorder in 8, eruption in 2 and other in 1 . Abnormality in laboratory tests was observed in 23 cases, hepatic disorder in 13, renal disorder in 3 and other laboratory tests in 7 . It was considered from the results of clinical and bacteriological efficacy in different dose study that dose of TMS-19-Q should be 600 mg.

Crit Care Clin, 1985 Mar, 1(1), 119 - 27
Burns . Infection and immunology; Munster AM et al.; The burn wound is successively colonized by gram-positive then gram-negative flora . The reduction of mortality from sepsis in burns depends on our understanding of the chain of events leading to microbial invasion of the burn wound and the host response that follows . These are outlined in this article, together with the current attempts to improve this response in the host.

Am J Med, 1985 Feb 8, 78(2A), 47 - 50
Aztreonam plus clindamycin as therapy for pelvic infections in women; Pastorek JG 2nd et al.; Aztreonam, a new monobactam antibiotic with specific gram-negative aerobic activity, was used in combination with clindamycin in the treatment of 40 women with pelvic infection, including post-partum endometritis, pelvic inflammatory disease, and post-hysterectomy pelvic cellulitis . Clinical cure was achieved in 87 percent of patients . Failure was related to the limited gram-positive aerobic spectrum of clindamycin . All aerobic gram-negative enteric organisms were sensitive in vitro to less than 0.125 microgram/ml of aztreonam.

Am J Vet Res, 1985 Feb, 46(2), 442 - 6
Rifampin in the horse: comparison of intravenous, intramuscular, and oral administrations; Burrows GE et al.; The plasma concentrations and pharmacokinetics of rifampin disposition were determined after a single IV, IM, or oral dose of 10 mg/kg of body weight and an oral dose of 25 mg/kg . The overall elimination rate constants per minute were similar for the 10 mg/kg dose (0.0021 +/- 0.0004, IV; 0.0017 +/- 0.0002, IM; and 0.0023 +/- 0.0006, orally) . The apparent bioavailability was moderate to low for IM and oral administrations (59.8% +/- 3.2% and 39.5% +/- 5.0%, respectively) . The rate of absorption was most rapid for oral administration with an absorption half-life of 249.7 +/- 71.6 minutes as compared with 403.5 +/- 89.7 minutes for IM administration . However, the IM route produced longer detectable plasma concentrations (50 hours in 2 of the 4 horses) . Based on bacterial sensitivity information derived for human and canine isolates, the daily oral administration of 10 mg of rifampin/kg administered in the feed represents a reasonable dose for susceptible gram-positive bacterial pathogens . Higher doses (greater than or equal to 25 mg/kg) or IV administration would be required for most gram-negative bacteria . Adverse effects of sufficient severity to limit use of the drug, especially by the oral route of administration, were not encountered under the single-dose experimental conditions used.

J Clin Microbiol, 1985 Feb, 21(2), 195 - 9
Improvement of two toluidine blue O-mediated techniques for DNase detection; Waller JR et al.; Two DNase detection techniques in which the metachromatic dye toluidine blue O (TBO) is used have been improved, and a potential source of difficulty for personnel attempting to use TBO-related methods has been identified . Reducing the concentration of TBO in the Streitfeld plate-flooding method from 0.1 to 0.05% resulted in easier control of staining intensity, less masking of DNase-positive reactions due to overstaining, sharper delineation of zones of DNase activity, and more sensitive detection of weak DNase reactions . Incorporation of 0.005% TBO in DNase agar, rather than the recommended 0.01%, allowed growth and expression of DNase activity by gram-positive as well as gram-negative bacteria . The reduced dye content in the agar also enhanced expression of DNase activity by some organisms and provided sharper delineation of DNase-positive reactions . Because optimum expression of DNase activity depends upon exact TBO concentrations in both the flooding and agar incorporation techniques, strict attention must be paid to the dye content of commercially available TBO dye powders . TBO concentrations must reflect actual dye content; therefore, calculations must include a conversion factor that accounts for the true dye content of the commercial preparation . The conversion factor that we developed is determined by dividing 100 by the percentage of dye in the commercial powder . The grams of commercial dye powder required per 100 ml of dye mixture is calculated by multiplying the percentage of dye required in the dye mixture by the conversion factor.

Infect Immun, 1985 Feb, 47(2), 384 - 7
Activation of the alternative complement pathway by pneumococcal lipoteichoic acid; Hummell DS et al.; Cell wall teichoic acids of some gram-positive bacteria are potent activators of the alternative pathway of complement . It is unclear, however, whether the other form of teichoic acid, cell membrane lipoteichoic acid (LTA), can also activate the alternative pathway . In the present study, radiolabelled pneumococcal LTA was found to bind spontaneously to sheep erythrocytes in a temperature- and time-dependent fashion . In addition, the presence of pneumococcal LTA on the erythrocyte surface was verified by the fact that they could be agglutinated by a myeloma protein (TEPC-15) specific for choline, a constituent of pneumococcal LTA . Pneumococcal LTA when fixed to the surface of erythrocytes was able to activate the alternative pathway of complement in both guinea pig serum deficient in the fourth component of complement and human serum deficient in the second component of complement, resulting in lysis of the sensitized erythrocytes . The sensitizing principle of the LTA preparation was removed before erythrocyte sensitization by immunoabsorption, using the choline-specific TEPC-15 myeloma protein . These data demonstrate that purified pneumococcal LTA will bind to sheep erythrocytes and endow them with the ability to activate the alternative pathway.

