Staphylococcus aureus

J Vet Med Sci, 1995 Apr, 57(2), 351 - 3
Application of the Limulus amoebocyte lysate test as an indicator of microbial contamination in pork carcasses; Misawa N et al.; The Limulus amoebocyte lysate (LAL) test, a simple and rapid method, was applied for the evaluation of bacterial contamination of carcasses in a slaughterhouse . Twenty-five pork carcasses were examined for bacterial contamination, and we evaluated the correlation between the LAL test and the methods usually employed for detecting indicator organisms of total viable cells, coliforms or Staphylococcus aureus . The reciprocal of the highest dilution found to be positive was used as the LAL index . A high correlation was observed between the LAL index and the number of coliforms, but not between the index and the number of other organisms . The LAL test was accomplished within 2 hr after sampling, and thus may serve as a useful tool for the substitute indicator of coliforms among bacterial contamination in carcasses.

J Vet Med Sci, 1995 Apr, 57(2), 299 - 305
Proliferative response and cytokine production of bovine peripheral blood mononuclear cells induced by the superantigens staphylococcal enterotoxins and toxic shock syndrome toxin-1; Yokomizo Y et al.; The potential of staphylococcal enterotoxin A (SEA), B (SEB), C(SEC) and toxic shock syndrome toxin-1 (TSST-1) to act as superantigens by inducing polyclonal T-cell mitogenesis and cytokine production was tested on bovine peripheral blood mononuclear cells (PBMC) . These four toxins were capable of inducing strong proliferative response of PBMC from calves over a broad dosage range (1 pg/ml to 1 microgram/ml) in vitro . The toxin-activated blast cells consisted of both CD4+ T-cells and CD8+ T-cells, but the T-cell proliferation depended upon the presence of monocytes . Treatment of monocytes with monoclonal antibody to major histocompatibility complex class II antigens substantially inhibited the toxin-induced T-cell proliferative response, but paraformaldehyde-fixation did not abrogate the accessory function . SEA, SEB, SEC and TSST-1, all induced the in vitro release of interleukin-2, interferon gamma and tumor necrosis factor alpha in a dose dependent manner . The results indicate that SEA, SEB, SEC and TSST-1 are capable of acting as superantigens by stimulating bovine T-cells as shown in the human and murine systems . The possible implications of these toxins in the immunopathogenesis of bovine mastitis caused by the infection with Staphylococcus aureus are discussed.

Zentralbl Veterinarmed B, 1995 Apr, 42(2), 118 - 26
Effects of Staphylococcus aureus mastitis after endotoxin application on milk yield and composition during subsequent lactation of guinea-pigs; Vandeputte-Van Messom G et al.; The effects of Staphylococcus aureus mastitis on milk yield and composition throughout subsequent lactation in lactating guinea-pigs and the role of endotoxin pretreatment on these phenomena were investigated . Primiparous lactating guinea-pigs were intramammarily inoculated with sterile saline (group 1), S . aureus strain UC 6097 (group 2), or with S . aureus UC 6097 after endotoxin pretreatment (group 3) . Clinical signs and survival rate were monitored . During the second lactation, daily milk yield was measured and milk composition was determined . In primiparous inoculated guinea-pigs, moderate (group 3)-to-severe acute mastitis (group 2) was produced . During subsequent lactation, milk yield in the control group peaked on day 5 and then decreased . Concentrations of Na+ and Cl- in milk, and concentrations of fat, gradually increased, but lactose and K+ decreased . After an early decrease, NAGase in milk increased towards the end of lactation . Except for higher NAGase concentrations in group 3, milk yield and composition during the second lactation did not differ significantly between the mastitis and the control groups . Endotoxin pretreatment only plays a role in the determination of the severity of the infection.

FEBS Lett, 1995 Mar 27, 362(1), 80 - 4
Overproduction of the bleomycin-binding proteins from bleomycin-producing Streptomyces verticillus and a methicillin-resistant Staphylococcus aureus in Escherichia coli and their immunological characterisation; Sugiyama M et al.; The bleomycin-binding proteins designated BLMA and BLMS, which confer resistance to bleomycin (Bm), from Bm-producing Streptomyces verticillus ATCC15003 and a methicillin-resistant Staphylococcus aureus B-26, respectively, were overexpressed in Escherichia coli . The present study showed that both BLMA and BLMS quench the antibacterial activity of Bm by the binding to the drug . To immuno-characterize the Bm-binding proteins, we constructed a monoclonal antibody against BLMA . The antibody, designated 893-12, did not cross react to BLMS and another Bm-binding protein from tallysomycin-producing Streptoalloteichus hindustanus . Although the ability of Bm to cleavage DNA was eliminated by a binding of BLMA to Bm, as shown by Sugiyama et al . {Gene 151 (1994) 11-15}, the Bm-induced DNA degradation was restored by pre-incubation of BLMA with the anti-BLMA monoclonal antibody.

Nippon Naibunpi Gakkai Zasshi, 1995 Mar 20, 71(2), 167 - 72
{A rare case of a diabetic patient with small cell lung cancer, initially diagnosed as pyogenic vertebral osteomyelitis}; Miyamoto T et al.; A rare case of a patient with non-insulin-dependent diabetes mellitus (NIDDM) with small cell lung cancer, initially diagnosed as pyogenic vertebral osteomyelitis, was reported . A 40-year-old male patient was diagnosed with NIDDM about 3 years earlier, but he did not receive any treatment . Then, a two-month history of high fever, persistent cough and back pain developed . Chest X-ray film showed a lung infiltrate with a small cavity in the upper portion of the left lung . Computed tomography and magnetic resonance imaging of the chest revealed a tumor mass shadow with osteoclasia along the bodies of the 6th and 7th thoracic vertebral bone . Staphylococcus aureus infection was confirmed by arterial blood culture . Administration of antibiotics resulted in the disappearance of the left lung infiltrate and a slight reduction of the tumor mass in the thoracic vertebral bone, suggesting pyogenic vertebral osteomyelitis as an unusual complication of NIDDM . However, as the tumor mass still remained, needle biopsy for the mass lesion was performed, resulting in the diagnosis of metastasis of small cell carcinoma from the left lung . Gene aberration in this lung disease has been reported recently, and its correlation with NIDDM which may also be induced by genetic abnormality is an interesting question that remains to be resolved.

Eur J Pharmacol, 1995 Mar 15, 289(1), 59 - 66
Ca2+ handling mechanisms underlying neuropeptide Y-induced contraction in canine basilar artery; Tanaka Y et al.; The effects of neuropeptide Y on isometric tension simultaneously measured with cytosolic Ca2+ concentration ({Ca2+}cyt) and Ca2+ sensitivity of contractile elements were studied in isolated canine basilar arteries . Neuropeptide Y (1-100 nM) increased {Ca2+}cyt and tension in a concentration-dependent and parallel manner, whereas 9,11-dideoxy-11 alpha,9 alpha-epoxymethano prostaglandin F2 alpha (U46619) (10-100 nM), a thromboxane A2 mimetic, produced a large contraction with a small increase in {Ca2+}cyt . Ca2+ channel antagonists such as d-cis-diltiazem (10 mM) abolished both {Ca2+}cyt and tension augmented by neuropeptide Y . In Ca(2+)-free solution containing 0.2 mM EGTA, neuropeptide Y did not change {Ca2+}cyt and tension, whereas U46619 transiently increased both of them . Furthermore, neuropeptide Y apparently did not affect the Ca2+ sensitivity when assessed in the artery permeabilized with Staphylococcus aureus alpha-toxin, whereas U46619 augmented it . These findings suggest that neuropeptide Y-induced contraction in the canine basilar artery is produced mainly by Ca2+ influx through L-type Ca2+ channels.

Eur J Biochem, 1995 Mar 15, 228(3), 798 - 804
Lactose-specific enzyme II of the phosphoenolpyruvate-dependent phosphotransferase system of Staphylococcus aureus . Purification of the histidine-tagged transmembrane component IICBLac and its hydrophilic IIB domain by metal-affinity chromatography, and functional characterization; Peters D et al.; The lactose-specific integral-membrane-protein enzyme II (IICBLac) of the bacterial phosphoenolpyruvate-dependent phosphotransferase system of Staphylococcus aureus catalyses the uptake and phosphorylation of lactose . It consists of an N-terminal membrane-spanning IIC domain and a C-terminal hydrophilic IIB domain . IICBLac was fused with a C-terminal tag of six histidine residues using recombinant DNA technology . The resulting protein, IICBLac-His, was produced in Escherichia coli and purified under nondenaturing conditions to homogenity . The purification procedure consists of a NaOH extraction step followed by solubilisation with Triton X-100, and metal-affinity chromatography using Ni(2+)-nitrilotriacetic acid resin . The purified recombinant His-tagged protein possessed substrate specificity identical to that of the wild-type protein . To investigate the hydrophilic IIB domain, the DNA sequence coding for IIB and the His tag were fused in-frame to a DNA sequence specific for an initiation signal . The overproduced recombinant IIBLac-His was obtained by metal-affinity chromatography in pure form . Bacterial phosphotransferase-system-dependent phosphorylation of IIB-His was demonstrated in a photometric assay and by urea/polyacrylamide gel electrophoresis . The phosphorylation activity of the mutant protein {C476S}-IICBLac, containing the mutagenized phosphorylation site, was restored in the presence of IIBLac-His in a phosphorylation assay.

Eur J Biochem, 1995 Mar 15, 228(3), 772 - 8
The DNA-binding site of the RecA protein . Photochemical cross-linking of Tyr103 to single-stranded DNA; Morimatsu K et al.; To investigate the DNA-binding site in the Escherichia coli RecA protein, RecA was covalently cross-linked to oligodeoxythymidine {p(dT)14} by irradiation with ultraviolet light . We identified the site of cross-linking of the protein when the RecA.p(dT)14 complex was formed in the absence of nucleotide cofactor as well as in the presence of adenosine 5'-{gamma-thio}triphosphate . When RecA.p(dT)14 complex formed without nucleotide cofactor was irradiated with ultraviolet light, a cross-linked peptide was found after digestion with Achromobactor lyticus protease I . Amino acid composition of the peptide was determined . The results indicated that the site of cross-linking was in the region spanning amino acid residues 89-106 . Further digestion of the cross-linked fragment with Staphylococcus aureus V8 protease indicated that Tyr103 was the site of cross-linking . When the complex formed with adenosine 5'-{gamma-thio}triphosphate was irradiated with ultraviolet light, two cross-linked sites were detected, which were in the region of residues 89-106 and residues 178-183 . These regions are far from the two disordered loops in the crystal structure, which were suggested to be DNA-binding sites by Story et al . {Story, R . M., Weber, T . W . & Steitz, T . A . (1992) Nature 355, 318-325}.

Eur J Biochem, 1995 Mar 15, 228(3), 732 - 8
Comparative biochemical and molecular analysis of the Staphylococcus hyicus, Staphylococcus aureus and a hybrid lipase . Indication for a C-terminal phospholipase domain; Nikoleit K et al.; The lipase gene, geh, from Staphylococcus aureus NCTC8530 was cloned in Staphylococcus carnosus . DNA sequencing revealed an open reading frame (ORF) of 2046 nucleotides encoding a 682-amino-acid protein with a molecular mass of 76900 Da . Determination of the transcriptional start site revealed a 203-nucleotide mRNA leader . Expression of geh in the protease-negative S . carnosus (pT181copSA22) resulted in overexpression of a 83-kDa lipase found in the culture supernatant . N-terminal protein sequencing and sequence comparison with three other staphylococcal lipases suggest that this lipase is organised as a pre-pro-enzyme . The substrate specificity of this lipase is different from the Staphylococcus hyicus lipase . The S . hyicus lipase expressed both a high Ca(2+)-dependent phospholipase and lipase activity while the S . aureus lipase lacked this phospholipase activity and its activity with tributyrylglycerol or p-nitrophenyl octanoate is hardly stimulated by Ca2+ ions . A hybrid protein was constructed in which the C-terminal 146 residues of the S . hyicus lipase were substituted by 145 residues of the C-terminal of the S . aureus lipase, which contains the proposed active-site amino acids Asp602 and His641 . The hybrid enzyme was still active and revealed an intermediary enzymic activity . The most striking effect was that it had lost the S . hyicus-specific phospholipase activity and that, in contrast to the two parental enzymes, its activity with p-nitrophenyl octanoate became highly sensitive to the presence of Ca2+ . These observations suggest that the C-terminal domain of the S . hyicus lipase strongly contributes to the binding pocket of the polar headgroup of phospholipids . The Ca(2+)-binding site seems to be located in the N-terminal fragment of the S . hyicus lipase . The fact that two closely related enzymes differ in the need for Ca2+ underscores the notion that it plays a structural rather than a catalytic role.

Spine, 1995 Mar 15, 20(6), 685 - 8
The effect of prophylactic antibiotics on iatrogenic intervertebral disc infections . a rabbit model; Guiboux JP et al.; STUDY DESIGN . A rabbit model was used to test the efficacy of two commonly used prophylactic antibiotics, cefazolin and vancomycin, in preventing iatrogenically introduced Staphylococcus aureus intervertebral disc infections . OBJECTIVE . This study was performed to assess the efficacy of two prophylactic antibiotics in preventing iatrogenically introduced Staphylococcus aureus intervertebral disc infections . SUMMARY OF BACKGROUND DATA . Previous studies have had conflicting results regarding the penetration of antibiotics into the nucleus pulposus and their ability to eradicate infection . METHODS . In this study, 40 adult New Zealand White rabbits underwent inoculation of 10(1) or 10(3) Staphylococcus aureus/ml into 3-6 lumbar intervertebral discs under direct visualization . Either no antibiotics (control groups) or various preoperative and postoperative dosing schedules of cefazolin or vancomycin were given intravenously . Five days after surgery, the discs were harvested and cultured . RESULTS . All 40 discs inoculated in the control groups became infected . None of the 35 discs inoculated in the cefazolin groups became infected . Infection developed in 23 of 107 discs inoculated in the vancomycin groups . Most notable of these were 17 of 17 positive cultures in animals given vancomycin 8 hours preoperatively only . CONCLUSIONS . Based on these results, it was concluded that intravenous cefazolin or vancomycin given within 1 hour before surgery can effectively prevent postoperative discitis . No advantage was found with additional postoperative antibiotics.

Southeast Asian J Trop Med Public Health, 1995 Mar, 26(1), 78 - 85
An unusual outbreak of food poisoning; Thaikruea L et al.; On August 25 1990, over 400 people who attended a Thailand handicappeds' sport day at a provincial physical education college developed gastrointestinal symptoms after having dinner . An epidemiological team want to determine causes(s) and recommend how to prevent and control a food poisoning outbreak . The investigation included interviewing all 1,210 persons who attended the sport's day . In addition, an environmental survey, laboratory analysis of food samples, and rectal, ear, throat and nasal swabs from foodhandlers were also performed . A case was defined as a person who ate any items of dinner food and experienced vomiting, nausea, abdominal pain, and diarrhea . There were 485 cases out of 1,094 persons, an attack rate of 43% . Interviews were completed for 470 out of 485 cases . The three most common symptoms were nausea (93%), vomiting (88%), and abdominal pain (81.5) . The mean incubation period was 3.20 hours . Three out of four items of food had a significant association with illness . Among these 3 items, eclairs had to the highest crude relative risk, 7.0 (95% CI = 4.8, 10.2) . For statistical analysis, logistic regression by unconditional method was used, and found that only eclairs which were prepared during the night before the dinner and kept at room temperature for at least 12 hours before serving, remained statistically significant in the model (RR = 11.96; 95% CI = 9-22) . Laboratory examination of foods and foodhandlers indicated heavy growth of Staphylococcus aureus producing toxins A and C and Bacillus cereus in eclairs . Culture of nasal swabs from healthy foodhandlers identified B . cereus and S . aureus of different phage types from those in eclairs.(ABSTRACT TRUNCATED AT 250 WORDS)

Am J Physiol, 1995 Mar, 268(3 Pt 2), H1223 - 31
Effects of cGMP on calcium handling in ATP-stimulated rat resistance arteries; Andriantsitohaina R et al.; The mechanisms by which guanosine 3',5'-cyclic monophosphate (cGMP) modulates the contraction induced by ATP were investigated in small mesenteric resistance arteries of the rat . The nitric oxide donors 3-morpholinosydnonimine (SIN-1, 10 microM) and sodium nitroprusside (SNP, 10 microM) increased cGMP but not adenosine 3',5'-cyclic monophosphate (cAMP) content of the tissue . SIN-1, SNP, and 8-bromoguanosine 3',5'-cyclic monophosphate (8-BrcGMP, 100 microM) inhibited the myosin light chain phosphorylation and the contractile response to ATP . Both effects were completely reversed by the selective inhibitor of cGMP protein kinase, Rp-8-bromoguanosine 3',5'-cyclic monophosphorothioate (30 microM) . The sensitivity to Ca2+ of arteries permeabilized with Staphylococcus aureus alpha-toxin (4,000 hemolytic units/ml) was not affected by 8-BrcGMP . The two nitric oxide donors and 8-BrcGMP decreased the rise in intracellular Ca2+ induced by ATP . The vasodilator agents abolished the contractile response to the exogenous calcium in vessels that were exposed to 3 mM ATP after depletion of intracellular Ca2+ stores . Thapsigargin (1 microM), an inhibitor of the sarcoplasmic reticulum Ca(2+)-adenosinetriphosphatase, reversed the inhibitory effect of the vasodilator agents when the contraction induced by ATP was elicited in the presence of the Ca2+ entry blocker nitrendipine (1 microM) or in Ca(2+)-free medium . These results show that cGMP inhibits ATP-induced contraction by decreasing intracellular Ca2+ concentration in small resistance arteries . They indicate that this effect results from decreased Ca2+ influx and enhanced Ca2+ sequestration through a thapsigargin-sensitive pump via activation of a cGMP protein kinase.

J Lab Clin Med, 1995 Mar, 125(3), 356 - 69
Immunosuppressive properties of surfactant and plasma on alveolar macrophages; Allen JN et al.; Alveolar macrophages have been shown to be major producers of the potent proinflammatory cytokines interleukin-1 beta and tumor necrosis factor-alpha, and of the antiinflammatory cytokine interleukin-1 receptor antagonist . During the adult respiratory distress syndrome the normally surfactant-coated alveolus becomes flooded with plasma proteins, altering the milieu of alveolar cells such as alveolar macrophages . To understand alveolar macrophage function during the adult respiratory distress syndrome, the individual and combined effects of surfactant and plasma on alveolar macrophage cytokine production was examined . A synthetic surfactant (Exosurf) and a bovine-derived surfactant (Survanta) both inhibited production of interleukin-1 beta, pro-interleukin-1 beta, tumor necrosis factor-alpha, and interleukin-1 receptor antagonist in a dose-dependent manner . This inhibition was noted when both endotoxin and heat-killed Staphylococcus aureus were used as stimuli . Autologous plasma also inhibited interleukin-1 beta and tumor necrosis factor-alpha release in a dose-dependent manner, but, unlike surfactant, plasma did not inhibit interleukin-1 receptor antagonist release . Similarly, the combination of plasma and surfactant inhibited interleukin-1 beta and tumor necrosis factor-alpha release but not interleukin-1 receptor antagonist release . In support of these data, interleukin-1 receptor antagonist was detectable in five of six bronchoalveolar lavage fluid samples from patients with adult respiratory distress syndrome at a mean concentration of 465 pg/ml; on the other hand, interleukin-1 beta was not detectable in any of these samples . These results indicate that the relative production of interleukin-1 beta, tumor necrosis factor-alpha, and interleukin-1 receptor antagonist can be altered depending on the local concentration of both surfactant and plasma.

J Med Microbiol, 1995 Mar, 42(3), 214 - 9
Mechanisms of 4-quinolone resistance in quinolone-resistant and methicillin-resistant Staphylococcus aureus isolates from Japan and China; Tanaka M et al.; Ninety-two and 33 methicillin-resistant Staphylococcus aureus (MRSA) strains were isolated in Japan and China respectively . They were categorised as ofloxacin-susceptible (MIC < 12.5 mg/L), moderately (MIC 12.5-25 mg/L) or highly (MIC > or = 50 mg/L) ofloxacin-resistant . 4-Quinolone concentrations required to inhibit purified DNA gyrase from the moderately and highly quinolone-resistant MRSA were at least 20 times higher than those required to inhibit the equivalent enzyme from quinolone-susceptible strains . Reconstitution assays demonstrated that the 4-quinolone-resistant MRSA had a mutation in subunit A of DNA gyrase . A portion of the gyrA gene from amino acids codons 40-115 was sequenced . Four moderately resistant and seven highly resistant MRSA contained a Ser-->Leu substitution at amino acid 84; one moderately and one highly resistant MRSA and one moderately resistant methicillin-susceptible S . aureus (MSSA) strain contained a Glu-->Lys substitution at amino acid 88 . Eight MRSA, including one quinolone-susceptible strain and one MSSA contained a silent mutation at amino acid 86 . Uptake of ofloxacin in moderately resistant strains was almost the same in the presence or absence of carbonyl cyanide m-chlorophenylhydrazone (CCCP), whereas in highly resistant strains, uptake increased when CCCP was added . Restriction fragment length analysis of the norA gene with the restriction endonuclease SfcI showed a mutation of nucleotide position 1085 in all MRSA strains tested except for one highly quinolone-resistant strain . Thus the mechanisms of 4-quinolone-resistance in these MRSA isolates involved alterations in both DNA gyrase and antimicrobial uptake and efflux.

J Bacteriol, 1995 Mar, 177(6), 1491 - 6
Identification of endo-beta-N-acetylglucosaminidase and N-acetylmuramyl-L-alanine amidase as cluster-dispersing enzymes in Staphylococcus aureus; Sugai M et al.; Two proteins which are capable of dispersing cell clusters of Staphylococcus aureus have been purified from a S . aureus FDA209P culture supernatant . Both of them were found to have bacteriolytic activity . From the elution profile of column chromatography and Western blot (immunoblot) analysis, one of them was identified as a 51-kDa endo-beta-N-acetylglucosaminidase (GL) . The other was a 62-kDa protein on the basis of sodium dodecyl sulfate gel electrophoresis . Analysis of the peptidoglycan fragments following treatment with the 62-kDa protein indicated that this protein is an N-acetylmuramyl-L-alanine amidase (AM) . In vitro studies of cluster dispersion activities using S . aureus mutant strains Lyt66 or S . aureus Wood46 grown as clusters demonstrated that these two enzymes act synergistically to disperse clusters into single cells . Antiserum against the 51-kDa GL cross-reacted with the 62-kDa AM, and S . aureus FDA209P grown in the presence of anti-51-kDa-GL immunoglobulin G induced giant clusters . Clusters induced by anti-51-kDa GL and by Cibacron blue F3G-A were dispersed by coincubation with the 51-kDa GL and the 62-kDa AM . Western blot analysis demonstrated that the 51-kDa GL and the 62-kDa AM were missing in culture supernatants of S . aureus Lyt66, Wood46, and RUSAL2 (Tn551 autolysin-defective mutant), which grow in clusters . These results strongly suggest that the 51-kDa GL and 62-kDa AM are involved in cell separation of daughter cells after cell division.

J Infect Dis, 1995 Mar, 171(3), 614 - 24
Eradication of endemic methicillin-resistant Staphylococcus aureus infections from a neonatal intensive care unit; Haley RW et al.; To control infections with endemic methicillin-resistant Staphylococcus aureus (MRSA) in a neonatal intensive care unit (NICU), triple dye was applied to the umbilical cords of infants in the intermediate-care but not the intensive-care area . The rate of MRSA infection, adjusted for time and intensity of care, decreased in the intermediate-care area (rate ratio, 0.35; 95% confidence interval {CI}, 0.14-0.87; P < .01) but not in the intensive-care area (rate ratio, 0.92; 95% CI, 0.41-2.24; P = .48) . After 22 months, the rate increased in both areas (Mantel-Haenszel rate ratio, 1.7; 95% CI, 1.0-2.8; P < .05) after overcrowding and understaffing increased . After temporary reduction of overcrowding and understaffing, extension of triple dye use to the intensive-care area and dedication of an infection control nurse to the NICU, MRSA colonization and infection rates decreased to near zero in both areas (infection rate ratios, 0.09 and 0.11, respectively; P < .005) . The endemic MRSA strain, identified by pulsed-field gel electrophoresis, was eradicated.

Antimicrob Agents Chemother, 1995 Mar, 39(3), 714 - 9
Mode of action of the lantibiotic mersacidin: inhibition of peptidoglycan biosynthesis via a novel mechanism?
Brotz H, Bierbaum G, Markus A, Molitor E, Sahl HG.
Mersacidin is an antibiotic peptide produced by Bacillus sp . strain HIL Y-85,54728 that belongs to the group of lantibiotics . Its activity in vivo against methicillin-resistant Staphylococcus aureus strains compares with that of the glycopeptide antibiotic vancomycin (S . Chatterjee, D . K . Chatterjee, R . H . Jani, J . Blumbach, B . N . Ganguli, N . Klesel, M . Limbert, and G . Seibert, J . Antibiot . 45:839-845, 1992) . Incubation of Staphylococcus simulans 22 with mersacidin resulted in the cessation of growth and slow lysis . Biosyntheses of DNA, RNA, and protein were not affected, whereas incorporation of glucose and D-alanine was inhibited and a regular reduction in the level of cell wall thickness was observed . Thus, unlike type A lantibiotics, mersacidin does not form pores in the cytoplasmic membrane but rather inhibits cell wall biosynthesis . Comparison with tunicamycin-treated cells indicated that peptidoglycan rather than teichoic acid metabolism is primarily affected . Mersacidin caused the excretion of a putative cell wall precursor into the culture supernatant . The formation of polymeric peptidoglycan was effectively inhibited in an in vitro assay, probably on the level of transglycosylation . In contrast to vancomycin, the activity of mersacidin was not antagonized by the tripeptide diacetyl-L-Lys-D-Ala-D-Ala, indicating that on the molecular level its mode of action differs from those of glycopeptide antibiotics . These data together with electron microscopy suggest that mersacidin acts on a novel target, which opens new perspectives for the treatment of methicillin-resistant S . aureus.

Vopr Med Khim, 1995 Mar-Apr, 41(2), 40 - 2
{The effect of Staphylococcus aureus toxic shock exotoxin on whole blood cell chemiluminescence in vitro and in vivo}; Antipov AIu et al.; Stimulated and nonstimulated blood chemiluminescence were studied in presence of the toxic shock syndrome toxin I (TSST-I) in vivo and in vitro . In vivo experiments involved evaluation of rabbit whole blood chemiluminescence developed within various periods after the TSST-I intraperitoneal administration . Effect of various TSST-I concentrations on blood chemiluminescence was studied in vitro . TSST-I was shown to inhibit the nonstimulated chemiluminescence in blood within 45 min after administration of LD50 of both opsonized zymosan and calcium ionophore A 23187 in vivo . Similar effects the toxin exhibited at concentrations 20 microM and more in vitro . The maximum effect TSST-I demonstrated within the first 5 min of incubation and this effect was distinctly dose-dependent.

Pediatr Dermatol, 1995 Mar, 12(1), 12 - 5
The frequency of erythromycin-resistant Staphylococcus aureus in impetiginized dermatoses; Misko ML et al.; A trend toward increasing resistance of Staphylococcus aureus to standard antibiotic therapy has been reported . Specimens were taken from 98 patients in our outpatient staff clinic who had clinical signs of superficial skin infections . Patients with erythromycin-resistant S . aureus were contacted by telephone or seen in clinic . The organism was found in 87% of patients . Twenty-two (26%) of the 85 cultures that grew S . aureus were resistant to erythromycin . Treatment failure occurred in one of these patients . We conclude that S . aureus is the most common causative organism in secondary skin infections and impetigo in our patient population . Despite significant erythromycin resistance, there was a low frequency of treatment failure in this group . Erythromycin may still be a reasonable agent in the treatment of uncomplicated superficial skin infections in our community at this time.

J Antimicrob Chemother, 1995 Mar, 35(3), 421 - 4
Susceptibility of methicillin-resistant Staphylococcus aureus to the essential oil of Melaleuca alternifolia; Carson CF et al.; All 66 isolates of Staphylococcus aureus tested were susceptible to the essential oil of Melaleuca alternifolia, or tea tree oil, in disc diffusion and modified broth microdilution methods . Of the isolates tested, 64 were methicillin-resistant S . aureus (MRSA) and 33 were mupirocin-resistant . The MIC and MBC for 60 Australian isolates were 0.25% and 0.50%, respectively . Comparable results were obtained by co-workers in Britain using similar methods . These in-vitro results suggest tea tree oil may be useful in the treatment of MRSA carriage.

J Antimicrob Chemother, 1995 Mar, 35(3), 399 - 408
A double-blind, randomized, placebo-controlled clinical trial to evaluate the safety and efficacy of mupirocin calcium ointment for eliminating nasal carriage of Staphylococcus aureus among hospital personnel; Fernandez C et al.; Sixty-eight health care workers were enrolled in a double-blind clinical trial and randomized to receive either mupirocin calcium ointment or placebo, intranasally bid for 5 days . Nasal cultures were taken immediately before starting treatment, 1 and 2 during treatment, at the end of treatment, 3 days later, weekly for 1-5 weeks and then monthly for 2-6 months after treatment . Mupirocin eliminated nasal carriage with Staphylococcus aureus in 58% of subjects within two days and 86.7% subjects by the end of therapy compared to 9.4% subjects at the end of treatment with placebo (P < 0.001) . Post-treatment colonization rates of 43%, 56% and 67% were attained after 1 month, 2-4 and 6 months treatment with mupirocin respectively and recolonisation with the same strain of S . aureus that had been isolated before treatment was noted in 32%, 40% and 48% . No resistance to mupirocin developed and the drug was well tolerated . Mupirocin is safe and effective in suppressing nasal carriage of S . aureus.

J Am Soc Nephrol, 1995 Mar, 5(9), 1697 - 702
Polymorphonuclear leukocyte oxidative burst is enhanced in patients with chronic renal insufficiency; Ward RA et al.; Previous reports that polymorphonuclear leukocyte (PMN) function is impaired in hemodialysis patients do not differentiate between effects of dialysis and of uremia . The hypothesis that chronic renal insufficiency impairs PMN function was tested . Phagocytosis and oxidative burst were measured in PMN from patients with varying degrees of chronic renal insufficiency impairs PMN function was tested . Phagocytosis and oxidative burst were measured in PMN from patients with varying degrees of chronic renal insufficiency (creatinine clearance, 6 to 35 mL/min per 1.73 m2) and normal subjects . The ability of tumor necrosis factor-alpha (TNF-alpha) to prime the oxidative burst was also assessed . Phagocytosis of Staphylococcus aureus and basal H2O2 and O2- release by PMN did not differ between normal subjects and patients with chronic renal insufficiency . However, the oxidative burst stimulated by S . aureus and formyl-Met-Leu-Phe, but not phorbol myristate acetate, was significantly enhanced in PMN from patients with chronic renal insufficiency . The increase in formyl-Met-Leu-Phe-stimulated oxidative burst correlated significantly with the level of renal function . TNF-alpha significantly increased S . aureus-induced H2O2 production in normal PMN, but not in PMN from patients with chronic renal insufficiency . These data indicate that chronic renal insufficiency does not impair PMN phagocytosis and oxidative burst . To the contrary, it enhances receptor-mediated oxidative burst . The inability of TNF-alpha to further enhance the oxidative burst suggests that PMN exist in a primed state in patients with chronic renal insufficiency.

J Burn Care Rehabil, 1995 Mar-Apr, 16(2 Pt 1), 97 - 103
Cytotoxicity testing of topical antimicrobial agents on human keratinocytes and fibroblasts for cultured skin grafts; Boyce ST et al.; Cultured epidermal skin has become an adjunctive therapy for treatment of major burn injuries, but its effectiveness is greatly limited because of destruction by microbial contamination . To evaluate candidate antimicrobial agents for use with cultured skin, a combined cytotoxicity-antimicrobial assay system was developed for determination of toxicity to cultured human keratinocytes and fibroblasts and for determination of susceptibility or resistance of common burn wound organisms . Candidate agents including chlorhexidine gluconate, polymyxin B, mupirocin, sparfloxacin, or nitrofurazone were tested separately for inhibition of growth of human cells and for inhibitory activity to microorganisms with the wet disk assay . The data showed that (1) chlorhexidine gluconate (0.05%) was uniformly toxic to both cultured human cells and microorganisms; (2) nitrofurazone (0.02%) had dose-dependent toxicity to human cells and limited effectiveness against gram-negative microorganisms; (3) sparfloxacin (30 micrograms/ml) had low toxicity to human cells and retained antimicrobial activity against both gram-positive and gram-negative bacteria; (4) polymyxin B (400 U/ml) was not toxic to human cells and had intermediate effectiveness on gram-negative bacteria; and (5) mupirocin (48 micrograms/ml) had no toxicity to skin cells and had uniform effectiveness against Staphylococcus aureus including methicillin-resistant Staphylococcus aureus . Selection of topical antimicrobial drugs by these assays may improve effectiveness of cultured skin for burns and may be used to control other surgical wound infections.

Am J Orthop, 1995 Mar, 24(3), 262 - 4
A septic hip complicated by a ruptured appendix in an intravenous drug user; Pereles TR et al.; This paper reports on a case of hip joint sepsis complicated by a ruptured appendix in an intravenous drug user . A 41-year-old woman underwent open irrigation and debridement of her right hip joint for a methicillin-sensitive Staphylococcus aureus infection . Five days later the patient developed an intraperitoneal mass, requiring laparotomy and debridement of a periappendiceal abscess . The organisms infecting the abscess were different from those infecting the patient's hip . The patient recovered satisfactorily after 6 weeks of intravenous antibiotic therapy.

Infect Dis Clin North Am, 1995 Mar, 9(1), 11 - 24
Staphylococcus aureus infections in diabetic patients; Breen JD et al.; Staphylococcus aureus infections may occur with greater frequency among patients with diabetes mellitus . This article reviews the available literature as it pertains to diabetes and S . aureus in three categories: colonization/carriage, bacteremia with or without metastatic complications, and dialysis-related infections . The clinical entity of pyomyositis is also discussed.

Clin Chest Med, 1995 Mar, 16(1), 111 - 20
Pneumonia due to Staphylococcus aureus infection; al-Ujayli B et al.; Staphylococcus aureus is the second most common infectious agent of pneumonia in the ICU . The virulence of this organism is highlighted by toxins and enzymes that result in severe damage to lung tissue . Clinical features fail to distinguish Staphylococcus aureus pneumonias from other pathogens, and clinical diagnosis has the same limitations that beset other bacterial causes of pneumonia . Effective therapy is dictated by carefully performed susceptibility testing . First-line therapy is with a beta-lactam agent . If BRSA is detected or beta-lactam intolerance occurs, vancomycin should be administered . Despite agents active in vitro, the mortality of this disease remains high, especially if spread through hematogenous routes.

QJM, 1995 Mar, 88(3), 181 - 9
Prognostic significance of the neutrophil count in immunocompetent patients with bacteraemia; Leibovici L et al.; To examine the prevalence of neutropaenia in immunocompetent, bacteraemic patients, and whether it carries an independent risk for mortality, we surveyed 2096 bacteraemic patients without malignant diseases, and who were not receiving cytotoxic drugs . The granulocyte count on the day of the first positive blood culture was < 1 x 10(9) cells/l in 33 patients (1.7%, group 1); 1.0-4.0 x 10(9) cells/l in 154 patients (7.9%, group 2); 4.0-8.0 x 10(9) cells/l in 564 patients (29%, group 3); 8.0-20.0 x 10(9) cells/l in 1034 patients (53%, group 4); and > 20.0 x 10(9) cells/l in 163 patients (8.4%, group 5) . The mortality rates in the five groups were 39.4%, 18.8%, 18.1%, 25.7% and 25.8%, respectively (p = 0.0001) . The main pathogens in group 1 were Staphylococcus aureus in 25% of patients and Pseudomonas sp . in 23% . Mortality in group 1 patients was higher than in the other patients (odds ratio 1.4, 95% CI 1.1-1.9} . Mortality was also significantly higher in group 2 patients with high blood urea nitrogen . The percentage of neutropaenia, septic patients without known risk factors for neutropaenia is small, but their mortality is high . Overall mortality in patients with relative neutropaenia (1.0-4.0 x 10(9) cells/l) is low, but a subgroup of patients with high blood urea nitrogen is at considerable risk for a fatal outcome . High leucocyte counts are also a marker of increased risk for mortality, but this association is not an independent prognostic factor.

Heart Lung, 1995 Mar-Apr, 24(2), 177 - 8
Escherichia coli sternal osteomyelitis after open heart surgery; Shea KW et al.; Deep-seated infections after open-heart surgical procedures, fortunately, are uncommon with appropriate prophylactic antibiotics and careful aseptic technique . When serious infection, such as sternal osteomyelitis, does occur, the effects are devastating and usually require one or more debridement procedures . The organisms usually implanted in postoperative sternal infections are primarily Staphylococcus aureus and aquatically based gram-negative bacilli . Common gram-negative pathogens such as Escherichia coli are very unusual in this setting . We report a case of E . coli sternal osteomyelitis in a diabetic patient after coronary artery bypass grafting.

