Clin Orthop, 1994 Feb, (299), 163 - 8 Preoperative assessment of skin colonization and antibiotic effectiveness in total knee arthroplasty; Tanzer M et al.; A bacteriologic screening procedure was performed to preoperatively assess the skin flora of 152 total knee arthroplasty patients and to determine the appropriate prophylactic antibiotic and skin-cleansing technique . Staphylococcus epidermidis resistant to standard prophylactic antibiotics was present in 4.6% of patients, whereas 44% of the patients had Staphylococcus aureus, which is poorly eradicated by standard cleansing techniques . Preoperative assessment of skin colonization has demonstrated that standard preoperative antibiotics and skin-cleansing techniques will not completely eradicate all pathogenic skin bacteria in every case . Preoperative screening effectively identifies bacterial skin flora and allows for the modification of antibiotic selection and preoperative cleansing to eradicate resistant bacterial organisms and thereby decrease the risk of postoperative prosthetic infections. J Gen Virol, 1994 Feb, 75 ( Pt 2), 335 - 9 Solid matrix-antibody-antigen complex can clear viraemia and antigenaemia in persistent duck hepatitis B virus infection; Wen YM et al.; One-day-old ducklings experimentally infected with duck hepatitis B virus (DHBV) were found to be immunologically tolerant to virus antigens (DHBsAg, DHBcAg), with no humoral or cellular immune responses being detected . When immunized with virus antigens in Freund's complete adjuvant, no immune responses could be induced . Rabbit anti-DHBs sera were complexed to a solid matrix (Staphylococcus aureus Cowan A strain) and purified DHBsAg was bound to this complex to form a solid matrix antibody-antigen (SMAA) complex . This SMAA was used as an immunogen to immunize the tolerant ducks . After three injections, in 12 of 17 ducks serum DHBV DNA became absent and serum DHBsAg was cleared . In eight of 16 ducks, low titres of anti-DHBs could be detected . The SMAA approach shows potential for application in immunoregulatory treatment for chronically infected hepatitis B patients. Biochem J, 1994 Feb 1, 297 ( Pt 3), 609 - 14 Purification and characterization of a cadmium-induced metallothionein from the shore crab Carcinus maenas (L.); Pedersen KL et al.; Two metallothionein variants were purified from the midgut gland of crabs (Carcinus maenas) exposed to a high cadmium concentration (2 p.p.m.) . One of the variants was purified from crabs exposed to a low cadmium concentration (0.5 p.p.m.) . The purification method involved acetone precipitation, gel filtration and reversed-phase h.p.l.c . The complete amino acid sequences of both variants have been elucidated by m.s . and automated sequence analysis on S-methylated proteins or fragments produced by cleavage of the S-methylated proteins with Staphylococcus aureus proteinase . The two variants from crabs exposed to the high cadmium concentration differed only by a single residue of methionine at the N-terminus . The single variant isolated from crabs exposed to the low cadmium concentration was the one without the N-terminal methionine, indicating that high cadmium concentrations either inhibit the processing enzymes and/or that the processing enzymes cannot keep pace with the increased metallothionein synthesis when cadmium availability is high . Cadmium-induced metallothionein from C . maenas shows a high degree of structural similarity to metallothioneins from the decapod crustaceans Scylla serrata and Homarus americanus. J Med Microbiol, 1994 Feb, 40(2), 98 - 101 A comparison of three semi-selective media for the isolation of methicillin-resistant Staphylococcus aureus; Allen JL et al.; During the 1980s the emergence of multiple antibiotic-resistant strains of Staphylococcus aureus posed new problems for infection control worldwide, many of which still remain . In investigations of outbreaks of infection, the laboratory has a key role in identifying infected or colonised patients and staff . The rapid isolation and accurate identification of the causative organisms are essential for the implementation of appropriate control measures . Speed and accuracy in identification, by colonial morphology, is often difficult to achieve in the presence of a mixed population of commensal bacteria . To this end, the sensitivity of three media for the isolation of methicillin-resistant S . aureus (MRSA) from simulated clinical specimens was compared . Initial colonial recognition of MRSA was enhanced on methicillin-milk agar when compared with that on other media. J Med Microbiol, 1994 Feb, 40(2), 79 - 89 Virulence factors involved in the pathogenesis of bovine intramammary infections due to Staphylococcus aureus; Sutra L et al.; Staphylococcus aureus is a major causative agent of intramammary infections in dairy cows . In this report, the pathogenesis of these infections is described . The potential role in virulence of S . aureus surface components (adhesins, protein A and capsular polysaccharides), toxins, extracellular enzymes and coagulase, and perspectives for the development of an efficient vaccine are discussed. J Infect Dis, 1994 Feb, 169(2), 330 - 6 Phagolysosomal alkalinization and intracellular killing of Staphylococcus aureus by amikacin; Maurin M et al.; The aminoglycosides are ineffective against intracellular Staphylococcus aureus, which resides within lysosomes, despite a strong extracellular bactericidal activity . Since they are slowly concentrated within lysosomes it was hypothesized that acidity within these cell compartments might impair antibiotic activity . The bactericidal activity of amikacin alone and combined with lysosomotropic alkalinizing agents (LAA), which can alkalinize acidic cell compartments, was evaluated . Before antibiotic challenge, some cells were preincubated with amikacin for 3 days to allow intracellular accumulation of drug . No intracellular killing activity was shown when non-preincubated cells were used . Conversely, with preincubated cells, S . aureus was killed within 4 h when LAA were incorporated into the incubation media but not with amikacin alone . Enhanced antimicrobial activity correlated with increase in lysosomal pH . Intracellular accumulation of amikacin was not changed by LAA . These results provide evidence that acidic pH within lysosomes impairs amikacin in killing S . aureus. J Chemother, 1994 Feb, 6(1), 44 - 9 Activity of aztreonam in pneumology, Part 2: Influence on phagocytosis and intracellular killing of human alveolar macrophages; Velluti G et al.; The study aim was to evaluate the activity of aztreonam on phagocytosis and intracellular killing of Staphylococcus aureus ATCC6538 by human alveolar macrophages . Drug concentrations of 1, 10, 25, 100 micrograms/ml were assayed in culture medium . Aztreonam induces dose-dependent phagocytosis up to 25 micrograms/ml concentrations; with a phagocytosis index (PIa) of 1.18 +/- 0.2 at 1 microgram/ml; of 1.27 +/- 0.2 at 10 micrograms/ml; of 1.42 +/- 0.3 at 25 micrograms/ml . No phagocytosis increase or inhibition, with unchanged cell viability compared to controls, is shown at 100 micrograms/ml aztreonam (PI 1.03 +/- 0.3) . Intracellular killing acts in a similar way: the killing index (KIa) is 1.27 +/- 0.3 at 1 microgram/ml concentrations; 1.38 +/- 0.3 at 10 micrograms/ml; 1.61 +/- 0.4 at 25 micrograms/ml whereas at 100 micrograms/ml the KIa is 1.03 +/- 0.3 . This study shows aztreonam's ability to stimulate macrophages' functional activity against a microorganism (S . aureus) which is not susceptible to its antibacterial activity. J Chemother, 1994 Feb, 6(1), 25 - 8 High rate of oxacillin-resistant Staphylococcus aureus isolates in an Italian University Hospital; Venditti M et al.; We reviewed our routine clinical laboratory records from January 1990 to March 1993 to evaluate the rate of oxacillin-resistance among nosocomial isolates of Staphylococcus aureus . Of 265 clinically significant isolates, 174 (65%) were oxacillin-resistant S . aureus (ORSA) . Most of these strains were obtained from surgery patients and/or were isolated from surgical wounds . The isolations of S . aureus increased during the study period: 45 in 1990, 50 in 1991, 130 in 1992 and 40 in the first trimester of 1993 . The annual rates of ORSA among S . aureus isolated varied from 62 to 68% through these years . Most ORSA isolates proved resistant to ciprofloxacin, gentamicin and rifampicin, and susceptible to vancomycin, netilmicin and cotrimoxazole . Based on these results, the need for a stringent application of infection control measures is outlined. Zhonghua Nei Ke Za Zhi, 1994 Feb, 33(2), 95 - 8 {A study on the resistance of methicillin resistant Staphylococcus aureus to antimicrobial agents}; Wang R et al.; The morbidity of the infections caused by methicillin resistant staphylococcus aureus increased in recent years . In order to know the resistance of MRSA to antimicrobial agents, the minimal inhibitory concentrations (MICs) of antimicrobial agents against S . Aureus isolated from inpatients were measured . The presence of beta-lactamase in and the types of coagulase of the strains tested were determined as well . The results showed that MRSA accounted for 50.7% of the strains tested, the incidence of MRSA producing beta-lactamase was 85.1% and the coagulase of MRSA was all of type II . MRSA showed resistance to most of the lactam antibiotics and some of the aminoglycosides . Vancomycin and arbikacin had the highest activity against MRSA; other effective antibiotics were in the following order: amikacin, minocycline, tosulfloxacin and imipenem . It is suggested that serious infections caused by MRSA may be cured by using vancomycin, arbikacin or other antibiotics mentioned above. Diagn Microbiol Infect Dis, 1994 Feb, 18(2), 121 - 4 Methicillin-resistant Staphylococcus aureus . Optimization of the agar screen plate method; Alfa MJ et al.; Swab inoculation of oxacillin agar screen plates was compared with drop inoculation for detection of methicillin-resistant Staphylococcus aureus . The poor sensitivity of the swab method (59%) was related to heteroresistance of the S . aureus isolates . We recommend the drop method (100% sensitivity) because interpretation of results was significantly easier, making it more reliable. J Protein Chem, 1994 Feb, 13(2), 187 - 94 The amino acid sequence and reactive site of a single-headed trypsin inhibitor from wheat endosperm; Poerio E et al.; The sequence of a trypsin inhibitor, isolated from wheat endosperm, is reported . The primary structure was obtained by automatic sequence analysis of the S-alkylated protein and of purified peptides derived from chemical cleavage by cyanogen bromide and digestion with Staphylococcus aureus V8 protease . This protein, named wheat trypsin inhibitor (WTI), which is comprised of a total of 71 amino acid residues, has 12 cysteines, all involved in disulfide bridges . The primary site of interaction (reactive site) with bovine trypsin has been identified as the dipeptide arginyl-methionyl at positions 19 and 20 . WTI has a high degree of sequence identity with a number of serine proteinase inhibitors isolated from both cereal and leguminous plants . On the basis of the findings presented, this protein has been classified as a single-headed trypsin inhibitor of Bowman-Birk type. Int J Food Microbiol, 1994 Feb, 21(3), 253 - 61 Bacteriological quality and associated public health risk of pre-processed bovine milk in Trinidad; Adesiyun AA; The bacteriological quality of pre-processed raw milk originating from all 16 milk collection centres in Trinidad was evaluated . The mean total aerobic counts for bacteria, Staphylococcus aureus and Escherichia coli were determined . The pH and presence of somatic cells in milk were also determined . Of the 507 milk samples collected, 454 (89.5%) were California mastitis test (CMT)-positive and the mean pH was 6.50 +/- 0.13 . The total aerobic plate count per ml was generally high for all samples ranging from 5.8 x 10(5) +/- 3.1 x 10(5) to 5.7 x 10(8) +/- 1.5 x 10(9) . S . aureus was isolated from 478 (94.3%) samples and the mean counts per ml ranged from 1.5 x 10(5) +/- 1.1 x 10(5) to 9.4 x 10(5) +/- 1.3 x 10(6) . Nine (7.7%) of 117 strains of S . aureus produced staphylococcal enterotoxins A(SEA), B(SEB), D(SED) or a combination . E . coli was isolated from 105 (20.7%) samples and the mean counts per ml ranged from 6.6 x 10(2) +/- 1.1 x 10(2) to 4.0 x 10(5) +/- 4.6 x 10(5) . Twenty-five (23.6%) of the 106 strains of E . coli tested produced verocytotoxin (VT) but none was positive for heat-labile (LT) toxin . It was concluded that pre-processed milk in Trinidad is of poor bacteriological quality . The detection of high counts of S . aureus in milk with some producing heat stable enterotoxins, coupled with the isolation of some verocytotoxigenic E . coli, are of public health significance to consumers. Int J Food Microbiol, 1994 Feb, 21(3), 217 - 36 Predictive modelling of growth of Staphylococcus aureus: the effects of temperature, pH and sodium chloride; Sutherland JP et al.; The growth responses of Staphylococcus aureus as affected by NaCl concentration, pH value and storage temperature were studied in laboratory medium . Growth curves at concentrations of NaCl in the range 0.5-13.5% (w/v), pH values in the range 4.0-7.0 and storage temperatures in the range 10-30 degrees C were fitted using the Gompertz routine and the derived parameters modelled . Growth curves could then be regenerated for any set of conditions within the matrix studied and values for growth rate, generation time, lag time and time to 1000-fold increase predicted . The model was validated against data from the literature and was found to give realistic estimates of generation time for media and a range of foods including milk, cheese, starch-based foods and cooked meats but not for mayonnaise or Wiltshire bacon . All predictions were consistently 'fail-safe'. Immunol Lett, 1994 Feb, 39(2), 121 - 