Arzneimittelforschung, 1985, 35(8), 1329 - 31
Fosfomycin levels in human aqueous humor after intravenous administration; Radda TM et al.; Following intravenous infusion of an 8 g single dose of the antibiotic agent fosfomycin, its penetration into human primary aqueous humor was investigated . 1-2 h after the start of infusion, peak values of 35 to 60 micrograms/ml were reached . These concentrations in the aqueous humor would inhibit a high percentage of gram-positive and gram-negative strains commonly causing bacterial endophthalmitis . The infusion of an 8 g dose of fosfomycin immediately preceding intraocular surgery thus constitutes effective peri-operative prophylaxis . Moreover, as a broad-spectrum antibiotic, fosfomycin is indicated as initial therapy in intraocular bacterial infections.

Curr Med Res Opin, 1985, 9(9), 611 - 5
Penetration of erythromycin into tonsillar tissue; Falchi M et al.; A study was carried out to investigate serum levels and tonsillar tissue penetration of erythromycin in 80 children suffering from chronic tonsillitis who had to undergo tonsillectomy . Oral erythromycin ethyl succinate (1 g twice daily) was given for the 2 days preceding surgery, the last dose scheduled for 2, 3, 4 or 6 hours before the start of the operation and the withdrawal of blood and tissue samples . The results showed that erythromycin penetrated quickly into tonsillar tissue and the levels were higher in tissue than in serum at all time points . Mean levels of erythromycin were consistently greater than the minimum inhibitory concentrations for most common Gram-positive oro-pharyngeal pathogens and H . influenzae.

Prog Clin Biol Res, 1985, 189, 101 - 13
Endotoxic effects of peptidoglycan; Verhoef J et al.; Peptidoglycans (PG) are cell wall fragments of gram-positive bacteria . The effect of PG on blood pressure, circulating leukocytes, and platelets was studied in a rat model . PG was able to decrease blood pressure and to induce leukopenia and thrombocytopenia . In vitro PG affected leukocyte function and was able to activate the contact activating system.

Drugs, 1985, 29 Suppl 5, 74 - 7
In vitro combination-effect of temocillin with ticarcillin and aminoglycosides on gram-negative and gram-positive bacteria; Just HM et al.; The in vitro efficacy of temocillin in combination with ticarcillin and with gentamicin, tobramycin, amikacin and netilmicin against 80 Gram-negative and 20 Gram-positive bacterial strains was compared by use of the checkerboard agar dilution technique . No synergistic or additive effect was seen on the Gram-positive strains . Great variations occurred between the different bacterial species, and the temocillin-ticarcillin combination had only little effect against the Pseudomonas strains tested . On average, only 12% of all strains tested were inhibited synergistically by temocillin-gentamicin combinations, and only 7 to 10% by combinations of temocillin with the other aminoglycosides . However, 25% of Gram-negative strains were inhibited synergistically and 40% of Gram-negative strains were inhibited additively by the combination of temocillin-gentamicin.

Drugs, 1985, 29 Suppl 5, 162 - 6
A study of the penetration of temocillin in the cerebrospinal fluid; Bruckner O et al.; Temocillin concentrations in serum and cerebrospinal fluid (CSF) samples from 8 patients were assayed by high pressure liquid chromatography . It was possible to determine sequential series of ventricular (CSF) and serum concentrations in 4 adult neurosurgical patients with slight to moderate impairment of blood-CSF barriers, because serial CSF samples were obtained from external ventricular drains . In 4 other patients with meningitis, temocillin was given in addition to the regular treatment schedule and 6 'spot' concentrations of temocillin in lumbar CSF and serum samples were determined . Temocillin CSF concentrations in these subjects seemed to be inadequate for the treatment of Gram-positive bacterial meningitis and only partially valuable for the treatment of Gram-negative bacillary meningitis.

Arzneimittelforschung, 1985, 35(6), 933 - 6
{Properties and efficacy of a human immunoglobulin M preparation for intravenous administration}; Stephan W et al.; From Cohn fraction III a new immunoglobulin (Ig) preparation (Pentaglobin) was prepared . This preparation contains 72% IgG and is enriched in IgM (12%) and IgA (16%) . Due to a treatment with beta-propiolactone it is suitable for intravenous application . This IgM-enriched immunoglobulin preparation is prominent in high antibody titers (passive hemagglutination) against gram-negative as well as gram-positive germs and shows significantly higher efficacy in mouse protection tests than intravenous standard IgG . The high IgM content of this preparation in particular is responsible for the binding of bacterial antigens . Thus a marked advancement in the treatment of bacterial infections is to be expected by this new intravenously tolerable immunoglobulin preparation.

Ann Inst Pasteur Microbiol, 1985 Jan-Feb, 136A(1), 45 - 50
Conformational and topological aspects of the three-dimensional architecture of bacterial peptidoglycan; Labischinski H et al.; An atomic model of the conformation of peptidoglycan was taken as the basis for an analysis of packing patterns of the peptidoglycan strands in two- and three-dimensional arrangements . For the sake of clarity, glycan strands were approximated by cylindrical rods around which a continuous helix of possible peptide cross-linkage sites was arranged . Using the packing patterns obtained, several important properties of the murein network could be explained . These include variations in the degree of cross-linking in Gram-negative and Gram-positive bacteria and an estimation of the number of peptide monomers, di/trimers and oligomers present . Furthermore, our model is compatible with the well known flexibility of the murein fabric and the distinct elastic properties of the cell wall in gram-positive cocci and rod-shaped bacteria.

