Vaccine, 1997 Aug, 15(11), 1165 - 73 Vaccinator device for delivering propellant-driven aerosols of Streptococcus suis bacterin into the respiratory tracts of swine; Brown AR et al.; Metered-dose propellant-driven small particle aerosols of a killed whole bacterium, Streptococcus suis, were produced and characterized for their aerodynamic particle sizes and antigenicity as potential respiratory mucosal vaccines against S . suis infections in swine . To facilitate the efficient delivery of such vaccine aerosols to large animals, an electro-mechanical device was developed to synchronize aerosol release to an animal's inhalation cycles . The device was tested for its capacity to deliver a fluorescein conjugate of this bacterin (FITC-S . suis) into the respiratory tracts of 18 pigs . Results showed that FITC-S . suis could be detected in the lungs of swine as small as 4.5 kg with as few as two aerosol actuations . Metered-dose propellant-driven aerosols of bacterin vaccines delivered by this respiratory vaccinating device are discussed as a new approach for stimulated mucosal immunity against respiratory infections in animals. J Vet Pharmacol Ther, 1997 Aug, 20(4), 318 - 22 Pharmacokinetics of ampicillin and sulfadimidine in pigs infected experimentally with Streptococcus suum; Yuan ZH et al.; Twenty-three hybrid pigs (23 +/- 3 kg body wt) were assigned to three groups to investigate the pharmacokinetics of ampicillin (APC, 10 mg/kg) administered intravenously (i.v.) and intramuscularly (i.m.), and sulfadimidine (SDM, 50 mg/kg) administered intravenously as a bolus injection . In the first series of experiments the animals remained healthy . Subsequently, the pigs were infected with Streptococcus suum by subcutaneous (s.c.) inoculation and the experiments were repeated . The total apparent distribution volume of APC given intravenously was increased from 0.512 +/- 0.026 L/kg in uninfected pigs to 0.68 +/- 0.06 L/kg (P < 0.01) in infected pigs, whereas there were no significant changes in the same parameter for SDM (P > 0.05) . The clearance of APC was increased markedly from 0.52 +/- 0.07 L/kg/h in uninfected pigs to 0.62 +/- 0.10 L/kg/h in infected pigs . In contrast, SDM clearance was decreased markedly from 0.023 +/- 0.003 L/kg/h to 0.017 +/- 0.003 L/kg/h (P < 0.05) . As a result, the biological half-lives of the drugs were altered to varying degrees in infected pigs . The half-life of SDM was increased from 15.0 +/- 3.0 h in uninfected pigs to 20 +/- 7h in infected pigs (P < 0.05), but differences in APC half-lives between uninfected and infected animals were not observed (P > 0.05) . There were no statistically significant differences in pharmacokinetic parameters of APC administered by intramuscular injection between the healthy and the diseased status, although its half-life was shortened from 0.76 +/- 0.22 h in the healthy to 0.57 +/- 0.23 h in the diseased . The results suggest that blood concentrations of APC and SDM are affected differently by the same disease due to its specific effects on their distribution and elimination. J Dairy Sci, 1997 Aug, 80(8), 1846 - 50 Evaluation of two iodophor teat germicides: activity against Staphylococcus aureus and Streptococcus agalactiae; Boddie RL et al.; Two germicides containing 0.5 and 1% titratable iodine were tested for efficacy against the development of new intramammary infections (IMI) caused by Staphylococcus aureus and Streptococcus agalactiae . The two trials for postmilking teat dip used a model for experimental challenge that was recommended by the National Mastitis Council . The 0.5% iodine formulation reduced new Staph . aureus IMI by 78.2% and reduced new Strep . agalactiae IMI by 73.2% . The 1% iodine product reduced new Staph . aureus IMI by 43.5% and reduced new Strep . agalactiae IMI by 46.4% . No adverse effects on the condition of teat skin or on teat ends were observed over the course of the trials . At the completion of each trial, the teat skin of dipped quarters was characterized as normal, smooth skin that was free from scales, cracks, or chapping; the teat orifice was characterized as smooth without evidence of irritation. Can J Surg, 1997 Aug, 40(4), 313 - 4 Clenched-fist injury complicated by methicillin-resistant Staphylococcus aureus; Berlet G et al.; Hand infections are a common sequela of clenched-fist injuries . The majority of these infections are due to Staphylococcus and Streptococcus species . Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly being isolated in Canadian health care facilities . In addition, MRSA now needs to be considered in community acquired hand infections that fail to respond to common empiric therapy . A 51-year-old man with MRSA due to a hand injury was treated successfully with vancomycin . The prevalence, mechanism of resistance and treatment of MRSA are briefly reviewed. Vet Res Commun, 1997 Aug, 21(6), 381 - 407 Streptococcus suis: past and present; Staats JJ et al.; Steptococcus suis is a Gram-positive, facultatively anaerobic coccus that has been implicated as the cause of a wide range of clinical disease syndromes in swine and other domestic animals . In swine, the disease has spread worldwide but is more prevalent in countries with intensive swine management practices . The disease syndromes caused by S . suis in swine include arthritis, meningitis, pneumonia, septicaemia, endocarditis, polyserositis, abortions and abscesses . S . suis has also been implicated in disease in humans, especially among abattoir workers and swine and pork handlers . In humans, S . suis type 2 can cause meningitis, which may result in permanent hearing loss, septicaemia, endocarditis and death . The pathogenic mechanism of S . suis is not well defined . Several virulence factors have been identified, but their roles in pathogenesis and disease have not been well elucidated . Much work is in progress on characterization of virulence factors and mechanisms, with emphasis on the control of the disease . Because of the non-availability of suitable immunoprophylaxis, control of S . suis infection has depended mainly on the use of antimicrobials. Ann Plast Surg, 1997 Aug, 39(2), 131 - 6 Evaluation of penicillin and hyperbaric oxygen in the treatment of streptococcal myositis; Zamboni WA et al.; The purpose of this study was to evaluate effects of hyperbaric oxygen (HBO) and penicillin (PCN) therapy in a murine model of streptococcal myositis . The thighs of Swiss Webster mice were inoculated with Streptococcus pyogenes . Four groups were evaluated: (1) control (N = 10), (2) HBO treatment (N = 10), (3) PCN treatment (N = 8), and (4) PCN and HBO treatment (N = 6) . Mortality (day of death) and the number of colony-forming units (cfu) were measured . PCN significantly lowered cfu from control (p < 0.05) . Cfu in group 4 was significantly lower than PCN alone (p = 0.006) . Survival was significantly longer in the PCN group compared with the control (p < 0.01) . Survival in the combined treatment group was significantly longer than PCN alone (p < 0.01) . These results suggest that (1) HBO treatment alone does not decrease mortality or bacterial proliferation in vivo significantly, (2) PCN therapy alone improves outcome significantly, and (3) the combined treatment of PCN and HBO exerts at least additive effects in both decreasing bacterial counts in vivo and increasing survival in this model. J Bacteriol, 1997 Aug, 179(16), 5178 - 87 Role of mga in growth phase regulation of virulence genes of the group A streptococcus; McIver KS et al.; To determine whether growth phase affects the expression of mga and other virulence-associated genes in the group A streptococcus (GAS), total RNA was isolated from the serotype M6 GAS strain JRS4 at different phases of growth and transcript levels were quantitated by hybridization with radiolabeled DNA probes . Expression of mga (which encodes a multiple gene regulator) and the Mga-regulated genes emm (which encodes M protein) and scpA (which encodes a complement C5a peptidase) was found to be maximal in exponential phase and shut off as the bacteria entered stationary phase, while the housekeeping genes recA and rpsL showed constant transcript levels over the same period of growth . Expression of mga from a foreign phage promoter in a mga-deleted GAS strain (JRS519) altered the wild-type growth phase-dependent transcription profile seen for emm and scpA, as well as for mga . Therefore, the temporal control of mga expression requires its upstream promoter region, and the subsequent growth phase regulation of emm and scpA is Mga dependent . A number of putative virulence genes in JRS4 were shown not to require Mga for their expression, although several exhibited growth phase-dependent regulation that was similar to mga, i.e., slo (which encodes streptolysin O) and plr (encoding the plasmin receptor/glyceraldehyde-3-phosphate dehydrogenase) . Still others showed a markedly different pattern of expression (the genes for the superantigen toxins MF and SpeC) . These results suggest the existence of complex levels of global regulation sensitive to growth phase that directly control the expression of virulence genes and mga in GAS. Antimicrob Agents Chemother, 1997 Aug, 41(8), 1673 - 6 Efficacy of azithromycin or clarithromycin for prophylaxis of viridans group streptococcus experimental endocarditis; Rouse MS et al.; The efficacy of azithromycin or clarithromycin was compared to that of amoxicillin, clindamycin, or erythromycin for the prevention of viridans group streptococcus experimental endocarditis . Rabbits with catheter-induced aortic valve vegetations were given no antibiotics or two doses of amoxicillin at 25 mg/kg of body weight, azithromycin at 10 mg/kg, clarithromycin at 10 mg/kg, clindamycin at 40 mg/kg followed by clindamycin at 20 mg/kg, or erythromycin at 10 mg/kg . Antibiotics were administered 0.5 h before and 5.5 h after intravenous infusion of 5 x 10(5) CFU of Streptococcus milleri . Forty-eight hours after bacterial inoculation, the rabbits were killed and aortic valve vegetations were aseptically removed and cultured for bacteria . Infective endocarditis occurred in 88% of untreated animals, 1% of animals receiving amoxicillin, 9% of animals receiving erythromycin, 0% of animals receiving clindamycin, 2.5% of animals receiving clarithromycin, and 1% of animals receiving azithromycin . All five regimens were more effective (P < 0.001) than no prophylaxis . Erythromycin was less effective (P < 0.05) than amoxicillin or clindamycin . Azithromycin or clarithromycin was as effective as amoxicillin, clindamycin, or erythromycin for the prevention of viridans group streptococcus experimental endocarditis in this model. J Bacteriol, 1997 Aug, 179(15), 4953 - 8 Molecular and genetic characterization of the capsule biosynthesis locus of Streptococcus pneumoniae type 19B; Morona JK et al.; We have previously reported the nucleotide sequence of the Streptococcus pneumoniae type 19F capsular polysaccharide synthesis locus (cps19f), which consists of 15 open reading frames (ORFs) designated cps19fA to -O . Hybridization analysis indicated that close homologs for cps19fA to -H and cps19fK to -O were found in type 19B, but there were no homologs for cps19fI and -J . In this study we used long-range PCR to amplify and clone a 10.5-kb section of the S . pneumoniae type 19B capsule locus (cps19b) between cps19bH and cps19bK . This region of the cps19b locus is 4 kb larger than that in the cps19f locus and replaces cps19fI and cps19fJ with five new ORFs, designated cps19bP, -I, -Q, -R, and -J . We have proposed functions for four of the protein products, including functional homologs of Cps19fI and Cps19fJ . Transformation of a S . pneumoniae mutant containing an interrupted type 19F capsule locus with the 10.5-kb cps19b PCR product converted the recipient strain to type 19B . Southern hybridization analysis indicated that cps19bP, -I, -Q, -R, and -J are unique to type 19B and the closely related type 19C. J Bacteriol, 1997 Aug, 179(15), 4901 - 8 Biochemical characterization of penicillin-resistant and -sensitive penicillin-binding protein 2x transpeptidase activities of Streptococcus pneumoniae and mechanistic implications in bacterial resistance to beta-lactam antibiotics; Zhao G et al.; To understand the biochemical basis of resistance of bacteria to beta-lactam antibiotics, we purified a penicillin-resistant penicillin-binding protein 2x (R-PBP2x) and a penicillin-sensitive PBP2x (S-PBP2x) enzyme of Streptococcus pneumoniae and characterized their transpeptidase activities, using a thioester analog of stem peptides as a substrate . A comparison of the k(cat)/Km values for the two purified enzymes (3,400 M(-1) s(-1) for S-PBP2x and 11.2 M(-1) s(-1) for R-PBP2x) suggests that they are significantly different kinetically . Implications of this finding are discussed . We also found that the two purified enzymes did not possess a detectable level of beta-lactam hydrolytic activity . Finally, we show that the expression levels of both PBP2x enzymes were similar during different growth phases. Biomaterials, 1997 Aug, 18(15), 1051 - 7 In vitro inhibition of caries around a resin composite restoration containing antibacterial filler; Syafiuddin T et al.; Class V cavities were prepared and restored with resin composite containing antibacterial filler powder (Apacider-AW, Ap-AW) using experimental restorations . The restored teeth were incubated in vitro with the cariogenic bacteria Streptococcus mutans IFO 13955 . Ground sections were then prepared and examined using macrophotography . Lesions of the outer and inner wall were noted, and the depths of which the lesions penetrated were measured . We found that, in restorations containing 1-5 wt% Ap-AW, caries penetrated the marginal area, while in restorations containing 10 wt% Ap-AW the margin remained free of caries out to a distance of about 1.1 and 1.8 mm on the occlusal and gingival