5 Cell adhesion molecules are co-receptors for staphylococcal enterotoxin B-induced T-cell activation and cytokine production; Krakauer T; Enterotoxins produced by Staphylococcus aureus are potent mitogens for human T cells and cause lethal toxic shock . These superantigens bind to major histocompatibility complex class II on antigen-presenting cells outside the conventional peptide-binding groove and stimulate T cells expressing certain T-cell receptor V beta gene products . We investigated other cell-surface molecules on human peripheral blood mononuclear cells that can mediate staphylococcal enterotoxin B (SEB)-induced T-cell proliferation and cytokine production . SEB-induced proliferation of T cells was inhibited by monoclonal antibodies to CD2, CD11a, CD18, CD28, CD44, CD58 and ICAM-1 . Anti-ICAM-1 also blocked the production of pro-inflammatory mediators, TNF alpha and IFN gamma by SEB-stimulated T cells . These data suggest that the surface molecules, CD11a:CD18/ICAM-1, CD2/CD58, CD28 and CD44, are all important co-receptors for T-cell activation by superantigens . Thus, like conventional antigens, multiple stimulatory signals from the interactions of these receptors are required for superantigen-induced immune responses . Reducing toxic mediators such as TNF alpha and IFN gamma by anti-ICAM antibodies in SEB-induced T-cell responses may be a useful therapeutic strategy to circumvent SEB toxicity and pathogenesis. Wiad Lek, 1994 Feb, 47(3-4), 88 - 92 {Phagocytosis and NBT test and phosphatase activity of peripheral blood neutrophils in patients with untreated duodenal ulcer}; Hrycek A et al.; In 21 patients with active, endoscopically confirmed untreated duodenal ulcer and in a control group of 20 persons, the studies were carried out of peripheral blood neutrophils which included: 1) test with the assessment of neutrophil phagocytic activity against live bacterial cells of the Staphylococcus aureus Oxford 209P standard strain and against latex particles, 2) test of nitroblue tetrazolium reduction (NBT test) by neutrophils, 3) evaluation of alkaline phosphatase activity in the neutrophils by a cytoenzymatic technique . In the group of patients as compared with the control group a decrease was observed of neutrophil phagocytic activity against live bacterial cells, and absence of similar differences was noted when latex particles were the stimulating factor . In the studied group an increase of the value of the index of spontaneous NBT reduction by neutrophils was observed as well as a decrease of the value of the index of latex-stimulated reduction of this dye . Besides that, higher alkaline phosphatase activity was observed in the neutrophils in patients as compared to the activity of this enzyme in the neutrophils of healthy persons . It may be supposed that in patients with duodenal ulcer, peripheral blood neutrophils reveal changes in the function of membranous structures of these cells, and disturbances of redox processes evaluated in the test with NBT. J Hosp Infect, 1994 Feb, 26(2), 123 - 7 Methicillin resistant Staphylococcus aureus: the scale of the problem in a Shri Lankan hospital; Thevanesam V et al.; A three month surveillance study of methicillin resistant Staphylococcus aureus (MRSA) was carried out in the male surgical unit of the General Hospital, Peradeniya, Shri Lanka . Nose, throat, axillary, perineal and wound swabs were taken from 251 patients and 35 staff members . Eighty-four (27.5%) of 305 isolates of S . aureus from patients were MRSA . Seventy-three of these isolates were also resistant to penicillin, tetracycline, erythromycin, gentamicin, chloramphenicol and co-trimoxazole . All isolates were sensitive to fusidic acid, clindamycin, vancomycin and rifampicin . The acquisition of MRSA was higher than of methicillin sensitive S . aureus (MRSA) . No deaths occurred due to MRSA . Staff carriage was only 6% . The treatment and management of MRSA in hospitals with very poor resources requires further study of interventions which are practicable in this situation. J Clin Microbiol, 1994 Feb, 32(2), 407 - 15 Comparison of traditional and molecular methods of typing isolates of Staphylococcus aureus; Tenover FC et al.; Fifty-nine Staphylococcus aureus isolates and 1 isolate of Staphylococcus intermedius were typed by investigators at eight institutions by using either antibiograms, bacteriophage typing, biotyping, immunoblotting, insertion sequence typing with IS257/431, multilocus enzyme electrophoresis, restriction analysis of plasmid DNA, pulsed-field or field inversion gel electrophoresis, restriction analysis of PCR-amplified coagulase gene sequences, restriction fragment length polymorphism typing by using four staphylococcal genes as probes, or ribotyping . Isolates from four well-characterized outbreaks (n = 29) and a collection of organisms from two nursing homes were mixed with epidemiologically unrelated stock strains from the Centers for Disease Control and Prevention . Several isolates were included multiple times either within or between the sets of isolates to analyze the reproducibilities of the typing systems . Overall, the DNA-based techniques and immunoblotting were most effective in grouping outbreak-related strains, recognizing 27 to 29 of the 29 outbreak-related strains; however, they also tended to include 3 to 8 epidemiologically unrelated isolates in the same strain type . Restriction fragment length polymorphism methods with mec gene-associated loci were less useful than other techniques for typing oxacillin-susceptible isolates . Phage typing, plasmid DNA restriction analysis, and antibiogram analysis, the techniques most readily available to clinical laboratories, identified 23 to 26 of 29 outbreak-related isolates and assigned 0 to 6 unrelated isolates to outbreak strain types . No single technique was clearly superior to the others; however, biotyping, because it produced so many subtypes, did not effectively group outbreak-related strains of S . aureus. Biotechnology (N Y), 1994 Feb, 12(2), 169 - 72 Bacteriophage surface display of an immunoglobulin-binding domain of Staphylococcus aureus protein A; Djojonegoro BM et al.; As a model system for the optimization of separation ligands by bacteriophage surface display, we have constructed a phage surface expression system for a single immunoglobulin-binding domain of Protein A of Staphylococcus aureus . Protein A domain B is genetically fused to the gpIII adsorption protein of the filamentous bacteriophage M13, and hence displayed on the phage surface . Phage displaying the Protein A domain are selectively retained on human IgG-sepharose . Retention is due to specific Protein A-IgG interactions, as demonstrated by competitive inhibition by soluble Protein A or polyclonal human IgG . Polyclonal goat IgG, which is known to bind less well to Protein A than does human IgG, inhibits phage adsorption less effectively . Phage expressing Protein A can be purified in a few rounds of selective adsorption from a vast excess of wild type phage . Diverse libraries constructed by mutagenesis of this construct will allow massive screening of mutant forms of Protein A for alterations in binding and elution properties . We anticipate that phage display will prove to be a widely-applicable method of identification and optimization of affinity ligands for separations. J Bacteriol, 1994 Feb, 176(3), 580 - 5 Regulation of alpha- and beta-hemolysins by the sar locus of Staphylococcus aureus; Cheung AL et al.; We recently identified a locus on the Staphylococcus aureus chromosome, designated sar, for staphylococcal accessory regulator, that is involved in the global regulation of extracellular and cell wall-associated proteins . Previous phenotypic and Southern blot analyses with Tn917 and agr probes indicated that this locus is distinct from agr, a previously described global regulator of exoproteins in S . aureus . To understand the mode of regulatory control of exoprotein synthesis by the sar locus, the sar genotype was transduced from the original sar mutant 11D2 into two prototypic S . aureus strains, RN6390 and RN450, with well-defined genetic backgrounds . An analysis of extracellular protein profiles by use of silver-stained sodium dodecyl sulfate gels revealed alterations in the pattern of exoprotein production in the late log-early stationary phase in the sar mutants in comparison with the corresponding parents . In addition, most of the phenotypic changes that occurred in the conversion from the sar+ genotype to the sar genotype in mutant 11D2 were also found in these mutants . Northern (RNA) blot analyses of two exoprotein transcripts (alpha- and beta-hemolysins) from strain RN6390 and its corresponding sar mutant revealed downregulation of these transcripts in the mutant . Serial studies of these hemolysin transcripts at various growth intervals demonstrated that the transcriptional regulation of the hemolysin genes by the sar locus began during the log phase and continued into the postexponential phase . These data suggested that the sar locus probably regulates exoprotein genes at the transcriptional level . This mode of regulation is similar to that of exoprotein target gene transcription by agr. Gene, 1994 Jan 28, 138(1-2), 51 - 7 The effect of lysogeny on the genomic organization of Staphylococcus aureus; Smeltzer MS et al.; The genome of Staphylococcus aureus strain S6C was shown to contain a prophage inserted within the beta-toxin (BT)-encoding structural gene (hlb) . The phage att site was identical to that reported for the BT-converting phages phi 13 and phi 42 . The prophage carried the genes encoding staphylokinase (sak) and enterotoxin A (sea), which suggests that it is similar to phi 42 . However, it was not included in the presence of mitomycin C (MC) and appears to be defective . Mapping studies revealed that the genomes of the BT-converting phages present in strains S6C and PS42D (a phi 42 lysogen) encode at least one SmaI restriction site . Moreover, the PS42D chromosome contained a second prophage that also had at least one SmaI site, carried both sak and sea, and hybridized with DNA probes that also hybridize with the BT-converting phages . The second phage in strain PS42D was mapped to a SmaI fragment corresponding to fragment A of the S . aureus strain 8325 genomic map . Although the BT-converting phage present in strain S6C could not be induced, a phage was induced from strain S6C using MC . Southern blots suggest that is is similar to phi 11; however, the restriction patterns of DNA from the induced phage and phi 11 were clearly distinct . We have designated the inducible phage present in strain S6C as phi 15, to denote the distinction . Relatively weak hybridization signals were also observed when phi 15 DNA was used to probe genomic DNA from S . aureus strains lysogenized with the BT-converting phages, phi 13, phi 42 and 42E.(ABSTRACT TRUNCATED AT 250 WORDS) J Biol Chem, 1994 Jan 21, 269(3), 1883 - 8 Promoter analysis of the staphylococcal enterotoxin A gene; Borst DW et al.; The promoter region of the staphylococcal enterotoxin A (SEA) gene (sea) of Staphylococcus aureus was localized by primer extension analysis in conjunction with in vitro mutagenesis . The 5'-end of sea mRNA was located 86 base pairs upstream of the translational initiation codon . A DNA region with good agreement with canonical promoter sequences was observed beginning 8 base pairs upstream of the apparent transcriptional start site . Analysis of a series of progressive deletions of upstream DNA revealed that no DNA upstream of the putative -35 region was required for transcription of sea (determined by primer extension analysis) or for SEA production as detected by Western immunoblot analysis . Deletion mutants extending into the -35 region or mutants containing nucleotide substitutions in the -10 region both showed dramatic reductions in SEA production and transcription of sea . Analysis of a deletion mutant in which 59 base pairs between the transcriptional and translational start sites were deleted revealed slightly increased levels of SEA production. Blood, 1994 Jan 15, 83(2), 404 - 14 Structural changes in platelet glycoprotein IIb/IIIa by plasmin: determinants and functional consequences; Pasche B et al.; Plasmin exposure modulates platelet aggregation responses, but a direct effect of plasmin on the platelet fibrinogen receptor, glycoprotein IIb/IIIa (GPIIb/IIIa), has never been conclusively shown in a plasma milieu . To examine this issue, we incubated platelets in platelet-rich plasma with plasmin and measured the effect of this treatment on platelet aggregation, fibrinogen binding, and the structural integrity of GPIIb/IIIa . Plasmin treatment reduced maximal reversible fibrinogen binding in a dose-dependent fashion, and this reduction in binding was accompanied by a correlative reduction in the maximal rate of aggregation . Immunoblots performed with polyclonal antibodies against GPIIb/IIIa showed that GPIIIa had been cleaved by plasmin, but this cleavage was detected only after subsequent degradation of the solubilized GPIIb/IIIa with Staphylococcus aureus V8 (Glu-C) endoprotease . Peptide sequence analysis showed that cleavage occurred at the lys444-pro445 bond in the first cysteine-rich repeat domain of GPIIIa a unique proteolytic event observed only in the presence of plasma fibrinogen . These observations suggest that plasmin modifies GPIIIa by a unique proteolytic event in plasma that is dependent on fibrinogen binding and, consequently, is accompanied by significant reductions in fibrinogen binding and aggregation response. J Am Vet Med Assoc, 1994 Jan 15, 204(2), 255 - 60 Comparison of microbiologic culture, an enzyme-linked immunosorbent assay, and determination of somatic cell count for diagnosing Staphylococcus aureus mastitis in dairy cows; Hicks CR et al.; Results of using microbiologic culture of a single milk sample, determination of somatic cell count (SCC), an ELISA, and a combination of determination of SCC and ELISA to diagnose Staphylococcus aureus mastitis in dairy cattle were compared . Cows were considered to have S aureus intramammary infections if microbiologic culture of at least 2 of 3 consecutive sets of milk samples yielded growth of the organism . Data were analyzed from milk samples collected over a 4-month period from 185 cows in 5 herds . Sensitivity, specificity, and likelihood ratio of a positive test result for microbiologic culture of a single milk sample were 93%, 99%, and 93.0, respectively . Sensitivity, specificity, and likelihood ratio of a positive test result for ELISA were 69%, 61%, and 1.8, respectively, and for determination of SCC, they were 79%, 72%, and 2.9, respectively . Combination of determination of SCC and ELISA had sensitivity, specificity, and likelihood ratio of a positive test result of 80%, 62%, and 3.4, respectively . Results from microbiologic culture of consecutive milk samples were more consistent than results of ELISA performed on consecutive samples . These data suggest that microbiologic culture of a single milk sample is the best of the 3 tests studied for diagnosing S aureus intramammary infection. J Biol Chem, 1994 Jan 14, 269(2), 1075 - 82 Enzymatic methylation of recombinant heterogeneous nuclear RNP protein A1 . Dual substrate specificity for S-adenosylmethionine:histone-arginine N-methyltransferase; Rajpurohit R et al.; We have previously reported the existence of two different molecular species of protein methylase I (S-adenosylmethionine:protein-arginine N-methyltransferase, E.C . 