Scand J Infect Dis, 1985, 17(1), 129 - 30
Serum triglyceride elevations in patients with septicemia; Julander I et al.; Among 239 patients with septicemia or endocarditis 41 (17%) had serum triglyceride levels in excess of 2.2 mmol/l (mean 3.1 mmol/l) . This was more common in infectious with gram-negative rods than gram-positive cocci (p less than 0.001) . A return to normal levels occurred in 22/37 patients during the course of the infection.

Infection, 1985, 13 Suppl 1, S56 - 61
Cefotaxime in the treatment of female pelvic soft tissue infections; Roy S et al.; Forty-six females with pelvic soft tissue infections (recurrent salpingitis {n = 14}, salpingitis with intrauterine contraceptive device {IUD} {n = 9}, salpingitis with adnexal mass {n = 14}, post-partum endomyoparametritis {n = 9}) were randomized for three antibiotic treatment regimens: cefotaxime (CTX) (n = 23), clindamycin and gentamicin (C + Gen) (n = 13), and clindamycin, gentamicin and penicillin (C + Gen + P) (n = 10) . Patients were evaluated by diagnosis for clinical response to the three regimens and by pre-treatment bacterial susceptibility to the individual as well as the combination antibiotics . All 14 recurrent salpingitis patients responded satisfactorily to the assigned antibiotic regimen (CTX, n = 8; C + Gen, n = 3; C + Gen + P, n = 3) . One of four patients with the diagnosis of salpingitis/IUD treated with CTX was a treatment failure, while three of three patients treated with C + Gen and two of two patients with C + Gen + P responded satisfactorily . Two of three patients with the diagnosis of salpingitis/adnexal mass failed therapy with C + Gen while the seven patients treated with CTX and the four patients with C + Gen + P responded satisfactorily . All nine patients with endomyoparametritis responded to their treatment regimen . Overall, there were no statistically significant differences in the responses by diagnosis and regimen, with the exception that C + Gen was significantly different (p less than 0.05) from CTX and C + Gen + P for the treatment of salpingitis with mass . Of the 141 bacterial isolates in all groups, 57 were aerobic or anaerobic gram-positive organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

Rheumatol Int, 1985, 5(4), 163 - 7
Bacterial cell wall composition, lysozyme resistance, and the induction of chronic arthritis in rats; Lehman TJ et al.; Bacterial cell wall induced arthritis is an experimental model of chronic erosive synovitis in which arthritis is induced in rats by a single injection of an aqueous suspension of cell wall fragments from selected Gram-positive bacteria . To understand better the Gram-positive bacterial cell wall characteristics necessary for the induction of chronic arthritis we tested the arthritogenicity of five Gram-positive bacteria which were (1) lysozyme resistant and contained a polyrhamnose peptidoglycan side chain moiety, (2) lysozyme resistant, but had little or no rhamnose in the peptidoglycan, polysaccharide, or (3) neither lysozyme resistant, nor contained rhamnose in their peptidoglycan, polysaccharide . All of the lysozyme resistant cell walls tested induced acute arthritis, but only those cell walls which were both lysozyme resistant and contained rhamnose in their polysaccharide side chain were able to induce chronic arthritis . Cell walls which were neither lysozyme resistant nor contained rhamnose were not arthritogenic . These data suggest that both lysozyme resistance and the rhamnose moiety in the peptidoglycan, polysaccharide side chain play an important role in the induction of chronic arthritis by Gram-positive bacterial cell walls in aqueous suspension.

Gene, 1985, 39(2-3), 191 - 201
Streptomyces contain Escherichia coli-type A + T-rich promoters having novel structural features; Jaurin B et al.; We describe here the isolation and characterization of a class of A + T-rich transcriptionally active sequences in the filamentous antibiotic-producing Gram-positive bacterial genus Streptomyces . These regions, which digress dramatically in base composition from the 73% G + C composition characteristic of the Streptomyces genome, promote gene expression in both Escherichia coli and Streptomyces lividans and contain the major elements that determine promoter strength in E . coli . The Streptomyces-E . coli-type promoters (SEP) also show novel structural features that include multiple direct repeats within the promoter region as well as a specific hexameric sequence in the vicinity of the mRNA start point.

Aesthetic Plast Surg, 1985, 9(2), 79 - 85
Resolution of late-developing periprosthetic breast infections without prosthesis removal; Wilkinson TS et al.; Based on prior experience with implant exposure, an aggressive regimen to eradicate periprosthetic infections has proven successful in delayed gram-positive and gram-negative bacterial infections and in atypical microbacterial infections . The objective of the "salvage" procedure is to retain a prosthesis, to maintain breast contour, and to avoid psychological and physical consequences of prosthesis removal . The "salvage" procedure involves topical antisepsis, contracture release if needed, systemic and topical antibiotics with intermittent or continuous irrigation, and reinforcement of incision lines in selected cases using local tissue flaps.

Scand J Infect Dis, 1985, 17(1), 107 - 12
Plasma fibronectin is initially decreased during septicemia; Ahlgren T et al.; Plasma fibronectin (PFN) levels were measured by radioimmunoassay in 24 normals and serially in 24 septic patients without underlying major trauma . All patients responded promptly to antibiotic therapy and none developed signs of shock or disseminated intravascular coagulation (DIC) . After an initial decrease in PFN registered in most of the septic patients, the levels were normalized within 2 weeks of antibiotic treatment . The mean nadir levels of PFN were decreased (p less than 0.001) both in patients with gram-negative and gram-positive etiologies compared to the control group . Furthermore, the mean PFN value of the gram-positive group was lower (p less than 0.05) than that of the gram-negative group . It is concluded that a transient depletion of PFN is a constant finding in septic patients with a favourable outcome and that a single low PFN level alone does not justify fibronectin replacement therapy nor does it indicate a poor prognosis.

