Anaerobes

FEMS Immunol Med Microbiol, 1993 Mar, 6(2-3), 181 - 92
Black-pigmented gram-negative anaerobes in periodontitis; Dahlen GG; Black-pigmented Gram-negative anaerobes have been associated with periodontal disease and tooth loss since they were first isolated by Burdon in 1928 . Porphyromonas gingivalis, which is usually not isolated from children, adolescents or adults with no periodontal breakdown, has been recognized as one of the most important periodontopathogens . Its presence is strongly correlated with deep periodontal pockets, which are assumed to be its main habitat . Correlations have been shown also with attachment loss, clinical inflammation and serum antibody levels, indicating an aetiological role in the periodontal disease . Their pathogenicity in animal models resembling periodontal disease is documented . They are frequently isolated from periodontal abscesses . The relationship between Prevotella intermedia and periodontal disease is not clear . It is frequently isolated from advanced periodontitis, often as the only black-pigmented Gram-negative anaerobic species; however, the prevalence in adults with no periodontal breakdown is high . It is found frequently in periodontal abscesses and in acute necrotizing and ulcerative gingivitis . Serogroup I is found predominantly in deep periodontal pockets, whereas all serogroups (I-III) are found in shallow pockets and gingivitis . No conclusive difference in pathogenicity between serogroups has been found . Pr . melaninogenica, Pr . denticola and Pr . loescheii are frequently found in the gingival crevice in preschool children and other age groups with gingivitis, but are seldom found in deep periodontal pockets.

FEMS Immunol Med Microbiol, 1993 Mar, 6(2-3), 159 - 63
Host factors predisposing to anaerobic infections; Finegold SM; Factors that predispose to infection in general, of course, may predispose to infection with anaerobes . Included in this category are diabetes mellitus, neutropenia, hypogammaglobulinaemia, malignancy, splenectomy, collagen vascular disease, cytotoxic drug therapy, corticosteroid therapy and other immunosuppression . However, even with these situations there may be certain, more specific, associations: anaerobic cholecystitis and anaerobic osteomyelitis in diabetics, neutropenic colitis, and the increased incidence of local anaerobic infections associated with carcinoma of the lung, colon and uterus . Conditions that lead to decreased redox potential more specifically predispose to infection with anaerobes . Included in this category are obstruction and stasis, tissue anoxia, tissue destruction, vascular insufficiency, prior aerobic infection, burns, foreign body implantation, and calcium salts in a wound (in association with fractures) . Other specific clinical situations that predispose to anaerobic infections include leukaemia; oral, gastrointestinal, and female pelvic surgery; trauma at other sites; childbirth; aspiration pneumonia; human and animal bites; and therapy with agents with poor activity against anaerobes (e.g . aminoglycosides, quinolones) . AIDS patients appear to be predisposed to severe periodontal disease and its complications.

Kokubyo Gakkai Zasshi, 1993 Mar, 60(1), 149 - 68
{Isolation and characterization of oral treponemes}; Koseki T; The oral treponemes were isolated on nine media and classified according to Anaerobe Laboratory Manual (1977) . The four media, which were used with the plate-in-bottle method, were Medium 10 (M10), M10 supplemented with 10% rumen fluid, M10 supplemented with 10% rabbit serum and cocarboxylate, and M10 added with rifampicin . The five media with the anaerobic glove box method were New Oral Spirochetes (NOS) medium, NOS medium added with rifampicin, alternated modified Oral Treponemes Isolation (aOTI) medium, and alternated M10 for anaerobic glove box . The isolation rate of the oral treponemes from 59 subgingival plaque samples of various forms of periodontal diseases was 85 percent . Ninety clinical isolates were subcultured and classified into six groups (I-VI) based on the carbohydrate fermentation and metabolic end products . Three saccaharolytic groups were further divided into nine subgroups by the fermentation patterns of sucrose, lactose, maltose and rhamnose . Two saccaharolytic subgroups were identified as Treponema socranskii, and two asaccharolytic groups were identified as "T . denticola" and "T . vincentii" . However, the other subgroups and group could not be identified according to the characteristics of the presently recognized species.

Diagn Microbiol Infect Dis, 1993 Mar-Apr, 16(3), 191 - 203
Multilaboratory evaluation of the in vitro activity of 13 beta-lactam antibiotics against 1474 clinical isolates of aerobic and anaerobic bacteria; Murray PR et al.; The in vitro activity of 13 beta-lactam antibiotics against 1474 recent clinical isolates was evaluated in a multilaboratory study . The most active antibiotic tested in this study was imipenem (98.5% of the strains were susceptible), followed by ticarcillin-clavulanate (91.4%), cefoperazone (90.0%), ceftazidime (87.9%), cefotaxime (87.7%), ceftriaxone (87.0%), ceftizoxime (86.3%), cefotetan (78.5%), ampicillin-sulbactam (77.9%), cefoxitin (73.5%), cefuroxime (70.9%), cefonicid (64.5%), and cefazolin (57.9%).

Acta Chir Belg, 1993 Mar-Apr, 93(2), 58 - 9
Intestinal obstruction and portal vein gas embolism; Dubail D et al.; The presence of hepatic portal vein gas is the consequence of invasion by anaerobic bacteria originating from an intestinal tract lesion . Although this phenomenon is rare, it may result from several common intestinal pathologies . The prognosis, despite intensive treatment, is often very poor . The authors report a case associated with bowel necrosis resulting from intestinal band.

Plasmid, 1993 Mar, 29(2), 125 - 34
Characterization, sequence, and replication of a small cryptic plasmid from Selenomonas ruminantium subspecies lactilytica; Zhang N et al.; A 2.5-kb cryptic plasmid, pJDB21, from the gram-negative ruminal anaerobe, Selenomonas ruminantium subspecies lactilytica, was mapped and sequenced . Five open reading frames (ORFs) were predicted and expression of two ORFs was demonstrated . Analysis of the predicted amino acid sequence of the ORF 1 protein indicated approximately 30% homology with the replication protein (rep) common to many gram-positive plasmids, and a highly conserved sequence representing the origin of replication in these plasmids was located upstream of ORF 1 . This finding was consistent with a rolling circle form of replication for pJDB21 . Transformation of Escherichia coli K-12 UB1636pol Ats with pJDB21 showed that the plasmid replicated independently of DNA polymerase I and produced a single-stranded DNA intermediate . Deletion analyses localized the E . coli replication function to a 1.4-kb sequence that was mapped to the predicted rep gene.

Chest, 1993 Mar, 103(3), 839 - 43
Empyema of the thorax in adults . Etiology, microbiologic findings, and management; Alfageme I et al.; The etiology, microbiologic findings, and management of 82 episodes of empyema treated by our unit over a period of 6 years were analyzed . Average patient age was 54 years . Eighty-two percent had underlying disease such as alcoholism (29 percent), malignancy (23 percent), and diabetes mellitus (20 percent) . Sixty (73 percent) had an empyema develop secondary to a bronchopulmonary infection . Other etiologies were as follows: infradiaphragmatic sepsis, five cases; iatrogenic, ten cases; and idiopathic, seven cases . Cultures were positive in 76 cases and negative in the remaining 6 (2 positive Gram stains, 1 positive under bacilloscopy, and 3 were sterile) . Anaerobes were isolated from 25 and aerobes from 47 of the positive cultures . A single bacteria was isolated from 43 and multiple organisms (average: 2.63/case) grew on the remaining 33 positive cultures . Length of hospitalization averaged 37 days . Seven patients received antibiotics only, thoracentesis was performed on three, intercostal chest tube drainage was required in 72, and more aggressive surgery was performed on 12 patients (7 with fibrothorax and 5 with pneumonectomy) . Streptokinase was instilled into the pleural space of eight patients with good results . Pleural drainage superinfection occurred at a rate of 8.5 percent . Nine patients died; the remaining recovered . Only three deaths came about as a direct result of the empyema.

Klin Monatsbl Augenheilkd, 1993 Mar, 202(3), 188 - 94
{Strategy for examination and therapy of mycotic keratitis}; Lund OE et al.; BACKGROUND: Keratomycosis still represents a major problem in ophthalmology because of diagnostic and therapeutic difficulties . This is caused by difficult clinical differentiation and problems in microbiological analysis due to pretreatment and lack of sample material in early stages of the infection . MATERIAL AND METHODS: A 16-year-old female contact lens wearer suffered from a monocular central stromal opacification of the cornea . Analysis of the contact lens storage case liquid (CLCL) was based on investigation of the direct sample, Gram and Lactophenol staining and on specific cultures for aerobic bacteria, anaerobic bacteria and fungi . RESULTS: The patient suffered from a mycotic keratitis caused by Acremonium kiliense . First microbiological results were obtained from the CLCL subsequently confirmed from aqueous and from cornea tissue after keratoplasty . Continuation of the systemic Itraconazol therapy resulted in cure and improvement of the visual acuity . CONCLUSION: Success factors for diagnosis and therapy are early detection of the causative agent in the cornea and/or in the contact lens storage case as well as diagnosis related intensive drug therapy and eventually surgical intervention.

Pharmacotherapy, 1993 Mar-Apr, 13(2 Pt 2), 4S - 17S
Overview of the fluoroquinolone antibiotics; Just PM; The fluoroquinolones represent an important advance in antimicrobial therapy . Commercially available products in the United States now include norfloxacin, ciprofloxacin, ofloxacin, enoxacin, and lomefloxacin . Although they share a common mechanism of action, they differ significantly in their antimicrobial spectrum of activity, their pharmacokinetic characteristics, and, to a lesser degree, their safety profiles . These compounds are generally highly effective against aerobic gram-negative and many gram-positive isolates; their activity is more limited against anaerobic bacteria . Quinolone-resistant bacteria have been isolated, but most do not appear to pose a clinically significant problem at this time . The agents are effective in the treatment of a wide range of infections . Although some, such as ciprofloxacin and enoxacin, have been associated with clinically significant interactions with theophylline derivatives, others such as ofloxacin and lomefloxacin appear to have a limited propensity for such interactions.

Ann Surg, 1993 Mar, 217(3), 260 - 71
Axonal necrosis of enteric autonomic nerves in continent ileal pouches . Possible implications for pathogenesis of Crohn's disease; Dvorak AM et al.; OBJECTIVE: Axonal necrosis was first described in samples of small intestine from patients with Crohn's disease (A.M . Dvorak et al . Hum Pathol 1980; 11:620-634) . Clinically evident inflammation of continent ileal reservoirs (pouches) has clinical features that resemble Crohn's disease . Possible similarities in the pathogenesis of Crohn's disease and pouchitis were sought using ultrastructural and microbiologic tools to identify damaged enteric nerves and tissue bacteria . METHODS: An encoded ultrastructural and microbiologic study of replicate biopsies from 114 samples of human intestine was done . Biopsies from ileum, colon, conventional ileostomy or continent pouch were obtained from patients with ulcerative colitis, Crohn's disease, or familial polyposis and grouped into three clinical study groups (control, normal pouch, pouchitis), based on clinical and endoscopic criteria . Biopsies were prepared for electron microscopy with standard methods; replicate biopsy samples were washed extensively before preparing cultures designed to identify aerobic as well as facultative and obligate anaerobic bacteria (Onderdonk et al . J Clin Microbiol 1992; 30:312-317) . The ultrastructural diagnosis of damaged enteric nerves was based on previously published criteria for axonal necrosis (A.M . Dvorak and W . Silen . Ann Surg 1985; 201:53-63) . Intergroup comparisons were tested for significance using Chi-square analysis . RESULTS: The highest incidence of axonal necrosis was present in Crohn's disease control biopsies (53%), regardless of whether bacteria were present (or not) in cultures of replicate biopsies . Axonal necrosis also occurred in more ulcerative colitis and familial polyposis biopsies (regardless of biopsy site) that had positive bacterial cultures than in those that did not (p < 0.001) . In addition, axonal necrosis was documented in 42% of the pouch biopsies from ulcerative colitis and familial polyposis patients, particularly in those pouches that were found to be inflamed by clinical criteria and that also had positive bacterial cultures of the biopsied tissues . Control biopsies from patients with ulcerative colitis and familial polyposis had significantly less nerve damage than pouch biopsies in the presence of positive cultures (p < 0.01) . Among the clinically inflamed pouches biopsied in ulcerative colitis or familial polyposis patients, we found that none had damaged enteric nerves when bacterial cultures were negative (p < 0.005) . If the presence of axonal necrosis alone was compared with the presence of undamaged enteric nerves in all biopsies from patients with ulcerative colitis, a highly significant number of ulcerative colitis biopsies with axonal necrosis occurred in pouches (72%) compared with controls (p < 0.001) . CONCLUSIONS: The ultrastructural finding of axonal necrosis in Crohn's disease confirms previous studies . The presence of damaged enteric nerves in patients with pouchitis provides ultrastructural support to the clinical impression of similarities between pouchitis and Crohn's disease . The association of damaged nerves and invasive bacteria in pouchitis suggests mechanistic similarities for the pathogenesis of Crohn's disease that requires further investigation.

J Assoc Physicians India, 1993 Mar, 41(3), 138 - 41
Clinico-therapeutic profile of pyogenic liver abscess; Nigam P et al.; Nineteen consecutive patients of pyogenic liver abscess (13 males, 6 females, mean age 45.2 +/- 6, 5 years) were studied over a period of 5 years for the clinical profile and therapeutic efficacy of percutaneous aspiration . Majority of them presented with spiking fever (94.7%), pain over right upper quadrant of abdomen (53.8%) and often with prostration and shock (31.6%) . The onset has been rather acute in patients with multiple abscesses (7 cases) . Ascites (10.5%), clubbing of fingers (15.8%) and splenomegaly (10.5%) were observed in cases with long duration of illness . There has been the polymorphonuclear leucocytosis (89.5%) and mild to moderate anaemia (52.6%) . Jaundice (42.1%) was usually mild degree (serum bilirubin 4.6 +/- 2.4 mg/dl) . The serum transaminases and alkaline phosphatase were raised in 94.9% of cases . Ultrasonography revealed predominantly hypoechoic (54.1%) areas with frequent distal acoustic enhancement and internal echoes (21.6%) . Seven patients had multiple abscesses with 25 lesions (size 5.2 +/- 4.6 cms) situated mainly over antero-inferior segment of the right lobe (45.9%) of the liver . The blood and pus cultures demonstrated the micro-organisms (positive in 63.9% and 86.6% respectively) predominantly of bowel flora including facultative gram negative rods and anaerobes . Mortality was 26.5% and pleuro-pulmonary complications were the commonest (26.4%) one . 15 cases were treated by percutaneous aspiration, proper antibiotic and metronidazole with encouraging results (only two deaths) . Complete resolution of abscess took place in 14.2 +/- 1.2 weeks (range 6 weeks to 7.5 months) . It is emphasized that percutaneous needle aspiration is useful both for diagnosis and treatment of pyogenic liver abscess.

Aust N Z J Ophthalmol, 1993 Feb, 21(1), 49 - 52
Anaerobic orbital abscess secondary to intraorbital wood; Sullivan TJ et al.; A case of anaerobic orbital cellulitis secondary to intraorbital wood and an approach to management are presented . Retained foreign bodies should be suspected in all penetrating orbital injuries involving wood . Computed tomography (CT) should be performed to delineate the location and size of any foreign body and to determine damage to adjacent structures . Magnetic resonance imaging (MRI) is useful in certain circumstances . Orbital infection should be anticipated and broad-spectrum antibiotic cover (including anaerobes) provided . Surgical intervention should be undertaken to remove any retained foreign bodies to prevent vision-threatening complications.

Enferm Infecc Microbiol Clin, 1993 Feb, 11(2), 84 - 9
{Diagnosis of anaerobic infection of the pleural fluid using gas-liquid chromatography}; Alvarez M et al.; BACKGROUND: An assessment of the efficacy of the detection of volatile and non-volatile fatty acids that are produced by microorganisms aimed at the possible diagnosis of pleural empyema . METHODS: 106 pleural fluids were examined by gas-liquid chromatography in contrast to conventional aerobic and anaerobic cultures . The sample previously prepared (1 microliter) was injected in an Hewlett-Packard 5890 chromatograph, that was equipped with a fused silica capillary column and a flame ionization detector . RESULTS: Growth of aerobic or anaerobic microorganisms was obtained in 13 (12.3%) of the samples, and volatile or non-volatile fatty acids were detected in all of them (sensitivity = 1) . No growth was obtained in the 93 samples, but volatile or non-volatile fatty acids were detected in 64 (68.8%) of them (specificity = 0.31) . A positive predictive value of 0.17 and a negative predictive value of 1 were obtained . Growth of anaerobic microorganisms was obtained in 9 samples (8.5%) and volatile fatty acids were detected in all of them (sensitivity = 1) . Anaerobic microorganisms did not grow in 97 samples, however volatile fatty acids were detected in 2 (2.1%) of them . A positive predictive value of 0.82 and a negative of 1 were obtained . CONCLUSIONS: Referring to pleural fluid samples, the detection of volatile and non-volatile fatty acids by gas-liquid chromatography is a highly sensitive method, that may be used to quickly reject negative samples in about 30 mins . Furthermore, when anaerobic microorganisms exist, the high specificity of gas-liquid chromatography will make it possible to confirm their presence in the sample, mainly if there is a clinical suspect of anaerobic infection . Thus, the utilization of this sensitive method may also change the therapeutic behaviour.

Clin Infect Dis, 1993 Feb, 16(2), 303 - 9
Pyogenic liver abscess involving Actinomyces: case report and review; Miyamoto MI et al.; We report a case of isolated hepatic actinomycosis and review 35 previously reported cases . Three-fourths of the reported patients were male, and more than one-half were between 30 and 50 years of age . Although some patients had oral disease or intraabdominal infections, the majority of cases were cryptogenic . Common presenting symptoms included fever, abdominal pain, and anorexia with weight loss . Findings on physical examination included pyrexia, abdominal tenderness, and hepatomegaly . Leukocytosis with a left shift, anemia, an elevated serum erythrocyte sedimentation rate, and an elevated level of alkaline phosphatase were almost universally present . Diagnosis was frequently made at the time of exploratory laparotomy, but percutaneous diagnostic procedures obviated the need for surgery in many recent cases . Microbiological diagnosis involved visualization of branching gram-positive Actinomyces organisms or recovery of organisms in anaerobic culture . Treatment most commonly consisted of prolonged administration of penicillin or tetracycline and was associated with an excellent outcome in the majority of cases.

Gastroenterol Nurs, 1993 Feb, 15(4), 178 - 80
Flagyl (metronidazole hydrochloride); Claussen DW; Flagyl (metronidazole) is an anti-infective agent used in the treatment of anaerobic bacteria and protozoa . The most common uses of Flagyl in the patient undergoing gastroenterology evaluation and interventions are generally for anaerobic invasion of the gastrointestinal tract causing conditions such as giardiasis . Flagyl is also commonly used in the preoperative treatment of patients prior to colorectal surgery or those at high risk for bacterial contamination during the operative intervention (e.g., patients having emergency abdominal surgery with an unprepared colon) . Flagyl is a highly potent anti-infective agent that must be administered and monitored appropriately for safe and effective use.

J Gen Microbiol, 1993 Feb, 139 ( Pt 2), 223 - 8
Purification and characterization of phosphoenolpyruvate carboxykinase,a catabolic CO2-fixing enzyme, from Anaerobiospirillum succiniciproducens; Podkovyrov SM et al.; Phosphoenolpyruvate (PEP) carboxykinase (EC 4.1.1.49) from the obligate anaerobe Anaerobiospirillum succiniciproducens was purified 18-fold . The enzyme was monomeric, with an Mr of 57,000 +/- 2,000 . The enzyme was oxygen stable, had a pH optimum of 6.7-7.1, and was stable from pH 5.0 to 9.0 . The enzyme displayed Michaelis-Menten kinetics for the substrate PEP and the cosubstrates bicarbonate and ADP with a Km of 0.54 mM, 17 mM and 0.42 mM, respectively . The enzyme required Mn(2+) or Co(2+) in addition to Mg(2+) to exhibit maximum activity . p-Chloromercuribenzoate inhibited activity and phosphoenolpyruvate protected the enzyme against inactivation, suggesting that an essential cysteine may be in the active site.

J Clin Microbiol, 1993 Feb, 31(2), 460 - 2
Oxyrase, a method which avoids CO2 in the incubation atmosphere for anaerobic susceptibility testing of antibiotics affected by CO2; Spangler SK et al.; The Oxyrase agar dilution method, with exclusion of CO2 from the environment, was compared with the reference agar dilution method recommended by the National Committee for Clinical Laboratory Standards (anaerobic chamber with 10% CO2) to test the susceptibility of 51 gram-negative and 43 gram-positive anaerobes to azithromycin and erythromycin . With the Oxyrase method, anaerobiosis was achieved by incorporation of the O2-binding enzyme Oxyrase in addition to susceptibility test medium, antibiotic, and enzyme substrates into the upper level of a biplate . Plates were covered with a Brewer lid and incubated in ambient air . With azithromycin, Oxyrase yielded an MIC for 50% of strains tested (MIC50) and MIC90 of 2.0 and 8.0 micrograms/ml, compared to 8.0 and > 32.0 micrograms/ml in standard anaerobic conditions . At a breakpoint of 8.0 micrograms/ml, 90.4% of strains were susceptible to azithromycin with Oxyrase, compared to 53.2% in the chamber . The corresponding erythromycin MIC50 and MIC90 were 1.0 and 8.0 micrograms/ml with Oxyrase, compared to 4.0 and > 32.0 micrograms/ml by the reference method, with 89.3% of strains susceptible at a breakpoint of 4 micrograms/ml with Oxyrase, compared to 60.6% in CO2 . Exclusion of CO2 from the anaerobic atmosphere when testing for susceptibility to azalides and macrolides yielded lower MICs, which may lead to a reconsideration of the role played by these compounds in treatment of infections caused by these strains.

Eur J Surg, 1993 Feb, 159(2), 109 - 13
Bacterial translocation during acute pancreatitis in rats; Tarpila E et al.; OBJECTIVE: To see if bile-induced pancreatitis could cause bacterial translocation to mesenteric lymph nodes, and therefore pancreatic necrosis, in rats . DESIGN: Controlled experiment . MATERIAL: 18 Male Wistar rats . INTERVENTIONS: Pancreatitis was induced in the experimental group (n = 12) by infusion of 0.2 ml of a solution containing 4 mumol (20 mumol/ml) sodium taurodeoxycholate into the pancreatic duct over one minute . The controls had sham operations (no infusion) . Two days later repeat laparotomy was done on all surviving animals and samples taken for microbiological analysis . All animals were weighed at the beginning and end of the experiment . RESULTS: Bacteria were isolated from the mesenteric lymph nodes in all survivors in the experimental group (9/12), and from the pancreas in all but one . Blood and peritoneal fluid were colonised in 5 and 7 rats, respectively . Escherichia coli was the most common organism isolated . Positive anaerobic cultures were obtained from mesenteric lymph nodes in 5, and from the pancreas in one . Rats with pancreatitis developed overgrowth of both aerobic and anaerobic bacteria in the caecum and the ileum, but on light microscopic examination the proximal and distal intestinal mucosa did not differ between control and experimental rats . Bacterial translocation increased as the condition of the animals worsened . CONCLUSION: Acute pancreatitis in rats causes systemic bacterial colonisation, probably as a result of bacterial translocation, which may therefore be a mechanism of pancreatic infection.

J Basic Microbiol, 1993, 33(1), 59 - 72
Steroid metabolism with intestinal microorganisms; Groh H et al.; As a result of the metabolic activities of numerous anaerobic microorganisms with sterols, bile acids and steroid hormones as substrates in connection with the enterohepatic circulation of these compounds, the intestine may be considered as an "endocrine" active site or organ . The review summarizes transformations of steroids by anaerobic intestinal bacteria, the physiological and supposed pathophysiological meaning thereof . The aim is to recommend further investigation in this field with respect to both the elucidation of the reactions and biological responses.

Acta Clin Belg, 1993, 48(2), 81 - 5
Comparative evaluation of the Rapid ID 32A kit system, miniaturized standard procedure and a rapid fermentation procedure for the identification of anaerobic bacteria; Pattyn SR et al.; The RAPID ID 32A and a rapid fermentation procedure were compared with a miniaturized standard procedure for the identification of 102 isolates of anaerobic bacteria belonging to 11 genera . The miniaturized standard procedure identified all 102 isolates at the genus level and 90 at the species level . The rapid fermentation procedure failed to identify 12 and 24 isolates at the genus and species levels respectively and is unsatisfactory . The RAPID ID 32A system misidentified 4 isolates (4%) at the genus level, 3 of which could have been avoided if the results of the Gram stain, the fundamental procedure in medical microbiology, had been taken into account . The system correctly identified 89 isolates at the species level . Since it does not produce species identifications within the genera Mobiluncus and Veillonella of which 7 and 2 isolates respectively were included in the study, the percentage of correct identifications at the species level is 96.7% (90/93) . The RAPID ID 32A system is about 25 times more expensive than the miniaturized standard procedure if the investment for a gas chromatograph is not taken into account.

Arch Microbiol, 1993, 159(4), 336 - 44
Geobacter metallireducens gen . nov . sp . nov., a microorganism capable of coupling the complete oxidation of organic compounds to the reduction of iron and other metals; Lovley DR et al.; The gram-negative metal-reducing microorganism, previously known as strain GS-15, was further characterized . This strict anaerobe oxidizes several short-chain fatty acids, alcohols, and monoaromatic compounds with Fe(III) as the sole electron acceptor . Furthermore, acetate is also oxidized with the reduction of Mn(IV), U(VI), and nitrate . In whole cell suspensions, the c-type cytochrome(s) of this organism was oxidized by physiological electron acceptors and also by gold, silver, mercury, and chromate . Menaquinone was recovered in concentrations comparable to those previously found in gram-negative sulfate reducers . Profiles of the phospholipid ester-linked fatty acids indicated that both the anaerobic desaturase and the branched pathways for fatty acid biosynthesis were operative . The organism contained three lipopolysaccharide hydroxy fatty acids which have not been previously reported in microorganisms, but have been observed in anaerobic freshwater sediments . The 16S rRNA sequence indicated that this organism belongs in the delta proteobacteria . Its closest known relative is Desulfuromonas acetoxidans . The name Geobacter metallireducens is proposed.

Clin Exp Obstet Gynecol, 1993, 20(2), 95 - 101
Perioperative prophylaxis in abdominal and vaginal hysterectomy; D'Addato F et al.; The aim of this study is to evaluate the clinical efficiency of perioperative short-term prophylaxis in gynecological surgery, in order to prevent both systemic and local infections, caused either by aerobic or by anaerobic bacteria . A group of 320 patients, undergoing abdominal or vaginal hysterectomy and treated with perioperative antibiotic prophylaxis is compared, with 320 women undergoing conventional wide-spectrum antibiotic treatment from the first post-operative day for 4-5 days.

Ann Otolaryngol Chir Cervicofac, 1993, 110(1), 55 - 9
{Acute mastoiditis due to anaerobic bacteria . Review of the literature apropos of a case}; Ducroz V et al.; The authors report a case of acute mastoiditis in a four year-old boy due to fusobacterium necrophorum . The importance of the complications (septiciemia, lateral sinus thrombosis, meningitis, osteitis) and the fusobacterium necrophorum are the two majors interests of this observation . A review of the literature is performed.

Annu Rev Microbiol, 1993, 47, 1 - 29
Reflections of a microbiologist, or how to learn from the microbes; Pfennig N; This autobiographical chapter summarizes the author's work with a defined mineral medium for fastidious sulfide-oxidizing phototrophic purple and green sulfur bacteria that were known already from Winogradsky's and Lauterborn's descriptions . The pure cultures, isolated from natural mud deposits, revealed interesting new cytological and biochemical features . In the wake of these studies, new anaerobic bacteria with unusual metabolic capacities were isolated and characterized . Ecologically most significant is the dehydrogenation of acetate to carbon dioxide . Electron acceptors are sulfur for the sulfur reducers and sulfate for the new sulfate reducers obtained by Widdel . Thauer and Fuchs showed that a modified TCA-cycle and the new acetyl-CoA:carbon monoxide dehydrogenase pathway operates in the oxidation of acetate . Many aliphatic and aromatic compounds were shown to be completely degradable by marine sulfate reducers . The biogeochemical transformations of the anoxic sulfur cycle are now understood in terms of the capacities of the phototrophic and chemotrophic bacterial species involved in the cycle.

Zhonghua Er Bi Yan Hou Ke Za Zhi, 1993, 28(4), 236 - 7, 253
{Suppurative mediastinitis as a complication of deep neck infection (report of 15 cases)}; Yang XM; Fifteen cases of suppurative mediastinitis secondary to perforation of pharynx or esophagus are reported . The cervical fascial spaces are the main route of spread of infection from the neck to the mediastinum . The infection is caused by both aerobic and anaerobic bacteria . Major treatments for suppurative mediastinitis are early surgical drainage and proper use of antibiotics; Irrigation of the mediastinum with povidone-iodine is a safe and effective treatment . Of these 15 patients, 11 survived and 4 died . One case complicated by common carotid artery rupture was cured by surgical repair.

Stomatologiia (Mosk), 1993 Jan-Mar, 72(1), 13 - 6
{The sensitivity of the causative agents of suppurative inflammatory diseases of the maxillofacial area and neck to antibacterial preparations}; Ushakov RV et al.; Antibacterial activities of 40 routinely used antibacterial drugs in respect of 288 strains of anaerobic and opportunistic anaerobic bacteria, isolated from purulent foci of 110 patients with odontogenic and nonodontogenic inflammations were examined . The results permitted a more accurate specification of the drug groups for local therapy of purulent wounds, drugs of choice, those for grave cases, and a reserve group; these groups were distinguished with due consideration for the bacterial sensitivity, side effects and mode of administration of the drugs . Data on the microflora composition, its sensitivity to antiseptics and antibiotics are presented.