2.1.1.23) in calf brain, one specific for myelin basic protein and the other for histone (Ghosh, S . K., Paik, W . K., and Kim, S . (1988) J . Biol . Chem . 263, 19024-19033) . In the present study, however, we report that heterogeneous ribonucleoprotein particle protein A1 is most likely an in vivo substrate for the "histone-specific protein methylase I." The unmethylated recombinant protein A1 has been found to be a much superior methyl acceptor for the enzyme than histone with a Km value two orders of magnitude lower (0.19 microM) than that for histone (21 microM) . Myelin basic protein, a specific inhibitor for histone protein methylase I, exhibited a lower IC50 for protein A1 methylation (IC50 = 33 microM) compared with histone methylation (IC50 = 220 microM) and competitively inhibited the former with a Ki value of 1.3 x 10(-6) M . The extent of inhibition of protein A1 and histone methylation by the polyclonal antibodies prepared against purified "histone protein methylase I" was identical . Maximally, 1.08-mol methyl groups were incorporated per mol of protein A1, which was 27-fold higher than that of histone (0.04 mol/mol of histone) . HPLC analysis of the enzymatically methylated amino acid residues in protein A1 revealed the formation of NG-monomethylarginine and NG,NG-dimethylarginine . The ratio of NG,NG-dimethylarginine/NG-monomethylarginine increased as a function of incubation period; however, NG,N'G-dimethylarginine was not detectable . Proteolytic cleavage of the methyl-3H-labeled recombinant protein A1 by trypsin and Staphylococcus aureus V8 endoprotease indicated that protein A1 possesses multiple sites for methylation, one of which was identified as residue 194 arginine, which coincided with the in vivo methylation site. Biochemistry, 1994 Jan 11, 33(1), 116 - 25 Characterization of covalently bound enzyme inhibitors as transition-state analogs by protein stability measurements: phosphonate monoester inhibitors of a beta-lactamase; Rahil J et al.; An experimental method is described for determining whether a covalent enzyme-inhibitor complex has the properties expected of a transition-state analog . The method involves a comparison of the noncovalent interaction energies between the enzyme and the inhibitor on one hand (determined from protein denaturation thermodynamics) and the analogous transition state on the other (determined from kinetic measurements) . These two quantities should presumably be large (in comparison with the interaction energies of substrates or reaction intermediates) and close to equal for a good transition state analog; the former is seen dramatically in a large increase in protein stability . The method is absolute in the sense that it does not require a crystal structure of the inhibited enzyme or any preconceptions as to the mechanism of action of the enzyme except those which led to adoption of the potential transition state analog and which might turn out to be right or wrong . In this paper the method is quantitatively applied to the inhibition of the Staphylococcus aureus PC1 beta-lactamase by phosphonate monoesters . It is concluded that the enzyme-inhibitor complex in this case is likely to be a good transition-state mimic . Therefore, mechanistic interpretation of the crystal structure of the complex can be made with more confidence . A semiquantitative assessment of the situation with serine proteinases is also made . It is concluded, in agreement with predictions based on the generally accepted mechanism and on crystal structures, that anionic, but not neutral, phosph(or/on)yl derivatives are good transition-state analogs. Biochemistry, 1994 Jan 11, 33(1), 256 - 65 N-(p-azido-3-{125I}iodophenethyl)spiperone binds to specific regions of P-glycoprotein and another multidrug binding protein, spiperophilin, in human neuroblastoma cells; Safa AR et al.; P-glycoprotein (P-gp) is an energy-dependent drug extrusion pump with broad specificity for diverse hydrophobic anticancer agents and compounds known to reverse multidrug resistance (MDR) . Among MDR reversing agents, phenothiazines (PTZs) and related compounds may sensitize MDR by interacting with a specific binding site(s) on P-gp and by other mechanisms . In order (1) to identify a binding site for PTZs and related compounds on P-gp, (2) to examine whether these compounds and other MDR modulators bind to the same domains of P-gp, and (3) to identify proteins with high specificity for these neuroleptic agents and other MDR modulators, we used a butyrophenone D2-dopamine receptor photoaffinity probe, N-(p-azido-3-{125I}iodophenethyl)spiperone ({125I}NAPS) . {125I}NAPS was actively effluxed from vincristine (VCR)-resistant SH-SY5Y/VCR human neuroblastoma cells, and nonradioactive I-NAPS was a potent chemosensitizing agent . After photolabeling, the probe bound specifically and with high efficiency to P-gp and to another multidrug binding 17-kDa membrane-bound protein, spiperophilin, in these cells . The efficiency of {125I}NAPS binding to P-gp was 5-6-fold more than {3H}azidopine and {125I}arylazidoprazosin ({125I}AAP), known photoaffinity analogs for P-gp . {125I}NAPS photolabeling of P-gp was preferentially competed by MDR-related drugs, with vinblastine > VCR > colchicine > doxorubicin > actinomycin D . Many drugs that are known to reverse MDR were potent inhibitors of {125I}NAPS binding to P-gp . While PTZs and related compounds were potent inhibitors of {125I}NAPS binding to P-gp, most of them enhanced the binding of {125I}AAP significantly . cis-Flupentixol increased the binding of {125I}AAP to P-gp 9-fold more than did trans-flupentixol, but both were potent inhibitors of {125I}NAPS binding, suggesting their stereoselective effect on the {125I}AAP binding site . Proteolysis of {125I}NAPS-bound P-gp with Staphylococcus aureus V8 protease revealed that this probe binds to two major peptides, 6 and 8 kDa, and a number of minor ones, while {125I}AAP binds to only an 8-kDa peptide . These results suggest that modulators of MDR may interact with separate or overlapping domains . Furthermore, most MDR modulators, dopaminergic drugs, and beta-adrenergic antagonists used also inhibited binding of {125I}-NAPS to spiperophilin, suggesting that this protein may be a target for these drugs. Arch Vet Pol, 1994, 34(1-2), 69 - 74 Determination of staphylococcal enterotoxins in milk and milk products by three methods; Burdova O et al.; For food evaluation, the determination of the number of Staphylococcus aureus colonies is insufficient in the view of present scientific knowledge . The results, advantages and disadvantages of diagnostic methods are demonstrated on an example of three methods of detection of staphylococcal enterotoxins in milk and milk products . 133 strains were investigated with the method of biotyping of Staphylococcus aureus strains . Four of their strains were included in biotype A, seven strains of S . aureus were not included in any biotype and the other strains belonged in biotypes C and E . This method can be used as an auxiliary method for evaluation of foods containing S . aureus bacteria . The agar-gel precipitation method of enterotoxin detection in isolated strains of Staphylococcus aureus has just restricted valiability . When examining 96 strains of S . aureus with this method, strains which were producing staphylococcal enterotoxins were isolated 17 times . The main disadvantage of this method is a fact that the result concerning the isolated strains need not be identical with the result of enterotoxin detection in food . Direct assays of staphylococcal enterotoxins in milk and milk products using an enzymoimmunological method (ELISA test) seem to be most promising, mainly due to their high sensitivity (0.0001-0.001 micrograms.ml-1) and other advantages. Arch Immunol Ther Exp (Warsz), 1994, 42(5-6), 383 - 6 Effect of hydrocortisone treatment on oxygen metabolism and phagocytosis of peripheral blood neutrophils in asthmatic patients, sensitive and resistant to glucocorticosteroid therapy; Jankowska R et al.; The inflammatory activity of peripheral blood neutrophils of patients suffering from atopic asthma and treated with glucocorticosteroids was investigated . Two tests were performed: 1 . chemiluminescence test of neutrophils, and 2 . phagocytosis test of latex and bacteria (Staphylococcus aureus 209 P) by neutrophils before and after incubation of the cells with hydrocortisone . The tests were carried out in 3 selected groups of (1) asthmatic steroid sensitive patients, (2) asthmatic steroid resistant patients, and (3) healthy individuals . The neutrophil chemiluminescence stimulation index was found to be significantly lower in the asthmatic steroid sensitive group as compared to the other groups . The index increased in this group after neutrophil incubation with hydrocortisone . The results of phagocytosis of latex by neutrophils before and after their incubation with hydrocortisone were similar in all the 3 groups . The results of phagocytosis of bacteria by neutrophils in the asthmatic steroid sensitive group were significantly lower after incubation of neutrophils with hydrocortisone only. Perit Dial Int, 1994, 14(1), 61 - 5 The impact of peritonitis on peritoneal and systemic acid-base status of patients on continuous ambulatory peritoneal dialysis; Sennesael JJ et al.; OBJECTIVE: To assess the possible effects of peritonitis on peritoneal and systemic acid-base status . DESIGN: pH, pCO2, lactate, and total leukocyte and differential count were simultaneously determined in the overnight dwell peritoneal dialysis effluent (PDE) and arterial blood in noninfected patients (controls) and on days 1, 3, and 5 from the onset of peritonitis . SETTING: University multidisciplinary dialysis program . PATIENTS: Prospective analysis of 63 peritonitis episodes occurring in 30 adult CAPD patients in a single center . RESULTS: In controls, mean (+/- SD) acid-base parameters were pH 7.41 +/- 0.05, pCO2 43.5 +/- 2.6 mm Hg, lactate 2.5 +/- 1.5 mmol/L in the PDE, and pH 7.43 +/- 0.04, PaCO2 36.8 +/- 3.8 mm Hg, lactate 1.4 +/- 0.7 mmol/L in the blood . In sterile (n = 6), gram-positive (n = 34), and Staphylococcus aureus (n = 9) peritonitis PDE pH's on day 1 were, respectively, 7.29 +/- 0.07, 7.32 +/- 0.07, and 7.30 +/- 0.08 (p < 0.05 vs control) . In gram-negative peritonitis (n = 14) PDE pH was 7.21 +/- 0.08 (p < 0.05 vs all other groups) . A two-to-threefold increase in PDE lactate was observed in all peritonitis groups, but a rise in pCO2 was only seen in gram-negative peritonitis . Acid-base profile of PDE had returned to control values by day 3 in sterile, gram-positive and Staphylococcus aureus peritonitis and by day 5 in gram-negative peritonitis . Despite a slight increase in plasma lactate on the first day of peritonitis, arterial blood pH was not affected by peritonitis . CONCLUSION: PDE pH is decreased in continuous ambulatory peritoneal dialysis (CAPD) peritonitis, even in the absence of bacterial growth . In gram-negative peritonitis, PDE acidosis is more pronounced and prolonged, and pCO2 is markedly increased . Arterial blood pH is not affected by peritonitis. Nippon Kyobu Geka Gakkai Zasshi, 1994 Jan, 42(1), 160 - 5 {Removal of infected total pacemaker system under extracorporeal circulation--a case report and review of the Japanese literature}; Shimizu H et al.; A 35-year-old male with sick sinus syndrome was complicated with recurrent local infection at the site of the generator pocket associate with a retained pacemaker lead, followed by septicemia presenting with Staphylococcus aureus . Several attempts to remove the lead via the implantation vein by direct traction were performed unsuccessfully because the leads were strongly adhered to the trabecula of the right ventricle . Repeated debridement employing antibiotic therapy was ineffective . As a last resort, we finally operated under extracorporeal circulation (ECC) 24 months after the first implantation and 22 months after initiation of the local infectious episode . As we found it difficult to remove the leads by traction even under direct vision, we used the vinyl chloride tube, which is a part of the ECC circuit, as a sheath for applying countertraction around the lead tip to prevent the myocardial wall from being torn and extracted together with the lead tip . The lead was removed successfully and a new epicardial lead was implanted . The postoperative course uneventful and no recurrence has occurred after 1 year . In reviewing the Japanese literature, 10 case, operated on under ECC to remove the infected retained leads, were described in detail . Among them, eight cases had undergone previous debridement including removal of the generator and the subcutaneous portion of the lead . It is clear that removal of all of the pacemaker system is necessary for eradication of infection . Adhesion of the lead to the wall is firm . Only one case besides ours succeeded in having its lead removed without requiring incision of the tissue around the lead tip.