J Biol Chem, 1984 Dec 10, 259(23), 14899 - 905
Binding of Escherichia coli to fibronectin . A mechanism of tissue adherence; Froman G et al.; Four out of 17 enterotoxigenic strains of Escherichia coli isolated from infantile diarrhea bound 125I-fibronectin . This binding, which was inhibited by unlabeled fibronectin but not by other proteins, appears to involve two classes of receptors, one of which binds the ligand reversibly . Consistent with the presence of two classes of receptors the bacteria bound to at least two distinct sites of the fibronectin molecule, one being the amino-terminal domain which also contains the binding sites for Gram-positive bacteria and the other located outside this domain . The E . coli strain expressing fibronectin receptors adhered to fibroblasts and to fibronectin but not to ovalbumin-coated coverslips . Bacteria grown at 40 degrees C did not express fibronectin receptors and did not adhere to either substrate . Saturation of receptors with fibronectin blocked adhesion to both fibronectin-coated coverslips and to cultured fibroblasts . These data suggest that binding to fibronectin represents a mechanism of tissue adherence of E . coli.

Am J Vet Res, 1984 Dec, 45(12), 2552 - 60
Actinomyces hordeovulneris, a canine pathogen that produces L-phase variants spontaneously with coincident calcium deposition; Buchanan AM et al.; The spontaneous production of cell-wall-deficient filaments and protoplasts by a strain of Actinomyces hordeovulneris (UCD 81-332-9) in 10% sucrose L-form media is reported . Multiple mineral deposits were present within the variants at 48 hours . Electron microscopy revealed that these deposits were amorphous, dense, and at the inner face of the cytoplasmic membrane in wall-less protoplasts and also in filaments which had a thin wall of 10 nm . These cell-wall-deficient variants produced L-form colonies when cultured for an additional 48 hours on 10% sucrose-BYE L-form plates . The colonies were composed of only a few filaments and many vesicles which were negative with Dienes' stain . Silver substitution stains of UCD 81-332-9 cells that had been grown in L-form broth for 5 days revealed heavy calcification of all cells including protoplasts . Gram stains of L-form grown cells revealed the presence of long-beaded, infrequently branched gram-positive filaments similar to those observed in clinical specimens . The formation of cell wall-deficient variants with coincident mineralization is believed to be related to the phenomenon of sulfur granule formation in vivo.

Z Kinderchir, 1984 Dec, 39 Suppl 2, 111 - 3
The use of intraventricular vancomycin in the treatment of CSF shunt-associated ventriculitis; Bayston R et al.; Ten cases of shunt-associated ventriculitis treated with intraventricular vancomycin are described . Eight were cured of their infection, one of these without shunt removal, though this failed in another instance . There were no toxic or untoward effects except in one case, where intravenous administration of vancomycin produced a histamine-like reaction . Intraventricular vancomycin, preferably combined with oral rifampicin, should be considered in cases of intractable or problematic shunt-associated ventriculitis due to Gram-positive organisms.

J Antimicrob Chemother, 1984 Dec, 14 Suppl D, 59 - 66
Vancomycin in infants and children: a review of pharmacology and indications for therapy and prophylaxis; Kaplan EL; Although used only rarely and cautiously by paediatricians in the past because of fear of toxicity, vancomycin has become part of the clinician's armamentarium to treat serious infections caused by Gram-positive bacteria, and for specific prophylaxic indications . The pharmacokinetics in infants and children have been recently studied and, while the new information has been helpful in determining more precisely correct doses, more data are needed, especially in young infants . The relatively new roles for vancomycin in the prevention of bacterial infection also require further clarification.

Jpn J Antibiot, 1984 Dec, 37(12), 2406 - 15
{Fundamental and clinical studies of ceftriaxone in the field of obstetrics and gynecology}; Kubota K; The study was done to evaluate the usefulness of ceftriaxone (Ro 13-9904, CTRX) injection for the treatment of infections in the field of obstetrics and gynecology . Fundamental and clinical studies were made and following results were obtained . When 1 g of CTRX is administered by intravenous single shot, the concentrations in various tissues of female genital organs were as follows: 40 micrograms/g in oviduct, 30 micrograms/g in ovary, 23 micrograms/g and 32 micrograms/g in corpus uteri and cervix uteri, respectively, at 2 hours 20 minutes after single shot . As for the transfer to the exudate in the pelvic dead space, the peak concentrations were 66-69 micrograms/ml after 4-5 hours . In the clinical studies, CTRX was given to 20 cases with female genital organ infections and others . As for the clinical effects, responses were excellent in 2 cases, good in 18 cases among 20 cases in total . The efficacy rate was 100% . As for the clinical effects on causative bacteria, the efficacy rates were 100% for single infections due to Gram-positive bacteria (6/6), due to Gram-negative bacteria (1/1), for mixed infection (3/3) . Side effect was observed in 1 case with diarrhea . CTRX showed a satisfactory clinical efficacy and a potent bacteriological effect in treatment of the infections in the field of obstetrics and gynecology, and it has been concluded that CTRX will be a useful addition to the antibiotics for the therapy of these infections.