Chemotherapy, 1995 Mar-Apr, 41(2), 77 - 81
Changes of surface hydrophobicity and charge of Staphylococcus aureus treated with sub-MIC of antibiotics and their effects on the chemiluminescence response of phagocytic cells; Nomura S et al.; The effects of the sub-MIC of antibiotics on the surface hydrophobicity and charge of Staphylococcus aureus were examined by the contact angle method and by microscopic electrophoresis, and the production of oxygen-derived radicals by mouse peritoneal macrophages was measured by a luminol-chemiluminescence assay . The treatment of the bacterial cells with antibiotics induced an increase in hydrophobicity and a decrease in the negative charge of the bacterial surface . The chemiluminescence of the macrophages stimulated by S . aureus treated with antibiotics was significantly higher than that obtained with the untreated bacterial cells . These findings suggest that the antibiotics caused an increase in the hydrophobicity and a decrease in the negative charge of the surface of S . aureus, resulting in the enhancement of nonopsonic phagocytosis of S . aureus by macrophages.

Jpn J Antibiot, 1995 Mar, 48(3), 402 - 8
Synergistic enhancement of in vitro antimicrobial activity of imipenem and cefazolin, cephalothin, cefotiam, cefamandole or cefoperazone in combination against methicillin-sensitive and -resistant Staphylococcus aureus; Uete T et al.; Synergistic enhancement of the in vitro antimicrobial activity of imipenem combined with cephalosporins against methicillin-resistant Staphylococcus aureus (MRSA) has been reported . In order to investigate which cephalosporin is more effective in enhancing the activity of imipenem against MRSA, the in vitro antimicrobial activities of imipenem, cefazolin, cephalothin, cefotiam, cefamandole and cefoperazone, alone and in combination, against methicillin-sensitive Staphylococcus aureus (MSSA) and MRSA were assessed . Using the checkerboard Mueller-Hinton agar dilution method, strong synergy was found in 97% to 100% of MRSA strains for imipenem and all tested cephalosporins except cefoperazone; fractional inhibitory concentration (FIC) indices were < or = 0.5 . Among the cephalosporins studied, cefamandole most markedly increased the activity of imipenem against MRSA, followed, in order of decreasing effect, by cefotiam, cephalothin, cefazolin, and cefoperazone . The synergistic effect of imipenem combined with cefamandole or cefotiam was confirmed using the broth dilution method with 2% of NaCl.

J Clin Microbiol, 1995 Mar, 33(3), 551 - 5
Pulsed-field gel electrophoresis as a replacement for bacteriophage typing of Staphylococcus aureus; Bannerman TL et al.; Bacteriophage typing (BT) (World Health Organization method) has been used at the Centers for Disease Control and Prevention for over 30 years to type isolates of Staphylococcus aureus . Since studies have shown that BT patterns have poor reproducibility and because BT fails to type a high percentage (15 to 20%) of isolates, the Centers for Disease Control and Prevention has converted from using BT to using pulsed-field gel electrophoresis (PFGE) for strain typing S . aureus . We compared the results of BT with results of PFGE for typing 300 isolates of S . aureus, including strains from several well-characterized outbreaks . Ninety-six isolates were BT group I, 19 were group II, 82 were group III, 7 were group V, and 96 were nontypeable . PFGE identified subgroups within each phage group and thus was more discriminating than BT, which identified no subgroups . PFGE was able to type all isolates and distinguish related from unrelated strains of S . aureus . Our modified, standardized PFGE methodology should enable typing laboratories to obtain rapid, reliable results in 3 to 4 days when starting with an isolated colony on agar media.

J Pediatr Orthop, 1995 Mar-Apr, 15(2), 169 - 71
Radial-nerve palsy associated with septic shoulder in neonates; Lejman T et al.; Four neonates presented with septic shoulders after delays in diagnosis of 7-20 days . All lacked active extension of the wrist and thumb, and three lacked active extension of the fingers . Two had positive cultures for Staphylococcus aureus, and one had a positive Escherichia coli culture . Surgical treatment was one single aspiration and three arthrotomies . Recovery of extension began in 10-21 days and was normal at 18-35 days post-treatment . At follow-up 9-13 months later, all limbs were neurologically normal . Cadaver dissections showed that the radial nerve passed close to the shoulder joint, and when the capsule was distended, it impinged on the nerve.

Cornea, 1995 Mar, 14(2), 175 - 9
Effect of topical antioxidant therapy on experimental infectious keratitis; Alio JL et al.; To test the effect that the treatment with topical antioxidants may have on corneal infection, we have studied the effect of topically applied antioxidants, such as dimethylthiourea 0.5% (DMTU) and dismutase superoxide 0.2% (SOD), on infectious experimental keratitis caused by Staphylococcus aureus . We have quantified the results of the incubated corneas in ex vivo as well as in in vivo treated with antioxidants by using the luminol amplified chemiluminescence technique (LAC) . The evaluation of corneal inflammation was performed calculating the average inflammatory index obtained from the clinical observation of the corneal secretion, corneal edema and ciliary injection . The evolution of the corneal infiltration was evaluated by means of computerized planymetry . The antioxidants used in this study demonstrated a significant reduction of the LAC values when compared with a control group both in the in vivo as well as in ex vivo studies . No significant differences in the clinical evaluation of the average inflammatory index were observed between the study and the control groups . However, a significant increase in the corneal infiltration was registered in the antioxidant treated group (p < 0.001) evaluated by computerized planymetry . Our results indicate that the use of antioxidants as antiinflammatory drugs may have a potential negative influence on the course of infectious keratitis.

J Dermatol, 1995 Mar, 22(3), 175 - 80
Staphylococcus aureus isolated from nostril anteriors and subungual spaces of the hand: comparative study of medical staff, patients, and normal controls; Namura S et al.; An epidemiologic investigation of methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus aureus (S . aureus) colonization was conducted at Kansai Medical University Hospital between 1990 and 1991 . The incidence of nasal and subungual positivity for S . aureus was examined in a total of 156 subjects including inpatients, physicians, and nurses at a ward for dermatology, plastic surgery, and emergency patients, outpatients with atopic dermatitis and other skin diseases, and normal controls . Inpatients were most heavily colonized with MRSA (40.8%), but S . aureus colonization was most frequent in outpatients with atopic dermatitis (95.5%) . Not only nostrils, which have been much discussed as a reservoir of S . aureus, but also subungual spaces seemed to be havens of S . aureus . Twelve out of 22 atopic dermatitis patients were positive for S . aureus on skin regions, and coagulase and phage testing showed a correlation between the nasal and skin-colonizing S . aureus . Coagulase type II and phase type NT (not typable) were the predominant types of S . aureus, including MRSA.

J Antibiot (Tokyo), 1995 Mar, 48(3), 233 - 42
Total structures and antimicrobial activity of bacitracin minor components; Ikai Y et al.; Total structures of 13 minor components of bacitracin (BC) were proposed, and their antimicrobial activities were investigated . The components of BC including bacitracins A (BC-A) and F (BC-F) were isolated by preparative HPLC and were hydrolyzed under acidic conditions . The resulting amino aids were derivatized with 1-fluoro-2,4-dinitrophenyl-5-L-alanineamide and were separated by HPLC to determine their absolute configurations . It was found that the N-terminal amino acids of BC-A and its related components were epimerized during the hydrolysis to yield their enantiomers . The formation of these artifactual amino acids suggests that our previously proposed structures of the BC minor components are incorrect; therefore, the structures were corrected based on these results . The structures of the BC minor components were the same as that of BCs-A and -F except that one to three of the L-isoleucines, including the N-terminal one, were replaced by L-valines . These structures were confirmed by tandem mass spectrometry under fast atom bombardment (FAB) conditions and Frit-FAB liquid chromatography/mass spectrometry . Based on the UV spectra of the BC components determined by photodiode array detection-HPLC analysis, a new systematic nonmenclature was proposed for the minor components . The isolated components were also used for the determination of their minimal inhibition concentrations and it was found that BC-A is 2 approximately 8 times more potent than the other minor components against strains of Micrococcus luteus and Staphylococcus aureus.

FEMS Microbiol Lett, 1995 Mar 1, 126(3), 305 - 9
Nucleotide and deduced amino acid sequence of the gene for a novel protein with a possible regulatory function encoded in the beta operon of Staphylococcus aureus; Aboshkiwa MA et al.; Although considerable homology exists between the translation products of the rplL, rpoB and rpoC genes of the beta operons of the Gram-negative organism Escherichia coli and the Gram-positive Staphylococcus aureus the region between the rplL and rpoB genes is quite different in the two bacterial species . In E . coli the 324 bp has three centres of dyad symmetry in the first half of the sequence and multiple nonsense codons in all three reading frames . By contrast, the corresponding region in S . aureus consists of 1000 bp capable of forming a similar arrangement of stem-loop structures but with an open reading frame, sited 177 bp downstream of the end of rplL and 217 bp upstream of the beginning of the rpoB gene, with consensus initiation and termination signals, which if translated would generate a 22,665 Da protein with 202 amino acids . In view of the inability to find any significant homology with other proteins in the data bank and because the evidence suggests, as in E . coli, that the rplL-rpoB intergenic sequence is involved in regulation it is proposed that the expression product of orf202 may be a further element of control in the S . aureus beta operon.

J Orthop Res, 1995 Mar, 13(2), 286 - 95
Contaminated fractures of the tibia: a comparison of treatment modalities in an animal model; Curtis MJ et al.; External fixation is the current standard treatment for skeletal stabilization of open tibial fractures, but intramedullary fixation techniques have become increasingly popular . The aim of this study was to compare, in an animal model, the susceptibility to infection of contaminated fractures stabilized with external fixation with that of contaminated fractures fixed with intramedullary locking nails with or without reaming . A unilateral osteotomy of the tibia was performed in 15 goats under general anesthesia . Each osteotomy was stabilized with either (a) a unilateral biplanar external fixator, (b) an 8 mm diameter intramedullary rod inserted without reaming of the medullary cavity, or (c) a 10 mm diameter rod inserted after reaming . A standardized inoculum of Staphylococcus aureus, 10(3) colony forming units per milliliter, was placed at each osteotomy site on a piece of absorbable gelatin sponge, to simulate contamination of an open fracture . Antibiotics were not administered . The animals were allowed full activity after the procedure . Fourteen days postoperatively, the animals were killed, radiographs of the tibiae were taken, and the tibiae were harvested in a sterile manner . Multiple specimens for quantitative microbiological analysis were taken from the fracture site and from sites 3 cm distal and 6 cm proximal to the fracture . Additional specimens of bone were taken for histological study . Clinical, radiographic, and microbiological analysis demonstrated that, in this animal model, there were significantly fewer and less severe infections in fractures fixed with external fixation than in those fixed with an intramedullary nail with or without reaming . There was marked cortical necrosis in tibiae that had been fixed with nailing and reaming.

Clin Diagn Lab Immunol, 1995 Mar, 2(2), 166 - 71
Effects of culture conditions on production of type 5 capsular polysaccharide by human and bovine Staphylococcus aureus strains; Poutrel B et al.; Two Staphylococcus aureus strains, the prototype human Reynolds strain and a bovine isolate, were grown in different complex media and in a synthetic medium (D . Taylor and K . T . Holland, J . Appl . Bacteriol . 66:319-329, 1989) and compared for their ability to produce type 5 capsular polysaccharide . Cell-bound and cell-free type 5 capsular polysaccharide were measured by a new one-step competition enzyme-linked immunosorbent assay . The total production and the proportion of cell-bound type 5 capsular polysaccharide were dependent on the nature of the medium, the duration of the culture, and the strain . Both strains produced more type 5 capsular polysaccharide when cultivated in the synthetic medium than when cultivated in complex media . The best yield of type 5 capsular polysaccharide, about 300 micrograms/ml of medium, was obtained with strain Reynolds grown for 48 h with shaking in the synthetic broth containing glucose as a carbon source.

Biomaterials, 1995 Mar, 16(5), 361 - 7
In vitro biocompatibility of a polyurethane catheter after deposition of fluorinated film; Pizzoferrato A et al.; The in vitro biocompatibility of an experimental surface-treated polyurethane was compared with an untreated polyurethane already used for intravascular catheters . The experimental surface was coated with a fluorinated film using a glow discharge treatment . Neither of the catheters was cytotoxic for L929 murine fibroblasts, caused platelet adhesion or release reaction, or changed the mean platelet volume . The surface-treated polyurethane, however, caused a higher adhesion of Staphylococcus aureus than did the untreated one . Therefore, using in vitro testing, it has been ascertained that the examined material, though not being cytotoxic and not modifying platelet behaviour, could favour bacterial adherence.

Zentralbl Hyg Umweltmed, 1995 Mar, 196(6), 545 - 61
{Microbial resistance to formaldehyde . III> Dependence of the microbial effect on Staphylococcus aureus, Enterococcus faecium and spores of Bacillus stearothermophilus on temperature}; Spicher G et al.; Temperature dependence of microbicidal efficacy of formaldehyde was examined with suspension tests (pH 7.0) . Test germs were Staphylococcus aureus, Enterococcus faecium and spores of Bacillus stearothermophilus . The methodology was nearly the same as in previous investigations (5, 7) . At given exposure periods and temperatures formaldehyde concentrations necessary to produce a microbicidal effect of log (N/N0) = -4.0 (concentrations of equal efficacy) were determined . N and N0 represent the numbers of colony-forming units in suspensions with and without formaldehyde, respectively . On rectangular graphic representation with the reciprocal value of absolute temperature on the abscissa and with the logarithm of the formaldehyde concentration on the ordinate, the formaldehyde concentrations of equal efficacy fitted straight lines . Lines referring to different exposure periods nearly paralleled each other . With increasing exposure periods the steepness of the lines decreased slightly . This effect was most pronounced with Staphylococcus aureus as a test germ . The ratio of formaldehyde concentrations of equal efficacy for exposure periods of 120 minutes at 20 degrees C and 30 degrees C, respectively, was 3.1:1 with Staphylococcus aureus, and 2.8:1 with Enterococcus faecium . The corresponding ratio obtained with spores of Bacillus stearothermophilus and referring to 60 degrees C and 70 degrees C, respectively, was 3.6:1 . The logarithms of these ratios decreased with temperature in the same measure as the pertinent absolute temperatures increased . On the basis of the previously presented three-dimensional model of the relations between concentration, period of action and efficacy of microbicidal agents, it could be shown that deviations of the results from a linear and parallel course reflect an inconstant concentration exponent . When low formaldehyde concentration, long exposure period and "high" temperature coincide, the efficacy of formaldehyde is lower than calculated for a linear and parallel course of the relation.

J Hosp Infect, 1995 Mar, 29(3), 177 - 88
Methicillin-resistant Staphylococcus aureus in Western Australia, 1983-1992; Riley TV et al.; A statewide screening programme has prevented imported strains of methicillin-resistant Staphylococcus aureus (MRSA) from becoming established in any hospital in Western Australia (WA) . Recently, notifications of MRSA in WA have increased, prompting a review of surveillance data for the period 1983-1992 . Our aims were to determine: (i) the distribution by age and sex of persons with MRSA; (ii) changes in notification rates over time and by location in WA; and (iii) temporal changes in antimicrobial resistance patterns . There were 631 notifications of MRSA for the 10 year period 1983-1992, ranging from a low of 36 in 1988 to a high of 117 in 1992 . When the distribution by age and sex was examined, three age group peaks were apparent: 0-9 years, 20-39 years and 60-79 years . There was a predominance of females in the 20-39 years age group, reflecting a greater proportion of hospital nursing staff carrying MRSA . In those aged 50 years or more, there was a marked predominance of males . The highest notification rates overall occurred in the remote Kimberley region of WA, however, rates increased significantly in all regions of the state in 1992 . Based on antimicrobial resistance patterns, MRSA was classified into two groups: multiresistant imported strains which often caused outbreaks in hospitals; and a less resistant MRSA (WA MRSA) . WA MRSA appears to have originated in the Kimberley region and then spread widely in the community to other regions of the state, and the proportion of WA MRSA has increased significantly since 1989.

Eur J Clin Microbiol Infect Dis, 1995 Mar, 14(3), 199 - 205
Diversity of methicillin-resistant Staphylococcus aureus isolated in a Canadian hospital; Hammerberg O et al.; Three neonates and three other patients located elsewhere in the hospital became infected with Staphylococcus aureus . Initial automated microdilution susceptibility testing with oxacillin and disk diffusion testing with amoxicillin-clavulanic acid indicated the isolates had borderline oxacillin resistance (MICs 4 micrograms/ml), presumably due to hyperproduction of beta-lactamase . Chromosomal DNA restriction fingerprinting and phage typing revealed the neonatal isolates to be identical; whereas, the other patients were infected with three different strains . Further analysis of the four strains by Southern hybridization with a mecA specific oligoprobe and a quantitative beta-lactamase assay demonstrated that two strains carried the mecA gene (coding for low affinity penicillin-binding protein 2a), and two strains were hyperproducers of beta-lactamase, including one which was mecA gene positive . One strain neither carried the mecA gene nor hyperproduced beta-lactamase . The two mecA gene positive strains displayed oxacillin MICs of 16 micrograms/ml on dilution susceptibility testing in 4% NaCl supplemented Mueller-Hinton agar . Hence, they were considered intrinsically methicillin-resistant Staphylococcus aureus . Both oxacillin and amoxicillin-clavulanic acid MICs were increased on NaCl supplementation . Results of amoxicillin-clavulanic acid disk diffusion susceptibility testing did not correlate with quantitative beta-lactamase production . It is recommended that clinical laboratories do not use amoxicillin-clavulanic acid disk diffusion assays to differentiate suspected borderline resistance due to beta-lactamase hyperproduction from mecA gene expression of PBP-2a since additional mechanisms may account for resistance.

Int J Urol, 1995 Mar, 2(1), 17 - 23
Combined intraarterial cisplatin infusion and radiation therapy for invasive bladder cancer; Mizoguchi H et al.; Combined intraarterial cisplatin infusion and radiation therapy were performed as the initial treatment for 23 patients (mean age: 70 years) with invasive bladder cancers (T2 in 17, T3 in 6) who were suitable for total cystectomy . Of these patients, five who had multiple invasive cancers without laterality had their intrapelvic hemodynamics altered by embolizing a contralateral internal iliac artery . Cisplatin (50 mg) was infused into the internal iliac artery through a subcutaneous reservoir twice a week over three weeks while concurrent radiation therapy with 30 Gy, delivered in 15 fractions, was performed . Additional cisplatin infusions were given in six patients . After this combined therapy, total cystectomy and ileal conduit was performed in six patients and transurethral resection of bladder tumor (TURBT) in 17 . Two of the patients who underwent total cystectomy were found to exhibit a complete response . Therefore, the overall response rate was 87%, including 13 complete responses and seven partial responses . The complete response rates in patients with clinical stage T2 and T3 disease were 53 and 67%, respectively . The complete response rate was slightly higher in patients with a non-papillary cancer than in those with a papillary one . Toxic reactions included a decrease in bladder capacity in two patients and severe diarrhea due to methicillin-resistant Staphylococcus aureus colitis in one . Other forms of toxicity, including nausea, vomiting, neurotoxicity in the gluteal region, nephrotoxicity and myelosuppression, were tolerable . All but one of the patients are alive . This patient died of distant metastasis and seven other patients had a local recurrence of bladder cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Infect Control Hosp Epidemiol, 1995 Mar, 16(3), 170 - 4
An overview of nosocomial infection control in Brazil; Pannuti CS et al.; Brazil is the largest country in Latin America, with a population of 146 million people . The socioeconomic development and the distribution of population and health services varies widely within the country . There are approximately 1.2 million hospital admissions per month, 80% of them paid by a government healthcare program that follows the diagnosis-related groups (DRGs) model . The Ministry of Health has been trying to establish a nationwide nosocomial infection control program since 1983 . Most Brazilian hospitals now have some kind of infection control activity, but only a few of them have complete programs . Infrastructural deficiencies, the scarcity of well-trained healthcare workers, and the widespread occurrence of multiresistant Staphylococcus aureus and gram-negative bacteria are some of the challenges faced by Brazilian hospitals in the control of nosocomial infection.

Electrophoresis, 1995 Mar, 16(3), 366 - 76
An improvement of restriction analysis of bacteriophage DNA using capillary electrophoresis in agarose solution; Kleparnik K et al.; Seven representatives of the serogroup B Staphylococcus aureus bacteriophages, 29, 53, 55, 83A, 85, phi 11 and 80 alpha, were examined by capillary electrophoresis (CE) for genomic homology using DNA restriction analysis . Genomic DNA of individual bacteriophages was cleaved by HindIII restriction endonuclease, and the resulting restriction fragments were separated by standard horizontal agarose slab gel electrophoresis (SGE) as well as by CE in low-melting-point agarose solutions . The number and size of restriction fragments identified by both methods were compared . The high separation power of CE makes it possible to extend the restriction fragment patterns . In most of the restriction patterns, some additional restriction fragments as small as 150 bp, not identified by SGE, were detected . With respect to speed, high separation efficiency, low sample consumption and automation, CE offers a simple procedure for processing of multiple samples cost-effectively in a reasonable time . The comparison of the complemented restriction patterns of the different phage strains and the subsequent identification of their common fragments leads to a deeper understanding of their phylogenetic relationships . The genome homologies expressed for individual phage pairs in terms of coefficient F values ranged from 15 to 69% . These values are in good accordance with the degree of DNA homology of these phages as determined by DNA hybridization studies and thermal denaturation analysis of DNA by other authors . The total size of each phage genome was estimated by adding the sizes of individual restriction fragments.

Vet Immunol Immunopathol, 1995 Mar, 45(1-2), 31 - 43
Monocyte function in cattle experimentally infected with bovine immunodeficiency-like virus; Rovid AH et al.; The effects of bovine immunodeficiency-like virus (BIV) on monocyte function were examined in experimentally infected cattle and in monocytes infected in vitro . Infection with the R29 isolate of BIV appeared to have relatively little effect on monocyte function in cattle during the first 2 years postinfection (PI) . For the first 4 to 8 months post infection, monocyte phagocytosis of Staphylococcus aureus tended to be lower (P = 0.06) in BIV infected calves than in control animals . After 8 months PI, however, phagocytosis became equal between the two groups . Random and chemotactic migration and antibody-dependent cell-mediated cytotoxicity (ADCC) did not appear to be affected by BIV infection . Monocytes from BIV infected cattle were able to respond to in vitro treatment with interferon gamma similarly to monocytes from control cattle . Although experimental infection with BIV R29 resulted in minimal effects on monocyte function, this result could have been due either to a low virus burden in vivo or because BIV is intrinsically unable to affect monocyte function . To distinguish between these possibilities, monocytes from control, uninfected cattle were treated with BIV virus in vitro . Treatment of normal monocytes with cell-free virus significantly (P < 0.05) increased phagocytosis and random and chemotactic migration and decreased ADCC, in a dose-dependent manner . It appears, therefore, that the normal function of peripheral blood monocytes in the BIV R29 infected animals may be due to a low virus burden rather than to the inability of BIV to affect monocyte function . The in vitro infection results also raise the possibility that the function of monocyte derived cells at local sites of BIV replication may be altered.

Immunol Lett, 1995 Mar, 45(3), 210 - 4
Differential regulation of surface immunoglobulin expression by various muramyl dipeptides in a murine pre-B cell line; Cohen LY et al.; The murine pre-B cell line 70Z/3 responds to lipopolysaccharide (LPS), interleukin-1 (IL-1) or interferon-gamma (IGN gamma) by kappa gene transcription and expression of surface IgM (sIg) . We found that muramyl dipeptide (MDP), a synthetic immunoadjuvant analog of a bacterial membrane structure, produced a weak increase in the number of sIg-positive 70Z/3 cells as measured by immunofluorescence staining . This number was significantly increased after exposure to MDP . Moreover, when MDP was used in combination with LPS, IL-1 or IFN gamma, an enhancement of sIg expression was observed showing an early influence of MDP in the presence of a second stimulant . Unexpectedly, two adjuvant-active analogs of MDP did not share its capacity to stimulate differentiation of the cell line when used alone or associated with other agents, indicating that adjuvanticity of MDP was not the only requirement . Two other products of bacterial origin, a Staphylococcus aureus cell extract (SAC) and the Toxic Shock Syndrome Toxin TSST-1 could neither enhance the kappa gene expression in 70Z/3 cells nor increase the MDP effect . The stimulating effect displayed by MDP could by related to NF-kappa B activation.

Br J Pharmacol, 1995 Mar, 114(6), 1317 - 23
Delayed circulatory failure due to the induction of nitric oxide synthase by lipoteichoic acid from Staphylococcus aureus in anaesthetized rats; De Kimpe SJ et al.; 1 . This study investigates the effect of lipoteichoic acid (LTA) from the cell wall of Staphylococcus aureus, a micro-organism without endotoxin, on haemodynamics and induction of nitric oxide synthase (iNOS) in the anaesthetized rat . 2 . Intravenous injection of LTA (10 mg kg-1) resulted in a decrease in blood pressure from 123 +/- 1 mmHg to 83 +/- 7 mmHg after 270 min (P < 0.001) and a reduction of the pressor response to noradrenaline (1 microgram kg-1) from 33 +/- 1 mmHg.min to 23 +/- 3 mmHg.min after 270 min (P < 0.05) . 3 . The delayed circulatory failure (hypotension and vascular hyporeactivity) caused by LTA was prevented by pretreatment of rats with dexamethasone (10 mg kg-1, 60 min prior to LTA) or the nitric oxide synthase inhibitor NG-monomethyl-L-arginine (L-NMMA, 10 mg kg-1 h-1, i.v . infusion starting 30 min prior to LTA) . 4 . In contrast, treatment of rats with polymyxin B (0.05 mg kg-1), an agent which binds endotoxin (lipopolysaccharides, LPS), did not affect the delayed circulatory failure caused by LTA . Polymyxin B, however, attenuated the hypotension and vascular hyporeactivity to noradrenaline afforded by endotoxaemia (2 mg kg-1 LPS, i.v.) for 270 min . 5 . The delayed circulatory failure caused by LTA was associated with a time-dependent increase in (i) the expression of iNOS protein in the lung (Western blot analysis), and (ii) iNOS activity . This increase in iNOS protein and activity was prevented by pretreatment of LTA-rats with dexamethasone (10 mg kg-1).(ABSTRACT TRUNCATED AT 250 WORDS)

Immunopharmacology, 1995 Mar, 29(2), 111 - 9
The effect of GM-CSF and G-CSF on human neutrophil function; Bober LA et al.; A direct comparison of GM-CSF and G-CSF in a panel of in vitro neutrophil-function assays was performed to investigate any differences in activity profiles . In our modified chemotactic assay, GM-CSF rapidly increased the migratory capacity of polymorphonuclear cells (PMNs) to move toward fMLP and LTB4 . In contrast, G-CSF only stimulated PMN migration towards fMLP . GM-CSF, but not G-CSF, increased PMN cytotoxic killing of C . albicans blastospores . The expression of PMN surface antigens associated with Fc- and complement-mediated cell-binding (Fc gamma R1, CR-1 and CR-3), and adhesion signalling (ICAM-1), was increased after the exposure of GM-CSF, but not to G-CSF . In contrast these CSFs demonstrated relative equipotency in their ability to induce PMN anti-bacterial phagocytosis, and to restore the Staphylococcus aureus killing capacity of dexamethasone-suppressed neutrophils . The phagocytic activity of PMNs for opsonized yeast, as well as hexose-monophosphate shunt activity, was equivalent following GM-CSF or G-CSF treatment . We discuss the significance of the difference in activity profiles in this article.

J Infect Dis, 1995 Mar, 171(3), 607 - 13
Effects of Staphylococcus aureus leukocidins on inflammatory mediator release from human granulocytes; Konig B et al.; The secretion of the Panton-Valentine leukocidin (Luk-PV) but not of another leukocidin (Luk-R) from Staphylococcus aureus strains is correlated with severe pyodermic infections (dermonecrosis) . The effects of both Luk-PV and Luk-R in amounts of 0-5000 ng on inflammatory mediator release from human leukocytes were studied . Luk-PV but not Luk-R induced a pronounced release of the vasodilator histamine from human basophilic granulocytes (up to 55% +/- 7%) and of enzymes (beta-glucuronidase, up to 45% +/- 10%; lysozyme, up to 35% +/- 7%), chemotactic components leukotriene B4 (42 +/- 8 ng/10(7) cells) and interleukin-8 (up to 33 +/- 5 ng/10(7) cells), and oxygen metabolites from human neutrophilic granulocytes . The results indicate that granulocytes play a central role in dermonecrosis; these in vitro data account for the histologic picture of Luk-PV infections, characterized by local vasodilation, infiltration of granulocytes, and a central necrotic area.

Infect Immun, 1995 Mar, 63(3), 1095 - 101
Role of a carboxy-terminal site of toxic shock syndrome toxin 1 in eliciting immune responses of human peripheral blood mononuclear cells; Drynda A et al.; Staphylococcus aureus toxic shock syndrome toxin 1 (TSST-1) is involved in the pathogenesis of toxic shock syndrome and perhaps other staphylococcal diseases . Recently, the C-terminal part of the TSST-1 toxin has been shown to be responsible for mitogenic activity in animal models . We studied the role of the C-terminal structural unit of TSST-1 with regard to proliferation, cytokine release (tumor necrosis factor alpha {TNF-alpha}, interleukin-6 {IL-6}, and IL-8), mRNA expression for IL-6, IL-8, IL-10, TNF-alpha, and CD40 ligand (CD40L), synthesis of immunoglobulin E (IgE), IgA, IgG, and IgM, CD23 expression, and soluble CD23 (sCD23) release from human peripheral blood mononuclear cells (PBMC) . For this purpose, we used the recombinant wild-type TSST-1 (p17) mutant toxin Y115A (tyrosine residue modified to alanine) and toxin H135A (histidine residue modified to alanine) . Unmodified toxin p17 and mutant toxin Y115A, at a concentration below 5 ng, to a lesser degree, induced a strong proliferation . Toxin p17 followed by toxin Y115A was the most pronounced inducer for mRNA expression for IL-10 and CD40L and cytokine generation (mRNA and protein) for TNF-alpha, IL-6, and IL-8 . Mutant protein H135A failed to activate human PBMC . Both toxins p17 and, to a lesser degree, Y115A significantly suppressed IL-4- and anti-CD40-induced synthesis of all four Igs as well as IL-4-induced CD23 expression and sCD23 release . Mutant toxin H135A failed to do so . Thus, our data show that a region in the C terminus of TSST-1 is responsible not only for mitogenic activity but also for additional immunomodulating biological activities of TSST-1 . More specifically, histidine residue H135A of the 194-amino-acid toxin appears to be critical for the expression of biological activities in a human in vitro model.

Protein Eng, 1995 Mar, 8(3), 315 - 8
Generation of analogs having potent antimicrobial and hemolytic activities with minimal changes from an inactive 16-residue peptide corresponding to the helical region of Staphylococcus aureus delta-toxin; Dhople VM et al.; The delta-toxin is a 26-residue peptide from Staphylococcus aureus with the sequence formyl-MAQDIISTIGDLVKWIIDTVNKFTKK . NMR studies indicate that the segment IISTIGDLVKWIIDTV occurs in an alpha-helical conformation in the toxin . A synthetic peptide corresponding to this segment, although helical, did not exhibit hemolytic activity . Since charged residues like D and K are likely to modulate cytolytic activity, analogs of the 16-residue peptide were synthesized where D was systematically replaced by K . Analogs in which the first D and both Ds were replaced by K showed potent antimicrobial and hemolytic activities . The analog in which the second D was replaced by K was relatively less active . However, all the peptides showed an alpha-helical structure with similar helical content . The activities of the peptides were found to correlate directly with their ability to permeabilize model membranes . Thus, by minimal judicious replacement of charged amino acids, it should be possible to generate cytolytic peptides from short segments of peptide toxins.

Proc Natl Acad Sci U S A, 1995 Feb 28, 92(5), 1619 - 23
Autocrine regulation of toxin synthesis by Staphylococcus aureus; Balaban N et al.; Staphylococcus aureus is a major human pathogen causing diseases which range from minor skin infection to endocarditis and toxic shock syndrome . The pathogenesis of S . aureus is due primarily to the production of toxic exoproteins, whose synthesis is controlled by a global regulatory system, agr . We show here that agr is autoinduced by a proteinaceous factor produced and secreted by the bacteria and that it is inhibited by a peptide produced by an exoprotein-deficient S . aureus mutant strain . The inhibitor, RIP, competes with the activator, RAP, and may be a mutational derivative . Our results suggest two possible approaches, independent of antibiotics, to the control of S . aureus infections . RIP may prove useful as a direct inhibitor of virulence and RAP as a vaccine against the expression of agr-induced virulence factors; either could interfere with the ability of the bacteria to establish and maintain an infection.

Biochem Biophys Res Commun, 1995 Feb 27, 207(3), 978 - 84
Isolation and the gene cloning of an alkaline shock protein in methicillin resistant Staphylococcus aureus; Kuroda M et al.; The growth of Staphylococcus aureus occurs at a wide range of pH(5-10), while the optimal is pH 7.0-7.5 . The molecular mechanism of such pH tolerant properties should be elucidated because the production of the virulence factors was greatly affected by environmental pH . The effect of pH shift on the composition of cytosolic proteins in S . aureus was examined . A protein with a molecular mass of 23 kDa was remarkably enhanced by a pH upshift from 7 to 10 . This alkaline shock protein (ASP23) was isolated and purified by ion-exchange chromatography . The N-terminal sequences of the purified protein and the protease-digested peptides were analyzed . The 320-bp DNA fragment that was designed from the peptide analysis was amplified . Using the amplified fragment as a probe, the ASP gene, asp23, was cloned . The deduced primary sequence of ASP23 comprised 169 amino acids with a calculated molecular weight of 19,191 . Northern analysis revealed that asp23 was positively regulated at the transcription level by alkaline shock . Homology search revealed that asp23 is a novel gene . Although the physiological role of ASP23 has yet to be further analysed, we suggest that ASP23 plays a key role in alkaline pH tolerance of S . aureus.

Arch Biochem Biophys, 1995 Feb 20, 317(1), 85 - 92
Characterization of the glycosaminoglycan-binding region of lactoferrin; Wu HF et al.; Lactoferrin is a prominent component of neutrophil secondary granules and its blood concentration is increased in certain inflammatory diseases . Although the biochemical characterization of lactoferrin as an iron-binding protein has been well described, its physiological role in inflammation remains undefined . We examined the ability of lactoferrin to regulate glycosaminoglycan-accelerated thrombin-serine protease inhibitor (serpin) reactions . Lactoferrin effectively reduced the rate of thrombin-serpin (antithrombin and heparin cofactor II) reactions by three physiological glycosamino-glycans including heparin, heparan sulfate, and dermatan sulfate . An enzyme kinetics analysis showed that lactoferrin did not alter the apparent heparin-thrombin or the heparin-antithrombin dissociation constant values for the heparin-catalyzed thrombin-antithrombin reaction . However, the maximum reaction velocity at saturation with respect to either protein was markedly decreased by lactoferrin . The glycosaminoglycan-binding region of lactoferrin was analyzed following limited proteolysis using Staphylococcus aureus V8 protease . Two lactoferrin fragments with Mr's of approximately 8 and approximately 11 kDa were purified based on their affinity to heparin-Sepharose . Amino acid sequence analysis demonstrated that both peptides were from the N-terminus . Although slightly less capable compared to intact lactoferrin, the lactoferrin peptides effectively neutralized heparin, heparan sulfate, and dermatan sulfate-catalyzed serpin-thrombin inhibition reactions . In addition, lactoferrin N-terminal peptides have approximately the same binding affinity to heparin-Sepharose as that of intact lactoferrin . Inspection of both the N-terminal amino acid sequence and the crystal structure of lactoferrin further supports the conclusion that lactoferrin is a novel glycosaminoglycan binding protein and that the putative glycosaminoglycan-binding site is localized to the N-terminus.

Med Clin (Barc), 1995 Feb 18, 104(6), 221 - 3
{The pediatric heart transplant . Its evolution and early postoperative complications}; Villaizan C et al.; BACKGROUND: Cardiac transplantation is an acceptable therapeutic alternative for cardiac diseases refractory to other forms of management in adults as well as in infants and children . METHODS: Between 1987-1992 7 children (4 girls and 3 boys) underwent cardiac transplantation: four with dilated cardiomyopathy, one with cardiac fibroma and two with hypertrophic cardiomyopathy . Age at transplantation ranged from 2 months to 13 years and 5 months, with a follow-up ranging from 15 months to 5 years and 9 months . Prophylaxis of acute rejection consisted of cyclosporine, azathioprine and glucocorticoids . RESULTS: Two patients presented acute rejection three weeks after cardiac transplantation, with a good response to high dose glucocorticoids . Two patients developed severe infection (sepsis by Staphylococcus aureus) with successful outcome after antibiotic treatment . One patient died in the early postoperative period and other after 4 years 11 months postransplantation because myelodysplastic syndrome . At present only one case is receiving glucocorticoids in immunoprophylaxis . The status is asymptomatic in the other 5 patients with a normal height-weight development . CONCLUSIONS: Heart transplantation provides durable therapy for congenital and myopathic heart disease in infants and children with an excellent quality of life.