(ABSTRACT TRUNCATED AT 250 WORDS) Nippon Kyobu Geka Gakkai Zasshi, 1994 Jan, 42(1), 156 - 9 {A successful case of valve-sparing surgery for tricuspid valve endocarditis}; Kuki S et al.; A successful repair for infective endocarditis of the tricuspid valve is presented . A 35-year-old man was referred to our hospital complaining of high fever despite antibiotic chemotherapy . Lung scan showed multiple thromboembolism . Blood cultures revealed staphylococcus aureus . Echocardiography showed vegetations attached to the tricuspid valve and severe tricuspid regurgitation . Conservative surgery such as vegetectomy and DeVega's annuloplasty was successfully carried out . The patient's postoperative course was uneventful . The conservative surgery might provide a satisfactory result in the selected cases with localized vegetation and minimum valve involvement. Chemotherapy, 1994 Jan-Feb, 40(1), 26 - 9 Susceptibility of methicillin-resistant Staphylococcus aureus to minocycline and other antimicrobials; Qadri SM et al.; The incidence of methicillin-resistant Staphylococcus aureus (MRSA) is on the rise, especially in nosocomial and intravenous-drug-abuse-related infections, with a concomitant increase in morbidity, mortality and health care costs . At present the drug of choice, vancomycin, which must be administered intravenously, is expensive and can cause serious side effects in vancomycin-intolerant patients . Recently, minocycline has received much attention as an antibiotic to combat the increasing frequency of MRSA-related infections . We tested 102 recent clinical isolates of MRSA from tertiary-care patients and found none to be resistant to minocycline, with minimum inhibitory concentrations of < 1-2 micrograms/ml . The only other drug that inhibited all the strains was vancomycin, followed by ciprofloxacin (87%), clindamycin (55%) and chloramphenicol (52%) . Gentamicin, beta-lactams, tetracycline and trimethoprim-sulfamethoxazole had little or no activity against our isolates of MRSA. Chemotherapy, 1994 Jan-Feb, 40(1), 21 - 5 Activity of twenty-one antimicrobial agents including l-ofloxacin against quinolone-sensitive and -resistant, and methicillin-sensitive and -resistant Staphylococcus aureus; Peterson LR et al.; There is a need to identify alternative agents to vancomycin for the treatment of infections with methicillin-resistant Staphylococcus aureus (MRSA) . One candidate is the l isomer of ofloxacin (DR-3355) . We tested 520 frozen MRSA isolates, 248 fresh MRSA isolates, and 375 fresh methicillin-susceptible S . aureus (MSSA) isolates from Minnesota, and 600 clinical isolates of S . aureus (150 MRSA and 450 MSSA) from Illinois . Over 90% of the MRSA strains were resistant to 32 micrograms/ml of oxacillin . Of the 520 frozen MRSA, 24% were susceptible to < or = 2 micrograms/ml ofloxacin, and an additional 74% were susceptible to ofloxacin between 8 and 16 micrograms/ml . More than 98% of all strains were susceptible to < or = 16 micrograms/ml ofloxacin or l-ofloxacin . All the quinolones had a bimodal distribution of in vitro activity, but for only ofloxacin and l-ofloxacin was activity confined to a very narrow range. Arch Microbiol, 1994, 161(1), 82 - 7 Biochemical studies on the lethal effects of solar and artificial ultraviolet radiation on Staphylococcus aureus; el-Adhami W et al.; The effects of UV-B radiation generated in the laboratory and as a component of sunlight on the viability and particular biochemical activities of the bacterium Staphylococcus aureus have been examined . UV-B radiation progressively inhibits protein synthesis (assayed as 3H-alanine incorporation) and kills cells . Cell respiration, and RNA and DNA synthesis (3H-uridine and 3H-thymidine incorporation) were not greatly affected by UV-B irradiation . The OH . and 1O2-free radical scavengers protected cells against killing and inhibition of protein synthesis by UV-B, suggesting that such radicals mediate the effects of UV-B on this organism . A similar protective effect using a ferric ion chelator suggests an important role for metallic ions in UV-B lethality. J Neuroimmunol, 1994 Jan, 49(1-2), 189 - 95 Effect of pure bovine brain-derived gangliosides on normal human B cell proliferation in vitro; Frugoni P et al.; Pure gangliosides obtained from bovine brain including GM1, GD1b, GT1b and asialo-GM1 (GA1) did not induce normal human B cell proliferation in vitro . No B cell proliferation was observed either when GM1 was tested in the presence of interleukin-2 (IL-2), IL-4 or IL-6 . Furthermore, the proliferative responses of human B cells induced by Staphylococcus aureus Cowan I (SAC), a T cell-independent B cell mitogen, were inhibited by these gangliosides . The degree of inhibition was influenced by ganglioside-bound sialic acid, although sialic acid per se was not inhibitory . Strongest inhibition was observed in the presence of GT1b (EC50 8.8 microM/10(5) B cells) and lowest in the presence of GA1 (EC50 129.5 microM/10(5) B cells) with intermediate values for GM1 and GD1b . GM1 inhibition of SAC-induced B cell proliferation did not represent cytotoxic effects and was still evident when GM1 was added 24-48 h after the beginning of the cultures . GM1 inhibition of SAC-induced proliferation was not reversed by the addition of IL-2, IL-4, IL-6 or their combination . In addition, GM1 inhibited the ILs-driven proliferative responses of SAC-induced B cell blasts . However, no inhibition of Epstein-Barr virus-induced B cell proliferative responses was observed . In conclusion, these results show that bovine brain-derived gangliosides do not induce proliferative responses of normal human B cells but, on the contrary, inhibit B cell responses induced by SAC. J Bacteriol, 1994 Jan, 176(2), 443 - 9 Site-directed mutagenesis of the mecA gene from a methicillin-resistant strain of Staphylococcus aureus; Wu CY et al.; The mecA-27r gene from Staphylococcus aureus 27r encodes penicillin-binding protein 2a (PBP2a-27r), which causes this strain to be methicillin resistant . Removal or replacement of the N-terminal transmembrane domain had no effect on binding of penicillin, but removal of portions of the putative transglycosylase domain (144, 245, or 341 amino acids after the transmembrane region) destroyed penicillin-binding activity . The SXXK, SXN, and KSG motifs, present in all penicillin-interacting enzymes, were found in the expected linear spatial arrangement within the putative transpeptidase region of PBP2a-27r . Alterations of amino acids in all three of these motifs resulted in elimination of penicillin-binding activity, confirming their roles in the interaction with penicillin. Am J Kidney Dis, 1994 Jan, 23(1), 99 - 104 Results of ultrasound-assisted diagnosis of tunnel infections in continuous ambulatory peritoneal dialysis; Plum J et al.; The management of catheter-related infections has become a major challenge in continuous ambulatory peritoneal dialysis treatment . Early recognition and discrimination of mere exit site infections from more invasive and catheter menacing tunnel infections (TIs) are of therapeutic importance . As the diagnosis of TI is still based on clinical signs and only indicates advanced infections, we studied the usefulness of the ultrasound examination (UE) of the continuous ambulatory peritoneal dialysis catheter . Examinations were made by a mobile ultrasound unit using a 7.5 MHz transducer . Sixty-two continuous ambulatory peritoneal dialysis patients with an Oreopoulos Zellermann catheter (Oreopoulos-Zellerman Cathete-THWII, Baxter GmbH, Unterschleissheim, Germany) were studied repeatedly between February 1991 and July 1992 . Pericatheter fluid collection (with typical sonographic localization) was consistent with surgical findings and histopathologic examination and proved to be a reliable criterion of TIs . The incidence of TIs was significantly higher when using UE (0.35/patient-year) compared with the usual clinical criteria (0.12/patient-year, P < 0.01) . Staphylococcus aureus exit site infections were predominant and had the highest risk of concomitant TIs (83%) . Eleven of 25 patients with a positive UE lost their catheter due to infectious complications, while no patient with a negative UE underwent operation for infectious reasons (P < 0.01) . The peritonitis rate (0.64/patient-year) was markedly increased when UE indicated a TI (1.7/patient-year, P < 0.01) . We conclude that sonography is a sensitive tool for the early diagnosis of unsuspected TIs . Sonography is a bedside method used for screening purposes and allows us to control the treatment regimen. J Surg Res, 1994 Jan, 56(1), 60 - 6 Comparison of Staphylococcus aureus and Escherichia coli infusion in conscious rats; Stewart KD et al.; The purpose of this study was to compare the pathophysiology of bacteremia produced by intravenous infusion of either a Gram-positive (Staphylococcus aureus) or a Gram-negative (Escherichia coli) organism . Conscious, unrestrained, instrumented rats received S . aureus, E . coli, or sterile saline over 120 min, followed by a 240-min monitoring period . The infusates produced 90% (S . aureus,) 80% (E . coli), and 0% (saline) mortality at 24 hr . Neither bacterial group produced hypotension during the entire 360-min study period . E . coli produced early tachycardia and increased glucose, followed by decreased stroke volume and increased lactate and pO2 . S . aureus caused early tachycardia followed by decreased pH, stroke volume, and cardiac output and increased lactate and systemic vascular resistance . Respiration rate and central venous pressure were not affected by either bacterial infusion . Compared to E . coli, S . aureus produced decreased pH, glucose, pO2, heart rate, and cardiac output and increased lactate, hematocrit, pCO2, and systemic vascular resistance . These data document quantitative differences in the acute response of the conscious rat to bacteremia caused by these isolates of E . coli and S . aureus. J Surg Res, 1994 Jan, 56(1), 1 - 4 In vivo ovine flap model to evaluate surgical infection and tissue necrosis; Phillips LG et al.; Although the inciting causes and the end results of soft tissue infection are well described, we have not achieved a quantitative methodistic description of the sequence of events in between . The following study presents an isolated in vivo model which will allow specific manipulations and quantifications of the events of integumentary infection . Pedicle flaps were raised on the buttock of the adult range ewe and it was multiply inoculated with Staphylococcus aureus, and followed for 96 hr . This pedicle contains not only a well-defined artery, vein, and nerve, but also a well-developed efferent lymphatic vessel . In addition, the distal portion of the flap is primarily supplied by a musculocutaneous arterial perforator, making the distal flap a watershed area . Anatomic, radiologic, and vital stain injection studies confirmed these results . The sheep model was found to be superior to the pig model both in terms of its anatomy (the addition of an efferent lymphatic vessel) as well as the disposition of the sheep which was more compliant than that of the pig . We believe that this flap will allow multiple manipulations and provide an in vivo isolated system to study the pathobiology of soft tissue infection. J Infect Dis, 1994 Jan, 169(1), 150 - 6 Effect of CL 184,005, a platelet-activating factor antagonist in a murine model of Staphylococcus aureus-induced gram-positive sepsis; DeJoy SQ et al.; Experiments using a murine model of heat-killed Staphylococcus aureus-induced gram-positive bacterial sepsis indicate that the lethal bacterial effects can be prevented if mice are pretreated with CL 184,005, a platelet-activating factor (PAF) antagonist . CL 184,005 was ineffective when administered after bacterial challenge . Plasma of mice pretreated with CL 184,005 contained significantly less tumor necrosis factor (TNF), suggesting that CL 184,005 interferes with TNF synthesis induced by S . aureus . Spleen-associated TNF protein was also decreased by pretreatment with CL 184,005 . Although TNF levels were significantly decreased in mice treated with CL 184,005, interleukin-6 levels in serum were significantly increased . Athymic mice were also susceptible to the lethal effects of S . aureus, suggesting that T cells were not involved . When rats rendered hypotensive with S . aureus were treated with CL 184,005, their blood pressure was normalized . Mice treated with enterotoxin B were not protected if they were pretreated with CL 184,005; however, TNF levels in these mice were significantly lower, suggesting that mediators other than PAF and TNF may contribute to the lethal effects of enterotoxin. Infect Immun, 1994 Jan, 62(1), 33 - 40 Necessity and sufficiency of beta interferon for nitric oxide production in mouse peritoneal macrophages; Zhang X et al.; Bacterial lipopolysaccharide and some cytokines can activate macrophages to secrete nitric oxide . Macrophage-derived nitric oxide is a key cytotoxic factor for microbicidal and tumoricidal processes . We report here that a monoclonal antibody specific for beta interferon inhibited lipopolysaccharide-induced nitric oxide production in thioglycolate-elicited C3HeB/FeJ peritoneal macrophages and macrophage-like cell line RAW 264.7 . In addition, exogenous added beta interferon enabled lipopolysaccharide-hyporesponsive thioglycolate-elicited C3H/HeJ peritoneal macrophages to produce nitric oxide in response to lipopolysaccharide . These data support the concept that beta interferon provides an essential signal(s) for lipopolysaccharide-triggered nitric oxide production by mouse macrophages . Heat-killed Staphylococcus aureus, a gram-positive bacterium which was unable to initiate nitric oxide production in thioglycolate-elicited C3HeB/FeJ peritoneal macrophages in vitro, promoted nitric oxide formation in the presence of beta interferon, suggesting that beta interferon may be a general cofactor necessary for bacterium-derived stimulus-induced nitric oxide production in these macrophages . However, neither beta interferon nor tumor necrosis factor alpha, alone or in combination, triggered nitric oxide production in thioglycolate-elicited mouse peritoneal macrophages, demonstrating that these macrophage-derived cytokines, while necessary, were not sufficient by themselves for the induction of nitric oxide production in these cells . On the other hand, gamma interferon and tumor necrosis factor alpha acted together to induce nitric oxide production in vitro in the absence of lipopolysaccharide in thioglycolate-elicited mouse peritoneal macrophages, indicating that these two types of interferons provided different signals during the activation of these macrophages. Infect Immun, 1994 Jan, 62(1), 152 - 61 The Staphylococcus aureus collagen adhesin is a virulence determinant in experimental septic arthritis; Patti JM et al.; The importance of a collagen-binding adhesin in the pathogenesis of septic arthritis has been examined by comparing the virulence of two sets of Staphylococcus aureus mutants in an animal model . Collagen adhesin-negative mutant PH100 was constructed by replacing the chromosomal collagen adhesin gene (cna) in a clinical strain, Phillips, with an inactivated copy of the gene . Collagen adhesin-positive mutant S . aureus CYL574 was generated by introducing the cna gene into CYL316, a strain that normally lacks the cna gene . Biochemical, immunological, and functional analyses of the generated mutants and their respective parent strains showed that binding of 125I-labeled collagen, expression of an immunoreactive collagen adhesin, and bacterial adherence to cartilage were directly correlated with the presence of a functional cna gene . Greater than 70% of the mice injected with the Cna+ strains developed clinical signs of arthritis, whereas less than 27% of the animals injected with Cna- strains showed symptoms of disease . Furthermore, mice injected with the Cna+ strain Phillips had remarkably elevated levels of immunoglobulin G1 and interleukin-6 compared with mice injected with the Cna- mutant PH100 . Taken together, these results demonstrate that collagen adhesin plays an important role in the pathogenesis of septic arthritis induced by S . aureus. Infect Immun, 1994 Jan, 62(1), 113 - 8 Phage-associated differences in staphylococcal enterotoxin A gene (sea) expression correlate with sea allele class; Borst DW et al.; Staphylococcus aureus strains which produced either high or low levels of staphylococcal enterotoxin A (SEA) with a minimal eightfold difference between the two groups were identified . For FRI100 and FRI281A (prototypes for each group), strain differences in the expression of the SEA-encoding gene (sea) were found to occur at the level of sea mRNA concentration, and part of the difference in expression was associated with the sea-containing phages . Southern blot analysis revealed that this phage-associated difference was not due to differences in the copy number of sea . Nucleotide sequence analysis of sea from FRI281A revealed a new allele of sea, with the majority of the sequence differences occurring in the upstream promoter region . Although a strict correlation was observed between the level of SEA production and sea allele class for several strains, the sequence differences observed in the upstream region were not sufficient in themselves to alter the expression level of sea. J Immunol, 1994 Jan 1, 152(1), 87 - 95 Immunobiologic and biochemical properties of mutants of toxic shock syndrome toxin-1; Murray DL et al.; Toxic shock syndrome (TSS) is a multisystem illness caused mainly by Staphylococcus aureus producing TSS toxin-1 (TSST-1) . A variant of TSST-1 has been isolated from ovine mastitis S . aureus . This toxin, TSST-ovine (TSST-O) is only weakly T cell mitogenic, is nonpyrogenic, does not enhance endotoxin shock, and does not cause TSS in the miniosmotic pump model . The sequence of the ovine gene (tstO) differs from the TSST-1 gene (tstH) by 14 nucleotides that change seven amino acids in the mature protein of which two are in the C-terminal half . A gene fusion containing half of both tstH and tstO was made and cloned into S . aureus . The fusion protein contained the two C-terminal amino acid differences that are in TSST-O at residues 132 and 140 . The fusion protein was not T cell mitogenic and did not elicit TSS in two rabbit models . Additional experiments used mutagenesis to change the lysine residue at position 132 of TSST-O to glutamate (TSST-OK132E), as exists in TSST-1, and to change the lysine residue of the human-ovine fusion at position 132 to glutamate (TSST-11140T) . Both mutants were pyrogenic, enhanced endotoxin shock, and caused TSS in the miniosmotic pump model . However, the proteins were only partially T cell mitogenic . The restoration of lethality of TSST-O and the human-ovine fusion by changing the lysine to glutamate, as exists in TSST-1, indicates that residue 132 is important in lethality . The failure to regenerate complete T cell mitogenicity of the same mutants indicates that residues 132 and 140 are important for that activity. Ann Intern Med, 1994 Jan 1, 120(1), 12 - 7 Association of chronic nasal carriage of Staphylococcus aureus and higher relapse rates in Wegener granulomatosis; Stegeman CA et al.; OBJECTIVE: To examine possible risk factors for relapse, including chronic nasal carriage of Staphylococcus aureus and serial antineutrophil cytoplasmic antibody (ANCA) determinations in patients with Wegener granulomatosis . DESIGN: Observational cohort study . SETTING: Outpatient clinic at a university-affiliated hospital . PATIENTS: Consecutive patients (n = 71) with biopsy-proven Wegener granulomatosis who were seen during follow-up at the outpatient clinic from January 1988 to July 1991 . Fourteen patients were ineligible or dropped out; 57 patients were analyzed . MEASUREMENTS: Serial ANCA determinations and swab cultures of both anterior nares for S . aureus taken at each visit every 4 to 6 weeks . Occurrence of infections and relapses of Wegener granulomatosis were identified according to strict, predefined criteria . RESULTS: Thirty-six of the 57 patients (63%; 95% CI, 49% to 76%) were found to be chronic nasal carriers of S . aureus (> or = 75% of nasal cultures positive for S . aureus) . Proportional-hazards regression analysis identified chronic nasal carriage of S . aureus (adjusted relative risk, 7.16; CI, 1.63 to 31.50), creatinine clearance above 60 mL.min-1 (adjusted relative risk, 2.94; CI, 1.27 to 6.67), and a history of previous relapses of Wegener granulomatosis (adjusted relative risk, 1.33; CI, 0.98 to 1.78) as independent risk factors for relapse . Twenty-two of 33 patients persistently or intermittently positive for ANCA had a relapse as opposed to only 1 of 21 persistently negative patients . Relapses of Wegener granulomatosis were not related to diagnosed infections . CONCLUSION: Chronic nasal carriage of S . aureus identifies a subgroup of patients with Wegener granulomatosis who are more prone to relapses of the disease, suggesting a role for S . aureus in its pathophysiology and a possible clue for treatment. Neth J Med, 1994 Jan, 44(1), 23 - 5 Mycotic aneurysm of the suprarenal abdominal aorta; Schrander-vd Meer AM et al.; Staphylococcus aureus is one of the main causes of bacteriaemia . Haemodialysis patients are likely to develop bacteriaemia due to S . aureus, probably because they are often carriers of S . aureus and also frequently have intravascular catheters . This case report describes a very rare complication of S . aureus sepsis in a 62-year-old haemodialysis patient, namely a suprarenal aneurysm of the abdominal aorta. Burns, 1994, 20 Suppl 1, S14 - 7; discussion S17-8 Reduction in Staphylococcus aureus wound colonization using nasal mupirocin and selective decontamination of the digestive tract in extensive burns; Mackie DP et al.; Following the introduction in 1988 of a regimen of selective decontamination of the digestive tract (SDD) for extensively injured patients in our burns centre, colonization rates with Gram-negative organisms declined significantly, but colonization with Staphylococcus aureus was unaffected . In an effort to reduce staphylococcal colonization, the SDD regimen has been supplemented with intranasal mupirocin since 1991 . In this paper, 33 consecutive patients with burns of > 30 per cent TBSA who were treated with the supplemental regimen (SDD + M) in 1991 and 1992, were compared with 34 consecutive patients admitted in the previous 2 years who were treated with SDD only . Staph . aureus colonization of wounds, sputum and gastric aspirates was significantly reduced in the SDD + M group . Gram-negative colonization rates and the incidence of clinical infections remained low in both groups . Our experience suggests that decontamination of endogenous bacterial reservoirs, in combination with isolation measures to prevent exogenous colonization, effectively prevents infectious complications in patients with severe burns. Cardiovasc Intervent Radiol, 1994 Jan-Feb, 17(1), 7 - 11 Transjugular intrahepatic portosystemic shunts using the Wallstent prosthesis: a follow-up study; Rousseau H et al.; PURPOSE: The aim of the present study was to assess the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) in 45 patients with cirrhosis during a mean follow-up of 7 months . METHODS: Forty-five consecutive patients treated by TIPS and who had been followed for at least 6 months after TIPS or until death, were included . Mean follow-up was 7.2 +/- 5.0 months . Shunt patency was assessed at 1 week and 1 month, then every 3 months after the procedure by Doppler US and angiography whenever needed . RESULTS: Thirty-six patients had been stented for refractory bleeding from ruptured esophagogastric varices . Of these, 8 patients (22%) rebled, 7 of whom were treated by a second shunt . Nine patients were treated for refractory ascites . Three patients had recurrent ascites due to shunt obstruction . All were treated by a second shunt which occluded in 2 patients . As a whole, 14 (31.1%) patients developed shunt obstruction within a mean of 120 +/- 136 days, 4 of whom remained asymptomatic . Other complications were septicemia by Staphylococcus aureus in 1 patient, transient encephalopathy in 9 patients, and disseminated intravascular coagulation in 1 patient . CONCLUSIONS: TIPS appears to be a relatively safe and effective technique in treating complications of portal hypertension in patients with cirrhosis . Shunt obstruction in 31% of our patients probably represents the most important limitation of this technique. Eur J Surg, 1994 Jan, 160(1), 3 - 7 Activity of serum angiotensin converting enzyme in septic pigs treated with intrapulmonary corticosteroid; Walther S et al.; OBJECTIVE: To evaluate serum angiotensin converting enzyme activity (S-ACE) in sepsis, its association with haemodynamics and pulmonary function, and the influence of intrapulmonary corticosteroid on its activity in serum . DESIGN: Randomised, blind, placebo controlled experiment . SETTING: Trauma research laboratory . MATERIAL: Sixteen juvenile pigs . INTERVENTIONS: Mechanical ventilation and continuous light anaesthesia . Brief infusion of live Staphylococcus aureus (4 x 10(10) colony forming units) followed by inhalation of nebulised beclomethasone dipropionate 50 micrograms/kg (n = 8) or placebo (n = 7) 30 and 360 minutes after the start of the septic challenge . MEASUREMENTS AND RESULTS: S-ACE activity, vascular pressures, lung mechanics, arterial oxygen tension, and global oxygen extraction were measured and calculated at regular intervals . One animal was withdrawn because of pulmonary arterial hypertension at the start of the experiment . The 15 remaining pigs were studied for 12 hours . The septic challenge induced a significant but transient increase in S-ACE activity in 13 animals (mean (SEM) +0.19 (0.06) mu kat/l) . There were no significant differences in S-ACE between the groups . Terminal S-ACE correlated with oxygen extraction (r = -0.76, p < 0.01), mean arterial pressure (r = 0.69, p < 0.01), arterial oxygen tension (r = 0.59, p < 0.05) and change in lung/thorax compliance (r = 0.63, p < 0.02) . CONCLUSION: S-ACE activity increases in response to a Gram positive septic challenge . This is followed by a gradual decline which reflects to some extent the degree of septic lung injury . S-ACE activity is not influenced by intrapulmonarily administered corticosteroid. Zh Mikrobiol Epidemiol Immunobiol, 1994 Jan-Feb, (1), 16 - 21 {Conjugative plasmid transfer in Staphylococcus aureus?