Med Pregl, 1993, 46(3-4), 101 - 4
{Actinomycosis of the minor pelvis associated with prolonged use of intrauterine contraceptive devices (IUD)}; Durdevic S et al.; Pelvic actinomycosis is a rare disorder caused by Gram-positive anaerobic bacteria Actinomyces Israeli, and it is commonly associated with the prolonged use of IUD . The authors present two cases of pelvic actinomycosis in patients who used IUD for prolonged periods of time (eight and fourteen years) . The diagnostic procedure in both cases lasted long and the definite diagnosis was made only after the pathohistological examination of the material taken during the surgical treatment . Actinomyces Israeli should be considered as one of the causes of the diagnosed pelvic inflammation especially when it is associated with the prolonged use of IUD.

J Egypt Public Health Assoc, 1993, 68(5-6), 495 - 505
Bacteriology of chronic secretory otitis media in children; el-Shamy HA; One hundred and four effusions from 66 children with CSOM were cultured for aerobic and anaerobic bacteria . Fifty percent of all effusions yielded bacterial growth and Gram negative organisms constituted 69.2% of those isolates . H . influenza was the most commonly isolated organism (36.5%) followed by B . catarrhalis and Str . pneumoniae . All B . catarrhalis, Staph . aureus and pseudomonas isolates were resistant to ampicillin while cefotaxime was active against all the isolated Gram positive and Gram negative bacteria . Considering B-lactamase production, all the isolated Staph . aureus were BLPs while in case of Gram negative bacteria, not all the ampicillin resistant strains were BLPs.

FEMS Microbiol Lett, 1992 Dec 15, 79(1-3), 221 - 5
Energy conservation in fermentative glutarate degradation by the bacterial strain WoG13; Matthies C et al.; Dicarboxylic acids with 2-5 carbon atoms can be degraded fermentatively by pure cultures of various strictly anaerobic bacteria . The small amount of free energy released in these decarboxylations (about 20-25 kJ mol-1) is conserved as sole source of growth energy either through sodium-pumping decarboxylases or through electrogenic substrate/product transport devices . In the glutarate-fermenting bacterial strain WoG13 a glutaconyl-CoA-decarboxylating enzyme activity was detected . This enzyme was inhibited by avidin and was stimulated by sodium ions . The enzyme activity was partially associated with the cytoplasmic membrane, indicating that energy conservation is accomplished through a sodium-ion-pumping glutaconyl-CoA decarboxylase enzyme.

J Mol Biol, 1992 Dec 5, 228(3), 995 - 7
Crystallization and preliminary crystallographic study of an octa-heme cytochrome c3 from Desulfovibrio desulfuricans Norway; Czjzek M et al.; An octa-heme cytochrome c3, isolated as a dimeric molecule of about 30 kDa from the anaerobic bacteria Desulfovibro desulfuricans Norway, has been crystallized in a form suitable for atomic resolution X-ray structural investigations . The crystals are trigonal, space group P3(1)21 (or its enantiomorph P3(2)21), with cell dimensions: a = b = 72.9 A c = 62.7 A . The asymmetric unit contains most probably one monomer and a solvent content of about 60% . Under this assumption, the crystallographic 2-fold axis relates the two subunits of the dimer . Diffraction extends to 2.0 A.

Appl Environ Microbiol, 1992 Dec, 58(12), 4051 - 4
Subculturing of a polychlorinated biphenyl-dechlorinating anaerobic enrichment on solid media; May HD et al.; An anaerobic culture capable of dechlorinating polychlorinated biphenyls was subcultured under strict anaerobic conditions on solid media containing sterilized river sediment . The dechlorination activity was transferred as a bacterial colony on a solid medium three times . After two transfers on solid medium, the culture was no longer methanogenic but still dechlorinated a mixture of tri- and tetrachlorobiphenyls . This demonstrates that anaerobic bacteria are responsible for the polychlorinated biphenyl dechlorination and can be grown without polychlorinated biphenyl on solid media.

Oral Microbiol Immunol, 1992 Dec, 7(6), 344 - 8
Evaluation of a non-radioactive DNA probe for detecting Porphyromonas gingivalis in subgingival specimens; Tay F et al.; This study compared the ability of a nonradioactive digoxigenin-labeled DNA probe and anaerobic culture to identify subgingival Porphyromonas gingivalis . Total cellular DNA from P . gingivalis ATCC 33277T was labeled using the Genius kit from Boehringer Mannheim Biochemicals . Anaerobic culture was performed using VMGA III transport medium and enriched brucella blood agar . The DNA probe could detect as little as 1000 P . gingivalis cells added to supragingival plaque . Also, the probe could detect P . gingivalis when it was present in proportions too low to be visualized on overgrown bacterial plates . The probe showed no visible reaction with strains of various oral species or with thousands of non-P . gingivalis colonies from plaque samples . VMGA III could maintain the viability of P . gingivalis for up to 6 days, as evidenced by DNA probing of colony blot of subgingival cultures . A total cellular DNA probe for detecting P . gingivalis seems to offer a simple and reliable method of detecting the organism in subgingival specimens.

Clin Oral Implants Res, 1992 Dec, 3(4), 162 - 8
Antimicrobial treatment of peri-implant infections; Mombelli A et al.; The purpose of this study was to investigate the possibility of antimicrobial treatment of peri-implant infections associated with a periodontitis-like subgingival microbiota . Nine partially or fully edentulous patients with titanium hollow cylinder implants were selected which showed loss of bone and probing depths > or = 5 mm on one or several implants after at least 6 months following installation . They also yielded subgingival microbial samples with > or = 10(6) CFU/ml, including > or = 20% gram-negative anaerobic bacteria . The treatment included mechanical cleaning, irrigation of all peri-implant pockets > 3 mm with 0.5% chlorhexidine and systemic antimicrobial therapy (1000 mg ornidazole for 10 consecutive days) . After therapy, bleeding scores decreased immediately and, over a one-year observation period, remained significantly lower than before treatment . A significant gradual reduction in mean probing depths was detected over this one-year period; only one case showed no improvement of local probing depth . Microbiological parameters indicated an instantaneous quantitative and qualitative change following treatment . Subsequently, several of these parameters tended to shift back towards pretreatment values . In the second half of the observation period, however, this tendency was reversed, and levels significantly different from baseline were eventually established . This study demonstrated that treatment aiming at reducing the subgingival bacterial mass and suppressing the anaerobic segment had a beneficial effect in patients suffering from peri-implantitis.

Arch Esp Urol, 1992 Dec, 45(10), 993 - 6
{Our caseload in Fournier's disease}; Monge Mirallas JM et al.; We reviewed the records of 17 cases of Fournier's gangrene that had been diagnosed and treated in the Urology Service of the Marques de Valdecilla Hospital from 1982-1991 . The series comprised male patients aged 32 to 77 . Eleven cases (64.7%) were due to a known cause, above all infection . Most of the patients had factors that predisposed to the development and progression of the disease, predominantly diabetes mellitus (5 cases, 29.4%) . The clinical features frequently corresponded to those of acute infection, with high fever, chills, pain, nausea and vomiting that could progress to a septic state . The local symptoms and signs included pain, swelling, erythema and necrosis, depending on the compromised area . Infection was usually caused by Gram-negative bacteria, particularly E . coli, although Gram-positive bacteria and anaerobes have been observed . Mixed bacterial infections have also been observed . Treatment must be instituted early using a combination of broad spectrum antibiotics that cover both aerobes and anaerobes, and wide surgical debridement of the compromised area . In some cases hyperbaric oxygen therapy may be warranted . The disease continues to be severe . In the present series, the outcome was favorable in 12 cases (70.5%) and there were 5 deaths (29.4%).

Eur J Clin Microbiol Infect Dis, 1992 Dec, 11(12), 1169 - 73
Comparison of the E test and a reference agar dilution method for susceptibility testing of anaerobic bacteria; Wust J et al.; The susceptibility of 146 recent clinical isolates of gram-negative and gram-positive anaerobes was determined by the E test (AB Biodisk) on both Wilkins-Chalgren and PDM ASM II (AB Biodisk) agar . Results of the E test were compared with results obtained by the NCCLS agar dilution method using Wilkins-Chalgren agar . Incubation was for 20 hours and 44 hours in the E test and for 44 hours in the NCCLS method . In general, 44 hour results were more reliable; however, NCCLS readings were made only once after 44 hours . After two days of incubation, 91% of E test results on Wilkins-Chalgren agar were within one dilution and 98% within two dilutions of the corresponding NCCLS values; on PDM agar these values were 89% and 98%, respectively . Major and very major discrepancies combined were less than 1%.

Blood, 1992 Nov 15, 80(10), 2668 - 76
Evidence that sustained growth suppression of intestinal anaerobic bacteria reduces the risk of acute graft-versus-host disease after sibling marrow transplantation; Beelen DW et al.; The influence of intestinal bacterial decontamination on the occurrence of grades II to IV acute graft-versus-host disease (GVHD) was retrospectively analyzed in 194 predominantly adult patients treated by genotypically identical sibling marrow transplantation under conditions of strict protective isolation and intestinal antimicrobial decontamination . Forty-five patients (23%) developed acute GVHD and univariate analysis identified four features that significantly increased the risk for this reaction: chronic myeloid leukemia as the underlying disease, as compared with all other disease categories (P < .0001); female marrow donors for male recipients, as compared with other gender combinations (P < .005); ineffective, as compared with sustained growth suppression of intestinal anaerobic bacteria (P < .006); and methotrexate as the sole immunoprophylactic compound, as compared with cyclosporine containing regimens (P < .05) . Using the duration of anaerobic growth suppression as a time-dependent explanatory variable, proportional hazards regression analysis confirmed these features as independent predictors for acute GVHD with relative risk estimates of 1.9 (95% confidence interval {CI}, 1.3 to 2.7) for the immunoprophylactic regimen (P < .0004), of 1.8 (95% CI, 1.3 to 2.5) for the underlying disease (P < .0005), of 1.7 (95% CI, 1.2 to 2.5) for anaerobic decontamination (P < .002), and of 1.3 (95% CI, 1.1 to 1.6) for the donor/recipient gender combination (P < .008), respectively . Best subset selection modeling also identified the quality of anaerobic decontamination as the third most important predictor for acute GVHD, when all four significant features were included . Estimates of acute GVHD stratified by the quality of anaerobic bacterial growth suppression showed a strong influence of anaerobic decontamination in patients burdened by at least one of the other unfavorable factors (P < .009) . In conclusion, this study provides strong evidence that sustained growth suppression of intestinal anaerobic bacteria after clinical sibling marrow transplantation can independently modulate the occurrence of grades II to IV acute GVHD, which is in concordance with previous results from animal transplantation models . Antimicrobial chemotherapy specifically targeted to the intestinal anaerobic bacterial microflora may be complementarily useful in preventing acute GVHD and should be investigated in a prospective trial.

Clin Infect Dis, 1992 Nov, 15 Suppl 1, S33 - 42
Evaluation of new anti-infective drugs for the treatment of intraabdominal infections . Infectious Diseases Society of America and the Food and Drug Administration; Solomkin JS et al.; These guidelines deal with the evaluation of anti-infective drugs for the treatment of intraabdominal infections . The clinical entities consist of infections arising from any part of the gastrointestinal tract, from the distal esophagus to the colon . These include surgical infections of the bowel, biliary tree, liver, spleen, and pancreas . Virtually all intraabdominal infections are due to multiple microorganisms resident in the gastrointestinal tract; these include aerobes and facultative and obligate anaerobes . Infections are classified as complicated (requiring an operative procedure), uncomplicated (managed medically), and postoperative wound (the operative procedure should be curative, but anti-infective drugs are used to prevent further infection at the site) . Clinical criteria are paramount for entry into a study and for evaluation of efficacy . For complicated infections an adequate operation is an important determinant of outcome and needs assessment . Cultures of purulent intraabdominal fluid or abscess material are the only valid microbiologic indicators of infection . The acute physiology and chronic health evaluation score is useful in defining the severity of acute illness . The control regimen should consist of effective, established drugs and surgical procedures for the condition . Duration of therapy for complicated infections is usually 5-14 days; for uncomplicated infections, 3-7 days; and for postoperative wound infection, 2-5 days . Periodic assessment of safety and efficacy must be conducted during therapy . The outcome at final assessment is cure, failure, or indeterminate.

Mol Biochem Parasitol, 1992 Nov, 56(1), 49 - 57
The facultative anaerobic energy metabolism of Schistosoma mansoni sporocysts; Tielens AG et al.; Schistosoma mansoni miracidia in water are known to possess an aerobic energy metabolism, the Krebs cycle being the main terminal of the breakdown of endogenous glycogen reserves . The present study demonstrated that after in vitro transformation of miracidia into sporocysts, the organisms degraded glucose to lactate and carbon dioxide in a more anaerobic ratio than do miracidia . The occurrence of a large Pasteur effect demonstrated, however, that oxidative phosphorylation was still the major process used for energy generation . After 24 h in vitro cultivation the sporocysts had consumed more external glucose and their metabolism had shifted towards lactate production . Sporocysts could cope with inhibited respiration: they had a large anaerobic capacity and survived perfectly in the presence of cyanide, producing a large amount of succinate in addition to lactate . It was demonstrated that this succinate was largely produced via phosphoenolpyruvate carboxykinase (PEPCK) . This pathway, which is known to occur in most parasitic helminths, has never been demonstrated in schistosomes, not even in the miracidial stage immediately preceding the sporocysts . It was also shown that in sporocysts part of the lactate was not formed directly by glycolysis, but via a detour including fumarate and the action of PEPCK . The results demonstrated that S . mansoni sporocysts are facultative anaerobes, fully equipped to adjust their energy metabolism to the variable conditions inside their intermediate host, the snail . In the presence of oxygen, they derive most of their energy from the aerobic degradation of glucose to carbon dioxide, but under anaerobic conditions they switch towards lactate and succinate production.

J Periodontal Res, 1992 Nov, 27(6), 575 - 80
Relationship between bacterial counts, microbial vitality and the accumulation of supragingival dental plaque in humans; Weiger R et al.; Comparisons between plaque index (PlI) and bacterial counts have been made already; however, these did not take into account the area used for plaque sampling . The objective of the present study was to determine the correlation between the PlI score, the number of bacteria and the bacterial plaque vitality when dental plaque was repeatedly sampled from the same area in each subject during early plaque accumulation . Between intervals of optimal oral hygiene, 10 participants refrained from all oral hygiene measures for periods of 1, 2, 3, 4 and 5 days . The PlI was recorded on the vestibular surface of all first premolars as local PlI:LS . For statistical reasons, the scores of the independent variable LS were added for each subject giving LS* values ranging from 0 to 8 . The plaque sampled from this specific surface was circumscribed by the marginal gingiva and an acrylic splint, giving reproducible areas for plaque collection . Total microscopic bacterial counts (BC), colony forming units of anaerobes (CFUan) and aerobes (CFUae), and proportions of vital bacteria (VF) were compared with LS* values . BC and LS* values were strongly correlated . CFUan and CFUae increased significantly with LS*, but this increase was higher for LS* 0 to 4 than for LS* 4 to 8 . The ratio between vital and dead microorganisms, assessed by two different methods, was low when an LS* of 0 was recorded, with higher ratios registered for LS* values 4 and 8.

Vet Clin North Am Small Anim Pract, 1992 Nov, 22(6), 1361 - 83
Gingivitis/stomatitis in cats; Williams CA et al.; Any alteration in the balance of bacterial challenge versus the host's ability to resist and repair will result in oral lesions that are similar in appearance . The bacterial cause of gingivitis and periodontitis in humans and in all other animals in which it has been studied is firmly established, and specific species of predominantly gram-negative anaerobes have been implicated . Naturally occurring or acquired immunopathologies are likely to result in premature dental disease . When oral disease is associated with the accumulation of plaque, a positive response can be achieved by reducing the bacterial challenge to the host through the maintenance of oral hygiene by timely professional dental prophylaxis and home care . Disease that is the result of atypical immune responses, however, can be much more difficult to manage . Such oral disease can occur with either immune deficiencies or exaggerated immune responses, and it is likely that multiple mechanisms are active concurrently . In any case, gram-negative anaerobes present in plaque are likely to be a major contributing factor . Therefore patients with chronic refractory gingivitis-stomatitis must be considered to be plaque intolerant . Only with a frequent regimen of aggressive and thorough professional dental treatment plus meticulous oral home care on a daily basis can one expect to keep these cases in remission . Because this is often unrealistic, the only other way to keep these patients free of disease is by total dental extraction . The tissues that are colonized by the causative organisms must be eliminated . All root tips and bony sequestra must be removed and healing with intact epithelium accomplished before these cases will go into remission . Edentulous feline patients that continue to have signs of gingivostomatitis have been found to have an area of nonhealed bony sequestrum and chronic osteomyelitis . Once effective debridement has been accomplished and epithelial healing completed, nonresponsive cases can be expected to go into remission (Color Plate 2, Figure 7) . It is hoped that as more is learned about this frustrating problem, the many factors influencing feline oral disease will be scientifically documented . In the future, actual diagnoses can be systematically made early on in disease, and treatment will be more than just symptomatic.

J Bacteriol, 1992 Nov, 174(21), 6822 - 30
Beta-succinyl-coenzyme A synthetase from Trichomonas vaginalis is a soluble hydrogenosomal protein with an amino-terminal sequence that resembles mitochondrial presequences; Lahti CJ et al.; We describe studies directed toward understanding the biogenesis and origin of the hydrogenosome, an unusual organelle found exclusively in certain anaerobic eukaryotes that lack mitochondria . Hydrogenosomes are involved in fermentative carbohydrate metabolism and are proposed to have arisen through conversion of mitochondria or via endosymbiosis with an anaerobic bacterium . We cloned a gene encoding the beta subunit of the hydrogenosomal protein succinyl-coenzyme A synthetase (beta-SCS) and isolated the protein from Trichomonas vaginalis . The T . vaginalis beta-SCS gene encodes a protein with a calculated molecular mass of 43,980 Da that has 43% amino acid identity (65% similarity) with beta-SCS from Escherichia coli . The trichomonad protein partitions into the soluble fraction of hydrogenosomes treated with sodium carbonate at high pH, consistent with a matrix localization within the organelle . The protein is encoded by a multigene family composed of at least three members . Amino-terminal sequencing of beta-SCS purified from T . vaginalis hydrogenosomes shows that the mature protein lacks the first nine amino acids encoded in the gene . This apparent amino-terminal leader sequence is strikingly similar to that of another hydrogenosomal protein and to mitochondrial presequences.

J Hosp Infect, 1992 Nov, 22 Suppl A, 3 - 8
Prophylaxis and treatment of infections complicating abdominal surgery; Wilson WR et al.; The suitability of commonly used antimicrobial regimens for prophylaxis in abdominal surgery and treatment of intra-abdominal sepsis is discussed . These various therapies are often limited in their usefulness by the range of microorganisms against which they are effective and thus, to extend the antimicrobial cover, agents may be combined . Some forms of therapy may produce adverse effects in susceptible patients, thus limiting their use to certain groups, or there may be cost constraints . Beta-lactamase-inhibiting compounds appear to offer an optimal combination of a broad spectrum of activity against aerobic and anaerobic microorganisms, minimal toxicity and reasonable cost.

Eur J Clin Microbiol Infect Dis, 1992 Nov, 11(11), 999 - 1011
Current antimicrobial therapy of anaerobic infections; Sanders CV et al.; The treatment of many anaerobic infections involves antimicrobial therapy, appropriate surgical drainage of abscesses, and debridement of devitalized tissue . Most anaerobic infections are polymicrobial and require treatment with agents active against an array of aerobic and anaerobic bacteria . Bacterial resistance, especially to penicillins and tetracyclines, but also to newer agents of other classes, continues to increase . As a result, treatment with more than one drug is often required . Combination therapy is often necessary in serious infection, and is indicated for empiric treatment before receiving culture results . In the past combination therapy has been the mainstay of antimicrobial therapy, but more recent studies suggest that monotherapy for anaerobic infections may dominate the future . Selection of an agent requires consideration of the site of infection and the most likely etiologic agents . In vitro susceptibility is important, but it is not the only determinant of antimicrobial effectiveness . The pharmacology of the drug--absorption, distribution, concentrations in body fluids and tissues, excretion and metabolism--also plays an important role . The nature and severity of the underlying illness are important factors in selecting empiric therapy . Although it is a clinical judgement, in patients considered to have mild to moderate infections, several factors in selecting antimicrobial agents may be considered, including cost, whereas in patients judged to have severe or life-threatening infections, the most potent agents should be chosen as initial therapy, regardless of cost . Finally, the toxicities of the agent must also be considered.

Eur J Clin Microbiol Infect Dis, 1992 Nov, 11(11), 1039 - 43
Methods for the isolation and identification of obligate anaerobes; Onderdonk AB; The methods used for the isolation and identification of obligate anaerobes often appear to be exactly the same as those used 20 years ago . However, careful evaluation of the methodology available reveals many improvements in technology . More importantly, the use of computerized instrumentation and new, non-growth-dependent methods for characterization suggest that in the next few years even greater changes will occur in systems for identification of this group of organisms.

Eur J Clin Microbiol Infect Dis, 1992 Nov, 11(11), 1025 - 31
Review of methods for susceptibility testing of anaerobes; Zabransky RJ; In the USA, the National Committee for Clinical Laboratory Standards has studied and published a reference agar dilution method for the susceptibility testing of anaerobic bacteria . While numerous investigators both in Europe and the USA have evaluated a variety of methods with a variety of modifications, only the broth microdilution method appears to be appropriate for routine use . The problems of the choice of breakpoint, inoculum size, media, media additives, endpoint recognition and other parameters affecting test performance and interpretation, while troublesome for anaerobes, are not unique to this group of organisms . The increasing resistance of anaerobes and the ever existing need to provide therapeutic guidance, surveillance for resistance and susceptibility data on new drugs make the need for an accurate and reliable susceptibility test for anaerobes critical . The newer methods, while showing promise, need further evaluation with all agents that have a therapeutic indication for anaerobic infections.

Eur J Clin Microbiol Infect Dis, 1992 Nov, 11(11), 1021 - 4
Clinical relevance of antimicrobial susceptibility testing; Finegold SM; In recent years, significant resistance to antimicrobial agents has been encountered among certain anaerobic bacteria . Susceptibility patterns vary from region to region, but even within a given region susceptibility is not always predictable . Initially, therapy of mixed anaerobic infections must be empirical, based on the nature of the infection, the usual flora of such infections, anticipated modification of this flora by pathophysiologic processes or prior antimicrobial therapy, and evaluation of Gram stains from appropriate specimens . If the infection does not respond well or the patient requires long-term therapy, antimicrobial susceptibility testing may be indicated in order to provide optimum therapy . Susceptibility testing is also indicated for determination of the usual patterns in a particular hospital, for monitoring geographical patterns, and to determine the activity of new antimicrobial agents.

Minerva Stomatol, 1992 Nov, 41(11), 499 - 506
{The clinical and microbiological evaluation of the efficacy of oral irrigation on the periodontal tissues of patients wearing fixed orthodontic appliances}; Di Murro C et al.; The aim of the present study has been the evaluation of the effectiveness of oral irrigation with or without toothbrushing and dental flossing, in individuals treated with fixed orthodontic appliances, on controlling the development of dental plaque and, hence, of gingivitis . Eight individuals with a good general and oral status have been chosen . Before the experimental period, they received instructions about oral hygiene with toothbrushing and dental flossing and then they have been monitored to verify they were doing well . At the time T0, the upper tooth have been banded, three Periodontal Indexes (Plaque Index according to Silness and Loe, Modified Gingival Index according to Lobene and Gingival Bleeding Index according to Ainamo and Bay) registered and subgingival plaque samples from the premolars' gingival sulcus collected in order to point out the total anaerobes bacterial counts, the rates of motile bacteria, spirochetes, Gram positive and Gram negative cocci and bacteria, by means of optical and dark field microscopy and of cultural methods . For their oral hygiene, the patients had to use, in the right side toothbrush and dental floss (Control 1), in the left side the oral irrigator alone (Test 1) . One month later (time T1), the lower teeth have been banded, too . In the right side the patients had to use toothbrush and dental floss (Control 2), while in the left one they used the same devices as Control 2 plus the oral irrigator (Test 2) . At the time T1 Periodontal Indexes and Microbiological analyses have been extended to all the four quadrants.(ABSTRACT TRUNCATED AT 250 WORDS)

Oral Microbiol Immunol, 1992 Oct, 7(5), 273 - 6
Relationship between oral gram-negative anaerobic bacteria in saliva of the mother and the colonization of her edentulous infant; Kononen E et al.; Various gram-negative anaerobic bacterial species can be detected in the oral flora of edentulous infants . However, knowledge of the initial infection source is still scarce . Thirty Caucasian mothers (mean age 30 years) and their edentulous infants (mean age 3 months) were examined for the possible similarity of the oral gram-negative anaerobic flora . Paraffin-stimulated saliva was collected from the mothers . A pooled swab sample from mucosal surfaces and unstimulated saliva were collected from the infants . The samples were inoculated on nonselective and selective media and cultured aerobically and anaerobically . All of the 30 mothers harbored Fusobacterium nucleatum and 29 mothers Prevotella melaninogenica in their saliva . The salivary levels of P . melaninogenica, F . nucleatum, nonpigmented Prevotella spp., Prevotella intermedia and Prevotella loescheii exceeded 10(4) CFU/ml in about half of the 30 mothers . At this maternal salivary level, the infants' colonization frequency of P . melaninogenica and F . nucleatum was doubled . A positive correlation between maternal salivary concentration and infant's colonization was found for P . melaninogenica . No positive association was found with nonpigmented Prevotella spp., P . intermedia and P . loescheii . It can be speculated that maternal saliva may act as a source of some gram-negative anaerobes in the oral microflora of edentulous infants as early as before tooth eruption.

Jpn J Antibiot, 1992 Oct, 45(10), 1267 - 9
{Antimicrobial activity of AO-128, a novel inhibitor of alpha-D-glucosidase, against anaerobic bacteria}; Kato N et al.; The in vitro antimicrobial activity of AO-128, an inhibitor of alpha-D-glucosidase, was evaluated against anaerobic bacteria of 45 reference strains (12 genera, 44 species) . AO-128 inhibited no strains tested at a concentration of 1,600 micrograms/ml . The results strongly suggested that this compound would not have any influence on the human intestinal microflora, a majority of which is composed of anaerobic bacteria.

Am J Obstet Gynecol, 1992 Oct, 167(4 Pt 1), 863 - 72
The natural interleukin-1 receptor antagonist in term and preterm parturition; Romero R et al.; OBJECTIVE: Interleukin-1 has been implicated in the mechanisms responsible for preterm labor in the setting of infection . The interleukin-1 receptor antagonist is a new member of the interleukin-1 gene family that inhibits the biologic effects of interleukin-1 by blocking its receptors . Reduction of interleukin-1-induced prostaglandin production by intrauterine tissues may have potential value in the treatment of preterm labor associated with infection . The purpose of these studies was (1) to determine interleukin-1 receptor antagonist levels in the amniotic fluid of women with term and preterm labor (with and without infection) and (2) to study the effects of interleukin-1 receptor antagonist on interleukin-1-induced prostaglandin biosynthesis by human amnion and chorion . STUDY DESIGN: Amniotic fluid was obtained from women in the midtrimester of pregnancy (n = 20), at term pregnancy (with and without labor, n = 69), and in preterm labor (n = 47) . Fluid was cultured for aerobic and anaerobic bacteria and Mycoplasmas . Interleukin-1 alpha, interleukin-1 beta, and interleukin-1 receptor antagonist concentrations were measured by immunoassays previously validated for human amniotic fluid . The effect of interleukin-1 receptor antagonist on interleukin-1-induced prostaglandin production by amnion and chorion was studied with primary cultures . Cells were incubated with interleukin-1 receptor antagonist and interleukin-1 alpha or interleukin-1 beta for 16 hours . Prostaglandin E2 released into the media was assayed by immunoassay . RESULTS: (1) Interleukin-1 receptor antagonist was present in all amniotic fluid samples; (2) amniotic fluid contains the highest interleukin-1 receptor antagonist concentrations detected in any biologic fluid to date; (3) amniotic fluid interleukin-1 receptor antagonist concentrations were not increased in women with preterm labor and intraamniotic infection in spite of dramatically elevated concentrations of interleukin-1 alpha and interleukin-1 beta in the same fluid (median 22 ng/ml and range 0.16 to 70 for preterm labor with negative amniotic fluid culture vs median 30 ng/ml and range 6 to 70 for preterm labor with positive amniotic fluid culture; p > 0.05); (4) interleukin-1 receptor antagonist reduced interleukin-1 beta-induced prostaglandin E2 production by amnion and chorion in a dose-dependent manner; (5) interleukin-1 receptor antagonist by itself did not stimulate prostaglandin E2 release by amnion and chorion when used in concentrations ranging from 0.1 to 1000 ng/ml . CONCLUSIONS: (1) Interleukin-1 receptor antagonist is a physiologic component of amniotic fluid; (2) the release of interleukin-1 alpha and interleukin-1 beta into the amniotic fluid in women with preterm labor is not associated with an increase in interleukin-1 receptor antagonist levels in amniotic fluid; (3) interleukin-1 receptor antagonist reduces interleukin-1-induced prostaglandin production by amnion and chorion; (4) exogenous anticytokine agents may be of value in the treatment of preterm labor.