sides, respectively. J Infect Dis, 1997 Aug, 176(2), 526 - 9 A new multiantigen immunoassay for the quantification of IgG antibodies to capsular polysaccharides of Streptococcus pneumoniae; Roth F et al.; A new nitrocellulose-based solid-phase multiantigen immunoassay (MAIA) for the detection of serum antibodies to Streptococcus pneumoniae capsular polysaccharides (PPSs) is presented . Evaluation with human sera showed that the MAIA test is reproducible, sensitive, and specific . It correlated well with a conventional ELISA method . The multiantigen strip system allowed quantification of antibodies against several PPS serotypes simultaneously and with a minimal amount of serum specimen . The presented solid-phase immunoassay for the quantification of anti-PPS antibodies seems to be a superior and attractive alternative to currently used ELISA tests and offers possibilities for standardization. J Infect Dis, 1997 Aug, 176(2), 439 - 44 Interleukin-6 gene-deficient mice show impaired defense against pneumococcal pneumonia; van der Poll T et al.; Induction of pneumonia in C57Bl/6 mice by intranasal inoculation with 10(6) cfu of Streptococcus pneumoniae resulted in sustained expression of interleukin (IL)-6 mRNA in lungs and increases in lung and plasma IL-6 concentrations . In IL-6-deficient (IL-6-/-) mice, pneumonia was associated with higher lung levels of the proinflammatory cytokines tumor necrosis factor-alpha, IL-1beta, and interferon-gamma and of the antiinflammatory cytokine IL-10 than in wild type (IL-6+/+) mice (all P < .05) . Also, the plasma concentrations of soluble tumor necrosis factor receptors were higher in IL-6-/- mice (P < .05), while the acute-phase protein response was strongly attenuated (P < .01) . Lungs harvested from IL-6-/- mice 40 h after inoculation contained more S . pneumoniae colonies (P < .05) . IL-6-/- mice died significantly earlier from pneumococcal pneumonia than did IL-6+/+ mice (P < .05) . During pneumococcal pneumonia, IL-6 down-regulates the activation of the cytokine network in the lung and contributes to host defense. J Biol Chem, 1997 Aug 1, 272(31), 19502 - 8 Functional analysis of glycosyltransferases encoded by the capsular polysaccharide biosynthesis locus of Streptococcus pneumoniae serotype 14; Kolkman MA et al.; Bacteria belonging to the species Streptococcus pneumoniae vary in their capsule . Presently, 90 capsular serotypes are known, all possessing their own specific polysaccharide structure . Little is known about the biosynthesis of these capsular polysaccharides . The cps locus of S . pneumoniae serotype 14 was cloned . So far, 7 open reading frames have been sequenced, cps14B to cps14H . The gene products are similar to proteins involved in bacterial polysaccharide biosynthesis, both of Gram-negative and -positive micro-organisms . Gene-specific mutants were created for cps14D to cps14H by insertional mutagenesis . All mutants no longer agglutinated with a monoclonal antibody against type 14 capsule polysaccharides . The biosynthetic function of cps14E and cps14G was determined by analysis of the intermediates in the synthesis of the oligosaccharide subunit, formed in membrane preparations of the wild-type and mutant strains and in membrane preparations of Escherichia coli expressing the pneumococcal glycosyltransferases . The enzyme encoded by cps14E is a glucosyl-1-phosphate transferase that links glucose to a lipid carrier, the first step in the biosynthesis of the type 14 repeating unit . The gene product of cps14G encodes a beta-1,4-galactosyltransferase, the enzyme responsible for the second step in the subunit synthesis, the transfer of galactose to lipid-linked glucose. Infect Immun, 1997 Aug, 65(8), 3255 - 60 Coexistence of CD14-dependent and independent pathways for stimulation of human monocytes by gram-positive bacteria; Cauwels A et al.; The cell wall is a key inflammatory agent of gram-positive bacteria . Possible receptors mediating cell wall-induced inflammation include CD14 and platelet-activating factor (PAF) receptor . To delineate the conditions under which these various receptors might be used, human monocytic THP-1 cells and heparinized whole human blood were stimulated with lipopolysaccharide (LPS), intact Streptococcus pneumoniae bacteria, or purified pneumococcal cell wall . THP-1 culture supernatant or cell-free plasma was analyzed for the presence of tumor necrosis factor, interleukin-1beta (IL-1beta), and IL-6 . For the cultured monocytes, anti-CD14 inhibited induction of the inflammatory cytokines by the cell wall and LPS but not by intact pneumococcal bacteria . Despite the difference in CD-14 usage, the intracellular pathways induced by the three agents demonstrated similarities, as revealed in the presence of specific signal transduction inhibitors such as cholera toxin, pertussis toxin, and genistein . Cytokine production in whole human blood indicated that anti-CD14 failed to block responses to cell wall and intact pneumococci, whereas while LPS-induced responses were inhibited . PAF receptor antagonist had no effect under any conditions in both assays . These results indicate that although cell walls bind to both CD14 and PAF receptor, only CD14 appears to engender a cytokine response under restricted conditions . Furthermore, host cell responses to intact pneumococci are consistently independent of CD14 and PAF receptor. J Clin Microbiol, 1997 Aug, 35(8), 2111 - 4 Molecular epidemiology of Streptococcus pyogenes in an area where acute pharyngotonsillitis is endemic; Nguyen L et al.; During an open clinical trial in an area where streptococcal infections are hyperendemic, we studied the genetic polymorphism of Streptococcus pyogenes isolates collected from patients and from healthy carriers living in close contact with them . The clonal diversity of isolates was analyzed by pulsed-field gel electrophoresis with three restriction enzymes (SmaI, ApaI, and SacII) . The pharynx of each patient and healthy carrier was colonized by a single clone, suggesting the clonal nature of streptococcal colonization in individuals . Among 52 isolates obtained from patients with acute pharyngotonsillitis, we found 14 genetically unrelated clones, showing the genetic diversity of S . pyogenes . However, two clones belonging to the M1 and M12 serotypes represented about 70% of isolates in carriers and patients . Pharyngeal colonization in cured patients was monitored for 3 to 4 months . After the initial elimination of S . pyogenes following antibiotic therapy, the rate of recolonization was high by day 30 (about 20%) and was also at that level between days 90 and 120; this was similar to the carriage rate in family contacts . Thus, cured patients can be recontaminated by unrelated clones, suggesting that colonization of healthy carriers might be a potential source of spread and redistribution of S . pyogenes isolates. Gene, 1997 Jul 31, 194(2), 249 - 55 Analysis of a Streptococcus pneumoniae gene encoding signal peptidase I and overproduction of the enzyme; Zhang YB et al.; The spi gene of Streptococcus pneumoniae was cloned and its nucleotide sequence was determined . It encodes a protein of 204 amino acids that is homologous to bacterial signal peptidase I proteins . The S . pneumoniae protein contains all of the conserved amino acid sequence motifs previously identified in this enzyme from both prokaryotic and eukaryotic sources . Sequence comparisons revealed several additional motifs characteristic of the enzyme . The cloned S . pneumoniae gene complemented an Escherichia coli mutant defective in its leader peptidase gene . Expression of the spi gene in S . pneumoniae appeared to be essential for viability . The cloned gene was shown to produce a polypeptide of approximately 20 kDa . Overproduction of the S . pneumoniae spi gene in an E . coli expression system gave a native protein product, soluble in the presence of a non-ionic detergent, which should be amenable to structural determination. BMJ, 1997 Jul 26, 315(7102), 216 - 9; discussion 220 Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and mortality in Malawi: clinical trial; Taha TE et al.; OBJECTIVE: To determine if cleansing the birth canal with an antiseptic at delivery reduces infections in mothers and babies postnatally . DESIGN: Clinical trial; two months of no intervention were followed by three months of intervention and a final month of no intervention . SETTING: Queen Elizabeth Central Hospital (tertiary care urban hospital), Blantyre, Malawi . SUBJECTS: A total of 6965 women giving birth in a six month period and their 7160 babies . INTERVENTION: Manual wipe of the maternal birth canal with a 0.25% chlorhexidine solution at every vaginal examination before delivery . Babies born during the intervention were also wiped with chlorhexidine . MAIN OUTCOME MEASURES: Effects of the intervention on neonatal and maternal morbidity and mortality . RESULTS: 3635 women giving birth to 3743 babies were enrolled in the intervention phase and 3330 women giving birth to 3417 babies were enrolled in the non-intervention phase . There were no adverse reactions related to the intervention among the mothers or their children . Among infants born in the intervention phase, overall neonatal admissions were reduced (634/3743 (16.9%) v 661/3417 (19.3%), P < 0.01), as were admissions for neonatal sepsis (7.8 v 17.9 per 1000 live births, P < 0.0002), overall neonatal mortality (28.6 v 36.9 per 1000 live births, P < 0.06), and mortality due to infectious causes (2.4 v 7.3 per 1000 live births, P < 0.005) . Among mothers receiving the intervention, admissions related to delivery were reduced (29.4 v 40.2 per 1000 deliveries, P < 0.02), as were admissions due to postpartum infections (1.7 v 5.1 per 1000 deliveries, P = 0.02) and duration of hospitalisation (Wilcoxon P = 0.008) . CONCLUSIONS: Cleansing the birth canal with chlorhexidine reduced early neonatal and maternal postpartum infectious problems . The safety, simplicity, and low cost of the procedure suggest that it should be considered as standard care to lower infant and maternal morbidity and mortalityPIP: A clinical trial of the effects of cleansing both the birth canal and the newborn with an antiseptic indicates that this simple procedure substantially reduces early neonatal and maternal postpartum infection . The antiseptic used, a 0.25% chlorhexidene solution, has been shown to reduce neonatal morbidity due to group B streptococcus and can neutralize HIV . Enrolled in the study were 6965 women giving birth to 7160 infants at Queen Elizabeth Central Hospital in Blantyre, Malawi, in a 6-month period in 1994 . 2 months of no intervention were followed by 3 months of intervention and a final month of no intervention . Significant differences were recorded between the 3743 infants delivered during the intervention phase and the 3417 controls in terms of overall neonatal admissions (16.9 vs . 19.3/1000 live births), admissions for neonatal sepsis (7.8 vs . 17.9/1000 live births), overall neonatal mortality (28.6 vs . 36.9/1000 live births), and mortality due to infectious causes (2.4 vs . 7.3/1000 live births) . Significant differences also were found between the 3635 mothers in the intervention group and the 3330 controls in delivery-related admissions (29.4 vs . 40.2/1000 deliveries), admissions due to postpartum infection (1.7 vs . 5.1/1000 deliveries), and the average duration of hospitalization (48.7 vs . 50.2 hours) . The cleansing procedure was easily administered, required almost no extra staff time, and cost less than US $0.10 per patient, making it appropriate for standard care . FEMS Microbiol Lett, 1997 Jul 15, 152(2), 363 - 9 Determination of specific DNA strand discontinuities with nucleotide resolution in exponentionally growing bacteria harboring rolling circle-replicating plasmids; Grohmann E et al.; Plasmid replication by the rolling circle mechanism and conjugative transfer of plasmids require the generation of a specific strand discontinuity in the DNA . In both processes cleavage at the so-called nic site is catalyzed by plasmid-encoded proteins . The strand discontinuities at the conjugative origins of transfer of plasmid pE194 and pMV158 were determined in Bacillus subtilis and Streptococcus pneumoniae, respectively, with a recently developed runoff DNA synthesis assay . The positions of intracellular cleavage within the respective transfer origins were shown to coincide with the site predicted for pE194 and with the nic site determined in vitro for pMV158 . For pMV158, the influence of a mutation in the S . pneumoniae polA gene on the efficiency of replication was investigated . In addition, the nic site within the double-stranded origin of the-rolling circle-replicating plasmid pMV158 in S . pneumoniae as well as that of pFX2 in Escherichia coli was mapped with nucleotide resolution. Proc Natl Acad Sci U S A, 1997 Jul 8, 94(14), 7435 - 40 Specific cleavage of chromosomal and plasmid DNA strands in gram-positive and gram-negative bacteria can be detected with nucleotide resolution; Zechner EL et al.; A sensitive and precise in vitro technique for detecting DNA strand discontinuities produced in vivo has been developed . The procedure, a form of runoff DNA synthesis on molecules released from lysed bacterial cells, mapped precisely the position of cleavage of the plasmid pMV158 leading strand origin in Streptococcus pneumoniae and the site of strand scission, nic, at the transfer origins of F and the F-like plasmid R1 in Escherichia coli . When high frequency of recombination strains of E . coli were examined, DNA strand discontinuities at the nic positions of the chromosomally integrated fertility factors were also observed . Detection of DNA strand scission at the nic position of F DNA in the high frequency of recombination strains, as well as in the episomal factors, was dependent on sexual expression from the transmissable element, but was independent of