}; Zueva VS et al.; The microbiological and electron-microscopic study of the transfer of conjugative (pG873) and nonconjugative (rms7 and pE994) plasmids in two systems, on nitrocellulose filters and in a fluid culture medium, was carried out . In both systems the low frequency of the transfer of plasmid pG873 or the absence of the transfer of plasmids rms7 and pE994 were observed when nonlysogenic recipients were used for crossing . The presence of prophage in recipient cells increased the rate of the detection of gentamicin-sensitive transconjugants 100-fold and provided to reveal the transfer rms7 and pE994 plasmids . The electron-microscopic study of specimens with lysogenic recipients revealed a picture which can be interpreted as the fusion of two cells . Such picture was not observed in crossings with a nonlysogenic recipient and in preparations obtained from separate donor and recipient cultures. Plasmid, 1994 Jan, 31(1), 12 - 20 IS257 and small plasmid insertions in the mec region of the chromosome of Staphylococcus aureus; Stewart PR et al.; Four copies of the insertion sequence IS257 are found in the mec region of the chromosome of the Australian methicillin resistant Staphylococcus aureus (MRSA) strain ANS46, two flanking a merAmerB sequence (encoding resistance to mercurial compounds), the other two flanking an integrated copy of the plasmid pT181 (tetracycline resistance) . The termini of the integrated copy of the plasmid pT181 carry a direct repeat of 8 bp of plasmid sequence, but otherwise there are no similarities in the 8 bp sequences flanking the four copies of IS257 in this strain . Integrated copies of pT181 in strains R35 (a New Jersey MRSA) and GH32 (MRSA of Greek origin) have the same terminal repeat as in ANS46, suggesting either a specific site of insertion of IS257 into the free plasmid before integration into the chromosome, or a common evolutionary lineage for these geographically diverse isolates . A different 8 bp terminal repeat of plasmid sequence is found in the chromosomally integrated copy of pUB110 (flanked by a pair of IS257s) in R155, another New Jersey MRSA . This 8 bp repeat differs from that reported previously for pUB110/IS257 inserted into the plasmid pSK41, indicating insertion of IS257 into different sites of pUB110 before integration into the chromosome or into pSK41 . In the plasmid pSK1, the two outer copies of IS257 of the three associated with Tn4003 (trimethoprim resistance) are also flanked by 8 bp repeats.(ABSTRACT TRUNCATED AT 250 WORDS) Mol Microbiol, 1994 Jan, 11(2), 237 - 48 Molecular characterization of the clumping factor (fibrinogen receptor) of Staphylococcus aureus; McDevitt D et al.; Four mutants of Staphylococcus aureus strain Newman that were defective in the fibrinogen receptor (clumping factor) were isolated by transposon Tn917 mutagenesis . Southern hybridization analysis of the mutants identified transposon-host DNA junction fragments, one of which was cloned and used to generate a probe to identify and clone the wild-type clumping factor locus (clfA) . The mutants failed to form clumps in soluble fibrinogen and adhered poorly to polymethylmethacrylate (PMMA) coverslips coated with fibrinogen . A single copy of the clfA gene, when introduced into the chromosome of the mutant strains, fully complemented the clumping deficiency of these strains and restored the ability of these mutants to adhere to fibrinogen-coated PMMA . In addition, the cloned clfA gene on a shuttle plasmid allowed the weakly clumping strain 8325-4 to form clumps with the same avidity as the wild-type strain Newman and also significantly enhanced the adherence of 8325-4 strains . Thus the formation of clumps in soluble fibrinogen correlated with adherence of bacteria to solid-phase fibrinogen . The clfA gene encodes a fibrinogen-binding protein with an apparent molecular mass of c . 130 kDa . The amino acid sequence of the protein was deduced from the DNA sequence; it was predicted that a 896 residue protein (molecular mass 92 kDa) would be expressed . The putative ClfA protein has features that suggest that it is associated with the cell surface . Furthermore it contains a novel 308 residue region comprising dipeptide repeats predominantly of Asp and Ser ending 28 residues upstream from the LPXTG motif common to wall-associated proteins . Significant homology was found between the ClfA protein and the fibronectin-binding proteins of S . aureus, particularly in the N- and C-termini. Eur J Clin Microbiol Infect Dis, 1994 Jan, 13(1), 96 - 102 Risk factors for nosocomial bacteremia due to methicillin-resistant Staphylococcus aureus; Pujol M et al.; In a prospective surveillance study (February 1990-December 1991) performed at a 1000-bed teaching hospital to identify risk factors for nosocomial methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, 309 patients were found to be colonized (n = 103; 33%) or infected (n = 206; 67%) by MRSA . Sixty-three of them developed bacteremia . Compared with 114 patients who had nosocomial bacteremia caused by methicillin-sensitive Staphylococcus aureus during the same period of time, MRSA bacteremic patients had more severe underlying diseases (p < 0.01), were more often in intensive care units (p < 0.01) and had received prior antibiotic therapy more frequently (p < 0.01) . To further identify risk factors for MRSA bacteremia, univariate and multivariate analyses of this series of 309 patients were performed using the occurrence of MRSA bacteremia as the dependent variable . Among 14 variables analyzed, intravascular catheterization, defined as one or more intravascular catheters in place for more than 48 h, was the only variable selected by a logistic regression model as an independent risk factor (OR = 2.7, CI = 1.1-6.6) . The results of this study reinforce the concept that recent antibiotic therapy may predispose patients to MRSA infection and suggest that among patients colonized or infected by MRSA, those with intravascular catheters are at high risk of developing MRSA bacteremia. Eur J Clin Microbiol Infect Dis, 1994 Jan, 13(1), 90 - 5 Long-term efficacy of a program to control methicillin-resistant Staphylococcus aureus; Valls V et al.; The long-term efficacy of a program to control methicillin-resistant Staphylococcus aureus (MRSA) was evaluated in a 350-bed university hospital . Three periods were monitored: pre-epidemic (January 1989-November 1989), outbreak (December 1989-June 1990) and control program (July 1990-December 1992) periods . Control measures included cohort isolation, patient care measures and therapy (oral cotrimoxazole plus fusidic acid ointment) of MRSA carriage in patients, roommates and personnel . A total of 117 MRSA-infected patients were detected . For each period respectively, MRSA incidence (number of cases per 1,000 patient-days) was 3.2, 8.2 and 2.0 in the intensive care unit (ICU) and 0.08, 0.23 and 0.26 in the general wards . During the outbreak there was a 2.7-fold overall increase of baseline MRSA incidence (p < 0.02) . The crude mortality was 68% and the attributable mortality was estimated to be 50% . The program was estimated to have prevented 76% (CI95 28-91, p < 0.0001) of expected MRSA cases and 85% (CI95 62-94, p < 0.0001) of expected fatalities due to MRSA in the ICU, but it had no significant effect in the general wards . The program did not control vancomycin consumption. Eur J Clin Microbiol Infect Dis, 1994 Jan, 13(1), 82 - 5 Control of methicillin-resistant Staphylococcus aureus bacteraemia in high-risk areas; Blumberg LH et al.; In a 3,000-bed tertiary care hospital, 88 cases of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia were identified from 22,383 blood cultures (0.39%) submitted to the microbiology laboratory over a one-year period . Two high-risk areas were identified: the paediatric oncology unit, in which 12 cases of MRSA bacteraemia were identified from 924 blood cultures (1.3%), and the intensive care unit (ICU), in which 14 cases of MRSA bacteraemia were identified from 1,391 blood cultures (1.0%) . In a one-year targeted intervention programme in which staff and patients were screened for MRSA carriage, patient carriers isolated, and mupirocin and chlorhexidine treatment administered, the number of MRSA bacteraemia cases decreased in these areas to 0 and 4, respectively (p = 0.000123 and 0.016), while the incidence of MRSA bacteraemia in non-targeted areas increased from 62 of 20,068 blood cultures (0.3%) to 82 of 18,784 blood cultures (0.44%) (p = 0.047) . In the year post intervention the incidence of MRSA bacteraemia increased to 3 of 815 cultures (0.37%) in the paediatric oncology unit, 10 of 1,934 cultures (0.5%) in the ICU, and 112 of 18,977 cultures (0.59%) in the rest of the hospital (p = 0.00004 versus preintervention period) . This study demonstrates the efficacy of targeted MRSA control measures in a hospital in which MRSA is endemic. Eur J Clin Microbiol Infect Dis, 1994 Jan, 13(1), 64 - 73 Methicillin-resistant Staphylococcus aureus disease in a Portuguese hospital: characterization of clonal types by a combination of DNA typing methods; de Lencastre H et al.; Fifteen pediatric patients as well as the five nursing staff of the Burn Unit of the Hospital D . Estefania in Lisbon, Portugal, were assayed at weekly intervals over a five-month period in order to identify the nature and number of methicillin-resistant Staphylococcus aureus (MRSA) clones associated with colonization and wound infection . Methicillin resistance was confirmed by a mec-specific DNA probe . MRSA isolates were classified into chromosomal types (clones) on the basis of a variety of techniques: (i) ribotyping; (ii) restriction digestion by the endonuclease ClaI followed by Southern hybridization with the mecA-specific DNA probe and (iii) by hybridization with Tn554; and (iv) pulsed-field electrophoresis (PFE) of SmaI digests followed by (v) Southern hybridization with the mecA DNA probe . A sixth, physiological technique (population analysis) was used to define the mode of phenotypic expression of methicillin resistance in each isolate . All isolates carried a single, common polymorph (ClaI type III) of the mecA gene . Hybridization with Tn554 resolved these isolates to two novel patterns (alpha and beta), of which one (Tn554 alpha) was predominant (90%) . This pattern could be further resolved to four closely related PFE types (A through D) . In contrast, all isolates with the Tn554 beta pattern belonged to an additional, grossly different PFE type E . The Tn554 beta class was also unique in that these bacteria carried the mecA gene in a SmaI fragment smaller (about 170 kb) than that found in the alpha type strains (194 kb) . Most isolates (83%) showed a single heterogeneous (population analysis Class 3) mode of resistance expression . The data demonstrate the full capacity of the globally rare (ClaI type III) MRSA clone for colonization and virulence . The results also document the stability of the complex heterogeneous resistance phenotype as well as the stability of the chromosomal types under conditions of in vivo carriage over a period of several months . In a few isolates the same mecA polymorph was present in several, grossly different genetic backgrounds, suggesting horizontal transfer of the mecA gene. Eur J Clin Microbiol Infect Dis, 1994 Jan, 13(1), 56 - 63 National survey of methicillin-resistant Staphylococcus aureus in Belgian hospitals: detection methods, prevalence trends and infection control measures . The Groupement pour le Dépistage, l'Etude et la Prévention des Infections Hospitalières; Struelens MJ et al.; A questionnaire survey of Belgian acute care hospitals was conducted to determine the methods used for detection of methicillin-resistant Staphylococcus aureus (MRSA), to estimate the prevalence of this organism during the period 1989-1991 and to describe the infection control measures used locally for limiting its spread . Questionnaires were returned by 144 acute care hospitals, with a coverage of 41 to 72% of hospitals by province . Methods used for detection of MRSA included disk diffusion (91%), microdilution panels (8%) and oxacillin agar screen (9%) . Only 34% of laboratories performed disk diffusion testing under optimal conditions for detection of heterogenous resistance . Among 36 hospitals reporting complete susceptibility data of Staphylococcus aureus isolates tested during the study period (n = 24,153), a mean MRSA prevalence of 14% was found (range: 0-70%) . The median prevalence increased from 9.5% in 1989 to 13.7% in 1991 and showed a significant linear increase during this period in 30% of these hospitals (p < 0.01) . Precautions used for controlling spread of MRSA included hand decontamination using either soap and water or antimicrobial preparations (68% of hospitals), room decontamination (62%), patient isolation (55%) and various barrier precautions (24-49%) . Carrier screening was performed in 37% of hospitals, but antibiotic decolonization was attempted in only 24% . This survey identified areas for improvement in MRSA detection methods and underscored the need for multicentric surveillance of MRSA prevalence and a reappraisal of MRSA control strategies in Belgian hospitals. Eur J Clin Microbiol Infect Dis, 1994 Jan, 13(1), 50 - 5 Methicillin-resistant Staphylococcus aureus in Europe; Voss A et al.; In order to obtain pan-European data on methicillin-resistant Staphylococcus aureus (MRSA), 43 laboratories from ten European countries each screened 200 consecutive Staphylococcus aureus isolates for methicillin resistance . Only one isolate per patient was permitted . All participants used a uniform oxacillin-supplemented screening plate . MRSA isolates were sent to Munich for reconfirmation and further susceptibility testing . Phage typing of the MRSA strains was performed in Denmark . Of the 7,333 Staphylococcus aureus strains screened, 936 (12.8%) were methicillin resistant . The proportion of MRSA in the various European countries ranged from < 1% in Scandinavia to > 30% in Spain, France and Italy . Rates of resistance to the non-glycopeptide antibiotics were lowest for rifampin and highest for ciprofloxacin . Sixty percent of the methicillin-resistant strains originated from patients in surgical and medical departments, with wounds being the most common isolation source . MRSA was found more frequently in intensive care patients . Only 13% of the strains were non-typable, and 76% of the isolates belonged to phage group III . For each area phage typing detected one or a few dominating (epidemic) types, but 46% of the strains did not belong to these types; the MRSA population is thus a mixture of epidemic and non-epidemic strains . MRSA seems to be a growing problem, especially in southern Europe, where incidence and