J Biol Chem, 1995 Feb 17, 270(7), 3365 - 9
The N-terminal portion of growth inhibitory factor is sufficient for biological activity; Uchida Y et al.; To determine its active site, growth inhibitory factor (GIF), a central nervous system-specific metallothionein-like protein, was digested with trypsin followed by Staphylococcus aureus protease V8 digestion . Of 5 peptide fragments separated from trypsin-digested GIF by reverse-phase high pressure liquid chromatography and gel filtration, only GIF1-26 or longer peptides showed growth inhibitory activity on cortical neurons in culture . A shorter peptide, GIF5-23, which was obtained by further digestion of GIF1-26 with V8 protease, also showed growth inhibitory activity . However, a synthetic peptide corresponding to GIF5-23 did not show growth inhibitory activity . Metal-free GIF1-26 prepared by acid treatment showed a similar level of growth inhibitory activity to that of metal-containing GIF1-26, indicating that metal in the peptide does not affect the activity . Treatment of metal-free GIF1-26 with beta-mercaptoethanol resulted in the loss of activity . The CD spectrum of beta-mercaptoethanol-treated metal-free GIF1-26 was different from that of nontreated metal-free GIF1-26 . These results indicate that the N-terminal portion of GIF is required for growth inhibitory activity and that folding of the peptide via S-metal bonding is critical for biological activity.

J Immunol, 1995 Feb 15, 154(4), 1606 - 13
Role of IL-12 in human B lymphocyte proliferation and differentiation; Jelinek DF et al.; The role of IL-12 in human peripheral blood B cell responsiveness was examined . To analyze the ability of IL-12 to directly mediate B cell growth and/or differentiation, FACS-purified (> 99% pure) B cells were studied and a polyclonal B cell-activating system utilizing Cowan I Staphylococcus aureus was used . Whereas IL-2 is highly effective in this system in promoting both B cell growth and differentiation, IL-12 was observed only to augment modestly B cell growth and to be ineffective by itself as a B cell differentiation factor for S . aureus-stimulated B cells . However, IL-12 markedly enhanced Ig secretion when added in the presence of IL-2 . Moreover, when the ability of IL-12 to augment IL-2-dependent B cell Ig secretion was compared with the ability of several known auxiliary B cell differentiation factors, IL-12 was observed to be the most potent cytokine that could costimulate with IL-2 . Analysis of IL-12-stimulated B cell cultures failed to reveal outgrowth of T cells and NK cells . In addition, assessment of IFN-gamma levels in IL-12-driven B cell culture supernatants and analysis of IFN-gamma effects on B cell responses added additional support to the conclusion that IL-12 directly modulates B cell function . Finally, these results suggest that IL-12 is a potent constimulus of B cell differentiation and that the signals conveyed by IL-12 seem to be qualitatively distinct from the differentiative signals delivered by other cytokines such as IL-2.

FEMS Microbiol Lett, 1995 Feb 15, 126(2), 139 - 43
The CAMP effect of Actinobacillus pleuropneumoniae is caused by Apx toxins; Jansen R et al.; Actinobacillus pleuropneumoniae shows synergistic haemolysis when cocultured with Staphylococcus aureus on blood agar plates . This CAMP effect has been attributed to a discrete CAMP factor, but also to the A . pleuropneumoniae-RTX-toxins I, II, and III . We examined the CAMP effect of recombinant Escherichia coli strains that secreted each of these toxins, and of A . pleuropneumoniae mutant strains that were devoid of one or more these toxins . We found that the E . coli strains were CAMP positive, whereas the A . pleuropneumoniae strain devoid of functional toxin genes was CAMP negative . This demonstrated that the CAMP effect of A . pleuropneumoniae is caused by the toxins and that no CAMP factor per se exists.

Biochemistry, 1995 Feb 14, 34(6), 1988 - 96
Purification and characterization of two potent heat-stable protein inhibitors of protein phosphatase 2A from bovine kidney; Li M et al.; Two heat-stable protein inhibitors of protein phosphatase 2A (PP2A), tentatively designated I1PP2A and I2PP2A, have been purified to apparent homogeneity from extracts of bovine kidney . The purified preparations of I1PP2A exhibited an apparent M(r) approximately 30,000 and 250,000 as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and gel permeation chromatography on Sephacryl S-300, respectively . In contrast, the purified preparations of I2PP2A exhibited an apparent M(r) approximately 20,000 and 80,000 as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and gel permeation chromatography on Sephacryl S-200, respectively . The purified preparations of I1PP2A and I2PP2A inhibited PP2A with 32P-labeled myelin basic protein, 32P-labeled histone H1, 32P-labeled pyruvate dehydrogenase complex, 32P-labeled phosphorylase, and protamine kinase as substrates . By contrast, I1PP2A and I2PP2A exhibited little effect, if any, on the activity of PP2A with 32P-labeled casein, and did not prevent the autodephosphorylation of PP2A in incubations with the autophosphorylation-activated protein kinase {Guo, H., & Damuni, Z . (1993) Proc . Natl . Acad . Sci . U.S.A . 90, 2500-2504} . The purified preparations of I1PP2A and I2PP2A had little effect, if any, on the activities of protein phosphatase 1, protein phosphatase 2B, protein phosphatase 2C, and pyruvate dehydrogenase phosphatase . With 32P-labeled MBP as a substrate, kinetic analysis according to Henderson showed that I1PP2A and I2PP2A were noncompetitive and displayed a Ki of about 30 and 25 nM, respectively . Following cleavage with Staphylococcus aureus V8 protease, I1PP2A and I2PP2A displayed distinct peptide patterns, indicating that these inhibitor proteins are the products of distinct genes . The N-terminal amino acid sequences of the purified preparations indicate that I1PP2A and I2PP2A are novel proteins.

Anal Biochem, 1995 Feb 10, 225(1), 64 - 72
A microtiter plate assay using cascade amplification for detection of nonisotopically labeled DNA; Rothschild CB et al.; We describe a microtiter-plate-based, colorimetric assay for DNA, the enzyme-linked DNA-enzyme-linked coagulation assay (EDNA-ELCA) . The EDNA-ELCA uses amplification of the common pathway of coagulation for the ultrasensitive detection of DNA which is tagged by incorporation of functional groups such as biotin and fluorescein . The EDNA-ELCA enables detection of attomole amounts of DNA (< 1 pg per microtiter well), with a sensitivity 200-1000 times higher than other colorimetric techniques . The assay has been applied as an adjunct to PCR for quantitative determination of methicillin-resistant Staphylococcus aureus DNA at levels corresponding to 1-10(5) organisms . The EDNA-ELCA can also be used to assay DNA by hybridization; < 50 amol of an unlabeled DNA template is detected by hybridization to biotin- and fluorescein-labeled probes.

Kyobu Geka, 1995 Feb, 48(2), 156 - 9
{Intermittent mini-dose vancomycin intravenous administration and closed continuous irrigation technique applied to mediastinitis caused by MRSA following mitral valve replacement}; Suetsugu F et al.; Mediastinitis caused by MRSA (Methicillin-Resistant Staphylococcus aureus) remains an intractable infection producing high mortality even in these days of advanced chemotherapy . The authors report a case of mediastinitis due to MRSA complicated with acute renal failure following mitral valve replacement . The patient's mediastinum had been thoroughly cleaned with physiological saline solution with 0.2% povidone iodine, and underwent a chemotherapy regimen of mini-dose vancomycin . The patient made favorable progress and recovered completely . Our patient's progress confirmed that when chemotherapy using vancomycin is administered in a patient whose condition is complicated with acute renal failure, closely monitoring the vancomycin serum concentration is essential . Intermittent mini-dose intravenous administration is sufficient to maintain an effective vancomycin serum concentration . In our case, vancomycin serum concentration measured before and at completion of dialysis revealed no appreciable decline.

FEMS Microbiol Lett, 1995 Feb 1, 126(1), 91 - 2
Antibacterial activity of 7-aminocholesterol, a new sterol; Dherbomez M et al.; A new sterol, 7-aminocholesterol, which inhibits growth of Saccharomyces cerevisiae, also displayed antibiotic activity against Gram-positive bacteria . The 50% growth inhibitory concentration against strains of Listeria innocua, L . monocytogenes, Staphylococcus aureus, Enterococcus hirae and Bacillus cereus was 3 microM.

J Med Microbiol, 1995 Feb, 42(2), 91 - 5
Superantigenic exotoxin production by isolates of Staphylococcus aureus from the Kawasaki syndrome patients and age-matched control children; Todome Y et al.; Nineteen strains of Staphylococcus aureus were isolated from the throat or the tooth surfaces of 19 cases amongst 127 patients with Kawasaki syndrome (KS) during the acute phases and 11 S . aureus isolates were obtained from five of 17 diseased controls and six healthy controls . The production of exotoxins, particularly superantigenic toxic shock syndrome toxin-1 (TSST-1), coagulase serotype, pigment production, haemolytic activity and tryptophan auxotrophy of these isolates were compared . Among 10 KS S . aureus strains isolated in 1990-1991, five (50%) secreted TSST-1, a higher frequency than two (18%) of 11 control isolates . In contrast, none of the nine KS strains collected in 1984 produced TSST-1 . Four of five TSST-1-secreting KS strains produced white or white to golden pigmentation, whereas the two control strains capable of TSST-1 production formed golden colonies . There were no noticeable differences between S . aureus strains from KS patients and control children in the production of staphylococcal exotoxins A-E, coagulase serotype, haemolysis of sheep erythrocytes and tryptophan auxotrophy . The pathological or aetiological role of a new TSST-1-secreting S . aureus clone in patients with KS was not confirmed.

J Med Microbiol, 1995 Feb, 42(2), 127 - 32
Typing of Staphylococcus aureus colonising human nasal carriers by pulsed-field gel electrophoresis; Hu L et al.; Colonisation by Staphylococcus aureus in the nares of 120 outpatients and 63 healthy adults was studied for c . 2 years . Two states of carriage of S . aureus were confirmed: persistent carriage and persistent non-carriage . The states of carriage and non-carriage were quite stable and > 60% of the population of any of the study groups were stable non-carriers . The results of typing the strains isolated from the same individuals at different times with DNA fingerprinting by digestion with SmaI enzyme showed that all the stable carriers were persistently infected with the same strain and that changes in the strain seldom occurred.

Epidemiol Infect, 1995 Feb, 114(1), 143 - 51
A comparative study of food retail premises by means of visual inspection and microbiological quality of food; Powell SC et al.; The relationship between visual inspection ratings given to ten food retail premises and the microbiological quality of food samples was examined . Viable counts of bacteria and of Staphylococcus aureus were determined for cooked meat samples from each of the premises . There was no correlation between potential risk of foodborne infection, as assessed by total inspection rating, and bacteriological counts in food (P < 0.05) . Neither was there a consistent relationship between scores given to any component of the total rating and the bacteriological quality of food . The effectiveness of the current UK inspection scheme in assessing risk of foodborne infection is questioned . Inclusion of appropriately weighted criteria such as food temperature abuse is suggested to improve the scheme.

Eur J Biochem, 1995 Feb 1, 227(3), 873 - 9
Duodenase, a new serine protease of unusual specificity from bovine duodenal mucosa . Primary structure of the enzyme; Zamolodchikova TS et al.; The complete amino acid sequence of duodenase, a new serine endopeptidase from bovine duodenal mucosa, has been determined . The sequence was reconstructed by the automated sequence analysis of the peptides obtained after cleavage with trypsin, Staphylococcus aureus V8 protease, cyanogen bromide and duodenase . The enzyme is composed of 226 amino acid residues yielding a molecular mass of 29.06 kDa . The presence of six cysteine residues and one potential sugar-chain-binding site at Asn50 was revealed . A predicted catalytic triade characteristic of the serine proteases was traced in the duodenase primary structure at the corresponding positions (His44, Asp87 and Ser181 in the sequence) . Comparison of the sequence of duodenase with the other known primary structures of mammalian serine proteinases reveales the duodenase identity to granzymes from human and mice, human cathepsin G and mast cell chymases from rat, and gives an overall sequence identity of 47-55% with the mentioned enzymes . Alignment of the known serine protease and duodenase primary structures showed unique amino acid residues within the duodenase substrate-binding pocket at positions 189 (Asn) and 226 (Asp) (the bovine chymotrypsinogen A numbering) . These results are discussed with respect to the relation between the duodenase unique residues within the primary specificity pocket S1 and the unusual dual specificity of the enzyme.

Can J Cardiol, 1995 Feb, 11(2), 123 - 8
Molecular analysis provides evidence for human to human transmission of Staphylococcus aureus endocarditis in non-drug abusers; Ignaszewski AP et al.; Two cases of invasive Staphylococcus aureus are reported in which human to human transmission resulted in primary bacteremia and endocarditis . The identity of the organism was confirmed by phage typing, antibiograms, coagulase gene polymorphisms and ribotyping . This is the first documented case of such transmission not involving an intravenous drug abuser.

Acta Orthop Scand, 1995 Feb, 66(1), 69 - 72
Collagen with gentamicin for prophylaxis of postoperative infection . Staphylococcus aureus osteomyelitis studied in rabbits; Riegels-Nielsen P et al.; In 34 rabbits, both tibiae were inoculated with Staphylococcus aureus . 14 legs received no treatment and served as controls . In 12 legs, the wound was treated with pure collagen and in 18 legs, collagen with gentamicin (Gentacoll) in a dose of 10 mg/kg body weight was applied to the wound before closure . Postoperatively 12 received 10 mg/kg body weight gentamicin intravenously and no local treatment . The animals were killed 7 days after inoculation and evaluated macroscopically and microbiologically for infection . 6 rabbits (12 legs) were used for pharmacokinetic studies only and they were killed after 2, 4, and 18 hours, respectively . 11/14 untreated legs developed a macroscopically acute osteomyelitis . No infection was found in the 18 legs treated with Gentacoll and 1/12 treated with gentamicin systemically had growth of the inoculated bacteria in tissue biopsies . The concentrations of gentamicin in the serum as well as locally reached peak values were well above the MIC value in all groups, with a maximum after 1-2 hours . No gentamicin could be detected after 18 hours, independently of the mode of administration.

J Leukoc Biol, 1995 Feb, 57(2), 235 - 41
Retention of phagocytic functions in cryopreserved human monocytes; Hansen JB et al.; Phagocytosis and respiratory burst activity were measured by flow cytometry in fresh and cryopreserved human monocytes, after ingestion of Escherichia coli and Staphylococcus aureus . Mononuclear leukocytes, isolated from 15 healthy donors, were divided into two portions, of which one was examined immediately and the other was cryopreserved for 3 weeks . Morphological characteristics and expression of receptors involved in phagocytosis were similar in fresh and cryopreserved monocytes . Furthermore, both internalization of bacteria and respiratory burst activity remained unchanged after cryopreservation . Transmission electron microscopy confirmed actual internalization of bacteria and not merely bacterial attachment to monocytes . Monocytes were demonstrated to retain integral cellular functions during cryopreservation . This may imply that the method has potential for use in basal and clinical trials.

J Lab Clin Med, 1995 Feb, 125(2), 200 - 11
Molecular correlation between in vitro and in vivo activity of beta-lactam and beta-lactamase inhibitor combinations against methicillin-resistant Staphylococcus aureus; Fasola EL et al.; Beta-Lactam resistance in Staphylococcus aureus is associated with beta-lactamase production, with the presence of a new penicillin binding protein (PBP) called PBP2a, with reduced affinity for beta-lactam antibiotics, and with modifications of normal PBPs . We have studied these mechanisms of resistance, in vivo and in vitro, for several beta-lactam antibiotics against both beta-lactamase-producing and non-producing methicillin-resistant S . aureus organisms (MRSA) . Our results showed that all tested agents inhibited binding of labeled penicillin G to many PBPs . The combination of cefoperazone and sulbactam was the best combination, and it inhibited radiolabeled penicillin G binding to PBP2a at a lower concentration than that needed for cefoperazone alone . In vivo, the regimen of cefoperazone plus sulbactam was also more effective than cefoperazone alone . For beta-lactamase-negative strains this correlated with an increased binding affinity of cefoperazone plus sulbactam to PBP2a and PBP4 . The improved efficacy of cefoperazone plus sulbactam versus cefoperazone with a beta-lactamase producing strain was closely related to cefoperazone hydrolysis by beta-lactamase that was inhibited by sulbactam . This study demonstrates that there is more than one effect of beta-lactamase inhibitors when they are combined with beta-lactam antimicrobial agents, and also that there may be a role for these agents in therapy for MRSA infections.

J Bone Joint Surg Am, 1995 Feb, 77(2), 258 - 65
Evaluation of treatment modalities for septic arthritis with histological grading and analysis of levels of uronic acid, neutral protease, and interleukin-1; Nord KD et al.; We compared the effectiveness of antibiotics alone and in combination with arthroscopy, arthroscopy with debridement, arthrotomy, or needle aspiration for the treatment of septic arthritis . Each modality has its proponents, but, to our knowledge, no comparative studies have been conducted in animals . We used biochemical and histological analysis to compare these methods of treatment in an experimental model . The right hind knee of thirty goats was injected with 1 x 10(5) Staphylococcus aureus bacilli . The left hind knee was not inoculated and served as the normal control . Seventy-two hours after inoculation, a two-week course of treatment with intramuscular administration of cefuroxime sodium, either alone or in combination with another mode of treatment, was initiated in each of five groups . The cartilage was evaluated histologically with biochemical, enzymatic, and interleukin-1 analyses . Despite the early therapeutic intervention, on the average, there was a 25 per cent loss of uronic acid (t test, p < 0.001) and a 43 per cent increase in neutral protease activity (signed-rank test, p = 0.003) in the treatment groups . There were no significant intergroup differences with regard to the histochemical-histological rating or the levels of uronic acid, neutral protease, or interleukin-1.

J Exp Med, 1995 Feb 1, 181(2), 537 - 46
Stimulatory and inhibitory effects of interleukin (IL)-4 and IL-13 on the production of cytokines by human peripheral blood mononuclear cells: priming for IL-12 and tumor necrosis factor alpha production; D'Andrea A et al.; The production of cytokines in monocytes/macrophages is regulated by several different cytokines that have activating or inhibitory effects . Interleukin (IL)-10, IL-4, IL-13, and transforming growth factor (TGF)-beta are usually considered to be the most important macrophage-deactivating factors, with inhibitory effects on cytokine production . Unlike IL-10 and TGF-beta, which appear to act as downmodulators of many phagocytic cell functions, the mode of action of IL-4 and IL-13 is more complex . Addition of IL-4 and IL-13 to peripheral blood mononuclear cell (PBMC) cultures inhibited production of IL-12, tumor necrosis factor (TNF)-alpha, IL-10, and IL-1 beta induced by lipopolysaccharide (LPS) or Staphylococcus aureus added simultaneously with the cytokines . However, pretreatment of PBMC with IL-4 or IL-13 for > or = 20 h enhanced the production of IL-12 and TNF-alpha in response to LPS or S . aureus several fold in these cells; this IL-4-induced priming for the two cytokines was inhibited by anti-IL-4 neutralizing antibodies . IL-4 priming also enhanced the accumulation of IL-12 and TNF-alpha mRNA induced by LPS and S . aureus . The enhanced accumulation of transcripts for the IL-12 p35 and p40 chains by IL-4 priming was reflected in enhanced secretion of both the IL-12 free p40 chain and the p70 heterodimer . These results suggest an unexpected complexity in the regulatory role of IL-4 and IL-13 in immune responses.

Infect Immun, 1995 Feb, 63(2), 585 - 90
Use of adhesion-defective mutants of Staphylococcus aureus to define the role of specific plasma proteins in promoting bacterial adhesion to canine arteriovenous shunts; Vaudaux PE et al.; We used an ex vivo canine arteriovenous shunt model, previously developed to study plasma protein adsorption and thrombogenesis on polymeric biomaterials, to define the role of host proteins in promoting adhesion of Staphylococcus aureus . Either polyethylene or polyvinyl chloride tubings were exposed to canine blood for 5, 15, or 60 min at a flow rate of 300 ml/min and then were flushed in phosphate-buffered saline (PBS), cut into 1.5-cm segments, and stored at -70 degrees C . After thawing, each segment was preincubated in 0.5% albumin in PBS to prevent nonspecific staphylococcal attachment to surfaces that were not exposed to blood . Each segment was then incubated with 4 x 10(6) CFU of {3H}thymidine-labelled S . aureus per ml for 60 min at 37 degrees C in an in vitro adhesion assay . Two site-specific mutants of S . aureus were tested: one specifically defective in adhesion to surface-bound fibronectin (FnAd-def) and the other defective in adhesion to fibrinogen (FgAD-def) {corrected} . Compared with their respective parental strains, the FgAd-def, but not the FnAd-def, mutant of S . aureus showed a strong (> 80%) decrease in attachment to ex vivo tubings . The adhesion of each strain of S . aureus onto polyethylene was consistently more than twofold higher than the adhesion onto polyvinyl chloride segments exposed to flowing blood for 5 or 15 min, but adhesion became similar to that on polyvinyl chloride after 60 min of exposure . In conclusion, the specific adhesion-defective mutants of S . aureus suggested that fibrinogen was the most active adhesion-promoting protein in a short-term blood-material interaction . The experimental approach described in this study should prove useful for screening materials thought to be resistant to protein-mediated staphylococcal adhesion and colonization.

Infect Immun, 1995 Feb, 63(2), 509 - 15
A mutation at histidine residue 135 of toxic shock syndrome toxin yields an immunogenic protein with minimal toxicity; Bonventre PF et al.; Structure-function studies have revealed that the region between amino acids 115 and 141 of toxic shock syndrome toxin 1 (TSST-1) constitutes a biologically active domain . A critical residue appears to be histidine 135, since a site-directed mutation that alters the histidine to alanine (H135A) results in a loss of mitogenic activity and an absence of toxicity as measured in a rabbit infection model of toxic shock syndrome . We have characterized the mutant toxin further and report here on its immunogenic activity in rabbits and on the protective ability of mutant-specific antibodies in two animal models of toxin-mediated shock . Antibodies raised in rabbits by immunization with the purified H135A are fully cross-reactive with staphylococcal TSST-1 and wild-type recombinant TSST-1 (rTSST-1) expressed in Escherichia coli . The H135A antibodies neutralized the mitogenic activity for murine splenic T cells equally well as did TSST-1-specific polyclonal and monoclonal antibodies . In addition, the H135A antibodies blocked the production of tumor necrosis factor by spleen cells stimulated with rTSST-1 . The toxicities of rTSST-1 and H135A were compared in D-galactosamine (D-GalNH2)-sensitized MRL-lpr/lpr mice . The nontoxicity of H135A was confirmed in this murine model of superantigen-induced septic shock . No toxicity of H135A was demonstrable at doses of 60 micrograms, while doses of rTSST-1 as low as 2 micrograms caused significant mortality within 24 to 72 h after challenge . Furthermore, subsequent to challenge of mice with H135A, no elevation in the serum levels of interleukin-2 or tumor necrosis factor was measurable . Passive immunization with H135A antibodies also protected MRL-lpr/lpr mice against lethal challenge with rTSST-1 . Finally, rabbits actively immunized with purified H135A did not succumb to infection with a transformed strain of Staphylococcus aureus expressing rTSST-1 . Additional animal studies will be required to confirm the immunizing potential of H135A and the efficacy of H135A antibodies as a neutralizing antitoxin.

Infect Immun, 1995 Feb, 63(2), 375 - 80
Antibodies to capsular polysaccharides are not protective against experimental Staphylococcus aureus endocarditis; Nemeth J et al.; The protective efficacy of antibodies to the Staphylococcus aureus capsular polysaccharide was examined in a rat model of catheter-induced endocarditis . Capsular antibodies were induced either by active immunization with killed S . aureus or by passive immunization with hyperimmune rabbit antiserum to S . aureus . Control rats were injected with phosphate-buffered saline or passively immunized with normal rabbit serum or rabbit antiserum to a nonencapsulated strain . Animals with indwelling catheters were challenged intravenously with 5 x 10(4) to 4 x 10(6) CFU of the homologous S . aureus strain (capsular serotype 5 strain Reynolds or serotype 1 strain SA1 mucoid) . Both immunized and control rats developed S . aureus endocarditis . The numbers of S . aureus cells recovered from the blood and aortic valve vegetations of immunized rats were similar to those of control rats, indicating that capsule-specific antibodies were not protective . To determine whether the presence of an indwelling catheter interfered with antibody-mediated protection against S . aureus endocarditis, catheters were removed 2 h after insertion in additional groups of rats . An inoculum of 10(8) CFU of strain Reynolds was needed to provoke endocarditis in rats catheterized for 2 h, compared with 5 x 10(4) CFU for rats with indwelling catheters . Passively transferred capsular antibodies were not protective since both immunized and nonimmunized animals developed endocarditis, and quantitative cultures of blood and valvular vegetations revealed no differences between immunized and control animals . The findings of this study indicate that antibodies to the capsular polysaccharide are not protective in the rat model of experimental S . aureus endocarditis.

Int Arch Allergy Immunol, 1995 Feb, 106(2), 124 - 33
Responsiveness of peripheral blood mononuclear cells from normal and atopic donors to microbial superantigens; Konig B et al.; Patients with atopic dermatitis (AD) are frequently colonized with Staphylococcus aureus strains secreting exotoxins such as the staphylococcal enterotoxin B (SEB) and A (SEA) . Nonetheless the role of SEB and SEA in AD is yet unknown . We analyzed the responsiveness of peripheral blood mononuclear cells (PBMCs) and isolated T cells from donors with AD and from normal donors to SEB and SEA . PBMCs as well as T cells from normal donors showed a significantly enhanced proliferation after stimulation with enterotoxin B, whereas the 3H-thymidine uptake of the T lymphocytes from patients with AD was markedly suppressed . Furthermore, we show that IFN-gamma mRNA and protein and mRNA for both chains of IL-12 (p35 and p40) are produced in human PBMCs from normal donors upon stimulation with SEB and SEA . In contrast to normal donors T cells from donors with AD predominantly express mRNA for IL-4, IL-5, and only diminished levels for IFN-gamma and IL-12 upon stimulation with SEB and SEA . Furthermore, in contrast to normal donors, PBMCs from donors with AD spontaneously produce high levels of IgE and express increased levels of CD23, the low-affinity receptor for IgE . Nonetheless, the superantigens by themselves, from 0.1 fg up to 1 microgram/10(6) cells, induced neither IgE secretion nor CD23 expression on PBMCs . Moreover, the addition of superantigens to IL-4-treated PBMC cultures diminished or totally suppressed the IL-4-induced IgE synthesis and CD23 expression . No differences were observed between PBMCs from normal donors of donors with AD . Both PBMCs isolated from normal and atopic donors produced high levels of soluble IL-4-receptor (up to 210 +/- 90 pg/ml) . Addition of soluble IL-4-receptor to PBMC cultures downregulated the IL-4-induced IgE synthesis and CD23 expression in unstimulated as well as in SEB-stimulated PBMCs from normal donors and donors with AD . Our results suggest that superantigen-producing staphylococcal strains on the skin of patients with AD may modulate and/or amplify allergic inflammation.

Mol Microbiol, 1995 Feb, 15(4), 679 - 87
Localization of the start sites of lagging-strand replication of rolling-circle plasmids from gram-positive bacteria; Dempsey LA et al.; A number of small, multicopy plasmids from Gram-positive bacteria replicate by an asymmetric rolling-circle mechanism . Previous studies with several of these plasmids have identified a palindromic sequence, SSOA, that acts as the single-strand origin (SSO) for the replication of the lagging-strand DNA . Although not all the SSOA sequences share DNA sequence homology, they are structurally very similar . We have used an in vitro system to study the lagging-strand replication of several plasmids from Gram-positive bacteria using the SSOA sequences of pT181, pE194 and pSN2 as representative of three different groups of Staphylococcus aureus plasmids . In addition, we have investigated the lagging-strand replication of the pUB110 plasmid that contains an alternative single-strand origin, SSOU . Our results confirm that RNA polymerase is involved in lagging-strand synthesis from both SSOA and SSOU-type lagging-strand origins . Interestingly, while initiation of lagging-strand DNA synthesis of pUB110 occurred predominantly at a single position within SSOU, replication of pT181, pSN2 and pE194 plasmids initiated at multiple positions from SSOA.

Int J Pept Protein Res, 1995 Feb, 45(2), 200 - 8
Probing the structure of human growth hormone by limited proteolysis; Polverino de Laureto P et al.; Digestion of human growth hormone (hGH) with the Glu-specific protease from Staphylococcus aureus V8 was performed at 20-22 degrees C or 37 degrees C at a 1:20 ratio (by weight) at pH 7.8 with or without 0.2% SDS . There are 14 Glu-residues evenly distributed along the polypeptide chain of hGH as possible sites of proteolytic cleavage of V8-protease . The pattern of fragmentation of hGH was analyzed by electrophoresis and reversed-phase HPLC, and the identity of the proteolytic fragments isolated to homogeneity was established by their partial sequencing and amino acid analysis after acid hydrolysis . Kinetic analysis of the proteolytic digestion process allowed to establish that initial nicking of the protein occurs at Glu33 and subsequently at Glu56 and Glu66 . Much slower cleavages occur at Glu30 and Glu186 . These cleavage sites are located at chain loops in the hGH molecule, and in particular outside the helical segments of the four-helix bundle of the crystal structure of hGH . Fragments 1-33 and 67-191 comprising entirely the N-terminal helix and the three C-terminal helices of hGH, respectively, were isolated to homogeneity in amounts useful for subsequent conformational and functional studies . The results of this study and of previous ones {Li, C.H . (1982) Mol . Cell . Biochem . 46, 31-41} describing limited proteolysis of hGH by various proteases have been interpreted on the basis of the three-dimensional structure and dynamics of hGH . Overall, it is shown that proteolytic enzymes preferentially cleave hGH at exposed and flexible loops only, thus emphasizing the fact that proteases can be used as reliable probes of protein structure and dynamics.

J Ethnopharmacol, 1995 Feb, 45(2), 97 - 111
Medicinal plants from Riau province, Sumatra, Indonesia . Part 2: Antibacterial and antifungal activity; Grosvenor PW et al.; Antibacterial assays of 114 species listed in Part 1 showed that 82% of the extracts tested were active against Staphylococcus aureus, while 35% were active against Escherichia coli . Antifungal activity was less dramatic: 19% of the extracts inhibited Saccharomyces cerevisiae, while 20% inhibited Fusarium oxysporum . Our survey of relevant literature indicates that less than 30% of these Angiosperm species have previously been assayed for any form of antimicrobial activity.

Immunol Cell Biol, 1995 Feb, 73(1), 38 - 43
Antibacterial proteins from porcine polymorphonuclear neutrophils; Alberdi F Jr et al.; Antibacterial peptides were purified from porcine neutrophil granules collected from healthy pigs . Granule proteins, extracted with 0.2 mol/L sodium acetate were subjected to ion-exchange chromatography and five peaks (designated A to E) were detected . Individual porcine neutrophil granule proteins were shown to inhibit the growth of target organisms Escherichia coli and Staphylococcus aureus . The antimicrobial activity was shown to be concentration and time dependent . Peak D showed strong antimicrobial activity against S . aureus and peak C (with a greater number of eluted proteins) was shown to be active against both S . aureus and E . coli . One of the peptides was purified further by reverse-phase HPLC from peak fraction C . The MW of this peptide was approximately 5500 Da as determined by SDS-PAGE and mass spectral analysis and was active against both E . coli and S . aureus in vitro sustaining a > 90% decrease, respectively, in CFU after a 2 h exposure with 50 micrograms of this peptide . Amino acid analysis showed the peptide was rich in aspartate/aspartic acid, glutamine/glutamic acid, proline, arginine and threonine . The antimicrobial activity of this peptide and other novel proteins in porcine neutrophilic granules demonstrates the probable role of these proteins and peptides in host defence of porcine neutrophils against bacterial infection.

Lett Appl Microbiol, 1995 Feb, 20(2), 82 - 4
Antibacterial activity of the anti-inflammatory compound ibuprofen; Elvers KT et al.; The effect of ibuprofen on growth in vitro of six bacterial species was tested . Ibuprofen inhibited growth of the Gram-positive species, but the two Gram-negative species were unaffected . Growth of Staphylococcus aureus was suppressed by ibuprofen concentrations greater than 150 micrograms ml-1 at initial pH 7 . At pH 6, such concentrations prevented growth . The antibacterial activity of ibuprofen was affected by pH, being more effective at values below pH 7 . Ibuprofen may have an ancillary benefit in topical application, in controlling bacteria.

J Hosp Infect, 1995 Feb, 29(2), 87 - 106
A major outbreak of methicillin-resistant Staphylococcus aureus caused by a new phage-type (EMRSA-16)
Cox RA, Conquest C, Mallaghan C, Marples RR.
An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection caused by a novel phage-type (now designated EMRSA-16) occurred in three hospitals in East Northamptonshire over a 21-month period (April 1991--December 1992) . Four hundred patients were colonized or infected . Seven patients died as a direct result of infection . Chest infections were significantly associated with the outbreak strain when compared with methicillin-sensitive S . aureus . Twenty-seven staff and two relatives who cared for patients were also colonized . A 'search and destroy' strategy, as advocated in the current UK guidelines for control of epidemic MRSA was implemented after detection of the first case . Despite extensive screening of staff and patients and isolation of colonized and infected patients, the outbreak strain spread to all wards of the three hospitals except paediatrics and maternity . A high incidence of throat colonization (51%) was observed . Failure to recognize the importance of this until late in the outbreak contributed to the delay in containing its spread . Key parts of the strategy which eventually contained the local outbreak were the establishment of isolation wards in two hospitals, treatment of all colonized patients and staff to eradicate carriage and screening of all patients upon discharge from wards where MRSA had ever been detected . EMRSA-16 spread to neighbouring hospitals by early 1992 and to London and the South of England by 1993 . It is distinguished from other epidemic strains by its characteristic phage-type, antibiogram (susceptibility to tetracycline and resistance to ciprofloxacin), and in the pattern given on pulse field electrophoresis.

J Hosp Infect, 1995 Feb, 29(2), 107 - 19
Epidemic methicillin-resistant Staphylococcus aureus: controlling the spread outside hospital; Cox RA et al.; Over a 21-month period an outbreak of methicillin-resistant Staphylococcus aureus infection occurred in east Northamptonshire . The outbreak was caused by a novel phage-type (EMRSA-16) and affected 400 patients . It was centred on three hospitals but spread was also detected in the community, particularly among clients of nursing and residential homes . Three hundred and fifty residents in 15 care homes were screened for MRSA . Cross-infection of MRSA was demonstrated in 14 patients in six different homes . A key aspect of the overall containment of the outbreak was the implementation of infection control measures in the community, together with treatment and screening of known positive patients following their discharge from hospital.

Infect Control Hosp Epidemiol, 1995 Feb, 16(2), 105 - 13
Recommendations for preventing the spread of vancomycin resistance . Hospital Infection Control Practices Advisory Committee (HICPAC) ; Expression of truncated and full-length forms of the Lyme disease Borrelia outer surface protein A in Escherichia coli; Symbicom AB, Umea, SwedenThe lipidated major outer surface protein, OspA, of the Lyme disease spirochaete may be important in the pathogenesis during Lyme borreliosis . To produce sufficient amounts of purified OspA variants to perform pathogenesis studies in vivo and in vitro, different recombinant OspA expression systems in Escherichia coli were constructed . Recombinant OspA variants were produced as a full-length molecule, as a truncated variant lacking the N-terminal lipidated cysteine, or as a fusion protein with the synthetic dimer of Staphylococcus aureus protein A IgG binding domain (ZZ) . In order to produce the full-length protein, four different promoters were evaluated . These were combined with either the OspA original signal sequence or the E . coli Brauns lipoprotein signal sequence, lpp . The most efficient production of the full-length lipidated OspA was mediated by the constitutive beta-lactamase promoter in combination with lipoprotein signal sequences . For production of truncated nonlipidated OspA the S . aureus protein A signal sequence was ligated to the OspA open reading frame . Alternatively, truncated OspA was produced intracellularly using expression vectors that lack signal sequences . Production of nonlipidated protein with a heterologous signal peptide resulted in a soluble protein located mainly in the periplasm and in the culture medium . The full-length lipidated OspA, on the other hand, was associated mainly with the membrane fraction . The production level of the lipidated recombinant OspA was much lower than the level obtained with the truncated ZZ-OspA fusion protein.