mating . These results imply that not only the transfer origins of extrachromosomal F and F-like fertility factors, but also the origins of stably integrated copies of these plasmids, are subject to an equilibrium of cleavage and ligation in vivo in the absence of DNA transfer. Mol Microbiol, 1997 Jul, 25(2), 329 - 41 Transcriptional analysis of the Streptococcus mutans hrcA, grpE and dnaK genes and regulation of expression in response to heat shock and environmental acidification; Jayaraman GC et al.; The dental pathogen Streptococcus mutans persists and causes diseases in highly dynamic environments and gains a selective ecological advantage in environmental conditions that frequently exceed the limits for growth of the organism, particularly with regard to environmental pH . The goal of this study was to begin a molecular genetic analysis of a major stress protein, DnaK/Hsp70, to begin to understand how stress responses are regulated in this lactic acid bacterium and to establish a relationship between dnaK gene expression and exposure to acidic environments . Cloning and nucleotide sequence analysis revealed that the dnaK gene is preceded by, and is in an operon-like arrangement with, the hrcA and grpE genes, although intergenic spacing was unlike that described in other bacteria . An inverted repeat (a CIRCE element) was identified by sequence analysis and, using primer extensions, a heat shock-responsive, sigmaA-type promoter, P1, 5' to the hrcA gene, and a sigmaB-type promoter, 5' to the grpE translational start site, were identified . No promoters were detected between grpE and dnaK . A strain carrying a strongly polar insertion in the hrcA gene had markedly diminished levels of dnaK mRNA, indicating that dnaK was transcribed as part of an operon from P1, and to a lesser extent from P2 . Results from physiological manipulation of S . mutans in continuous chemostat culture demonstrated that steadystate levels of S . mutans dnaK mRNA and DnaK protein were (i) increased in response to acid shock; (ii) elevated in acid 'adapted' cells; and (iii) induced in response to alkali shock of acid 'adapted' cells . In all cases, increased amounts of dnaK mRNA could be correlated with enhanced transcription from P1 . This study provides the first detailed analysis of the expression of a heat shock gene from an oral isolate, and the evidence provided suggests that sigmaB-like promoters may also be involved in class I heat shock gene expression in some Gram-positive organisms. J Laryngol Otol, 1997 Jul, 111(7), 666 - 8 Lateral neck abscess caused by Streptococcus bovis in a patient with undiagnosed colon cancer; Goumas PD et al.; Bacteraemia or endocarditis caused by Streptococcus bovis, a non-enterococcal group D streptococcus, is a very common finding in patients suffering from intestinal tumours or other colon diseases . A case of a patient with a laternal neck abscess caused by S . bovis is reported . During the treatment the patient was found to have colonic malignant lesions . The problems in the appropriate diagnosis and the possible correlation between these two clinical entities are presented and discussed. Zentralbl Veterinarmed A, 1997 Jul, 44(5), 271 - 80 Microbiology and pathology of fibrinous pericarditis in Danish slaughter pigs; Buttenschon J et al.; The prevalence of fibrinous pericarditis detected at slaughter in Danish slaughter pigs is approximately 0.02% . The microbiology and pathology of this disorder was studied through 46 field cases collected at slaughter from May 1994 to August 1995 . Mycoplasmas (Mycoplasma hyopneumoniae, M . hyosynoviae and M . hyorhinis) were isolated from the pericardium in 38 cases and from the joints in six . M . Hyopneumoniae dominated with 33 isolates from the pericardium . Actinobacillus pleuropneumoniae was isolated from the pericardium in three cases (as mono-infection in one and together with M . hyopneumoniae in two cases) and Actinomyces pyogenes was isolated from the pericardium twice (as mono-infection in one case and together with M . hyopneumoniae in another) . A . pyogenes was also present in the lung, liver and kidney in one of these cases . Streptococcus suis was isolated together with mycoplasmas from the pericardium in three cases . The pericardium was sterile in three cases and contained a low grade mixed flora in two; the latter is believed to be a result of the slaughter procedure rather than an infection . No chlamydiae were found in connection with the microbiological examination . Parvovirus was found in one case in the pericardium and in two cases in the spleen . Forty-five cases were subacute to chronic . The gross pathological examination showed that bronchopneumonia, chronic pleuritis and synovitis or a low grade arthritis occurred in most cases . Only the arthritic lesions are believed to be pathogenetically concurrent with the pericarditis . Slight evidence of stasis of the liver and/or periangiolar edema was present in six cases . The histopathological examination confirmed the above mentioned findings . Bacterial colonies were found within the fibrinous layer on the pericardium in all cases from which either A . pleuropneumoniae, A . pyogenes or S . suis was isolated . It is concluded that in this study mycoplasmas, particularly M . Hyopneumoniae, are the more likely cause of fibrinous pericarditis in slaughter pigs. Eur J Clin Microbiol Infect Dis, 1997 Jul, 16(7), 512 - 6 Effect of clavulanic acid and/or polymorphonuclear neutrophils on amoxicillin bactericidal activity against Streptococcus pneumoniae; Martin M et al.; The effects of polymorphonuclear neutrophils (PMNs) and/or clavulanic acid on the bactericidal activity of amoxicillin (at human serum achievable concentrations) against a serotype 3 penicillin-susceptible Streptococcus pneumoniae strain {minimal inhibitory concentration/minimal bactericidal concentration (MIC/MBC) values of penicillin, amoxicillin, and amoxicillin/clavulanic acid (2:1) = 0.01/0.01 microgram/ml} and a serotype 9 penicillin-resistant strain {MIC/MBC of penicillin, amoxicillin, and amoxicillin/clavulanic acid (2:1) = 1/2 microgram/ml} were studied . Against the penicillin-resistant strain, subinhibitory concentrations of amoxicillin reduced the growth rate; this effect was increased by the addition of clavulanic acid . A reduction of the penicillin-resistant initial inocula (3 x 10(6) cfu/ml) at subinhibitory concentrations was obtained only with amoxicillin plus clavulanic acid and PMNs . At suprainhibitory concentrations, both clavulanic acid and PMNs increased the bactericidal activity of amoxicillin, as evidenced by an increased reduction in the penicillin-resistant initial inocula . The combined effect of these antibiotics and immune defenses may help explain the maintenance of their clinical efficacy in respiratory tract infections, despite the increase in the incidence of penicillin-resistant pneumococci. Clin Exp Rheumatol, 1997 Jul-Aug, 15(4), 399 - 404 Antibodies to streptococcal cell wall in psoriatic arthritis and cutaneous psoriasis; Rantakokko K et al.; OBJECTIVE: To evaluate the possible role of streptococcal cell wall antigens in the development of psoriatic arthritis . METHODS: IgM, IgA and IgG class serum antibodies against peptidoglycan-polysaccharide (PG-PS) and peptidoglycan (PG), both from group A streptococcus, were measured in patients with psoriatic arthritis (PA), non-arthritic psoriasis (NAP), rheumatoid arthritis (RA) and in healthy controls, using ELISA . RESULTS: Both groups of psoriatic patients had elevated IgA levels specific to streptococcal PG-PS . No association with the severity of the skin disease or with the different subsets of PA was detected . Higher concentrations of IgG against the two streptococcal preparations was observed in PA than in RA . Analysis of antibody levels in patients with recent onset arthritis showed lower concentrations of IgM antibodies against streptococcal as well as control antigens in early than in late PA, whereas an overall increase of specific IgA and IgG antibodies was observed in early RA . CONCLUSION: The results suggest chronic mucosal stimulation of lymphocytes by long-lived streptococcal antigens in patients with psoriasis, without any difference observed between PA and NAP . The differences between recent onset versus established PA and RA could reflect a distinct immunopathology in the two arthritides. Vaccine, 1997 Jul, 15(10), 1138 - 43 Further studies on the efficacy of a live vaccine against mastitis caused by Streptococcus uberis; Finch JM et al.; Three groups of dairy cows were immunized by subcutaneous (s.c.) administration of a preparation of live Streptococcus uberis (strain 0140J) and an intramammary infusion of a soluble surface extract derived from same the bacteria . Animals in Groups 1 and 2 received two s.c . vaccinations plus an intramammary inoculation . Animals in Group 3 received two s.c . vaccinations but did not receive the intramammary infusion . In addition to the vaccinated animals, each group also contained two non-vaccinated (control) animals . All animals were challenged experimentally by intramammary infusion (in two quarters per animal) of ca 100 c.f.u . of S . uberis (strain 0140J or C221) and monitored for clinical signs of disease, bacterial numbers in milk, somatic cell count in milk, and daily milk yield for the following 10 days . Animals in Group I were challenged with strain 0140J . Only one out of six challenged quarters of three vaccinated cows developed clinical disease compared to all (four out of four) quarters of non-vaccinated cows . Animals in Group 2 were challenged with strain C221 . All challenged quarters of three vaccinated (six out of six) and two non-vaccinated (four out of four) cows developed clinical mastitis . Animals in Group 3 were challenged with strain 0140J . Five out of eight quarters on four vaccinated cows developed clinical mastitis but the onset was delayed in comparison with that in both non-vaccinated cows in which four out of four challenged quarters developed clinical mastitis . These results indicated that vaccination with live S . uberis protects against challenge with the homologous strain but was less effective against a heterologous strain . Reduced protection was also seen when the intramammary booster was omitted. Infection, 1997 Jul-Aug, 25(4), 250 - 1 Analysis of a case of recurrent bacteraemia due to group A Streptococcus equisimilis by pulsed-field gel electrophoresis; Bert F et al.; An 86-year-old woman with a history of metastatic breast cancer developed two episodes of streptococcal bacteraemia and erysipelas separated by an interval of 3 months . The isolates belonged to Lancefield group A but were biochemically identified as Streptococcus equisimilis . The similarity of the two isolates was established by DNA macrorestriction analysis and pulsed-field gel electrophoresis, indicating that the second episode was due to relapse and not reinfection. J Pediatr Hematol Oncol, 1997 Jul-Aug, 19(4), 327 - 33 Influence of penicillin prophylaxis on antimicrobial resistance in nasopharyngeal S . pneumoniae among children with sickle cell anemia . The Ancillary Nasopharyngeal Culture Study of Prophylactic Penicillin Study II; Woods GM et al.; PURPOSE: To evaluate the consequences of prolonged prophylactic penicillin use on the rates of nasopharyngeal colonization with Streptococcus pneumoniae and the prevalence of resistant pneumococcal strains in children with sickle cell anemia . METHODS: Nasopharyngeal specimens were obtained from children with sickle cell anemia (Hb SS or Hb S beta degrees thalassemia) at 10 teaching hospitals throughout the United States . These patients were participating in a prospective, randomized, placebo-controlled trial in which they were prescribed prophylactic penicillin before their fifth birthday and were randomized to prophylactic penicillin or placebo after their fifth birthday (PROPS II) . The specimens were cultured for S . pneumoniae, and isolates were analyzed for antimicrobial susceptibility to nine commonly prescribed antimicrobial agents . RESULTS: Of the 226 patients observed, an average of 8.4 specimens were collected per patient . From 1,896 individual culture specimens, 5.5% of the specimens were positive for S . pneumoniae; 27% of patients had at least one positive culture . Nine percent of the study patients had at least one isolate of penicillin intermediate or resistant pneumococci . There was no significant difference in the percent of positive cultures for S . pneumoniae in those patients given penicillin prophylaxis after 5 years of age (4.1%) compared with those patients given placebo after 5 years of age (6.4%) . Likewise, there was no significant difference (p = 0.298) in the percent of patients with at least one positive culture for S . pneumoniae in the group given prophylactic penicillin after 5 years of age (21.8%) compared with the group given placebo after 5 years of age (28.3%) . There was no difference between the penicillin and placebo groups in the proportion of patients with penicillin intermediate or resistant pneumococci, but there was a trend toward increased carriage of multiply drug-resistant pneumococci in children > 5 years of age receiving prophylactic penicillin compared to children > 5 years of age receiving placebo . The increased colonization rate with multiply drug-resistant organisms of children > 5 years of age receiving penicillin prophylaxis is not statistically significant . CONCLUSIONS: The potential for continued penicillin prophylaxis to contribute to the development of multiply resistant pneumococci should be considered before continuing penicillin prophylaxis in children with sickle cell anemia who are older than 5 years of age . Added to the published data from PROPS II, which demonstrated no apparent advantage to continue prophylaxis, the data support the conclusion that, for children with no history of invasive pneumococcal disease, consideration should be given to discontinue prophylactic penicillin after their fifth birthday. J Hosp Infect, 1997 Jul, 36(3), 191 - 200 Outbreak of scarlet fever at a hospital day care centre: analysis of strain relatedness with phenotypic and genotypic characteristics; Hsueh PR et al.; An outbreak of scarlet fever involving 12 children occurred at a hospital day care centre from February to March 1996 . Twenty-five throat isolates of Streptococcus pyogenes (GAS, group A streptococcus) available from 24 children, including 10 children with scarlet fever and 14 asymptomatic carriers, and one asymptomatic staff member were studied for the presence of genes encoding streptococcal pyrogenic exotoxin types A (speA), B (speB), and C (speC) and for protease activity . Antimicrobial susceptibilities using the E-test, cluster analysis by cellular fatty acid composition and random amplified polymorphic DNA (RAPD) patterns by means of arbitrarily-primed polymerase chain reaction (APPCR) of the isolates were performed to investigate the outbreak . Only one isolate from an asymptomatic child possessed the speA gene . All isolates possessed the speB gene and 24 (96%) isolates were positive for the speC gene . There was no difference in protease activity between isolates from children with scarlet fever and from asymptomatic carriers . Thirteen isolates (10 recovered from children with scarlet fever, two from asymptomatic children, and one from the staff member) were considered to be the same strain according to the identical antimicrobial susceptibility profile and RAPD patterns and were also considered to be similar by cluster analysis of fatty acid composition . These findings suggest that the outbreak was caused by a unique clone of GAS . We conclude that RAPD typing and cluster analysis by cellular fatty acids composition both provide a powerful tool for epidemiological investigation of GAS infections. Auris Nasus Larynx, 1997 Jul, 24(3), 247 - 54 The role of immune complex in otitis media with effusion; Ueyama S et al.; Fifteen chinchillas were inoculated with immune complexes of Streptococcus pneumoniae into the tympanic cavity, and with formalin-killed bacteria into the opposite side . Middle ear effusion (MEE) were found in 14 ears having inoculation with immune complexes and in only four ears having inoculation with formalin-killed S . pneumoniae . In another experiment, 20 chinchillas received intra-tympanic inoculation with live S . pneumoniae after systemic immunization with formalin-killed S . pneumoniae of the same strain . As a control, 12 chinchillas were inoculated with live bacteria of the same strain into the tympanic cavity without pre-immunization . MEE was observed in nine of pre-immunized animals and persistent MEE lasting for more than 3 weeks was observed in seven of the animals . In control, persistent MEE was not observed . Though six animals developed otitis media with effusion (OME) . The results suggest that the formation of immune complexes in the tympanic cavity plays an important role in the occurrence of persistent MEE after pneumococcal otitis media. Microb Pathog, 1997 Jul, 23(1), 11 - 21 Heat shock response of Streptococcus pneumoniae: identification of immunoreactive stress proteins; Hamel J et al.; In order to investigate whether pneumococcal heat shock proteins (HSPs) were major immunogens of humoral immune response, we first characterized the heat shock response of S . pneumoniae . Three HSPs, HSP62, HSP72 and HSP80, having an apparent molecular mass of 62, 72, and 80 kDa, respectively, were detected by labelling proteins synthesized with {35S}methionine after a shift from 37 degrees C to 45 degrees C and fluorography of SDS-polyacrylamide gels . Radioimmunoprecipitation and immunoblot analyses with mouse anti-pneumococcal sera revealed that HSP72 was a major immunogen . S . pneumoniae HSP62 was another antigen which was precipitated by some immune sera . Anti-HSP72 antibodies appeared after the first immunization with S . pneumoniae antigens and subsequent immunization elicited a booster response . Monoclonal antibodies (MAbs) to pneumococcal HSP72 were produced and their specificities defined . The epitopes reactive with four MAbs are highly conserved in S . pneumoniae since 20 out of 20 different strains were recognized by each individual MAb . Western blot analysis revealed cross-reactivities with few non-pneumococcal strains . By N-terminal sequence analysis, the S . pneumoniae HSP72 was found to belong to the heat shock protein 70 family . That HSP72 is an important highly conserved antigen in S . pneumoniae should provide a basis for further investigation of its physiological and potential pathogenic role. J Periodontol, 1997 Jul, 68(7), 626 - 31 The relationship between gingivitis and the serum antibodies to the microbiota associated with periodontal disease in children with Down's syndrome; Morinushi T et al.; Gingival inflammation in Down's syndrome children (DS) develops earlier and is more rapid and extensive than in non-DS children . Abnormalities in host response to the oral flora have been proposed as etiological factors of this gingival inflammation . However, the relationship between gingivitis and the host response to oral microorganisms in DS by age has not been determined . The objective of this study was to clarify this relationship . Sera were obtained from 75 DS subjects (aged 2 to 18 years) and their gingival health assessed using a modified PMA Index (M-PMA) . Antibody titers to Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Treponema denticola (Td), Fusobacterium nucleatum (Fn), Selenomonas sputigena (Sel), Actinobacillus actinomycetemcomitans (Aa), and Streptococcus mitis (Mi) were determined using the micro-ELISA . DS subjects under 4 years old were found to have significantly more gingival inflammation than did normal children the same age . A significant positive correlation (r = 0.548, P < 0.0001) existed in the relationship between M-PMA score and plaque score for subjects in the G1 age group (deciduous dentition) . At G1, the average antibody titers to Aa, Mi, and Fn exceeded those of the normal adult reference serum pool . In addition, IgG antibody titers to Pg, Aa, Fn, Sel, and Mi correlated significantly with the M-PMA scores in the G1 age group . There was a correlation between age (2 to 18 years) and these antibody titers . IgG antibody titers to Pg, Aa, Sel, and Mi increased significantly with increasing M-PMA score . Furthermore, the IgG antibody titers to Pg were higher (P < 0.05) in the most extensive disease group compared to the DS no-disease group . The IgG antibody titers to Pg at G3 (early puberty) were significantly higher when compared to G1 (preschool children) . The IgM antibody titers to Aa at G3 were higher (P < 0.05) when compared to G1 . This study suggests that colonization by Aa and Fn are closely associated with the onset of gingival inflammation in DS patients under 5 years old . Colonization by Pg, Aa, Sel, and Mi in DS appears to be associated with gingivitis at puberty. J Antimicrob Chemother, 1997 Jul, 40(1), 105 - 8 Decreased susceptibility to imipenem among penicillin-resistant Streptococcus pneumoniae; Pikis A et al.; We assessed the antimicrobial susceptibilities of 59 penicillin-intermediate or penicillin-resistant pneumococci . All strains were susceptible to vancomycin and rifampicin . The frequency of strains with decreased susceptibility to cefotaxime, chloramphenicol, imipenem and meropenem was 15, 31, 47 and 49% respectively . The high percentage of penicillin-intermediate or penicillin-resistant Streptococcus pneumoniae with decreased susceptibility to third-generation cephalosporins, chloramphenicol and carbapenems limits the therapeutic options for the treatment of invasive pneumococcal infections and particularly of meningitis. No To Hattatsu, 1997 Jul, 29(4), 291 - 7 {Factors associated with the prognosis of bacterial meningitis in children}; Takayanagi M et al.; Treatment of bacterial meningitis depends on its severity . The signs, symptoms, and laboratory values of 51 patients with bacterial meningitis admitting to the Department of Pediatrics at Sendai City Hospital from January 1985 to December 1994 were analyzed in order to evaluate their prognostic value . The overall mortality rate was 3.9% . The incidence of neurological deficit on discharge was 31.4% . According to their prognoses, patients were divided into two groups: those who recovered with no detectable disabilities (good prognosis) and those who died or were left with neurological deficits (poor prognosis) . An analysis of these groups using Fisher's exact probability test revealed that the following risk factors were associated with poor prognosis: 1) duration of fever (including the periods of relapse) for more than 10 days ; 2) abnormal findings on brain imaging, such as cerebral infarction, cerebral hemorrhage, cerebral abscess and subdural effusion: 3 initial serum CRP value above 16 mg/dl; 4) initial CSF glucose value below 12 mg/dl; and 5) initial CSF LDH value above 220 IU/l . Streptococcus pneumoniae infection carried the worst prognosis: the causal organism of both the two fetal cases was S . pneumoniae . The incidence of poor prognosis was also high in S . pneumoniae meningitis (60.0%), compared to those by Hemophilus influenzae (46.7%) and group B streptococcus (25.0%) . In the cases in which causal agents were not detected, this incidence was as low as 10 percent, showing significant difference from cases in which causal agents were identified . In order to improve the prognosis of bacterial meningitis, factors associated with poor prognosis should be recognized at early stages of the illness. Lett Appl Microbiol, 1997 Jul, 25(1), 38 - 42 In vitro cariogenicity of trans-galactosyl-oligosaccharides; Hartemink R et al.; Trans-galactosyl-oligosaccharides (TOS) are a class of oligosaccharides produced by transgalactosylation of lactose . TOS are used as bifidogenic factors in human and animal nutrition . TOS can be present in the oral cavity and form a risk of caries . All oral bacteria tested were able to degrade and ferment both TOS and galactosyllactose (GLL), one of its components . Growth was improved compared with carbohydrate-free media and acid was produced after 24 h incubation of the bacteria with TOS and GLL . Degradation patterns, using HPAEC, showed degradation of most components . GLL was degraded only partially . Rapid acidification was only observed for Streptococcus mutans, resulting in a pH of 5.4 within 30 min . All other strains fermented TOS and GLL only slowly . Plaque formation could not be detected on both substrates . It can be concluded that TOS and GLL present only a small risk of caries formation, unless proven otherwise in animal studies. Microbiology, 1997 Jul, 143 ( Pt 7), 2449 - 55 Mitogenic factor secreted by Streptococcus pyogenes is a heat-stable nuclease requiring His122 for activity; Iwasaki M et al.; The gene encoding a mitogenic factor, termed MF, was cloned from Streptococcus pyogenes and the recombinant MF was overexpressed in Escherichia coli . Both the natural and recombinant MF had heat-resistant nuclease activity . The nuclease activity of MF was characterized using the recombinant protein . MF showed endonuclease activity, digesting ssDNA, dsDNA and tRNA . The optimal pH for the DNase activity of MF was 9.5 . The DNase activity was enhanced approximately tenfold by the simultaneous presence of two divalent cations, Mg2+ and Ca2+, compared to either alone and was inhibited by EDTA or NaCl . The heat stability of MF was biphasic; the DNase activity was heat-stable from 0 to 50 degrees C over 80 degrees C but very unstable at around 60 degrees C . DNA digested by MF possessed 5'-phosphorylated and 3'-hydroxylated termini, identical to those obtained by digestion of DNA by pancreatic deoxyribonuclease I . A mutant clone revealed that His122 was a residue essential to the nuclease activity. Acta Paediatr, 1997 Jul, 86(7), 769 - 71 Neonatal pleural empyema with group A Streptococcus; Thaarup J et al.; A case of early neonatal septicaemia with pneumonia and pleural empyema is reported . The causal microorganism was beta-haemolytic Streptococcus pyogenes group A originating from the mother, who had a perineal infection and bacteraemia. Clin Radiol, 1997 Jul, 52(7), 541 - 5 Lobar or segmental consolidation on chest radiographs of patients with HIV infection; Amin Z et al.; PURPOSE: To correlate chest radiographic abnormalities with diagnoses in HIV infected patients presenting with acute respiratory symptoms and lobar or segmental consolidation . MATERIALS AND METHODS: Retrospective review of chest radiographs of 53 HIV infected patients with lobar or segmental consolidation, and their microbiological and cytological diagnoses . RESULTS: A specific diagnosis was made in 35 patients of which 12 had Pneumocystis carinii pneumonia (including four co-infections) and 23 had bacterial pneumonias (10 of these were due to Streptococcus pneumoniae and four to Mycobacterium tuberculosis) . Microbiological and cytological tests were negative in 18 patients . Non-specific radiographic features included bronchial wall thickening (79%), reticulonodular or reticular change (55%), effusions (38%) and lymphadenopathy (25%); effusions favoured a bacterial aetiology . Ten of the 12 cases with P . carinii pneumonia had upper lobe consolidation (three of these had received inhaled pentamadine) . Of 13 other cases of upper lobe consolidation, eight were due to pyogenic infection and only one to M . tuberculosis alone . CONCLUSION: A wide variety of causative agents may produce lobar or segmental consolidation in HIV infected individuals, and the most common cause is bacterial infection . Where there is upper lobe consolidation P . carinii pneumonia should be considered in the differential diagnosis. Pediatr Infect Dis J, 1997 Jul, 