rates of antibiotic resistance are alarmingly high. Zentralbl Bakteriol, 1994 Jan, 280(3), 371 - 81 Toxic shock syndrome toxin-1 (TSST-1) production and phage susceptibility of Staphylococcus aureus strains from human vaginas and anterior nares in Trinidad; Adesiyun AA et al.; The carriage rates of Staphylococcus aureus in the anterior nares of children and women as well as in the vagina of women were determined . The ability of strains of S . aureus to produce toxic shock syndrome toxin-1 (TSST-1) and their susceptibility to phages of the international phage set (IPS) for human strains were also investigated . Of 200 women studied, the carriage rate of S . aureus in high vaginal swabs and anterior nares swabs was 57 (28.5%) and 73 (36.5%), respectively . Eight (4.0%) and 16 (8.0%) patients were carriers of TSST-1-producing strains in their vaginas and anterior nares, respectively . Amongst the 220 children sampled, 100 (45.5%) were carriers of S . aureus in their anterior nares, with 51 (23.2%) children being positive for TSST-1 producing strains . Overall, of the 233 strains of S . aureus isolated from all sources 176 (75.5%) were typable and 75 (32.2%) were positive for TSST-1 production . For strains from anterior nares, isolates from children were more susceptible (81.2%) to IPS phages than those from women (67.1%) but the difference was not significant (P > or = 0.05; chi 2) . Forty-five (76.3%) of 59 strains of vaginal origin were typable . The frequency of production of TSST-1 amongst strains isolated from children, i.e . (50.5% (51 of 101), was significantly higher (P > or = 0.001; chi 2) than that found for isolates from women's anterior nares (21.9%) and vagina (13.6%) . S . aureus was recovered from both the anterior nares and vaginal swabs of 11 patients sampled . The phage patterns of 5 of the 6 typable pairs of isolates established their relatedness suggesting that the same strains colonized the anterior nares and vagina of each of these patients . It was concluded that the carriage of TSST-1-producing strains of S . aureus in the anterior nares and vagina of women was much lower than that detected in children's anterior nares and that the risk of vaginal toxic shock syndrome (TSS) in Trinidadian women was relatively low . Susceptibility of strains was high to IPS phages . Epidemiological significance was attributed to the finding that the same strains of S . aureus colonized the anterior nares and vaginas of some women. Vaccine, 1994, 12(3), 243 - 9 Use of liposome-immunopotentiated exopolysaccharide as a component of an ovine mastitis staphylococcal vaccine; Amorena B et al.; Experiments on the development of a vaccine against staphylococcal mastitis were carried out in ewes . The vaccine (Spanish patent no . 9200223) has the following components: (i) inactivated (formalinized) bacteria (Staphylococcus aureus and a coagulase-negative staphylococcal species . Staphylococcus simulans) and S . aureus toxoid in presence of an adjuvant (dextran sulfate, Mw 500,000); and (ii) S . aureus exopolysaccharide included within liposomes . High serum antibody titres were obtained against whole cells from Staphylococcus aureus, Staphylococcus simulans, Staphylococcus hyicus and Staphylococcus epidermidis strains . However, there was no response to cells from Staphylococcus warneri and Staphylococcus chromogenes strains . An immune response (serum IgG) against the inoculated exopolysaccharide was obtained when > or = 20 micrograms of exopolysaccharide were included in liposomes and when > or = 20 mg of exopolysaccharide were adjuvanted with dextran sulfate instead of liposomes . For experimental infection assays, ewes were vaccinated during pregnancy and challenged either with a low virulence S . simulans strain or with a highly virulent S . aureus strain . In these assays, the incidence of S . simulans subclinical mastitis and of S . aureus acute mastitis was significantly lower in vaccinated animals than in unvaccinated controls . Specifically, on challenge with S . simulans, two out of 14 glands became infected among the vaccinated animals and nine out of ten glands in the unvaccinated group (p < 0.001) . On challenge with S . aureus, no protection was detected when component (ii) was omitted from the vaccine; nine out of ten animals developed mastitis (two mild, two moderate and five severe).(ABSTRACT TRUNCATED AT 250 WORDS) Thromb Haemost, 1994 Jan, 71(1), 129 - 33 Prevalence and induction of circulating antibodies against recombinant staphylokinase; Declerck PJ et al.; Streptokinase (SK) is a routinely used thrombolytic agent but it is immunogenic and allergenic; staphylokinase (STA) is a potential alternative agent which is under early clinical evaluation . The comparative prevalence of antibodies against recombinant STA (STAR) and against SK was studied in healthy subjects and their induction with intravenous administration in small groups of patients . Enzyme-linked immunosorbent assays, using microtiter plates coated with STAR or SK and calibration with affinospecific human antibodies, revealed 2.1 to 65 micrograms/ml (median 11 micrograms/ml) anti-STAR antibodies and 0.9 to 370 micrograms/ml (median 18 micrograms/ml) anti-SK antibodies (p < 0.001 vs anti-STAR antibodies) in plasma from 100 blood donors, with corresponding values of 0.6 to 100 micrograms/ml (median 7.1 micrograms/ml) and 0.4 to 120 micrograms/ml (median 7.3 micrograms/ml), respectively, in 104 patients with angina pectoris . Three out of 17 patients with Staphylococcus aureus bacteremia had significantly increased anti-STAR antibody levels (150, 75 and 75 micrograms/ml), and STAR neutralizing activities (2.2, 3.6 and 4.1 micrograms STAR neutralized per ml plasma, respectively) . In 6 patients with acute myocardial infarction, given 10 mg STAR intravenously over 30 min, median anti-STAR antibody levels were 3.5 micrograms/ml at baseline, 2.9 micrograms/ml at 6 to 8 days and 1.2 mg/ml at 2 to 9 weeks, with median corresponding titers of STAR neutralizing activity at 2 to 9 weeks of 42 micrograms/ml plasma . Conversely, in 5 patients treated with 1,500,000 units SK over 60 min, median anti-SK antibodies increased from 2.9 micrograms/ml at baseline to 360 micrograms/ml at 5 to 10 days, with corresponding median SK neutralizing activities of 13 micrograms/ml.(ABSTRACT TRUNCATED AT 250 WORDS) J Antimicrob Chemother, 1994 Jan, 33(1), 7 - 24 Molecular aspects of methicillin resistance in Staphylococcus aureus; de Lencastre H et al.; All clinical methicillin-resistant Staphylococcus aureus (MRSA) isolates examined so far contain the mecA gene, a 2130bp stretch of DNA of non-staphylococcal origin which, together with a larger block (up to 40-60 Kb) of 'foreign' DNA, is incorporated into the staphylococcal chromosome . mecA encodes for the 78 Kd penicillin-binding protein (PBP) 2A, which has very low affinity for beta-lactam antibiotics . The sequence of the mecA gene contains structural motifs characteristic of cell wall synthetic transpeptidases . It is generally assumed that the mecA gene product (PBP 2A) acts as a surrogate enzyme which takes over the task of cell wall synthesis from the normal complement of staphylococcal PBPs, since the latter are inhibited by relatively low (e.g . methicillin) concentrations of beta-lactam antibiotics . While direct biochemical evidence for a transpeptidase activity in PBP 2A is still missing, the essentiality of an intact mecA gene for the expression of high-level methicillin resistance has been clearly established by transposon inactivation experiments . On the other hand, it was already noted some time ago that an intact mecA and its gene product PBP 2A alone cannot be fully in control of the resistant phenotype, since all MRSA isolates, irrespective of their MIC values (from as low as 3 mg/L or as high as 1600 mg/L), were found to contain comparable amounts of PBP 2A . Such major disparities between cellular amounts of PBP 2A and the antibiotic MIC values suggested that a factor or factors of unknown nature ('factor X') other than the mecA gene product also played an essential role in the phenotypic expression of resistance . The same conclusion was reached in early genetic studies in which methicillin resistance could be reduced by insertional inactivation of a chromosomal site (omega 2003) within the so-called femA gene--(factor essential for the expression of methicillin resistance) outside the mecA determinant . More recently, several additional chromosomal sites were identified outside the mecA gene in which transposon inactivation reduced the level of beta-lactam resistance . The importance of these genes becomes clear if one realizes that it is the appropriate functioning of these determinants (in the genetic background of MRSA) rather than the quantity of PBP 2A in the cells that seems to determine the MIC value of an MRSA isolate . It is not clear at the present time how many such 'auxiliary genes' exist and exactly how these gene co-operate with the mecA gene in bringing about high-level beta-lactam resistance.(ABSTRACT TRUNCATED AT 400 WORDS) J Antimicrob Chemother, 1994 Jan, 33(1), 41 - 55 The effect of glycerol monolaurate on growth of, and production of toxic shock syndrome toxin-1 and lipase by, Staphylococcus aureus; Holland KT et al.; The effects of glycerol monolaurate on the growth of, and production of Toxic Shock Syndrome Toxin-1 (TSST-1) and lipase by, Staphylococcus aureus FRI 1187 were investigated in batch and continuous culture models using a defined synthetic medium . The growth and yield of S . aureus depended on glycerol monolaurate concentration, pH of the environment and the inoculum size . The MICs for glycerol monolaurate of 29 S . aureus isolates, determined in a complex medium, were between 10 and 20 mg/L with a 10(3) to 10(4) cfu inoculum; a 1000-fold increase in inoculum size increased the MIC five-fold . In continuous culture, glycerol monolaurate increased the cell yield of S . aureus . In batch cultures with 17 mg/L glycerol monolaurate, TSST-1 and lipase production by S . aureus was delayed and their specific production was not decreased compared with cultures without glycerol monolaurate . At 150 mg/L glycerol monolaurate, growth and toxin production were decreased . The lipase of S . aureus hydrolyzed glycerol monolaurate . The reduction of toxin production was associated with effects on S . aureus growth, and these effects might have been relieved after lipase had been produced. Vet Med (Praha), 1994, 39(1), 37 - 44 Characteristics of strains of Staphylococcus aureus isolated at dairy farms; Ruzickova V; Biochemical characteristics of 432 strains of S . aureus with special regard to those relevant to identification and estimation of enterotoxigenicity were examined . The STAPHYtest identified reliably 100, 100, 99 and 94% of strains isolated from milking machines, human carriers and bulk milk and quarter milk samples, respectively . Enterotoxins were produced by 9 strains from human carriers and only by 2, 1 and 1 strains isolated from bulk milk, milking machine and a quarter milk sample, respectively . 7, 4, 1 and 1 strains produced enterotoxins C, A, B and A + B, respectively . Enterotoxigenicity correlated well with the following characteristics: pigment production, presence of the clumping factor, coagulation of rabbit plasma, haemolysis of sheep erythrocytes, positivity in the STAPHYtest, fermentation of mannitol, strong haemolysis of bovine blood and strong thermonuclease activity . A simple three-step scheme for the examination of S . aureus isolates has been devised. Biol Pharm Bull, 1994 Jan, 17(1), 163 - 5 Substrates and inhibitors of antiseptic resistance in Staphylococcus aureus; Sasatsu M et al.; The range of substrates of antiseptic resistance associated with the ebr gene is very wide and includes antiseptics, DNA-intercalating drugs and preservatives which have no quaternary ammonium group in methicillin-resistant Staphylococcus aureus . Antiseptic resistance was inhibited by calcium channel blockers and calmodulin inhibitors similarly to the resistance to multiple antitumor agents encoded by the mdr gene in human cells . These results show that the common properties of the mdr gene and the ebr gene may be shared by the mechanisms that are involved in the removal of toxic substances from the cell. Biol Pharm Bull, 1994 Jan, 17(1), 136 - 8 Evaluation of antiseptics by the modified phenol coefficient method: sensitivity of methicillin-resistant Staphylococcus aureus; Sasatsu M et al.; The relationship between an effective concentration and the duration of exposure to antiseptics was evaluated in strains of Staphylococcus aureus with a known genetic background, which include methicillin-resistant strains, using a modified version of the phenol coefficient method as part of an effort to investigate the antiseptic resistance of S . aureus . Chlorhexidine digluconate killed an antiseptic-sensitive strain within 1.5 min at 22 degrees C at a standard concentration (0.1%), whereas resistant strains still survived after 1.5 min . Povidone-iodine killed the sensitive strain within 1.5 min at a concentration of 0.1%, whereas it took this agent 3.0 and 4.5 min to kill low- and high-level resistant strains, respectively, at a concentration of 0.8% . These results indicate that the modified phenol coefficient method used is suitable for the evaluation of the sensitivity of microorganisms to antiseptics . An antiseptic-resistant chain that was associated with the ebr gene exhibited cross-resistance to povidone-iodine. Br J Theatre Nurs, 1994 Jan, 3(10), 4 - 7 MRSA in the operating department; Taylor M et al.; In recent years, infection control in the operating department has focused on the concept of universal precautions . This allows protection for both patients and staff in relation to blood borne pathogens . Recent research, however, suggests that the introduction of universal precautions could lead to an increase in the transmission of other pathogens, for