Minerva Med, 1984 Nov 30, 75(45-46), 2755 - 64
{Atmospheric radiations . Effects of potassium-inhibitory and potassium-retentive hormones on two types of infective agent}; Noferi V et al.; The glucocorticoids and the estrogens facilitate the loss of potassium from the cells (iK+ hormones) . The thyroid hormones, the androgens, the growth hormone and the insulin facilitate the penetration of potassium into the cells (rK+ hormones) . The incretion of iK+ hormones follows the course of the intensity of the atmospheric radiations (atmospheric electric field, terrestrial magnetic field), that is it grows or diminishes according to the increase or decrease of the intensity of said radiations, while the incretion of rK+ hormones has an opposite course in comparison with the variations of said intensity . The iK+ hormones cause loss of iodine, decrease of eosinophils, of RNA and antibodies, while the rK+ hormones cause opposite effects . High temperatures produce an increase of iK+ hormones and low temperatures an increase of rK+ hormones . The study of the effects of atmospheric radiations on infectious diseases has shown the existence of two kind of infectious agents: the iK+ agents and the rK+ agents on which the hormones iK+ and rK+ have an effect . The hormones iK+ work jointly with iK+ agents (virus RNA, bacteria Gram-negative) and counteract the rK+ agents (virus DNA, bacteria Gram-positive, protozoa) . The rK+ hormones have opposite effects in comparison to those of iK+ hormones, that is they counteract the iK+ agents and work jointly with the rK+ agents.

Arch Biochem Biophys, 1984 Nov 15, 235(1), 276 - 82
The gene encoding translation initiation factor 3 is highly conserved in gram-negative bacteria; Pramanik A et al.; A 1.1-kb Hp alpha I fragment of the Escherichia coli chromosome containing the gene for translation initiation factor 3 was employed as a probe in heterologous hybridization to chromosomal DNA from a variety of other procaryotes . Positive hybridization was observed to DNA derived from all gram-negative bacteria tested . In contrast, no hybridization to DNA from gram-positive bacteria was detected . In addition, homologous sequences were found in Euglena gracilis chloroplast DNA, while this was not the case with Saccharomyces cerevisiae mitochondrial DNA . These results are discussed in light of existing data on the components and mechanism of translation initiation in the various organisms and organelles employed in this study.

J Antibiot (Tokyo), 1984 Nov, 37(11), 1294 - 300
Thiotropocin, a new sulfur-containing 7-membered-ring antibiotic produced by a Pseudomonas sp; Kintaka K et al.; Thiotropocin, a new sulfur-containing 7-membered-ring antibiotic, was isolated from a culture broth of Pseudomonas sp . CB-104 . The antibiotic occurs as orange or yellowish orange needles and has the molecular formula C8H4O3S2 . It is active against Gram-positive and Gram-negative bacteria, some phytopathogens and mycoplasma.

Appl Environ Microbiol, 1984 Nov, 48(5), 964 - 9
Characterization of predominant bacteria from the colons of normal and dysenteric pigs; Robinson IM et al.; Bacterial populations adherent to the mucosa of the proximal colons of weaned, healthy pigs were compared with populations from pigs with dysentery induced by inoculation with a culture of Treponema hyodysenteriae . Isolates (136) representative of the predominant flora adherent to colonic epithelia of normal pigs and isolates (162) from pigs with dysentery were cultured anaerobically on a rumen fluid-based medium and characterized . Most (71%) of the isolates from colonic epithelia of normal pigs were gram positive, whereas 88% of the epithelia-associated isolates from pigs with dysentery were gram negative . The geometric mean of colony counts was 5.7 X 10(7)/cm2 of colonic tissue from three normal pigs and 7.7 X 10(8)/cm2 from four pigs with dysentery . A number of isolates obtained from contents of the lumens of normal pigs with dysentery were also characterized . Comparison of isolates from epithelial tissue and from contents of the lumens of the same pig indicated that these populations were different . Our results indicate that physiological changes that occur in the colons of pigs with dysentery are accompanied by marked changes in the microbial populations in the colons . The factors which regulate the population changes are not yet understood.

Am J Public Health, 1984 Nov, 74(11), 1239 - 43
Occurrence and impact of zoonoses in pet dogs and cats at US Air Force bases; Warner RD; A descriptive epidemiologic study was conducted to quantitate the occurrence of zoonoses in pet animals (almost exclusively dogs and cats) at 30 Air Force bases in nine regions of the United States during 1980 and 1981 . Reviews of reported cases of pet-associated zoonoses in humans at these bases were included . Occurrence of a zoonotic disease in dogs and cats was expressed as a ratio of reported cases per 100 rabies vaccinations (cs/Crv) . Overall, the four zoonoses reported most frequently from these pets were hookworms, roundworms, tapeworms, and fleas . Annual ratios revealed geographic variations: for example, hookworms in dogs and cats in the southeast ranged from 12.3 to 9.4 cs/Crv; in the northern Great Plains, hookworms ranged from 0.9 to 0.4 cs/Crv . Dermatomycoses in the southeast ranged from 1.3 to 1.1 cs/Crv, and in Alaska from 0.3 to 0.2 cs/Crv . Quarterly zoonoses occurrence revealed seasonal variations in several regions . Reports of zoonoses in people from these bases indicated that five less frequent zoonoses in dogs and cats (Microsporum canis dermatomycosis, fleas, Sarcoptes scabiei var canis, Gram-positive bacterial infections, and rabies) presented greater acute threats to humans than did the four most frequent zoonoses reported from their pets.