16(7), 667 - 74 Immune responses of infants vaccinated with serotype 6B pneumococcal polysaccharide conjugated with tetanus toxoid; Sigurdardottir ST et al.; BACKGROUND: Streptococcus pneumoniae is a major cause of meningitis, bacteremia, pneumonia and otitis media . Pneumococcal polysaccharides are not immunogenic in infants, but improved immunogenicity of polysaccharide-protein conjugates has been demonstrated . Antibiotic-resistant pneumococci have increased the need for an effective vaccine . OBJECTIVE: To study the safety and immunogenicity of a pneumococcal type 6B polysaccharidetetanus toxoid conjugate (Pn6B-TT) in infants and to assess the function of antibodies . METHODS: Healthy infants were injected, Group A at 3, 4 and 6 months (n = 21) and Group B at 7 and 9 months (n = 19) . Booster injection was given at 18 months . Antibodies were measured by enzyme-linked immunosorbent assay and radioimmunoassay, and functional activity was measured by opsonization of radiolabeled pneumococci . Nasopharyngeal cultures were obtained . RESULTS: No significant adverse reactions were observed . Pn6B-IgG (enzyme-linked immunosorbent assay) increased to a geometric mean of 0.62 microgram/ml (P = 0.367, compared with prevaccination titers) in Group A at 7 months and 1.22 micrograms/ml (P < 0.001) in Group B at 10 months . Total Pn6B antibodies (radioimmunoassay) were 44 ng of antibody N/ml (P < 0.053) in Group A and 211 ng of antibody N/ml (P < 0.001) in Group B . A smaller increase in IgM and IgA anti-Pn6B was observed . Reinjection at 18 months elicited booster responses in total and IgG anti-Pn6B; 62% of those in Group A and 79% of those in Group B had > 300 ng of antibody N/ml . Opsonic activity, after initial and booster vaccinations, correlated with Pn6B-antibody titers . Three infants with nasopharyngeal cultures repeatedly positive for serogroup 6 had poor serum IgG responses . CONCLUSION: Our results demonstrate that Pn6B-TT is safe, elicits functional antibodies and memory responses in infants. Int J Syst Bacteriol, 1997 Jul, 47(3), 893 - 4 The tannin-degrading species Streptococcus gallolyticus and Streptococcus caprinus are subjective synonyms; Sly LI et al.; The tannin-degrading species Streptococcus gallolyticus and Streptococcus caprinus have been shown to be subjective synonyms on the basis of their levels of 16S rRNA sequence similarity (98.3%) and DNA-DNA homology (> 70%) and the phenotypes of their type strains . S . gallolyticus has nomenclatural priority according to Rule 24b(2) of the International Code of Nomenclature of Bacteria. J Clin Periodontol, 1997 Jul, 24(7), 478 - 85 Occurrence of invading bacteria in radicular dentin of periodontally diseased teeth: microbiological findings; Giuliana G et al.; Bacterial invasion in roots of periodontally diseased teeth, which has been recently documented using cultural and microscopic techniques, may be important in the pathogenesis of periodontal disease . The purpose of this investigation was to determine the occurrence and the species of invading bacteria in radicular dentin of periodontally diseased teeth . Samples were taken from the middle layer of radicular dentin of 26 periodontally diseased teeth . 14 healthy teeth were used as controls . Dentin samples were cultured anaerobically . The chosen methodology allowed the determination of the numbers of bacteria present in both deeper and outer part of dentinal tubules, and the bacterial concentration in dentin samples, expressed as colony forming units per mg of tissue (CFU/mg) . Invading bacteria was detected in 14 (53.8%) samples from periodontally diseased teeth . The bacterial concentration ranged from 831.84 to 11971.3 CFU/mg (mean+/-standard deviation: 3043.15+/-2763.13) . Micro-organisms identified included putative periodontal pathogens such as Prevotella intermedia, Porphyromonas gingivalis, Fusobacterium nucleatum, Bacteroides forsythus, Peptostreptococcus micros and Streptococcus intermedius . These findings suggest that radicular dentin could act as bacterial reservoir from which periodontal pathogens can recolonize treated periodontal pockets, contributing to the failure of therapy and recurrence of disease. Clin Diagn Lab Immunol, 1997 Jul, 4(4), 415 - 22 Standardization of an opsonophagocytic assay for the measurement of functional antibody activity against Streptococcus pneumoniae using differentiated HL-60 cells; Romero-Steiner S et al.; Host protection against pneumococcal disease i primarily mediated by phagocytosis . We developed and standardized an opsonophagocytic assay using HL-60 cells (human promyelocytic leukemia cells) . Fifty-five serum samples were analyzed for the presence of functional antibody against seven pneumococcal serogroups or serotypes (4, 6B, 9V, 14, 18C, 19F, and 23F) by using differentiated HL-60 cells (granulocytes) and peripheral blood leukocytes (PBLs) . Six of the 55 serum samples were from unvaccinated adult volunteers, 31 serum samples were from adults who received one dose of the 14-valent or the 23-valent polysaccharide vaccine, and 18 serum samples were from 16-month-old infants who received four doses of an investigational 7-valent polysaccharide-protein conjugate vaccine . The results of an opsonophagocytic assay with HL-60 cells correlated highly with those of an assay with PBLs as effector cells (median r for seven serotypes = 0.87: P < 0.01) . Opsonophagocytic titers were compared with the immunoglobulin G antibody concentrations determined by enzyme-linked immunosorbent assay (ELISA) . The r values for serogroups or serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F were 0.61, 0.60, 0.67 0.90, 0.61, 0.39, and 0.57, respectively, when HL-60 cells were used as effector cells and 0.56, 0.47, 0.61, 0.90, 0.71, 0.31, and 0.62, respectively, when PBLs were used . The assay requires small amounts of serum (40 microliters per serotype), making this test suitable for assaying infant sera . Culturable cells aid in assay standardization and likely reduce donor-to-donor variability . This standardized assay, in combination with the standardized ELISA, can be used to evaluate current and developing pneumococcal vaccines, in which functional opsonophagocytic antibody activity may correlate with protection against pneumococcal disease. Can Vet J, 1997 Jul, 38(7), 429 - 37 Streptococcus agalactiae mastitis: a review; Keefe GP; Streptococcus agalactiae continues to be a major cause of subclinical mastitis in dairy cattle and a source of economic loss for the industry . Veterinarians are often asked to provide information on herd level control and eradication of S . agalactiae mastitis . This review collects and collates relevant publications on the subject . The literature search was conducted in 1993 on the Agricola database . Articles related to S . agalactiae epidemiology, pathogen identification techniques, milk quality consequences, and control, prevention, and therapy were included . Streptococcus agalactiae is an oblique parasite of the bovine mammary gland and is susceptible to treatment with a variety of antibiotics . Despite this fact, where state or provincial census data are available, herd prevalence levels range from 11% (Alberta, 1991) to 47% (Vermont, 1985) . Infection with S . agalactiae is associated with elevated somatic cell count and total bacteria count and a decrease in the quantity and quality of milk products produced . Bulk tank milk culture has, using traditional milk culture techniques, had a low sensitivity for identifying S . agalactiae at the herd level . New culture methods, using selective media and large inocula, have substantially improved the sensitivity of bulk tank culture . Efficacy of therapy on individual cows remains high . Protocols for therapy of all infected animals in a herd are generally successful in eradicating the pathogen from the herd, especially if they are followed up with good udder hygiene techniques. Ann Pharmacother, 1997 Jul-Aug, 31(7-8), 897 - 906 Prevention of group B Streptococcus infection in neonates; Logsdon BA et al.; OBJECTIVE: To review the epidemiology of group B Streptococcus (GBS) infection, risk factors for infection, and clinical manifestations of disease in the neonate, as well as the role of chemoprophylaxis and immunoprophylaxis in prevention of GBS disease and current recommendations for prevention . DATA SOURCES AND STUDY SELECTION: MEDLINE searchers (1976-1997) of the English-language literature . DATA SYNTHESIS: Despite clinical advances in health care in the past two decades, GBS remains a leading cause of serious neonatal infection . Most early-onset GBS infections can be prevented through the use of intrapartum antimicrobial chemoprophylaxis . Preventing GBS infection in neonates is more cost-effective than treating GBS infections, and implementing prevention programs can reduce morbidity and mortality resulting from GBS disease . Many proposals have been made regarding prevention strategies; however, they have not been implemented widely and consistently in the US . To coordinate both pediatric and obstetric supported strategies, the Centers for Disease Control and Prevention (CDC) recently published recommendations for prevention of neonatal GBS disease through two possible strategies . In the first strategy, intrapartum antibiotic chemoprophylaxis should be offered to all women identified by prenatal culture as colonized and those who develop premature membrane rupture or onset of labor at less than 37 weeks gestation . The second strategy involves administration of intrapartum antibiotics to all women who develop one or more risk factors at the time of membrane rupture or onset of labor . CONCLUSIONS: GBS is difficult to eradicate, causing many women to be colonized with the organism during pregnancy and labor, thereby infecting their infant . Prevention strategies have been published for more than 10 years without successful implementation . Although optimal prevention management has not been defined, following one of two strategies recommended by the CDC can prevent the majority of GBS infections in neonates. Chemotherapy, 1997 Jul-Aug, 43(4), 297 - 302 Comparison of ceftibuten versus amoxicillin/clavulanate in the treatment of acute exacerbations of chronic bronchitis; Aubier MA; The efficacy and tolerability of once- or twice-daily ceftibuten (400 mg daily) were compared with three-times daily amoxicillin/clavulanate (AMX/CA, 500 mg/125 mg) in the treatment of acute exacerbations of chronic bronchitis (AECB) in an open, parallel-group 10- to 14-day study in 443 patients . Patients were assessed at baseline and on days 5, 10-14 and after 4-6 weeks of treatment, and the clinical response defined as cured, improved, stabilized or failed . Clinical efficacy between the 3 groups was equivalent (p = 0.002) with 90% of patients in each group responding to treatment (cured or improved) and the incidence of complete cures (with no clinical signs of relapse) was also equivalent . In conclusion, this study showed that ceftibuten is clinically equivalent to a standard regimen of amoxicillin/clavulanate in the treatment of AECB, including those patients infected with Streptococcus pneumonia . Ceftibuten was better tolerated than AMX/CA and was associated with significantly fewer gastrointestinal side effects . Furthermore, once-daily was a well tolerated and effective as twice-daily ceftibuten. Chemotherapy, 1997 Jul-Aug, 43(4), 264 - 71 Rifabutin for experimental pneumococcal meningitis; Schmidt H et al.; Rifabutin is a lipophilic antibacterial with high in vitro activity against many pathogens involved in bacterial meningitis including pneumococci . Resistance to beta-lactam antibiotics in pneumococci is not associated with a decreased sensitivity to rifabutin (30 strains from Germany with intermediate penicillin resistance; MIC range of penicillin: 0.125-1 mg/l, MIC of rifabutin: < 0.008-0.015 mg/l) . Rifabutin at doses of 0.625, 1.25, 2.5, 5 and 10 mg/kg/h i.v . was investigated in a rabbit model of meningitis using a Streptococcus pneumoniae type 3 (MIC/MBC of rifabutin: 0.015/0.06 mg/l) . The bacterial density in CSF at the onset of treatment was 7.3 +/- 0.6 log CFU/ml (mean +/- SD) . Rifabutin decreased bacterial CSF titers in a dose-dependent manner {delta log CFU/ml/h (slope of the regression line log CFU/ml vs . time) at a dose of 0.625 mg/kg/h: -0.16 +/- 0.06 (n = 3), at 1.25 mg/kg/h: -0.20 +/- 0.12 (n = 4), at 2.5 mg/kg/h: -0.24 +/- 0.04 (n = 4), at 5 mg/kg/h: -0.31 +/- 0.10 (n = 8), and at 10 mg/kg/h: -0.29 +/- 0.10 (n = 5)} . At high doses rifabutin was as active as ceftriaxone at 10 mg/kg/h (delta log CFU/ml/h: -0.29 +/- 0.10, n = 10) . Two and 5 h after initiation of therapy, CSF TNF-alpha activities were lower with rifabutin 5 mg/kg/h than with ceftriaxone (medians 2 vs . 141 U/ml, p = 0.005 at 2 h; median 51 vs . 