example, Methicillin Resistant Staphylococcus Aureus (MRSA) . This article aims to provide a brief overview of the universal precautions, followed by an in-depth consideration of MRSA, its history, incidence, transmission, effect and implications for both patients and staff in the operating department. Reg Anesth, 1994 Jan-Feb, 19(1), 43 - 7 Do agents used for epidural analgesia have antimicrobial properties? Feldman JM, Chapin-Robertson K, Turner J. BACKGROUND AND OBJECTIVES . Local anesthetics inhibit bacteria growth in culture although this effect diminishes as the concentration of the drug is reduced . The antimicrobial properties of opioids are unknown . This study was designed to determine the ability of lidocaine and bupivacaine, with or without fentanyl or sufentanil, to inhibit bacteria growth in culture at concentrations typically used to provide analgesia . METHODS . Potential bacteria pathogens were cultured in agar media containing: agar alone, 2%, 1.5%, and 1% lidocaine, 0.5%, 0.25%, and 0.125% bupivacaine, 0.125% bupivacaine + fentanyl 2 mcgs/mL, 0.125% bupivacaine + sufentanil 0.3 mcgs/mL, and fentanyl 5 mcgs/mL, fentanyl 2 mcgs/mL or sufentanil 0.3 mcgs/mL . Organisms were deemed sensitive to the study agent if no growth was apparent after incubation for 24 hours . RESULTS . Both lidocaine and bupivacaine significantly reduced bacteria growth at all concentrations studied compared to the growth observed in agar alone (P < .0001) . This growth inhibition diminished as the concentration of local anesthetic was reduced especially for certain bacteria species for example . Staphylococcus aureus (P < .0001) . Neither fentanyl nor sufentanil inhibited any bacterial growth in culture . CONCLUSIONS . Since the growth in culture of common pathogens, especially S . aureus, is not inhibited as the concentration of local anesthetic is reduced, the local anesthetics tested are unlikely to help prevent epidural-catheter-related infection due to common pathogens . More study is necessary to determine if local anesthetics help prevent infection from less common pathogens in patients at increased risk for infectious complications. Eur Respir J, 1994 Jan, 7(1), 121 - 6 Altered bactericidal activity against Staphylococcus aureus in tuberculous bronchoalveolar lavage fluids; Selvaraj P et al.; We wished to evaluate the pulmonary defence capacity against common bacterial infections in patients with pulmonary tuberculosis . Bactericidal activity against Staphylococcus aureus of bronchoalveolar lavage fluids (cell-free supernatants) of patients with active (n = 13) and inactive pulmonary tuberculosis (n = 8), and normal individuals (n = 6), were studied . The 2 and 4 h bactericidal activities were higher than the 0 h activity in lavage fluids of healthy subjects and patients with inactive pulmonary tuberculosis . Active tuberculous lavage fluids were equally competent in their bactericidal activity against S . aureus at 0 and 2 h, but a reduced S . aureus killing was seen at 4 h of incubation . Estimation of total phospholipid levels revealed no significant difference between the various lavage fluids . This reduced killing of S . aureus showed a relationship with the cellular components (lymphocytes and macrophages) of active tuberculous lavage fluids . A reduced killing was associated with no lymphocytic alveolitis, and an increased killing with lymphocytic alveolitis . This study suggests that alveolar lining material of patients with active pulmonary tuberculosis has less bactericidal activity against bacterial infections, such as S . aureus. Protein Eng, 1994 Jan, 7(1), 91 - 7 A pore-forming protein with a protease-activated trigger; Walker B et al.; alpha-Hemolysin (alpha HL) is a 293 amino acid pore-forming toxin, which is secreted as a water-soluble monomer by Staphylococcus aureus . By forming a hexameric pore, alpha HL damages the plasma membranes of target cells . Previous studies established that alpha HL proteins with nicks near the midpoint of a central glycine-rich loop are held together by a domain-domain interaction and are hemolytically active . In contrast, alpha HL proteins comprising two alpha HL truncation mutants that overlap in the central loop have no or greatly reduced pore-forming activity, even though the two chains again form a tight complex . Based on these findings, overlap mutants have now been designed that are activated when redundant amino acids in the loop are removed by proteases . Further, the identity of the activating enzyme can be specified by additional mutagenesis of the protease recognition site in the overlap sequence . Mutants of alpha HL that are activated by tumor-associated proteases might be useful components of immunotoxins. Nurse Pract, 1994 Jan, 19(1), 68 - 71 The human immunodeficiency virus and nonmenstrual toxic shock syndrome: a female case presentation; Woods SL et al.; Toxic shock syndrome (TSS) generally is associated with tampon use among menstruating women . Descriptions from the early 1980's detailed this sudden, multisystem, frequently fatal disease . The bacterial agent, Staphylococcus aureus produced exotoxins, which were quickly identified as the cause of TSS as well as a host of other systemic, bacterial infections . While S . aureus has become one of the more common bacterial pathogens in patients with Acquired Immune Deficiency Syndrome (AIDS), staphylococcal toxin-related disorders rarely have been reported in individuals infected with Human Immunodeficiency Virus (HIV) or individuals diagnosed with AIDS . To date all published cases of TSS attendant with HIV involved homosexual, hemophiliac, or drug injecting male patients . This report describes a woman infected with HIV and diagnosed with the classic array of symptoms found in toxic-shock syndrome, and provides information specific to women and their experience with HIV infection. Injury, 1994 Jan, 25(1), 31 - 8 The prevention of infection in open fractures: an experimental study of the effect of fracture stability; Worlock P et al.; An experimental model of a contaminated open fracture has been developed . This model has been used to test the hypothesis that stable fixation of a contaminated open fracture will reduce its susceptibility to infection . The tibiae of male New Zealand white rabbits were fractured and then fixed with either a dynamic compression plate (stable group) or a loose-fitting intramedullary rod (unstable group) . The fracture site was then inoculated with a standard inoculum of Staphylococcus aureus . There were 20 rabbits in the stable group and osteomyelitis developed in seven (35 per cent); in the unstable group 15 (71 per cent) out of 21 animals developed osteomyelitis . This difference in infection rates was statistically significant (P < 0.02) . This experimental study supports the concept of stabilization of open fractures in man. Immunology, 1994 Jan, 81(1), 47 - 52 Nedocromil sodium acts directly on human B cells to inhibit immunoglobulin production without affecting cell growth; Kimata H et al.; The effect of nedocromil sodium (NES) on human immunoglobulin (Ig) isotypes, IgG subclasses and IgA subclasses was studied . NES inhibited IgM and IgA1 production from human lymphoblastoid B-cell lines CBL and GM-1056, respectively, in a dose-dependent fashion . This inhibition was not due to decreased cell growth as cell proliferation was not affected by NES and cell viability was always greater than 98% . Of the various cytokines tested, interleukin-4 (IL-4) reduced the NES-induced inhibition of Ig production, whereas other cytokines, including IL-1 beta, IL-2, IL-3, IL-5, IL-6, interferon-alpha (IFN-alpha), IFN-gamma, granulocyte-macrophage colony-stimulating factor (GM-CSF) and erythropoietin (Epo) failed to do so . The reducing effect of IL-4 was blocked by anti-IL-4 antibody but not by control IgG . Moreover, IFN-alpha and IFN-gamma, but not GM-CSF, overcame the reducing effect of IL-4 . NES also inhibited production of IgM, IgG1, IgG2, IgG3, IgG4, IgA1 and IgA2 by tonsillar B cells stimulated with Staphylococcus aureus Cowan strain I (SAC) and IL-6 without affecting proliferation . This inhibition was reduced by IL-4 specifically . These results indicate that in addition to its anti-allergic function, NES may act as a B-cell regulatory reagent. Crit Care Med, 1994 Jan, 22(1), 33 - 9 Selective decontamination of the digestive tract in multiple trauma patients--is there a role? Results of a prospective, double-blind, randomized trial; Hammond JM et al.; OBJECTIVE: To evaluate the efficacy of the technique of selective decontamination of the digestive tract in preventing the development of secondary infection and its influence on morbidity and mortality rates in multiple trauma patients with chest injuries requiring intermittent positive-pressure ventilation . DESIGN: Prospective, double-blind, randomized study . SETTING: A multidisciplinary respiratory intensive care unit (ICU) in a 1,500-bed teaching hospital . PATIENTS: Seventy-two patients (mean Injury Severity Score of 29.5) who were intubated for > 48 hrs and remained in the ICU for > 5 days . INTERVENTIONS: Patients were randomized on admission to receive selective decontamination therapy or placebo . All patients received intravenous cefotaxime for 72 hrs and the treatment group received oral and enteral selective decontamination with amphotericin B, polymyxin E, and tobramycin (n = 39), while the placebo group received a placebo containing oral paste and enteral solution (n = 33) . MEASUREMENTS: Secondary infection was determined clinically and microbiologically and surveillance cultures were monitored for gastrointestinal colonization . RESULTS: The patient groups were fully comparable for age, severity of illness, and compromising factors . There was no difference in the number of patients infected (11 treatment group vs . 11 placebo), infections (17 vs . 16) and deaths (5 vs . 3); the duration of ICU (15.5 vs . 14.2 days) and hospital stays (26.3 vs . 25.5) were also similar . Microbiological surveillance cultures confirmed effective elimination of aerobic Gram-negative bacilli, and infections in the treatment group were largely due to Staphylococcus aureus and Staphylococcus epidermidis . CONCLUSION: We have been unable to show any benefit from the use of selective decontamination of the digestive tract in the prevention of secondary infections in multiple trauma patients. J Dairy Sci, 1994 Jan, 77(1), 75 - 9 Factors associated with bacteriological cure after dry cow treatment of subclinical staphylococcal mastitis with antibiotics; Sol J et al.; Data from five dry cow antibiotic therapy trials were analyzed . Records were only included for cows with > or = 1 culture-positive quarters that were subclinically infected with Staphylococcus aureus . Data for 406 quarters affected with S . aureus from 283 cows on 73 farms were analyzed for quarters, cows, and herds . The probability of cure of an infected quarter decreased when SCC increased, when another quarter was infected in the same cow, when the infection was in a hind quarter, and when the percentage of samples that were positive for S . aureus was higher before drying off . Variables predicting complete bacteriological cure of a cow were log SCC, age of the cow, and the number of infected quarters . The probability of a cure decreased as SCC increased . The probability of cure decreased as age increased, and cows with more than one quarter infected were .57 times less likely to be cured than cows with 1 infected quarter. Clin Orthop, 1994 Jan, (298), 106 - 18 Implant failure and the immuno-incompetent fibro-inflammatory zone; Gristina AG; Biomaterial implants are surrounded by an immuno-incompetent, fibro-inflammatory, integration-deficient zone within which stimulation of cellular immune responses results in superoxide radical and cytokine-mediated tissue damage with increased susceptibility to infection or aseptic loosening . Three important questions that pertain to surgical implants are (1) What are the mechanisms that cause abnormal inflammatory responses in the absence of infection and result in interface cellular disorganization and device failure? (2) What causes host defenses to be compromised to the extent that normal flora organisms like Staphylococcus epidermidis, with little or no virulence potential, can cause life-threatening infections at the implant-host interface? (3) What is the nature of surface regions of biomaterials that facilitate bacterial adherence? Pathogenic strains of S . epidermidis and Staphylococcus aureus have an affinity for biomaterial surfaces and are capable of initiating infection . Binding may be nonspecific and glue-like rather than a receptor-ligand event as for S . aureus and matrix proteins . This study indicates bacterial binding to sites of higher vanadium concentration at grain boundaries and mixed phases in titanium alloys . Repeated macrophage priming by biomaterial particulates results in the production of reactive oxygen intermediates, macrophage exhaustion, and adjacent tissue damage . A cytokine cascade is also initiated . A self-perpetuating enlarging immuno-incompetent fibro-inflammatory zone develops about implants, which features tissue cell damage, increased susceptibility to infection, and results in septic or aseptic failure of the implant . These effects are clearly exemplified by fibrosis about breast implants and osteolysis at the interface of total joint replacements. Indian J Pathol Microbiol, 1994 Jan, 37(1), 65 - 73 Induced eye infection in rat with Staphylococcus aureus; Famurewa O et al.; The pathogenicity of one Staphylococcus aureus strain HI/F-20 was assessed by infecting normal pathogen-free mice . The bacterium which caused death of mice then use to investigate ocular infection in rat . Eye infection was induced by injecting microorganism transcorneally and through catheterized common carotid artery respectively . Transcorneal infection resulted in reversible changes which were limited