Clin Chem, 1984 Nov, 30(11), 1875 - 6
Lactate production by aerobic bacteria grown in cerebrospinal fluid; Kiechle FL et al.; The source of the abnormally high concentration of lactate in the cerebrospinal fluid in patients with bacterial meningitis is not known . It may represent a bacterial metabolite . To determine whether cerebrospinal fluid possesses appropriate substrates to support the growth of pathogenic aerobic bacteria, three Gram-positive and nine Gram-negative bacteria were separately inoculated in pooled normal cerebrospinal fluid . After incubation for 24 h, all Gram-positive bacteria increased lactate, eight Gram-negative bacteria decreased lactate, and one Gram-negative bacteria failed to significantly change the lactate concentration . We conclude that lactate produced in cerebrospinal fluid in patients with aerobic bacterial meningitis is not necessarily a bacterial metabolite.

Hinyokika Kiyo, 1984 Oct, 30(10), 1505 - 18
{Laboratory and clinical study of ofloxacin in the treatment of bacterial prostatitis}; Suzuki K et al.; Ofloxacin (OFLX), a new pyridonecarboxylic acid derivative for oral use, was administered in the treatment of 22 cases of bacterial prostatitis (acute 4, chronic 18) . In advance of the clinical trial, the concentration of OFLX in prostatic fluid (PF) was determined following administration of the drug to 3 patients with chronic bacterial prostatitis at a stationary phase . Assays revealed antibiotic concentrations of a mean level of 1.34 micrograms/ml in 3 PF samples . The ratios to the plasma antibiotic level (R value) averaged approximately 1.10 . In clinical use, the drug was given at a daily dosage of 300-600 mg for 5-21 days . The bacteriological response of the infections caused by gram negative bacteria, in all eight patients (100%) was complete eradication, whereas that in 14 cases (including 5 mild infections) caused by gram positive cocci, was excellent or moderate in 10 (71%) and poor in 4 cases . Adverse reactions were observed in 2 cases; complaint of diarrhea (drug administration was discontinued in 1 case) . No abnormal values such as of kidney or liver functions or of peripheral hematology were encountered . From the data obtained ofloxacin was concluded to be highly effective, safe and useful in treatment of bacterial prostatitis.

Pathology, 1984 Oct, 16(4), 434 - 40
Biochemical identification of bacteria by replicator methods on agar plates; Lennox VA et al.; Biochemical tests commonly used for the identification of bacteria were adapted to a replicator technique using agar plates . As many as 48 organisms could be tested on one 10 cm square Petri dish . A new indicator, 2-(2,4-dinitrophenylazo)-l-naphthol-3,6-disulphonic acid disodium salt made it possible to investigate Gram-positive as well as Gram-negative organisms . For certain tests, such as citrate, DNAase, gelatin or lipase, a standard method using agar was already available . For others the usual test in liquid medium had to be adapted to solid medium . All such tests were compared with the API 20E system or with a conventional test and the results of the replicator tests showed a high correlation with those of other systems . For Gram-negative rods the corrected error rates (a measure of reproducibility) of 22 tests were 1% or less, for the remaining 9 tests the figure ranged between 1.5% and 4.8% . For Gram-positive cocci the corrected error rates of 21 tests were 1% or less and for the remaining 10 the figure ranged between 2% and 11% . The plates could be kept at 4-6 degrees C for 2 wk without appreciable loss of activity . The duration of incubation affected the results only marginally . This system has considerable advantages . Control organisms can be included in every run . As the cost in time and reagents for individual tests is much reduced, a larger number of tests can be carried out and this provides better identification . As Gram-positive organisms will grow on these media, it would be possible to speciate them in a more detailed fashion than is usually done now.

Antibiotiki, 1984 Oct, 29(10), 725 - 9
{Directed isolation of gram-negative asporogenous bacteria from natural substrates}; Ivanitskaia LP et al.; A method for selective isolation of gramnegative nonsporulating bacteria from soil substrates was developed . The method consists of plating out the substrates on a glucose-yeast medium with addition of benzylpenicillin and nalidixic acid . The isolation frequency of gramnegative nonsporulating bacteria increased under such conditions from 9-16 (control) to 80-100 per cent . At the same time the isolation frequency of gram-positive bacteria decreased from 88.5 to 9.6 per cent.

Jpn J Antibiot, 1984 Oct, 37(10), 1757 - 62
{Study on penetration of cefotiam into the cerebrospinal fluid}; Kodama Y et al.; Cefotiam (CTM) is a new cephem antibiotic which has potent activities against Gram-positive and Gram-negative bacteria . We investigated the prophylactic treatment of CTM in orthopedic surgery and the concentrations of CTM Gram-negative in cerebrospinal fluid . The mean serum concentration at 2 hours after the drip infusion of CTM (3 g) was 28.28 +/- 5.48 micrograms/ml, and the mean concentration of CTM in cerebrospinal fluid was 0.58 +/- 0.07 micrograms/ml . From the result of multi-regression analysis in group I (12 cases, over 40 years old) and group II (10 cases, below 39 years old), it was suggested that the factor of age had a marked effect on cerebrospinal fluid concentrations of CTM . (Group I greater than Group II) High concentrations of CTM in cerebrospinal fluid after the 3 g-administration, exceeding the MIC80 for most causative organisms, suggested very useful prophylactic treatment of CTM in orthopedic surgery.

N Z Med J, 1984 Aug 8, 97(761), 531 - 3
Blood culture isolates at Green Lane Hospital, 1972-1982; Sage MJ et al.; Bacteraemic patients identified annually at Green Lane Hospital by positive blood culture increased by 215% between 1972 and 1982 . In the same period the patient population increased by 22% . There was a disproportionate increase in gram-positive organisms . Antibiotic sensitivity patterns are discussed.