Appl Environ Microbiol, 1992 Oct, 58(10), 3249 - 56
Reductive debromination of the commercial polybrominated biphenyl mixture firemaster BP6 by anaerobic microorganisms from sediments; Morris PJ et al.; Anaerobic microorganisms eluted from three sediments, one contaminated with polybrominated biphenyls (PBBs) and two contaminated with polychlorinated biphenyls, were compared for their ability to debrominate the commercial PBB mixture Firemaster . These microorganisms were incubated with reduced anaerobic mineral medium and noncontaminated sediment amended with Firemaster . Firemaster averages six bromines per biphenyl molecule; four of the bromines are substituted in the meta or para position . The inocula from all three sources were able to debrominate the meta and para positions . Microorganisms from the Pine River (St . Louis, Mich.) contaminated with Firemaster, the Hudson River (Hudson Falls, N.Y.) contaminated with Aroclor 1242, and Silver Lake (Pittsfield, Mass.) contaminated with Aroclor 1260 removed 32, 12, and 3% of the meta plus para bromines, respectively, after 32 weeks of incubation . This suggests that previous environmental exposure to PBBs enhances the debromination capability of the sediment microbial community through selection for different strains of microorganisms . The Pine River inoculum removed an average of 1.25 bromines per biphenyl molecule during a 32-week incubation period, resulting in a mixture potentially more accessible to aerobic degradation processes . No ortho bromine removal was observed . However, when Firemaster was incubated with Hudson River microorganisms that had been repeatedly transferred on a pyruvate medium amended with Aroclor 1242, 17% of the meta and para bromines were removed after 16 weeks of incubation and additional debromination products, including 2-bromobiphenyl and biphenyl, were detected . This suggests the possibility for ortho debromination, since all components of the Firemaster mixture have at least one ortho-substituted bromine.(ABSTRACT TRUNCATED AT 250 WORDS)

J Dairy Sci, 1992 Sep, 75(9), 2494 - 503
In vitro effects of the thiopeptide A10255 on ruminal fermentation and microbial populations; Tung RS et al.; Experiments used unadapted mixed cultures of ruminal microorganisms in batch or continuous culture fermentation to investigate the effect of a thiopeptide, A10255, on ruminal fermentation and microbial populations . After 24 h of fermentation in batch culture, addition of A10255 (.5 to 20 ppm of the culture fluid) to 0, 45, 60, and 75% concentrate diets had no effect on total VFA but increased molar proportion of propionate and decreased butyrate . The molar proportion of acetate was decreased by treatment only in the 0 and 75% concentrate diets . The increase in molar proportion of propionate by 20 ppm of A10255 was less than the increase caused by a similar concentration of monensin . The same concentration of A10255 (20 ppm) decreased ADF digestion less than 20 ppm of monensin . In continuous culture, A10255 (33 mg/kg of dietary DM) did not affect total VFA concentration, culture pH, OM digestion, or ADF digestion . Ruminal bacterial populations of total anaerobes and lactate-producing, lactate-utilizing, cellulolytic and amylolytic bacteria were unaffected by treatment . However, molar proportions of acetate, butyrate, and isovalerate were decreased, and propionate was increased, by addition of A10255.

J Bacteriol, 1992 Sep, 174(17), 5489 - 95
Methane from acetate; Ferry JG; The general features are known for the pathway by which most methane is produced in nature . All acetate-utilizing methanogenic microorganisms contain CODH which catalyzes the cleavage of acetyl-CoA; however, the pathway differs from all other acetate-utilizing anaerobes in that the methyl group is reduced to methane with electrons derived from oxidation of the carbonyl group of acetyl-CoA to CO2 . The current understanding of the methanogenic fermentation of acetate provides impressions of nature's novel solutions to problems of methyl transfer, electron transport, and energy conservation . The pathway is now at a level of understanding that will permit productive investigations of these and other interesting questions in the near future.

Nippon Geka Gakkai Zasshi, 1992 Sep, 93(9), 906 - 9
{Hospital acquired infection in surgical field and its countermeasure present situation of anaerobes, P . aeruginosa and MRSA infection}; Iwai S et al.; The important organisms of hospital acquired infection in surgical field are anaerobes, P . aeruginosa and MRSA . From 1977, isolation frequency of anaerobes from pus has been increasing remarkably and it became 60% in 1978 . The isolation rates of P . aeruginosa increased 20 to 30% . Since 1988, the incidence of isolation of MRSA has increased markedly . Almost of all the coagulase typing of MRSA were type II, and it suggested the possibility of hospital infection . In 1988, high antimicrobial activity against MRSA was observed with vancomycin, imipenem, minocycline and new quinolones, but in 1990 the multiresistant strains against imipenem, minocycline and new quinolones were increased . Among the various antimicrobial agents examined, vancomycin demonstrated the strongest activity to MRSA . The symptomatic infections were postoperative enterocolitis, respiratory infection, biliary tract infection and wound infection . The most severe symptom was observed in MRSA enterocolitis . We conducted a nation wide questionnaire of postoperative enterocolitis from January 1988 to June 1990 . 169 institutes replied, and 126 cases were involved in postoperative MRSA enterocolitis in 53 institutes . Eighteen cases died, and mortality rate was 14.3% . In the treatment of MRSA infection vancomycin was the most effective antibiotics . It is the most important to prevent nosocomial infection.

Cleve Clin J Med, 1992 Sep-Oct, 59(5), 517 - 28
Uses of hyperbaric oxygen therapy in the 1990s; Kindwall EP; Hyperbaric oxygen can produce a variety of effects in addition to reducing air and gas embolism . It increases the killing ability of leukocytes and is lethal to certain anaerobic bacteria . It inhibits toxin formation by certain anaerobes, increases the flexibility of red cells, reduces tissue edema, preserves intracellular adenosine triphosphate, maintains tissue oxygenation in the absence of hemoglobin . In addition, it stimulates fibroblast growth, increases collagen formation, promotes more rapid growth of capillaries, and terminates lipid peroxidation . These actions of hyperbaric oxygen are useful in treating anaerobic infections that result in gas gangrene, as well as severe aerobic infections such as necrotizing fasciitis, malignant external otitis, and chronic refractory osteomyelitis . Hyperbaric oxygen can help preserve ischemic tissues and facilitates the rapid spread and arborization of new capillaries . It promotes healing in certain problem wounds . Adjunctive hyperbaric oxygen treatment is a new approach to the management of radionecrosis . Hyperbaric oxygen treatment reduces morbidity and mortality resulting from carbon monoxide poisoning . Protocols for hyperbaric oxygen therapy are at present mostly empirical; much additional research is needed to better define therapeutic indications.

Nippon Hinyokika Gakkai Zasshi, 1992 Sep, 83(9), 1395 - 9
{Partial purification of oxalate degrading enzyme produced by human intestinal bacteria}; Ito H; It is unclear whether the oxalate in foods degrades or not in the intestinal tract . We isolated oxalic acid decarboxylase from anaerobic bacteria present in human feces which was grown in the culture medium containing oxalic acid as the sole carbon source . The enzyme was partially purified by 80% ammonium chloride precipitation, DEAE-cellulose chromatography and molecular sieve chromatography . The amino acid composition was found to be relatively rich in glycine and alanine, but to have low basic, hydrophobic and aromatic amino acid residues compared with average proteins.

Infect Dis Clin North Am, 1992 Sep, 6(3), 571 - 99
Acute cholangitis; Sinanan MN; Acute cholangitis is a clinical syndrome marked by fever, jaundice, and abdominal pain that develops because of stasis and infection in the biliary tract . Patients with cholangitis may present with symptoms ranging from a mild, recurrent illness to overwhelming sepsis . Increased age, malignant obstruction, and a rapidly progressive, systemic illness define a group of patients at increased risk . Patients who are delayed in diagnosis, present with septicemia, or fail to respond to conservative treatment still have substantial morbidity and death from cholangitis . Antibiotic therapy that includes coverage for anaerobes and gram-negative, enteric organisms together with other supportive measures often resolves the acute episode, permitting elective diagnostic procedures prior to definitive treatment of biliary tract obstruction . Advances in endoscopic and transhepatic procedures have reduced the necessity for and risks associated with emergent operative biliary drainage.

Infect Dis Clin North Am, 1992 Sep, 6(3), 545 - 70
Antimicrobial therapy of intra-abdominal sepsis; Sawyer MD et al.; Intra-abdominal sepsis remains a highly morbid and lethal event despite the availability of potent antimicrobial agents and improvements in surgical management and intensive care . Appropriate management consists of source control, antimicrobial agents directed against both facultative gram-negative and anaerobic organisms, and physiologic and metabolic support . A variety of single and dual agent regimens are appropriate for initial therapy, as long as both aerobes and anaerobes are effectively targeted . Culture, Gram stain, and sensitivity testing may provide valuable information, especially when resistant organisms are encountered . Further studies to determine the relative efficacy of various agents need to be carefully designed both to avoid the pitfalls of previous studies and to provide useful and comparable data.

Diagn Microbiol Infect Dis, 1992 Sep-Oct, 15(7), 595 - 600
Lack of predictability of cefotetan in vitro susceptibility tests against cefotetan-resistant anaerobic bacteria in determining clinical and bacteriologic efficacies; Sheikh W et al.; Interpretive criteria for cefotetan in vitro susceptibility testing appear to be clinically relevant when applied to aerobic bacteria . To determine whether the same was true for anaerobic bacteria, we conducted a retrospective analysis of intraabdominal, gynecologic, and skin and skin structure infections treated with cefotetan . Of the infections, 202 contained at least one anaerobe isolate . Of the 51 patients, 47 (92.9%) from whom one or more cefotetan-resistant anaerobes were isolated were clinically cured or showed improvement . Similarly, cefotetan was efficacious for 95.4% of the patients harboring only cefotetan-susceptible anaerobes . Favorable bacteriologic responses were observed in 94.1% and 97.4% of these patient groups, respectively . The data suggests that the therapeutic utility of cefotetan against anaerobic bacteria cannot be accurately predicted on the basis of in vitro susceptibility test results alone but may be explained by a variety of factors, as discussed in this report.

Antimicrob Agents Chemother, 1992 Sep, 36(9), 2014 - 9
Antimicrobial prophylaxis for major head and neck surgery in cancer patients: sulbactam-ampicillin versus clindamycin-amikacin; Phan M et al.; A total of 99 patients with head and neck cancer who were to undergo surgery were randomized in a prospective comparative study of sulbactam-ampicillin (1:2 ratio; four doses of 3 g of ampicillin and 1.5 g of sulbactam intravenously {i.v.} every 6 h) versus clindamycin (four doses of 600 mg i.v . every 6 h)-amikacin (two doses of 500 mg i.v . every 12 h) as prophylaxis starting at the induction of anesthesia . The two groups of evaluable patients (43 in the clindamycin-amikacin treatment group and 42 in the sulbactam-ampicillin treatment group) were comparable as far as age (mean, 57 years; range, 21 to 84 years), sex ratio (71 males, 28 females), weight (mean, 66 kg; range, 40 to 69 kg), indication for surgery (first surgery, 48 patients; recurrence, 37 patients), previous anticancer treatment (surgery, radiation therapy, chemotherapy), type of surgery, and stage of cancer . The overall infection rate (wound, bacteremia, and bronchopneumonia) within 20 days after surgery was 20 patients in each group . Wound infections occurred in 14 (33%) sulbactam-ampicillin-treated patients and 9 (21%) clindamycin-amikacin-treated patients (P = 0.19; not significant) . The rates of bacteremia were 2 and 4%, respectively . The rates of bronchopneumonia were 14.3 and 23.2%, respectively (P was not significant) . Most infections were polymicrobial, but strict anaerobes were recovered only from patients who received sulbactam-ampicillin . Antimicrobial treatment was required within 20 days after surgery for 42% of the sulbactam-ampicillin-treated patients and 44% of the clindamycin-amikacin-treated patients . By comparison with previous studies, we observed a decreased efficacy of antimicrobial prophylaxis in patients with head and neck cancer undergoing surgery because of the increased proportion of patients who were at very high risk for infection (extensive excision and plastic reconstruction in patients with recurrent stage III and IV cancers) and because of the longer duration of surgery.

Microbiol Rev, 1992 Sep, 56(3), 482 - 507
Microbial reductive dehalogenation; Mohn WW et al.; A wide variety of compounds can be biodegraded via reductive removal of halogen substituents . This process can degrade toxic pollutants, some of which are not known to be biodegraded by any other means . Reductive dehalogenation of aromatic compounds has been found primarily in undefined, syntrophic anaerobic communities . We discuss ecological and physiological principles which appear to be important in these communities and evaluate how widely applicable these principles are . Anaerobic communities that catalyze reductive dehalogenation appear to differ in many respects . A large number of pure cultures which catalyze reductive dehalogenation of aliphatic compounds are known, in contrast to only a few organisms which catalyze reductive dehalogenation of aromatic compounds . Desulfomonile tiedjei DCB-1 is an anaerobe which dehalogenates aromatic compounds and is physiologically and morphologically unusual in a number of respects, including the ability to exploit reductive dehalogenation for energy metabolism . When possible, we use D . tiedjei as a model to understand dehalogenating organisms in the above-mentioned undefined systems . Aerobes use reductive dehalogenation for substrates which are resistant to known mechanisms of oxidative attack . Reductive dehalogenation, especially of aliphatic compounds, has recently been found in cell-free systems . These systems give us an insight into how and why microorganisms catalyze this activity . In some cases transition metal complexes serve as catalysts, whereas in other cases, particularly with aromatic substrates, the catalysts appear to be enzymes.

J Periodontal Res, 1992 Sep, 27(5), 522 - 7
A preliminary evaluation of the use of a redox agent in the treatment of chronic periodontitis; Wilson M et al.; A small-scale clinical trial was carried out to evaluate the effect of a redox agent, methylene blue, on microbiological and clinical indices of chronic periodontitis . Methylene blue was applied subgingivally on a daily basis for 7 d to 25 test sites in 7 patients and the sites evaluated clinically and microbiologically for up to 14 d: 25 control sites in the same patients received sterile water . The test sites showed statistically significant differences from the control sites in terms of changes in a number of clinical and microbiological indices . In the test sites the proportions of anaerobes, Gram-negative anaerobes, spirochetes and motile bacteria decreased, as did the crevicular fluid flow, while the proportions of facultative anaerobes and cocci increased . These changes are indicative of a shift towards periodontal health . No significant differences were observed between the test and control sites in terms of bleeding on probing or pocket depth . The encouraging results of this preliminary study suggest that the use of redox agents in the treatment of chronic periodontitis warrants further investigation.

Oral Microbiol Immunol, 1992 Aug, 7(4), 253 - 6
Experimentally induced infection by oral anaerobic microorganisms in a mouse model; Baumgartner JC et al.; A mouse model was developed to study the abscessogenic potential of pure and mixed cultures of oral anaerobes associated with infections of endodontic origin . Maximum subcutaneous lesions were seen on their backs between 3 and 14 d after inoculation . Strains of Fusobacterium nucleatum, Peptostreptococcus anaerobius, and Veillonella parvula were pathogenic in pure culture . A mixed culture of F . nucleatum with either Porphyromonas gingivalis or Prevotella intermedia was significantly more pathogenic than F . nucleatum in pure culture . Histopathological examination of tissue sections from control mice injected with India ink in the medium demonstrated a pathway of particulate migration from the backs of the mice to their abdomen.

Clin Geriatr Med, 1992 Aug, 8(3), 599 - 616
Considerations for physicians caring for older adults with periodontal disease; Ellen RP; Periodontal disease is a generic term encompassing a variety of inflammatory conditions affecting the supporting tissues of the teeth . Periodontitis is inflammation associated with net resorption of supporting alveolar bone and periodontal ligament . Gingivitis is inflammation limited to the covering gingival tissues and does not directly lead to tooth mobility or loss . Periodontal diseases are very prevalent . Because the bone and ligament resorption are essentially irreversible, accumulated tissue damage of periodontitis is reflected in a prevalence and severity that increase with age . Periodontitis is not caused by aging per se but by a complex host-parasite relationship in which specific pathogens among the subgingival microbiota not only injure tissues directly but stimulate a cascade of inflammatory mediators to damage host tissues . Analytic epidemiology has identified several risk indicators for advanced periodontitis in older adults . These are microbiologic (prevalence of certain anaerobes in the microbiota), behavioral (tobacco smoking and infrequent professional dental care), medical (older age, preexisting and generalized periodontitis, gingival bleeding), and social (financial worries) . Periodontitis in older adults is treated by reducing the impact of these risk indicators . The infections are controlled by combinations of debridement, antimicrobial agents, and surgical procedures as indicated . Medically well older adults can be treated similarly to younger adults . Management of periodontal conditions can be complicated for patients who are medically compromised . Communication between physicians and dental personnel is often required to ascertain the medical history and list of medications taken by older patients . Many of the medications prescribed for medical problems associated with aging impact on treatment choices for managing periodontitis . Moreover, periodontists frequently prescribe analgesics, antibiotics, and anti-inflammatory agents that might interact with others among the numerous drugs taken by older patients . Older adults with cognitive or physical disabilities have special needs for individualized hygiene instruction and implements . Periodontal health promotion and improving access to periodontal care for the elderly are challenges, because dental services are most often in the private sector and dental insurance does not often apply after retirement . Because they grew up in an era in which tooth loss due to "gum" diseases was considered inevitable, their current motivation toward regular preventive care must be improved by removing barriers and impediments to care . In addition to life-threatening medical conditions, frail individuals institutionalized in collective living centers face compounded problems concerning the provision of adequate, not even optimal, dental care . Their periodontal health often deteriorates rapidly after institutionalization, and in some instances it can possibly predispose to aspiration pneumonia or other disseminated infections.(ABSTRACT TRUNCATED AT 400 WORDS)

J Clin Microbiol, 1992 Aug, 30(8), 1995 - 8
BioArgos: a fully automated blood culture system; Courcol RJ et al.; BioArgos (Sanofi Diagnostics Pasteur, Marnes-la-Coquette, France) is a fully automated blood culture system that detects carbon dioxide production by infrared spectroscopy through a glass bottle . This hands-off system was compared with the BACTEC NR-660 system (Becton Dickinson Diagnostic Instrument Systems, Towson, Md.) . A total of 336 microorganisms belonging to 74 taxa were tested in simulated blood cultures by both systems . Experimental data showed no significant differences between the two systems . The inclusive detection times (+/- the standard deviations) were 33.2 +/- 28.7 and 35.0 +/- 30.6 h with BioArgos and BACTEC, respectively . Anaerobes were detected earlier with BioArgos, whereas detection of some organisms that need oxygen to grow was slightly delayed . In conclusion, BioArgos is as reliable and accurate as BACTEC NR-660 and shows better practicability owing to noninvasive detection, reduction of vial manipulation, and absence of daily maintenance.

Am Rev Respir Dis, 1992 Aug, 146(2), 523 - 5
Polymicrobial bacterial pericarditis after transbronchial needle aspiration . Case report with an investigation on the risk of bacterial contamination during fiberoptic bronchoscopy; Epstein SK et al.; A 63-yr-old man developed pericardial effusion with tamponade after transbronchial needle aspiration (TBNA) of a subcarinal mass . A diagnosis of polymicrobial bacterial pericarditis was made when pericardiocentesis revealed purulent fluid that grew a mixed culture of anaerobes and aerobes, organisms that constitute part of the normal upper respiratory tract flora . To examine the possibility that contamination of the transbronchial needle (TBN) could lead to purulent pericarditis by inoculation of bacteria into the mediastinum, quantitative cultures of the TBN content were performed in seven consecutive patients . Abundant growth of multiple anaerobic and aerobic organisms was demonstrated in all seven cultures . We conclude that subcarinal TBNA is another potential cause of purulent pericarditis . This results from upper respiratory tract contamination of the open distal end of the TBN as it passes through the suction channel of the bronchoscope.

J Comp Pathol, 1992 Aug, 107(2), 147 - 67
A survey and review of hepatobiliary lesions in Australian macropods; Canfield PJ et al.; This report presents information on the range of diseases and lesions that occurred in sections of livers of macropods held in the Non-Domestic Animal Registry at Taronga Zoo . Of 142 affected livers, 52 were due to parasites, 24 to bacteria, nine to Macropod Herpesvirus, four to fungal agents and ten to tumours . In addition, 17 livers had acute degenerative or necrotic lesions, 22 were affected by fibrosis or other chronic lesions and four had miscellaneous degenerative lesions . Common parasitic diseases included toxoplasmosis, coccidial cholangitis, cestode cholangitis (Progamotaenia sp.), fascioliasis and capillarial hepatitis . Bacterial diseases were varied but lesions due to anaerobic bacteria or Mycobacteria spp . were most common . Many of the acute degenerative lesions were associated with cardio-respiratory disease . Chronic lesions were often of unknown origin, although it was speculated that parasitic and bacterial organisms contributed to the aetiology . There were four primary and six metastatic tumours.

Bol Med Hosp Infant Mex, 1992 Aug, 49(8), 502 - 5
{Splenic abscesses . A case report and review of the literature}; Escamilla-Lopez M et al.; This is a report of a case of a 3-year-old boy who developed splenic abscesses after a mild plantar wound . His initial complains were fever and several distal cutaneous abscesses (septic emboli) . Multiple cultures for bacteria, fungi, mycobacterium and anaerobes were performed, but all were negative . In spite of an energetic antimicrobial treatment, he continued with high fever . Echocardiography was normal . Two weeks later, a thoracic radiography showed the left hemidiafragm was elevated and a small pleural effusion . An abdominal echosonography showed multiple hypoechoic splenic lesions, and this finding was confirmed by magnetic resonance imaging . After splenectomy, the patient healed and was discharged . Anatomopathological examination of the spleen showed eight pyogenic abscesses of different size . The causal agent was not isolated.

Hepatogastroenterology, 1992 Aug, 39(4), 362 - 5
Major bacterial infections following liver transplantation: a prospective study; Lumbreras C et al.; The incidence and characteristics of major bacterial infections were studied prospectively in 50 consecutive adult patients who underwent liver transplantation (LT) . All patients received the same protocol of immunosuppression, bowel decontamination, antibiotics prophylaxis, and follow-up . Thirty-two patients (64%) had at least one episode of major bacterial infection . One death was directly related to a bacterial infection, accounting for 13% of postoperative mortality . The most critical period for infection was the first 2 months after surgery, when 69% of the infections occurred . The most frequent clinical presentations were bacteremia, pneumonia and abdominal abscesses . Eighty percent of the bacteremias had an identifiable source, the most frequent being intravascular catheters . Gram-positive microorganisms (69%) predominated over gram-negative rods (26%) and anaerobes (5%) . The use of selective bowel decontamination (SBD) with norfloxacin may explain this predominance . Major bacterial infections are an important source of morbidity and mortality after LT . Efforts to prevent these infections and to determine their source and specific treatment, will improve the management and the outcome of these patients in the future.

Eur J Clin Microbiol Infect Dis, 1992 Aug, 11(8), 683 - 92
Randomized multicenter clinical trial with imipenem/cilastatin versus cefotaxime/gentamicin in the treatment of patients with non-life-threatening infections . German and Austrian Imipenem/Cilastatin Study Group.
{Incidence of Mobiluncus spp . from the patients with clinical bacterial vaginosis}
Mikamo H, Izumi K, Ito K, Tamaya T, Sawa K, Watanabe K, Ueno K.

Department of Obstetrics and Gynecology, School of Medicine, Gifu UniversityAerobic and anaerobic cultures as well as a Gram stain and wet mount preparations were made of vaginal swabs in twenty patients with clinical bacterial vaginosis . Mobiluncus spp . were detected in 7 cases (35%) . Cultures appeared to indicate that mixed abnormal flora between aerobic and anaerobic bacteria are found in bacterial vaginosis, and that Mobiluncus spp . may play a role in bacterial vaginosis.

Dis Colon Rectum, 1992 Jul, 35(7), 640 - 4
Synergistic soft tissue infections of the perineum; Iorianni P et al.; Seven patients with necrotizing soft tissue infections of the perineum are described . Predisposing factors related to infection were present in four patients (diabetes mellitus, multiple myeloma, HIV, and a poorly defined immunodeficiency syndrome) . Anaerobic and facultative anaerobic bacteria were cultured in each case . Two patients required skin graft closure of the debrided wounds, with the remaining wounds closed by contracture and epithelialization . A diverting sigmoid colostomy to facilitate wound care was performed on one patient who had complete dissolution of all anal sphincters . The role of hyperbaric oxygen therapy in four patients was of uncertain value.

Jpn J Antibiot, 1992 Jul, 45(7), 763 - 73
{In vitro study on efficacy of combination use of aspoxicillin and beta-lactam preparations (ceftazidime, cefmetazole and aztreonam) against bacteria isolated from abdominal infections}; Chimura T et al.; An in vitro study was done to evaluate combination use of aspoxicillin (ASPC) with each of 3 beta-lactam preparations, ceftazidime (CAZ), cefmetazole (CMZ) and aztreonam (AZT) . The results obtained are summarized as follows: 1 . ASPC has strong activity against Gram-positive bacteria and anaerobic bacteria, while CMZ and CAZ have strong activity against Gram-negative bacteria . 2 . Rates of beta-lactamase producing strains among the isolated bacteria (a total of 383 isolates) were 4.4% among Gram-positive bacteria, 71.6% among Gram-negative bacteria and 89.3% among anaerobic bacteria . The overall rate of beta-lactamase secreting strains among all isolates was 46.5% . 3 . Efficacies of combination uses were studied using the FIC index . Combination of ASPC and CAZ was effective against 95.0% of the isolates, ASPC and AZT against 85.7%, and ASPC and CMZ against 83.5% . Combination of ASPC and CMZ showed antagonism in 12.8% of the isolates . In conclusion, combination use of ASPC with any one of CMZ, AZT or CAZ proved to be highly effective . In particular, combination of ASPC and CAZ appeared to be the best in view of complementing antibacterial spectra.

J Periodontol, 1992 Jul, 63(7), 618 - 25
Rinsing with delmopinol 0.2% and chlorhexidine 0.2%: short-term effect on salivary microbiology, plaque, and gingivitis; Collaert B et al.; The aim of this short-term study was to compare the effect of delmopinol HCl 0.2% and chlorhexidine digluconate 0.2% rinses on the development of dental plaque, the healing of experimental gingivitis, and the salivary microbiology . As part of a larger study protocol, 45 healthy males enrolled in an oral hygiene program to upgrade their oral health . For this portion of the study, participants had their teeth professionally cleaned on day 0 . The participants then abstained from standard mechanical oral hygiene procedures, but applied a placebo solution twice daily for 2 weeks . At the end of this period the subjects received a second professional cleaning and were then assigned to 2 treatment groups: Group 1 rinsed with 10 ml of delmopinol HCl 0.2% and Group 2 rinsed with 10 ml of chlorhexidine digluconate 0.2% for 1 minute twice daily for the next 2 weeks and continued to refrain from mechanical oral hygiene procedures . At the end of the placebo and active treatment periods 1) saliva samples were taken and cultivated on a series of media; 2) the degree of gingivitis was assessed with gingival crevicular fluid (GCF) and gingivitis index (GI); and 3) the plaque index was assessed and the stainable buccal plaque extension was analyzed planimetrically . No changes in the salivary microbiological counts were detected for the subjects rinsing with delmopinol . Subjects rinsing with chlorhexidine showed significant reductions of anaerobes, aerobes, and S . mutans in saliva . The amounts of GCF and GI were reduced largely to the same extent in both treatment groups . Mean plaque extension was reduced by 52% after delmopinol and 88% after chlorhexidine rinsing.(ABSTRACT TRUNCATED AT 250 WORDS)

Vet Microbiol, 1992 Jun 1, 31(2-3), 235 - 42
Tissues and exudates contain sufficient thymidine for growth of anaerobic bacteria in the presence of inhibitory levels of trimethoprim-sulfamethoxazole; Indiveri MC et al.; Obligate anaerobes are susceptible in vitro to trimethoprim-sulfonamides . Clinical efficacy of this drug combination for treatment of infectious processes in which anaerobes are involved is uncertain . We hypothesize that this uncertainty is a result of thymidine in tissues and exudates which abrogates the inhibitory effect of trimethoprim-sulfonamides . We shown herein that species of anaerobic bacteria commonly encountered in infectious processes grew on thymidine-containing medium despite the presence of levels of trimethoprim-sulfamethoxazole (S x T) previously shown to be inhibitory . Biologic fluids and tissues, where anaerobic bacteria are commonly encountered in diseased states, were shown to contain thymidine levels that were sufficient to reverse the inhibitory effect of S x T upon these species of bacteria . These observations suggest that the use of trimethoprim-sulfonamides is not a rational choice for treatment of infectious processes in which an obligate anaerobe is a component.

J Clin Microbiol, 1992 Jun, 30(6), 1529 - 34
National hospital survey of anaerobic culture and susceptibility testing methods: results and recommendations for improvement; Goldstein EJ et al.; The methods for performing anaerobic bacterial isolation and identification continue to change and improve . Anaerobic susceptibility testing has become controversial, and method-dependent variability has been noted . To assess the status of clinical anaerobic bacteriology in the United States, we surveyed, by means of a questionnaire, 120 hospitals, selected at random, with bed capacities of 200 to 1,000, and we received responses from 88 (73%) . All hospitals performed cultures for anaerobes . The media and methods used for transport, initial processing, incubation, and identification varies between the different regions in the United States . Thirty percent of laboratories did not perform susceptibility studies, 16% used a reference laboratory, and 54% performed them in house . For half the laboratories, susceptibility testing was performed on isolates depending on the source; in this case, blood cultures were tested by 97% of the laboratories, serious infections were tested by 60%, sterile body sites were tested by 73%, pure cultures were tested by 47%, and tests were done by physician request by 39% . For laboratories doing testing, the broth disk method, no longer sanctioned by the National Committee for Clinical Laboratory Standards, was used most often (56%), followed by microdilution (33%), beta-lactamase testing (25%), macrotube dilution (2%), and agar dilution (2%) . The antimicrobial agents tested were as follows: penicillin-ampicillin, 94%; clindamycin, 94%, metronidazole, 90%; chloramphenicol, 80%; cefoxitin, 76%; tetracyclines, 51%; and erythromycin, 45% . All other agents were tested by less than or equal to 25% of laboratories; the methods used could be improved to make the results more timely and consequently more clinically relevant.