120 U/ml 5 h after initiation of therapy, p = 0.04) . This did not result, however, in a decrease of indicators of neuronal damage . In conclusion, intravenous rifabutin was bactericidal in experimental pneumococcal meningitis . Provided that a well-tolerated i.v . formulation will be available it may qualify as a reserve antibiotic for pneumococcal meningitis, in particular when strains with a reduced sensitivity to beta-lactam antibiotics are the causative pathogens. Chemotherapy, 1997 Jul-Aug, 43(4), 232 - 8 Trends of genetic relationship of serotype 23F penicillin-resistant Streptococcus pneumoniae in Japan; Yoshida R et al.; No data on the genetic analysis of penicillin-resistant Streptococcus pneumoniae (PRP) in Japan has been reported . The SmaI restriction endonuclease digested patterns of chromosomal DNAs from 15 PRP serotyped 23F isolated in Japan were analyzed by pulsed-field gel electrophoresis (PFGE) . The isolates were genetically heterogeneous and seven different PFGE patterns were identified . Nine strains were also resistant to erythromycin and tetracycline . Four strains revealed resistance to ceftriaxone . The PFGE patterns of some strains isolated in Nagasaki University Hospital were identical to each other and closely resembled those of isolates from three different areas of Japan . These results indicate a need for additional studies by PFGE to determine the possibility of clonal spread in Japan. Chemotherapy, 1997 Jul-Aug, 43(4), 227 - 31 Serum concentrations and ex vivo inhibitory/bactericidal activity of clindamycin after administration of two oral dosages; Dan M et al.; Two dosages of clindamycin, 300 and 600 mg, were given orally to 10 patients each . The patients were admitted for minor elective surgery . Their mean age was 39.3 years; mean weight was 67.5 kg . None of them had taken antibiotics for at least 1 month . After administration of a single dose, blood samples were obtained at 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10 and 12 h after dosing . Drug levels were determined by the bioassay method using Micrococcus luteus as test organism . Serum inhibitory and bactericidal activities against five isolates each of Staphylococcus aureus and Streptococcus pyogenes were determined by the microdilution method according to the National Committee for Clinical Laboratory Standards guidelines . The mean peak serum level was 3.4 mg/l for the 300-mg dose and 4.8 mg/l for the 600-mg dose . The mean reciprocal peak inhibitory titers for the 300-/600-mg doses were 13.7/23.8 and 15.2/34.7 against S . aureus and S . pyogenes, respectively . Most serum samples did not show bactericidal activity against S . aureus. Biochemistry, 1997 Jul 1, 36(26), 8107 - 13 C repeats of teh streptococcal M1 protein achieve the human serum albumin binding ability by flanking regions which stabilize the coiled-coil conformation; Gubbe K et al.; The M and M-like proteins of Streptococcus pyogenes are fibrous cell surface proteins . They have multiple binding sites for several human proteins and are composed of the C-terminal anchor domain, the alpha-helical coiled-coil domain, and the N-terminal non-coiled-coil domain . The coiled-coil domain of the M1 protein consists of repeat units called B, C, and D and a spacer unit S between B and C . Recombinant fragments A-B-S-C-D, A-B-S, B-S-C, S-C, S-C-D, C-D, and C of the coiled-coil domain were studied by analyzing their secondary structures and binding affinities to human serum albumin (HSA) . As shown by circular dichroism, all fragments are in an alpha-helical conformation . C-D and S-C-D form coiled coils at room temperature and bind below 37 degrees C with high affinity to HSA . C-D and S-C-D unfold in two steps with Tm values of approximately 31 and approximately 65 degrees C; complex formation with HSA increases the unfolding temperatures . B-S-C has a lower alpha-helical content, a less pronounced coiled-coil conformation, and a reduced thermal stability, binds HSA weaker, and is only slightly stabilized by HSA binding in comparison to C-D and S-C-D . C and S-C are less stable than the other fragments and are not organized as coiled coils showing some features of alpha-helical single strands only below 20 degrees C, and binding of HSA was not observed . The results indicate that the formation of coiled-coil structures, supported by flanking D regions and, to a lesser extent also B regions, is essential for the binding of C repeat units to HSA. Infect Immun, 1997 Jul, 65(7), 2868 - 75 Analysis of toxicity of streptococcal pyrogenic exotoxin A mutants; Roggiani M et al.; Streptococcal pyrogenic exotoxin A (SPE A) is secreted by some strains of Streptococcus pyogenes and is strongly associated with streptococcal toxic shock syndrome (STSS), a severe and often fatal illness . SPE A possesses a number of biological properties, some of which are shared with a group of exotoxins of streptococcal and staphylococcal origins, the pyrogenic toxin superantigens (PTSAgs) . SPE A's most extensively studied property is superantigenicity . Superantigenic activation of T cells and monocytes stimulates the release of cytokines such as tumor necrosis factors alpha and beta, interleukin 1, and gamma interferon . These endogenous mediators are considered to be the primary cause of capillary leak, hypotension, and shock, the most severe manifestations of STSS . However, several studies have suggested that other properties of SPE A, such as ability to greatly enhance host susceptibility to endotoxin and ability to interact directly with endothelial cells, may play substantial roles in the syndrome . In this work we generated single- and double-site mutations of SPE A at residues K16, N20, C87, C90, C98, K157, S195, N20/C98, and N20/K157 . The mutant SPE A's were analyzed in vivo for their lethal activity and in vitro for their superantigenic ability . Our results indicate that SPE A's ability to induce lethality and endotoxin enhancement does not require superantigenicity, and conversely superantigenicity does not necessarily lead to lethality . Thus, these properties and their relative contributions to the onset of hypotension and shock may be separable . Furthermore, evidence is presented that certain mutant toxins may be suitable for use as vaccine toxoids. Infect Immun, 1997 Jul, 65(7), 2759 - 64 High-frequency invasion of epithelial cells by Streptococcus pyogenes can be activated by fibrinogen and peptides containing the sequence RGD; Cue DR et al.; The ability of Streptococcus pyogenes to invade human epithelial cells has been suggested to be an important contributing factor to the bacterium's ability to cause severe, invasive infections . We know little, however, of the mechanism underlying intracellular invasion by this organism . In this study, we demonstrate that the invasion of cultured human epithelial cells by a serotype M1 strain of S . pyogenes (strain 90-226) is stimulated over 50-fold by the addition of fetal calf serum (FCS) to the cell culture medium (RPMI medium) . Purified human fibrinogen and peptides containing the sequence Arg-Gly-Asp (RGD) were also found to promote bacterial invasion of cultured cells . Experiments that demonstrate that the agonists stimulate invasion by interacting with bacterial cells are described . Invasion stimulation did not appear to involve de novo synthesis of a bacterial protein, as FCS and fibrinogen stimulated invasion in the presence of chloramphenicol . Although the agonists stimulated adherence by up to threefold, strain 90-226 efficiently adhered to cultured cells in unsupplemented RPMI medium . The invasion index (the number of internalized CFU/the number of adherent CFU) of strain 90-226 was increased 10- to 25-fold by the addition of the agonists . Postinternalization survival of bacteria was unaffected by fibrinogen or FCS . Thus, the agonistic factors affect the efficiency by which adherent bacteria are internalized by epithelial cells. Infect Immun, 1997 Jul, 65(7), 2537 - 41 Increased intracellular survival of Mycobacterium smegmatis containing the Mycobacterium leprae thioredoxin-thioredoxin reductase gene; Wieles B et al.; The thioredoxin (Trx) system of Mycobacterium leprae is expressed as a single hybrid protein containing thioredoxin reductase (TR) at its N terminus and Trx at its C terminus . This hybrid Trx system is unique to M . leprae, since in all other organisms studied to date, including other mycobacteria, both TR and Trx are expressed as two separate proteins . Because Trx has been shown to scavenge reactive oxygen species, we have investigated whether the TR-Trx gene product can inhibit oxygen-dependent killing of mycobacteria by human mononuclear phagocytes and as such could contribute to mycobacterial virulence . The gene encoding M . leprae TR-Trx was cloned into the apathogenic, fast-growing bacterium Mycobacterium smegmatis . Recombinant M . smegmatis containing the gene encoding TR-Trx was killed to a significantly lesser extent than M . smegmatis containing the identical vector with either no insert or a control M . leprae construct unrelated to TR-Trx . Upon phagocytosis, M . smegmatis was shown to be killed predominantly by oxygen-dependent macrophage-killing mechanisms . Coinfection of M . smegmatis expressing the gene encoding TR-Trx together with Staphylococcus aureus, which is known to be killed via oxygen-dependent microbicidal mechanisms, revealed that the TR-Trx gene product interferes with the intracellular killing of this bacterium . A similar coinfection with Streptococcus pyogenes, known to be killed by oxygen-independent mechanisms, showed that the TR-Trx gene product did not influence the oxygen-independent killing pathway . The data obtained in this study suggest that the Trx system of M . leprae can inhibit oxygen-dependent killing of intracellular bacteria and thus may represent one of the mechanisms by which M . leprae can deal with oxidative stress within human mononuclear phagocytes. Microb Drug Resist, 1997 Summer, 3(2), 177 - 93 Molecular bases of three characteristic phenotypes of pneumococcus: optochin-sensitivity, coumarin-sensitivity, and quinolone-resistance; de la Campa AG et al.; Streptococcus pneumoniae is uniquely sensitive to amino alcohol antimalarials in the erythro configuration, such as optochin, quinine, and quinidine . The protein responsible for the optochin (quinine)-sensitive (Opts, Qins) phenotype of pneumococcus is the proteolipid c subunit of the FzeroF1 H(+)-ATPase . OptR/QinR isolates arose by point mutations in the atpC gene and produce different amino acid changes in one of the two transmembrane alpha-helices of the c subunit . In addition, comparison of the sequence of the atpCAB genes of S . pneumoniae R6 (Opts) and M222 (an OptR strain produced by interspecies recombination between pneumococcus and S . oralis), and S . oralis (OptR) revealed that, in M222, an interchange of atpC and atpA had occurred . We also demonstrate that optochin, quinine, and related compounds specifically inhibited the membrane-bound ATPase activity . Equivalent differences between Opts/Qins and OptR/QinR strains, both in growth inhibition and in membrane ATPase resistance, were found . Pneumococci also show a characteristic sensitivity to coumarin drugs, and a relatively high level of resistance to most quinolones . We have cloned and sequenced the gyrB gene, and characterized novobiocin resistant mutants . The same amino acid substitution (Ser-127 to Leu) confers novobiocin resistance on four isolates . This residue position is equivalent to Val-120 of Escherichia coli ryGB, a residue that lies inside the ATP-binding domain but is not involved in novobiocin binding in E . coli, as revealed by crystallographic data . In addition, the genes encoding the ParC and ParE subunits of topoisomerase IV, together with the region encoding amino acids 46 to 172 (residue numbers as in E . coli) of the pneumococcal ryGA subunit, were characterized in respect to fluoroquinolone resistance . The gyrA gene maps to a physical location distant from the gyrB and parEC loci on the chromosome . Ciprofloxacin-resistant (CpR) clinical isolates had mutations affecting amino acid residues of the quinolone resistance-determining region of ParC (low-level CpR), or in both resistance-determining regions of ParC and GyrA (high-level CpR) . Mutations were found in residue positions equivalent to Ser-83 and Asp-87 of the E . coli GyrA subunit . Transformation experiments demonstrated that topoisomerase IV is the primary target of ciprofloxacin, DNA gyrase being a secondary one. Microb Drug Resist, 1997 Summer, 3(2), 165 - 76 Bacteriophages of Streptococcus pneumoniae: a molecular approach; Garcia P et al.; We have characterized four families of pneumococcal phages with remarkable morphologic and physiological differences . Dp-1 and Cp-1 are lytic phages, whereas HB-3 and EJ-1 are temperate phages . Interestingly, Cp-1 and HB-3 have a terminal protein covalently linked to the 5' ends of their lineal DNAs . In the case of Dp-1, we have found that the choline residues of the teichoic acid were essential components of the phage receptors . We have also developed a transfection system using mature DNAs from Dp-4 and Cp-1 . In the later case, the transfecting activity of the DNA was destroyed by treatment with proteolytic enzymes, a feature also shared by the genomes of several small Bacillus phages . DNA replication was investigated in the case of Dp-4 and Cp-1 phages . The terminal protein linked to Cp-1 DNA plays a key role in the peculiar mechanism of DNA replication that has been coined as protein-priming . Recently, the linear 19,345-bp double-stranded DNA of Cp-1 has been completely sequenced, several of its gene products have been analyzed, and a complete transcriptional map has been ellaborated . Most of the pneumococcal lysins exhibit an absolute dependence of the presence of choline in the cell wall substrate for activity, and phage lysis requires, as reported for other systems, the action of a second phage-encoded protein, the holin, which presumably forms some kind of lesion in the membrane . The two lytic gene cassettes, from EJ-1 and Cp-1 phages, have been cloned and expressed in heterologous and homologous systems . The finding that some lysogenic strains of Streptococcus pneumoniae harbor phage remnants has provided important clues on the interchanges between phage and bacteria and supports the view of the chimeric origin of phages. Microb Drug Resist, 1997 Summer, 3(2), 159 - 63 Capsular type distribution and susceptibility to antibiotics of Streptococcus pneumoniae clinical strains isolated from Uruguayan children with systemic infections . Pneumococcus Study Group; Hortal M et al.; Children under 24 months of age are at high risk for serious infection with Streptococcus pneumoniae but they do not elicit effective immune responses to the currently available capsular polysaccharide vaccines . A polysaccharide protein conjugated vaccine involving the most frequent types has become an urgent need . To