J Appl Bacteriol, 1984 Aug, 57(1), 125 - 30
Use of the Direct Epifluorescent Filter Technique for predicting the keeping quality of pasteurized milk within 24 hours; Rodrigues UM et al.; The keeping quality (KQ) of pasteurized milk stored at 5 degrees C and 11 degrees C was predicted within 24 h by pre-incubating samples and counting bacteria by the Direct Epifluorescent Filter Technique (DEFT) . For samples from 5 degrees C storage, 0.03% (w/v) benzalkonium chloride and 0.002% (w/v) crystal violet (final concentration) were added to inhibit the growth of Gram positive bacteria during pre-incubation . The samples from milk stored at 11 degrees C were pre-incubated without the addition of inhibitors . After pre-incubation there was a satisfactory relationship between the DEFT count and the KQ of milks at both 5 degrees C and 11 degrees C . The DEFT count following pre-incubation correctly classified greater than 80% of pasteurized milks on the basis of KQ.

Am J Clin Pathol, 1984 Aug, 82(2), 203 - 6
Comparative investigation of a quantitative chromogenic endotoxin assay and blood cultures; Thomas LL et al.; In a prospective study, the clinical relevance of a quantitative chromogenic endotoxin assay in plasma (detection limit 10 ng/L, assay time 2.5 hours) versus blood cultures was evaluated in 51 critically ill patients with increased susceptibility for infectious complications . Of the 400 samples tested, the endotoxin assay and bacterial culture both were negative in 342 samples . In 21 samples from 15 patients, gram-negative aerobic microorganisms were cultured . Corresponding endotoxin assays were positive in 14 samples (mean 100 ng/L) . Twenty-three samples grew gram-positive bacteria . The associated endotoxin assays all were negative . Twelve samples were found to be endotoxin-positive without a corresponding gram-negative bacterial culture . In 7 of these 12 positive endotoxin assays, a laboratory or clinical explanation for these positive tests could be provided . In view of the high sensitivity, specificity, and predictive values obtained, the authors conclude that the endotoxin assay used is a useful clinical adjunct for both the detection and exclusion of gram-negative septicemia.

J Antibiot (Tokyo), 1984 Aug, 37(8), 836 - 46
Griseochelin, a novel carboxylic acid antibiotic from Streptomyces griseus; Grafe U et al.; Griseochelin, C33H60O7, isolated from an asporogenous strain of Streptomyces griseus represents a novel carboxylic acid antibiotic . The metabolite, which is active against Gram-positive bacteria, forms water-insoluble salts with mono- and divalent cations and binds alkaline-earth metal ions specifically in 2:1 (X2M) stoichiometry . Detailed spectral (IR, MS and NMR) studies provide full characterization of its constitution featuring a carboxylic acid function, a substituted tetrahydropyran ring, an allylic OH group which are accommodated within a tetrahydroxylated-octamethyl-C25 diene backbone.

Ann Acad Med Singapore, 1984 Jul, 13(3), 451 - 4
Infections in children with acute lymphoblastic leukaemia; Lou J et al.; Infective and febrile episodes were studied in 28 patients with childhood acute lymphoblastic leukaemia . Most of the infections were referrable to the respiratory tract . Organisms commonly cultured were Gram positive bacteria . The incidence of febrile episodes were generally low but was higher during induction and remission.

Acta Paediatr Scand, 1984 Jul, 73(4), 515 - 22
Severe infections in childhood leukemia . A follow-up study of 100 consecutive ALL patients; Saarinen UM; Severe infections during the course of childhood ALL were surveyed as a whole in 100 consecutive patients, followed up for 2-8.5 years from the ALL diagnosis . The most important findings were a total absence of disseminated candidiasis, a relative infrequency of gram-negative septicemia (8 episodes), and a predominance of gram-positive cocci (29 episodes) in the 48 verified septicemias . S . aureus was responsible for 50% of culture-positive septicemias . The gram-positive predominance depended probably on local factors, and reservation in using broad-spectrum antibiotics might have played a part . There were 9 cases of disseminated Varicella-zoster, cured successfully with antiviral agents . Pneumocystis carinii pneumonitis numbered 8 episodes, concentrated to the early remission period . One case of miliary tuberculosis was found . Risk factors regarding age of patient and phase or intensity of cytotoxic therapy are evaluated.

Ann Ostet Ginecol Med Perinat, 1984 Jul-Aug, 105(4), 267 - 71
{Use of a clindamycin phosphate-gentamycin combination in endometritis following induced abortion}; Rossi P et al.; PIP: Endometritis is a major complication in induced abortion and according to statistics compiled in Italy it varies in frequency from .5% to 5% in women who undergo abortion . In the complications arising after induced abortion, bacteriological research has shown the constant presence of a mixed bacterial flora with the particular development of anaerobic germs, especially Bacterioides Fragilis; therefore, Cephalosporines and similar drugs, such as penicillin-gentamycin and penicillin-kanamycin, have been used . 28 women affected by endometritis were surveyed . Of these, 23 had undergone hysterosuction and the others had undergone therapeutic abortion . All of the patients were given an antibiotic treatment with 600 mg clindamycin phosphate intramuscularly every 12 hours and 80 mg gentmycin intramuscularly every 12 hours . Temperatures were checked 4 times/day and the patients were monitored for possible side effects . The results confirmed that in all cases the fever disappeared; in 10 patients, this happened after only 2 days of therapy; in 10 others, it happened after 3 days; and for the rest, it took more than 4 days . During the survey period there were no noticeable side effects requiring the drug to be discontinued or replaced . A month later, all patients were completely well and only 2 suffered diarrhea following the treatment . The combination of clindamycin phosphate and gentamycin presents an advantage over other treatments because it covers the total range of gram-positive (clindamycin phosphate) and gram-negative (gentamycin) germs . In 67.8% of the cases, the hyperpyrexia disappeared after 2 days of treatment; in 71.4%, the clinical symptomatology was resolved after 3 days . The method of administration, the manageability, and the tolerability of the 2 drugs lead to the conclusion that they can be used advantageously in moderate and mild cases of endometritis following induced abortion .