Ophthalmologe, 1992 Jun, 89(3), 233 - 6
{Diagnosis and therapy of chronic canaliculitis}; Struck HG et al.; The chronic lacrimal canaliculitis is often overlooked and unsatisfactory treated . The purpose of this long-term study (1978-1991) is to call attention to special bacteriological signs and to give recommendations for proper treatment . 54 patients (39 females and 15 males) in age from 29 to 85 years (average age of 60 years) with a chronic lacrimal canaliculitis were evaluated . "Sulfur granules" were obtained from 32 patients and 54 specimens were collected from 44 patients and processed immediately for aerobic and anaerobic cultivation as well as microscopic investigation . Altogether 100 bacteria could be isolated: 56 anaerobes, 38 aerobes as well as 6 microaerophilic and capnophilic strains, respectively . Members of the genus Actinomyces were the most often isolated anaerobes . They could be detected in specimens of 15 patients by culture and in materials of 4 patients only by microscopic study . 42 from 50 patients were permanently cured by immediate treatment according to our operative procedure despite the splitted canaliculus . The most common cause of chronic lacrimal canaliculitis is a mixed infection . Despite the characteristic clinical symptoms the laboratory evaluation should be done to provide the diagnosis . The surgical procedure leads to a permanent functional healing in a high degree.

J Biol Chem, 1992 May 25, 267(15), 10537 - 43
Identification, purification, and reconstitution of OxlT, the oxalate: formate antiport protein of Oxalobacter formigenes; Ruan ZS et al.; We had proposed earlier that the anaerobe Oxalobacter formigenes sustains a proton-motive force by exploiting a secondary carrier rather than a primary proton pump . In this view, a carrier protein would catalyze the exchange of extracellular oxalate, a divalent anion, and intracellular formate, the monovalent product of oxalate decarboxylation . Such an electrogenic exchange develops an internally negative membrane potential, and since the decarboxylation reaction consumes an internal proton, the combined activity of the carrier and the soluble decarboxylase would constitute an "indirect" proton pump with a stoichiometry of 1H+ per turnover . This model is now verified by identification and purification of OxlT, the protein responsible for the anion exchange reaction . Membranes of O . formigenes were solubilized at pH 7 with 1.25% octyl glucoside in 20 mM 3-(N-morpholino)propanesulfonic acid/K, in the presence of 0.4% Escherichia coli phospholipids and with 20% glucerol present as the osmolyte stabilant . Rapid methods for reconstitution were developed to monitor the distribution of OxlT during biochemical fractionation, allowing its purification by sequential anion and cation exchange chromatography . OxlT proved to be a single hydrophobic polypeptide, of 38 kDa mobility during sodium dodecyl sulfate-polyacrylamide gel electrophoresis, with a turnover number estimated as at least 1000/s . The properties of OxlT point to an indirect proton pump as the mechanism by which a proton-motive force arises in O . formigenes, and one may reasonably argue that indirect proton pumps take part in bacterial events such as acetogenesis, malolactate fermentation, and perhaps methanogenesis.

Pharmacoeconomics, 1992 Jun, 1(6), 443 - 59
Imipenem/cilastatin: a pharmacoeconomic appraisal of its use in intra-abdominal infections; Benfield P et al.; Imipenem/cilastatin possesses a very broad spectrum of antibacterial activity that encompasses the range of Gram-negative and Gram-positive aerobes and anaerobes usually associated with intra-abdominal and other polymicrobial infections . Its therapeutic efficacy is comparable to that of aminoglycoside/antianaerobe combination regimens, and the most commonly reported adverse effects are similar to those of other beta-lactam antibacterials and are generally of a non-serious nature . The acquisition cost of imipenem/cilastatin is generally greater than that of aminoglycoside/antianaerobe combination regimens, but treatment with the latter incurs the additional costs of multiple intravenous administration, aminoglycoside pharmacokinetic and other monitoring, and possible nephrotoxicity and ototoxicity . The available pharmacoeconomic studies show a trend towards lower total treatment costs with imipenem/cilastatin compared with gentamicin plus clindamycin . Results from other sources suggest that imipenem/cilastatin may achieve further cost savings through reduced duration of hospitalisation . Although further study is required to confirm these trends, it appears that the total treatment cost of imipenem/cilastatin does not exceed that of usual combination therapy and the risk of aminoglycoside-induced toxicity is avoided.

Contraception, 1992 May, 45(5), 511 - 8
The effects of a combined contraceptive vaginal ring releasing ethinyloestradiol and 3-ketodesogestrel on vaginal flora; Davies GC et al.; Fifty nine women with documented normal ovulatory cycles and with no symptoms of vaginal infection were divided into four groups . Each group used a combined contraceptive vaginal ring (CCVR) with a mean daily release rate of 0.015 mg of ethinyloestradiol (EE) and 0.120 mg of 3-ketodesogestrel (3-KDG) per day, for one cycle of either 21, 28, 42, or 56 days . Cultures from the posterior vaginal fornix and from the endocervical canal were obtained immediately before insertion of the ring and on removal of the ring . Changes in the numbers of vaginal cells, aerobic and anaerobic bacteria, Chlamydia trachomatis, Gardnerella vaginalis, yeasts and Trichomonas vaginalis were documented at the end of each treatment . Intra- and inter- group changes in the vaginal flora were assessed at the end of each treatment . The comparison between the number and type of flora showed no significant change between the pre-treatment population and the post-treatment population . The results of this study suggest that the use of this CCVR for 21, 28, 42 and 56 days is not associated with an increase in inflammatory cells or pathogenic bacteriaPIP: Researchers recruited 59 healthy volunteers from England and the Netherlands for a study to determine changes in the vaginal flora or inflammatory cells when a combined contraceptive vaginal ring (diameter of 6 cm) releasing .015 mg of ethinyl estradiol and .12 mg of 3-ketodesogestrel daily was in position for 21, 28, 42, or 56 days . They obtained cultures from the posterior vaginal fornix and the endocervical canal right before insertion of the ring and after its removal . Even though the researchers allowed sexual activity, they did not record data on sexual activity for this study . None of the volunteers had 1 sexual partner . The researchers specifically looked at vaginal cells, aerobic and anaerobic bacteria, Chlamydia trachomatis, Gardnerella vaginalis, yeasts, and Trichomonas vaginalis . No significant changes in vaginal flora or vaginal cells occurred between pretreatment and posttreatment for any of the 4 matched treatment groups (21, 28, 42, or 56 days insertion) . Moreover there were no significant changes between treatment groups . The researchers suggested this vaginal ring performed so well in comparison to other rings such as those which release ethinyl estradiol and levonorgestrel because of its reasonable dimensions, its flexibility, and its low hormone release rate . They concluded that it can be used for extended periods .

Appl Environ Microbiol, 1992 May, 58(5), 1466 - 76
Modelling of mixed chemostat cultures of an aerobic bacterium, Comamonas testosteroni, and an anaerobic bacterium, Veillonella alcalescens: comparison with experimental data; Gerritse J et al.; A mathematical model of mixed chemostat cultures of the obligately aerobic bacterium Comamonas testosteroni and the anaerobic bacterium Veillonella alcalescens grown under dual limitation of L-lactate and oxygen was constructed . The model was based on Michaelis-Menten-type kinetics for the consumption of substrates, with noncompetitive inhibition of V . alcalescens by O2 . The growth characteristics of the aerobic and anaerobic organisms were determined experimentally with pure cultures of the individual species in (oxygen-limited) chemostats . Using these pure-culture data in the model of the mixed culture resulted in a good description of the actual mixed cultures of the two bacteria . In the actual mixed-culture experiments, coexistence of the two species occurred only when the cultures were oxygen limited . With increasing oxygen supply (the actual oxygen concentration in the culture remaining at less than 0.2 microM), the biomass of C . testosteroni increased, whereas that of V . alcalescens decreased . Apparently, C . testosteroni protected V . alcalescens from inhibition by oxygen by maintaining sufficiently low oxygen concentrations . The model calculations indicated that competition between the aerobic and the anaerobic bacterium for common substrates (L-lactate and oxygen) occurred and that the anaerobe was the better competitor . Analysis of the culture fluid indicated that C . testosteroni grew primarily at the expense of the fermentation products of V . alcalescens, i.e., propionate and acetate . The model further indicated that with different values of several growth parameters (e.g., substrate affinity and/or inhibition constants), the affinity of the aerobic organism for oxygen and the sensitivity of the anaerobic organism for oxygen were the most important properties determining the coexistence of these two physiologically different types of bacteria.

Am Surg, 1992 May, 58(5), 324 - 8
Changes in biliary bacteria after endoscopic cholangiography and sphincterotomy; Sand J et al.; This prospective study consisted of 32 patients . In each patient, bile was collected during two separate endoscopic retrograde cholangiopancreatographies (ERCP) to study changes in biliary bacteriology and cytology . The mean interval between ERCPs was 20 months (15-29 months) . Twenty-three patients had gallstones in the gallbladder, bile ducts, or both . Nineteen of them had bactibilia compared to none of the 9 patients with normal ERCP (P less than 0.001) . Fifteen patients had normal bile ducts in ERCP (Group 1) . Four of these patients (27%) had bactibilia initially and 9 (60%) at follow-up (P = 0.069) . Seventeen patients had bile duct stones and underwent endoscopic sphincterotomy (Group II) . Fifteen of these patients (88%) had bactibilia initially, and 15 (88%) also had bactibilia at follow-up . Initially, anaerobic bacteria were detected in 37 per cent of Group I patients with bactibilia and in 50 per cent of Group II patients with bactibilia . At follow-up, the bile in Group I patients infrequently (11%) contained anaerobes, whereas in Group II patients anaerobes predominated (67%; P less than 0.011) . Clear correlation between the biliary cytology and bacteriology could not be observed . The authors conclude that ERCP may result in increased incidence of long-term bactibilia and suggest that contamination occurred during ERCP . The bactibilia associated with bile duct stones does not subside after endoscopic treatment of the common duct stones.

Am J Obstet Gynecol, 1992 May, 166(5), 1576 - 87
Tumor necrosis factor in preterm and term labor; Romero R et al.; OBJECTIVE: Our objective was to determine if labor (term and preterm) and microbial invasion of the amniotic cavity were associated with changes in amniotic fluid concentrations of tumor necrosis factor . STUDY DESIGN: Amniotic fluid was retrieved by transabdominal amniocentesis from 269 women in the following groups: midtrimester (n = 38), preterm labor with intact membranes (n = 52), preterm premature rupture of membranes (n = 74), term in active labor (n = 84), and term not in labor (n = 21) . Fluid was cultured for aerobic and anaerobic bacteria and for Mycoplasma species . Tumor necrosis factor was measured with a commercially available enzyme-linked immunosorbent assay validated for amniotic fluid (sensitivity 60 pg/ml) . RESULTS: Amniotic fluid from pregnant women in the second and third trimesters who were not in labor did not contain tumor necrosis factor . Among women in preterm labor, 92.3% (12/13) of patients with a positive amniotic fluid culture had detectable tumor necrosis factor in the amniotic fluid (median 820 pg/ml, range less than 60 to 2340 pg/ml) . In contrast, only 10.2% (4/39) of women with a negative amniotic fluid culture had detectable tumor necrosis factor . Histopathologic chorioamnionitis was found in all patients who had a positive amniotic fluid culture, and tumor necrosis factor was detectable in the amniotic fluid of all but one of these patients . Among women in active labor at term, 25% (21/84) had detectable tumor necrosis factor in the amniotic fluid . Tumor necrosis factor was detected more frequently in the amniotic fluid of patients with a positive amniotic fluid culture than in patients with a negative culture (46.6% {7/15} vs 20.2% {14/69}, p = 0.047) . Amniotic fluid concentrations of tumor necrosis factor were significantly higher in patients with preterm premature rupture of membranes, labor, and a positive amniotic fluid culture than in the other subgroups of patients with preterm premature rupture of membranes . CONCLUSION: Parturition in the setting of microbial invasion of the amniotic cavity is associated with activation of the cytokine network as demonstrated by the detection of tumor necrosis factor in human amniotic fluid.

Q J Med, 1992 May, 83(301), 401 - 7
Spontaneous peritonitis in cirrhotic hospital in-patients: retrospective analysis of 101 cases; Mbopi Keou FX et al.; One hundred and one patients with cirrhosis resulting from alcohol abuse, admitted to Broussais University Hospital, Paris, between January, 1986 and December, 1989 were assessed for infection of the ascitic fluid using clinical and cytobacteriological criteria . All of 46 patients (45.5%) with clinical signs and symptoms of peritonitis had an ascitic fluid polymorphonuclear (PMN) count > 250 cells/mm3 . Bacteria could be isolated from the ascitic fluid of 23 patients (50%) . Twenty-six bacterial strains were isolated (there was more than one strain in two samples) . Escherichia coli was found in 14 cases . It is noteworthy that no anaerobes were grown . Mortality, biochemical parameters and clinical features correlated significantly with an ascitic fluid PMN count > 250 cells/mm3 . High mortality correlated with a PMN count > 1000 cells/mm3 (70% vs . 33%).

Antibiot Khimioter, 1992 May, 37(5), 10 - 1
{A cassette micromethod of determining the sensitivity of anaerobic microorganisms to antimicrobial drugs}; Ushakov RV et al.; A micromethod based on the use of plates with wells and microquantities of microbial suspensions is described . It provides determination of MICs of antibacterial drugs and sensitivity of clinical strains of anaerobes of 2 or 3 species predominating in pathological materials as well as to preliminarily identify some anaerobic bacteria by their antibiotic sensitivity.

J Esthet Dent, 1992 May-Jun, 4(3), 84 - 5
Vital bleaching agents and oral antiseptic: effect on anaerobic bacteria; Scherer W et al.; This in vitro study compared the antimicrobial effect of several at-home bleaching agents and an oral antiseptic against anaerobic bacteria that are commonly found in the oral cavity . Zones of inhibition produced by Rembrandt Lighten Bleaching Gel, Opalescence, and Peroxyl were measured and compared . All the materials produced zones of inhibition with the five bacteria used in the study.

Stomatologiia (Mosk), 1992 May-Dec, (3-6), 31 - 4
{The therapy of inflammatory diseases of the maxillofacial area with the use of imidazole derivatives}; Ushakov RV et al.; Qualitative and quantitative composition of associations of the agents of odontogenic infection were studied making use of present-day bacteriologic methods and of analysis of the microflora sensitivity to trichopol and nitazole, imidazole derivatives . The microflora was found to be represented by associations with the predominance of obligate and facultative anaerobes . The anaerobes were found highly sensitive to trichopol, both in vivo and in vitro, and even more so to nitazole, the drug manufactured in this country.

Vet Rec, 1992 Apr 18, 130(16), 349 - 50
Rationale for treatment of retained placenta in cows with neomycin and metronidazole; van den Bogaard AE et al.; A combination of neomycin and metronidazole was compared with oxytetracycline for its activity against the intrauterine flora of 10 cows with retained placenta . In vitro the metronidazole/neomycin combination reduced the numbers of aerobic and obligately anaerobic bacteria much more effectively than did oxytetracycline.

Oral Microbiol Immunol, 1992 Apr, 7(2), 106 - 10
Serum IgG reactive with oral anaerobic microorganisms associated with infections of endodontic origin; Baumgartner JC et al.; Numerous species of bacteria have been implicated with infections of endodontic origin . The purpose of this study was to compare the levels of serum IgG antibodies reactive with a panel of 10 oral anaerobic microorganisms implicated in infections of endodontic origin . Serum samples were collected from 4 patient groups that included healthy patients without endodontic or periodontal disease, patients with chronic adult periodontal disease, patients with endodontic disease and patients with combined endodontic-periodontal disease . When Prevotella intermedia was allowed to react with sera from the 4 patient groups, significant pairwise differences were shown between the healthy group and each of the other 3 groups . In addition, there was a significant difference between the periodontal disease group and the combined endodontic-periodontal disease group . When Porphyromonas gingivalis was allowed to react with sera from the 4 patient groups, significant pairwise differences were shown between the healthy group and the periodontal disease group, the healthy group and the combined endodontic-periodontal disease group, the endodontic disease group and the periodontal disease group and the endodontic disease group and the combined endodontic-periodontal disease group . The results of this investigation support other studies that associate P . intermedia with both endodontic disease and chronic adult periodontal disease . The results also support studies that implicate P . gingivalis as a periodontopathogen.

Clin Podiatr Med Surg, 1992 Apr, 9(2), 443 - 64
Aminoglycosides, imipenem, and aztreonam; Johnson JG et al.; The aminoglycosides continue to be the cornerstone of antibiotic therapy for serious infections caused by gram-negative aerobic pathogens, even with the recent introduction of potent beta-lactams and the fluoroquinolones . Two of these newer agents are imipenem and aztreonam . Imipenem is the most expensive commercially available antibiotic, but it has the broadest range of activity, including most gram-negative and gram-positive, aerobic and anaerobic bacteria . Aztreonam, the first monobactam antibiotic to be released, has excellent activity against aerobic, gram-negative bacteria . It is not, however, simply a nonnephrotoxic replacement for aminoglycoside therapy . This article reviews the basic pharmacology and clinical utility of the aminoglycosides, imipenem, and aztreonam.

Clin Podiatr Med Surg, 1992 Apr, 9(2), 409 - 23
Clindamycin, erythromycin, and the newer macrolides; Raebel MA et al.; Clindamycin continues to be an important agent for the management of infections due to gram-positive cocci and anaerobes . Such pathogens are frequently important in skin, soft tissue, and deep infections of the foot . Erythromycin has an impressive safety record and has retained its activity against many organisms, including several that play a role in infections of the foot . Clindamycin and erythromycin are frequently used as alternatives to the penicillins and cephalosporins . Newer macrolides, in comparison to erythromycin, have similar antimicrobial spectra of activity, improved pharmacokinetic parameters, and better tissue penetration . As new microorganisms emerge as clinical problems, newer macrolides may play a therapeutic role.

Wiad Lek, 1992 Apr, 45(7-8), 298 - 302
{Viruses and bacteria in the etiology of acute respiratory tract infections in young children}; Torbicka E; Respiratory infections in small children are among the major problems in paediatrics . They are caused most frequently by viruses or bacteria . The role played by certain types of respiratory viruses in these infections is discussed, considering selected subgroups of children and the seasonal incidence of infections . The usefulness of certain virological investigations in clinical diagnosis is analysed . In the description of bacterial respiratory infections in small children attention is called also to certain bacteria belonging to opportunistic commensals and the importance of anaerobes . The main stress is laid on infections of newborns and infants which may be connected with the transfer of pathogens from mothers . Attention is called to the necessity of close monitoring of the aetiological factors of acute respiratory infections in the youngest children which could increase the accuracy of therapeutic management and prophylactic measures which should be regarded as a very important factor in the control of these infections.

Am J Reprod Immunol, 1992 Apr-May, 27(3-4), 117 - 23
Interleukin-1 alpha and interleukin-1 beta in preterm and term human parturition; Romero R et al.; Interleukin-1 (IL-1) has been implicated in the mechanism of human parturition in the setting of infection . The purpose of this study was to determine the effect of labor (term and preterm) and microbial invasion of the amniotic cavity on amniotic fluid (AF) concentrations IL-1 alpha and IL-1 beta . AF was retrieved by transabdominal amniocentesis from the following groups of women: midtrimester genetic amniocentesis (16 to 18 wk) (N = 15), preterm labor with intact membranes (21 to 36 wk) with or without infection (N = 72), preterm premature rupture of membranes (PROM) (N = 88), and term not in labor or in active labor with or without infection (N = 58) . AF was cultured for aerobic and anaerobic bacteria as well as Mycoplasmas . IL-1 was measured with a commercially available immunoassay validated for AF (sensitivity: IL-1 alpha, 157 pg/ml; IL-1 beta, 50 pg/ml) . All women at midtrimester had undetectable AF IL-1 alpha and IL-1 beta . Among women in preterm labor with positive AF cultures, IL-1 alpha and IL-1 beta were detectable in the AF in 86.6% (13/15) and 100% (15/15), respectively . In contrast, all women with negative AF cultures without labor (N = 36) had undetectable AF IL-1 alpha concentrations and 52.7% (19/36) had undetectable AF IL-1 beta concentrations . Histopathological chorioamnionitis was present in 92.8% (13/14) of patients who had positive AF cultures and detectable IL-1 in the AF . IL-1 was significantly higher in patients with preterm PROM, labor, and positive AF cultures than in the other subgroups of patients with preterm PROM.(ABSTRACT TRUNCATED AT 250 WORDS)

Kansenshogaku Zasshi, 1992 Mar, 66(3), 382 - 9
{Colonization rates of Mobiluncus spp . in female lower genital tract and its relationship with bacterial vaginosis}; Kaneko T et al.; To clarify the colonization rate of Mobiluncus spp., 889 specimens were collected from the vagina and 688 specimens from the cervical canal in three groups of women, namely, non-pregnant women, pregnant women, and patients fulfilling the criteria of bacterial vaginosis . On screening, this organism was detected from the vagina in 18/576 cases (3.2%) in non-pregnant women and in 2/280 cases (0.7%) in pregnant women, and it was detected from the cervical canal in 12/410 cases (2.9%) in non-pregnant women, and 3/278 (1.1%) in pregnant women . Although the positive rates were slightly higher in non-pregnant women from both the vagina and cervical canal, they were not significant . However, in cases of bacterial vaginosis, the positive rate of Mobiluncus spp . was 9/33 cases (27.3%), so that it was significantly higher than in the other two groups . Although the role of Mobiluncus spp . in bacterial vaginosis has not been clarified, our results indicate that the presence of Mobiluncus spp . is abnormal, since its colonization rate in healthy women is too small to be regarded as a member of normal flora . G . vaqinalis and anaerobes (other than Mobiluncus spp.) are also closely connected to bacterial vaginosis . G . vaginalis alone was seen in 7/33 cases (21.3%), anaerobes alone in 7/33 (21.3%), and Mobiluncus spp . alone in 3/33 cases (9.1%) . Multiple infections including 2 or 3 of the above organisms were seen in 13/33 cases (39.3%), and all cases had anaerobes . On the other band, only three cases were infected by none of the above organisms.(ABSTRACT TRUNCATED AT 250 WORDS)

Eur J Clin Microbiol Infect Dis, 1992 Mar, 11(3), 260 - 2
Effect of several antimicrobial agents on ciprofloxacin uptake by human neutrophils; Garcia I et al.; The effect of antimicrobial agent active against anaerobes, gram-positive cocci and fungi on the uptake of ciprofloxacin by human neutrophils (PMNs) was evaluated . In the presence of therapeutic extracellular concentrations of these agents, ciprofloxacin reached high intracellular concentrations {cellular-to-extracellular ratio (C/E) greater than or equal to 2.9}, this value being higher in the presence of amphotericin B (C/E 6.3 +/- 0.9) . The intracellular penetration of ciprofloxacin was higher when PMNs were stimulated with opsonized zymosan (C/E greater than or equal to 5.6) . In summary, none of the antimicrobial agents tested significantly impaired the uptake of ciprofloxacin by human PMNs.

J Environ Pathol Toxicol Oncol, 1992 Mar-Apr, 11(2), 45 - 8
Patulin production by Penicillium granulatum and inhibition of ruminal flora; Escoula L; The maximum patulin production by Penicillium granulatum was obtained during the 16th day of culture at 26 degrees C (2.9 g/L) on liquid Czapek medium (+ 8 p . 1000 glucose), followed by 32 degrees C after 24 days and 20 degrees C after 32 days . At 26 degrees C patulin production was maximum before the greatest rate of sporulation when the pH of the medium was about 4 . Toxin production was studied by anaerobic culture for 75 days and then the cultures were exposed to ambient air . P . granulatum did not produce its toxin under anaerobic conditions . An in vitro fermentation model with rumen liquor was used, and within 4 hr acetic acid production declined and dose-dependent protein synthesis was inhibited with 20, 100, and 300 microgram patulin/mL rumen liquid.

JPEN J Parenter Enteral Nutr, 1992 Mar-Apr, 16(2), 122 - 8
Effect of a diet deficient in essential fatty acids on the translocation of intestinal bacteria; Barton RG et al.; Normal intestinal bacteria can initiate systemic disease by translocating out of the intestinal lumen to extraintestinal sites such as the mesenteric lymph nodes (MLN), liver, and spleen . To determine whether dietary essential fatty acids can affect the incidence of bacterial translocation, separate groups of mice were fed one of two diets for 8 days: an essential fatty acid-replete diet (EFA-R) containing a basal formula supplemented with arginine, yeast RNA, menhaden oil, and safflower oil, or an essential fatty acid-deficient diet (EFA-D) containing the same ingredients with the safflower oil replaced by menhaden oil . Mice were given either diet alone, diet plus 50 micrograms of intraperitoneal lipopolysaccharide (LPS), or diet plus 3 days of 4 mg of intramuscular metronidazole (MET) three times a day . (Both LPS and MET have been shown to increase the incidence of bacterial translocation to the MLN.) Within treatment groups there were no significant differences in the total numbers of viable ileal bacteria (separate quantitation of strict anaerobes, aerobic, and facultative Gram-positive results, and aerobic and facultative Gram-negative results) . The incidence of bacterial translocation to the MLN was increased in mice fed EFA-D as compared with EFA-R in mice treated with diet alone (17% vs 0%; p less than .005) and in mice treated with diet plus LPS (71% vs 48%; p = .027) . There was no difference in the incidence of bacterial translocation in mice fed EFA-D or EFA-R and treated with MET (83% vs 81%).

J Periodontol, 1992 Mar, 63(3), 200 - 5
The occurrence of periodontitis-related microorganisms in relation to titanium implants; Ong ES et al.; The peri-implant space was examined for the presence of periodontitis-related microorganisms in 19 patients . All patients had been fitted with osseointegrated titanium implants which were clinically sound at the time of examination and all had been prescribed daily 0.2% chlorhexidine mouthrinse . In 17 patients, two contralateral fixtures in patients were selected, the remaining 2 patients had only one fixture, and associated mucosal clinical variables assessed for plaque accumulation, gingival inflammation, bleeding tendency, and probing depth . The bacteriological composition of submucosal plaque samples was investigated using non-selective media and selective media for Actinobacillus actimomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) . The peri-implant tissues were healthy . Twenty-two of 37 sites had a greater proportion of anaerobes than aerobes . Aa was detected at one site . Pg was not cultivated, and Pi was present in 7 of 37 sites, comprising between 0.4% and 60.9% of the total anaerobic viable counts . Since the presence of any of these organisms may play a contributory role to the loss of the fixture, it is recommended that the submucosal plaque of implants be monitored regularly for the presence of these periodontitis-associated species.

Ugeskr Laeger, 1992 Feb 3, 154(6), 336 - 9
{Removal and storage of human bone for transplantation . Directives for infection control}; Angermann P et al.; When bone is transplanted from one person to another, a risk of simultaneous transfer of infectious material is present . Transfer of bacteria is commonest but transmission of Hepatitis virus and HIV have been described . In order to reduce this risk as much as possible, medical and social screening of the donors are recommended together with hepatitis B antigen test (HBsAg), hepatitis C antibody test (anti-HCV) and HIV antibody test . In addition, living donors are preferable on account of the better possibilities for screening . The risk of transfer of HIV is limited at present, if male donors are aged over 60 years and female donors are over 40 years . Removal of the tissue should always be undertaken under sterile conditions . Aerobic and anaerobic culture of multiple bone biopsies from the transplant on removal of the tissue are recommended . Neither freezing nor freeze-drying result in decontamination of the bone . Chemical methods and also irradiation are considered inadequate or injurious to the quality of the bone.

Appl Environ Microbiol, 1992 Feb, 58(2), 557 - 61
Anaerobic transformation and toxicity of trichlorophenols in a stable enrichment culture; Madsen T et al.; The transformation and toxicity of trichlorophenols (TCPs) were studied with a methanogenic enrichment culture derived from sewage sludge . Transformation of TCPs rapidly resumed after heating of the culture at *) degrees C for 1 h, suggesting that the dechlorinating bacteria are spore-forming anaerobes . 2,4,6-TCP was rapidly dechlorinated via 2,4-dichlorophenol to 4-chlorophenol . During the transformation of 2,4,6-TCP, the most probable number of dechlorinating bacteria increased by 4 orders of magnitude . The most extensive dechlorination was observed in media with complex carbon sources such as yeast extract, peptone, and Casamino Acids, but glucose, galactose, and lactose were also used by the consortium . Experiments using chloramphenicol indicated that the reductive dechlorination of 2,4,6-TCP was regulated by an inducible enzyme system . The highest initial concentration at which dechlorination of 2,4,6-TCP was observed was 400 microM . 2,4,5-TCP and 3,4,5-TCP were dechlorinated to, respectively, 3,4-dichlorophenol and 3-chlorophenol at initial concentrations of less than or equal to 40 microM . Toxicity for the acid-producing and methanogenic bacteria in the consortium was a function of chemical structure, as the inhibition of these activities increased from 2,4,6-TCP, via 2,4,5-TCP, to 3,4,5,-TCP.