produce such a vaccine for Latin America, information on type distribution is required . Recently, Uruguay was 1 of the 6 countries in Latin America where surveillance for invasive pneumococcal infections in children under the age of 5 years was carried out . Seventy percent of the 182 invasive S . pneumoniae isolates were recovered from patients under 24 months of age, and 19% were recovered from infants under 6 months . The 7 most frequent types were 14, 5, 1, 6B, 3, 7F, and 19A; representing 80% of invasive isolates . Twenty-one types were identified, 16 in pneumonia and 14 in meningitis . Resistance to penicillin increased during the study period, from 29% in 1994, to 40% in 1995-1996, mainly because of the spread of type 14 strains resistant to penicillin and trimethoprim/sulphamethoxazol (89% of resistant isolates) . The high proportion of systemic pneumococcal infections recorded in patients under 24 months of age and the increasing resistance of these agents to first-choice antibiotics point to an urgent need for a capsular polysaccharide protein conjugated vaccine. Microb Drug Resist, 1997 Summer, 3(2), 153 - 7 Antimicrobial susceptibilities and capsular types of invasive Streptococcus pneumoniae isolated in children in Mexico City; Echaniz-Aviles G et al.; As part of the Sistema Regional de Vacunas (SIREVA) initiative, we conducted a surveillance study to determine the relative prevalence of capsular types of Streptococcus pneumoniae and antimicrobial susceptibility of invasive isolates in children less than 5 years old . We collected 220 isolates and found 33 of the 90 known types, with type 23F as the most common followed by types 6A+B, 14, 19F, and 19A . High penicillin resistance was found in 49 strains (22.2%), 31 belonging to type 23F . Twenty-nine (13.1%) were resistant to erythromycin, 95 (43.1%) were resistant to chloramphenicol, and 24 (10.9%) were resistant to cefotaxime . No strains were resistant to vancomycin. Microb Drug Resist, 1997 Summer, 3(2), 147 - 52 Distribution of capsular types and antimicrobial susceptibility of invasive isolates of Streptococcus pneumoniae in Colombian children . Pneumococcal Study Group in Colombia; Castaneda E et al.; Streptococcus pneumoniae is the leading bacterial cause of childhood pneumonia in the developing world . This study describes the type distribution and antimicrobial susceptibility of invasive pneumococcal isolates from Colombian children and is part of the Sistema Regional de Vacunas (SIREVA), a PAHO regional initiative designed to determine the ideal serotype composition of a protein polysaccharide pneumococcal conjugate vaccine for use in children less than 5 years old in Latin America . In Colombia, during the study period, centres in Bogota, Medellin, and Cali collected 324 S . pneumoniae isolates from invasive diseases, 238 (73.5%) from children under the age of 2 . Pneumonia was the clinical diagnosis in 41.3% cases, meningitis in 41%, and sepsis in 11.2% . The seven most frequent types included 14(21.9%), 5(10.5%), 23F(9.6%), 1(9%), 6B(9%), 19F(7.1%), and 6A(6.2%) . The frequency of diminished susceptibility to penicillin (DSP) was 12%, with 8.9% of isolates showing intermediate level resistance and 3.1% showing high level resistance . Among DSP isolates, 23% were also resistant to cefotaxime, 33.3% to erythromycin, 48.7% to chloramphenicol, and 74.3% to trimethoprim/sulfamethoxazole . Multiple resistance was detected in 59% of the isolates that have DSP . Penicillin resistance was associated with types 23F (53.8%) and 14 (25.6%) . These data provides information on capsular types prevalent in Colombia that will not only allow the formulation of an ideal vaccine for the region but also reinforce the need for ongoing regional surveillance. Microb Drug Resist, 1997 Summer, 3(2), 141 - 6 Prevalence of serotypes and antimicrobial resistance of streptococcus pneumoniae strains isolated from Brazilian children with invasive infections . Pneumococcal Study Group in Brazil for the SIREVA Project . Regional System for Vaccines in Latin America; Brandileone MC et al.; A laboratory surveillance study was developed in Brazil in 1993 to determine capsular types and antimicrobial susceptibility of Streptococcus pneumoniae strains . By studying 360 strains isolated from children with invasive infections in three different cities, 8 out of 34 types were identified as being the most prevalent and considered as the reference group for further analyses . This group comprised 77.7% of all strains studied, and includes the types 1, 5, 6A/B, 9V, 14, 19F, 19A, and 23F . The prevalence of this reference group was significantly higher among strains isolated from children with pneumonia than meningitis . Similarly, this group was more prevalent among strains isolated from children 3 to 6 years of age than from children under 2 years of age . Most strains (78.6%) were found to be susceptible to penicillin and only 1.4% showed high resistance to this antibiotic . However, intermediate resistance to penicillin was detected in 20% of the strains . This laboratory surveillance will be maintained and extended to other cities of Brazil to better define and monitor the trends of pneumococcal infections for proper control and prevention. Microb Drug Resist, 1997 Summer, 3(2), 135 - 40 Distribution of capsular types and penicillin-resistance of strains of Streptococcus pneumoniae causing systemic infections in Argentinian children under 5 years of age . Streptococcus pneumoniae Working Group; Rossi A et al.; Streptococcus pneumoniae (SPN) is the most common cause of invasive infections in children, with high levels of mortality in developing countries . An increase in frequency of penicillin-resistant strains is reported in most parts of the world . A study was undertaken in Argentina and 5 other countries of the region, to determine the type distribution and penicillin resistance rate of SPN isolated from invasive infections in children less than 5 years old . Between June 1994 and March 1996, a total of 505 SPN isolated from sterile sites were collected from 15 hospitals located in 9 cities of different geographic areas . Clinical and epidemiological data from 443 children were analyzed . Sixty five percent SPN were isolated from children less than 2 years old . Pneumonia was the clinical diagnosis in 58% of the cases, meningitis in 22%, and sepsis in 10.6% . Isolates were recovered from blood (51.2%), pleural fluid (22.7%), CSF (20.7%), and other sterile sites (5.4%) . Thirty different pneumococcal capsular types were identified and the 10 most frequent in descending order were: 14, 5, 1, 6A/6B, 7F, 9V, 19F, 19A, 16F y 23F, representing 89.3% of the total . Overall, 13.1% of isolates showed intermediate resistance to penicillin while 11.3% showed high resistance . Lethality was 8.8%, without correlation with penicillin-resistance and/or type . These result should be used in selecting the optimal combination of specific types for a conjugate vaccine, useful in children less than 2 years old and for considering therapeutic strategies for invasive pneumococcal infections. Microb Drug Resist, 1997 Summer, 3(2), 125 - 9 Epidemiology of pneumococcal serotypes and conjugate vaccine formulations; Butler JC; The incidence of bacteremia and meningitis due to Streptococcus pneumoniae is highest among preschool-age children, particularly those < 2 years of age . Clinical trials of capsular polysaccharide vaccines among young children have been disappointing . Conjugation of bacterial polysaccharides to proteins can increase antibody responses following vaccination of young children . Most conjugate vaccines proposed to date have been seven-valent . To identify serotypes most commonly associated with infection in young children, we serotyped pneumococcal isolates submitted to the CDC through national surveillance from 3884 children < 6 years old with pneumococcal bacteremia (n = 3169), meningitis (n = 401), or otitis media (n = 314) from 1978 to 1994 . Seven serotypes (14, 6B, 19F, 18C, 23F, 4, and 9V) accounted for 3045 (78%) isolates . A conjugate pneumococcal vaccine protecting against these seven serotypes and serologically cross-reactive serotypes could potentially prevent 86% of bacteremia, 83% of meningitis, and 65% of otitis media cases . The proportion of isolates covered by such a vaccine increased from 78% to 87% from 1978 to 1994 . Of 70 isolates submitted during 1992-1994 which were nonsusceptible to penicillin (minimal inhibitory concentration {MIC} > 0.1 microgram/mL, 56 (80%) were among the seven most prevalent serotypes . All 21 isolates resistant to penicillin (MIC > or = 2.0 micrograms/mL) were among these seven serotypes. FEBS Lett, 1997 Jun 30, 410(2-3), 275 - 9 Purification and structure of mutacin B-Ny266: a new lantibiotic produced by Streptococcus mutans; Mota-Meira M et al.; Mutacins are bactericidal substances of proteinaceous nature produced by Streptococcus mutans . Lantibiotics are antibacterial substances containing post-translationally modified amino acids such as lanthionine . Mutacin B-Ny266 was purified from the cell pellet of S . mutans strain Ny266 by ethanol extraction at pH 2.0 followed by reversed-phase chromatography (Sep-Pak cartridge) and by HPLC on a C18 column . The mean purification factor was 3240 +/- 81 and the mean yield was 1.0 +/- 0.1% . Molecular mass of mutacin B-Ny266 as determined by mass spectroscopy is 2270.29 +/- 0.21 Da . The amino acid sequence of the purified active fraction was obtained by Edman degradation after treatment with alkaline ethanethiol . Twenty-one amino acids were detected in this analysis . Mutacin B-Ny266 belongs to the type A lantibiotics . The proposed sequence is: F-K-A-W-U-F-A-Abu-P-G-A-A-K-O-G-A-F-N-U-Y-A . The molecule differs from that of epidermin/staphylococcin 1580 and gallidermin at positions 1, 2, 4, 5 and 6. FEMS Microbiol Lett, 1997 Jun 15, 151(2), 205 - 11 Construction and characterization of a recombinant ureolytic Streptococcus mutans and its use to demonstrate the relationship of urease activity to pH modulating capacity; Clancy A et al.; To begin to understand the contribution of oral microbial ureolysis to the inhibition of dental caries, we sought to construct a recombinant, ureolytic mutans streptococcus and correlate the ureolytic capacity of plaque bacteria with pH moderating ability . Streptococcus mutans GS-5 was transformed with a plasmid containing the urease genes from Streptococcus salivarius 57.I . The recombinant strain, S . mutans AC04, stably maintained the urease genes . High levels of urease activity were detected, with a maximum specific activity of 0.9 mumol of urea hydrolyzed/min/mg cell dry weight when the growth medium was supplemented with 50 microM exogenous NiCl2 . Harboring the recombinant plasmid, or growth in NiCl2, did not markedly affect the glycolytic capacity of S . mutans . In vitro pH drop analysis of S . mutans AC04, metabolizing glucose and physiologically relevant concentrations of urea simultaneously, demonstrated that increasing the urease activity of plaque bacteria resulted in a corresponding reduction in the depth and the duration of the glycolytic pH fall . The results demonstrate the feasibility of engineering urease producing S . mutans and suggest that enhancing the ureolytic capacity of dental plaque, particularly cariogenic plaque, may help to offset the progression of the caries process. FEMS Microbiol Lett, 1997 Jun 15, 151(2), 155 - 62 Restriction fragment length polymorphisms of 16S rDNA and of whole rRNA genes (ribotyping) of Streptococcus iniae strains from the United States and Israel; Eldar A et al.; Streptococcus iniae (junior synonym S . shiloi) isolated from tilapia and trout in Israel and in the United States were subtyped by restriction length polymorphism (RFLP) based on PCR amplified 16S rDNA and by ribotyping . 