Shock, 1995 Feb, 3(2), 145 - 51
The pathogenesis of experimental toxic shock syndrome: the role of interleukin-2 in the induction of hypotension and release of cytokines; Tokman MG et al.; Toxic shock syndrome (TSS) is a multisystem disorder characterized by fever, hypotension, and involvement of three other organ systems . The etiologic agent is a toxigenic strain of Staphylococcus aureus which secretes the exotoxin, TSST-1 . The toxin is a superantigen which stimulates the immune system to produce interleukin-1 (IL-1), interleukin-2, and tumor necrosis factor (TNF) . We hypothesized that TSST-1 induces the release of IL-2 which in turn is either directly involved or acts via an additional mediator to produce hypotension . We submitted four pairs of normal anesthetized adult female baboons to intravenous boluses of TSST-1 . One baboon in each pair received anti-IL-2 intravenously and anti-IL-2 receptor intrathyroidally 15 min prior to TSST-1 . The other baboon received the same dose and placement of anti-sheep red blood cell antibody . Systolic and diastolic blood pressure was recorded continuously and mean arterial pressure was calculated and plotted . IL-1, IL-2, IL-6, and TNF were measured in serum at varying times before and after toxin administration . Systolic, diastolic, and mean arterial pressure were significantly lower in the sham-treated group versus the experimental (anti-IL-2/IL-2R) group (p < .05 for all variables) . In addition no differences were seen in any of the measurements between experimentally treated baboons and those receiving no TSST-1.(ABSTRACT TRUNCATED AT 250 WORDS)

Vet Immunol Immunopathol, 1995 Feb, 44(3-4), 251 - 67
Study of immunological dysfunction in periparturient Holstein cattle selected for high and average milk production; Detilleux JC et al.; Data from twenty assays of traits associated with innate and adaptive immunity were evaluated from 137 periparturient Holstein cows . These cows had been selected through planned matings for four different levels of milk production (high and average pounds of milk, and high and average pounds of milk fat plus protein) . For up to seven generations, the genetic lines were produced by mating females of each line to sires of corresponding merit . With the exceptions of neutrophil ingestion of Staphylococcus aureus and directed migration, all assays measuring neutrophil functions were depressed beginning 2 to 3 weeks before calving through 3 weeks after calving . Serum concentrations of immunoglobulin G1 decreased while those of immunoglobulin G2 increased around calving time . Serum complement and conglutinin concentrations decreased before calving and reached a minimum around calving time . Cows selected for high milk production (pounds of milk and pounds of milk fat plus proteins) had significantly higher (P < 0.10) numbers of circulating neutrophils and mononuclear cells, had higher (P < 0.10) neutrophil resting chemiluminescence and higher (P < 0.10) neutrophil directed migration than cows with average production potentials . There were significant (P < 0.001) sire progeny group differences for most traits associated with the immune system that we tested . These results can be considered encouraging, in that selection for high milk yield did not produce unfavorable correlated responses in the functional capacity of immune function traits, and that there is sufficient genetic variation in these immunological traits among sires of high genetic merit for milk production to potentially improve the immunocompetence of periparturient cows through planned mating experiments.

Vet Immunol Immunopathol, 1995 Feb, 44(3-4), 237 - 50
Immunomodulatory effects of extracellular secretory vesicles isolated from bovine semen; Lazarevic M et al.; We demonstrate that extracellular secretory vesicles isolated from bovine seminal plasma have immunomodulatory properties . They inhibit mitogen induced proliferation of bovine and human peripheral blood lymphocytes in a dose dependent fashion . They also inhibit phagocytosis of latex particles by bovine neutrophils . Phagocytosis of opsonised Staphylococcus aureus however was not affected . Furthermore phorbol ester and chemotactic peptide induced superoxide production was decreased especially when a suboptimal dose of stimulants was used . We suggest that extracellular secretory vesicles may preserve sperm survival in the female reproductive tract.

Jpn J Antibiot, 1995 Feb, 48(2), 284 - 92
{In vitro studies on the combined effects of arbekacin and fosfomycin on methicillin-resistant Staphylococcus aureus}; Watanabe T et al.; We investigated the bactericidal activity and post-antibiotic effect (PAE) of arbekacin (ABK) and fosfomycin (FOM) on clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) strain 1936, and the morphological changes of the bacterium . Both antibiotics were used in combination at concentrations lower than their respective MICs . The following results were obtained . 1 . When the bacterium was simultaneously exposed to ABK and FOM, growth inhibition and a PAE longer than that effected by ABK alone were observed . 2 . When exposed to ABK after treatment with and removal of FOM, bactericidal activity was stronger than that obtained when exposed to ABK alone . However, no increase in bactericidal activity was obtained when exposed to FOM after pretreatment with ABK . 3 . Transmission electron microscopy revealed that, when the bacterium was exposed to ABK after treatment with and removal of FOM, large bacterial cells with cross walls at irregular sites and lysed cells showing destruction of the cell wall at the site of bacterial segmentation caused by ABK and FOM . These results demonstrated that ABK in combination with FOM shows stronger bactericidal activity against MRSA in vitro than ABK alone.

J Dairy Sci, 1995 Feb, 78(2), 277 - 84
Effects of Staphylococcus aureus toxins on the growth of bovine mammary epithelial cells (MAC-T) in culture; Zavizion B et al.; The effects of Staphylococcus aureus M60 culture supernatant on growth of mammary epithelial cells were tested in vitro . Exposure of MAC-T cells to S . aureus culture supernatant reduced cell proliferation and colony-forming ability because of reduced ability to adhere to plastic . Growth-inhibiting effects of S . aureus culture supernatant were abolished by pretreatment with trypsin . Lysis of S . aureus cells with lysostaphin demonstrated that the inhibition was also present in cell lysates . Treatment of MAC-T cells with culture supernatant from isogeneic mutants of S . aureus M60 that produced either alpha or beta toxins implicated alpha toxin as the main factor inhibiting cell proliferation.

Clin Infect Dis, 1995 Feb, 20(2), 320 - 8
Pyogenic vertebral osteomyelitis: analysis of 20 cases and review; Torda AJ et al.; The diagnosis of vertebral osteomyelitis is easily missed, particularly for the elderly in whom signs of sepsis may not manifest . The case records of 20 patients with vertebral osteomyelitis who were treated at our hospital between January 1989 and April 1993 were reviewed . The average age of the patients was 72 years . Infection was most commonly due to intravenous cannula-related sepsis . Eighty-five percent of patients presented with back pain, and only 30% had a fever . Computerized tomography and magnetic resonance imaging were the most useful radiological investigations; nuclear scanning was sensitive but insufficiently specific . Staphylococcus aureus was the infecting organism in 13 of 16 patients whose microbiological diagnosis was made by blood or bone cultures . Six (45%) of these 13 patients were infected with methicillin-resistant S . aureus (MRSA) . Nosocomial infection occurred in 12 (60%) of the patients studied, including all patients with MRSA infections . Vertebral osteomyelitis may be largely preventable if infection-control aspects of intravenous cannulation are improved, attempts at reducing and preventing MRSA colonization are made, and therapy for bacteremias is optimized.

J Dairy Res, 1995 Feb, 62(1), 69 - 81
Dairy cow characteristics related to Staphylococcus aureus isolation from quarter samples; Enevoldsen C et al.; A comprehensive description of the health status of 2406 cows in 28 herds was used to study complex interrelationships between Staphylococcus aureus occurrence and potential risk factors at the cow level over a broad spectrum of production conditions . The objective of the study was to characterize those cows shedding Staph . aureus in milk and to provide indications of possible causal relations that should be further explored . The estimates are expected to aid in providing valid and precise evaluations of results from cross sectional microbiological examination of bovine (quarter) milk samples . Staph . aureus were isolated at microbiological examination of quarter milk from 5.2, 13.5, 17.9 and 22.0% of 1552, 490, 296 and 277 cows in lactations 1, 2, 3 and 4-9 respectively . Simultaneous isolation of other mastitis pathogens was not significantly associated with occurrence of Staph . aureus . Of the positive samples, 95% had a positive California mastitis test reaction . Among the clinical measures of udder health, only visibly abnormal milk combined with normal udder tissue was associated with increased occurrence of Staph . aureus, although not consistently . Prior antibiotic treatment for udder disorders was not significantly associated with Staph . aureus isolation . The occurrence of sole ulcers in multiple digits was consistently associated with Staph . aureus in the first lactation . Milk yield was involved in interactions with other pathogens isolated, prior veterinary disease treatment, body weight and season of calving . Strong herd-year effects were revealed . This, combined with the interactions, indicated that some herd-specific factors were major determinants of Staph . aureus occurrence . The study indicated which cow characteristics should be taken into account in epidemiological analyses and causal interpretations of data from cross sectional microbiological examinations of dairy herds.

J Dairy Res, 1995 Feb, 62(1), 1 - 13
Field studies show associations between pulsator characteristics and udder health; Osteras O et al.; Four different field studies including 64, 140, 850 and 180 herds were used to investigate the association between pulsator characteristics and udder health . The results indicate that the best udder health is found in herds with a d phase > 330 ms and a pulsation rate > 55 min-1 . A d phase of < 250 ms was associated with significant elevation in bulk milk somatic cell count, a higher incidence of acute clinical mastitis and a higher frequency of cows having mastitis associated with major pathogens (mainly Staphylococcus aureus) as compared with a d phase of > 331 ms . There was also a significant positive association between a shorter d phase and a high incidence of teat lesions needing veterinary treatment . Herds having no such teat lesions had pulsators with significantly longer d phase than herds with teat lesions (300 ms v . 288 ms) . These results strongly suggest that in high-line milking machines the d phase should not be as short as 250 ms and should preferably be approximately 300 ms, and the pulsation rate should be at least > 55 cycles min-1 . There was a strong relationship between the effect of d phase and the rate of pulsation.

Antimicrob Agents Chemother, 1995 Feb, 39(2), 559 - 60
Comparison of effects of suture and cyanoacrylate tissue adhesive on bacterial counts in contaminated lacerations; Howell JM et al.; We studied the effects of closing lacerations with suture or cyanoacrylate tissue adhesive on staphylococcal counts in inoculated guinea pig lacerations . Wounds closed with adhesive alone had lower counts than wounds containing suture material (P < 0.05) . The results of a time-kill study were consistent with a bacteriostatic adhesive effect of the adhesive against Staphylococcus aureus.

Antimicrob Agents Chemother, 1995 Feb, 39(2), 525 - 8
Right-sided endocarditis caused by Staphylococcus aureus in drug abusers; Fortun J et al.; A prospective, open, and randomized study of right-sided endocarditis caused by Staphylococcus aureus in drug abuse patients is reported . The following parenteral treatments were compared . Group A patients were treated with 2 g of cloxacillin every 4 h and 1.5 mg of gentamicin per kg of body weight every 8 h for 2 weeks . Group B patients were treated with teicoplanin at 10 mg/kg/12 h on the 1st to 3rd days, 6 mg/kg/12 h on the 4th to 7th days, and 7 mg/kg/24 h on the 8th days . Drug abusers with bacteremia caused by S . aureus and suggestive signs of endocarditis were included . Clinical failures were observed in one patient in group A and in four of six patients in group B . Three patients in group B developed breakthrough bacteremia with teicoplanin-susceptible strains on days +6, +14, and +19 . Serum teicoplanin levels and serum bactericidal titers showed a decrease in the 2nd week, when dosages received were 7 mg/kg/day . In conclusion, in treatment of right-sided endocarditis caused by S . aureus in drug abusers with teicoplanin, the use of dosages of 7 mg/kg/day is not recommended even if patients have received dosages of 12 mg/kg/day during the 1st week.

Antimicrob Agents Chemother, 1995 Feb, 39(2), 507 - 12
Effect of aerobic and anaerobic environments on antistaphylococcal activities of five fluoroquinolones; Zabinski RA et al.; A previously established in vitro pharmacodynamic system was used to evaluate the antistaphylococcal activities of five fluoroquinolones under both aerobic and anaerobic conditions . Staphylococcus aureus ATCC 29213 was exposed to a 5-micrograms/ml concentration of each of the following fluoroquinolones: ciprofloxacin, ofloxacin, temafloxacin, sparfloxacin, and clinafloxacin . Terminal elimination half-lives of 4, 6, 8, 8, and 13 h were simulated for the respective drugs . Each fluoroquinolone was bactericidal under both aerobic and anaerobic conditions . However, the bactericidal activity of each fluoroquinolone was delayed by anaerobiosis . This difference in fluoroquinolone activity under aerobic and anaerobic conditions could not be attributed to any particular parameter or physiochemical property but was most likely caused by a combination of factors (e.g., variations in hydrophobicity, intracellular pH, antibiotic concentration, and structure-activity relationships) . Fluoroquinolone uptake studies were also performed to investigate the possibility of active, energy-dependent transport mechanisms in S . aureus ATCC 29213 . Uptake studies indicated that active efflux does occur in S . aureus ATCC 29213.

Antimicrob Agents Chemother, 1995 Feb, 39(2), 400 - 5
Critical influence of resistance to streptogramin B-type antibiotics on activity of RP 59500 (quinupristin-dalfopristin) in experimental endocarditis due to Staphylococcus aureus; Fantin B et al.; In order to determine the microbiological and pharmacokinetic parameters that best predicted the in vivo antistaphylococcal activity of the streptogramin RP 59500 (quinupristin-dalfopristin), we evaluated the activity in rabbit aortic endocarditis of three regimens of quinupristin-dalfopristin against five strains of Staphylococcus aureus with various streptogramin B-type antibiotic resistance phenotypes and susceptible to streptogramin A-type antibiotics . Quinupristin-dalfopristin was as active as vancomycin against three strains that were susceptible to its streptogramin B component quinupristin, including one strain that was inducibly resistant to erythromycin, but had a significantly decreased activity against two strains that were resistant to quinupristin, for all quinupristin-dalfopristin regimens tested (P < 0.05) . The area under the concentration-time curve for quinupristin-dalfopristin in plasma divided by the MIC of quinupristin was the only parameter retained by multilinear regression that predicted the in vivo activity of quinupristin-dalfopristin (P = 0.0001), emphasizing the importance of determining the susceptibility to quinupristin in order to predict the in vivo activity of quinupristin-dalfopristin against S . aureus.

Antimicrob Agents Chemother, 1995 Feb, 39(2), 369 - 73
Prevalence of erm gene classes in erythromycin-resistant Staphylococcus aureus strains isolated between 1959 and 1988; Westh H et al.; The epidemiology of the two common erythromycin resistance methylase (erm) genes ermA and ermC was analyzed by Southern blotting in 428 erythromycin-resistant Staphylococcus aureus strains isolated from blood between 1959 and 1988 in Denmark . ermA and/or ermC was present in 98% of the erythromycin-resistant strains tested . ermA was found only as a chromosomal insert and was solely responsible for erythromycin resistance in these strains until about 1971 . ermA was the only erm gene found in 337 strains and was a single insert in 61% of these strains, two inserts were seen in 37%, and three inserts were found in 2% . Thirteen different ermA EcoRI restriction fragment length polymorphisms were identified . ermA was not found in strains of phage type patterns group II and type 95, which are very common today . ermC was found on a plasmid in 77 strains . ermC was first seen in 1971 and spread rapidly in the S . aureus population, with a 5- to 10-fold increase every 5 years, and in 1984 to 1988, it was responsible for erythromycin resistance in 72% of the strains . The predominant plasmid carrying ermC was 2.5 kb, while four plasmids were smaller and three were larger . ermC has been found in all phage type patterns . Eight strains contained combinations of ermA and ermC, and no erm gene was detected in six strains.

J Dermatol, 1995 Feb, 22(2), 153 - 5
Activity of eight fluoroquinolones against both methicillin-susceptible and -resistant Staphylococcus aureus isolated from skin infections; Nishijima S et al.; The in vitro susceptibility of Staphylococcus aureus to eight fluoroquinolones, norfloxacin, ofloxacin, enoxacin, ciprofloxacin, lomefloxacin, tosufloxacin, sparfloxacin, and nadifloxacin was established by agar dilution tests, 71 isolates of methicillin-susceptible (MSSA) and 74 isolates of -resistant S . aureus (MRSA) isolated from skin infections . Among all of the fluoroquinolones, nadifloxacin exhibited the lowest MIC for both MSSA and MRSA . In addition, there were no resistant S . aureus, neither MSSA and MRSA, to nadifloxacin . With the exception of nadifloxacin, the incidence of MRSA resistant to fluoroquinolones has gradually increased in recent years . Over half of the MRSA strains were resistant to norfloxacin, ofloxacin, enoxacin, ciprofloxacin, and lomefloxacin.

Nat Genet, 1995 Feb, 9(2), 202 - 9
Mouse model of X-linked chronic granulomatous disease, an inherited defect in phagocyte superoxide production; Pollock JD et al.; Chronic granulomatous disease (CGD) is a recessive disorder characterized by a defective phagocyte respiratory burst oxidase, life-threatening pyogenic infections and inflammatory granulomas . Gene targeting was used to generate mice with a null allele of the gene involved in X-linked CGD, which encodes the 91 kD subunit of the oxidase cytochrome b . Affected hemizygous male mice lacked phagocyte superoxide production, manifested an increased susceptibility to infection with Staphylococcus aureus and Aspergillus fumigatus and had an altered inflammatory response in thioglycollate peritonitis . This animal model should aid in developing new treatments for CGD and in evaluating the role of phagocyte-derived oxidants in inflammation.

Ophthalmologe, 1995 Feb, 92(1), 17 - 20
{Isotretinoin administration in treatment of acne vulgaris . A prospective study of the kind and extent of ocular complications}; Egger SF et al.; Isotretinoin (13-cis-retinoic acid) is commonly used for the treatment of acne vulgaris . In the skin this substance causes an atrophy of sebaceous gland acini and a decrease in sebum production . Systemic treatment also alters meibomian gland function and structure . These alterations seem to be responsible for ocular complications (dryness of the eye, blepharitis, conjunctivitis) during therapy with isotretinoin . We inspected 30 patients before, during and after therapy with isotretinoin with regard to ocular side effects . Examination included careful slit-lamp inspection, measurement of break-up time (BUT) and the Schirmer test . Conjunctival smears were taken from every patient . The most frequently observed side-effects were decreased tear break up time and alterations of the lid margin . In addition, an enormous increase of Staphylococcus aureus in conjunctival flora was noticed . However, all ocular complications of systemic treatment with isotretinoin were reversible after cessation of therapy.

Am J Vet Res, 1995 Feb, 56(2), 203 - 7
Morphologic observation of neutrophil diapedesis across bovine mammary gland epithelium in vitro; Lin Y et al.; Neutrophils are present in milk of cows as a means of suppressing invading pathogens during mastitis . However, the manner by which neutrophils traverse the secretory epithelia is still not clear: do they diapedese between epithelial cells or do they kill epithelial cells to gain entry into milk? We investigated the process of bovine neutrophil diapedesis across bovine mammary gland epithelium in vitro . The bovine mammary epithelial cell line MAC-T, grown on collagen-coated filters, formed a confluent monolayer with characteristic tight junctions, basal-apical polarity, and functional barriers to the dye trypan blue . Neutrophils added on the apical surface of the monolayer were stimulated to diapedese across the epithelium by the addition of Staphylococcus aureus (10(7) colony-forming units/ml) to the basal compartment . Light and transmission electron microscopy revealed the series of events for neutrophil transmigration: accumulation of neutrophils on the surface of epithelial monolayer; projection of pseudopods into intercellular junctions and movement of neutrophils between adjacent epithelial cells; and reapproximation of the lateral epithelial cell membranes and reformation of the apical tight junctions after neutrophils crossed the epithelium . Morphologically, epithelial cell damage caused by neutrophil diapedesis was not evident . This in vitro model provides a two-dimensional epithelial sheet by which neutrophil diapedesis can be qualitatively studied under defined conditions . Results of the study suggest a major mode by which bovine neutrophils diapedese across the alveolar epithelia into milk during mastitis.

J Clin Microbiol, 1995 Feb, 33(2), 376 - 80
Molecular population genetic analysis of Staphylococcus aureus recovered from cows; Kapur V et al.; Staphylococcus aureus is one of the most common causes of bovine mastitis . To estimate genetic relationships among S . aureus strains recovered from cows, 357 isolates from milk samples from worldwide localities were examined for electrophoretic variation at 13 metabolic-enzyme loci . Thirty-nine electrophoretic types which represented distinctive multilocus enzyme genotypes were identified, and nearly 90% of all isolates were assigned to one of eight clones . Genetic heterogeneity was found among organisms recovered from dairy herds from which multiple isolates were obtained, indicating that the S . aureus population in a single herd can be multiclonal . Although humans and cows shared 7 of the 39 S . aureus clones, each clone was predominantly associated with one of these host species . These results are consistent with the concept of host specialization among S . aureus clones and imply that successful transfer of bacteria between humans and cows is limited.

Arch Microbiol, 1995 Feb, 163(2), 138 - 42
Proline betaine is a highly effective osmoprotectant for Staphylococcus aureus; Amin US et al.; Proline betaine is an osmoprotectant that is at least as effective as glycine betaine, and more effective than L-proline, for various strains of Staphylococcus aureus, and Staphylococcus epidermidis and Staphylococcus saprophyticus . 13C NMR studies revealed that proline betaine accumulated to high levels in osmotically stressed S . aureus, but was also detected in organisms grown in its presence in the absence of osmotic stress . Competition experiments indicated that proline betaine was taken up by the proline transport systems of S . aureus, but not by the high affinity glycine betaine transport system.

Ann Rheum Dis, 1995 Feb, 54(2), 131 - 3
Staphylococcus aureus triggered reactive arthritis; Siam AR et al.; OBJECTIVES--To report two patients who developed reactive arthritis in association with Staphylococcus aureus infection . METHODS--A review of the case notes of two patients . RESULTS--Two adult female patients have developed sterile arthritis in association with Staph aureus infection . The first patient has had two episodes of arthritis; the first followed olecranon bursitis, the second followed infection of a central venous catheter used for dialysis . The second patient developed sterile arthritis while being treated for pyomyositis . Both patients had a self limited arthritis and were HLA-B27 negative . CONCLUSION--Reactive arthritis may rarely follow Staph aureus infection . HLA-B27 negativity may be associated with a self limited arthritis in these cases.

Immun Infekt, 1995 Feb, 23(1), 9 - 14
{Coagulase gene polymorphism in Staphylococcus aureus--a new epidemiologic marker}; Schwarzkopf A; Nosocomial infections with Staphylococcus aureus necessitate the prompt recognition of the infectious chain as well as a rapid investigation and exclusion of infectious sources . Conventional typification procedures (e.g . phage typing) and genotyping methods with pulsed-field gel electrophoresis (PFGE) are labor-intensive and time-consuming and can be performed only in a few laboratories . A new attractive typing technique for S . aureus utilizes the polymorphism of the coagulase (coa) gene as an epidemiological marker . This typing method is performed with primers, homologous to a conserved region within the coa gene, in order to amplify the sequences encoding the C-terminal region of this molecule . Since the number of repetitive sequences varies within the coa gene, the resulting PCR products of individual strains can be of different lengths . We have assessed the coa gene length polymorphism in 150 strains of S . aureus . By the sizes of the PCR products these strains could be categorized into 10 subgroups . AluI restriction analysis of the PCR products resulted in a significantly higher degree of discrimination . Since the repeated sequences, consisting of 81 base pairs, possess a high variability of the nucleotides, a characteristic restriction fragment length polymorphism (coa-RFLP) pattern is yielded . Overall, we could distinguish 64% of the clinical isolates by RFLP analysis; in strains sharing identical antibiograms, 56% could be distinguished . 46% oxacillin-resistant strains, some of which originated from epidemic outbreaks, could be discriminated by their RFLP pattern . Comparing these results with those obtained from the PFGE method, isolates which differed by their coagulase gene RFLP also differed by their PFGE patterns.(ABSTRACT TRUNCATED AT 250 WORDS)

J Chemother, 1995 Feb, 7(1), 12 - 5
Genetics of streptomycin resistance in methicillin-sensitive multiply-resistant Staphylococcus aureus; Udo E et al.; Streptomycin resistance was detected in 17 of 20 multiply-resistant Staphylococcus aureus isolates from a hospital in a southeastern Nigerian town . The isolates were uniformly sensitive to methicillin, erythromycin, gentamicin, mupirocin, ciprofloxacin and vancomycin but produced beta-lactamase and were resistant to other antimicrobial agents and harbored different plasmids which ranged in size and number from 1.0 to c, 40 kb and one to six respectively . Curing and transfer experiments demonstrated that streptomycin resistance (Smr) was located on plasmids in 15 of the 17 isolates . 16 Smr plasmids were isolated and characterized . They belonged to three distinct groups based on size and resistance phenotypes . Eight 4.4 kb plasmids encoded Smr only, three 4.7 kb plasmids encoded resistance to streptomycin and chloramphenicol (SmCm) and five 23.8 kb plasmids encoded resistance to streptomycin, kanamycin, neomycin, cadmium and beta-lactamase production (CPKNS) . Restriction endonuclease analysis demonstrated that the 4.4 kb Smr plasmids were similar to one another and indistinguishable from pUB109, an incompatibility group 5 Smr plasmid, suggesting that they may also belong to incompatibility group 5 . The SmCm and the CPKNS plasmid groups also gave identical restriction patterns with single and double enzyme digests . Further transfer experiments with one of the SmCm plasmids led to the isolation of a 4.4 kb Smr plasmid which was indistinguishable from the other 4.4 kb plasmids, suggesting that the SmCm plasmids are natural recombinants between a streptomycin and chloramphenicol resistance plasmid . The results demonstrate a multiple origin of streptomycin resistance in the S . aureus population studied.

Diagn Microbiol Infect Dis, 1995 Feb, 21(2), 81 - 4
Influence of beta-lactamase inhibitors on the activity of oxacillin against methicillin-resistant Staphylococcus aureus; Chang SC et al.; We studied the in vitro susceptibility to oxacillin of 46 isolates of methicillin-resistant Staphylococcus aureus (MRSA) isolates with a minimum inhibitory concentration (MIC) > 8 micrograms/ml of oxacillin, with and without adding clavulanic acid, sulbactam, or tazobactam in three different concentrations (2, 4, and 8 micrograms/ml) . All 46 strains were found by the rapid chromogenic cephalosporin method to be beta-lactamase producers . For those strains with low-level resistance (MIC of 16 or 32 micrograms/ml), the MICs of oxacillin decreased four- to 32-fold and two- to 32-fold after adding sulbactam and tazobactam, respectively . For those with high-level resistance (MIC of > or = 64 micrograms/ml), the MICs either did not change or decreased only two-fold after we added one of three beta-lactamase inhibitors . The results suggest that beta-lactamase production probably plays a role in resistance to oxacillin in those MRSA strains of low-level oxacillin resistance.

Comp Immunol Microbiol Infect Dis, 1995 Feb, 18(2), 123 - 8
Intracellular activity of both teicoplanin and vancomycin against Staphylococcus aureus in human neutrophils; Pedrera MI et al.; The effects in vitro of both teicoplanin and vancomycin of blood peripheral human neutrophils have been studied by assays of antibiotic uptake and intracellular killing of previously phagocytosed Staphylococcus aureus . The effects of vancomycin and teicoplanin (a novel glycopeptide antibiotic), at the therapeutic concentrations reached in plasma (10, 25, 50, 75 and 100 mg/l) and at different times of incubation (5, 15, 30 and 60 min) were studied . The results indicate that: (1) the bactericidal effect of neutrophils increases with incubation time, (2) in the presence of both teicoplanin and vancomycin, the number of CFU/ml of intraphagocytic S . aureus declines with both increasing incubation time and exposure dose of the antibiotics and (3) at 100 mg/l of teicoplanin there is a significant increase in the percentage inhibition of S . aureus growth at all the times studied.

Am J Orthop, 1995 Feb, 24(2), 130 - 6
Postoperative toxic shock syndrome; Raab MG et al.; PURPOSE: To determine risk factors for postoperative toxic shock syndrome (PTSS), a rare, rapidly progressive, and potentially fatal syndrome associated with postoperative wound infections . Components of PTSS include fever, rash, desquamation, hypotension, and multisystem organ dysfunction . METHODS: We conducted a retrospective review of all cases of PTSS occurring in 2 community hospitals from 1981 to 1993, following 390,000 surgical procedures . RESULTS: There were 12 cases of PTSS among the procedures reviewed (0.003%) . Orthopedic procedures included excision of accessory navicular and patellar realignment . Wounds ranged from those with scant superficial exudates to those with gross purulence; all cultures yielded Staphylococcus aureus . All tested isolates were susceptible to methicillin or cephalothin . Mean time from surgery to onset of symptoms was 4 days . All patients had sudden onset of fever; mean maximal temperature was 40 degrees C . All patients displayed a rash, most in a truncal "sunburn" pattern . Eleven of 12 patients desquamated . All patients required vigorous fluid resuscitation . All patients survived . No correlation could be demonstrated between PTSS and patient age, sex, preoperative skin preparation or antibiotics, members of surgical team, or duration of procedure . CONCLUSIONS: Early recognition and treatment of PTSS are essential . No risk factors for PTSS have been identified . PTSS should be considered in the postoperative, acutely febrile, systemically ill patient, though surgical wounds may be deceptively benign in appearance.

J Clin Invest, 1995 Feb, 95(2), 510 - 4
Signaling through CD40 rescues IgE but not IgG or IgA secretion in X-linked immunodeficiency with hyper-IgM; Saiki O et al.; The ligand for CD40 (CD40L) is a membrane protein on activated T cells that induces B cell proliferation and differentiation . Several mutations of the CD40L gene were reported responsible for defective class switching of B cells in an X-linked immunodeficiency with hyper IgM (X-HIM) . We studied four affected males from three families and found three independent mutations including new mutations of CD40L gene . In every X-HIM patient tested, however, anti-CD40 plus IL-10 did not induce class switching from IgM to IgG or IgA, even in the presence of Staphylococcus aureus Cowan I strain (SAC) . CD4+ T cell clones, expressing CD40L on their surface, also did not rescue IgG or IgA induction by X-HIM peripheral blood B cells in vitro . But signaling through CD40 induced both B cell proliferation and IgE secretion when IL-4 was added to the culture . Taken together, these results show that in vitro signaling through CD40 rescues IgE but not IgG or IgA secretion by peripheral blood X-HIM B cells and suggest that in vivo CD40 and CD40L interaction might be necessary for IgG and IgA differentiation in X-HIM.

J Clin Invest, 1995 Feb, 95(2), 456 - 63
The ability of synoviocytes to support terminal differentiation of activated B cells may explain plasma cell accumulation in rheumatoid synovium; Dechanet J et al.; To understand the accumulation of plasma cells within RA synovium, the ability of rheumatoid synoviocytes to support the differentiation of B cells into plasma cells was explored . Tonsillar B lymphocytes cultured over confluent monolayers of synoviocytes, secreted threefold more Igs (mainly IgM) than B cells cultured directly on plastic well . More importantly, synoviocytes enhanced by 14-fold the production of Igs (mainly IgG) by B cells costimulated with Staphylococcus aureus Cowan (SAC) particles . IL-10 and, in a lower extent, IL-2 increased Ig secretion in cocultures, and their combination was synergistic . In the presence of SAC, IL-2, and IL-10, synoviocytes increased by 13-884-fold the production of IgG, which reached 0.19 ng/cell per day . RA as well as normal synoviocytes were more potent than other adherent cell lines to support terminal B cell differentiation . Synoviocyte activity involved both a support of B cell survival, and an induction of the terminal differentiation of B cells into mature plasma cells with typical morphology, high levels of intracytoplasmic Igs, and CD20- CD38high surface expression . The present observation should permit the identification of molecules involved in the maturation of B cells into plasma cells, and in their accumulation in rheumatoid synovium.

Pharm World Sci, 1995 Jan 27, 17(1), 12 - 6
Selective digestive decontamination in multiple trauma patients: cost and efficacy; Langlois-Karaga A et al.; A double-blind randomized placebo-controlled study was carried out to evaluate the efficacy and the cost of selective digestive decontamination (SDD) to prevent nosocomial pneumonia in multiple-trauma patients . Nosocomial infections, particularly pneumonia, were more frequent in the placebo group . The most common infectious agent was Staphylococcus: Staphylococcus aureus in the placebo group and Staphylococcus epidermidis in the SDD group . Methicillin-resistant Staphylococcus epidermidis was detected more often in the SDD group . No methicillin-resistant Staphylococcus aureus was observed in this study . Fewer patients in the SDD group required antibiotherapy . SDD resulted in a saving of about 41% in drug expenditure.

Eur J Biochem, 1995 Jan 15, 227(1-2), 68 - 77
An increase in phosphorylation of microtubule-associated protein 2 accompanies dendrite extension during the differentiation of cultured hippocampal neurones; Diez-Guerra FJ et al.; Hippocampal neurones, from embryonic rats, were cultured for different times and the extension of dendrite-like processes was analysed morphologically and by immunofluorescence, using microtubule-associated protein 2 (MAP2) as a marker . Simultaneously, the changes in phosphorylation in MAP2 were analyzed and a correlation between dendrite sprouting and an increase in MAP2 phosphorylation was found . Phospho-MAP2 was cleaved by Staphylococcus aureus V8 protease limited proteolysis and its phosphopeptide pattern was compared to that obtained with two protein kinases (calcium/calmodulin-dependent kinase and protein kinase C) in vitro . An involvement of calcium/calmodulin-dependent protein kinase in the phosphorylation of MAP2, occurring simultaneously with dendrite extension during neuronal differentiation in vitro, is suggested.

Presse Med, 1995 Jan 14, 24(2), 113 - 7
{Infectious endocarditis: the right time for surgery}; Witchitz S; Valve repair is often required to maintain haemodynamic performance in patients with infectious endocarditis . Localizations on the aortic valve are frequent and lead to rapid, often severe, deterioration, especially when the valve ring and the septum are also infected . Conduction disorders and rupture of the abscess into the heart cavities are formal indications for surgery . Mitral regurgitation requires surgical repair less often and has a slower clinical course . The tricuspid valve generally tolerates infection well and surgery is only exceptionally indicated . An emergency situation due to heart failure occurring simultaneously with valve damage (ruptured mitral chordae) and moderate regurgitation, can most often be managed medically . Inversely, surgery is required when blood cultures are persistently positive and sepsis remains uncontrolled after 8 days of adapted antibiotics . Surgery is entertained when the risk of emboli is established echographically, although growth on valves is not in itself sufficient . Most operated cases also involve an initial embolic event . Conservative surgery (mitral or tricuspid plasty) should always be performed to avoid the long-term complications of prostheses: valve dysfunction (disinsertion or thrombosis), bacterial resistance, risk of embolism especially for mechanical valves, risk of brain haemorrhage related to anticoagulant therapy . When endocarditis develops on a prosthesis early after implantation reoperation is usually required, especially when certain organisms (yeasts, Staphylococcus aureus) are involved . Haemodynamic performance and bacterial resistance dominate the decision making processes which must be adapted to each individual case . Once the decision for surgery has been made, the operation should not be delayed in the hope a longer antibiotic course will be effective since prognosis worsens rapidly if the haemodynamic situation is allowed to deteriorate.

Gene, 1995 Jan 11, 152(1), 127 - 32
Compositional properties of nuclear genes from Plasmodium falciparum; Musto H et al.; We have analyzed the compositional distributions of coding sequences and their different codon positions, as well as the codon usage of the nuclear genes of Plasmodium falciparum, a parasite characterized by an extremely GC-poor genome . As expected, coding sequences are AT-rich, codon usage is strongly biased towards A or T in third codon positions, and some particular amino acids (aa) are especially abundant in the encoded proteins . Remarkably, however, no difference was detected between housekeeping (HK) and antigen (Ag) genes, in spite of differences in expression level and evolutionary constraints . Moreover, all the features found in P . falciparum are very similar to those found in a bacterium characterized by a very GC-poor genome, Staphylococcus aureus . These findings stress the importance of compositional constraints in determining codon usage and aa utilisation.

FEBS Lett, 1995 Jan 9, 357(3), 260 - 4
Existence of a new protein component with the same function as the LukF component of leukocidin or gamma-hemolysin and its gene in Staphylococcus aureus P83; Choorit W et al.; Staphylococcal toxins, leukocidin and gamma-hemolysin, consist of two protein components, i.e . LukF and LukS for leukocodin and H gamma I and H gamma II for gamma-hemolysin . From a culture fluid of Staphylococcus aureus strain P83, a new protein component of leukocidin or gamma-hemolysin which was designated as LukM was isolated . This component showed the same biological activity as that of LukF component for leukocidin or H gamma I component of gamma-hemolysin in combination with LukS or H gamma II . However, the LukM component cross-reacted with the anti-LukS antibodies but not with the anti-LukF antibodies . On the basis of chemical analysis of the LukM component and the cloning and nucleotide sequencing of the lukM gene of S . aureus P83, we have demonstrated that LukM is an entirely new protein component of leukocidin or gamma-hemolysin . The deduced amino acid sequence of LukM from the lukM gene showed 66.7% and 67% identity to that of LukS and H gamma II, respectively . However, the amino acid sequence of LukM and LukF showed only 29% homology.

EMBO J, 1995 Jan 3, 14(1), 196 - 205
Tn552 transposase purification and in vitro activities; Rowland SJ et al.; The Staphylococcus aureus transposon Tn552 encodes a protein (p480) containing the 'D,D(35)E' motif common to retroviral integrases and the transposases of a number of bacterial elements, including phage Mu, the integron-containing element Tn5090, Tn7 and IS3 . p480 and a histidine-tagged derivative were overexpressed in Escherichia coli and purified by methods involving denaturation and renaturation . DNase I footprinting and gel binding assays demonstrated that p480 binds to two adjacent, directly repeated 23 bp motifs at each end of Tn552 . Although donor strand cleavage by p480 was not detected, in vitro conditions were defined for strand transfer activity with transposon end fragments having pre-cleaved 3' termini . Strand transfer was Mn(2+)-dependent and appeared to join a single left or right end fragment to target DNA . The importance of the terminal dinucleotide CA-3' was demonstrated by mutation . The in vitro activities of p480 are consistent with its proposed function as the Tn552 transposase.

Proc Natl Acad Sci U S A, 1995 Jan 3, 92(1), 285 - 9
A Staphylococcus aureus autolysin that has an N-acetylmuramoyl-L-alanine amidase domain and an endo-beta-N-acetylglucosaminidase domain: cloning, sequence analysis, and characterization; Oshida T et al.; The Tn551 insertion site of the autolysis-deficient Staphylococcus aureus mutant RUSAL2 was cloned and used to identify the autolysis gene atl in the parent strain, RN450 . The open reading frame for atl was 3768 bp in length, encoding a deduced protein of 1256 amino acids and molecular size of 137,381 Da . The atl gene product is a bifunctional protein that has an amidase domain and an endo-beta-N-acetylglucosaminidase domain which must undergo proteolytic processing to generate the two extracellular lytic enzymes found in the culture broth of S . aureus.