J Clin Periodontol, 1992 Feb, 19(2), 127 - 34
The effects of antimicrobial acrylic strips on the subgingival microflora in chronic periodontitis; Wade WG et al.; This study investigated the effects of root planing and/or the placement of acrylic strips containing chlorhexidine, metronidazole or tetracycline on the composition and antimicrobial susceptibility of the subgingival flora in chronic periodontitis . 101 periodontal pockets from 73 patients were entered into 6 treatment groups which were, chlorhexidine, metronidazole or tetracycline strips, root planing, root planing followed by metronidazole strips and a control, no treatment group . Total anaerobic counts and anaerobe/aerobe ratios were estimated from samples taken before treatment and 1, 2, 4, 8 and 12 weeks after treatment . In addition, a more detailed analysis of the effects of the treatments on the subgingival flora was carried out on 12 pockets in 12 patients . Tetracycline strips, metronidazole strips and root planing and metronidazole strips were more effective than chlorhexidine strips in causing reductions in total anaerobic count and anaerobe/aerobe ratio . However, the changes in microbial parameters rebounded to approach baseline levels 4 weeks after treatment . Chlorhexidine caused no detectable changes in the composition of the subgingival microflora, while metronidazole had a variable effect . Tetracycline appeared to effect major shifts in the composition of the microflora of treated pockets but caused a marked selection of tetracycline-resistant organisms.

J Am Vet Med Assoc, 1992 Feb 1, 200(3), 351 - 4
Pneumothorax in a dog with a pulmonary abscess and suspected infective endocarditis; Forrester SD et al.; Nontraumatic pneumothorax was diagnosed in a dog with a pulmonary abscess and evidence of infectious endocarditis, including fever, mitral murmur, and vegetative lesion of mitral valve leaflets . Pneumothorax persisted after 4 days of continuous thoracic drainage . At exploratory thoracotomy, the diaphragmatic lung lobe was identified as the source of air leakage and was excised . Results of culturing of blood and lung tissue for aerobic and anaerobic bacteria were negative . Antibiotics were administered because of suspected bacterial endocarditis . Pneumothorax and fever resolved after surgical and medical treatments.

Gene, 1992 Feb 1, 111(1), 105 - 8
Partial purification and characterization of Ral8I, a class-IIS restriction endonuclease from Ruminococcus albus 8 which recognizes 5'-GGATC; Morrison M et al.; Heparin-agarose chromatography was used to isolate a restriction endonuclease (ENase) from the cellulolytic Gram+ anaerobe, Ruminococcus albus 8 . The enzyme, Ral8I, was eluted from the column using 230-310 mM Na+ . However, the preparation was active only with DNA substrates that were not Dam-methylated . Moreover, the restriction fragment pattern generated from simian virus 40 (SV40) DNA was not consistent with the expected number of Dam-methylation sites . Alignment of the Dam-methylation sites in SV40 DNA indicated that Ral8I may actually recognize the asymmetric sequence, GGATC . This was confirmed by nucleotide (nt) sequence analysis and, further, Ral8I was found to cause cleavage of the DNA approx . 5 nt downstream from the recognition sequence . Ral8I can therefore be classified as a type-IIS restriction endonuclease and is an isoschizomer of AlwI, BinI and BthII.

J Clin Microbiol, 1992 Feb, 30(2), 312 - 7
Microbiologic assessment of tissue biopsy samples from ileal pouch patients; Onderdonk AB et al.; Tissue biopsy samples from patients with and without ileal pouches were examined by electron microscopic and microbiologic culture techniques to determine the numbers and types of microorganisms closely associated with or within the tissue biopsy samples . The disease status of each patient was determined by endoscopic and histopathologic methods . Of the 78 biopsy samples included in this study, 64 (82%) yielded obligately anaerobic and/or facultative bacteria when they were cultured . Fourteen of the 78 samples (17.9%) were negative by culture . Of the positive samples, 54 contained facultatively anaerobic bacterial species and 50 yielded obligately anaerobic species . The total counts for facultatively anaerobic bacteria for samples from patients with pouchitis were significantly greater than for samples from patients in control groups . In addition, the number of samples from patients with normal pouches that did not contain obligate anaerobes was significantly less than that from patients with pouchitis; 4 of 23 and 6 of 12 samples, respectively (P less than 0.043) . For samples in which organisms were detected, there was agreement with electron microscopic detection of bacteria in 23 of 27 samples, for an overall sensitivity of electron microscopy compared with that of culture of 85% . The qualitative studies resulted in the characterization of 273 isolates comprising 77 different phenotypes . The specificity of these findings in patients with ileal pouchitis is discussed.

Bull Tokyo Dent Coll, 1992 Feb, 33(1), 1 - 6
Corroding characteristics of Eikenella corrodens; Shiozu I et al.; Fourteen strains of Eikenella corrodens isolated from human oral cavity were studied to determine corroding characteristics . Nine out of the 14 strains produced corroding colonies under anaerobic culture condition . One of them produced corrosion even in an aerobic culture . No morphological differences in surface structures were observed between corroding and non-corroding strains of E . corrodens by transmission electron microscopy . The morphology of corroding colonies of E . corrodens was then examined by scanning electron microscopy . The surface of the corroding-colony center was smoothly convex . A boundary line was clear between the smooth center and the surrounding corrosion region . Double or triple frill-like structures surrounded the center portion with small convexities . Spreading bacterial masses were observed in the outer portion of the colony . Morphological observations of the corroding colony edge indicated that a surface translocation termed "twitching motility" or "gliding motility" occurs in the outer portion and plays a role in its colonization of periodontal regions.

Arzneimittelforschung, 1992 Feb, 42(2), 156 - 9
Disk diffusion sensitivity testing and antibacterial activity of azithromycin; Davila D et al.; Azithromycin (CAS 83905-01-5) disks with the selected loading (10, 15, 20 micrograms) were used for determination of the most suitable azithromycin disk concentration . Estimation was carried out by means of the regression line related to the zone size inhibition . Testing was performed on a variety of freshly isolated gram-positive, gram-negative and anaerobic bacteria derived from various specimens collected from patients . Using the disk diffusion method with 10 micrograms of azithromycin per disk in total 431 gram-positive, 875 gram-negative bacterial strains and 59 anaerobic bacteria were analysed . It was concluded that azithromycin disk containing 10 micrograms is sufficient for determination of bacterial sensitivity.

J Anim Sci, 1992 Jan, 70(1), 281 - 8
In vitro effects of the ionophore lysocellin on ruminal fermentation and microbial populations; Kung L Jr et al.; Batch and continuous culture techniques were used to evaluate the effect of the ionophore lysocellin on ruminal fermentation and microbial populations . In batch culture, .5 and 1 ppm (of the fluid) lysocellin markedly decreased (P less than .01) the acetate:propionate ratio without affecting fiber digestion, ammonia concentration, or culture pH . Greater concentrations of lysocellin had negative effects (P less than .05) on fiber digestion and increased (P less than .05) culture pH . In continuous culture, a low level of lysocellin (33 ppm of the diet DM or about .7 ppm of the fluid) decreased pH (P less than .05) and methane (P less than .05) production but had no effect on fiber digestion . Lysocellin tended to increase (P less than .05) OM digestion in corn-based diets but decreased OM digestion in barley-based diets (starch source x lysocellin interaction, P less than .05) . In addition, the molar proportion of propionate was increased more in barley- than in corn-based diets . Total anaerobes and amylolytic and lactate-utilizing microorganisms were not affected by the ionophore . In continuous culture, cellulolytic and lactate-producing organisms were insensitive to lysocellin, but, in lysocellin-treated media, cellulolytic organisms were resistant, whereas lactic acid producers were sensitive to lysocellin at 4 ppm . In summary, the ionophore lysocellin alters ruminal fermentation by decreasing ruminal methane production and increasing the molar proportion of propionate; however, effects varied depending on whether corn or barley served as the primary starch source.

Br J Surg, 1992 Jan, 79(1), 58 - 9
Breast abscesses and cigarette smoking; Bundred NJ et al.; An 11-year retrospective review of women with breast abscesses presenting to a district general hospital was performed . A total of 122 women were identified with a breast abscess: 85 (70 per cent) with non-lactational abscesses and 37 (30 per cent) with an abscess in the puerperium . Six of 37 lactational and 24 of 85 non-lactational abscesses recurred . Sixteen mammillary fistulae developed, all following incision and drainage of non-lactational breast abscesses . Women with non-lactational breast abscesses were more likely to smoke cigarettes (P less than 0.005) . Breast abscesses containing anaerobic bacteria were significantly more likely to occur in current cigarette smokers (P less than 0.05) . Women with non-lactational breast abscesses who were heavy cigarette smokers were more likely to suffer recurrent abscesses (P less than 0.01) . There was histological evidence of duct ectasia on biopsy in 25 women with non-lactational abscesses and 21 of 25 were current smokers . Mammillary fistulae developed more frequently in current smokers (P less than 0.03) . Cigarette smoking is important in the natural history of non-lactational breast abscesses and may predispose to anaerobic breast infections and the development of mammillary fistulae.

Ann Otol Rhinol Laryngol Suppl, 1992 Jan, 155, 46 - 50
Medical and surgical management of sinusitis in adults; Richtsmeier WJ; Sinusitis may be caused by bacteria, viruses, or trauma and may appear in immunosuppressive settings . Acute sinusitis is most commonly diagnosed on the basis of pain and discharge; endoscopic or fiberoptic examination may be helpful in less obvious cases . Radiography can identify maxillary, frontal, and sphenoid sinusitis; transillumination can be used if radiography is undesirable . Culture and Gram stains may help determine the appropriate antibiotic therapy . Surgery may be necessary if the frontal or sphenoid sinus is involved, or if ethmoiditis is progressing to orbital cellulitis . In chronic sinusitis, endoscopic examination and computed tomographic scanning are useful for diagnosis . Chronic sinusitis may be associated with airway disease, aspirin allergy, and such diseases as cystic fibrosis . Antibiotic therapy that acts against anaerobes and beta-lactamase-producing organisms should be chosen . Surgical treatment includes intranasal and external ethmoidectomy, antrostomy, and, on occasion, obliteration of the involved cavity.

Clin Infect Dis, 1992 Jan, 14(1), 361 - 3
Osteomyelitis due to Veillonella parvula: case report and review; Singh N et al.; Anaerobic gram-negative cocci of the genus Veillonella are generally normal flora of the oropharynx and upper respiratory tract . When isolated in clinical specimens, these bacteria are usually regarded as commensal organisms rather than as pathogens . We report a case of spinal osteomyelitis in which Veillonella parvula was isolated in pure culture from bone as well as blood . Osteomyelitis of the spine due to anaerobic bacteria may occur more frequently than has been recognized, and anaerobic cultures of biopsy specimens should be routinely performed.

Med Hypotheses, 1992 Jan, 37(1), 20 - 3
The primordial thesis of cancer; Bradford RW et al.; We define The Primordial Thesis of Cancer, relating the nature and origin of cancer to the early history of the earth and the first appearance of life and noting that the initial absence of oxygen in the earth's atmosphere resulted in anaerobic microorganisms whose gene structure partly persists in present-day mammalian cells . Under various conditions a mammalian cell will transform from a respiratory state, requiring oxygen, to a glycolytic or cancerous state (primordial) not requiring oxygen, for the purpose of survival . Implicit in this thesis are useful therapeutic modalities, universal cancer screening potentials and new approaches to understanding the multiple 'causes' of cancer.

Arch Gynecol Obstet, 1992, 251(1), 1 - 7
Intraamniotic infection with fusobacteria; Chaim W et al.; A literature search produced ten studies in which Fusobacterium was cultured from amniotic fluid in women with preterm labor and intact membranes or with preterm premature rupture of membranes (PROM) . Fusobacterium was isolated in 9.9% (9/91) of positive amniotic fluid cultures in women with preterm PROM and in 28.3% (17/60) of positive amniotic fluid cultures in women presenting with preterm labor and intact membranes . Fusobacterium plays a previously unrecognized role in the pathogenesis of premature labor and delivery . Amniotic fluid culture for anaerobes, specifically Fusobacterium, is suggested for all women who present with premature labor and intact membranes and do not respond to tocolytic drugs.

Appl Environ Microbiol, 1992 Jan, 58(1), 409 - 11
Specific deuteration of dichlorobenzoate during reductive dehalogenation by Desulfomonile tiedjei in D2O; Griffith GD et al.; Desulfomonile tiedjei DCB-1 is a strict anaerobe capable of reductively dechlorinating meta-chlorobenzoates . To probe the mechanism of this aryl dechlorination, we incubated cell suspensions of D . tiedjei in D2O and with 2,5-dichlorobenzoate . The deuterium was incorporated into the dechlorination product exclusively at the position of dehalogenation, as shown by gas chromatography-mass spectrometry and proton magnetic resonance analyses . These results favor a model for dechlorination that should not allow proton exchange at other positions, as would be the case if partial ring reduction occurred.

Arch Microbiol, 1992, 157(3), 290 - 6
Fermentative degradation of glutarate via decarboxylation by newly isolated strictly anaerobic bacteria; Matthies C et al.; Two strains of new strictly anaerobic, gram-negative bacteria were enriched and isolated from a freshwater (strain WoG13) and a saltwater (strain CuG11) anoxic sediment with glutarate as sole energy source . Strain WoG13 formed spores whereas strain CuG11 did not . Both strains were rod-shaped, motile bacteria growing in carbonate-buffered, sulfide-reduced mineral medium supplemented with 2% of rumen fluid . Both strains fermented glutarate to butyrate, isobutyrate, CO2, and small amounts of acetate . With methylsuccinate, the same products were formed, and succinate was fermented to propionate and CO2 . No sugars, amino acids or other organic acids were used as substrates . Molar growth yields (Ys) were very small (0.5-0.9 g cell dry mass/mol dicarboxylate) . Cells of strain WoG13 contained no cytochromes, and the DNA base ratio was 49.0 +/- 1.4 mol% guanine-plus-cytosine . Enzyme activities involved in glutarate degradation could be demonstrated in cell-free extracts of strain WoG13 . A pathway of glutarate fermentation via decarboxylation of glutaconyl-CoA to crotonyl-CoA is suggested which forms butyrate and partly isobutyrate by subsequent isomerization.

Pharmacotherapy, 1992, 12(6 Pt 2), 50S - 63S
Selective decontamination of the digestive tract as an infection-control measure in intensive care unit patients; Occhipinti DJ et al.; Infection is responsible for a large percentage of morbidity and mortality in intensive care unit (ICU) patients . Conventional infection-control measures are directed at decreasing infection by exogenous sources and have had variable success in significantly reducing nosocomial infection rates . Selective gastrointestinal decontamination with topical nonabsorbable antibiotics attempts to reduce infection by eliminating intestinal mucosal colonization by pathogenic microorganisms . These antibiotics are selectively bactericidal against gram-negative organisms and yeasts, thereby leaving the normal flora (mainly anaerobes) unharmed . In the majority of clinical trials, selective decontamination effectively reduced colonization and infection among ICU patients, with the most significant reductions observed in gram-negative respiratory infections . Resistance to the antimicrobials was not documented in the majority of trials; however, follow-up periods were minimal and may not have been adequate to detect selection of resistant strains . Reductions in infection do not alter mortality; however, patients without significant underlying disease appear to be the subgroup that will most likely benefit.

Schweiz Monatsschr Zahnmed, 1992, 102(11), 1321 - 6
{The microbial colonization of implant elements made of plastics and titanium}; Wahl G et al.; 12 edentate subjects wearing lower complete dentures stabilized by an IMZ-implant-supported Dolder bar took part in the experiment . Elastic (POM) and titanium connection parts were alternatingly inserted . After the removal of 24 POM and titanium elements from each of the patients, a qualitative analysis of the microbial flora was performed . Except for actinomycetes, aerobic as well as anaerobic microorganisms were found less frequently with titanium than with POM elements.

Ann Biol Clin (Paris), 1992, 50(4), 239 - 45
{An automatic gas scanning device, technical improvement for obtaining a favourable atmosphere for in vitro culture of anaerobic bacteria}; Willemot JM et al.; All methods for growth of anaerobic bacteria on solid media depend on the elimination of atmospheric O2 through use of a palladium catalyst (Deoxo-Catalyst), active in presence of at least 5% H2 with resultant formation of water . Anaerobic chambers and jars are the two conventional methods employed . Both are based on the elimination of air by means of a pump and its replacement with gas from a cylinder (evacuation-replacement technique) . An alternative chemical technique for use in anaerobic jars consists of adding internal gas-generating sachets . The former techniques are more efficient but the trend, particularly in the clinical laboratories, is to use the simpler chemical system that has two inconveniences: a slow establishment of anaerobiosis, and a high cost . We propose a new system that does not require a vacuum pump and consists in flushing anaerobic jars with a convenient gas mixture (H2, CO2, N2: 4.5; 5; 90.5 v/v) by means of an automaton regulating both time and gas flow . Gas-liquid chromatography analysis of the gas inside the jar shows a rapid elimination of gaseous O2, whose residual concentration is low enough to permit growth of all anaerobes of clinical interest, including those which are more O2-sensitive . Comparative qualitative and quantitative data obtained with all available techniques demonstrate the advantages of the new system.

Acta Physiol Scand Suppl, 1992, 607, 97 - 103
Structure and function of the Na(+)-translocating ATPase of Propionigenium modestum; Dimroth P; The strict anaerobic bacterium Propionigenium modestum performs a Na+ cycle over the membrane to couple ATP synthesis to the decarboxylation of methyl-malonyl-CoA . The responsible ATPase has a typical F1F0 structure, the water-soluble F1 moiety being composed of five different subunits and the more firmly membrane-bound F0 part consisting of three different subunits . The F1F0 ATPase but not F1 alone was specifically activated by Na+ ions, suggesting that the Na+ binding site is located on the F0 moiety . The ATPase reconstituted into proteoliposomes catalyzed an ATP-dependent Na+ accumulation that was stimulated to the same extent by dissipating the membrane potential with valinomycin or with the uncoupler carbonylcyanide-m-chloro phenylhydrazone . The transport of Na+ is therefore a primary event, not a secondary event involving the intermediate formation of a proton gradient . The ATPase also catalyzed H+ translocation at Na+ concentrations below 1 mM . Our results indicate a common mechanism of the ATPase for Na+ and H+ (H3O+) translocation and a switch from H+ to Na+ translocation by increasing the Na+ concentration . A hybrid ATPase consisting of F1 from E . coli and F0 from P . modestum had the same specificity with respect to the translocated cations as the homologous F1F0 ATPase of P . modestum, indicating again that the Na+ (H+) binding site is located on the F0 part . Also in accord with this supposition is a diffusion potential-induced translocation of Na+ or H+ through the F0 part of the enzyme complex . The phylogenetic relationship between the Na(+)-translocating ATPase of P . modestum and other F1F0 ATPases has been clearly demonstrated by sequencing studies.

Pharm Acta Helv, 1992, 67(5-6), 148 - 51
Antimicrobial activity of naphtoquinones and Allium extracts combined with antibiotics; Didry N et al.; Combinations of antibiotics and known antimicrobial natural products, naphtoquinones and Allium extracts, were investigated . The chessboard broth method was applied to assess the activity of these combinations against aerobic and anaerobic bacteria . If no antagonism was observed, the combinations studied lead from partial to total synergism, mainly against aerobic bacteria.

Ciba Found Symp, 1992, 167, 205 - 20; discussion 220-3
Interleukin 6 determination in the detection of microbial invasion of the amniotic cavity; Romero R et al.; A growing body of evidence suggests a role for cytokines in the mechanisms responsible for preterm parturition associated with intrauterine infection . Interleukin 6, a polyfunctional cytokine that is secreted by tissues in the feto-maternal interface in response to microbial products, has been implicated in the host response to intrauterine infection . The purpose of this study was to establish whether measurement of amniotic fluid concentrations of interleukin 6 could be of value in the diagnosis of microbial invasion of the amniotic cavity . Fluid was obtained by transabdominal amniocentesis from patients with preterm labour and intact chorioamniotic membranes and cultured for aerobic and anaerobic bacteria and mycoplasmas . Interleukin 6 concentrations were determined by an ELISA validated for human amniotic fluid . An interleukin 6 concentration above 11.2 ng/ml had a 93.7% sensitivity and a 92.3% specificity in the diagnosis of intra-amniotic infection . Moreover, patients with an amniotic fluid interleukin 6 level above 11.2 ng/ml and a negative amniotic fluid culture failed to respond to tocolysis, delivered a preterm infant and showed histological evidence of chorioamnionitis, and their neonates were at risk for congenital infections.

Arch Med Res, 1992, 23(2), 223 - 5
Bile salts promote adherence-decreasing effect of colonic luminal hydrolases on Entamoeba histolytica; Variyam EP; E . histolytica trophozoites cultivated for > 7 h in the presence of glycosidases, produced by a subset of the colonic anaerobic bacteria of healthy humans, and pancreatic proteases show decreased adherence to Chinese hamster ovary epithelial cells . Since activities of the glycosidases are enhanced by bile salts we investigated whether bile salts would enhance the E . histolytica-CHO cell adherence decreasing effects of the luminal hydrolases (glycosidases plus proteases) . CHO cell adherence of control trophozoites was 78.4 +/- 1.2% (mean +/- SEM) . Incubations with the hydrolases alone for 4 h did not change adherence . Addition of 5.0 mM sodium taurocholate to the hydrolases for 4 h decreased trophozoite adherence to 30.5 +/- 3.2% of that of control trophozoites (p < 0.05) . The effect of sodium taurocholate was dose dependent over 0.5-5.0 mM . Four hour incubation with the hydrolases and sodium taurodeoxycholate at 2.0 and 5.0 mM also decreased trophozoite adherence to 25.1 +/- 2.9% and 29.4 +/- 1.7%, respectively, of that of control trophozoites . These findings show that bile salts enhance the effects of luminal hydrolases on E . histolytica trophozoites, decreasing their ability to adhere to epithelial cells.

Arch Oral Biol, 1992, 37(7), 515 - 20
Correlation of haemagglutination activity with trypsin-like protease activity of Porphyromonas gingivalis; Hoover CI et al.; Porphyromonas gingivalis is a Gram-negative anaerobic bacterium associated with various forms of periodontal disease . Several characteristics of P . gingivalis are thought to contribute to its pathogenicity; these include haemagglutination and trypsin-like protease activity . Previous studies suggest an association between haemagglutination and trypsin-like protease activity of P . gingivalis . To investigate this, two complementary quantitative experimental approaches were taken . Five independent mutants of P . gingivalis deficient in trypsin-like protease activity were shown to exhibit reduced haemagglutination activity . In addition, enhancers (cysteine and dithiothreitol) and inhibitors (N-ethylmaleimide, N-p-tosyl-L-lysine-chloromethyl ketone, and phenylmethylsulphonyl fluoride) of trypsin-like protease activity were shown, respectively, to significantly enhance and inhibit haemagglutination activity of washed, wild-type P . gingivalis cells (p less than 0.05, paired t-test) . Statistical analysis indicated a strong correlation between haemagglutination and trypsin-like protease activity (r = 0.85, p less than 0.001, Spearman rank correlation) . The effect of the protease enhancers and inhibitors on haemagglutination activity was specific for P . gingivalis, as they did not significantly change the haemagglutination activity of Fusobacterium nucleatum . These results suggest that the proteolytic site of the trypsin-like protease participates in haemagglutination activity of P . gingivalis.

Med Dosw Mikrobiol, 1992, 44(1-2), 61 - 7
{Rapid preliminary diagnosis of anaerobic bacterial infections . II . Investigation of the presence of volatile and non-volatile fatty acids (C1-C6) in pus, purulent fluids and dressing by application of gas chromatography}; Kalowski M et al.; Studies were performed in the years 1986-1990 and dealing with 405 clinical materials originating from infections within the abdominal cavity, maxilla, reproductive organ, post-operative wounds as well as dressings, extremities, blood, bile and other types of material and usefulness of analysis by gas chromatography of presence of lower fatty acids in materials for rapid and preliminary diagnostics with strictly anaerobic bacteria was confirmed . Presence in chromatograms of isobutyric, butyric isovaleric, valeric, isocaproic and caproic acid, and partly of propionic acid, is a good indication of infection with strictly anaerobic bacteria . Moreover, presence of succinic acid may suggest presence of anaerobic infection, similarly as presence in chromatograms of three or more various lower fatty acids . Rapid, approximative diagnosis of anaerobic bacteria by application of gas chromatography is worth of broader application . Investigation of clinical material by this method lasts only 1-2 hours and obtained results my present a basis for preliminary diagnosis of the etiological factor and for direction of chemotherapy, which is very important in most early period of treatment of infections.

Med Dosw Mikrobiol, 1992, 44(1-2), 55 - 60
{Rapid preliminary diagnosis of anaerobic bacterial infections . I . Natural fluorescence of pus, purulent fluids and dressing under UV radiation}; Kalowski M et al.; For evaluation of usefulness of natural fluorescence of clinical materials in UV radiation as rapid diagnostic method of infections with anaerobes, 405 samples of pus, bloody-purulent fluids, blood, wound secretions, dressings and other materials were investigated . Occurrence of red-brick UV fluorescence of clinical materials was compared with results of culture aimed at isolation of non-sporeforming anaerobes from "B . melaninogenicus group (P . melaninogenica, P . intermedia and P . saccharolytics) . Significant correlation red-brick fluorescence of clinical materials resulting from UV irradiation with presence in these materials of anaerobes such as P . melaninogenica, P . intermedia and P . asaccharolytics was detected . Investigation of clinical materials with application of fluorescence in UV radiation lasts only 1-2 minutes and together with preparation and microscopical inspection which is Gram-stained--only 15-20 min . Positive results of this test may constitute a basis for rapid, preliminary identification of the etiologic factor and for direction of chemotherapy in the early period of infection.

APMIS Suppl, 1992, 30, 40 - 3
In vitro antimicrobial activity of 18 phenothiazine derivatives: structure-activity relationship; Bourlioux P et al.; The antimicrobial activity of 18 phenothiazine derivatives has been evaluated against aerobic and anaerobic bacteria . The mean of the MIC reveals five active drugs against the bacterial strains tested: thioridazine, chlorpromazine, trifluoperazine, fluphenazine and triflupromazine . The other derivatives are less active and some show no antimicrobial activity . It seems that in vitro antibacterial activity alone is insufficient to explain certain intestinal diseases linked to the use of these molecules in psychiatry.

Cas Lek Cesk, 1991 Dec 27, 130(26), 715 - 22
{Lincosamide antibiotics}; Vacek V; A survey of microbiological and pharmacological properties of, of clinical experience with and of untoward reactions of lincomycin and clindamycin has been presented . Both antibiotics are active against gram-positive aerobic and many anaerobic bacteria . As to anti-anaerobic activity, clindamycin is superior to lincomycin . Consequently, anaerobic infections are main indication for clindamycin in clinical practice . On the other hand, lincomycin shows excellent penetration into body fluids and tissues and its dosage can be adapted to actual clinical situation in a very wide range . Recently, combinations of clindamycin with other drugs have proved effective in the treatment of falciparum malaria as well as of acute toxoplasmosis and Pneumocystis pneumonia in AIDS patients . Both lincomycin and clindamycin play still an important role in chemotherapy of infections.

J Bone Miner Res, 1991 Dec, 6(12), 1367 - 71
No evidence for an effect of lactase deficiency on bone mass in pre- or postmenopausal women; Slemenda CW et al.; The potential role for lactase deficiency in the development of low bone mass was examined in 342 adult female twins . Diminished lactase activity, defined as greater than 20 ppm increase in expired hydrogen at 2 or 2.5 h after an oral lactose load, was examined: (1) by comparing bone mass between members of twin pairs discordant for lactase activity; (2) by examining the linear association between bone mass and total expired hydrogen gas; and (3) by comparing all lactase-deficient individuals to those with persistent lactase activity . Among members of discordant (primarily DZ) pairs, the lactase-deficient member had greater bone mass 54% of the time . The correlations between the increase in expired hydrogen and bone mass at various sites were between -0.02 (femoral neck) and 0.11 (midshaft radius), suggesting no association between these variables . Finally, all lactase-deficient subjects were compared with those with normal lactase activity, regardless of twin status, and at each skeletal site the differences in bone mass were 1% or less . Thus, all primary hypotheses were not supported by these data; that is, in this large sample we could find no evidence of a detrimental effect of lactase deficiency on adult bone mass . However, baseline expired hydrogen was consistently and positively associated with bone mass at all sites, independently of age, suggesting the possibility that some aspect of intestinal function related to the activity of bacterial anaerobes may be positively associated with bone mass.

Antimicrob Agents Chemother, 1991 Dec, 35(12), 2606 - 10
Penetration of cefotaxime and desacetylcefotaxime into brain abscesses in humans; Sjolin J et al.; Since clinical trials comparing the efficacies of different antibiotic regimens for treatment of brain abscesses are difficult to perform, the choice of antibiotics must rely on the antibacterial spectrum and the ability of the drug to penetrate into the abscess fluid . The aim of this investigation was to study the ability of cefotaxime and its active metabolite desacetylcefotaxime to penetrate into brain abscesses . Eight patients were given 3 g of cefotaxime intravenously every 8 h . Abscess fluid samples, obtained at surgery at various times after dosing, and blood samples were analyzed for their concentrations of cefotaxime and desacetylcefotaxime by using a newly developed microbiological assay . The brain abscess concentrations of cefotaxime and desacetylcefotaxime were 1.9 +/- 1.7 and 4.0 +/- 2.2 mg/liter, respectively . Simultaneous concentrations in plasma were 2.0 +/- 1.0 and 3.9 +/- 1.8 mg/liter, respectively . With increasing time following cefotaxime dosing there was a significant increase in the abscess:plasma concentration ratio of desacetylcefotaxime . Since both cefotaxime and desacetylcefotaxime penetrate well into the brain abscess, reaching concentrations above the MIC for probable bacteria except gram-negative anaerobes, it is concluded that cefotaxime in combination with metronidazole may be used as an alternative in the treatment of brain abscesses.