Farmaco {Sci}, 1984 Jul, 39(7), 640 - 8
{Synthesis and biological activity of new compounds with the 1,3-dioxol(4,5-g)quinoline structure}; Pellerano C et al.; The synthesis of some 1,3-dioxol{4,5-g}quinoline derivatives is described . The compounds show appreciable activity in vitro against some gram-positive bacteria and do not show any significant activity against P388 lymphocytic leukemia . Microbiological and antitumor results are presented.

JPEN J Parenter Enteral Nutr, 1984 Jul-Aug, 8(4), 391 - 5
Microbial growth comparisons of five commercial parenteral lipid emulsions; Crocker KS et al.; The ability of parenteral lipid emulsions to support microbial growth was compared using commercially available brands of lipid emulsion . Both 10 and 20% concentrations of soybean and safflower oil emulsions were used . Washed cultures of six gram-negative, three gram-positive, and one yeast, in concentrations of 1 x 10(4) to 2 x 10(4) colony-forming units/ml, were inoculated into lipid emulsion aliquots and stored at room temperature . There were than subcultured at 0, 6, 12, 24 and 48 hr . After 48 hr at 37 degrees C, growth was recorded as colony-forming units/ml . Normalized growth curves were expressed as mean +/- SEM . ANOVA demonstrated no difference in growth patterns due to the nature of the oil or its concentration . Gram-negative organisms multiplied faster when compared to gram-positive (p less than 0.05 at 12 hr, p less than 0.01 at 24 hr, and p less than 0.005 at 48 hr) . Yeast grew as well as bacteria . The Center for Disease Control's recommendation of a 12-hr hang time for parenteral lipid emulsions should be observed until correlation of laboratory microbial growth patterns and clinical use are studied further.

Am Surg, 1984 Jul, 50(7), 358 - 61
Bacterial peritonitis . Protecting the high-risk patient; Jones LM et al.; Cefamandole in combination with tobramycin was evaluated in the treatment of peritonitis as an adjunct to laparotomy and performance of the indicated surgical procedure in 88 patients . The clinical response was judged satisfactory in 91 per cent . Of four deaths, only one could be attributed to infection . Side effects noted were decreased creatinine clearance in 16 patients, increased liver enzymes in ten patients, and eosinophilia in nine patients . Microbiologic studies revealed aerobic peritonitis in 44 cultures and anaerobic in 32 . Eighty-five per cent of the gram-negative and 69 per cent of the gram-positive strains were susceptible to cefamandole . Cefamandole alone or in combination with tobramycin appears to be an effective and safe antibiotic when used in appropriate doses for the treatment of bacterial peritonitis.

J Periodontol, 1984 Jun, 55(6), 359 - 63
B-lymphocyte blastogenesis in response to periodontitis-associated bacteria . Kinetics and proportion of total response; Donaldson SL et al.; A role for activated B-lymphocytes in mediating the initiation and/or progression of periodontal diseases has been proposed in previous work . The present study was conducted to: (1) assess the proportion of total lymphocyte blastogenic response to selected oral bacteria which is composed of T-cell and B-cell activation, respectively, and (2) to determine whether different kinetic patterns exist for the T-cell vs . the B-cell responses to these bacteria . Using lymphocyte rosetting and culturing techniques, rosette-positive and rosette-negative lymphocyte preparations were examined for blastogenic responsiveness following stimulation with a variety of both Gram-positive and Gram-negative periodontitis-associated bacteria . Results of these studies indicated that both peripheral blood lymphocytes (PBL) from healthy adults and cord blood lymphocytes (CBL) from placental afterbirths responded to these bacteria with similar kinetic patterns . The net PBL blastogenic response appeared to consist of an early B-cell response, which peaked at Days 2 or 3 of culture, followed by a later T-cell response, which peaked at Days 5 to 6 of culture . The B-cell response appeared to be T-cell-dependent in that B-cells cultured alone showed minimal thymidine uptake over the entire 6-day period, but the addition of irradiated T-cells to these B-cell cultures resulted in a greatly enhanced B-cell response.

Pathol Biol (Paris), 1984 Jun, 32(5 Pt 2), 611 - 4
{Inactivation of disinfectants by proteins and calcium ions as a function of their chemical constitution and bacterial species}; Guiraud-Dauriac H et al.; Activity of nine disinfectants was evaluated with interfering substances (albumin-yeast mixture and hard water), by two methods (NFT . 72 170, NFT . 72 171 and without interfering substance NFT . 72 150, NFT 72 151 respectively) . Interference indexes were defined as the ratio of bactericidal concentration without interfering substances to bactericidal concentration with interfering substances . Five different ratings of interference effects were arbitrarily defined (no effect, moderate, average, strong, very strong) . Proteins and hard water significantly inactivate aldehydes and quaternary ammonium salts : interference index is usually 25 but may reach 100-500 . Inactivation of phenolic products by these two interfering substances is either lacking or inconsiderable . Conversely to Gram negative bacteria, activity of disinfectants on Gram positive bacteria is not significantly affected by proteins or hard water . P . aeruginosa can survive despite high concentrations of disinfectant in the presence of proteins and calcium ions . This finding may be a reason why this microorganism is difficult to eliminate from hospital wards.

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