Microb Drug Resist, 1995 Winter, 1(4), 307 - 13
Tracing the spread of methicillin-resistant Staphylococcus aureus by Southern blot hybridization using gene-specific probes of mec and Tn554; Kreiswirth BN et al.; In a community hospital in Brooklyn, New York, over a 3-year period, 79 methicillin-resistant Staphylococcus aureus (MRSA) isolates from five different case clusters were subtyped by Southern blot hybridization with two previously characterized gene probes, mec and Tn554 . Together, the genotyping enabled the hospital infection control team to differentiate simultaneous MRSA clusters in the surgical intensive care unit (type I:A) and the open heart unit (type II:J), document the spread of one strain (type I:A) between roommates, identify an endemic strain (type II:J) from cardiac monitors and medical personnel, and identify an unrelated outbreak strain (type II:NH) in the labor and delivery unit . On the basis of this investigation it is clear that the routine DNA fingerprinting of MRSA in health care facilities, to monitor their spread and identify cases of nosocomial infections, is an important infection control measure.

Microb Drug Resist, 1995 Winter, 1(4), 299 - 306
Multidrug-resistant Iberian epidemic clone of methicillin-resistant Staphylococcus aureus endemic in a hospital in northern Portugal; Sanches IS et al.; Forty-two methicillin-resistant Staphylococcus aureus (MRSA) isolates collected during 1992-1995 at a hospital in the north of Portugal were characterized by a variety of genomic fingerprints . Hybridization of ClaI and SmaI restriction digests with the mecA- and Tn554-specific DNA probes was used to identify polymorphs and determine their localization in chromosomal DNA preparations, and pulsed-field gel electrophoretic analysis of SmaI digests was used to determine chromosomal backgrounds . A major clone (and its variants) carrying the mecA polymorph I, Tn554 type E in the PFGE background of pattern A, accounted for 85% of all MRSA tested in 1992-1993 and 66% in 1994-1995 . This clone is closely related to the epidemic Iberian clone that was associated with outbreaks in Spain during 1989-1993 and was endemic in 1992-1993 in two hospitals in Lisbon (Portugal).

Acta Biochim Pol, 1995, 42(4), 517 - 24
Evolution and resistance expression of MRSA . Evaluation of beta-lactam antibiotics against a set of isogenic strains with different types of phenotypic expression; Asada K et al.; Methicillin-resistant Staphylococcus aureus (MRSA) has two mechanisms of resistance to beta-lactam antibiotics; one is mediated by mecA gene expression, and the other by penicillinase production . It has been generally accepted in the clinical field that beta-lactam antibiotics are not the drugs of choice for MRSA infection . In this report, however, ampicillin and penicillin G were shown to have relatively good activity against MRSA if combined with a beta-lactamase inhibitor, sulbactam . These beta-lactam antibiotics were found to have relatively high binding affinities to PBP2', the mecA-encoded MRSA-specific penicillin-binding protein . The possible therapeutic application of sulbactam/ampicillin against MRSA infection in combination with arbekacin, an aminoglycoside antibiotic newly developed and introduced into clinical use in Japan, is discussed.

Med Dosw Mikrobiol, 1995, 47(3-4), 127 - 32
{Susceptibility to antibiotics of Staphylococcus aureus strains isolated from pus specimens obtained from patients referred for autovaccine therapy}; Ekiel A et al.; Autovaccine was prepared for 268 patients treated for: osteomyelitis--95, acne--63, furunculosis--53, and other pyogenic infections--57 patients . 540 bacterial strains were isolated from the specimens obtained from patients . 170 Staphylococcus aureus strains were cultured, what represents 31.5% of the isolated strains . Isolated Staphylococcus aureus strains were most often penicillin-resistant (91.5%), amplicillin-resistant (86%), less frequently tetracycline-resistant (73%), and doxycycline-resistant (53.1%) . Staphylococcus aureus strains isolated from outpatients were found to be less resistant to particular antibiotics as compared to the group of strains isolated from the inpatients receiving treatment in different hospital departments . 13.5% of studied Staphylococcus aureus strains were methicillin-resistant.

Bull Hosp Jt Dis, 1995, 54(2), 106 - 8
Acute abdomen: an atypical presentation of pubic osteomyelitis; Pang KW et al.; A 67-year-old woman was admitted with diffuse lower abdominal and suprapubic pain, with diastasis of the pubic symphysis . She developed an acute abdomen necessitating an exploratory laparotomy . During laparotomy, the pubic lesion was explored, and histology confirmed the diagnosis of pubic osteomyelitis and the presence of Staphylococcus aureus . The patient recovered fully with a four-week course of antibiotic therapy . This case confirms the protean presentation of pubic osteomyelitis, alerting physicians of the necessity to institute prompt treatment is such cases.

Folia Microbiol (Praha), 1995, 40(6), 655 - 8
Staphylococcus aureus in chronic and recurrent infections; Slobodnikova L et al.; Ninety-four Staphylococcus aureus strains isolated from chronic and recurrent skin and respiratory tract infections were investigated for several virulence factor expressions . Production of protein A was noticed in all of the tested strains in amounts from less than 0.1 to more than 2.5 ng per 10(6) bacterial cells . The percentage of the extracellularly produced protein A was found to lie between 4.5 and 27.8% . Two strains (both from the respiratory tract) produced more than 50% of protein A in the extracellular form and one strain did not produce any detectable amount of the extracellular protein A; 99% of the tested strains produced the clumping factor, 96% staphylocoagulase, 79% staphylokinase and 90% gelatinolytic activity; 79% produced alpha-toxin exclusively or in combination with delta- or beta-toxin; 8% of strains produced beta-toxin . There were differences in beta-toxin production between strains from the respiratory tract (5%) and skin infections (25%) . delta-Toxin was produced by 53% of the strains . In each of the tested strains a complex of virulence factors was detected . The importance of inactivated extracellular products (especially alpha- and delta-toxin and in the case of skin infections also beta-toxin) as components of staphylococcal whole-cell vaccine was suggested.

Bull Soc Belge Ophtalmol, 1995, 257, 87 - 91
Bilateral endogenous Staphylococcus aureus endophthalmitis: a case report; Claes C et al.; In this article the authors present a case of bilateral endophthalmitis caused by Staphylococcus aureus . The characteristics, the treatment and the prognosis of endogenous bacterial endophthalmitis are discussed . The patient was diabetic and treated for a septicaemia caused by Staphylococcus aureus . After a few days we diagnosed a bilateral endophthalmitis . Despite treatment with antibiotics and a bilateral vitrectomy, the final visual outcome was limited.

Scand J Infect Dis, 1995, 27(6), 569 - 73
Staphylococcus aureus meningitis: a review of 28 consecutive community-acquired cases; Lerche A et al.; From 1966 to 1989 a total of 1,830 cases of bacterial meningitis were recorded at the Department of Infectious Diseases, Rigshospitalet, Denmark . Staphylococcus aureus meningitis accounted for 44 (2.4%) of these cases . Among these, 28 cases were classified as community-acquired S . aureus meningitis . The mortality rate for these cases was 43% . A retrospective study of clinical features and parameters in these community-acquired cases showed the following conditions to be associated with a high mortality risk: advanced age, an underlying condition requiring artificial ventilation, cardiovascular disease and immune deficiencies . At admission, more than 75% of the patients had fever, nuchal rigidity and decreased consciousness . In 57% of cases the focus for the S . aureus infection was endocarditis, pneumonia or skin infections . All the patients had complications due to the meningitis, the major one being insufficient respiration . Autopsy performed in 9 of the 12 fatalities showed endocarditis in 5, pneumonia in 4, and pyelonephritis in 2 . All of the brains examined at autopsy showed cerebral and subarachnoid hemorrhage.

Scand J Infect Dis, 1995, 27(6), 563 - 8
Staphylococcus aureus bacteremia: a 14-year nationwide study in hematological patients with malignant disease or agranulocytosis; Skov R et al.; This retrospective nationwide study of 756 cases of S . aureus bacteremia in hematological patients, between 1977-1990, confirms that S . aureus bacteremia is disproportionately prevalent among, and a major cause of morbidity and mortality in, hematological patients . The case mortality rate attributable to S . aureus bacteremia (44%) was significantly higher than the rate (29%) found in patients without hematological disease . A decreasing mortality was, however, observed from the first to the last part of the study period (53 and 37% respectively) . A logistic regression analysis showed that mortality was further dependent on age, the type of hematological disease and origin of infection/primary focus of infection . Analysis of clinical features confirmed that in comparison with other patients, S . aureus bacteremia in hematological patients more often was hospital-acquired, acquired without known portal of infection/primary focus of infection and much less frequently resulted in osteomyelitis or endocarditis . From phage typing and antibiotic susceptibility patterns no specific types of S . aureus were associated with hematological patients.

Microbiol Immunol, 1995, 39(11), 895 - 96
Prevention of vascular graft infection by sisomicin incorporated into fibrin glue; Yamamura K et al.; To examine the efficacy of sisomicin (SISO) incorporated into fibrin glue (FG) for the prevention of graft infection in animal models, the susceptibility to infection of Dacron grafts (control) and SISO-FG Dacron grafts following the inoculation of Staphylococcus aureus or S . epidermidis was compared . The results showed that SISO-FG Dacron grafts displayed resistance to graft infection.

Microbiol Immunol, 1995, 39(11), 839 - 44
Genetic identification of Staphylococcus aureus by polymerase chain reaction using single-base-pair mismatch in 16S ribosomal RNA gene; Saruta K et al.; Staphylococcus aureus is the most predominant and important pathogen in clinical microbiology . A DNA amplification assay using the polymerase chain reaction (PCR) was designed to identify S . aureus through a single-base-pair mismatch in the sequences of staphylococcal 16S ribosomal RNA (16S rRNA) genes . It was able to detect and identify S . aureus without requiring additional analytical techniques . Twenty-eight staphylococcal and non-staphylococcal strains were tested to verify the specificity of the assay, and only S . aureus strains gave a positive reaction . It may be possible to provide immediate and exact information for the identification of S . aureus.

Trop Geogr Med, 1995, 47(2), 74 - 7
The problems of peritoneal dialysis in the management of chronic uraemia in Nigeria; Arije A et al.; The problems encountered in the use of peritoneal dialysis (PD) in the initial management of patients with chronic renal failure in Nigeria were highlighted, studying 23 patients (13 males and 10 females) aged between 15 and 68 years (mean age 36.4 years) . Peritonitis was the most common complication, occurring in 16 (70%) of patients; effluent drainage obstruction in 11 patients (48%); haemorrhagic effluent in 10 patients (44%); fluid leak from catheter site infection in 7 patients (30%); accidental disconnection of line/catheter joint in 5 patients (22%); and catheter site infection in 2 patients (9%) . A positive effluent culture was found in only 4 out of 18 cultured samples, with Klebsiella and Staphylococcus aureus being the organisms isolated . Dialysis was terminated in patients for the following reasons: financial constraints (8 patients), unresolving peritonitis (7 patients), drainage problems (3 patients), and clinical improvement (5 patients) . The study concludes that PD in the management of chronic uraemia in developing countries, while producing clinical benefits in the majority of patients, is still not generally acceptable as a long-term treatment modality in view of the number of problems.

Arch Orthop Trauma Surg, 1995, 114(6), 303 - 7
Prophylaxis with oral cefadroxil versus intravenous cefuroxime in trochanteric fracture surgery . A clinical multicentre study; Nungu KS et al.; A prospective, randomized study was performed in 559 patients to compare two doses of oral cefadroxil with three doses of intravenous cefuorxime as antibiotic prophylaxis in intra- and subtrochanteric hip fracture surgery . Antibiotic concentrations in the wound fluid were determined at the start and at the end of the operation . The first dose of cefadroxil was given about 2 h before surgery and cefuroxime about 30 min before operation . In 226/242 (93%) patients randomized to oral cefadroxil, the concentration in the wound during surgery was on average 15 micrograms/ml, i.e., well above the minimum inhibitory concentration (MIC-90) for Staphylococcus aureus . In the cefuroxime group, antibiotic levels in the wound exceeded the MIC-90 for S . aureus in 204/210 (97%) of the patients at the start and/or at the end of surgery . All patients were followed up for 4 months . One deep and five superficial infections occurred in the cefuroxime group and no deep but one superficial infection in the cefadroxil group (P = 0.07) . S . aureus was cultured in three of the infected cases while cultures were negative in four patients . Four of the seven infected patients had adequate levels of antibiotic in the wound during surgery, and in three patients no antibiotic assay was performed . The infected patients did not differ in age, sex, operation time, bleeding or any other basic variable compared with patients who healed without complications . Two doses of cefadroxil seems to be practical and as effective as intravenously administered cefuroxime as antibiotic prophylaxis in trochanteric hip fracture surgery.

Scand J Infect Dis, 1995, 27(5), 529 - 32
Protracted and recurrent methicillin-resistant Staphylococcus aureus bacteremia despite defervescence with vancomycin therapy; Khatib R et al.; Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia persisted for 46 days in a 63-year-old patient and recurred over 98 days in a 79-year-old patient, despite vancomycin therapy . Although the fever resolved, patient 1 developed a spinal epidural abscess 38 days after beginning therapy and patient 2 sustained multiple relapses . A time-kill study demonstrated a reduced vancomycin killing rate in both isolates when compared to the killing rate of a control MRSA strain . The bacteremia persisted after increasing the vancomycin dose to achieve trough levels of 15-20 micrograms; it cleared after adding gentamicin . These cases illustrate that MRSA bacteremia may persist during vancomycin therapy despite resolution of fever and may lead to delayed complications, and that adding gentamicin may be necessary for ultimate clearance of the bacteremia.

Scand J Infect Dis, 1995, 27(5), 483 - 7
Staphylococcus aureus endocarditis in Danish intravenous drug users: high proportion of left-sided endocarditis; Faber M et al.; In a retrospective study covering the years 1982-1989 episodes of Staphylococcus aureus endocarditis in 51 intravenous drug users were studied . Tricuspid involvement dominated (34/51), but the frequency of left-sided involvement (33.3%) was greater than in earlier reports . Involvement of both sides of the heart was not detected, but 27.8% of the left-sided endocarditis cases had multiple pulmonary infiltrates, indicating that some of them might have had a concomitant right-sided endocarditis . The 2 groups were compared: patients with left-sided endocarditis were significantly older and with a longer time of intravenous drug use . The complication rate was the same (44.1%) as was the duration of antibiotic treatment (median 42 days) . In total, five patients underwent surgery, two (5.8%) due to right-sided failure and three (29.4%) because of left-sided endocarditis . The mortality of tricuspid endocarditis was low (2.9%), whereas 5 patients (29.4%) with left-sided involvement died . The patients who died were significantly older and had a shorter duration of symptoms before hospitalization.

Scand J Infect Dis, 1995, 27(5), 475 - 9
Testing of methicillin resistance by in vitro susceptibility and the presence of the mecA gene in clinical Staphylococcus aureus isolates in Finland; Kotilainen P et al.; A total of 140 epidemiologically unrelated Staphylococcus aureus strains collected in Finland between 1983 and 1994 were sent to the reference laboratory with verified or suspected methicillin resistance . These strains and 37 S . aureus strains previously identified as methicillin-susceptible were retested using 5 different susceptibility test methods including agar screening, disc diffusion, growth around methicillin (25 micrograms) test strips and minimal inhibitory concentration (MIC) determinations by an agar dilution method and E-test . The isolates were also analyzed for the presence of the mecA gene by the polymerase chain reaction (PCR) . Based on in vitro susceptibility, 69 strains were identified as methicillin-resistant and were positive for the mecA gene in PCR, while 84 strains were methicillin-susceptible and negative for this gene . Susceptibility testing gave conflicting results for 24 (14%) strains . When the tests were repeated in triplicate for each isolate, discrepant results were still achieved with 18 of the 24 strains in at least 2 different tests . Thus, based on in vitro susceptibility, these strains could not be definitely classified as resistant or susceptible to methicillin . Yet 7 of them were positive for the mecA gene as an indication of genetic resistance to methicillin . Corroborating earlier studies, these results illustrate the difficulty of detecting methicillin resistance/susceptibility based only on susceptibility testing and underscore the importance of confirming methicillin resistance in S . aureus in specialized laboratories.

Res Exp Med (Berl), 1995, 195(5), 297 - 307
Inhibition of tumor necrosis factor production and ICAM-1 expression by pentoxifylline: beneficial effects in sepsis syndrome; Mandi Y et al.; Tumor necrosis factor (TNF) has a pivotal role in the pathogenesis of sepsis and septic shock . Suppression of its biosynthesis might therefore be one of the strategies in the treatment of sepsis . When peripheral white blood cells were stimulated with either E . coli lipopolysaccharide (LPS) or Staphylococcus aureus, pentoxifiline (PTX) inhibited TNF production . In contrast, only a moderate inhibitory effect was observed on the induction of interleukin 6 (IL-6) . PTX inhibited not only the TNF production of monocytes, but also the TNF secretion of both granulocytes and unseparated whole blood . The in vitro TNF and IL-6 producing capacities were higher in septic patients (n = 31) than in healthy blood donors (n = 15) . Administration of PTX (400 mg/day) to 20 of the septic patients resulted in TNF production similar to that found in healthy controls . It also subsequently led to an improvement of the clinical status classified by the APACHE II score . The soluble intercellular adhesion molecule-1 (sICAM-1) level was significantly higher in the sera of septic patients before PTX treatment (800-1200 ng/ml) than in normal individuals (50-150 ng/ml), but it decreased following PTX therapy . Cytofluorometric analysis revealed that the expression of ICAM-1 on stimulated mononuclear cells was inhibited by PTX . It is presumed that the suppressive effect of pentoxifylline on TNF production may be of clinical importance, improving the therapeutic strategies in septic syndrome.

Chir Narzadow Ruchu Ortop Pol, 1995, 60(5), 409 - 13
{Septic arthritis in newborns and infants--clinical epidemiology}; Lejman T et al.; Septic arthritis in 99 newborns and 58 infants was analyzed epidemiologically . Multiple localization of septic process has been found in 37.4% of newborns and 16.0% of infants included in this study . The hip joint, knee and shoulder were affected most frequently in both groups . In 45.2% of newborns septic condition of the skin and in 37.1% otitis media was the source of infection . In infants septic arthritis was related to otitis media in 36.8%, septic condition of the skin in 23.3% and respiratory tract infection also in 23.3% . Staphylococcus aureus was the most frequent joint aspirate culture finding.

Acta Neurochir (Wien), 1995, 133(1-2), 36 - 43
Multiple pyogenic brain abscesses; Sharma BS et al.; Thirty eight patients with multiple pyogenic brain abscesses constituted 11% of all the brain abscesses treated during a 12 year period . Sixty per cent (23) of the patients were in the first two decades of life, including 9 (24%) infants . The clinical presentation was similar to brain abscess in general . 21 patients had altered "sensorium" at the time of admission . Otogenic brain abscesses were the commonest (26%), followed by those associated with congenital cyanotic heart disease (18%) . The abscesses were invariably large in size . The pus was sterile on culture in 11 (29%) patients, while Staphylococcus aureus was the commonest organism grown in 9 (24%) patients . Aspiration of the pus was required as a life saving measure, to control raised intracranial pressure, in 29 (76%) patients . Twelve (32%) of these patients underwent secondary excision of the abscess capsule . The overall mortality was 32% with failure to control intracranial and systemic infection as the major causes of mortality . Level of consciousness at the time of admission was the most significant factor affecting the outcome . Surgery has a definite therapeutic and life saving role in the management of multiple pyogenic brain abscesses . A systematic treatment plan for multiple abscesses is proposed.

Trop Geogr Med, 1995, 47(5), 200 - 2
Tropical pyomyositis in Gondar, Ethiopia; Selassie FG; Seventy-two cases of pyomyositis are reported from the north-western highlands of Ethiopia . The majority (76.4%) came from highland areas over 1,800 meters above sea level . The clinical picture of the disease was similar to that seen in other East African countries . Staphylococcus aureus was recovered from 69 of 72 pus cultures . Spontaneous rupture of abscesses was seen in two cases . Four of the five deaths were assumed to be due to complications of the pyomyositis . Further search into non-altitudinal factors is implicated to get a better insight into the nature of the disorder.

Microbiol Immunol, 1995, 39(6), 425 - 7
Salt-induced L-forms of Staphylococcus aureus; Yabu K; When growing cultures of a salt-sensitive strain of Staphylococcus aureus were inoculated on nutrient agar containing 0.8 M NaCl and 0.5% bovine serum albumin, typical colonies of L-form developed extensively after 2 days of incubation at 30 C . Incubation of growing cultures with lipoteichoic acid, sodium polyanethole sulfonate and subtilisin resulted in inhibition of L-form induction.

Microbiol Immunol, 1995, 39(6), 379 - 86
Rapid identification by polymerase chain reaction of staphylococcal exfoliative toxin serotype A and B genes; Sakurai S et al.; A new system was designed to detect staphylococcal exfoliative toxin A (ETA) and B (ETB) genes by the polymerase chain reaction (PCR) . The primer pairs for the ETA gene (eta) were 20 and 20-mer, and its PCR product was a 741-bp eta fragment, while the primer pairs for the ETB gene (etb) were also 20 and 20-mer, and its PCR product was a 629-bp etb fragment . When these primers were simultaneously used in the PCR, the two types of ET were clearly detected as two bands in an ETA and ETB double-producer using only one colony within 3 hr . We examined 66 strains of Staphylococcus aureus isolated from patients with staphylococcal scalded skin syndrome (SSSS) and compared the results obtained by ELISA and PCR . The same results were obtained for 56 of the strains, i.e., 30 strains were ETA producers, 20 strains were ETB producers, and 6 strains were double-producers . However, positive results were obtained for 5 of the 10 non-ET-producing strains . Two of these strains were judged by PCR as ETA producers and three as ETB producers . Thus, PCR is very sensitive and rapid in detecting ETA and ETB gene fragments in colonies isolated from patients with SSSS.

Acta Microbiol Immunol Hung, 1995, 42(3), 301 - 8
Effects of pentoxifyllin and PentaglobinO on TNF and IL-6 production in septic patients; Mandi Y et al.; Pentoxifylline inhibited the TNF production of purified human white blood cells and whole blood cultures stimulated either by LPS or by Staphylococcus aureus . PTX did not influence the CD14 expression . The in vitro TNF and IL-6-producing capacities of septic patients were higher than in the control group . Administration of PTX to septic patients resulted in the normalization of TNF synthesis and in a moderate decrease in IL-6 production . It also subsequently led to an improvement in the clinical status . A further improvement in APACHE II score could be achieved by administration of PentaglobinO (Biotest) . The prevention of in vitro TNF production by PentaglobinO could be demonstrated involving the use of whole blood rather than purified lymphocytes . The level of soluble ICAM-1 in the serum of septic patients was significantly higher than in normal individuals, but it decreased following PTX and PentaglobinO therapy . It is presumed that PTX and PentaglobinO can antagonize cytokine production at different levels, resulting in synergistic action that is beneficial in the treatment of sepsis.

Can J Infect Control, 1995 Winter, 10(4), 114 - 6
Attitudes and beliefs of Canadian infection control decision-makers towards 'borderline' methicillin-resistant Staphylococcus aureus; Miller MA et al.; 'Borderline' methicillin-resistant Staphylococcus aureus (MRSA) strains are inhibited by drug concentrations of 2 to 8 micrograms/mL . This type of resistance is usually mediated by 'hyper beta-lactamase' production which is detectable in vitro by susceptibility to combinations of a beta-lactam and a beta-lactamase inhibitor (ie, amoxicillin and clavulanic acid) . A survey of Canadian infection control experts was performed to assess the knowledge, attitudes and beliefs regarding the containment requirements for borderline MRSA strains in acute health care facilities . Twenty-three of 38 Canadian infection control experts (61%) (members of the Canadian Hospital Epidemiology Committee {CHEC} or the Society for Healthcare Epidemiology of American {SHEA}) returned a questionnaire about a fictional patient with a postoperative wound infection with such a strain . Eleven respondents (48%) considered the isolate as an MRSA, 11 did not and one was unsure . All who did not believe the strain to be MRSA would not have isolated or cohorted the patient . Four in the latter group would have isolated the patient if he or she were on a neurosurgery or cardiovascular surgery unit, indicating a desire to restrict spread of this isolate on those units . Seven of the 12 individuals who had managed at least one patient with a borderline MRSA did not advocate patient isolation or cohorting, and five did . This survey has supported the belief that there are discrepancies among infection control decision-makers in Canada regarding the approach, precautions and therapy of patients infected with borderline strains of MRSA . Further data on virulence of and effective therapy for these isolates are needed to assess whether the additional cost is warranted in controlling the nosocomial spread of these isolates.

Am J Nephrol, 1995, 15(6), 521 - 3
Infected arteriovenous hemodialysis graft presenting as left and right infective endocarditis; Mohamed M et al.; Prosthetic grafts have become an acceptable alternative to the autogenous arteriovenous dialysis fistula . The major drawback in their use for the dialysis patient is infection . We present a case of infected polytetrafluoroethylene arteriovenous fistula (endarteritis) with signs of unilateral splinter hemorrhage, Janeway lesions in the affected limb and septic venous embolization to the lungs . The graft eventually ruptured requiring emergency surgery . Staphylococcus aureus is by far the most common implicated organism . An otherwise non-threatening infection at a fistula site can lead to more serious complications such as infective endocarditis.

Microbios, 1995, 83(335), 119 - 37
Correlation of teichoic acid D-alanyl esterification with the expression of methicillin resistance in Staphylococcus aureus; O'Brien MJ et al.; Methicillin-susceptible and -resistant isolates of Staphylococcus aureus, including a teichoic acid-deficient mutant, were examined under varying physiological conditions for their degree of teichoic acid and lipoteichoic acid D-alanyl esterification . Methicillin-resistant strains grown in the presence of methicillin and NaCl possessed significantly decreased amounts of D-alanyl ester when compared with methicillin-susceptible isolates . These strains also exhibited reduced autolysis . An autoradiographic procedure was used to detect mutants, isolated by Tn917 and nitrosoguanidine mutagenesis of methicillin-susceptible strains, which were defective in D-alanyl ester formation . The quantitative uptake of D-{14C}alanine in these mutants was determined and the effect of methicillin on the growth and viability of each mutant was compared with the wild-type strain . S . aureus mutant strains, defective in the uptake and incorporation of D-alanine, were shown to exhibit slightly reduced autolysis and an enhanced expression of methicillin resistance.

Adv Perit Dial, 1995, 11, 52 - 6
Spontaneous peritonitis and peritoneal fibrosis in rats on peritoneal dialysis for 9 weeks; Suzuki K et al.; To investigate characteristics of peritonitis in rats on peritoneal dialysis (PD), we retrospectively studied 36 cases of peritonitis in 23 rats . After breakin dialysis postcatheter insertion, the animals were dialyzed twice daily with 1.5% or 4.25% Dianeal for 8 weeks . White blood cell (WBC) count with differentials and microbiological culture of the dialysate were examined twice weekly . Peritonitis was treated with cefazolin and tobramycin until the tenth day after the dialysate became clear . The peritoneal equilibration test (PET) was performed at weeks 2, 6, and 10 . The dialysate was obtained at 0, 2, and 4 hours for glucose assay . The peritoneal cavity was inspected, and peritoneal tissue specimens were taken . There were 10 single episodes of peritonitis, 7 recurrences, and 6 reinfections . The organisms isolated were Staphylococcus aureus in 24 cases of peritonitis and Escherichia coli in 6 cases of peritonitis . The average treatment period was 16 days . The glucose absorption ratio became higher over time in single episodes of peritonitis, but was unchanged in recurrences and reinfections . Sixteen adhesions, 1 abscess, and 12 sclerotic retractions of the mesentery were observed . Fibrotic thickening of the peritoneum was found histologically in all animals . In spontaneous peritonitis in rats, we often found complicated clinical courses, catheter closure, intraperitoneal adhesion, and fibrotic thickening of the peritoneum.

Adv Perit Dial, 1995, 11, 193 - 6
A longitudinal in vitro antimicrobial evaluation of two silver polymer surface treatments for peritoneal dialysis catheters; Kubey W et al.; The oligodynamic effect of silver has been utilized in medicine for many decades . This study evaluated the antimicrobial properties of two silver polymer surface treatments over 9 months to assess their usefulness for chronic percutaneous access . Silicone catheters were either dip-coated with micronized silver oxide in a silicone matrix (AgX) or impregnated with silver using an ion beam deposition process (Spire Argent I) . Four-inch (10-cm) segments were shaken continuously in 10 mL minimum essential media (MEM) with 2% fetal bovine serum (FBS) at 25 degrees C . The medium was replaced weekly . Monthly eluate samples were assayed for Ag+ concentration using ICP atomic emission spectroscopy . Bimonthly, segments were removed, placed in fresh medium inoculate with 10(5) colony-forming units (cfu)/mL Staphylococcus aureus ATCC 25923 and quantitated over 24 hours for bacterial survival/growth . Relative to control catheters, there was a mean log10 reduction of S . aureus of 4.4 with AgX and 1.7 with Spire Argent I persisting over the 9-month study period . Silver ion elution followed a biphasic pattern with both coatings establishing a steady state of 0.2 ppm at 4 months . These data suggest that the test surface coatings employed will deliver long-term oligodynamic activity when implanted percutaneously.

Adv Perit Dial, 1995, 11, 157 - 9
Subcutaneous cuff removal in persistent exit-site/tunnel infections in peritoneal dialysis; Suh H et al.; The purpose of this study was to analyze catheter outcome of persistent exit-site/tunnel infections (ESI/TIs) in peritoneal dialysis patients who underwent removal of the subcutaneous cuff due to persistent ESI/TI from January 1989 to June 1994 . One hundred and sixty-eight patients (98 male, 70 female) from our tertiary university hospital underwent 177 double-cuff coiled Swan neck catheter implantations surgically . Nineteen patients (11%) had persistent ESI/TIs for more than 6 months . Thirteen persistent ESI/TIs responded to subcutaneous cuff removal . One hundred and fifty-four episodes of ESI/TI in 168 patients were observed over 3189 patient-months (0.58 episodes/patient-year) . Nineteen patients (11%) had persistent ESI/TI with Staphylococcus aureus in 12 and Pseudomonas aeurginosa in 7 patients without episode of peritonitis except 2 patients with Staphylococcus aureus . Thirteen persistent ESI/TI resolved after subcutaneous catheter removal without catheter loss, 8 with Staphylococcus aureus and 5 with Pseudomonas . Sixteen catheters were lost due to fungal peritonitis and two secondary to recurrent bacterial peritonitis . None of the catheters were removed as a result of ESI/TI and related peritonitis . Subcutaneous cuff removal in persistent ESI/TI in peritoneal dialysis patients can significantly reduce catheter loss related to ESI/TI.

Gynecol Obstet Invest, 1995, 40(3), 179 - 82
Endocervical pathogens in women with preterm and term labour; Nadisauskiene R et al.; The purpose of this study was to compare the endocervical microflora of women in preterm and term labour and to determine whether the presence of a specific microflora is significantly associated with preterm labor . A prospective study was performed in Lithuania among 212 women in preterm labour (latent phase, n = 110; active phase, n = 102) and among 62 healthy women in term labour . Microbiological assessment included cultures for aerobic bacteria, yeasts, and Trichomonas vaginalis and direct immunofluorescence reaction for Chlamydia trachomatis, Escherichia coli (odds ratio 8.16; 95% confidence interval 1.27-340.23) and Staphylococcus aureus (odds ratio 7.79; 95% confidence interval 1.21-325.40) were significantly more often isolated from women in preterm than from women in term labour . The prevalence of C . trachomatis was the same in the preterm and in the term labour group . The pregnancy outcome during the latent or active phase of preterm labour with or without C . trachomatis infection did not differ . It is concluded that E . coli and S . aureus are significantly more prevalent in endocervical cultures from Lithuanian women in preterm than from those in term labour.

Nephrol Dial Transplant, 1995, 10 Suppl 6, 108 - 10
Five years' experience at one centre with protein A immunoadsorption in patients with deleterious allo/autoantibodies (anti-HLA antibodies, autoimmune bleeding disorders) and post-transplant patients relapsing with focal glomerular sclerosis; Kriaa F et al.; Protein A is extracted from a strain of Staphylococcus aureus and binds specifically to the constant domains of immunoglobulins and possibly to fibronectin . It has already been shown that concentrations of all IgG isotypes (except IgG3) are efficiently decreased by immunoadsorption (IA) on protein A linked to sepharose beads . This system has been developed by Cobe-Excorim Co . to either remove IgG in some instances where they wil be harmful, i.e . allo- and autoantibodies inducing pathological conditions (autoimmune diseases, haematological disorders with allo/autoantibodies, anti-HLA antibodies in sensitized patients awaiting organ transplantation) or treat several immunological diseases with unknown pathogenesis . In our unit, 20 patients with high titres of anti-HLA panel-reactive antibodies, four patients with haematological disorders (haemophilia with anti-VIII antibodies and Glanzmann diseases) and three patients with post-transplant focal glomerular sclerosis (FGS) underwent IA over the past 5 years . Infectious complications were not observed after IA and the procedure was always well tolerated . In spite of the use of adjunctive immunosuppressive therapy with prednisone and cyclophosphamide, and although the reduction in serum IgG was close to 90%, the de novo synthesis of allo- and autoantibodies was important after IA procedures . In the cases of removal of anti-HLA antibodies, patients with a pre-IA antibody titre which was > 1:128 clearly did not benefit from the technique and other immunological criteria were not predictive of efficacy . Fourteen patients were transplanted, four with a well-matched kidney with both pre- and post-IA negative cross-matching, and 10 with a positive historical cross-match with the donor.(ABSTRACT TRUNCATED AT 250 WORDS)

Pneumonol Alergol Pol, 1995, 63(7-8), 371 - 7
{Pneumonia in patients after extracorporeal circulation}; Klodkowska-Farner E et al.; Hospital infections are still an important problem of to-days medicine . The most common and dangerous one is pneumonia . The purpose of this study was to determine the cause of pneumonia in patients operated on under extracorporeal circulation . It was proved that micro-organisms responsible for pneumonia in our patients were Pseudomonas sp . and Staphylococcus aureus . No correlation between the bacterial flora cultured from the air in operating theatre and post-op . ward and bacterial flora responsible for pneumonia was found . It can be infer that pulmonary infections were rather caused by hospital cross-infections or endogenic infections in colonized patients.

Crit Care Med, 1995 Jan, 23(1), 84 - 91
Soft tissue infection prophylaxis with gentamicin encapsulated in multivesicular liposomes: results from a prospective, randomized trial; Grayson LS et al.; OBJECTIVES: Systemically administered antibiotic agents are not evenly distributed in the body, which frequently results in subtherapeutic regional drug concentrations, particularly in areas of poor vascularization, including wound sites . We have developed a lipid-based drug delivery system to provide prolonged levels of gentamicin in local tissues after local administration . Multivesicular liposomes are microspheres composed of lipid bilayer membranes surrounding multiple aqueous compartments that can contain drug . The preparation may be effective for the prevention and treatment of a variety of infections, including infections associated with indwelling vascular catheters . DESIGN: Prospective, randomized trial . SETTING: Animal laboratory . SUBJECTS: Mice, 6 to 12 wks of age, weighing 20 to 30 g . INTERVENTIONS: We administered 0.5 mg of gentamicin encapsulated in multivesicular liposomes to dorsal subcutaneous tissue in mice . Animals were inoculated with 10(5) to 10(7) colony-forming units (cfu) of Staphylococcus aureus 2, 4, 6, and 8 days later . The cfu/g of tissue values were determined 2 days after inoculation . MEASUREMENTS AND MAIN RESULTS: With a 10(7) cfu challenge, animals that received 2- and 4-day pretreatment with multivesicular liposome/gentamicin had a 4 log10 reduction in cfu/g of tissue compared with controls . When 10(5) cfu of Staphylococcus aureus were inoculated after 2- and 4-day pretreatment with multivesicular liposome/gentamicin, a 6 log10 reduction in bacteria colony-forming units was observed . CONCLUSION: Local injection of multivesicular liposome/gentamicin provides sustained drug concentrations in regional tissues that protect against a massive bacterial challenge for at least four subsequent days.

Pancreas, 1995 Jan, 10(1), 78 - 84
Failure of local and systemic bacterial clearance in rats with acute pancreatitis; Gianotti L et al.; These studies were designed to investigate the ability of rats to clear subcutaneous bacterial abscesses following acute pancreatitis . Animals underwent subcutaneous injection of 1 x 10(9) Escherichia coli and Staphylococcus aureus and, 24 h later, were randomized into four groups to receive (A) an intravenous (i.v.) infusion of cerulein, (B) saline i.v., (C) ligation of the pancreatic head, or (D) sham ligation . After 12 h, abscess sizes were measured and blood was withdrawn for culture and assay amylase and endotoxin level assay . Animals were observed for an additional 12 h to record mortality . Both E . coli and S . aureus abscesses were larger in group C vs . group D, while only the E . coli lesion was larger in group A vs . group B . Bacteremia was detected in 60% of the animals in group A, 40% in groups B and D, and 100% in group C . Mortality was 80% in group C vs . 10% in all other groups . Amylase and endotoxin levels were higher in group C vs . all groups . In the second experiment rats were injected with bacteria as above . Four, twelve, and twenty-four hours later the abscesses were removed for quantitation of bacteria and histologic evaluation . At 24 h rats underwent procedure A, B, C, or D and the abscesses were excised 12 h later . Group C had a significantly higher number of viable bacteria inside the lesion compared to group D . Histology showed tissue necrosis and cellulitis not observed in group D . It is concluded that acute pancreatis causes failure of local and systemic bacterial clearance and that the incidence of bacteremia and mortality is proportional to the severity of the disease.