FEMS Microbiol Lett, 1991 Dec 1, 68(3), 319 - 23
Iron content and FNR-dependent gene regulation in Escherichia coli; Niehaus F et al.; The significance of intracellular iron levels of Escherichia coli on the expression of the fumarate reductase operon (frd), which is regulated by the transcriptional activator FNR, was studied in vivo . The iron contents of aerobically and anaerobically grown E . coli were determined and related to the expression of frd and of genes (fiu, fepA, fhuF) which are regulated by the iron uptake regulatory protein Fur . The iron contents varied from 1.6 to 6.9 mumol Fe/g protein with no significant difference in aerobic and anaerobic bacteria . Expression of frd was not related to the different iron levels, but to oxygen supply . Only severe iron limitation in iron-depleted medium, which caused lower iron contents (0.8 to 1.6 mumol/g), reduced the expression of frd under anaerobic conditions . On the other hand, expression of fiu, fepA and fhuF clearly responded to iron supply and cellular content, but only slightly to changed O2 supply . Generally, expression of frd responded only to much stricter iron limitation, than expression of Fur regulated genes . It is concluded that the functional state of FNR during aerobic/anaerobic switch is not regulated by iron content and reversible binding of Fe2+ under physiological conditions . Therefore FNR does not communicate with the iron pool regulating the Fur protein.

Dan Med Bull, 1991 Dec, 38(6), 481 - 5
Wound contamination and postoperative infection . A review; Raahave D; The risk of postsurgical infection is closely related to the type of operation performed . Wound sampling by Raahave's velvet pad method shows that operation wounds harbour ordinary aerobic and anaerobic commensals after incision (exogenous flora) . When bacteria-containing viscera are opened or found perforated, bacterial densities increase significantly before wound closure (endogenous flora) . Contamination level justifies the criteria for use of wound class, i.e . clean, potentially contminated, contaminated and dirty . There is a dose-response relationship between the density of bacteria during operation and postsurgical wound sepsis . The median infective dose of aerobic and anaerobic bacteria is 4.6 x 10(5) CFU x cm-2 wound . The surgeon opens up tissue planes which are primarily sterile and breaks natural barriers . However, using a trained technique, the surgeon should be able to control wound contamination safely throughout the operation . Although hos immunity and tissue resistance intervene between contamination and infection, the magnitude of contamination seems crucial . It ought to be axiomatic by now that reducing bacterial contamination reduces infection.

Zentralbl Bakteriol, 1991 Dec, 276(1), 1 - 8
A modified procedure for the identification of anaerobic bacteria by high performance liquid chromatography--quantitative analysis of short-chain fatty acids; Krausse R et al.; We have developed a new rapid method for analysing volatile and non-volatile short-chain fatty acids using high-performance liquid chromatography . Within 50 min, 22 fatty acids in a standard mixture could be detected in a single chromatographic run . The fatty acids released by anaerobic bacteria in the culture media were ether-extracted and analysed with an Aminex HPX-87H column . Using a microprocessor-controlled chromatography unit, a quantitative analysis of the fatty acids produced in bacterial cultures was possible . Resolution, rapidity and sensitivity were improved as compared to previous methods by using an eluent of 5% acetonitrile in 0.01 N H2SO4 and changing the column temperature to 35 degrees C.

APMIS, 1991 Dec, 99(12), 1083 - 8
Darkening of haemoglobin in simulated, continuously agitated aerobic blood cultures: an early indicator of bacterial growth; Prag J et al.; The change of purple oxyhaemoglobin to the darker reduced haemoglobin and methaemoglobin was used as an initial visual growth indicator in continuously agitated, aerobic Colorbact bottles after inoculation with a broad assortment of aerobic and facultatively anaerobic bacteria previously isolated from blood cultures . Growth of all the faster growing strains could be detected by darkening of the blood cultures within a 24 h period of agitation, after they had stood unshaken for eight h . The darkening was accompanied by consumption of O2 and acidification of the fluid media . The slower growing bacteria were detected by turbidity . This growth detection method is easy, quick, inexpensive and reliable, and is especially promising for application in clinical microbiological departments which daily receive blood cultures from peripheral hospitals.

J Can Dent Assoc, 1991 Dec, 57(12), 937 - 9
Comparison of two popular methods for removal and killing of bacteria from dentures; Chan EC et al.; A study was undertaken to compare the efficacy of a soaking solution (Efferdent Extra-Strength Denture Cleanser Tablets) to mechanical cleaning with a denture paste (Advanced Formula Dentu-Creme Denture Cleaning Paste) to remove and kill plaque bacteria from removable dentures . The study was conducted in a randomized, four-way crossover fashion with 18 subjects . At each clinic visit, subjects were randomized to one of four treatment regimens: 1) no treatment; 2) brushing with denture paste; 3) soaking in Efferdent; 4) brushing followed by soaking in Efferdent . Microbiological sampling for plaque bacteria was made before and after each treatment . Aliquot samples of 10-fold serial dilutions were plated on supplemented Schaedler Agar (for total anaerobes) and on CVE agar (for fusobacteria) . Analysis of covariance was performed on the log10 transformed scores at posttreatment using the pre-treatment scores as covariates . Significant treatment effects were: F(3,41) = 81.60, p less than 0.001 for anaerobes and F(3,50) = 104.38, p less than 0.001 for fusobacteria . Pairwise comparisons using Tukey hsd post hoc tests showed that for total anaerobes, treatments 1 and 2 yielded higher scores than treatments 3 and 4 . For fusobacteria, treatment 1 greater than 2 greater than 3 or 4; no difference between treatments 3 and 4 . The results demonstrated the superior performance of Efferdent over Dentu-Creme.

Unfallchirurg, 1991 Dec, 94(12), 619 - 23
{Organization of a bone bank}; Stutzle H et al.; The transmission of infectious diseases by allografts from bone banks has led to considerable restrictions on bone transplantations . HIV and hepatitis are considered to be the most dangerous diseases transmitted in this way . To prevent the transmission of any infections, extensive precautions have to be applied when allografts are taken and during their storage . Donors have been checked for infectious diseases at the time of collection and 3 months later . In addition, the donated grafts must be cultured for aerobic and anaerobic bacteria . This elaborate series of tests can only be mastered if the bone bank is tightly organised . The number of available grafts also be increased by sterilisation and the use of demineralised bone matrix.

J Biol Chem, 1991 Nov 5, 266(31), 20687 - 93
Characterization of the NiFeCO complex of carbon monoxide dehydrogenase as a catalytically competent intermediate in the pathway of acetyl-coenzyme A synthesis; Gorst CM et al.; Many anaerobic bacteria fix CO2 via the acetyl-CoA pathway . Carbon monoxide dehydrogenase (CODH), a key enzyme in the pathway, condenses a methyl group, a carbonyl group from CO, CO2, or the carboxyl group of pyruvate, and CoA to form acetyl-CoA . When treated with CO, CODH exhibits an EPR signal which results from an organometallic complex containing nickel, at least 3 iron, and CO and has been referred to as the NiFeC signal . Although this EPR signal has been presumed to be the spectroscopic signature of the enzyme-bound C-1 precursor of the carbonyl group of acetyl-CoA, its catalytic relevance had not been rigorously studied . We have demonstrated the catalytic competence of this NiFeC species by showing that the rate of formation of the NiFeC EPR signal is faster than the rate of an isotope exchange reaction between CO and acetyl-CoA, a partial reaction in the overall synthesis . Generation of the NiFeC signal in the absence of CO by acetyl-CoA has been demonstrated and requires a one-electron reduction at a midpoint potential of -541 mV versus the standard hydrogen electrode . In addition, we have observed and characterized an isotope exchange reaction between the carbonyl group of acetyl-CoA and the carbonyl group of the NiFeC complex, indicating that the C in the NiFeC complex is in the form of CO . These combined results demonstrate that the NiFeCO complex exhibits the characteristics expected of the precursor of the carbonyl group of acetyl-CoA.

Dig Dis Sci, 1991 Nov, 36(11), 1601 - 5
Colonic fermentation of potato starch after a freeze-thaw cycle; Scheppach W et al.; To estimate colonic carbohydrate fermentation following a potato meal, 13 healthy volunteers consumed 375 g potatoes containing 60 g starch on three different occasions in random order: (A) potatoes boiled and consumed fresh at 60 degrees C; (B) potatoes boiled, frozen, thawed and consumed at 20 degrees C; and (C) potatoes boiled, frozen, thawed, reheated to 90 degrees C, and consumed at 60 degrees C . End-expiratory breath hydrogen (H2) was measured every 15 min for 10-14 hr with a selective electrochemical cell . The extent of colonic carbohydrate fermentation (AUC = area under the breath H2 concentration vs time curve) in experiment B was significantly higher (+186%, P less than 0.002) than in experiment A . The breath hydrogen AUC in experiment C was higher than in experiment A (+48%, P less than 0.04) but lower than in experiment B (-94%, P less than 0.003) . It is suggested that structural alterations of the starch molecule occur during freezing, thawing, and reheating and alter the availability of carbohydrates for fermentation by colonic anaerobes.

Rev Infect Dis, 1991 Nov-Dec, 13(6), 1115 - 9
Disseminated pelvic actinomycosis presenting as metastatic carcinoma: association with the progestasert intrauterine device; Perlow JH et al.; Actinomycosis is caused by the anaerobic bacterium Actinomyces israelii . Asymptomatic colonization of the cervix with this organism has been noted in users of an intrauterine device (IUD), and its prevalence ranges between 1.6% and 36% . Rarely, symptomatic infection may occur, with the potential for extensive morbidity and even death . Herein we report a patient who survived severe disseminated actinomycosis yet presented with the clinical picture of a metastasized malignancy . This is the first report of disseminated pelvic actinomycosis presenting as an external lesion of the abdominal wall and in which a Progestasert IUD (Alza, Palo Alto, CA) was present . The common difficulty, and thus delay, in diagnosing this disease led to considerable morbidity due to an infection considered curable with penicillin . We recommend that all patients with an IUD or a history of IUD use have such information made known to those responsible for interpreting the Papanicolaou smear . Such knowledge may heighten suspicion and focus attention on the identification of these organisms before onset of clinical disease . It is important to consider this disease when caring for patients with an IUD or when counseling those contemplating its use as a contraceptive.

Ann Acad Med Singapore, 1991 Nov, 20(6), 808 - 11
Actinomycosis of the brain; Oh HM et al.; Actinomyces species are rare but treatable causes of central nervous system infection . A case of actinomycotic cerebral abscess is reported . The primary source of infection was probably the lung based on radiological findings although culture of the bronchial brushings was negative . The patient had surgical excision and repeated drainage with two prolonged causes of antibiotic therapy . At follow-up examination 36 months later, the patient was well except for a residual left hemiplegia . Diagnosis of cerebral actinomycosis can be made by anaerobic culture of the appropriate specimens or on histologic grounds . Optimal management combines adequate surgical drainage and prolonged antibiotic therapy.

Stomatologiia (Mosk), 1991 Nov-Dec, (6), 8 - 10
{The effect of nitazole preparations on the microflora in periodontitis}; Oleinik II et al.; Twenty-three patients with generalized periodontitis were examined . Microbiologic examination of the periodontal pouch contents, making use of anaerobic cultivation, resulted in isolation and identification of 103 strains, 76 (72.8%) of which were referred to obligate anaerobes . Facultative anaerobes made up 27.2% of the total number of the isolates . Therapy with water-soluble nitasole resulted in reduction of the number of microorganisms, decrease or arrest of pus discharge from the pouch, resolution of the edema and gingival ridge hyperemia, etc . Diffusion of nitasole (water-soluble) and cliostom from various dressings used in periodontitis was studied and the efficacy of combining these dressings revealed.

Jpn J Antibiot, 1991 Nov, 44(11), 1240 - 9
{Pharmacokinetic and clinical studies on flomoxef in neonates and premature infants}; Akita H et al.; Studies were made on pharmacokinetics, clinical effects and influence on intestinal bacterial flora in neonates upon administration of flomoxef (FMOX), and the results obtained are summarized as follows: 1 . Serum concentrations of FMOX after intravenous administration of 20 mg/kg/dose were 48.5 micrograms/ml in 30 minutes, 33.0 micrograms/ml in 1 hour and 7.3 micrograms/ml in 6 hours . The T 1/2 was 2.7 hours . FMOX at a dose of 40 mg/kg was given to only one new born baby on the 1st day after birth, and serum concentrations were 73.6 micrograms/ml in 30 minutes, 55.9 micrograms/ml in 1 hour and 16.9 micrograms/ml in 6 hours . The T 1/2 was 4.60 hours . 2 . FMOX was administered to 21 neonates between 0 and 32 days of age . Clinical effects were evaluable in 8 of 21 cases . The results were excellent in 2 cases, good in 5 cases and poor in 1 case . Of the 21 cases, diarrhea in 1 case, elevation of eosinophile in 2 cases (9.5%), elevation of platelet count in 3 cases (14.3%), and elevation of GOT in 2 cases (9.5%) were recognized during treatment . 3 . FMOX was detected in feces at levels of 0.84-44.4 micrograms/g . Except for a slight decrease in numbers of anaerobes, little fluctuations of intestinal flora were observed during treatment.

J Antimicrob Chemother, 1991 Nov, 28(5), 727 - 30
Effect of antimicrobial agents on the uptake of ofloxacin and its optically active isomer (-)-ofloxacin by human polymorphonuclear leucocytes; Pascual A et al.; The effect of several antimicrobial agents, active against Gram-positive cocci, anaerobes or fungi on the intracellular penetration of ofloxacin and its optically active isomer (-)-ofloxacin into human polymorphonuclear leucocytes (PMNs) was studied . In the presence of therapeutic extracellular concentrations of these drugs, both ofloxacin and (-)-ofloxacin reached high intracellular concentrations (cellular to extracellular ratio (C/E greater than 3) . Ofloxacin and (-)-ofloxacin uptake by PMNs was higher when cells were stimulated with opsonized zymosan (C/E greater than 5) . It is concluded that none of the antimicrobial agents studied significantly affected the uptake of both quinolones by human PMNs.

Drugs, 1991 Nov, 42(5), 825 - 76
Ofloxacin . A reappraisal of its antimicrobial activity, pharmacology and therapeutic use; Todd PA et al.; Ofloxacin is a fluoroquinolone whose primary mechanism of action is inhibition of bacterial DNA gyrase . In vitro it has a broad spectrum of activity against aerobic Gram-negative and Gram-positive bacteria, although it is poorly active against anaerobes . Ofloxacin, unlike most other broad spectrum antibacterial drugs, can be administered orally as well as intravenously . Penetration into body tissues and fluids is highly efficient . Clinical trials with orally and intravenously administered ofloxacin have confirmed its potential for use in a wide range of infections, where it has generally proved as effective as standard treatments . Ofloxacin in well tolerated, and in comparison with other available fluoroquinolones is less likely to cause clinically relevant drug interactions . Ofloxacin thus offers a valuable oral treatment (with an option for intravenous administration if necessary) for use in a wide range of clinical infections, but with a particular advantage in more severe or chronic infections when recourse to parenteral broad spectrum agents would normally be required, thereby providing cost savings and additionally allowing outpatient treatment.

J Hosp Infect, 1991 Nov, 19(3), 181 - 9
Intraoperative wound contamination during abdominal hysterectomy; Houang ET et al.; Qualitative bacterial culture of specimens taken from several operative sites during abdominal hysterectomy has not been of value in predicting postoperative infection . We have therefore studied the relationship between the magnitude of contamination and the likelihood of the development of postoperative infection, in the course of a trial comparing the efficacy of cefotetan with ampicillin-plus-metronidazole for chemoprophylaxis in 163 women undergoing abdominal hysterectomy . Forty women who did not receive chemoprophylaxis were also studied . From each patient, an intraoperative sample of pelvic fluid was obtained after closure of the vaginal vault and examined quantitatively for anaerobic, aerobic and microaerophilic bacteria . The incidence of postoperative infectious morbidity (wound infection and febrile morbidity) was correlated with bacterial counts . Analyses by step-up multiple logistic regressions were performed on all the variables and only the total and microaerophilic bacterial counts were significant . Of the 40 patients with total bacterial counts greater than or equal to 10(4) cfu ml-1, 42.5% developed postoperative infectious morbidity, compared with 12.6% of 135 of patients with counts of less than or equal to 10(3) cfu ml-1 . The contaminating bacteria were similar to those of the vaginal and skin flora, with anaerobes occurring in 52.9% and microaerophiles in 63.9% of positive fluid samples . Thus, we have concluded that the magnitude of contamination during abdominal hysterectomy is an important determinant in the development of postoperative infectious morbidity.

Am J Obstet Gynecol, 1991 Oct, 165(4 Pt 2), 1240 - 4
Nonbarrier contraceptives and vaginitis and vaginosis; Roy S; Within the limitations of the available data, it has been reported that oral contraceptive use versus other contraceptive methods is associated with a greater or similar frequency of candidiasis, increased numbers of anaerobic microorganisms, an increased or similar frequency of chlamydia trachomatis, and a reduced frequency of bacterial vaginosis and trichomoniasis . The impact of contraceptive steroids on cellular and humoral immunologic factors may explain these observations . Intrauterine contraceptive device use is reported to be associated with an increased rate of bacterial vaginosis and anaerobic organism recovery from the vagina regardless of symptoms . Patients having a contraceptive vaginal ring were found to have the same number and types of vaginal organisms as oral contraceptive users . Levonorgestrel-releasing subdermal implant (Norplant, Wyeth-Ayerst, Philadelphia, Pa.) users have been reported to have approximately half the rate of vaginitis and vaginosis compared with that of Copper T-200 intrauterine device usersPIP: A literature review was conducted to determine the association between vaginitis/vaginosis and four forms of contraception--oral contraceptives (OCs), IUD, vaginal ring, and Norplant . This review failed to provide evidence of any direct associations between the occurrence of the various vaginitidies and these four contraceptive methods . In comparison with the other methods, OC use is associated with a greater or similar frequency of candidiasis, increased numbers of anaerobic microorganisms, an increased or similar frequency of Chlamydia trachomatis, and a reduced incidence of bacterial vaginosis and trichomoniasis . The frequency of candidiasis and C trachomatis is reduced in IUD users compared to OC users, while that of bacterial vaginosis appears to be slightly increased . The risk of infection of the upper genital tract is greatest immediately after IUD insertion . Contraceptive vaginal ring users have the same number and type of vaginal organisms as OC users . Finally, women who use the levonorgestrel-releasing subdermal implant have approximately half the rate of vaginitis and vaginosis as that identified in Copper T-200 IUD users . The prospective, randomized type of study adjusted for confounding factors such as age, parity, sexual activity, and smoking that is required to calculate the precise likelihood of the development of vaginitis and vaginosis by type of contraception used has never been conducted, however .

Am J Obstet Gynecol, 1991 Oct, 165(4 Pt 1), 821 - 30
Amniotic fluid white blood cell count: a rapid and simple test to diagnose microbial invasion of the amniotic cavity and predict preterm delivery; Romero R et al.; The purpose of this study was to determine the value of amniotic fluid white blood cell count in the diagnosis of microbial invasion of the amniotic cavity . Amniotic fluid was retrieved by amniocentesis from 195 patients with preterm labor and intact membranes . Fluid was cultured for aerobic and anaerobic bacteria, as well as for mycoplasmas . The prevalence of a positive amniotic fluid culture was 12.8% (25/195) . Patients with a positive amniotic fluid culture had a significantly higher median amniotic fluid white blood cell count than did patients with a negative amniotic fluid culture (median, 6 cells/mm3; range, 0 to 11,000 cells/mm3 vs median, 320 cells/mm3; range, 1 to 4480 cells/mm3; p less than 0.0001) . An amniotic fluid white blood cell count greater than or equal to 50 cells/mm3 had a sensitivity of 80% (20/25), a specificity of 87.64% (149/170), a positive predictive value of 48.78% (20/41), and a negative predictive value of 96.75% (149/154) in the detection of a positive amniotic fluid culture for microorganisms . Although the sensitivity of an amniotic fluid white blood cell count (greater than or equal to 50 cells/mm3) in the detection of microbial invasion of the amniotic cavity was greater than that of the Gram stain of amniotic fluid (80% {20/25} vs 48% {12/25}; p less than 0.05), the specificity was lower (87.64% {149/170} vs 98.8% {168/170}; p less than 0.05) . However, 88% (15/17) of all patients with an amniotic fluid white blood cell count greater than or equal to 50 cells/mm3 and a negative amniotic fluid culture had a spontaneous preterm delivery . We conclude that the amniotic fluid white blood cell count is a sensitive, simple, and inexpensive test for the detection of microbial invasion of the amniotic cavity . An elevated amniotic fluid white blood cell count is a risk factor for preterm delivery.

Am J Obstet Gynecol, 1991 Oct, 165(4 Pt 1), 1105 - 10
Correlation of amniotic fluid glucose concentration and intraamniotic infection in patients with preterm labor or premature rupture of membranes; Gauthier DW et al.; Amniotic fluid glucose concentration has previously been suggested as a rapid and sensitive test for diagnosing intraamniotic infection . In this study, 204 patients less than or equal to 34 weeks estimated gestational age with preterm labor or premature rupture of membranes underwent amniocentesis to detect subclinical intraamniotic infection . Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as for Mycoplasma species . Amniotic fluid glucose levels were significantly lower in patients with positive amniotic fluid cultures than in patients with negative cultures (median, 10 mg/dl; range, 1 to 62 mg/dl vs median, 31 mg/dl; range, 2 to 126 mg/dl, respectively; p less than 0.001) . In terms of predicting amniotic fluid culture results, an amniotic fluid glucose concentration of less than or equal to 16 mg/dl had a sensitivity of 79%, specificity of 94%, positive predictive value of 87%, and negative predictive value of 90% . The determination of amniotic fluid glucose concentration is useful in detecting subclinical intraamniotic infection in patients less than or equal to 34 weeks estimated gestational age with preterm labor or premature rupture of membranes.

J Med Microbiol, 1991 Oct, 35(4), 224 - 8
Comparison of immunofluorescence and culture for the detection of Actinomyces israelii in wearers of intra-uterine contraceptive devices; Leslie DE et al.; A direct immunofluorescence (IF) method was compared with traditional culture methods for the detection of Actinomyces israelii in endocervical and intra-uterine-device (IUD) smears from 124 IUD wearers . Of 11 specimens that gave positive results by IF, only one was positive by culture . Of the 10 patients with positive IF specimens, three (30%) had signs and symptoms suggestive of pelvic infection and no other pathogen was detected . Direct IF of cervical smears offers a simple, relatively cheap method to screen IUD wearers for A . israelii . Clinical management of such cases is discussedPIP: An immunofluorescent microscopic method (IF) was compared with conventional culture methods for detection of Actinomyces israelii in smears from the endocervix and IUD of 124 women over a 4-month period at the Royal Women's Hospital, Melbourne . Genital actinomycosis is a non-contagious, chronic, suppurative infection caused by a slowly growing, filamentous, gram-positive anaerobe, and it can lead to fibrosis, abscess or death . The women, attending the Family Planning, Gynecology or Emergency Departments for termination of contraception, replacement of an IUD or for signs or symptoms of pelvic infection, work plastic or copper IUDs . All were screened for Chlamydia and cervical cytology . Actinomyces cultures were screened for 4 weeks and A . israelii identified by morphology, Gram stain and gas-liquid chromatography . The immunofluorescence method involved pepsin treatment of heat-fixed slides, staining with fluorescein-conjugated antibody to A . israelii types I and II, counter-staining, and examination under fluorescence microscopy . Slides were graded subjectively in comparison with positive and negative controls . 9 (11%) of 82 cervical smears, and 2 (4%) of 49 IUD smears were positive by IF, while only 1 was positive by culture: all from 10 patients . One patient has a positive chlamydia culture, and also symptoms of pelvic infection requiring hospitalization . There were 6 others who had symptoms such as pain and discharge, who were treated with IUD removal and antibiotics . 3 women asymptomatic women merely had their IUDs removed . There were no incidents of severe actinomycosis requiring surgery or prolonged hospital treatment although this infection can in rare case be life-threatening . Management of pelvic actinomycosis was discussed .

Surgery, 1991 Oct, 110(4), 671 - 6; discussion 676-7
Comparison of serum and tissue antibiotic levels in diabetes-related foot infections; Seabrook GR et al.; Parenteral antibiotics are used as an adjunct to amputation or operative debridement for patients with diabetes who require emergency surgery for a septic foot . In 26 patients with a diabetes-related foot infection, one dose of various intravenous antibiotic regimens (gentamicin and clindamycin, ticarcillin/clavulanate, ampicillin/sulbactam) was administered during the hour before the procedure, and assays were performed to measure the antibiotic serum and tissue levels at the time of surgical debridement . Aerobic and anaerobic cultures were performed on infected tissue . The 172 bacterial isolates, including 95 aerobes and 77 anaerobes, (6.6 isolates per patient) underwent antibiotic susceptibility testing . Antibiotic levels were calculated by biologic assay from serum and tissue biopsies from the viable margins of the surgical site, which subsequently healed primarily or supported a split-thickness skin graft . Sixteen of the patients achieved therapeutic serum levels, and therapeutic tissue levels were reached in six patients at the time of surgery . A significantly lower number of patients had therapeutic tissue levels compared to serum levels (p less than 0.01, chi square) . Initial intravenous antibiotic administration provides inadequate tissue concentrations for treating foot infections in patients with diabetes . Adequate serum antibiotic levels do not reflect therapeutic tissue antibiotic levels at the surgical margins in this group of patients.

Obstet Gynecol, 1991 Oct, 78(4), 696 - 702
Ciprofloxacin monotherapy for acute pelvic infections: a comparison with clindamycin plus gentamicin; Thadepalli H et al.; This prospective, randomized controlled study compared the efficacy and safety of ciprofloxacin alone versus a conventional two-drug regimen, clindamycin with gentamicin . The study group included 71 patients hospitalized for pelvic infections such as acute (N = 33) and chronic (N = 8) salpingitis, tubo-ovarian abscesses (N = 11), endometritis (N = 9), septic abortion (N = 3), and other categories (N = 7) . Twenty-two of 35 patients on ciprofloxacin and 20 of 36 on clindamycin plus gentamicin had culturable pathogens: gonococci in 28, anaerobes in six, chlamydia in four, and associated pathogens in 19 . Complete clinical and bacteriologic cure was achieved in 21 of 22 (95%) in the ciprofloxacin group and 19 of 20 (95%) in the clindamycin plus gentamicin group . The mean duration of intravenous/oral ciprofloxacin therapy was 3.7/7.2 days, and it was 3/6.6 days for clindamycin plus gentamicin . Ciprofloxacin, a new quinolone, appears to be safe as a single-drug therapy and was as effective as the combination of clindamycin plus gentamicin for the treatment of severe pelvic infections requiring hospitalization.

Neth J Surg, 1991 Oct, 43(5), 184 - 8
Fournier's gangrene: the need for early recognition and radical surgical débridement; de Roos WK et al.; Fournier's gangrene, a specific form of necrotizing fasciitis, predominantly affects the male genitals, perineum and perianal region . Most frequently Fournier's gangrene is caused by the synergistic action of aerobic and anaerobic microorganisms and leads to early septicaemia with a high mortality . The case histories of three patients with Fournier's gangrene are presented to illustrate the importance of early recognition and radical surgical debridement as essential objectives for therapeutic success . In the first patient, who died of Fournier's gangrene after a vasectomy, appropriate therapy was significantly delayed due to late recognition of the condition . The second patient presented with a rapidly progressive fasciitis secondary to a perianal abscess; immediate excision of all necrotic tissue was successfully performed . The third patient developed gangrene from an urogenital infectious focus, which was primarily treated by insufficient incisional and drainage therapy . Only after radical debridement his general condition rapidly improved.

Clin Microbiol Rev, 1991 Oct, 4(4), 470 - 84
Susceptibility testing of anaerobic bacteria: myth, magic, or method?
Wexler HM.
The demand for susceptibility testing of anaerobes has increased, yet consensus as to procedure and interpretation in this area has not been achieved . While routine testing of anaerobic isolates is not needed, certain isolates in specific clinical settings should be tested . Also, laboratories may monitor their local antibiograms by doing periodic surveillance batch testing . The National Committee for Clinical Laboratory Standards has published a protocol of methods approved for susceptibility testing of anaerobic bacteria . Both agar and broth microdilution are included; however, the broth disk elution method is no longer approved by the National Committee for Clinical Laboratory Standards because of method-related interpretive errors . A number of newer methods are undergoing evaluation and seem promising . Clinicians and microbiologists reviewing susceptibility reports should be aware of sources of variability in the test results . Variables in susceptibility testing of anaerobes include the media and methods used, organisms chosen for testing, breakpoints chosen for interpretation, antibiotic, and determination of endpoint . Clustering of MICs around the breakpoint may lead to significant variability in test results . Adherence of testing laboratories to approved methods and careful descriptions of the method and the breakpoints used for interpretation would facilitate interlaboratory comparisons and allow problems of emerging resistance to be noted . A variety of resistance mechanisms occurs in anaerobic bacteria, including the production of beta-lactamase and other drug-inactivating enzymes, alteration of target proteins, and inability of the drug to penetrate the bacterial wall . Antimicrobial resistance patterns in the United States and abroad are described.

Trop Doct, 1991 Oct, 21(4), 149 - 52
Management of bowel perforation in typhoid fever; Richens J; The best survival rates after ileal perforation in typhoid fever are to be found in patients undergoing operation within 24 h . Conservative management of typhoid perforation, which was widely advocated after the introduction of chloramphenicol, appears to be associated with a substantially increased mortality compared to surgery, although randomized comparisons have never been conducted . Clinical, radiological and ultrasound examination assist in the diagnosis of perforation . After vigorous resuscitation, simple surgical closure of the perforation and abdominal irrigation will suffice for most cases . Antibiotics effective against S . typhi, coliforms and anaerobes are required.