16S rDNA RFLP discriminated between S . iniae and other fish pathogens but not between S . iniae strains . HindIII and EcoRI ribotypes of S . iniae discriminated American from Israeli strains rejecting the possibility of an epidemiological link between S . iniae infections in the two countries . Israeli strains isolated from tilapia and trout could not be completely differentiated . The S . iniae ATCC 29178T (T = Type strain) strain, isolated from a freshwater dolphin belonged to a ribotype different from those of all the fish isolates. J Am Vet Med Assoc, 1997 Jun 15, 210(12), 1774 - 8 Acute hemorrhagic pulmonary infarction and necrotizing pneumonia in horses: 21 cases (1967-1993); Carr EA et al.; OBJECTIVE: To characterize history, clinical signs, and pathologic findings in horses with histologically confirmed acute hemorrhagic pulmonary infarction and necrotizing pneumonia . DESIGN: Retrospective study . ANIMALS: 21 horses . RESULTS: 19 of the 21 horses were Thoroughbred racehorses in training . Eighteen horses had had strenuous exercise immediately prior to onset of illness . Fifteen horses had a serosanguineous nasal discharge during hospitalization . Seventeen horses had radiographic evidence of pulmonary consolidation and pleural effusion . Nine of 14 horses had ultrasonographic evidence of large pulmonary parenchymal defects consistent with consolidation . Pleurocentesis yielded a suppurative, serosanguineous effusion in the 14 horses in which it was performed . Bacteria were isolated from all transtracheal aspirates (14) and from 6 of 12 pleural fluid samples . Actinobacillus suis-like organisms and Streptococcus equi subsp zooepidemicus were most commonly isolated . Nineteen horses were hospitalized and treated . Mean duration of treatment was 5 days, and most horses were euthanatized because of secondary complications, continued costs of medical treatment, or poor prognosis for future performance . Pathologic lesions included well-demarcated regions of hemorrhagic pulmonary infarction with necrosis and a serosanguineous pleural effusion . Thrombosis of pulmonary vessels was found in 11 horses . CLINICAL IMPLICATIONS: An acute or peracute onset of severe respiratory distress, with serosanguineous nasal discharge, ultrasonographic and radiographic evidence of severe pulmonary consolidation, and serosanguineous suppurative pleural effusion, is strongly suggestive of pulmonary infarction in horses . Horses with pulmonary infarction responded poorly to conventional treatment for pleuropneumonia and had a poor prognosis for recovery. Thorac Cardiovasc Surg, 1997 Jun, 45(3), 150 - 2 Fibrous tissue overgrowth and prosthetic valve endocarditis: report of a case; Kaneko Y et al.; Mechanical valve stenosis without restricted occluder motion and paravaluvular leakage developed in a patient who had undergone patch closure of partial atrioventricular septal defect and replacement of the left atrioventricular valve 13 years previously . Dense calcification of the supravalvular region was shown in a cineradiogram, whereas transthoracic and transesophageal echocardiography failed to reveal any obstructive mechanism . Elevated transprosthetic pressure gradient with unrestricted occluder motion suggested prosthetic valve stenosis resulting from fibrous tissue overgrowth, although this was not visualized by the modern diagnostic imaging tools . Reoperation confirmed calcified fibrous tissue overgrowth obstructing the mechanical valve inflow . Examination of resected tissue revealed prosthetic valve endocarditis due to alpha-streptococcus . Paravalvular leakage accompanying fibrous tissue overgrowth may indicate the presence of prosthetic valve infection even if the clinical manifestations are scarce. S Afr Med J, 1997 Jun, 87 Suppl 3, C157 - 60 Sydenham's chorea--analysis of 27 patients and a review of the literature; Van der Merwe PL et al.; The first documented epidemic of Sydenham's chorea was in 1418 . In 1686 Thomas Sydenham was the first to describe the condition, but it was Richard Bright who in 1831 first made the association between chorea and rheumatic fever . Chorea is one of the major diagnostic criteria for rheumatic fever . Chorea is often considered a benign self-limiting condition . Little is known about the pathophysiological process . A link between the group A beta-haemolytic streptococcus through an antibody-mediated immune response targeting the basal ganglia has been described . Special investigations have been done to ascertain the pathophysiology, but none is of diagnostic value . The aims of this study were to analyse the clinical findings, the role of special investigations in the management and course of Sydenham's chorea and to review the literature . Data on 27 patients were analysed . Special investigations in these patients can be divided into those necessary to assist in diagnosing acute rheumatic fever and those to exclude other causes that mimic chorea . None of these tests was helpful in diagnosing chorea due to other causes; neither did they influence the management of these patients . In conclusion, Sydenham's chorea remains a clinical diagnosis and extensive and expensive special investigations are seldom warranted. Eur J Oral Sci, 1997 Jun, 105(3), 258 - 63 Caries and plaque inhibition in rats by five topically applied dentifrices; Guggenheim B et al.; The effectiveness of 5 different brands of dentifrices on caries and plaque were tested in rats in 2 experiments . 10 litters of rats each were infected with Streptococcus sobrinus OMZ-176 and Actinomyces viscosus Ny1 . The rats were offered the diet 2000a containing either 40% of sucrose (study I) or 10% of sucrose (study II) . The following products were tested topically: (1) H2O, (negative control); (2) chlorhexidine diacetate, (positive control); (3) Parodontax NF; (4) Meridol; (5) Colgate Total; (6) Mentadent C; (7) Dent Xpress . Comparisons with the water control in study I showed that plaque extent was decreased by chlorhexidine diacetate, Dent Xpress and by Mentadent C only . All fluoride-containing dentifrices tested reduced caries . In study II, comparisons with the water control showed that plaque extent was reduced by chlorhexidine diacetate, Parodontax, Meridol, Dent Xpress and by Mentadent C . All dentifrices reduced caries, however, the incidence was low . These 2 studies confirm that fluorides incorporated in dentifrices decrease dental caries in the rat . Differences in the effectiveness of caries inhibition between the 5 dentifrices could not be explained either by the form of fluoride utilized or by the antimicrobials added . Rather, the performance of a given dentifrice depended upon the concerted action of the particular ingredients . It appears that the effect of antiplaque agents should be evaluated in the rat model using a diet containing sucrose at a low level. J Laryngol Otol, 1997 Jun, 111(6), 546 - 50 Retropharyngeal abscess: a clinical review; Goldenberg D et al.; Retropharyngeal abscesses are uncommon but potentially lethal infections, especially in the paediatric population under the age of five years . Abscesses in this group are classically secondary to upper respiratory infections especially oropharyngeal infections, while in the adult group they are usually secondary to trauma, foreign bodies, or as a complication of dental infections . Early diagnosis and the wide spread use of antibiotics have made these infections less common today . Between the years 1985-1996, 19 cases of retropharyngeal abscesses were treated in our department . Factors such as age, sex, aetiology, presenting signs, symptoms, methods of diagnosis, treatment and complications were reviewed . Thirty-two per cent of the cases were secondary trauma . A lateral neck film showing widening of the prevertebral space was the most important diagnostic tool, computed tomography (CT) scan was used in 63 per cent of cases to verify the signs of an abscess and to provide more accurate anatomical localization . Thirteen cases required surgical drainage . The single most commonly-isolated pathogen was Streptococcus pyogenes . There were no deaths and only one recurrence requiring repeated surgical drainage . One case was complicated by a spinal canal abscess . We also report two cases of retropharyngeal abscess in children caused by swallowing of unusual foreign bodies. Eur J Emerg Med, 1997 Jun, 4(2), 111 - 4 Fatal Streptococcus viridans descending mediastinitis: case report and review of the literature; Berlot G et al.; Mediastinitis is a life-threatening complication of cardiac, neck and oesophageal surgery . It has also been reported following upper digestive and respiratory procedures and as a consequence of oesophageal perforation following the ingestion of foreign bodies . Much more infrequently, mediastinitis can occur in association with oropharyngeal or cervical infections . We describe the case of a patient with fatal mediastinitis and septic shock . The onset of mediastinitis was preceded by a 2-day course of sore throat and other flu-like symptoms. Jpn Circ J, 1997 Jun, 61(6), 467 - 70 Timing of surgical treatment for active native value endocarditis; Iemura J et al.; The aim of the study was to assess the optimum timing of surgical treatment for the active phase of native valve endocarditis . A retrospective study was conducted of the records of patients who had undergone aortic and/or mitral valve replacement for active native valve endocarditis during 1979-94 at Kinki University Hospital . Thirty-three patients with active infective endocarditis of the native valves were treated surgically . Their mean age was 45.4 years (range 11-71) . The infective organism was streptococcus in 9 cases, Staphylococcus aureus in 8, and enterococcus in 4 cases . Blood cultures were negative in 9 cases . Of the patients infected with Staphylococcus aureus, 3 died soon after the operation and 1 died later during hospitalization . These 4 patients had been treated medically more than 2 weeks before operation . Another patient who was also treated medically more than 2 weeks before surgery survived . In contrast, all 3 patients infected with Staphylococcus aureus who were operated on within 2 weeks after the onset survived . No early or in-hospital deaths were documented among patients infected with organisms other than Staphylococcus aureus . Among patients who had suffered preoperative embolic episodes, the time from the initial pyrexia to the embolic event was clearly shorter in those infected with Staphylococcus aureus than in those infected with other organisms . Among the former group, 5 out of 6 patients suffered an embolism within 2 weeks of the onset of pyrexia and the remaining 1 within 3 weeks . Thus, in patients presenting with active native valve endocarditis caused by Staphylococcus aureus, surgical treatment should be performed as soon as possible after the onset of pyrexia, preferably within 2 weeks or as soon as the infective organism is identified as Staphylococcus aureus. J Antimicrob Chemother, 1997 Jun, 39 Suppl B, 51 - 5 In-vitro and in-vivo activity of trovafloxacin against Streptococcus pneumoniae; Klugman KP et al.; Trovafloxacin had greater in-vitro activity than comparative fluoroquinolone agents against penicillin-sensitive pneumococci in studies from the USA, UK, Slovakia, Czech Republic, Sweden and South Africa . This activity was maintained against penicillin-resistant strains, with MIC90 values of < or = 0.25 mg/L observed for both groups . Bactericidal activity appeared to occur within one or two dilutions of the MIC and, in the limited number of strains studied, the MIC was independent of the medium tested and pH over the range pH 5-8 . Mutation to decreased susceptibility to trovafloxacin occurred in vitro at a low frequency in the pneumococcus (< or = 8.9 x 10(-9)) . Mutants with changes in the topoisomerase IV A subunit (GrlA) were still inhibited by 0.5 mg/L of trovafloxacin . Trovafloxacin was more efficacious than ciprofloxacin, temafloxacin or ofloxacin in mouse pneumonia models for both penicillin-susceptible and penicillin-resistant pneumococci . Trovafloxacin was also highly efficacious in a rabbit pneumococcal meningitis model . These data suggest that the clinical efficacy of trovafloxacin against pneumococci should be evaluated further. J Antimicrob Chemother, 1997 Jun, 39(6), 781 - 8 Trovafloxacin delays the antibiotic-induced inflammatory response in experimental pneumococcal meningitis; Nau R et al.; This study evaluates the ability of the new fluoroquinolone trovafloxacin to attenuate the inflammatory burst known to occur after initiation of antibiotic treatment in pneumococcal meningitis . After exposure to trovafloxacin or ceftriaxone for 3 h in vitro, Streptococcus pneumoniae was injected intracisternally (i.c.) into rabbits every 3 h over 9 h (n = 6 for each antibiotic) . Ceftriaxone-treated S . pneumoniae induced consistently higher CSF leucocyte counts (median 2568/microL versus 543/microL at 6 h; P = 0.03; 4560/microL versus 2207/microL at 18 h; P = 0.03) than trovafloxacin-treated bacteria . Meningitis induced in rabbits by i.c . injection of live S . pneumoniae was treated with equal doses of trovafloxacin or ceftriaxone i.v . (ten per group) . The bactericidal rates of both antibacterial agents in CSF were almost identical . In comparison with ceftriaxone, trovafloxacin resulted in lower tumour necrosis factor (TNF) and interleukin 1beta (IL-1beta) CSF levels 2 h after the initiation of treatment (TNF levels, median 26 U/mL versus 141 U/mL; P = 0.02; IL-1beta levels 455 pg/mL versus 1399 pg/mL; P = 0.02) . Twelve hours after initiation of therapy, however, TNF and IL-1beta were higher in trovafloxacin-treated animals (TNF, 61 U/mL versus 7 U/mL; P = 0.001; IL-1beta, 4320 pg/mL versus 427 pg/mL; P = 0.006) . The increase in CSF lactate was less during trovafloxacin therapy than with ceftriaxone (median: 2.0 mmol/L versus 4.0 mmol/L; P = 0.03) . In conclusion, S . pneumoniae treated in vitro with trovafloxacin induced less CSF leucocytosis than ceftriaxone-treated S . pneumoniae . After i.c . inoculation of live S . pneumoniae, trovafloxacin therapy delayed, but did not inhibit, the release of the proinflammatory cytokines TNF and IL-1beta, probably by slowing the liberation of bacterial cell wall components into the subarachnoid space. J Antimicrob Chemother, 1997 Jun, 39(6), 719 - 23 The bactericidal activity of levofloxacin compared with ofloxacin, D-ofloxacin, ciprofloxacin, sparfloxacin and cefotaxime against Streptococcus pneumoniae; George J et al.; The bactericidal activity of levofloxacin was compared with that of four other quinolones and one cephalosporin against four strains of Streptococcus pneumoniae with varying degrees of penicillin G susceptibility . Levofloxacin was found to be the most bactericidal quinolone at its optimum bactericidal concentration, followed by ofloxacin, ciprofloxacin, sparfloxacin and D-ofloxacin, in that order . There was no correlation between quinolone-susceptibility and penicillin-susceptibility with any quinolone tested . To allow a comparison between the bactericidal activity of the quinolones and cefotaxime to be made a bactericidal index was used . Against two penicillin-sensitive pneumococci and a penicillin-intermediate pneumococcus, cefotaxime was the most potent antibacterial agent tested, followed by levofloxacin . However, against the penicillin-resistant pneumococcus, levofloxacin was considerably more potent than cefotaxime . The remaining quinolones tested were inferior to levofloxacin . Levofloxacin has enhanced activity against pneumococci compared with clinically available quinolones . In addition, levofloxacin may be the future quinolone of choice in the treatment of penicillin-resistant pneumococci. Mol Microbiol, 1997 Jun, 24(5), 895 - 904 Quorum sensing by peptide pheromones and two-component signal-transduction systems in Gram-positive bacteria; Kleerebezem M et al.; Cell-density-dependent gene expression appears to be