Infect Control Hosp Epidemiol, 1995 Jan, 16(1), 12 - 7
The evolving epidemiology of methicillin-resistant Staphylococcus aureus at a university hospital; Layton MC et al.; OBJECTIVE: To describe the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) at a university hospital during a 14-month period . DESIGN: Prospective laboratory-based surveillance for MRSA with descriptive epidemiology based on medical chart review and characterization of strains by DNA typing, using pulsed-field gel electrophoresis (PFGE) . SETTING: An 850-bed tertiary care university hospital . PATIENTS: Patients with clinical isolates of MRSA . MAIN OUTCOME MEASURE: Determination whether MRSA isolates were community- or hospital-related . RESULTS: Among 87 patients with MRSA, 36 (41%) had community-acquired infections . Community acquisition was associated with recent hospitalization, previous antibiotic therapy, nursing home residence, and intravenous drug use . Greater than 3 months had elapsed from the time of discharge for 13 (62%) of the 21 patients with community-acquired isolates hospitalized within the last year . Eight patients (22%) with community-acquired MRSA had no discernible risk factors . PFGE allowed differentiation of 35 distinct whole-cell DNA patterns; heterogeneity was seen among both nosocomial and community-acquired isolates, with few instances of cross-transmission . CONCLUSIONS: Our data suggest an increase in community acquisition of MRSA . PFGE demonstrated heterogeneity of MRSA isolates from both the community and the hospital setting.

Appl Environ Microbiol, 1995 Jan, 61(1), 252 - 9
Identification of a PutP proline permease gene homolog from Staphylococcus aureus by expression cloning of the high-affinity proline transport system in Escherichia coli; Wengender PA et al.; The important food-borne pathogen Staphylococcus aureus is distinguished by its ability to grow at low water activity values . Previous work in our laboratory and by others has revealed that proline accumulation via transport is an important osmoregulatory strategy employed by this bacterium . Furthermore, proline uptake by this bacterium has been shown to be mediated by two distinct transport systems: a high-affinity system and a low-affinity system (J.-H . Bae, and K . J . Miller, Appl . Environ . Microbiol . 58:471-475, 1992; D . E . Townsend and B . J . Wilkinson, J . Bacteriol . 174:2702-2710, 1992) . In the present study, we report the cloning of the high-affinity proline transport system of S . aureus by functional expression in an Escherichia coli host . The sequence of the staphylococcal proline permease gene was predicted to encode a protein of 497 amino acids which shares 49% identity with the PutP high-affinity proline permease of E . coli . Analysis of hydropathy also indicated a common overall structure for these proteins.

Rinsho Byori, 1995 Jan, 43(1), 61 - 6
{DNA polymorphisms in strains of Staphylococcus aureus . I . Usefulness of coagulase gene as an epidemiological marker}; Yamashita K et al.; In this study, we report the genotyping of Staphylococcus aureus by restriction enzyme digestion of the nested PCR products of coagulase gene from clinical strains of 83 MRSA (methicillin-resistant S . aureus) and 23 MSSA (methicillin-sensitive S . aureus) . Using Alu I restriction enzyme, a total of 106 strains could be classified into 19 different restriction patterns, arbitrarily designated the genotypes 1 to 19 for strains . The DNA patterns of the PCR coagulase gene products were visualized by ethidium bromide after 2% agarose gel electrophoresis and hybridized with alkaline-phosphatase labeled probe . Because of unique sequences of the coagulase gene containing 81-bp tandem repeats and Alu I recognition sites, most of clinical strains had bands in multiples of 81 bp which allowed easy discrimination among isolates . The deduced DNA fragment sizes ranged from approximately 80 to 900 bp, and the numbers of DNA fragments generated were 2 to 9 . Eighteen of the 20 MRSA strains taken from the patients hospitalized in 1991 belonged to the genotypes 2 and 3, and 27 of the 29 MRSA strains taken from patients in 1992 belonged to the genotypes 1, 2 and 3, suggesting the possibility of nosocomial outbreaks caused by these strains . In conclusion, this coagulase gene restriction fragment length polymorphism (RFLP) technique will be useful for epidemiological evaluations of nosocomial MRSA infections.

Chemotherapy, 1995 Jan-Feb, 41(1), 45 - 9
Enhancement of the susceptibility of Staphylococcus aureus to phagocytosis after treatment with fosfomycin compared with other antimicrobial agents; Perez Fernandez P et al.; Phagocytosis and intracellular killing of invading pathogens by host cells play the major role in resistance to bacterial infections . In vitro, antibiotics improve the susceptibility of microorganisms to antimicrobial activity of leukocytes, suggesting that this effect may contribute to determine the antimicrobial therapy and safe dosing intervals . The susceptibility of Staphylococcus aureus to phagocytosis and killing by human polymorphonuclear leukocytes (PMNL) in the presence of normal human serum in the postantibiotic phase of fosfomycin were compared with ciprofloxacin, cefotaxime and pristinamycin . Pretreatment of S . aureus for 10 min with 4 x MIC of fosfomycin and ciprofloxacin clearly sensitized the bacteria to leukocytic killing in the presence of normal human serum (10% v/v); cefotaxime and pristnamycin failed to enhance the phagocytic killing.

Z Kardiol, 1995 Jan, 84(1), 51 - 4
{Bacterial endocarditis of the transvenous lead of an implantable cardioverter/defibrillator}; Werner GS et al.; A 27-year-old patient carrying a transvenous ICD developed infective endocarditis more than 1 year after surgery . Staphylococcus aureus was isolated from blood cultures . A transesophageal echocardiogram revealed a mobile vegetation on a thrombus attached to the ICD lead in the right atrium . The ICD lead was removed by right anterolateral thoracotomy . This raises the issue of the risk of thrombus formation in patients with intravenous ICD leads and the associated susceptibility to infective endocarditis.

Am J Physiol, 1995 Jan, 268(1 Pt 1), L85 - 94
Staphylococcus aureus stimulates neutrophil recruitment by stimulating interleukin-8 production in dog trachea; Massion PP et al.; The present study examined whether neutrophil recruitment in dog airways by Staphylococcus aureus is mediated by interleukin-8 (IL-8) . S . aureus culture supernatant was superfused into an isolated tracheal segment in six dogs, and neutrophil recruitment and IL-8 concentrations were measured in the superfusate . Dog IL-8 was cloned, expressed in Escherichia coli, purified by chromatography, and shown to be biologically active . With the use of an enzyme-linked immunoabsorbent assay (ELISA) for the measurement of dog IL-8, we showed that S . aureus supernatant induced neutrophil recruitment and increased IL-8 concentration in the superfusate in a time-dependent manner . The chemotactic activity present in the superfusate 6 h after superfusion with S . aureus was inhibited by an anti-IL-8 antibody . S . aureus supernatant also stimulated IL-8 production and gene expression by cultured canine tracheal epithelial cells . These results provide evidence that IL-8 plays a major role in S . aureus-induced neutrophil recruitment in the airways by stimulating IL-8 production in airway cells.

Arthritis Rheum, 1995 Jan, 38(1), 139 - 41
Spinal involvement in gout; Staub-Schmidt T et al.; A 45-year-old man with severe gout was admitted to the hospital because of Staphylococcus aureus septicemia . He had also a biclonal dysglobulinemia, without signs of myeloma . An asymptomatic lytic lesion of the left pedicle of L5 was discovered on radiographs . Histologic examination of the biopsied lesion showed typical tophaceous gout.

Clin Exp Immunol, 1995 Jan, 99(1), 21 - 8
Failure of IgG production due to a defect in the opening of the chromatin structure of I gamma 1 region in a patient with IgG and IgA deficiency; Kondo N et al.; Patients with common variable immunodeficiency (CVID) display reduced levels of two or all three of the major immunoglobulin isotypes, and the deficiency is characterized by failure of B cells to differentiate into plasma cells in many cases . A patient (14 years old, female) showed normal serum IgM levels and low serum IgG and IgA levels, including low levels of all IgG subclasses . Northern blot analysis suggested that the patient's B cells may be defective at the immunoglobulin heavy chain isotype switch . The germ-line C gamma 1 transcript was amplified from cDNA of healthy controls by the addition of recombinant IL-2 (rIL-2) to pokeweed mitogen-stimulated peripheral mononuclear cells or Staphylococcus aureus Cowan I (SAC)-stimulated IgM-producing lymphoblastoid cell lines (LCL) transformed by Epstein-Barr virus, while it was not amplified from cDNA of the patient . In the I gamma 1 region of LCL cultured with SAC plus rIL-2, the inner cytosine in the 5' C-C-G-G 3' sequence nearest the 3' site of the I gamma 1 region, at least, was not completely unmethylated in the patient . Moreover, the DNase I hypersensitive site was not induced in the patient's LCL by SAC plus rIL-2 . These results indicate that the defects of the immunoglobulin heavy chain isotype switch in the patient's B cells are due to failure in the synthesis of germ-line C gamma transcripts, and this may be caused by defects in opening of the chromatin structures of specific switch regions.

J Infect Dis, 1995 Jan, 171(1), 216 - 9
Nasal carriage of Staphylococcus aureus as a major risk factor for wound infections after cardiac surgery; Kluytmans JA et al.; To evaluate the importance of nasal carriage of Staphylococcus aureus as a risk factor for the development of wound infection at the sternotomy site after cardiac surgery, a case-control study was done . The study population consisted of 1980 consecutive patients . Cases were all patients who developed a sternal wound infection from which S . aureus was cultured . Forty cases were identified, and 120 controls were selected . Preoperative nasal carriage of S . aureus, insulin-dependent diabetes mellitus, and younger age were identified as significant risk factors . The crude odds ratio of nasal carriage was 9.6 (95% confidence interval, 3.9-23.7) . The median postoperative length of hospital stay for cases was 30 days longer than for controls . Mortality was also significantly higher for cases than for controls (10.0% and 0.8%, respectively).

Lasers Surg Med, 1995, 16(3), 272 - 6
Lethal photosensitisation of Staphylococcus aureus in vitro: effect of growth phase, serum, and pre-irradiation time; Wilson M et al.; BACKGROUND AND OBJECTIVES: Staphylococcus aureus can be killed by low-power laser light in the presence of aluminium disulphonated phthalocyanine (AlPcS2) . The purpose of this study was to determine the effect of pre-irradiation time (PIT), the presence of serum, and the physiological state of the organism on the kills achieved . STUDY DESIGN/MATERIALS AND METHODS: To determine the effect of PIT on killing, suspension of methicillin-resistant S . aureus (MRSA) were incubated in the dark with 12.5 micrograms/ml of AlPcS2 for 60 s or 300 s, and survivors were enumerated after exposure to 1.2 J of light from an 11-mW gallium aluminium arsenide laser . The susceptibility of MRSA in its various growth phases was determined in a similar manner using a PIT of 300 s . The effect of serum on killing was determined using stationary phase cells resuspended in horse serum . RESULTS: Using a PIT of either 60 s or 300 s, 10(6) cfu (99.9%) of MRSA were killed . There was little difference in the susceptibility of lag-, logarithmic-, or stationary-phase cells, the kills being 99.9%, 99.8%, and 99.9%, respectively . Although kills were reduced in the presence of serum, 99.6% of MRSA were killed using a light dose of 1.2 J . CONCLUSION: These results demonstrate that MRSA can be rapidly sensitised by AlPcS2 to killing by low-power laser light, that killing is not dependent on the organism's growth phase, and that substantial kills can be achieved in the presence of serum.

Cardiovasc Intervent Radiol, 1995 Jan-Feb, 18(1), 39 - 42
Persistent iliac endarteritis with pseudoaneurysm formation following balloon-expandable stent placement; Liu P et al.; We present a patient who developed endarteritis and pseudoaneurysm formation complicating iliac artery stent placement . Blood cultures grew Staphylococcus aureus . Three weeks after antibiotic treatment, the aortic bifurcation and the stents were removed, together with the left common iliac artery pseudoaneurysm . As with any other implantable device, septic complications are dreaded and should be recognized and treated early . Consideration may be given to the use of appropriate prophylactic antibiotics.

Rev Rhum Engl Ed, 1995 Jan, 62(1), 29 - 34
Cervical epidural infection . Four case-reports; Soubrier M et al.; The authors report four cases of cervical epidural infection, in two females (aged 58 and 82 years) and two males (aged 41 and 51 years) . Risk factors were noninsulindependent diabetes mellitus in one patient and multiple myeloma treated by chemotherapy in another . Duration of cervical pain at evaluation was five to 15 days . Three patients had a fever and a neurologic deficit: one had brachial diplegia; the myeloma patient developed brachial diplegia after a lumbar puncture and the diabetic patient developed quadriplegia with respiratory disorders also after a lumbar puncture . Cerebrospinal fluid studies showed elevated protein levels with approximately 20 cells per mm3 and no pathogens in smears or cultures . Roentgenograms were normal at admission . The diagnosis was established by myelography (n = 2) and/or computed tomography (n = 2) and/or magnetic resonance imaging (n = 2) . The infected area was anterior in three cases and posterolateral in one . Two to seven vertebral levels were affected . A Staphylococcus aureus was recovered from the blood cultures in all four cases and from a local specimen in one of the two patients who had a laminectomy . Of the two patients who did not have surgery, one had a normal neurologic evaluation and the other was an elderly patient with myeloma . In both, antimicrobial and corticosteroid therapy ensured complete resolution of the infection, and the myeloma patient recovered normal neurologic function . Residual neurologic loss was seen in one of the two surgically-treated patients . Two patients developed discitis.

Scand J Infect Dis, 1995, 27(1), 45 - 9
Disk diffusion susceptibility tests: need for laboratory-specific breakpoints; Manninen R et al.; Significant changes were observed in the measured resistance levels of Escherichia coli and Staphylococcus aureus when the Biodisk disk susceptibility test method used in 1992 was replaced with another commercial method, Oxoid . For example, when non-species-specific breakpoints were used, the frequency of cephalotin-resistant E . coli was 12% of all isolates in 1992 but only 4% in 1993; the corresponding figures for the intermediately resistant isolates were 84% and 8% . The population distribution histograms were however, practically unchanged . Thus, the resistance percentages apparently did not reflect the real development of resistance . Similar findings were also made for several other antimicrobials . Susceptibility test breakpoints should therefore be examined separately for all bacterial species in each laboratory, and the application of adjusted laboratory-specific breakpoints should be considered . For this purpose, the WHONET computer program provides excellent assistance.

Scand J Infect Dis, 1995, 27(1), 19 - 21
Mortality rate and magnitude of Staphylococcus aureus bacteremia as assessed by a semiquantitative blood culture system; Schonheyder HC et al.; A 4-year retrospective study ascertained the relation between the magnitude of Staphylococcus aureus bacteremia and mortality . 253 episodes of S . aureus bacteremia diagnosed in a Danish regional Department of Clinical Microbiology were included . Blood cultures were routinely done by inoculation of aseptically drawn blood into multiple tubes of bacteriological media . The rate of positive tubes was assumed to distinguish high- from low-grade bacteremia without providing an absolute count of colony forming units . The median number of tubes inoculated was 18 (range 6-48) with approximately 0.5-1 ml of blood per tube . The rate of positive tubes was related neither to the source of infection, i.e . whether the S . aureus infection was nosocomially or community-acquired, nor to the portal of entry . However, mortality increased with increasing rate: it was 18% for rates < 0.30, 23% for 0.30-0.69, 30% for 0.70-0.99, and 37% for a rate of 1.0 . Thus, for S . aureus infections the magnitude of bacteremia seems to be a prognostic factor with possible bearings on clinical and therapeutic decisions.

Nephrologie, 1995, 16(3), 229 - 32
{Nasal carriage of Staphylococcus aureus: prevalence in a hemodialysis center and effect on bacteremia}; Roubicek C et al.; We evaluated nasal carriage of Staphylococcus aureus (S . aureus) in 114 hemodialysis patients by performing two nasal swab cultures at a one month interval . The incidence of bacteremia was then followed for one year . Other factors associated with infections in hemodialysis patients, such as diabetes, central venous catheter, and high serum ferritin levels were also evaluated . Nasal carriage of S . aureus was present in 29.8% of patients (34/114) . Six S . aureus bacteremia occurred in 6 patients . This represents an annual incidence of 0.058 bacteremia/patient-year . The incidence of bacteremia was higher in patients with S . aureus nasal carriage (0.0945) than in patients without (0.0417), but the difference was not significant . The relative risk (RR) was 2.35 . On the contrary, bacteremia were significantly more frequent in patients with diabetes (RR = 11.41; p = 0.004) or in patients with central venous catheter (RR = 14.29; p = 0.002) . In conclusion, in our population, diabetes and central venous catheter are more significant risk factors of bacteriemia than S . aureus nasal carriage.

Microbiol Immunol, 1995, 39(2), 153 - 5
Conspicuous growth of intravenously inoculated Staphylococcus aureus in subcutaneously established Ehrlich ascites tumor tissue of mice; Murai M et al.; Intratumoral growth of Staphylococcus aureus was compared with the intrarenal growth, to examine the usefulness of the method as a marker of its pathogenicity . When 5 x 10(7) CFU/mouse of three derivatives from S . aureus Cowan I with different intrarenal growth were intravenously injected into Ehrlich tumor-bearing mice, they lodged in the tumor tissue at approximately 10(3) CFU/0.1 g by 30 min after infection, and grew in the range of 10(6) CFU/0.1 g to 10(8) CFU/0.1 g by day 4, regardless of their intrarenal growth capacity . In contrast, S . saprophyticus lodged in both tissues to the same degree as S . aureus, but did not grow at all . The time course of the staphylococcal growth was different between tumor tissue and kidney, suggesting differences in the local responses against S . aureus.

Eur Surg Res, 1995, 27(3), 189 - 96
Effect of allogeneic polymorphonuclear neutrophils on staphylococcal sepsis in mice; Belotsky S et al.; The antibacterial and host-damaging properties of locally injected allogeneic polymorphonuclear neutrophils (PMN) were studied in vivo . Peritoneal PMN were obtained from donor mice 24 h after i.m . infection with sublethal (SD) and lethal (LD) dose of Staphylococcus aureus . These donor PMN were mixed with S . aureus and injected i.m . into normal recipient mice . Normal donor PMN and PMN obtained from SL-infected donor mice did not induce the mortality of SL-infected recipient mice but protected LD-infected recipients (5.8% mortality vs . 29.4%) . PMN obtained from LD-infected donor mice caused ca . 77% mortality in SD-infected recipients . In survivors, during the first 3 h infection, serum tumor necrosis factor (TNF) concentrations were higher than those in nonsurvivors and then decreased . In contrast, TNF level in nonsurvivors continued to be increased until death . PMN from LD-infected donors had the highest spontaneous chemiluminescence response (CL), the shortest time of peak and the lowest level of intracellular CL against S . aureus . These donor PMN exhibited increased phagocytosis and decreased killing of S . aureus than that of PMN of SD-infected donor mice . Early stimulation of PMN functions such as bacterial internalization and respiratory burst may result in decrease of their tissue-damaging properties.

J Vet Diagn Invest, 1995 Jan, 7(1), 82 - 6
Detection of anti-listeriolysin O in dairy cattle experimentally infected with Listeria monocytogenes; Baetz AL et al.; A dot-blot assay and an enzyme-linked immunosorbent assay (ELISA) to detect listeriosis in dairy cattle were developed that detected anti-listeriolysin O antibodies in the serum of cows experimentally infected with Listeria monocytogenes . The tests utilized purified listeriolysin O (LLO) as the detection antigen and streptolysin O (SLO) to absorb cross-reacting antibodies . The two tests were compared with an agglutination test that used formalin-killed whole L . monocytogenes cells . Blood samples were collected periodically from 17 cows after intramammary gland infection, and the development of anti-LLO antibodies was followed by an agglutination test, the dot-blot test, and the ELISA . In general, an agglutination titer of > 640 was needed for a positive dot-blot anti-LLO test for nonpregnant cows . However, 1 pregnant cow with an agglutination titer of 20 was positive in the dot-blot test . The ELISA was as sensitive as the dot-blot assay but gave a quantitative measurement to distinguish serum samples of positive reactors from cross-reactors . The specificity of the LLO-based tests was further evaluated using serum from cows that had been experimentally infected with Staphylococcus aureus, 17 of which had agglutination titers for L . monocytogenes > 640 . These elevated agglutination titers were probably due to cross-reacting bacterial antigens because serum from 9 of 17 of these animals did not react to the purified LLO antigen . A positive response to the LLO-based dot-blot and ELISA assays is indicative of previous or current infection with L . monocytogenes.

Zh Mikrobiol Epidemiol Immunobiol, 1995 Jan-Feb, (1), 75 - 8
{The demonstration of the genes controlling enterotoxigenicity in Staphylococcus aureus strains by using the polymerase chain reaction}; Grabovetskii VV et al.; The selection and subsequent synthesis, according to the nucleotide sequences of S . aureus genes responsible for the expression of enterotoxins A and B, of highly specific primers for polymerase chain reaction Pcr were carried out with the use of the program "Primer" . The optimum temperature conditions of polymerase chain reaction for all pairs of primers were selected . The method for the rapid determination of the enterotoxigenic properties of S . aureus strains by means of Pcr was proposed . The enterotoxigenic properties of several S . aureus strains were determined, which revealed that 3 clinical isolates had the gene of enterotoxin A in their genome, while laboratory strain FRI-722(H) carried the genes of enterotoxins A and B.

Zh Mikrobiol Epidemiol Immunobiol, 1995 Jan-Feb, (1), 66 - 9
{The lymphocyte proliferative response to Staphylococcus aureus antigen in mice with an opposite susceptibility to staphylococcal infection}; Averbakh MM et al.; The difference between the proliferative response of spleen cells to S . aureus cytoplasmic antigen on days 5 and 9 of the infectious process was shown in experiments of CBA and C3HA mice, opposite in their susceptibility to systemic staphylococcal infection . Hybrid mice F1 (CBA x C3HA) inherited a high level of proliferative response on day 5 (as in resistant CBA mice) and its low level on day 9 (as in susceptible C3HA mice) . These data on genetic differences in proliferative response to S . aureus cytoplasmic antigen were confirmed in the test of the proliferation of lymph node lymphocytes taken from mice of these lines immunized with the above-mentioned antigen in Freund incomplete adjuvant into the pad of their paws 14 days before the test.

J Antimicrob Chemother, 1995 Jan, 35(1), 95 - 102
In-vitro and in-vivo selection of Staphylococcus aureus mutants resistant to ciprofloxacin; Doss SA et al.; Staphylococcus aureus mutants resistant to ciprofloxacin were selected both in vitro and in vivo . In-vitro selection was achieved by incubating two strains of S . aureus (MICs of ciprofloxacin of 0.5 and 4 mg/L respectively) in the presence of ciprofloxacin in concentrations equivalent to 1/2 x MIC for 24 h and isolating the mutants on agar containing the quinolone at 1, 2 or 5 x MIC . Stably-resistant mutants of both strains were isolated, although the frequency of mutation of the susceptible strain was higher than that of the resistant strain . A murine subcutaneous abscess model was used for in-vivo selection . Mice which had been infected with a ciprofloxacin-susceptible strain of S . aureus were treated for 24 h with ciprofloxacin in a dosage which yielded concentrations in the abscess cavity equivalent to 1/2 or 1 x MIC for the pathogen . Additional groups of infected mice received ciprofloxacin for varying periods in a dosage which produced concentrations at the site of infection equivalent to 1/2 x MIC . Stably-resistant mutants were isolated from the abscesses, the number of mice from which mutants were isolated and the mutational frequency being inversely proportional to the dosage of ciprofloxacin administered and the duration of treatment . The results of this study confirm that, in the treatment of patients with infections caused by S . aureus, the dosage of ciprofloxacin should be adequate to ensure inhibitory concentrations at the site of infection.

J Ind Microbiol, 1995 Jan, 14(1), 21 - 5
Comparison of Dey and Engley (D/E) neutralizing medium to Letheen medium and standard methods medium for recovery of Staphylococcus aureus from sanitized surfaces; Dey BP et al.; The ability of Dey and Engley (D/E) Neutralizing Medium to recover Staphylococcus aureus ATCC 6538 from tile surfaces exposed to a commercial phenol (Mikro-Bac) and a quaternary ammonium compound (Mikro-Quat) was compared to recovery with Letheen Medium . Standard Methods Medium was used as a control recovery medium . Organisms were exposed to both antimicrobials for varying time periods, then were recovered by swab and Rodac plate on both test media . The recovery by either procedure was significantly higher with Dey and Engley (D/E) Neutralizing Medium than with Letheen and Standard Methods Medium . The D/E Medium shows promise for evaluating antimicrobial chemicals used in environmental sanitation.

New Microbiol, 1995 Jan, 18(1), 41 - 51
Antibiotic resistance, plasmid content, phage type, and capsule type of Staphylococcus aureus isolates at a children's hospital; Salamah AA; One hundred clinical isolates of Staphylococcus aureus were obtained from Al-Solimaniah Children's Hospital, Riyadh, Saudi Arabia . The isolates were screened for their antibiotic susceptibility, plasmid profiles, phage types, and capsular polysaccharide types . A total of 29 antibiotic resistance patterns were obtained . Nine plasmids were detected and 18 plasmid profiles were obtained . Thirteen isolates were non-phage-typeable and 14 different phage-typing-patterns were obtained from the other 87 isolates . Thirty eight isolates were capsular polysaccharide type 8 and 56 were capsular polysaccharide type 5; the other 6 isolates were non typeable . According to the above typing criteria, the isolates were divided into 13 groups . Plasmid profiles were found to be superior to phage typing, whereas, phage typing was superior to the antibiogram as a technique for determining similarities and differences among S . aureus hospital isolates.

J Pediatr Ophthalmol Strabismus, 1995 Jan-Feb, 32(1), 42 - 9
Periocular infection after strabismus surgery . The Periocular Infection Study Group; Kivlin JD et al.; Fewer than 15 cases of cellulitis and subconjunctival abscess after extraocular muscle surgery have been reported in detail . In an effort to provide greater information about this serious complication, the members of the American Association for Pediatric Ophthalmology and Strabismus (AAPO&S) were surveyed and contributed cases were analyzed . Among the 25 cases of cellulitis, there was a predominance of preschool age patients and Staphylococcus aureus cultures . Many cases presented after a normal initial postoperative visit . The most common symptoms were marked swelling and pain . Possible predisposing factors included unsuspected sinusitis, eye rubbing, and poor hygiene . Two patients had documented bacteremia, but no patient developed endophthalmitis . All cases resolved on antibiotics, but only five patients were successfully treated with oral antibiotics alone . Periocular infections after extraocular muscle surgery can present after a normal initial postoperative visit . Symptoms of marked swelling and pain are cause for closer inspection . S . aureus is the most common organism and oral antibiotics alone can fail to halt the infection.

Kansenshogaku Zasshi, 1995 Jan, 69(1), 21 - 7
{On the antibacterial effect of hinokitiol against Staphylococcus aureus showing double zone phenomenon}; Matsunaga T et al.; We studied the antibacterial effect of Hinokitiol against Staphylococcus aureus . As reference, we studied also the antibacterial effects of the oil and water from Thujopsis dolablata var . hondai Makino which contains Hinokitiol an important element of its antibacterial effect . Interestingly, Hinokitiol showed the double zone phenomenon, i.e., minimum inhibitory concentration of hinokitiol against MSSA was 15-125 micrograms/ml and against MSSA was 125 micrograms/ml . But when the concentration of Hinokitiol was diluted to 1.87-0.94 micrograms/ml, then the growth of MSSA was inhibited (Table 1 and Fig . 1) . This phenomenon was observed the study on antibacterial effect using disk containing Hinokitiol (Fig/3) . Similar phenomenon were observed also in the study using water from Thujopsis dolablata (Table 2 & Fig . 2) . We deduce that Hinokitiol has a strong antibacterial effect against S . aureus . But this effect shows double zone effect . The antibacterial effect of Hinokitiol is more prominent against MRSA than MSSA.

J Med Microbiol, 1995 Jan, 42(1), 43 - 7
No difference in enterotoxin production among Staphylococcus aureus strains isolated from blood compared with strains isolated from healthy carriers; Roder BL et al.; The production of enterotoxin A, B, C and D by 196 Staphylococcus aureus strains isolated from blood cultures and 95 strains from nasal carriers was investigated . Half of the bacteraemia strains were from patients who died with or because of their infection, the other half from patients who survived . The nasal strains were selected to match the bacteraemia strains regarding phage types . Overall, 30.6% of the bacteraemia strains and 40.0% of the nasal strains produced enterotoxins; enterotoxins B and C were the toxins produced most frequently in both groups . A similar incidence and pattern of enterotoxin production was found among the bacteraemia strains of S . aureus regardless of acquisition of the infection, the portal of entry, presence or absence of endocarditis and outcome of the infection . Thus, the concept that the enterotoxins play an important role in staphylococcal infections, apart from the diseases caused by the toxins per se such as food poisoning and toxic shock syndrome, cannot be substantiated by the results of the present study.

J Fr Ophtalmol, 1995, 18(2), 106 - 13
{Organ culture preservation of the human cornea at +31 degrees C and risk of infection}; Erbezci M et al.; PURPOSE: In order to reduce the risk of infection, we analyzed each stage of conservation of human cornea in organ culture at +31 degrees C . METHODS: This epidomiological study was conducted in 266 human corneas preserved in organ culture between January 1991 and December 1993 . There were 3 stages: In the period of preservation (analysis of the contaminated medium), Before clinical use of the graft (analysis of the preservation medium), After the penetrating keratoplasty (analysis of the corneo-scleral rim and the transportation medium) . The bacteriological media used were thioglycolate broth, trypticase soja and Sabouraud . RESULTS: In 266 storage media, 42 (15.7%) cultures are positive . The most commonly found organism was Staphylococcus aureus (21.4%) . At the end of the conservation procedure, all of the cultures of the media were sterile (n = 165) . After penetrating keratoplasty, 8 cultures were positive for the transportation medium and the corneo-scleral rim (5.1%), 3 cultures were positive for the corneo-scleral rim only (1.9%) and 5 cultures were positive (3.2%) for the transportation medium without contamination of the corneo-scleral rim . CONCLUSION: Preservation at +31 degrees C in organ culture of human corneas allows elimination of the contaminated or potentially contaminant corneas before an eventual transplantation . In our experience, the risk of infection is especially situated in the period of preservation which shows the insuffiency of the decontamination procedures or the antibiotical content of the medium and probably the virulence of the organisms in donors hospitalized for long period.

Rev Alerg Mex, 1995 Jan-Feb, 42(1), 9 - 13
{In vitro effect of bacterial extracts of S . aureus in chemokinesis and chemotaxis of polymorphonuclear cells}; Cisneros Gonzalez N et al.; The purpose of the study was to determine if the extract of Staphylococcus aureus in vitro can modify chemokinesis and induce chemotaxis of polimorphonuclear (PMN) cells of peripheral blood in healthy donors . Chemocinesis and chemotaxis of PMN of peripheral blood in 30 healthy donors of either sex from 18 to 40 years old was measured . A 5 mL sample of peripheral blood was drawn . PMN were separated by Boyum's method and challenged with of Staphylococcus aureus extract and C5a as chemotactic factors, and Hank's solution chemokinesis . Chemokinesis was 54.6 +/- 8.8 microns, chemotactic response to C5a was 89 +/- 12.5 microns and with bacterial extract the response was 103 +/- 20.1 microns (p) . In conclusion, complete extract of Staphylococcus aureus stimulates in vitro chemotaxis of PMN from healthy donors, and this stimulation is similar to known chemotactic factors as C5a.

Kidney Int, 1995 Jan, 47(1), 207 - 16
Glomerulonephritis associated with MRSA infection: a possible role of bacterial superantigen; Koyama A et al.; We report 10 cases of glomerulonephritis following methicillin-resistant Staphylococcus aureus (MRSA) infection . The clinical features of this syndrome were an abrupt or insidious onset of rapidly progressive glomerulonephritis (RPGN) with nephrotic syndrome and occasionally purpura, following MRSA infection . The renal histologic findings showed a variety of types of proliferative glomerulonephritis with varying degrees of crescent formation; immunofluorescence revealed of glomerular deposition of IgA, IgG, and C3 . Laboratory findings showed polyclonal increases of serum IgA and IgG, with high levels of circulating immune complexes (ICs) . Increased numbers of DR+CD4+, and DR+CD8+T cells were observed in the peripheral circulation, with a high frequency of T cell receptor (TCR) V beta + cells . MRSA produced enterotoxins C and A and toxic shock syndrome toxin (TSST)-1, all of which are known to act as superantigens . From the above observations, we speculate that post-MRSA glomerulonephritis may be induced by superantigens causing production of high levels of cytokines, and polyclonal activation of IgG and IgA . The formation of ICs containing IgA and IgG in the circulation result in development of glomerulonephritis and vasculitis . Accordingly, microbial superantigens may play an important role in the pathogenesis of this unique syndrome of nephritis and vasculitis.

Eur J Clin Microbiol Infect Dis, 1995, 14 Suppl 1, S3 - 5
Usefulness of pulsed-field gel electrophoresis in the epidemiological analysis of Staphylococcus aureus isolates with decreased susceptibility to teicoplanin; Goering RV et al.; Pulsed-field gel electrophoresis for analysis of comparatively mega-base sized chromosomal restriction fragments is an important molecular technique in the epidemiological study of a variety of nosocomial pathogens . The usefulness of this approach is demonstrated in the evaluation of Staphylococcus aureus isolates exhibiting decreased susceptibility to teicoplanin in two clinical settings: multiple cultures from a single patient and isolates from different patients within the same hospital.

Eur J Clin Microbiol Infect Dis, 1995 Jan, 14(1), 43 - 6
Frequency of toxic shock syndrome toxin- and enterotoxin-producing clinical isolates of Staphylococcus aureus; Lehn N et al.; In 183 clinical isolates of Staphylococcus aureus, toxic shock syndrome toxin was detected in 13.7%, enterotoxin A in 20.2%, enterotoxin B in 7.7%, enterotoxin C in 5.5% and enterotoxin D in 3.3% . Seventy-three (39.9%) of the strains were found to produce one or more toxins . Multiple secretion of toxins was rare (< 1% of all strains) except for the combinations enterotoxin A with toxic shock syndrome toxin and enterotoxin A with enterotoxin D . These combinations were observed at significantly higher frequencies (4.9% and 2.2%, respectively) than would have been expected from values calculated from respective individual frequencies (0.88% and 0.06%) (p < 0.0001) . In comparison with Staphylococcus aureus strains isolated from miscellaneous material, Staphylococcus aureus blood culture isolates produced enterotoxin D in significantly larger amounts and at higher frequencies (p = 0.01 in both cases) . These toxins might play an important pathogenic role in Staphylococcus aureus infections.

Eur J Clin Microbiol Infect Dis, 1995 Jan, 14(1), 34 - 40
Nasopharyngeal carriage of Staphylococcus aureus and carriage of tetracycline-resistant strains associated with HIV-seropositivity; Amir M et al.; The aim of this prospective study was to investigate the relationship between carriage of antibiotic-resistant Staphylococcus aureus and infection with the human immunodeficiency virus (HIV) . A total of 554 pernasal swabs was taken during a six-month period from 554 adult patients attending three outpatient clinics and from inpatients from a hospital in Nairobi, Kenya . Overall, 121 swabs (22%) yielded Staphylococcus aureus, there being significantly higher carriage in HIV-positive patients (71/264, 27%) than in HIV-negative patients (50/290, 17%); p = 0.008 . Antimicrobial resistance rates were determined for 110 isolates and were high for penicillin (91%) and tetracycline (72%) and low for erythromycin (8%), methicillin (3%), gentamicin (5%) and chloramphenicol (0%) . Genetic analysis showed plasmids in the range of 24-42 MDa to be associated with beta-lactamase production and plasmids in the range of 3-5 MDa to be associated with resistance to tetracycline, erythromycin and trimethoprim . All nine erythromycin-resistant strains were from HIV-positive patients (p = 0.02) . There was a significant association of tetracycline resistance with HIV seropositivity (p = 0.002) . The association of HIV seropositivity with Staphylococcus aureus carriage and carriage of antibiotic-resistant strains against the background of the HIV epidemic are of relevance in individual patient care and raise concern for public healthPIP: The authors report findings from a prospective study conducted to investigate the relationship between the carriage of antibiotic-resistant Staphylococcus aureus and infection with HIV . 554 pernasal swabs were taken during a six-month period from 554 adult patients attending three outpatient clinics and from inpatients in a hospital in Nairobi, Kenya . 22% of swabs yielded Staphylococcus aureus, with significantly higher carriage in HIV-positive patients than in HIV-negative patients: 27% and 17%, respectively . Antimicrobial resistance rates determined for 110 isolates were 91% for penicillin, 72% for tetracycline, 8% for erythromycin, 3% for methicillin, 5% for gentamicin, and 0% for chloramphenicol . Genetic analysis identified plasmids in the range of 24-42 MDa associated with B-lactamase production and plasmids in the range of 3-5 MDa associated with resistance to tetracycline, erythromycin, and trimethoprim . All nine erythromycin-resistant strains were from HIV-positive patients . There was a significant association of tetracycline resistance with HIV seropositivity .