Ann Otol Rhinol Laryngol Suppl, 1991 Sep, 154, 34 - 9
Role of anaerobic bacteria in perimandibular space infections; Horn J et al.; This review includes 44 patients with perimandibular space infections admitted to Johns Hopkins Hospital during a 5-year period . The most frequent spaces involved were the submandibular, peritonsillar, and parapharyngeal spaces . As expected, 1) peritonsillar abscesses were invariably associated with pharyngitis, 2) submandibular and buccal space infections generally represented complications of dental infections, and 3) parapharyngeal space infections were associated with both portals of entry . Most patients were treated with drainage procedures, and all received antimicrobial agents, the most common being penicillin . Serious complications included potential airway obstruction requiring tracheostomy in six patients with Fusobacterium bacteremia and two patients with septic emboli to the lung . All patients survived, and most had a relatively brief hospitalization with no sequelae.

Ann Otol Rhinol Laryngol Suppl, 1991 Sep, 154, 17 - 22
Role of anaerobic bacteria in sinusitis and its complications; Baker AS; Anaerobic bacteria comprise a major portion of the pathogenic bacteria in chronic sinus and ear infections, as well as the complications of these infections . Thus, therapy for frontal osteomyelitis, subdural abscess, orbital abscess, lateral sinus thrombosis, and brain abscess should include antibiotics that penetrate the central nervous system as well as cover anaerobic organisms . Penicillin, metronidazole, and chloramphenicol are three such agents.

Nippon Geka Gakkai Zasshi, 1991 Sep, 92(9), 1288 - 91
{Intestinal microflora and bile acids following biliary tract reconstruction}; Yamamoto T et al.; The purpose of this study was to evaluate the intestinal microflora and the composition of various bile acids in jejunal fluid following B-I and B-II types of biliary reconstruction in dogs . B-1 type reconstruction, in which the biliary tract was directly anastomosed to the food passing tract, was performed in 8 dogs, which received cholecystoduodenostomy (group C-D) and in 8 which received cholecystojejunostomy (group C-J) . B-II type reconstruction by Roux-Y cholecystojejunostomy, in which bile flowed into the jejunal limb, was performed in 8 dogs (group R-Y) . Incidences of detection of gram-positive, gram-negative and anaerobic bacteria were as follows: 33%, 33% and 6% in the jejunal fluid obtained at initial operation, 67%, 67% and 33% in group C-D, 83%, 67% and 33% in group C-J, and 75%, 88% and 75% in group R-Y . In six dogs in group R-Y, unconjugated or secondary bile acids in the jejunal fluid increased, while these increases were observed in only two dogs in group C-J and in no dogs in C-D . Unconjugated and secondary bile acids were more likely to increase following B-II type reconstruction than following B-I type reconstruction . These findings are thought to be associated with bacterial overgrowth in the jejunal loop . These results suggest that B-II type reconstruction, in which bilio-enterostomy is exposed with infected intestinal fluid and unconjugated and secondary bile acids, is inferior in preventing ascending cholangitis.

Int J Dermatol, 1991 Sep, 30(9), 660 - 1
Topical metronidazole gel . The bacteriology of decubitus ulcers; Witkowski JA et al.; Ten putrid-smelling decubitus ulcers were successfully treated with metronidazole gel . Anaerobes were cultured from five ulcers and Wood's light examination was positive in four ulcers before treatment . The odor was eliminated after 36 hours of therapy . All results of post-treatment cultures of anaerobes and Wood's light examinations were negative.

Respir Med, 1991 Sep, 85(5), 383 - 8
Differences in tonsil core bacteriology in adults and children: a prospective study of 262 patients; Gaffney RJ et al.; The tonsillar microflora of 262 patients with recurrent acute tonsillitis studied in 1989-1990 is presented . The patient population was divided into three age groups to determine any age-related features . One-hundred and forty-nine patients (57%) were in the 2-7-year-old group, 72 (28%) the 8-14-year-old age group, and the remaining 41 (15%) were over 15 years of age . H . influenzae was the single most common bacterium isolated from the centre of the tonsil (referred to as 'tonsil core'), and this was more prevalent in the 2-7-year-old age group . Staph aureus was the next most commonly isolated bacterium and was most frequently seen in the 8-14-year-old age group (29%) . Anaerobic bacteriology was performed in 120 patients . Strict anaerobic species were isolated in significant numbers from the tonsil core in 5% but were present in the superficial culture in all . Anaerobes were present in moderate to heavy numbers in 32% of superficial swabs overall and this was more frequently seen in the older age groups . Mixed pathogens were found throughout all age groups and were most prevalent in the 8-14-year-old age group at 46% . The commonest mixture was H . influenzae and Staph aureus . Normal flora only was commonly found in the superficial swab and rarely in the tonsil core . The number of specimens containing a beta-lactamase producer was assessed for each group; this was similar in all of the groups ranging from 43% in the 2-7-year-old group and 53% in the 8-14-year-old group to 39% in the greater than 15-year-old group.

Rev Infect Dis, 1991 Sep-Oct, 13 Suppl 10, S815 - 20
Antimicrobial prophylaxis for appendectomy and colorectal surgery; Gorbach SL; Current opinion favors the use of antimicrobial prophylaxis in all operations for acute appendicitis . In clinical trials with placebo controls, the reduction in the rate of postoperative infectious complications is most apparent in perforated and/or gangrenous appendicitis, but benefits are also seen in nonperforated appendicitis and even in those with a normal appendix . In elective colorectal operations, it has been established that all patients should receive prophylactic antibiotics . The choices are an oral bowel preparation consisting of neomycin or kanamycin combined with erythromycin or metronidazole; a parenteral antimicrobial drug such as cefoxitin or cefotetan; or a combined oral/parenteral regimen . Risk factors for postoperative wound infection include a prolonged duration of surgery (greater than 3.5 hours) and rectal resection . The most popular prophylactic regimen employed by American surgeons, particularly in the presence of adverse risk factors, is oral neomycin/erythromycin along with a short course (one to three doses) of a systemic cephalosporin active against anaerobes.

J Biol Chem, 1991 Aug 5, 266(22), 14208 - 16
The novel tungsten-iron-sulfur protein of the hyperthermophilic archaebacterium, Pyrococcus furiosus, is an aldehyde ferredoxin oxidoreductase . Evidence for its participation in a unique glycolytic pathway; Mukund S et al.; The anaerobic archaebacterium, Pyrococcus furiosus, grows optimally at 100 degrees C by a fermentative-type metabolism in which H2, CO2, and organic acids are end products . The growth of this organism is stimulated by tungsten, and, from it, a novel, red-colored, tungsten-iron-sulfur protein, abbreviated RTP, has been purified (Mukund, S., and Adams, M . W . W . (1990) J . Biol . Chem . 265, 11508-11516) . RTP (Mr approximately 85,000) contained approximately 1W, 7Fe, and 5 acid-labile sulfide atoms/molecule and exhibited unique EPR properties . The physiological function of the protein, however, was unknown . We show here that RTP is an inactive form of an aldehyde ferredoxin oxidoreductase (AOR) . The active enzyme was obtained by rapid purification under anaerobic conditions using buffers containing dithiothreitol and glycerol . AOR catalyzed the oxidation of a range of aliphatic aldehydes with an optimum temperature for activity above 90 degrees C, but it did not oxidize glucose or glyceraldehyde 3-phosphate, nor reduce NAD(P), and its activity was independent of CoA . The active (AOR) and inactive (RTP) forms of the enzyme were indistinguishable in their contents of metals and acid-labile sulfide and in their EPR properties . The latter are though to originate from two nonidentical and spin-coupled iron-sulfur clusters, whereas the tungsten in this enzyme, which was not detectable by EPR, appears to be present as a novel pterin cofactor . Inhibition and activation studies indicated that AOR contains a catalytically essential W-SH group that is not present in RTP, the inactive form . AOR is a new type of aldehyde-oxidizing enzyme and is the first aldehyde oxidoreductase to be purified from an archaebacterium or a nonactogenic anaerobic bacterium . Its physiological role in P . furiosus is proposed as the oxidation of glyceraldehyde to glycerate in a unique, partially nonphosphorylated, glycolytic pathway that generates acetyl-CoA from glucose without the participation of nicotinamide nucleotides.

Ear Nose Throat J, 1991 Aug, 70(8), 488 - 90
Management of odontogenic sinusitis with persistent oro-antral fistula; Lin PT et al.; Sixteen patients were treated for odontogenic sinusitis secondary to persistent oro-antral fistula . Males outnumbered females 12 to 4 . Frequency of presentation increased directly with age . Chronic signs and symptoms included facial pain, swelling, tenderness and nasal and oral discharge . The clinical diagnosis of chronic sinusitis was confirmed in all cases by radiographic findings . An opacified maxillary sinus with or without ethmoid involvement was observed in all 16 patients . Surgical pathology revealed chronic mucosal thickening and/or antral polyps in 69% of the cases . Surgical treatment of the sinusitis consisted of antrostomy alone or in combination with Caldwell-Luc procedure . The oro-antral fistula was repaired with mucosal flaps from the buccal and/or palatal region . No postoperative recurrences have been noted during a follow-up period of six months to seven years . Bacterial cultures grew out pure aerobes (44%) or mixed aerobic-anaerobic bacteria (44%) . None yielded pure anaerobes . The bacteriologic spectrum was notably lacking in S . pneumoniae and H . influenzae and differed from organisms commonly found in sinusitis of rhinogenous origin.

J Dairy Sci, 1991 Aug, 74(8), 2472 - 8
Effects of premilking teat preparation on spores of anaerobes, bacteria, and iodine residues in milk; Rasmussen MD et al.; Premilking teat preparations using individual paper or cotton towels for either 6 or 20 s to reduce bacteria and iodine residues from teat surfaces were determined through Latin square designs applied to 50 cows . A cotton towel used for 20 s was most effective in cleaning teats, probably because of the physical structure of the towel, physical action on teat surface, and scrubbing of the teat ends . Premilking teat preparation of 6 s was inadequate to clean teats and to avoid iodine residues in milk . Teat end erosions increased iodine residue in milk . Two days after a treatment period, iodine content in milk from iodophor-dipped groups was similar to that of the undipped control group . Against our expectation, teat dipping with a .25% iodophor teat dip caused higher iodine residue in milk than a .50% iodophor teat dip . Differences in formulations and inert ingredients of iodophor teat dips indicate a need for further studies.

J Appl Bacteriol, 1991 Aug, 71(2), 154 - 61
The characteristics of a new non-spore-forming cellulolytic mesophilic anaerobe strain CM126 isolated from municipal sewage sludge; Nitisinprasert S et al.; A new mesophilic anaerobic cellulolytic bacterium, CM126, was isolated from an anaerobic sewage sludge digester . The organism was non-spore-forming, rod-shaped, Gram-negative and motile with peritrichous flagella . It fermented microcrystalline Avicel cellulose, xylan, Solka floc cellulose, filter paper, L-arabinose, D-xylose, beta-methyl xyloside, D-glucose, cellobiose and xylitol and produced indole . The % G + C content was 36 . Acetic acid, ethanol, lactic acid, pyruvic acid, carbon dioxide and hydrogen were produced as metabolic products . This strain could grow at 20-44.5 degrees C and at pH values 5.2-7.4 with optimal growth at 37-41.5 degrees C and pH 7 . Both endoglucanase and xylanase were detected in the supernatant fluid of a culture grown on medium containing Avicel cellulose and cellobiose . Exoglucanase could not be found in either supernatant fluid or the cell lysate . When cellulose and cellobiose fermentation were compared, the enzyme production rate in cellobiose fermentation was higher than in cellulose fermentation . The optimum pH for both enzyme activities was 5.0, the optimum temperature was 40 degrees C for the endoglucanase and 50 degrees C for the xylanase . Both enzyme activities were inhibited at 70 degrees C Co-culture of this organism with a Methanosarcina sp . (A145) had no effect on cellulose degradation and both endoglucanase and xylanase were stable in the co-culture.

J Med Chem, 1991 Aug, 34(8), 2356 - 60
2-Chloro-1-(2,4-dichlorophenyl)-3-(1H-imidazol-1-yl)-2-phenylpropan-1-one hydrochloride, a novel, nonmutagenic antibacterial with specific activity against anaerobic bacteria; Dickens JP et al.; 1-(2,4-Dichlorophenyl)-2-phenylpropen-1-one (2) is identified as a potent antibacterial agent . A compound, 2-chloro-1-(2,4-dichlorophenyl)-3-(1H-imidazol-1-yl)-2-phenylpropan++ +-1-one (5) has been designed with the intention of its acting as a pro-drug, liberating the lethal species 2 specifically within the target anaerobic bacterial cell following bioreduction by bacterial ferredoxin or related electron transfer proteins . The synthesis and biological activity of 5 is described and compared with the activities of the analogous alpha-bromo ketone 6 and alpha-fluoro ketone 7 . Synthesis of 6, 7, and the corresponding alpha-hydroxy ketone 11 is also described.

J Infect Dis, 1991 Aug, 164(2), 414 - 7
Quantitative culture of bronchoalveolar lavage from patients with anaerobic lung abscesses; Henriquez AH et al.; The study of anaerobic infections of the lung is usually limited to the use of invasive techniques such as transtracheal aspiration (TTA) to avoid contamination by oral flora . Bronchoalveolar lavage (BAL) has been used successfully in the study of the etiology of pneumonia in immunocompromised patients . This study evaluated the role of the quantitative culture of BAL in the diagnosis of lung abscess . Four episodes of lung abscess in three patients were studied, and the results of quantitative culture of BAL were compared with those of the standard technique of TTA . Nineteen anaerobic bacterial species were recovered from the BAL fluid, all but one at concentrations greater than 10(3) cfu/ml . Culture of BAL fluid yielded 18 of 22 of the isolates cultured from TTA, including 12 of 16 of the anaerobic bacteria . This study suggests that quantitative culture of BAL fluid may be useful in the bronchoscopic evaluation of lung abscess.

Curr Opin Dent, 1991 Aug, 1(4), 411 - 4
Bacterial infections of salivary glands; Fox PC; Bacterial infections of the salivary glands are most often seen in the setting of diminished salivary function . In uncompromised individuals, such infections are rare . With the widespread use of prophylactic antibiotics and better maintenance of fluid balance, even the postoperative patient rarely presents with bacterial sialadenitis . The major recent advance in knowledge in this area is the recognition of the pathogenic role of gram-negative facultative anaerobes and strict anaerobic organisms in bacterial infections of salivary glands.

Oral Microbiol Immunol, 1991 Aug, 6(4), 216 - 20
Complement factor D-like activity of Porphyromonas gingivalis W83; Schenkein HA; Porphyromonas gingivalis is a proteolytic gram-negative anaerobic bacterium that is frequently isolated from lesions of human periodontal disease . Previous studies have shown that P . gingivalis strain W83 inactivates C3 in pooled normal human serum (NHS) by a mechanism that is inhibitable by EDTA, yet it degrades purified complement proteins by a mechanism that is not EDTA-inhibitable . Furthermore, during complement activation, only a small number of C3 molecules accumulate on the surface of this organism unless the bacteria are treated with the protease inhibitor TLCK prior to complement activation . The hypothesis was tested that P . gingivalis W83 contains protease activity mimicking that of complement factor D, thus enabling it to activate C3 in serum without significant C3 accumulation on the cell surface . It was first noted that incubation of P . gingivalis W83 in absorbed human serum that was depleted of factor D resulted in C3 consumption that was reversed in the presence of the protease inhibitor TLCK . To directly demonstrate that factor B-dependent C3 consumption occurs in the absence of factor D, P . gingivalis W83 was incubated with purified C3 or a mixture of C3 and B . Although some proteolysis of C3 was noted, increased C3 consumption was noted in mixtures containing both C3 and B . This increment in C3 consumption was inhibited by both EDTA and TLCK . Furthermore, the addition of purified factor H to this mixture inhibited the increment in C3 consumption, indicating that a C3 convertase was probably formed.(ABSTRACT TRUNCATED AT 250 WORDS)

Rev Infect Dis, 1991 Jul-Aug, 13 Suppl 9, S752 - 7
Antibiotic therapy for postcesarean endomyometritis; Pastorek JG 2nd et al.; Puerperal uterine infection, or endomyometritis, occurs more commonly after cesarean section than after vaginal birth . With the rate of cesarean delivery almost 25% of all births in this country, such infection is relatively common . The classic therapy for postcesarean endomyometritis is the combination of clindamycin and an aminoglycoside, usually gentamicin or tobramycin . This regimen has requisite antimicrobial activity against the aerobes and anaerobes of the cervicovaginal flora that usually cause this illness . In the last decade, however, the availability of broad-spectrum beta-lactam antibiotics has enabled the clinician to combat postcesarean infection with single-agent antimicrobial chemotherapy, or monotherapy . "Higher-generation" cephalosporins such as cefoxitin, cefotetan, and moxalactam, as well as the semisynthetic penicillins ticarcillin, piperacillin, and mezlocillin, have all been used alone in the therapy for postpartum infection . The addition of a beta-lactamase inhibitor to this class of drugs now offers a further resource to the practitioner if beta-lactamase-mediated antibiotic resistance arises in the patient population being treated.

Radiology, 1991 Jul, 180(1), 171 - 5
Lung abscesses: US examination and US-guided transthoracic aspiration; Yang PC et al.; Examinations with ultrasound (US) and US-guided transthoracic aspiration were conducted in 35 patients to enable diagnosis of lung abscesses . Thirty-three of the abscesses (94%) were demonstrated at US, while two lesions were not depicted . At US, lung abscesses were depicted as hypoechoic lesions with irregular outer margins and an abscess cavity that was manifested as a hyperechoic ring . Twenty-five abscesses (71%) had local adhesion to parietal pleura (lesion-pleura symphysis) . US-guided transthoracic needle aspiration of fluid from the abscess cavity was performed successfully in 31 of 33 patients (94%) . A total of 65 pathogens were isolated from 31 aspirates (41 anaerobes and 24 aerobes), not-withstanding the fact that 23 of the patients had been previously treated with antibiotics . Only two of 65 pathogens (3%) could be recovered from blood culture, seven (11%) from sputum culture, and two from bronchoalveolar lavage (3%) . Two patients developed minimal pneumothorax . The authors conclude that US examination and US-guided transthoracic aspiration are useful and safe diagnostic methods of collecting specimens to enable accurate diagnosis of lung abscesses.

J Indian Med Assoc, 1991 Jul, 89(7), 200 - 3
Non-sporing anaerobes in hospital sepsis; Chakraborti CK et al.; In comparison to normal controls, the non-sporing anaerobes were often isolated from orodental sepsis (42% to 44.4%), chronic suppurative otitis media (40%), septic abortion (40.3%), uterocervical wound (45.4%), vaginitis (50%) and cancer cervix (50%) . This was true (40%) in perforating ulcers of foot in leprosy . These organisms were less frequently noted in abdominal (11%) and episiotomy (22.8%) wounds and leucorrhoea (33.3%) . The role of non-sporing anaerobes was also suggested by the high percentage ratio of number of isolates to number of cases and by its primary isolation in moderate to heavy number . Barring the cases of cancer cervix, the aerobic bacteria were the most common (78.8% to 100%) in all other conditions.

Khirurgiia (Mosk), 1991 Jul, (7), 40 - 4
{The rapid diagnosis of the anaerobic component of mixed infections in surgery}; Ianisker GIa et al.; Rapid diagnosis of obligate anaerobes was conducted by means of gas liquid chromatography, bacterioscopy, and monitoring . It was found that in 80% of patients the results of rapid diagnosis coincided with those of complete cultural study . Monitoring of obligate anaerobes yields generalized information on their species composition, drug sensitivity, and etiological importance in mixed anaerobo-aerobic infections . The data of rapid diagnosis makes it possible to use directed antibiotic therapy before bacteriological examination is completed.

Vet Clin North Am Food Anim Pract, 1991 Jul, 7(2), 311 - 25
Rumen digestive physiology and microbial ecology; Hoover WH et al.; The rumen is a dynamic, continuous fermentation compartment that provides a suitable environment for a variety of species of anaerobic bacteria, protozoa, and fungi . These microorganisms have a complex series of interactions with the feeds supplied to the host, with some using particulate matter as both sources of nutrients and sites of sequestration to avoid being washed from the rumen by the rapid flow of fluids . Because of the ability to use soluble nutrients and to reproduce rapidly, other microbes associate primarily with the liquid phase of the rumen contents . Due to the metabolic activity of all microbial populations, feeds are converted to microbial matter and fermentation end products, which serve as nutrients for the ruminant . Optimum feed utilization by ruminants is dependent on achieving maximum rumen fermentation and flow of microbial protein to the duodenum . At this time, it is clear that the major nutrients required by the microbial populations include both fibrous and nonfibrous sources of carbohydrates and nitrogen in the form of ammonia, amino acids, and peptides . In spite of five decades of research, the exact quantities and sources of these nutrients that will result in optimum rumen fermentation rates and microbial yields are only partially known.

Oral Surg Oral Med Oral Pathol, 1991 Jul, 72(1), 15 - 8
Cervical necrotizing fasciitis of odontogenic origin; Rapoport Y et al.; Necrotizing fasciitis is a severe soft tissue infection caused by both aerobic and anaerobic bacteria and is characterized by a rapid extension along fascial planes and by necrosis of soft tissues . The disease rarely occurs in the head and neck . Three cases of necrotizing fasciitis of the neck after a dental infection are presented . The difficulty in diagnosing the early stage of this condition in relation to other soft tissue infections of odontogenic origin in the neck is discussed . The importance of an early diagnosis followed by an appropriate combination of medical, surgical, and dental treatment is emphasized.

Med J Aust, 1991 Jun 3, 154(11), 737 - 40
Haematological effects of reinfused mediastinal blood after cardiac surgery; Fuller JA et al.; OBJECTIVE: To explore the risk of inducing a coagulation defect in cardiac surgery patients by the reinfusion of mediastinal blood . DESIGN: Ten patients who underwent coronary artery surgery were prospectively studied for the haematological effects of reinfusion of blood drained from the chest drain tubes after the operation by a Sorenson autologous transfusion system . SETTING: Surgery was performed at a private hospital and patient selection was made at the time of reinfusion . PATIENTS: Nine patients had primary coronary artery surgery and one had a reoperation . MAIN OUTCOME MEASURES: Blood samples were taken from the patients before reinfusion, one hour after reinfusion, and 24 hours later as well as from the collected blood . Measurements were made of the haemoglobin content, white cell and platelet counts, fibrinogen and fibrinogen degradation products, D-dimer, antithrombin III and plasma haemoglobin content . Estimations were also made of the prothrombin time, the thrombin clotting time and the activated partial thromboplastin time . The hypothesis to be tested by this study was that the reinfusion of mediastinal blood after the operation did not cause any significant disturbance of the patient's blood clotting profile . RESULTS: An average of 535 mL (range, 400-950 mL) was reinfused after a period of three hours drainage (range, 45 minutes to 5 hours) . While the initial patient samples contained a raised plasma haemoglobin level (0.19 g/L) significantly related to the cardiopulmonary bypass time (P less than 0.001), these were free of fibrinogen degradation products except for a sample from one patient who had a reoperation . The blood drained by the Sorenson system was lower in haemoglobin content (7.7 g/dL), and had a significant content of fibrinogen degradation products (147 mg/L) and D-dimer (6.4 mg/L) together with reduced clotting factors when compared with the patients' blood . After reinfusion, the patient sample showed evidence of altered coagulation with mildly increased clotting times (activated partial thromboplastin time 57 s, thrombin clotting time 123 s), the extent of which was related to the volume reinfused (P less than 0.001), but 24 hours later, these effects had all disappeared . All samples were sterile in aerobic and anaerobic culture media . CONCLUSION: We conclude that the Sorenson system of retrieval of mediastinal blood after cardiac surgery provides a safe and simple method of blood conservation provided that the volume of reinfusion is not excessive.

Pharm Res, 1991 Jun, 8(6), 796 - 800
Influence of antibiotics on the recovery and kinetics of Saccharomyces boulardii in rats; Boddy AV et al.; Saccharomyces boulardii (SB) is a yeast that is used for the prevention and treatment of antibiotic-associated diarrhea and for the treatment of pseudomembranous colitis . Since SB will most commonly be used when the bacterial flora of the gastrointestinal tract have been disrupted by antibiotic treatment, the influence of different antibiotics on the kinetics and recovery of SB in feces was investigated in rats . Following a single oral dose, SB concentrations in feces were measured for periods of 1 to 6 days . Although SB is eliminated exclusively in the feces, less than 3% of the dose is recovered as viable yeast . When rats were treated with neomycin, which is active against gram-negative aerobic bacteria but not against anaerobes, no change was observed in recovery of SB when compared with recovery from untreated rats . Also, there was no change in the rate at which SB concentrations declined in feces . In contrast, treatment with clindamycin and the broad-spectrum antibiotic ampicillin, which are active against anaerobes, produced an increase in the recovery of SB of up to seven times that of controls and slowed the rate of decline of SB concentration in the feces . This antibiotic effect on SB disposition was also found when SB was administered in multiple doses . An eightfold increase in the steady-state output of SB was observed from ampicillin-treated animals . Analysis of the recovery and kinetic data showed that the primary effect of these antibiotics was to reduce the destruction of SB, probably in the cecum and colon.(ABSTRACT TRUNCATED AT 250 WORDS)

J Bone Joint Surg Am, 1991 Jun, 73(5), 745 - 9
Accuracy of cultures of material from swabbing of the superficial aspect of the wound and needle biopsy in the preoperative assessment of osteomyelitis; Perry CR et al.; The pathogens that were identified on cultures of material obtained by swabbing of the superficial aspect of the wound and needle biopsy were compared with those that were isolated from material that was obtained at debridement from sixty patients who had post-traumatic or postoperative osteomyelitis . The cultures of material that was obtained by superficial swabbing of the wound and needle biopsy were inadequate for prediction of the presence of aerobic organisms . Moreover, the failure to isolate anaerobes from the material obtained by needle biopsy did not rule out the presence of anaerobic organisms . Therefore, tissue for culture of aerobic and anaerobic organisms must be obtained during operative debridement in order to identify all pathogenic organisms . Fungi were isolated from the material obtained by biopsy in two patients . In addition, histological examination of the tissue obtained at biopsy led to the diagnosis of epidermoid carcinoma in two patients in whom this diagnosis had not been suspected before biopsy . Cultures were negative for mycobacteria in all patients . An additional ten patients who had a tibial non-union and latent osteomyelitis were studied . In nine of them, cultures of material obtained by needle biopsy showed no growth . Six of these nine patients had an exacerbation of the osteomyelitis after intramedullary nailing for the non-union . Therefore, the absence of growth of organisms from tissue obtained at needle biopsy does not rule out the possibility that osteomyelitis may be reactivated after intramedullary nailing with reaming.

Enferm Infecc Microbiol Clin, 1991 Jun-Jul, 9(6), 339 - 44
{Bacteremia in a community hospital . Review of 78 cases}; Aznar R et al.; We analyze retrospectively all bacteremic episodes seen between January and December, 1987 in our institution . From a total number of blood cultures performed of 897, 145 were positive (16%), and 67 of them considered as contamination (7.5%) . There were 78 episodes of bacteremia in 74 patients, 38 males and 36 females . Forty-eight episodes were community-acquired and 30 were nosocomial bacteremia episodes . Aerobic bacteria were isolated in 64 cases, anaerobic bacteria in 9 cases and polymicrobial bacteremia in 5 cases . The most commonly isolated microorganism was S . epidermidis in nosocomial cases and E . coli in community-acquired cases . Predisposing conditions registered were diabetes mellitus in 16 cases (20%), cirrhosis of the liver in 3 (4%), corticosteroid therapy in 7 (9%) and surgical procedures in 19 (24%) . Shock was seen in 16 cases (20%), DIC in 8 cases (10%) and ARDS in 5 (6.5%) . Appropriate antibiotic treatment was used in 60 episodes (77%) . Seventeen patients (22%) died . Prognostic factors identified were: nosocomial bacteremia (p less than 0.05), corticosteroid prior therapy (p less than 0.05), underlying disease UF or RF (p less than 0.0001) and the presence of shock (p less than 0.0001) . Mean hospital stay was 20.1 days in bacteremic patients vs . 7.6 days in non bacteremic patients (p less than 0.00001).

Antimicrob Agents Chemother, 1991 Jun, 35(6), 1196 - 202
Comparison of spiral gradient and conventional agar dilution for susceptibility testing of anaerobic bacteria; Wexler HM et al.; Antimicrobial susceptibility tests were performed on brucella laked blood agar with 340 isolates and 14 antimicrobial agents by the standard agar dilution technique and the spiral gradient technique in which antibiotic concentrations were established by diffusion from the agar surface . For comparison, spiral gradient MICs were determined by calculating antimicrobial concentrations at growth endpoints and rounding up to the next twofold incremental concentration . The cumulative percentage of strains susceptible at the breakpoint determined from spiral gradient data was within 10%, generally, of the percentage of strains susceptible at the breakpoint determined from agar dilution data . The overall agreement between the two techniques (within one doubling dilution) was 90.6% . The spiral gradient agar dilution technique is a reasonable alternative to the conventional agar dilution technique for susceptibility testing of anaerobic bacteria.

J Vet Dent, 1991 Jun, 8(2), 18 - 21
Anaerobes in periodontal disease in the dog: a review; Hennet PR et al.; As anaerobic sampling and culture techniques improved, the documented prevalence of anaerobic bacteria in periodontal disease has increased . The anaerobic bacteria have become more well-known in humans and consequently in dogs, since this species is a major model in periodontal studies . A review of the literature related to anaerobic flora is described.