ASAIO J, 1995 Jan-Mar, 41(1), 127 - 31
Elimination of Staphylococcus aureus in hemodialysis patients; Bommer J et al.; Staphylococcus aureus infection and its complications are of great concern in the care of hemodialysis patients . Nasal contamination with S . aureus seems to be the main source of cutaneous contamination . The decontamination and recontamination of the skin of hemodialysis patients after using mupirocin nasal ointment was followed in a placebo control study . After 10 days of therapy with mupirocin nasal ointment, 25 of 33 (73%) patients were free of nasal S . aureus contamination in the nares (control subjects 2 of 21, 10%) . At the same time, the prevalence of positive skin cultures for S . aureus decreased from 30 of 33 (90%) to 11 of 33 (33%) patients . However, during the ensuing 130 days, 14 of 25 (58%) patients with negative nasal cultures became recontaminated, while the skin became recontaminated in 11 of 22 (50%) patients . In 10 of 14 S . aureus recontaminated patients the original S . aureus lysotype was documented by specific phage reaction . Four of fourteen patients had a new S . aureus lysotype . Mupirocin nasal ointment eradicated S . aureus transiently in 75% of the patients but continuously in only 11 of 33 (30%) patients.

Clin Infect Dis, 1995 Jan, 20(1), 95 - 102
Persistent and relapsing infections associated with small-colony variants of Staphylococcus aureus; Proctor RA et al.; Small-colony variants (SCVs) of Staphylococcus aureus were cultured from five patients with persistent and relapsing infections . All five SCV strains were nonhemolytic and nonpigmented and grew very slowly on routine culture media in an ambient atmosphere . In several instances, these phenotypic characteristics led to the initial misidentification of the organisms in the clinical microbiology laboratory . All four strains available for further analysis were shown to be auxotrophs that reverted to normal growth and morphology in the presence of menadione, hemin, and/or a CO2 supplement . Similarly, these isolates were resistant to aminoglycosides under routine conditions but susceptible in the presence of the metabolic supplements . For two patients, the large and small colony forms isolated concurrently were indistinguishable when analyzed by pulsed field gel electrophoresis and thus represented phenotypic variants within individual clones . We propose a model relating the phenotypic characteristics of S . aureus SCVs with the clinical pattern of persistent and relapsing infection.

Vox Sang, 1995, 68(1), 5 - 8
Pharmacokinetics of single and multiple infusions of 5S intravenous immunoglobulin; Theobald K et al.; A prospective, open and uncontrolled trial was performed to investigate the pharmacokinetics of a 5S intravenous immunoglobulin (IVIG) after single and multiple infusions . Twelve healthy volunteers received a 5S-IVIG enriched in antibodies against Staphylococcus aureus alpha-toxin (aSAT) either as a single infusion or as three infusions in daily intervals . The fate of the injected immunoglobulin was observed by serial measurements of the serum level of aSAT titres . The 5S-IVIG had a half-life with a median of 0.24 (distribution) and 2.0 (terminal) days, respectively . The pharmacokinetic parameters did not differ with dose groups or number of applications . The study medication was well tolerated.

Res Vet Sci, 1995 Jan, 58(1), 20 - 5
Effect of alpha-toxin and capsular exopolysaccharide on the adherence of Staphylococcus aureus to cultured teat, ductal and secretory mammary epithelial cells; Cifrian E et al.; Cultures of teat, ductal and secretory epithelial cells were used to study the role of alpha-toxin and the capsular exopolysaccharide on the adherence of Staphylococcus aureus to mammary epithelium . The adherence of S aureus to the cells and their susceptibility to damage by alpha-toxin increased from teat to ductal to secretory cells . Alpha-toxin increased the susceptibility of epithelial cell monolayers to adherence by S aureus, and the extent of the adherence increased with the time of exposure to alpha-toxin . The exopolysaccharide capsule deterred the adherence of S aureus to mammary epithelial cells and to collagen . Organisms with a rigid capsule adhered to a smaller extent than those with a flaccid capsule . Both encapsulated and unencapsulated S aureus adhered more readily to collagen than to either healthy monolayers of epithelial cells or monolayers of cells damaged by alpha-toxin.

J Clin Nurs, 1995 Jan, 4(1), 5 - 12
Staphylococcus aureus: a review of the literature; Gould D et al.; Staphylococcus aureus has a long association with nosocomial infection . Problems date from the 1950s, although methicillin-resistant Staphylococcus aureus (MRSA) did not emerge until the following decade . Initially the pathogenicity of antibiotic-resistant strains was underestimated, and is still sometimes questioned, but today most authorities consider MRSA a serious threat, especially given current preoccupation with cost-effectiveness within the health service: nosocomial infection is associated with increased expenditure and may be regarded as a hallmark of indifferent nursing and medical care . This review documents the emergence of MRSA and recognition of the ensuing problems throughout the 1980s and early 1990s, with suggestions for nursing activities which could contribute towards improved control . Lessons learnt during outbreaks are seen to be of value, but there is also a need for staff at ward level to review routine practice continually so that awareness of activities likely to result in cross-infection is maintained . The use of protective clothing emerges as less important than handwashing, which may be periodically audited to maintain standards.

In Vitro Cell Dev Biol Anim, 1995 Jan, 31(1), 67 - 70
Innate immune properties of the immortalized macrophage cell line I-9.5; Chang W et al.; A colony stimulating factor-1-dependent macrophage cell line, I-9.5, originally derived from a BALB/c splenic macrophage colony, was maintained in culture and examined for the expression of certain properties key to its innate immune function . Chemotaxis, phagocytosis, and superoxide release were assessed in this cell line and compared to either freshly isolated elicited murine peritoneal or splenic macrophages from BALB/c mice . Three separate experiments indicated that I-9.5 displayed comparable phagocytosis of 14C-radio-labeled Staphylococcus aureus and similar levels of superoxide release in response to opsonized zymosan . I-9.5, however, demonstrated impaired chemotaxis toward the chemoattractant, N-formyl-methionyl-leucyl-phenylalanine, and displayed impaired random migration in response to a balanced salt solution . This observation suggests that I-9.5 may serve as an important model for elucidating the structural and molecular correlates of chemotaxis.

Ann Cardiol Angeiol (Paris), 1995 Jan, 44(1), 21 - 4
{Purulent pericarditis in dermatopolymyositis}; Falcon-Eicher S et al.; The authors report the case of a 33-year-old patient with dermatopolymyositis, admitted to hospital for acute cystic pericarditis with fever and deterioration of the general state . The aetiological diagnosis was obtained by analysis of the pericardial fluid after surgical drainage, revealing purulent Staphylococcus aureus pericarditis . This case emphasises that, despite the marked rarity of pericardial effusion in the course of dermatopolymyositis, due to the steroid sensitivity of this disease, the possibility of septic contamination should be considered in the presence of persistent pericarditis in the context of this disease.

J Clin Microbiol, 1995 Jan, 33(1), 96 - 8
Four-year prospective study of STAPH-IDENT system and conventional method for reference identification of Staphylococcus, Stomatococcus, and Micrococcus spp.; Rhoden DL et al.; A 4-year prospective study compared the accuracy of the STAPH-IDENT system (bioMerieux Vitek, Inc., Hazelwood, Mo.) with that of the reference procedure of the Centers for Disease Control and Prevention for the identification of Staphylococcus species, Stomatococcus mucilaginosus, and Micrococcus species . The study compared the results from 1,106 cultures (500 eye cultures, 217 strains submitted for reference identification, and 389 known stock strains) representing 21 species of the family Micrococcaceae . The overall agreement of genus and species identifications was 81.1% . The percent agreement for the five most common clinical isolates was as follows: Staphylococcus epidermidis, 97.1% (517 isolates); Staphylococcus hominis, 82.5% (57 isolates); Staphylococcus aureus, 77.2% (162 isolates); Staphylococcus haemolyticus, 75.8% (61 isolates); and Staphylococcus warneri, 64.1% (39 isolates) . The lowest percent agreement was with Staphylococcus cohnii (11.1%; (9 isolates) . Of the 217 isolates sent to the Centers for Disease Control and Prevention for identification, 60.4% (131) were correctly identified by the STAPH-IDENT system . Of these, S . epidermidis accounted for 23.9%, S . aureus accounted for 15.6%, S . warneri accounted for 6.9%, Staphylococcus lugdunensis accounted for 6.5%, S . haemolyticus accounted for 5.5%, and S . hominis accounted for 4.1% . The STAPH-IDENT system did not perform adequately when dealing with commonly encountered organisms and is unsuitable for identifying uncommon isolates.

Antimicrob Agents Chemother, 1995 Jan, 39(1), 175 - 9
Comparative study of mupirocin and oral co-trimoxazole plus topical fusidic acid in eradication of nasal carriage of methicillin-resistant Staphylococcus aureus; Parras F et al.; Mupirocin is a topically applied drug that is very active in the eradication of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) . However, studies designed to compare mupirocin treatment with other antimicrobial regimens are lacking . We therefore conducted an open, prospective, randomized, controlled trial to compare the efficacy and safety of mupirocin versus those of oral co-trimoxazole plus topical fusidic acid (both regimens with a clorhexidine scrub bath) for the eradication of MRSA from nasal and extranasal carriers of MRSA . The eradication rates with mupirocin and co-trimoxazole plus fusidic acid at 2, 7, 14, 21, 28, and 90 days were 93 and of 93, 100 and 100, 97 and 94, 100 and 92, 96 and 95, and 78 and 71%, respectively, for nasal carriage . At 7, 14, and 28 days the eradication rates for extranasal carriage by the two regimens were 23 and 74, 83 and 76, and 45 and 69%, respectively . The efficacies and safety of both regimens were similar . The MRSA isolates were not resistant to the study drugs either at the baseline or at follow-up . These results suggest that mupirocin and co-trimoxazole plus fusidic acid, both used in conjunction with a chlorhexidine soap bath, are equally effective and safe for the eradication of MRSA from nasal and extranasal MRSA carriers . Mupirocin was easier to use but was more expensive.

Antimicrob Agents Chemother, 1995 Jan, 39(1), 103 - 6
Point mutations in Staphylococcus aureus PBP 2 gene affect penicillin-binding kinetics and are associated with resistance; Hackbarth CJ et al.; In Staphylococcus aureus, penicillin-binding protein 2 (PBP 2) has been implicated in non-PBP 2a-mediated methicillin resistance . The PBP 2 gene (pbpB) was cloned from an expression library of a methicillin-susceptible strain of S . aureus (209P), and its entire sequence was compared with that of the pbpB gene from strains BB255, BB255R, and CDC6 . Point mutations that resulted in amino acid substitutions near the conserved penicillin-binding motifs were detected in BB255R and CDC6, two low-level methicillin-resistant strains . Penicillin binding to PBP 2 in both BB255R and CDC6 is altered, and kinetic analysis indicated that altered binding of PBP 2 by penicillin was due to both lower binding affinity and more rapid release of bound drug . These structural and biochemical changes may contribute to the strains' resistance to beta-lactam antibiotics.

Przegl Epidemiol, 1995, 49(1-2), 17 - 21
{Carrier status of Staphylococcus aureus among students of different courses}; Bryl M et al.; Staphylococcus aureus is a frequent pathogen of nosocomial infections . The main part in the spread of these microorganisms take symptomless carriers . The aim the research was defining the carrierstate of S . aureus among students of Medical Academy and University . The investigation showed a greater carrierstate in the group of Medical students (33%) than in the group of University students . Strains isolated from the Medical students were more differentiated in biochemical tests and they were more drug-resistant mainly to Augmentin (51.5% resistant strains) and doxycycline (24% resistant strains) . A great percentage of ampicillin-resistant strains (94%) was found among the strains isolated from both groups . Results of the research showed greater carrierstate among people who had direct contact with patients and infectious materials and proved a wide range of drug-resistance among hospital strains . Carriers of S . aureus among medical personnel could influence the spreading of nosocomial infections mainly on ICU and Newborn Wards.

J Biomater Sci Polym Ed, 1995, 7(1), 49 - 60
Effect of toluene extraction on Biomer surface: I . ESCA, ATR/FTIR, contact angle analysis and biological properties; Nurdin N et al.; Biomer is a poly(ether-urethane-urea) block copolymer widely used as biomedical devices . Extraction process of this polymer has purified its surface of low molecular weight polyurethane chains and Santowhite Powder additive . ESCA and ATR/FTIR have suggested a homogenization of the polymer by enrichment of the first layers with poly(aminomethacrylate) additive after extraction . Therefore, the surface of the extracted Biomer exhibits a different wettability and biological response . The treatment causes a significant decrease in fibronectin adsorption and induces a reduction in Staphylococcus aureus adhesion.

Acta Biochim Pol, 1995, 42(1), 119 - 23
Energetics of Cd2+ efflux system in cadmium-resistant Staphylococcus aureus 17810R; Tynecka Z et al.; Energetics of 109Cd efflux in resting cells of cadmium-resistant Staphylococcus aureus 17810R was assayed in 1 or 100 mM potassium/sodium phosphate buffer, pH7 (PB) . Experiments with the use of inhibitors and ionophores showed that Cd2+ extrusion in this organism required ATP and either a pH gradient (delta pH) in 1 mM PB or membrane potential (delta psi) in 100 mM PB . The role of high phosphate ion concentration in delta psi-dependent Cd2+ efflux is discussed.

Microbios, 1995, 82(332), 181 - 5
Broth micro-dilution method for determining the susceptibility of Escherichia coli and Staphylococcus aureus to the essential oil of Melaleuca alternifolia (tea tree oil); Carson CF et al.; A broth micro-dilution method was used to examine the susceptibility of Escherichia coli (n = 110) and Staphylococcus aureus (n = 105) to the essential oil of Melaleuca alternifolia (tea tree oil) . The detergent Tween 80 was used successfully to enhance the solubility of tea tree oil in the test medium . The MIC90 of tea tree oil for E . coli was 0.25% while for S . aureus it was 0.50%.

Blood Purif, 1995, 13(3-4), 171 - 9
Research directions in peritoneal dialysis infections; Piraino B; There are many promising areas of research on peritoneal dialysis related infections . Improvements in connection technology, especially the Y set and CCPD, have led to a decrease in the rate of peritonitis due to Staphylococcus epidermidis . The search to find a more biocompatible dialysate that is less immunocompromising is underway; clinical trials examining peritonitis rates with these new formulations remain to be performed . Considerable progress has been made in elucidating peritonitis related to catheter infection, especially that due to Staphylococcus aureus . Nasal carriage has been identified as a risk factor for subsequent infections . Several prophylactic antibiotic approaches including rifampin, trimethoprim/sulfamethoxazole and mupirocin have shown promise in reducing these infections . Innovative catheter designs that decrease the risk of bacterial colonization are another investigative approach . The timing of both catheter removal and replacement for infection is controversial and requires further study . Lastly, much remains to be learned about peritonitis from an enteric source.

Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi, 1995 Jan, 11(1), 45 - 8
{The effects of mupirocin on burned wound with Staphylococcus aureus infection}; Deng S et al.; The therapeutic results of 41 cases of S . aureus infected burn wound (average 2.1% TBSA, approximately 200 cm2) treated with Mupirocin are reported in this paper . The effects of Mupirocin was obviously superior to that of SD-Ag used in control group . During the observation period the total effective rate of the studied group was 88.9% (control group: 70%, P < 0.05) and the bacterial clearance rate of S . aureus from the wound was 88.8% (control group: 40% P < 0.05) . The sensitivity of 30 strains of S . aureus isolated from burn wounds to 11 varieties of antibiotics indicated that the sensitive rate to Mupirocin was as high as 92.68%, only lower that Vanconmycin . The bacteriological assay (MIC < or = 0.25 mg/L, MIC < or = 4 mg/L) also showed high sensitivity of S . aureus to Mupirocin . We suggest Mupirocin be the first choice of topical antibacterial agents for burn wound with S . aureus infection, especially for infection with MRSA.

Acta Orthop Belg, 1995, 61(2), 126 - 34
Septic arthritis: Arthroscopic management with local antibiotic treatment; Jerosch J et al.; In a retrospective study, the results of arthroscopic treatment of septic arthritis were evaluated in 12 patients . Ages ranged from 4 to 57 years . The knee joint was affected in 9 cases, the elbow in 2 cases, and the shoulder joint in one case . In 3 patients the infection was hematogenous . Four patients had a postoperative infection and in 5 patients the infection followed an intraarticular injection . The indication for arthroscopic treatment was based on clinical findings, an increased ESR and/or CRP, an increase in leukocyte count in the joint fluid and no bone involvement on x-ray . Arthroscopic management was performed according to the intraoperative findings (lavage, debridement, synovectomy) . The procedure was completed by intraarticular placement of an antibiotic collagenous fleece . Additionally systemic antibiotics, active against staphylococcus aureus, were used for perioperative therapy before starting a specific antibiotic treatment according to the cultured organism . In 10 out of 12 cases the infection was cured by one operation . Because of the advantages of arthroscopic treatment, it should be performed as soon as joint infection is confirmed.

Surg Today, 1995, 25(6), 483 - 9
Nosocomial propagation of multiresistant Staphylococcus aureus: an analysis using biotyping and drug sensitivity; Yoshida J et al.; We performed an epidemiologic study of multi-resistant Staphylococcus aureus in our hospital . We combined bacteriologic biotyping and sensitivity to 19 drugs to conduct an environmental investigation . We assumed that complete matching in two or more strains denoted nosocomial propagation . A total of 667 isolates were recovered from a total of 144 patients . In a general surgical ward, 19 (52.8%) out of 36 patients developed an infection . The number of strains for every biotype and the combined susceptibility tended to show negative correlation (r = -0.376) before and after 1990, when an isolation policy was initiated . A similar regression analysis disclosed that between the general surgical ward and other wards the number of strains tended to show a positive association (r = 0.349) . Thus, the isolation system employed in the general surgical ward may have arrested the persistence of intraward strains but permitted the interward travel of strains . In conclusion, an analysis of the propagation of multiresistant S . aureus using biotyping and drug sensitivity was found to be an effective method for evaluating the most appropriate measures to counter the endemic spread of this microbe.

Zentralbl Chir, 1995, 120(8), 630 - 4
{Prevention and therapy of prosthesis infections in the thoracic area}; Haverich A et al.; Infections of vascular prostheses following replacement of the thoracic aorta remain a rare complication, fortunately . The incidence of prosthetic infection amounts to approximately 1.6%, however, there is only limited information from single center studies, and linearized actuarial data for more exact estimations are not available . Experience with prophylaxis and treatment of bacterial endocarditis as well as data available from peripheral vascular reconstruction nevertheless allow the development of treatment strategies concerning this complication . Experimentally, there is clear evidence that pretreatment of Dacron-grafts using the fibrin sealant-antibiotic compound results in a significant protection from infection, created by artificial contamination with staphylococcus aureus . This concept could clearly be confirmed in clinical series involving treatment of prosthetic valve endocarditis . Currently, the concept of implantation of cryopreserved human vascular allografts is studied clinically . Its efficiency in infected areas and following prosthetic replacement of the thoracic aorta has not been proven . Some preliminary results as well as studies on treatment for bacterial endocarditis would suggest a clear advantage of this strategy, however statistically significant improvements have not been published . Currently available data, however, appear to be sufficient to advocate potentially successful techniques as a prophylaxis in routine thoracic aortic replacement as well as for treatment in case of a vascular prosthetic infection following such procedures.

Rev Pneumol Clin, 1995, 51(3), 137 - 44
{Mucoviscidosis: in children and adults}; Hubert D et al.; Because the lifespan of patients with cystic fibrosis is now longer, both pediatricians and adult care physicians are involved in the health care strategy . Respiratory manifestations occur due to bronchial dilatation and chronic bronchial infection, mainly due to Staphylococcus aureus and Pseudomonas . Episodes of adult infection are frequent and death usually results from respiratory failure . Characteristically, the disease also involves exocrine pancreas insufficiency . Other intestinal tract manifestations include meconial ileus and liver disease which may reach the stage of biliary cirrhosis . Nutritional disorders are frequent . Clinically there are respiratory and digestive tract disorders, pansinusitis and frequent nasal polyposis, sometimes associated with diabetes mellitus or joint pain . Male sterility results from bilateral agenesia of the vas deferens and in the female, fertility is decreased although pregnancy is possible . Clinical presentation suggests the diagnosis which is confirmed by a sweat test and genetic analysis . Care should be provided by a centre specialized in cystic fibrosis . The main treatments rely on respiratory physical therapy, antibiotics and gastroprotected pancrease extracts.

Drugs Exp Clin Res, 1995, 21(3), 125 - 8
RP 59500 postantibiotic effect defined by bacterial ultrastructure; Lorian V et al.; Staphylococcus aureus was exposed to 0.3 microgram/ml RP 59500, an injectable streptogramin, 0.75 minimum inhibitory concentration (MIC) for six hours, washed, resuspended in fresh medium and incubated for ten hours . The postantibiotic effect (PAE) was determined by growth kinetics and by bacterial ultrastructure . The PAE was eight hours when determined by changes in the cell diameters and three hours when determined by the count of colony forming units (CFU).

Rev Assoc Med Bras, 1995 Jan-Feb, 41(1), 47 - 52
{Staphylococcus aureus septicemia in children: bacterial tolerance to vancomycin and serum bactericidal activity}; Reis AG et al.; PURPOSE--To evaluate the susceptibility and of strains of Staphylococcus aureus isolated from children with septicemia, and to evaluate the importance of the serum bactericidal test . METHODS--Seventeen children with Staphylococcus aureus septicemia admitted to the Semi Intensive Care Unit of the Instituto da Crianca do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo were studied . Twenty nine tests in the pico and 23 in the nadir of the antibiotics were made . RESULTS--Strains of Staphylococcus aureus from hospital origin were resistant to all the antibiotics but vancomycin and pefloxacin . The phenomenon of tolerance was seen in 5 (50%) of the strains that were tested for vancomycin, and 4 of the children had a bad evolution . The serum bactericidal tests showed titles in the pico > or = 1/8 in 55.5% of the observations; in this group the evolution was better . CONCLUSION--Strain of Staphylococcus aureus from hospital origin are multiresistant . The phenomenon of antimicrobial tolerance, as well as the serum bactericidal test may be related to a bad therapeutic evolution . The increasing value of the serum bactericidal test as a way to evaluate the therapeutic evolution in severe infections, and the role of the tolerance of the Staphylococcus aureus to vancomycin more studies.

Eur J Cardiothorac Surg, 1995, 9(6), 325 - 9
Prophylaxis in cardiac surgery . A controlled randomized comparison between cefazolin and cefuroxime; Wellens F et al.; In a prospective randomized two center trial, short-term prophylaxis with cefuroxime (CFX) in 189 patients was compared with cefazolin (CFZ) in 196 patients submitted to elective cardiac surgery . A total of 3 g was administered over 24 h in both groups . One major adverse reaction with CFX was noted . Patients were prospectively screened by infectious disease nurses for surgical wound and secondary infections . Sternal wound infections occurred in eight patients treated with CFX and all were minor . One patient from this group eventually died of infectious causes . In the CFZ-treated patients two major and six minor wound infections occurred requiring extensive debridement in two . Secondary infections occurred less frequently in the CFX group (13.2 per 100) than in the CFZ group (16.8 per 100) with two infection-related deaths in the CFX and one in the CFZ group . The most commonly identified organisms were Staphylococcus aureus and a variety of gram-negative organisms . No major differences were observed between the CFX and CFZ groups . Short-term administration of 3 g CFZ or CFX in this study could not demonstrate the advantage of one of the antibiotics used over the other in terms of clinical outcome, incidence or site of infection or organisms identified . The 24 h administration of 3 g CFZ or CFX provided suboptimal prophylaxis for wound infection or secondary infections in patients undergoing elective open heart surgery.

J Membr Biol, 1995 Jan, 143(2), 143 - 51
Staphylococcus aureus alpha-toxin-induced pores: channel-like behavior in lipid bilayers and patch clamped cells; Korchev YE et al.; The conductance of pores induced by Staphylococcus aureus alpha-toxin in Lettre cells has been compared to that in bilayers composed of synthetic lipids or Lettre cell membrane constituents . Previously described characteristics of toxin-induced conductance changes in lipid bilayers, namely rectification, voltage-dependent closure, and closure at low pH or in the presence of divalent cations (Menestrina, 1986) are displayed also in bilayers prepared from Lettre cell membranes and in patch clamped Lettre cells . It is concluded that endogenous proteins do not affect the properties of alpha-toxin-induced channels significantly and that the relative lack of ion channels in Lettre cells makes them ideal for studies of pore-forming toxins by the patch clamp technique.

Pediatr Res, 1995 Jan, 37(1), 50 - 5
Chronic neutropenia and defect in superoxide generation of granulocytes in two patients: enhancement of bactericidal capacity and respiratory burst activity by treatment with recombinant human granulocyte colony-stimulating factor; Kaposzta R et al.; We have identified two unrelated girls with chronic neutropenia {absolute neutrophil counts (ANC) 10-870 and 10-940/microL in patients 1 and 2, respectively} and severe defect in superoxide anion generation by granulocytes . Formyl-methionyl-leucyl-phenylalanine-induced superoxide release was 1.2 +/- 0.9 and 1.9 +/- 1.9% (mean +/- SEM, n = 3) of normal controls', mean value in patients 1 and 2, respectively . However, granulocytes from both patients released a normal amount of superoxide upon stimulation with phorbol myristate acetate . Patient 2 exhibited characteristic features of Duane syndrome, a rare disorder of eye movement . Treatment of the patients with recombinant granulocyte colony-stimulating factor led to significant clinical improvements and reduction of infectious complications and to increases in the ANC, to 400-2100/microL in patient 1 and to 500-3000/microL in patient 2 . Treatment with 5 micrograms/kg/d resulted in increased intracellular killing of opsonized Staphylococcus aureus by granulocytes and an enhancement of superoxide release upon stimulation with formyl-methionyl-leucyl-phenylalanine in both patients up to 11.1 +/- 6.0 and 13.5 +/- 7.0% (mean +/- SEM, n = 5) of normal controls', mean value in patient 1 and patient 2, respectively . These data suggested that recombinant human granulocyte colony-stimulating factor treatment enhanced resistance to bacterial infection by stimulation of superoxide generation and increasing the bactericidal capacity of peripheral blood granulocytes.

Infect Immun, 1995 Jan, 63(1), 253 - 8
Reconstituted high-density lipoprotein neutralizes gram-negative bacterial lipopolysaccharides in human whole blood; Parker TS et al.; We have tested hypotheses relating lipoprotein structure to function as measured by the relative ability to neutralize endotoxin by comparing natural human lipoproteins, a chemically defined form of reconstituted high-density lipoprotein (R-HDL), and a lipid emulsion (Intralipid) . The human whole-blood system was used as an in vitro model of lipopolysaccharide (LPS) binding protein and CD14-dependent activation of cytokine production . When lipoproteins were compared on the basis of protein content, R-HDL was most effective in reducing tumor necrosis factor alpha (TNF-alpha) production followed in order by very low density lipoprotein, low-density lipoprotein, Intralipid, and natural HDL . However, when these particles were compared by protein, phospholipid, cholesterol, or triglyceride content by stepwise linear regression analysis, only phospholipid was correlated to effectiveness (r2 = 0.873; P < 0.0001) . Anti-CD14 monoclonal antibodies MY4 and 3C10 inhibited LPS binding protein and CD14-dependent activation of TNF-alpha production by LPS at LPS concentrations up to approximately 1.0 ng/ml . R-HDL (2 mg of protein per ml) blocked TNF-alpha production by LPS from both smooth- and rough-type gram-negative bacteria at concentrations up to 100 ng of LPS per ml but had little effect on heat-killed gram-positive Staphylococcus aureus and no effect on other LPS-independent stimuli tested . These results support our hypothesis that LPS is neutralized by binding to phospholipid on the surface of R-HDL and demonstrate that R-HDL is a potent inhibitor of the induction of TNF-alpha by LPS from both rough- and smooth-form gram-negative bacteria in whole human blood.

Microbiol Immunol, 1995, 39(8), 629 - 33
Alteration of bacteriolytic enzyme profile of Staphylococcus aureus during growth; Komatsuzawa H et al.; Profiles of cell-associated bacteriolytic activities and those in the culture supernatant of Staphylococcus aureus FDA209P at various stages of growth were analyzed using sodium dodecyl sulfate-polyacrylamide gels containing Micrococcus luteus or S . aureus . In the logarithmic growth phase, the cell-associated bacteriolytic activities extracted with Triton X-100 contained a number of bacteriolytic proteins, the profiles of which were similar to those we reported elsewhere (Sugai, M., Akiyama, T., Komatsuzawa, H., Miyake, Y., and Suginaka, H . (1990) J . Bacteriol., 172, 6494-6498) . The proteins include P1, P2, P7, P9, PX, P13, P18 and other minor components . At the stationary growth phase, the bacteriolytic band-profile of the Triton X-100 extract changed dramatically . P1, P7 and P9 disappeared, and the other minor bands had markedly decreased band intensities . On the other hand, P2, PX, P13, and P18 retained their band intensities during the stationary growth phase . The band intensities of P7, P13, PX, and P18 increased in the supernatant during the logarithmic growth phase . These results indicated that the bacteriolytic band-profile changes during growth.

Microbiol Immunol, 1995, 39(8), 615 - 7
Auxiliary method for clonal identification of Staphylococcus aureus by protein band pattern of released proteins on SDS-polyacrylamide gel; Seki K et al.; A supportive method for clonal identification of Staphylococcus aureus strains was devised . Culture supernatant obtained by cellophane surface culture was subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) without performing any concentration procedure prior to electrophoresis . The combined use of cellophane surface culture and SDS-PAGE was convenient for determining whether the strains belonged to the same clone or not when conducted in conjunction with other tests for bacteriological characterization.

J Appl Biomater, 1995 Fall, 6(3), 167 - 9
A novel drug delivery system for osteomyelitis using porous hydroxyapatite blocks loaded by centrifugation; Itokazu M et al.; A novel drug delivery system for osteomyelitis was developed using porous hydroxyapatite blocks (HA-b) loaded with antibiotics by centrifugation . In the study, 10 mm3 HA-b was placed in a container and mixed with antibiotic solution; the antibiotic was then loaded into the pores of the HA-b by centrifuging at 1500 rpm for 15 min . Slow release of HA-b in both moist form and dried form (by heating at 160 degrees C) was tested after loading with the antibiotic arbekacin sulfate (ABK), 1-N-(S)-4 amino-2-hydroxybutyryl dibekacin . To estimate the concentration of antibiotic, both forms of HA-b were placed in 3 mL of phosphate buffered saline (PBS), which was replaced every 48 h . In both groups, which were loaded with 70 mg ABK per one block of HA (concn 0.5 microgram/mL) which is sufficiently high to control most pathogens, was maintained for 21 exchanges of PBS (after 42 days) . Minimum inhibitory concentration for methicillin-resistant Staphylococcus aureus (MRSA), 3.13 micrograms/mL, was maintained until nine exchanges took place (after 18 days) . The centrifugation method is simple, and dried ABK produced by heating loaded HA-b is particularly useful in clinical applications for osteomyelitis.

Acta Vet Scand, 1995, 36(2), 237 - 43
A comparative study of Staphylococcus aureus strains isolated from bovine subclinical mastitis during 1952-1956 and 1992; Aarestrup FM et al.; Fifty-two strains of S . aureus isolated from cases of bovine subclinical mastitis in 52 different dairy herds in Denmark, in the periods 1952 to 1956 and 1992, were compared with regard to their phage- and EcoRI ribotypes . Furthermore, susceptibility to penicillin and production of fibrinolysin were used as additional phenotypic markers . Forty-nine strains (94%) could be separated into 12 phage types . Ribotyping assigned the 52 strains to 21 different types . Both methods showed that 57% of the 1950's strains and between 38-45% of the 1992 strains belonged to 3 dominating types . The remaining strains were placed by ribotyping in 8 types occurring among the 1952-1956 strains and 10 types occurring among the 1992 strains . In 87% of the strains the results of the 2 typing methods were in accordance . However, 7 strains gave different results by the 2 methods including 2 strains with major differences . Penicillin resistance only occurred in a single genotype from the 1950's compared to 6 different genotypes among the 1992 strains.

Vox Sang, 1995, 69(1), 27 - 37
In vitro cytokine treatment of B cell defects in HIV-infected hemophilia patients; Weimer R et al.; HIV-infected patients exhibit defects in B cell differentiation and in the IL-6 response of B cells, in association with autoantibody formation against T cells . These autoantibodies have been implicated as important factors in the development of immunodeficiency disease . As the restoration of defective B cell responses might prevent autoantibody formation and the resulting immunosuppression, we studied whether in vitro treatment with recombinant IL-2 (rIL-2), recombinant IL-4 (rIL-4) or recombinant IL-6 (rIL-6) might restore the response of B cells of HIV-infected patients . B cells of 6 HIV-negative hemophilia patients, 4 HIV-positive patients at CDC stage II, III, 4 HIV-positive patients at CDC stage IV, and 6 healthy controls were tested in Staphylococcus aureus Cowan I (SAC-I)-stimulated B cell cultures and Pokeweed mitogen (PWM)-stimulated allogeneic B and T cell cocultures . B cell differentiation was assessed in a reverse hemolytic plaque assay and by ELISA determination of IgM, IgG and IL-6 in culture supernatants . In vitro application of rIL-6 resulted in suppression of both elevated unstimulated and mitogen-stimulated B cell responses in a dose-dependent manner which was in part due to feedback inhibition . PWM- and SAC-I-stimulated IgG and IgM responses, respectively, could be restored after addition of 10 U/ml rIL-2 in HIV-negative patients, but not in HIV-positive patients . Addition of rIL-4 to cultures resulted in suppression of both unstimulated and mitogen-stimulated IL-6 secretion and B cell responses . Severely depressed B cell responses in CDC IV patients were not significantly affected by cytokine application . These results indicate that defective Ig responses in HIV-negative patients may be restored by rIL-2 treatment whereas HIV-induced B cell defects are not corrected by supply of T cell help or cytokines promoting B cell growth and differentiation.

Microbios, 1995, 81(327), 85 - 91
Cure of prophage in Staphylococcus aureus by furocoumarin photoadditions; Cavalcanti SM et al.; In a previous report curing of prophage in Staphylococcus aureus by treatment with 8-methoxypsoralen plus near-UV (365 nm) radiation was described . In the present work the use of angelicin and 4,5',8-trimethylpsoralen and repeated irradiation show that monoadducts and DNA interstrand cross-links formed by furocoumarin photoaddition are involved in the curing of the prophage responsible for the suppression of the lipolytic activity in a putative repair proficient strain of Staphylococcus aureus.

Science, 1994 Dec 16, 266(5192), 1874 - 8
Subsets of HLA-DR1 molecules defined by SEB and TSST-1 binding; Thibodeau J et al.; Superantigens bind to major histocompatibility complex class II molecules on antigen-presenting cells and stimulate T cells . Staphylococcus aureus enterotoxin B (SEB) and toxic shock syndrome toxin-1 (TSST-1) bind to the same region of human lymphocyte antigen (HLA)-DR1 but do not compete with each other, which indicates that they bind to different subsets of DR1 molecules . Here, a mutation in the peptide-binding groove disrupted the SEB and TSST-1 binding sites, which suggests that peptides can influence the interaction with bacterial toxins . In support of this, the expression of the DR1 molecule in various cell types differentially affected the binding of these toxins.

Science, 1994 Dec 16, 266(5192), 1870 - 4
Toxic shock syndrome toxin-1 complexed with a class II major histocompatibility molecule HLA-DR1; Kim J et al.; The three-dimensional structure of a Staphylococcus aureus superantigen, toxic shock syndrome toxin-1 (TSST-1), complexed with a human class II major histocompatibility molecule (DR1), was determined by x-ray crystallography . The TSST-1 binding site on DR1 overlaps that of the superantigen S . aureus enterotoxin B (SEB), but the two binding modes differ . Whereas SEB binds primarily off one edge of the peptide binding site of DR1, TSST-1 extends over almost one-half of the binding site and contacts both the flanking alpha helices of the histocompatibility antigen and the bound peptide . This difference suggests that the T cell receptor (TCR) would bind to TSST-1:DR1 very differently than to DR1:peptide or SEB:DR1 . It also suggests that TSST-1 binding may be dependent on the peptide, though less so than TCR binding, providing a possible explanation for the inability of TSST-1 to competitively block SEB binding to all DR1 molecules on cells (even though the binding sites of TSST-1 and SEB on DR1 overlap almost completely) and suggesting the possibility that T cell activation by superantigen could be directed by peptide antigen.

Arch Intern Med, 1994 Dec 12-26, 154(23), 2641 - 5
Influence of blood culture results on antibiotic choice in the treatment of bacteremia; Arbo MD et al.; BACKGROUND: It is unclear how often blood culture results influence empiric antibiotic regimens . METHODS: To assess the frequency of antibiotic modification and the rates of proper documentation of blood culture results by house staff physicians, we prospectively evaluated 226 episodes of bacteremia in 199 patients . RESULTS: Antibiotics were changed in 49.6% of episodes of true bacteremias . Physicians were more likely to change therapy if gram-negative rods (odds ratio {OR}, 3.19) or Staphylococcus aureus (OR, 3.12) were isolated, if the blood culture was obtained in the first 7 days of hospitalization (OR, 1.9), or if house staff physicians properly documented the culture results in the medical chart (OR, 3.8) (all P values, < .05) . Documentation of positive blood culture results by house staff physicians was absent in 26% of patients, and it was observed less often in patients on the surgical service (OR, 0.35; P = .004) or if a contaminant was recovered (OR, 0.24; P < .001) . Eighty-three percent of "true-positive" blood cultures, as compared with 55% of "contaminated" blood cultures, were documented with a note in the medical records (P < .0001) . Rates of documentation were higher for gram-negative rods, for patients who were already receiving antibiotic therapy, and for those who had a change of therapy after the culture results became available (all P values, < .05) . A multivariate logistic regression model showed that documentation of the blood culture result (OR, 1.78; P = .006) or a positive culture within 7 days of hospitalization (OR, 1.49; P = .01) was independently associated with a change in therapy . CONCLUSIONS: In a significant proportion of patients with bacteremia, the blood culture result may not be the most important factor that determines antibiotic choice . Bacteremia is not adequately documented by house staff physicians in up to a quarter of patients.

J Biol Chem, 1994 Dec 9, 269(49), 30917 - 26
Amino acid sequence of the winged bean (Psophocarpus tetragonolobus) basic lectin . Adenine binding and identification of the active-site tryptophan residue; Puri KD et al.; The complete amino acid sequence of winged bean basic agglutinin (WBA I) was obtained by a combination of manual and gas-phase sequencing methods . Peptide fragments for sequence analyses were obtained by enzymatic cleavages using trypsin and Staphylococcus aureus V8 endoproteinase and by chemical cleavages using iodosobenzoic acid, hydroxylamine, and formic acid . COOH-terminal sequence analysis of WBA I and other peptides was performed using carboxypeptidase Y . The primary structure of WBA I was homologous to those of other legume lectins and more so to Erythrina corallodendron . Interestingly, the sequence shows remarkable identities in the regions involved in the association of the two monomers of E . corallodendron lectin . Other conserved regions are the double metal-binding site and residues contributing to the formation of the hydrophobic cavity and the carbohydrate-binding site . Chemical modification studies both in the presence and absence of N-acetylgalactosamine together with sequence analyses of tryptophan-containing tryptic peptides demonstrate that tryptophan 133 is involved in the binding of carbohydrate ligands by the lectin . The location of tryptophan 133 at the active center of WBA I for the first time subserves to explain a role for one of the most conserved residues in legume lectins.

FEBS Lett, 1994 Dec 5, 355(3), 275 - 8
Inhibition of growth and cysteine proteinase activity of Staphylococcus aureus V8 by phosphorylated cystatin alpha in skin cornified envelope; Takahashi M et al.; The activity of a cysteine proteinase purified from Staphylococcus aureus V8 (SAV8) was inhibited by phosphorylated cystatin alpha (P-cystatin alpha) and by purified cornified envelope protein of newborn rat, a conjugated form of P-cystatin alpha . Immunohistochemical analysis demonstrated a marked decrease in P-cystatin alpha content in cornified envelope treated with sphingosine . The inhibition of papain activity by proteins from sphingosine-treated skin was much weaker than that exerted by proteins from the untreated skin . The suppression of SAV8 colony formation inoculated on the sphingosine-treated skin was examined . Colony formation on the sphingosine-treated skin was enhanced compared to that on normal skin . These findings suggest that P-cystatin alpha in the cornified envelope may have a bacteriostatic barrier function against bacterial infection, such as that with SAV8.

FEBS Lett, 1994 Dec 5, 355(3), 254 - 8
Cysteines of chloroplast NADP-malate dehydrogenase form mixed disulfides; Ocheretina O et al.; Chloroplast NADP-malate dehydrogenase (NADP-MDH) from pea and from spinach was N-terminally truncated by limited proteolysis with Staphylococcus aureus protease V8 . The resulting monomeric enzymes lacking, respectively, the 37 and 38 N-terminal amino acids were inactive . Reduction and addition of low concentrations of guanidine-HCl (50-100 mM) resulted in a highly active enzyme of 850 units per mg protein . Equilibration of the truncated enzyme with various glutathione (GSH) redox buffers and assaying its activity in the presence of guanidine-HCl was used to establish the existence of protein-GSH mixed disulfides . This finding was further confirmed using incorporation of radioactively labelled thiol . The possible function of such cysteine modifications under oxidative stress and their regeneration by the thioredoxin system in the light is discussed.

Orv Hetil, 1994 Dec 4, 135(49), 2701 - 3
{Relationship between urticaria-like toxic allergic exanthema and infection by toxin-producing Staphylococcus strains in infants}; Toth P; The author observed that in the throat and/or nasal culture of approximately 80% of little children admitted to hospital with urticaria-like toxic-allergic exanthem, exotoxin-producing strains of Staphylococcus aureus could be isolated . In 15 of the 19 cases presented . Toxic Shock Syndrome Toxin (TSST-1) and in 4 cases various enterotoxins were identified . With aimed antibiotic treatment the skin symptoms of the children healed up in 3-4 days . Thus, the following question is raised: when facing the Toxic Shock Syndrome Toxin for the first time, why do children develop only skin symptoms, without severe complications of the Toxic Shock Syndrome observed in adult patients . It is assumed that similarly to classic infectious diseases, the course of the illness is milder in little childhood and the frequency of complications are lower than in adulthood . This phenomenon may be attributed to the immature immune reactivity of little children.

Gene, 1994 Dec 2, 150(1), 149 - 51
Cloning and expression of the gene encoding the glutamic acid-specific protease of Streptomyces griseus ATCC10137; Suzuki Y et al.; The gene (sgpE) encoding the Streptomyces griseus glutamic-acid-specific protease (SGPE) was cloned and sequenced . The sgpE gene contained an open reading frame of 1065 nucleotides encoding 355 amino acids (aa) with a pre-propeptide of 168 aa ending at Glu, suggesting the probability of auto-proteolysis . A Streptomyces lividans strain carrying the plasmid-borne sgpE under control of the traA gene promoter secreted mature SGPE into the culture medium . Compared to Staphylococcus aureus protease V8, the purified SGPE was more resistant to urea . It is suggested that SGPE would be a useful tool for site-specific processing of proteins, even under denaturing conditions.

Malays J Pathol, 1994 Dec, 16(2), 157 - 60
Evaluation of variable parameters in neutrophil function test using chemiluminescence assay; Noah RM et al.; Variable parameters in chemiluminescence assay, one of the methods used to assess the functional capacity of neutrophils, were evaluated for suitable adaptation locally . The use of pooled normal human serum as compared to single normal human serum in opsonizing particles for phagocytosis was found to exhibit lower chemiluminescence activity (reduction range of 30%-50%) . A similar degree of depression was observed when the particles were opsonized using normal human serum in comparison to that using autologous serum . Different intensity of chemiluminescence was also noted when the opsonized particle used was the Oxford strain of Staphylococcus aureus (NCTC 6571) in contrast to a strain of Staphylococcus aureus isolated from a patient . The results obtained warrant clinicians to deliver appropriate samples as best they can when the chemiluminescence assay is requested.

Malays J Pathol, 1994 Dec, 16(2), 151 - 6
Pulsed-field gel electrophoresis of chromosomal DNA of methicillin-resistant Staphylococcus aureus associated with nosocomial infections; Hanifah YA et al.; Methicillin-resistant Staphylococcus aureus (MRSA) infection has been endemic in the University Hospital, Kuala Lumpur since the late 1970s . Fifty isolates of MRSA obtained from clinical specimens of patients with nosocomial infections associated with this organism have been studied by pulsed-field gel electrophoresis (PFGE) of its chromosomal DNA fragments to discrimate between strains and to identify the predominant strain . Twenty-one chromosomal patterns were observed which could be further grouped into nine types . The predominant strain was Type 9-b (40% of isolates) found mainly in the Orthopaedic and Surgical Units . Outbreak strains found in the Special Care Nursery were of Type 1, entirely different from those of the surgical ward S2, which were of Type 9-b . Type 8 strains were found mainly at one end of the hospital building where the maternity, paediatric and orthopaedic units were situated . Genomic DNA fingerprinting by PFGE is recommended as a useful and effective tool for the purpose of epidemiological studies of MSRA infections, particularly for nosocomial infections.

J Bacteriol, 1994 Dec, 176(24), 7719 - 26
Genetic and biochemical analyses of the biosynthesis of the yellow carotenoid 4,4'-diaponeurosporene of Staphylococcus aureus; Wieland B et al.; The major pigment produced by Staphylococcus aureus Newman is the deep-yellow carotenoid 4,4'-diaponeurosporene; after prolonged cultivation, this pigment is in part converted to the orange end product staphyloxanthin . From this strain a 3.5-kb DNA fragment was identified which after being cloned into Escherichia coli and Staphylococcus carnosus conferred the ability to produce 4,4'-diaponeurosporene . DNA sequencing of this fragment revealed two open reading frames (ORFs) which are very likely cotranscribed . ORF1 encodes a 254-amino-acid hydrophobic protein, CrtM (M(r), 30,121) . The deduced sequence of CrtM exhibits in three domains similarities to the sequences of Saccharomyces cerevisiae and human squalene synthases and phytoene synthases of various bacteria . ORF2 encodes a 448-amino-acid hydrophobic protein, CrtN, with an M(r) of 50,853 whose deduced sequence is similar to those of phytoene desaturases of other bacteria . At the N terminus of CrtN a classical FAD-, NAD(P)-binding domain is found . Spectrophotometry and gas chromatography-mass spectrometry analyses of the carotenoid production of E . coli and S . carnosus clones containing either ORF1 or both ORFs together suggest that ORF1 and ORF2 represent the dehydrosqualene synthase gene (crtM) and the dehydrosqualene desaturase gene (crtN), respectively . The results furthermore suggest that the biosynthesis of 4,4'-diaponeurosporene starts with the condensation of two molecules of farnesyl diphosphate by dehydrosqualene synthase (CrtM); it is shown that the reaction product of this enzyme is dehydrosqualene and not squalene . Dehydrosqualene (4,4'-diapophytoene) is successively dehydrogenated by a desaturase (CrtN) to form the yellow main intermediate 4,4'-diaponeurosporene.

Eur J Biochem, 1994 Dec 1, 226(2), 323 - 33
Probing the structure of hirudin from Hirudinaria manillensis by limited proteolysis . Isolation, characterization and thrombin-inhibitory properties of N-terminal fragments; Vindigni A et al.; Hirudin is the most potent and specific inhibitor of the blood-clotting enzyme thrombin so far known . Several hirudin variants were isolated mostly from Hirudo medicinalis and shown to be polypeptide chains of approximately 7 kDa with three internal disulfide bridges . In this study, limited proteolysis has been used to probe aspects of the structure and dynamics of a hirudin variant HM2 isolated from Hirudinaria manillensis . Proteolysis of the polypeptide chain of 64-amino-acid residues of hirudin HM2 by protease from Staphylococcus aureus V8, trypsin, thermolysin and subtilisin occurs at region 41-49 of the chain . The N-terminal fragments 1-41 and 1-47 were isolated to homogeneity and shown to maintain inhibitory action on thrombin, though much lower than the intact protein . The results were interpreted on the basis of a proposed three-dimensional structure of hirudin HM2 deduced by protein modelling the known structure of hirudin variant HV1 from Hirudo medicinalis (75% sequence similarity between HM2 and HV1) . Both proteolysis experiments and protein modelling provide evidence for the existence in hirudin HM2 of a N-terminal well-structured domain (core) and a C-terminal flexible polypeptide segment . Determination of the accessible surface area of the three-dimensional model of hirudin HM2 showed that the sites of preferential cleavages are at the surface of the polypeptide molecule.

J Surg Res, 1994 Dec, 57(6), 698 - 705
The use of biodegradable amikacin microspheres to prevent vascular graft infection; Ney AL et al.; The following study was performed to determine if an antibiotic impregnated in a biodegradable polymer can prevent infection and eradicate inoculum bacteria from contaminated polytetrafluoroethylene vascular grafts . Poly(glycolide-co-dl-lactide) amikacin microspheres (PAM) measuring 50-100 microns were designed to deliver 100 mg (PAM 100) or 300 mg (PAM 300) amikacin per unit dose . Twenty mongrel dogs had a short segment of infrarenal aorta replaced with a graft that had been bathed in a 2 cc solution of Escherichia coli and Staphylococcus aureus (3 x 10(8) CFU/ml) . Dogs were divided into three groups: Controls had contaminated grafts placed and received no therapy; PAM 100 and PAM 300 were used, respectively, to cover the grafts in the other two groups . Animals were sacrificed 14 days postoperatively at which time grafts were examined and cultured . Among controls, 7/8 had clinical graft infections and all had positive cultures for S . aureus (8/8) or E . coli (5/8) . None of the treated animals had clinical graft infections (P < 0.001) . Positive cultures were obtained for S . aureus in 2/8 (P < or = 0.007) and E . coli in 0/8 (P < or = 0.03) PAM 100 dogs and for S . aureus in 0/8 (P < or = 0.0002) and E . coli in 0/8 (P < or = 0.03) PAM 300 dogs . Two PAM 100 and four PAM 300 dogs had rare growth of contaminant bacteria (NS) . In conclusion, PAM can prevent clinical graft infection and completely eradicate a standardized bacterial inoculum.

J Pediatr, 1994 Dec, 125(6 Pt 1), 922 - 30
Intravenous immune globulin prophylaxis of late-onset sepsis in premature neonates; Weisman LE et al.; To determine whether a single dose of intravenously administered immune globulin (IVIG) decreases late-onset sepsis in premature infants, we prospectively entered 753 neonates with birth weight 500 to 2000 gm, gestation < or = 34 weeks, and age < or = 12 hours into a multicenter, double-blind, controlled trial . Infants were randomly selected to receive a single intravenous infusion, 10 ml/kg, of either IVIG (500 mg/kg) or albumin (5 mg/kg) and were observed for 8 weeks for infection . Maternal and neonatal risk factors for infection did not differ between groups . Although serum IgG values before infusion were related to gestation (R = 0.62), the change in serum IgG or half-life of IgG after IVIG infusion was not (R < or = 0.09) . The serum IgG concentration was increased (p < 0.05) in IVIG-treated patients for 8 weeks . There were 88 episodes of late-onset sepsis in 79 neonates (10.5%) . Causative organisms included the following: Staphylococcus epidermidis (37 episodes), Enterococcus (9), Staphylococcus aureus (7), Candida (6), Escherichia coli (6), and multiple organisms (11) . Sepsis, death, and death as a result of infection were unaffected by treatment . We conclude that a single infusion of IVIG, 500 mg/kg, shortly after birth was not effective prophylaxis for late-onset infection in premature neonates . Future studies of late-onset sepsis prophylaxis should consider IVIG with known pathogen-specific antibody concentrations against organisms causing these infections, in particular S . epidermidis.

Epidemiol Infect, 1994 Dec, 113(3), 463 - 70
Staphylococcus aureus strains of type 95 . Spread of a single clone; Rosdahl VT et al.; Staphylococcus aureus strains of type 95 in Denmark have increased to a frequency of 20% of the total S . aureus population . A clonal origin and possible subdivision of these strains have been discussed . In the present investigation 35 epidemiologically unrelated S . aureus strains of type 95 as well as reference strains of other types have been analysed by other typing techniques including lectin-typing, multilocus enzyme electrophoresis and pulsed-field gel electrophoresis of genomic restriction fragments . No subdivision could be achieved based on any of these methods and a clonal origin seems therefore possible.

J Histochem Cytochem, 1994 Dec, 42(12), 1609 - 13
Localization of sugar-binding sites in Staphylococcus aureus using gold-labeled neoglycoprotein; Morioka H et al.; We studied post- and pre-embedding staining of sugar-binding sites on thin sections of Staphylococcus aureus with an electron microscopic neoglycoprotein-gold technique . Although gold particles of cellobiosyl bovine serum albumin (BSA)-glycosylated BSA-, lactosyl BSA-, and melibiosyl BSA-gold did not label, heavy labeling of N-acetylglucosaminide-BSA-gold was observed in both the cell wall and the cytoplasm on Spurr-embedded thin sections of S . aureus . Inhibition of labeling with wheat germ agglutinin-biotin and N-acetylglucosaminidase indicated that the labeling was due to N-acetylglucosamine . These data suggested that molecules that bind specifically with N-acetylglucosamine occur in the cell wall and cytoplasm of S . aureus . Pre-embedding staining revealed that these molecules are abundant at the surface of the cell wall and that the abundance differs depending on the bacterial strain . An N-acetylglucosamine-specific lectin-like substance, glucosaminidase, and toxins are proposed as candidates for molecules responsible for the labeling, and the possible functional significance of the findings is discussed briefly.

Ann Intern Med, 1994 Dec 1, 121(11), 873 - 6
Short-course antibiotic therapy for right-sided endocarditis caused by Staphylococcus aureus in injection drug users; DiNubile MJ; Right-sided endocarditis caused by Staphylococcus aureus is a frequent complication of injection drug use . Fortunately, the prognosis for this infection when treated with the standard regimen of 4 to 6 weeks of parenteral antistaphylococcal antibiotics is favorable . Nevertheless, in many cases, once drug users feel better, they leave the hospital against medical advice before completing the full course of antibiotic therapy . This problem has stimulated interest in shortening the duration of antibiotic to a penicillinase-resistant penicillin . Data from in vitro synergy studies and animal models of endocarditis suggest that S . aureus can be eradicated more quickly by combination therapy than by monotherapy . Reports of three prospective, nonrandomized clinical trials have been published that support the use of a 2-week course of a penicillinase-resistant penicillin and an aminoglycoside antibiotic to treat uncomplicated, exclusively right-sided endocarditis caused by methicillin-susceptible S . aureus in injection drug users.

J Med Microbiol, 1994 Dec, 41(6), 441 - 7
Evaluation of an antibiogram-resistogram typing scheme for methicillin-resistant Staphylococcus aureus; Rossney AS et al.; Between Dec . 1992 and Aug . 1993, the MRSA population in the Federated Dublin Voluntary Hospitals and St James's Hospital group was studied with an antibiogram-resistogram (AR) typing scheme in which AR patterns were determined by testing susceptibility to 22 antibiotics and chemicals by a modified Stokes' disk diffusion technique . The typing scheme divided this MRSA population into 31 AR types but 90% of isolates belonged to seven types . Isolates belonging to the most frequently occurring types (AR types 13 and 14) differed only in their reaction to lincomycin (or clindamycin) and could not be distinguished by phage typing, plasmid profiling or restriction endonuclease analysis . The AR typing scheme showed that the incidence of different AR types varied in different hospitals and changed during the study period . This typing method differentiated a strain of MRSA responsible for a nosocomial outbreak in an intensive care unit from other MRSA isolated in the unit, and has distinguished imported strains from local ones . In one hospital, AR typing showed that, although a major outbreak occurred with one AR type, there was also a series of smaller outbreaks with other AR types . The technique can be performed in the diagnostic laboratory and results were available within 24 h.

J Med Microbiol, 1994 Dec, 41(6), 430 - 40
Antibiogram-resistogram typing scheme for methicillin-resistant Staphylococcus aureus; Rossney AS et al.; An antibiogram-resistogram (AR) typing scheme that can simply and rapidly differentiate methicillin-resistant Staphylococcus aureus (MRSA) isolates has been devised . Susceptibility to antibiotics and chemicals was determined by disk diffusion testing . Three disk diffusion methods and three control S . aureus strains were evaluated . A modified Stokes' technique in which S . aureus ATCC 25923 replaced S . aureus NCTC 6571 as the control organism was chosen . Susceptibility patterns against 18 antibiotics and four chemicals were used to determine AR types . AR subtypes were determined with reference to knowledge of the local MRSA population so that plasmid loss would not result in misclassification . AR typing was compared with phage typing and plasmid profiling and found to be more discriminatory than either of these typing methods . Representative isolates of the most frequently occurring AR patterns were further characterised by investigating enterotoxin production, MICs of gentamicin and amikacin, and restriction endonuclease analysis of plasma DNA, to determine whether apparently different strains could have the same AR pattern and to devise confirmatory tests for any such similar patterns . One pattern was shared by two strains but isolates could be differentiated by susceptibility to minocycline . This typing scheme can be used in the diagnostic laboratory and results may be obtained within 24 h.

J Med Microbiol, 1994 Dec, 41(6), 408 - 13
The effect of topical antimicrobial agents on the production of toxic shock syndrome toxin-1; Edwards-Jones V et al.; Three hundred isolates of Staphylococcus aureus from wound swabs were examined for the production of toxic shock syndrome toxin 1 (TSST-1) . The isolates were collected from community patients, surgical inpatients and from patients in the Regional Burns Unit, Booth Hall Children's Hospital, Manchester . The overall incidence of toxin production was 17% and there was no significant variation between the sources of the strains . All 55 TSST-1-producing strains were grown in sublethal concentrations of five topical antimicrobial compounds and the level of toxin produced was determined and compared with the amount produced in a control broth after incubation for 24 h . The effects of sublethal concentrations of the compounds on TSST-1 production were strain dependent; some compounds tended to increase production (at least four-fold) and some tended to decrease production (at least four-fold) . Some of the strains showed an increase in toxin production in the presence of chlorhexidine gluconate/cetrimide solution and silver sulphadiazine cream whereas 18%, 42% and 47% of the strains showed a decrease in toxin production in the presence of povidone iodine solution, stabilised hydrogen peroxide cream and mupirocin ointment, respectively . Preliminary results suggest that silver sulphadiazine cream induces toxin formation earlier in the growth cycle.

Infect Immun, 1994 Dec, 62(12), 5679 - 82
Ability of Staphylococcus aureus coagulase genotypes to resist neutrophil bactericidal activity and phagocytosis; Aarestrup FM et al.; This study investigated the functional capabilities of neutrophils against different Staphylococcus aureus genotypes isolated from cows with mastitis . Six strains of S . aureus were chosen for use in the study, two with a common genotype, two with an intermediate genotype, and two with a rare genotype . The interaction between bacteria and neutrophils was measured by phagocytosis and bactericidal effect . The average percent killing of bacteria was lowest (40.0%) with strains belonging to the most common genotype, medium (50%) with strains belonging to the intermediate type, and highest (64.2%) with strains belonging to the rare type (P < or = 0.001) . Statistically significant differences (P < or = 0.001) in the numbers of phagocytized bacteria were also found between the most prevalent type (6.27 bacteria per cell) and the other two types (intermediate type, 9.26/cell; rare type, 10.5/cell) . These findings suggest that one of the reasons for the variation in prevalence of different genotypes of S . aureus in the mammary gland is due to the superior ability of some types to resist phagocytosis and/or killing by bovine neutrophils.

Am J Respir Crit Care Med, 1994 Dec, 150(6 Pt 1), 1545 - 9
Ventilator-associated pneumonia by Staphylococcus aureus . Comparison of methicillin-resistant and methicillin-sensitive episodes; Rello J et al.; All episodes of ventilator-associated pneumonia (VAP) caused by Staphylococcus aureus were prospectively analyzed for a 30-mo period . Methicillin-sensitive S . aureus (MSSA) was isolated in 38 episodes and methicillin-resistant S . aureus (MRSA) in 11 others . The two groups were similar regarding sex, severity of underlying diseases, prior surgery, and presence of renal failure, diabetes, cardiopathy, and coma . MRSA-infected persons were more likely to have received steroids before developing infection (relative risk {RR} = 3.45, 95% confidence interval {CI} = 1.38-8.59), to have been ventilated > 6 d (RR = 2.03, 95% CI = 1.36-3.03), to have been older than 25 yr (RR = 1.50, 95% CI = 1.09-2.06), and to have had preceding chronic obstructive pulmonary disease (RR = 2.76, 95% CI = 0.89-8.56) than MSSA-infected patients . MSSA-infected persons were more likely than MRSA-infected patients to have cranioencephalic trauma (RR = 1.94, 95% CI = 1.22-3.09) . All patients with MRSA VAP had previously received antibiotics, compared with only 21.1% of those with MSSA infection (p < 0.000001) . The incidence of empyema was similar in both groups; nevertheless, the presence of bacteremia and septic shock was more frequent in the MRSA group . Finally, mortality directly related to pneumonia was significantly higher among patients with MRSA episodes (RR = 20.72, 95% CI = 2.78-154.35) . This analysis was repeated for monomicrobial episodes, and the difference remained statistically significant . We conclude that MRSA and MSSA strains infect patients with different demographic profiles; previous antibiotic therapy is the most important risk factor for developing MRSA infection.(ABSTRACT TRUNCATED AT 250 WORDS)

J Hosp Infect, 1994 Dec, 28(4), 265 - 71
Audit of infection in continuous ambulatory peritoneal dialysis; Wilson AP et al.; The major cause of failure of continuous ambulatory peritoneal dialysis is peritoneal or exit site infection with Staphylococcus aureus . From 1989-1992, eradication of nasal and perineal carriage, continued use of an occlusive dressing to the exit site, improved aseptic technique for dressing changes by the patient and avoidance of wetting of the dressing were used in an attempt to reduce staphylococcal infections . By comparison with the 3-year period prior to intervention, a significant increase in the life of the catheters was achieved (removed at 1 year, 13 vs . 28%, P < 0.001) with a reduction in episodes of peritonitis due to S . aureus . The study was not prospectively controlled but there did not appear to be any other factor to account for the sudden and consistent improvement observed.

Eur J Clin Microbiol Infect Dis, 1994 Dec, 13(12), 1053 - 5
Activity of the fourth generation cephalosporin FK-037 against methicillin-resistant Staphylococcus aureus under conditions maximizing PBP2' production; Hamilton-Miller JM; To investigate the in vitro activity of the fourth generation cephalosporin FK-037, MICs were determined for 80 strains of methicillin-resistant Staphylococcus aureus from 11 countries . Methicillin and cefamandole served as comparators . The method ensured good expression of PBP2' by use of a large inoculum, salt supplement and incubation for 48 hours at 30 degrees C . FK-037 was twice as active as cefamandole against both strains with high-level and strains with low-level methicillin resistance (geometric mean MICs 23.4 and 10.8 mg/l, respectively).

Infect Agents Dis, 1994 Dec, 3(6), 302 - 12
Variant subpopulations of Staphylococcus aureus as cause of persistent and recurrent infections; Proctor RA et al.; While S . aureus small colony variants (SCVs) have been recognized in clinical materials for decades, only recently have these strains been linked to persistent, resistant, and relapsing infections . The biochemical basis for this phenotype appears to be reduced electron transport, which leads to many changes in these organisms, including decreased alpha-toxin production . Reduced alpha-toxin has been found to facilitate bacterial survival within cultured endothelial cells . This SCV subpopulation is more resistant to antibiotics, grows very slowly, and demonstrates unusual colony morphology . Hence, these resistant strains can be easily overloaded in the clinical microbiology laboratory, and may be resistant to conventional antibiotic therapy . Clinicians should ask the laboratory to search for SCVs with relapsing and resistant S . aureus infections.

Clin Infect Dis, 1994 Dec, 19(6), 1123 - 8
Efficient detection and long-term persistence of the carriage of methicillin-resistant Staphylococcus aureus; Sanford MD et al.; The natural history of the carriage of methicillin-resistant Staphylococcus aureus (MRSA) was examined in a 9-year retrospective cohort study of 102 known carriers . The populations studied consisted of patients admitted to a university hospital from 1989 through 1991; a review extending back to January 1983 was conducted . The focuses of the study included the duration of carriage among patients who were known to have carried MRSA previously and who were readmitted to the hospital (36 patients) and the optimal anatomic site for screening (66 patients) . Cultures of the nares (sensitivity, 93%; negative predictive value, 95%) were considerably more valuable for the detection of MRSA colonization than were cultures of cutaneous sites of the axilla, groin, and perineum (sensitivity, < or = 39%; negative predictive value, < or = 69%) . The estimated half-life of MRSA colonization in this special population of patients was approximately 40 months . Restriction enzyme analysis of plasmid types of paired isolates from the 12 patients with MRSA carriage persisting for > 12 months revealed five instances (42%) in which both isolates were of the same type . In summary, our results indicate that the majority of readmitted carriers harbor MRSA for > 3 years and that, in this population, culture of the anterior nares alone (with culture of wound or sputum, when present) is a valid and efficient method for the detection of persistent MRSA carriage.

AIDS Res Hum Retroviruses, 1994 Dec, 10(12), 1619 - 27
Dysregulation of interleukin 8, interleukin 10, and interleukin 12 release by alveolar macrophages from HIV type 1-infected subjects; Denis M et al.; We examined the in vitro release of interleukin 8 (IL-8), interleukin 10 (IL-10), and interleukin 12 (IL-12) by alveolar macrophages from normal volunteers and HIV-1-infected subjects . Normal volunteers had very low levels of IL-8 and IL-10 and undetectable IL-12 in the cell-free bronchoalveolar lavage fluid (BALF) . Asymptomatic HIV-1-infected subjects had elevated levels of IL-8 and IL-10 in their BALF, and HIV-1-infected subjects with nonspecific interstitial pneumonitis (NIP) or infected with Pneumocystis carinii had the highest BALF levels of IL-10 and IL-8 . It was found that alveolar macrophages from asymptomatic HIV-1 subjects and from NIP subjects spontaneously released elevated IL-8, IL-10, and IL-12 . However, AIDS subjects infected with P . carinii had cells that released elevated levels of IL-10 and IL-8, but low levels of IL-12 . When alveolar macrophages were stimulated with Staphylococcus aureus Cowan (SAC), cells from normal volunteers responded with a considerably increased release of IL-8, IL-10, and IL-12; cells from HIV-1-infected subjects without P . carinii infection responded with a moderate increase in release of all three monokines . SAC stimulation did not enhance the release of monokines by cells from AIDS subjects with P . carinii infection, and IL-12 levels remained low . There was no strict relationship between spontaneous cytokine release and p24 HIV-1 antigen expression by alveolar macrophages . Finally, we showed that neutralizing IL-10 production by alveolar macrophages from AIDS subjects substantially increased IL-12 releasability.(ABSTRACT TRUNCATED AT 250 WORDS)

APMIS, 1994 Dec, 102(12), 891 - 900
Staphylococcal neutral phosphatase . A highly cationic molecule with binding properties for immunoglobulin; Yousif Y et al.; Staphylococcal neutral phosphatase (NPtase) was purified from two Staphylococcus aureus strains by sequential high salt extraction, ultracentrifugation and ion exchange chromatography . The enzyme showed maximum phosphatase activity at neutral pH, appeared as two bands in SDS-PAGE (31 and 32 kDa), and the isoelectric point was > 10 . No close similarity between NPtase and other known bacterial proteins in respect of their N-terminal amino acid sequences was found . Purified NPtase bound rat and human polyclonal IgG {intact and F(ab')2 fragments}, IgM, IgA, intact myeloma immunoglobulins, myeloma light chains, gamma heavy chain and, with a much lower affinity, Fc fragments . Furthermore, NPtase can bind serum albumin . Heparin, a highly negatively charged molecule, significantly inhibited NPtase binding to immunoglobulins and HSA, but did not inhibit the binding of specific antibodies to NPtase; this indicates that charge interactions are important . The newly characterized staphylococcal phosphatase with binding properties for immunoglobulin is an interesting bacterial protein that could be involved in post-infectious sequelae.

Burns, 1994 Dec, 20(6), 514 - 21
Patterns of Staphylococcus aureus colonization, toxin production, immunity and illness in burned children; Childs C et al.; Toxic shock syndrome toxin-one (TSST-1) produced from some but not all strains of Staphylococcus aureus is considered to be responsible for the development of the serious illness, toxic shock syndrome (TSS) . The aim of this study was to establish the importance of S . aureus in the aetiology of suspected cases of TSS in acutely burned children . The pattern of colonization of S . aureus, and in particular toxic shock syndrome toxin-one (TSST-1) producing isolates, was studied in 53 burned children admitted as consecutive cases . S . aureus was not normally present on admission . Although it was the most common wound pathogen, it was acquired during the first few days after admission . Antibody status to TSST-1 on admission and at discharge was determined . Only half (49 per cent) of the children had antibodies to TSST-1 . When it was possible to obtain paired admission and discharge samples in patients who had been given blood products, an assessment of seroconversion could be made . Two of the four patients given blood products during the resuscitation and postoperative period were antibody negative on admission (the other two were TSST-1 antibody positive) . By discharge they had antibodies to TSST-1 . Whilst the majority of donated blood products had antibodies to TSST-1 (76 per cent), some (24 per cent) did not . Seven of 53 children (13 per cent) developed a toxic shock-like illness which caused clinical concern.(ABSTRACT TRUNCATED AT 250 WORDS)

Kansenshogaku Zasshi, 1994 Dec, 68(12), 1523 - 6
{A case of MRSA sepsis treated by the sequential combination therapy netilmycin and minocycline}; Maesaki S et al.; A sixteen year old female was feverish from June 12, 1993 . Methicillin-resistant Staphylococcus aureus was isolated from the blood, the diagnosis of MRSA sepsis was established . Vancomycin (2 g/day) was administered for eighteen days, but MRSA was not eradicated in the blood culture . Then she was administered a combination therapy of arbekacin (200 mg/day) and imipenem/cilastain (1 g/day) for seven days, but MRSA in the blood was cultured continuously . The sequential combination therapy of netilmycin (200 mg/day) and minocycline (200 mg/day) was started, MRSA was eradicated from the blood culture after four days . The sequential combination therapy netilmycin and minocycline was seemed to be effective for MRSA infection.

Kansenshogaku Zasshi, 1994 Dec, 68(12), 1518 - 22
Antibacterial activity of epigallocatechin gallate against methicillin-resistant Staphylococcus aureus; Kono K et al.; The antibacterial activity of epigallocatechin gallate (EGCg), a catechin, against 53 clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) was evaluated and expressed as minimal inhibitory concentration (MIC) . The MIC50 and MIC90 of the strains were found be 64 and 126 micrograms/ml, respectively by the microdilution method . A time-kill study using an isolate showed that EGCg appeared to be bacteriostatic at 1-2 x MIC and bactericidal at 6 x MIC against MRSA . In addition, the activity of EGCg was stable to various physical conditions including boiling or freezing . These findings suggest that EGCg could be a useful agent for treating MRSA infection.

Immunology, 1994 Dec, 83(4), 631 - 8
Studies of protein A and herpes simplex virus-1 induced Fc gamma-binding specificities . Different binding patterns for IgG3 from Caucasian and Oriental subjects; Johansson PJ et al.; Herpes simplex virus type 1 (HSV-1) expresses a receptor that binds the Fc portion of IgG . This HSV-1 Fc gamma-binding protein is, like protein A of Staphylococcus aureus, known to bind human IgG1, IgG2 and IgG4 but not IgG3 subclasses . However, IgG3 with the allotype Gm(s+)(t+), prominent in the Oriental population, reacts with protein A . This prompted us to investigate the reactivity of Oriental IgG3 monoclonal myeloma proteins of various allotypes with the HSV-1 Fc gamma-binding protein . Of seven Oriental IgG3 myeloma proteins with allotypes Gm(s+)(t+)(u-)(b+)(g-), Gm(s-)(t-)(u+)(b+)(g-) and Gm(s-)(t-)(u+)(b-)(g+), all reacted with the HSV-1 Fc gamma-binding protein . This was in contrast to negative reactions obtained with three IgG3 myeloma proteins of Caucasian origin with Gm(b+)(g-) or Gm(b-)(g+) phenotypes . The same binding pattern, i.e . binding of IgG3 of Oriental but not of Caucasian origin, was found with protein A . The binding of the monoclonal Oriental IgG3 proteins was again independent of the G3m phenotype . These findings support the concept that the HSV-1 Fc gamma-binding protein A have a similar binding site on the IgG molecule . All monoclonal IgG3 proteins derived from Oriental subjects with or without histidine at position 435 bound to HSV Fc gamma-binding protein . This suggests that Oriental IgG3 myeloma proteins with Gm(s-)(t-) phenotypes have additional critical amino acid residue substitutions important for HSV Fc gamma binding different from those already known.

Immunology, 1994 Dec, 83(4), 611 - 6
Differential effects of chlorination of bacteria on their capacity to generate NO, TNF-alpha and IL-6 in macrophages; Marcinkiewicz J et al.; Activated rodent macrophages produce high amounts of nitric oxide (NO) . NO as a tumoricidal and defence molecule against intracellular parasites is commonly accepted . However, its role as an obligatory killing factor for extracellular bacteria is controversial . In the present study we stimulated murine peritoneal macrophages by heat-killed bacteria (Staphylococcus aureus, S . epidermidis and Escherichia coli) . In some groups bacteria were pretreated with HOCl, to replace the chlorinating system in activated neutrophils that operates as a bactericidal system in vivo . High levels of NO, tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were detected after stimulation by all non-chlorinated bacteria strains tested . However, after chlorination Gram-positive bacteria lost their ability to induce NO and TNF-alpha, whereas phagocytosis and IL-6 production were not affected by chlorination.

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