Semin Respir Infect, 1991 Jun, 6(2), 103 - 11
Antibiotics in lung abscess; Bartlett JG; Anaerobic bacteria are relatively common and important pathogens in the lower airways, but are rarely detected due to problems in obtaining adequate specimens for anaerobic bacterial culture . As a consequence, therapeutic decisions are generally empiric and made on the basis of suspected involvement of these organisms according to various clinical clues . With respect to antibiotic options, there is probably a multitude of drugs that would be effective, but there are only three that have a sufficient experience according to published reports: clindamycin, penicillin, and metronidazole combined with penicillin . Recent studies suggest that many of the bacteria involved in these infections produce beta-lactamase, consequently favoring drugs other than penicillins for these infections . Nevertheless, the in vivo experience continues to be relatively good for penicillin when given for orodental or pulmonary infections involving anaerobes derived from the upper airways . For a serious anaerobic infection, such as putrid abscesses associated with large cavities or severe toxicity, the usual drug recommendation is clindamycin . For less serious infections, regimens with established merit are noted above . It is likely that almost any beta-lactam (other than antistaphylococcal penicillins, ceftazidime, or azthreonam) would be adequate; metronidazole should not be used as a single agent.

Am J Physiol, 1991 Jun, 260(6 Pt 2), R1168 - 75
Inactivation of 6-phosphofructo-2-kinase during anaerobiosis in the marine whelk Busycon canaliculatum; Bosca L et al.; 6-Phosphofructo-2-kinase (PFK-2) was analyzed in four organs of the anoxia-tolerant marine gastropod mollusk Busycon canaliculatum . Whelk PFK-2 resembled the nonhepatic enzyme from mammals with highest activity occurring in gill (22 pmol.min-1.g-1) . Hepatopancreas PFK-2 was purified over 8,000-fold to a final specific activity of 11 mU/mg protein (at 20 degrees C) and gave a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis . The enzyme was a dimer with a native molecular mass of 142 kDa and a subunit molecular mass of 67 kDa . The purified enzyme showed negligible fructose-2,6-bisphosphatase (FBPase-2) activity, although the activity ratio of PFK-2 to FBPase-2 was 0.625 in crude extracts . In response to environmental anoxia, the activity of PFK-2 dropped in all organs to 34-56% of the corresponding aerobic value (half-time was 2 h in gill), and the Michaelis constant for fructose 6-phosphate increased by 50% (to 92 microM in gill) . These changes paralleled decreases in organ fructose 2,6-bisphosphate concentration and pyruvate kinase activity and contribute to the overall glycolytic rate depression induced by anoxia in this facultative anaerobe . In vitro treatment of the anoxic form of hepatopancreas PFK-2 with alkaline phosphatase increased enzyme activity, suggesting that the aerobic and anoxic enzyme forms are interconverted by reversible protein phosphorylation . However, the protein kinase involved in this process is not yet known; incubation of aerobic PFK-2 with Mg-ATP plus adenosine 3',5'-cyclic monophosphate-dependent protein kinase or protein kinase C did not alter enzyme activity.

J Am Vet Med Assoc, 1991 May 1, 198(9), 1649 - 50
Pyoderma caused by Peptostreptococcus tetradius in a pup; Price PM; Pyoderma caused by Peptostreptococcus tetradius in a pup was successfully treated with cefadroxil . Although this bacterium is rarely found in veterinary medicine, it is a known pathogen in human beings and should be considered as a potential causative agent in pyodermas in which anaerobes are suspected.

Am Surg, 1991 May, 57(5), 317 - 22
Bacteriology of the appendix and the ileum in health and in appendicitis; Thadepalli H et al.; The bacteriology of the ileum and the appendix in appendicitis patients with or without perforation and compared with patients who had "incidental appendectomy" was studied . Of 42 appendicitis patients, 24 (57%) of them had anaerobic bacteria in the appendix compared with two of eight (25%) with normal appendix . Anaerobes were found in the ileal aspirates of 20 of 42 (47.6%) appendicitis patients and two of eight (25%) in normal persons . This suggests that anaerobic bacteria increasingly colonize the appendix and the ileum in cases of appendicitis.

J Dent Res, 1991 May, 70(5), 910 - 2
Single-dose concentrations of tinidazole in gingival crevicular fluid, serum, and gingival tissue in adults with periodontitis; Liew V et al.; Previous studies have shown that metronidazole is effective in the treatment of subgingival microflora associated with destructive periodontitis . The aim of this study was to determine whether tinidazole, a close analogue of metronidazole, would reach sufficient concentrations in serum, gingival crevicular fluid, and gingival tissue, to inhibit putative periodontopathic bacteria . Ten adult patients with moderate to advanced periodontitis took a single 2-g dose of tinidazole orally . Samples were assayed by high-performance liquid chromatography . The concentrations of tinidazole in serum and GCF were in a similar range (3.2-46.5 micrograms/mL) . Tinidazole was not detected in the GCF in three of the patients . The drug was found in gingival tissue obtained at two h (0.17 +/- 0.14 micrograms/mg) and six h (0.15 +/- 0.18 micrograms/mg) after oral administration . The mean concentration of tinidazole in serum at 24 h (13 +/- 3.0 micrograms/mL) is greater than the minimum inhibitory concentration for anaerobic bacteria as reported by others . The present data suggest that a single 2-g oral dose of tinidazole may lead to the presence of potentially bactericidal levels of tinidazole for up to 24 h in the periodontal pockets of some patients with periodontitis.

Pathol Biol (Paris), 1991 May, 39(5), 558 - 60
{Randomized study of amoxicillin-clavulanic acid versus amoxicillin-metronidazole combinations in pyogenic infections of dental origin}; Chomarat M et al.; Thirty patients, without any valve defect, cardiac malformation or previous antibiotic administration and presenting dental infections, have been treated either with amoxycillin-clavulanic acid or amoxycillin and metronidazole . Aerobic and anaerobic bacteria have been isolated . These infections were due to mixed flora . Nearly one half of anaerobes were Peptostreptococcus, S . milleri and S . sanguis being predominant among aerobes . The species identified were those found in the mouth in the absence of infection becoming as opportunistic flora . The percentage of cures was equivalent in the two groups . the association amoxycillin-clavulanic acid seems to be as active as amoxycillin + metronidazole on the microflora isolated from dentogenous pyogenic infections.

Jpn J Antibiot, 1991 May, 44(5), 538 - 42
{Clinical study on cefteram pivoxil in asymptomatic bacteriospermia}; Chimura T; In order to understand the clinical efficacy of cefteram pivoxil (CFTM) in the treatment of asymptomatic bacteriospermia, the following studies were performed . 1 . Concentrations of CFTM in the semen after oral administration of 200 mg to normal healthy adults (n = 5) reached a maximum level of 0.66 +/- 0.04 microgram/ml in 5 hours after the administration, then decreased rapidly, and averaged 0.15 +/- 0.03 micrograms at 7 hours after administration . 2 . Activities of CFTM, cefaclor (CCL) and lomefloxacin (LFLX) against bacteria which were detected in semen (n = 65) (11 aerobic bacterial strains and 48 anaerobic bacterial strains) were retrospectively studied . The study of activities of these 3 agents against anaerobic bacteria showed that CFTM tended to be more active than CCL, LFLX, and similar tendency was noted in LFLX more than CCL against Peptostreptococcus sp . When penetration of antibiotic agents into semen is considered, however, some anaerobic bacteria as well as some aerobic bacteria may not be eradicated or inhibited, hence farther studies are needed to facilitate the selection of proper methods of administration as well as that of effective antibiotics.

J Reprod Med, 1991 May, 36(5), 398 - 402
Abdominal wall Actinomyces abscess associated with an intrauterine device . A case report; Pearlman M et al.; An abdominal wall Actinomyces abscess occurred in a woman with an intrauterine device . Contributing factors were local trauma, spread from surrounding colonized body sites and symbiotic growth of other anaerobes . The diagnosis was based on the histologic finding of the sulfur granule . Special studies may be needed to distinguish this condition from other, similar ones (Nocardia, botryomycosis).

G Chir, 1991 Apr, 12(4), 258 - 60
{Hemolytic jaundice in anaerobic bacteremia . A report of a case resolved surgically}; Nalli J et al.; The authors report a case of haemolytic jaundice caused by anaerobic bacteria arising from an abdominal abscess . This is undoubtedly a rare pathology but, when occurring, the resolution may be achieved by surgical therapy.

Chirurg, 1991 Apr, 62(4), 317 - 22
{Pancreatic penetration of antibiotics}; Koch K et al.; Antibiotic therapy is indicated in acute pancreatitis because the most common complication and the mean reason for mortality is a bacterial infection . Concentrations of nine antibiotics from various classes were studied in the pancreatic tissue and pancreatic juice of patients and dogs . The volume of distribution is the most valuable parameter for predicting the potential pancreatic penetration of a substance . As a result of our pharmacokinetic studies mezlocillin and cefotiam, especially ciprofloxacin, have the most antiinfectious potential in treatment of acute pancreatitis . Metronidazole is suitable for combination in cases of pancreatic infections covering anaerobic bacteria.

Neurosurg Clin N Am, 1991 Apr, 2(2), 411 - 24
Complications of head injury and their therapy; Marion DW; Common intracranial complications following head injury are meningitis, usually associated with a basilar skull fracture or open-depressed skull fracture; delayed hematoma; hydrocephalus; and vascular injuries . Prophylactic antibiotics are not recommended for the management of basilar skull fractures . The best means of preventing infection from open-depressed skull fractures is operative debridement and thorough irrigation, though recent evidence suggests that select cases can be safely managed without operation . Serial CT scans should be obtained in severely head-injured patients to identify delayed hematomas . CT and MRI scans obtained several weeks or months after severe head injury frequently reveal enlarged ventricles, though only a small percentage of these patients have clinical hydrocephalus . Those that do, often benefit from a shunt . Vascular injuries frequently are not detected until ischemic symptoms develop hours or days after the injury . Recommended treatment for intimal tears or dissection is full anticoagulation, but in those with cerebral contusions or other intracranial lesions, this may present an unacceptable risk for intracranial hemorrhage . Pulmonary infections frequently occur following head injury, and can be associated with admission to the ICU and intubation . A large percentage of these infections are caused by enteric gram-negative organisms, and aggressive treatment with appropriate antibiotics is necessary . Aspiration of gastric contents is common in head-injured patients and is frequently complicated by bacterial superinfection . The routine use of antacids and H2 blocking agents leads to bacterial colonization of the stomach with anaerobes and gram-negative aerobes . Thus, empiric therapy for aspiration pneumonia should include clindamycin . Sinusitis is a frequent cause of fever and leukocytosis in patients with nasotracheal or nasogastric tubes in place for several days and often subsides spontaneously with removal of the tubes . Pulmonary edema is often caused by excessive fluid administration during resuscitation of these patients, and can be avoided by monitoring central venous pressures . Pulmonary edema may also be caused by ARDS, excessive catecholamine release, or primary cardiac failure . Most of these patients will benefit from early intubation and PEEP . Pulmonary emboli most often originate from deep venous thrombi, and there is increasing evidence that prophylaxis with low-dose heparin and pulsating boots can significantly reduce the incidence of both complications . Erosive gastritis is found in the majority of severely head-injured patients and may be due to ischemia of the gastric mucosa as well as gastric hyperacidity.(ABSTRACT TRUNCATED AT 400 WORDS)

Biochemistry, 1991 Mar 12, 30(10), 2713 - 9
Reductive formation of carbon monoxide from CCl4 and FREONs 11, 12, and 13 catalyzed by corrinoids; Krone UE et al.; In an earlier publication, we reported that corrinoids catalyze the sequential reduction of CCl4 to CHCl3, CH2Cl2, CH3Cl, and CH4 with titanium(III) citrate as electron donor {Krone, U . E., Thauer, R . K., & Hogenkamp, H . P . C . (1989) Biochemistry 28, 4908-4914} . However, the recovery of these products was less than 50%, indicating that other products were formed . We now report that, under the same experimental conditions, CCl4 is also converted to carbon monoxide . These studies were extended to include FREONs 11, 12, 13, and 14 . Corrinoids were found to catalyze the reduction of CFCl3, CF2Cl2, and CF3Cl to CO and, in the case of CFCl3, to a lesser extent, to formate . CF4 was not reduced . The rate of CO and formate formation paralleled that of fluoride release . Both rates decreased in the series CFCl3, CF2Cl2, CCl4, and CF3Cl . The reduction of CFCl3 gave, in addition to CO and formate, CHFCl2, CH2FCl, CH3F, C2F2Cl2, and C2F2Cl4 . The product pattern indicates that the corrinoid-mediated reduction of halogenated C1-hydrocarbons involves the intermediacy of dihalocarbenes, which may be a reason why these compounds are highly toxic for anaerobic bacteria.

Biochim Biophys Acta, 1991 Mar 4, 1073(2), 253 - 9
The role of protein kinases in anoxia tolerance in facultative anaerobes: purification and characterization of a protein kinase that phosphorylates pyruvate kinase; Brooks SP et al.; A protein kinase which phosphorylates pyruvate kinase (PK) in vitro was purified and characterized from the foot muscle of the anoxia-tolerant gastropod mollusc Busycon canaliculatum . Purification involved four steps: poly(ethylene glycol) fractionation, affinity chromatography on Blue agarose, ion-exchange chromatography on phosphocellulose and preparative isoelectric focusing (pI = 5.5) . The activity was monitored by following changes in pyruvate kinase I50 values for L-alanine which have previously been linked to changes in the degree of enzyme phosphorylation . The correlation between enzyme phosphorylation and changes in the L-alanine inhibition constant was also directly demonstrated in the present paper by radioactively labelling PK with {tau-32P}ATP . The final purified protein kinase solution gave a single band on SDS-gel electrophoresis with a molecular weight of 37,000 +/- 2000 . Kinetic analysis of the purified protein kinase (PK-kinase) showed a pH optimum of 7.0, an absolute requirement for magnesium ions (Km = 1.29 mM), a relatively high affinity for MgATP (Km = 57 microM), and inhibition by increasing salt concentrations (I50 = 55 mM KCl) . The protein kinase activity was not affected by either spermine, heparin, cAMP, cGMP or concentrations of CaCl2 less than 10 mM . The enzyme did not phosphorylate either phosphofructokinase or glycogen phosphorylase, two enzymes that are also phosphorylated during anoxia in whelks . The purified enzyme is different from the catalytic subunit of cAMP-dependent protein kinase as shown by the inability of cAMP to stimulate the protein kinase at all stages of the preparation; cAMP did not activate either crude enzyme, the 7% poly(ethylene glycol) supernatant, or any of the column eluant peak fractions when measured by changes in pyruvate kinase kinetic parameters.

Nihon Kyobu Shikkan Gakkai Zasshi, 1991 Mar, 29(3), 353 - 9
{Ecological study of the pharyngeal bacterial flora in patients with lung cancer}; Kawana A et al.; We investigated the relationship between changes in pharyngeal bacterial flora and the immunological condition of 10 lung cancer patients before and after anti-cancer chemotherapy . There were significant differences in bacterial flora between normal subjects and patients . However, there were little differences in pharyngeal flora in patients before and after chemotherapy . In 4 out of the 10 lung cancer patients, the ratio of anaerobic bacteria/total bacteria of pharyngeal flora decreased . These 4 cases were in the non-responsive (NC, PD) group of anti-cancer chemotherapy . After administration of anti-cancer drugs, the ratio of anaerobic bacteria increased . No aerobic gram negative rods were isolated at any time during the observation period, because immunological suppression was mild . The results indicate the importance of surveillance for the immunological state of the hosts and changes in pharyngeal bacterial flora.

Rev Esp Cardiol, 1991 Mar, 44(3), 207 - 9
{Right-sided endocarditis due to Fusobacterium nucleatum}; Gonzalez Cocina E et al.; We present 1 case of right sided endocarditis caused by Fusobacterium nucleatum in a patient with intravenous drug addiction and human immunodeficiency . The clinical features were fever, anemia, and pulmonary embolism . The echocardiogram showed a giant vegetation originated from the right atrial wall prolapsing in diastole into the right ventricle which disappeared after the patient presented pulmonary embolism . The clinical course was uncontrolled with empiric antimicrobial therapy but it was good with metronidazol . The cases previously described in the literature caused by gram-negative anaerobic bacteria are discussed and compared with the present case.

Antimicrob Agents Chemother, 1991 Mar, 35(3), 594 - 9
Susceptibility of anaerobic bacteria to BAY v 3522; Nord CE et al.; The activity of BAY v 3522 against 340 strains of anaerobic bacteria was determined by an agar dilution method . Its activity was compared with those of amoxicillin, amoxicillin-clavulanate, cefaclor, cefadroxil, cefoxitin, cefuroxime, cephalexin, clindamycin, doxycycline, and metronidazole . BAY v 3522, amoxicillin-clavulanate, cefoxitin, clindamycin, and metronidazole were the most active agents tested . On the basis of these results, BAY v 3522 appears to have an antibacterial activity that warrants further investigation in clinical trials.

Dis Colon Rectum, 1991 Mar, 34(3), 223 - 8
Postoperative irrigation-suction drainage after pelvic colonic surgery . A prospective randomized trial; Galandiuk S et al.; A 2-year randomized prospective clinical trial was undertaken to determine whether postoperative irrigation of the pelvis would result in a decreased incidence of local septic complications . Two hundred consecutive patients undergoing low pelvic procedures with rectal resection and entry of the presacral space by a single surgeon, were randomized . In the irrigation group, two of four presacral sump drains were placed to low intermittent suction and the remaining sumps infused continuously with saline until the effluent was clear . In the drainage alone group, all four presacral sump drains were placed to suction . Drains were removed when drainage was less than 50 ml/24 hours . Perioperative antibiotics and bowel preparation were identical . Postoperative complications included pelvic abscess (n = 7), anastomotic leak/cuff sinus (n = 11), abdominal wound infection (n = 19), and perineal wound infection (n = 5) . Postoperative irrigation of the pelvis did not result in a reduction in the overall rate of local pelvic septic complications . Positive intraoperative presacral cultures, the presence of anaerobes in the presacral space, and duration of pelvic drainage had no effect on the development of pelvic sepsis.

J Med Assoc Thai, 1991 Mar, 74(3), 162 - 4
Treatment of puerperal infection; Bhiraleus P et al.; Ninety-two patients with puerperal infection admitted to Siriraj Hospital from April 1, 1980 to March 1, 1983 were studied . The treatment in this study was both medical and surgical, blood transfusion was given in some cases with low hematocrit level . The medical treatment alone was based on the causative organisms which were detected by cervical & intrauterine swab, smear & gram stain and cultures . PGS & Kanamycin were the most frequently used antibiotics which were intended to treat both gram-positive and gram-negative bacteria and adjunctive chloramphenicol for anaerobes . The surgical procedures which were performed in combination with medical treatment included total abdominal hysterectomy, uterine curettage, appendectomy and drainage of subdiaphragmatic abscess . The result of the treatment was satisfactory, 96.7 per cent improved after therapy with slight morbidity in some patients.

Ann Ostet Ginecol Med Perinat, 1991 Mar-Apr, 112(2), 75 - 82
Bacterial interactions in the intestine of the newborn delivered by cesarean section; Bezirtzoglou E et al.; The purpose of this study was to clarify the role of the intestinal anaerobic bacteria colonizing the intestine of the newborn delivered by cesarean section . Control of the intestinal microecology is dependent on many factors including intestinal peristalsis, the intraluminal environment, and microbial interactions, that deter the overgrowth of pathogens populations . Numerous factors help achieve this normal balance . The effect of feeding seems to induce bacteriological changes.

J Chemother, 1991 Feb, 3 Suppl 2, 7 - 11
Treatment of infections caused by anaerobes; Wilson WR; In summary, the selection of a specific antimicrobial agent for the treatment of infections caused by anaerobic microorganisms depends upon the site of infection, the suspected anaerobic and aerobic microorganisms causing the infection, and the pharmacokinetics and drug distribution of the antimicrobial agent . Appropriate surgical debridement or drainage of abscess material is as important, if not more so, than the selection of a specific antimicrobial agent for the successful management of patients with infections caused by anaerobic microorganisms . The availability of new antimicrobials with activity against anaerobic microorganisms, and combination therapy for managing infection caused by mixed flora of aerobic and anaerobic microorganisms, has increased our ability to successfully manage hospitalized patients with infections caused by these microorganisms.

J Otolaryngol, 1991 Feb, 20(1), 54 - 6
Fatal necrotizing mediastinitis secondary to acute suppurative parotitis; Guardia SN et al.; A unique case of fatal necrotizing mediastinitis secondary to acute suppurative parotitis is reported . The infection was the result of synergistic necrotizing cellulitis caused by mixed aerobic and anaerobic bacteria . To the best of the authors' knowledge, this is the first reported case of necrotizing mediastinitis resulting from a descending acute suppurative parotitis . Acute parotitis should be included in the broad spectrum of infections resulting from synergism between aerobic and anaerobic bacteria in which anaerobes indigenous to the oral cavity predominate.

Appl Environ Microbiol, 1991 Feb, 57(2), 359 - 65
Molecular cloning, expression, and characterization of endoglucanase genes from Fibrobacter succinogenes AR1; Cavicchioli R et al.; A cosmid gene library was constructed in Escherichia coli from genomic DNA isolated from the ruminal anaerobe Fibrobacter succinogenes AR1 . Clones were screened on carboxymethyl cellulose, and 8 colonies that produced large clearing zones and 25 colonies that produced small clearing zones were identified . Southern blot hybridization revealed the existence of at least three separate genes encoding cellulase activity . pRC093, which is representative of cosmid clones that produce large clearing zones, was subcloned in pGem-1, and the resulting hybrid pRCEH directed synthesis of endoglucanase activity localized on a 2.1-kb EcoRI-HindIII insert . Activity was expressed from this fragment when it was cloned in both orientations in pGem-1 and pGem-2, indicating that F . succinogenes promoters functioned successfully in E . coli . A high level of endoglucanase activity was detected on acid-swollen cellulose, ball-milled cellulose, and carboxymethyl cellulose; and a moderate level was detected on filter paper, Avicel, lichenan, and xylan . Most activity (80%) was localized in the periplasm of E . coli, with low but significant levels (16%) being detected in the extracellular medium . The periplasmic endoglucanase had an estimated molecular weight of 46,500, had an optimum temperature of 39 degrees C, and exhibited activity over a broad pH range, with a maximum at pH 5.0.

J Laryngol Otol, 1991 Feb, 105(2), 119 - 20
Otogenic Fusobacterium necrophorum meningitis; Pace-Balzan A et al.; A case of meningitis secondary to acute suppurative otitis media in a previously healthy child is reported . The only organism isolated from blood after aerobic and prolonged anaerobic culture was identified as Fusobacterium necrophorum . Complete recovery followed treatment with surgery and prolonged antibiotic therapy . The role of anaerobes in the development of meningitis, the isolation and identification of Fusobacterium necrophorum, the clinical presentations of F . necrophorum infection and the choice of antibiotics in the treatment of these infections are discussed.

J Clin Microbiol, 1991 Feb, 29(2), 231 - 5
Evaluation of AN-Ident; Quentin C et al.; AN-Ident (Analytab Products, Inc., Plainview, N.Y.) is a ready-to-use system for anaerobe identification . It is based on the detection of constitutive preformed enzymes, is growth independent, and requires only 4 h of aerobic incubation . This micromethod was evaluated for its ability to identify anaerobic bacteria by using a conventional methodology as a reference . Of 265 clinical isolates, AN-Ident accurately identified 241 (91%) of the isolates to the species level and 259 (98%) of the isolates to the genus level, with limited supplemental testing needed (5%) . The AN-Ident system performed well for the most common pathogens but less satisfactorily for infrequently isolated and/or asaccharolytic species; expansion and updating of the data base would be helpful . Although some color reactions were difficult to interpret, the commercial kit was easy to use.

Oral Microbiol Immunol, 1991 Feb, 6(1), 17 - 23
Divergent effect of the anaerobic bacteria by-product butyric acid on the immune response: suppression of T-lymphocyte proliferation and stimulation of interleukin-1 beta production; Eftimiadi C et al.; The effects of short-chain fatty acids (SCFA) produced by anaerobic bacteria, namely propionic, butyric and iso-butyric on T-cell proliferation was investigated . A dose-dependent inhibition of both phytohemagglutinin-induced blastogenesis and mixed lymphocyte culture was observed in the millimolar range of SCFA concentrations . The tested SCFA displayed different levels of suppression . The degree of activity was in the following order: butyrate greater than propionate greater than isobutyrate . T-cell inhibition was partially reversed, at least for propionic and isobutyric acids, by increasing the concentration of macrophages in the assay system . Furthermore, butyric acid displayed an interesting biphasic stimulation of monocyte interleukin-1 beta production, a cytokine with a powerful bone-resorbing activity . Since millimolar concentrations of SCFA are present in gingival fluid from periodontal pockets, the observed results support the role of these by-products of anaerobic metabolism in the pathogenesis of periodontal diseases.

Biochem Int, 1991 Feb, 23(3), 571 - 80
Some biochemical properties of human lymphoblastoid Namalwa cells grown anaerobically; Vaillant F et al.; Using cultured lymphoblastoid Namalwa cells, we have demonstrated that humans cells can be grown for long periods in the absence of oxygen . Such anaerobic growth occurs at the same rate as that of aerobic cultures, but is characterized by a strict dependence on pyruvate . Cells in anaerobic culture undergo a severe loss of mitochondrial cytochromes, that is reversible on reaeration . Anaerobically grown cells show a two-fold increase in glucose consumption, consistent with anaerobic glycolysis providing the source of ATP for cellular maintenance and growth . The requirement for pyruvate is explained by the necessity for these cells to re-oxidise NADH derived from metabolic reactions . Detailed study of anaerobically grown human cells provides a new framework for investigating tissues depleted in mitochondrial functions, as occurs in mitochondrial diseases and the ageing process.

Antonie Van Leeuwenhoek, 1991 Feb, 59(2), 65 - 76
Oxygen regulated gene expression in Escherichia coli: control of anaerobic respiration by the FNR protein; Unden G et al.; Molecular oxygen is an important regulatory signal in facultative anaerobic bacteria and controls the expression of a great variety of genes positively or negatively . The expression of anaerobic respiration and of related functions of E . coli is controlled by the positive gene regulator FNR, which activates transcription in the absence of O2 . The regulated genes carry a FNR consensus sequence upstream of the promoter . Under the same conditions FNR represses some of the genes of aerobic respiration . The binding to the DNA occurs by an alpha-helix-turn-alpha-helix DNA-binding domain . FNR contains 5 cysteine residues, four of which are arranged in a cluster close to the N-terminal end . For the function of FNR as a O2-dependent regulator three of the cysteine residues in the cluster and the residue outside the cluster are essential . FNR binds iron as a cofactor which most likely is involved in the O2-sensing by the protein . The experiments indicate that the cysteine residues are responsible for the binding of the iron . From the protein in vivo two functional states can be differentiated, an aerobic or metal-depleted form and an anaerobic form . Only the anaerobic form acts as a gene activator or repressor . Sensing of O2 or of positive redox potentials by the iron ion is thought to cause the conversion of the two functional states . The FNR protein in addition contains a potential nucleotide binding domain . The significance and function of this site is not clear.

J Leukoc Biol, 1991 Feb, 49(2), 180 - 8
Intracellular pH regulates the production of different oxygen metabolites in neutrophils: effects of organic acids produced by anaerobic bacteria; Tonetti M et al.; The effects of short chain carboxylic acids (SCCA), namely succinic, butyric, and iso-butyric, on neutrophil metabolic activation were assessed . SCCA induced a significant decrease in O2.- recovery and chemiluminescent response in neutrophils activated with the diacylglycerol analog tetradecanoyl-phorbol-acetate (TPA) . SCCA did not alter O2 consumption, H2O2 production, or the calorimetrically determined energy expenditure occurring during the metabolic burst . SCCA also induced a significant acidification of intracellular pH (pHi) . These results are consistent with an increased divalent versus univalent O2 reduction performed by the NADPH oxidase at a more acidic intracellular pH.

Genitourin Med, 1991 Feb, 67(1), 47 - 8
Isolation of anaerobes from bubo associated with chancroid; Kumar B et al.; Ten men with bubo associated with chancroid were studied for bacterial flora especially anaerobes . Anaerobes were isolated from all 10 buboes and eight out of 10 ulcers of chancroid . Anaerobic cocci, B melaninogenicus and B fragilis were the most common isolates . anaerobes probably play a role in the pathogenesis of bubo in chancroid.

Trans Am Ophthalmol Soc, 1991, 89, 313 - 43; discussion 343-7
Anaerobic orbital cellulitis: a clinical and experimental study; Jedrzynski MS et al.; In this article we have reviewed the clinical and bacteriologic aspects of anaerobic orbital cellulitis and have presented six patients to illustrate these points . Physicians who treat patients with orbital cellulitis should have a high index of suspicion for possible instances involving anaerobes, so that appropriate management can be started early . To investigate this problem further, we created an animal model of anaerobic orbital cellulitis . This model may be useful in future studies of the pathogenesis and treatment of this serious and often devastating disease.

J Chromatogr, 1991 Jan 4, 536(1-2), 193 - 201
Use of ion-exclusion chromatography for monitoring fatty acids produced by bacterial anaerobic degradation of tetrachloroethene in ground water; Chamkasem N et al.; A rapid method for the simultaneous quantification of non-volatile and volatile fatty acids in aqueous sample by ion-exclusion chromatography is described . The sample is directly injected into the column and detected by a chemically suppressed conductivity detector, connected in tandem with an UV detector at 210 nm . The method allows detection of fatty acid as low as 1 ppm with a linear dynamic range up to 1000 ppm . At least 13 fatty acids can be determined within 50 min . This technique has been used to monitor the common fermentation products (lactate, acetate, propionate and butyrate) of the reductive dehalogenation of tetrachloroethene by anaerobic bacteria.

Ann Biol Clin (Paris), 1991, 49(1), 14 - 7
{Evaluation of ATB 32 A system for automated identification of anaerobic bacteria}; Roger F et al.; A new automated system for identification of anaerobes in 4 hours, ATB 32 A, was evaluated with 124 strains isolated in routine and 10 collection strains, and was compared with techniques commonly used in the hospital . The system allowed identification of 89.5% (111/124) of clinical strains, including 6.4% (7/124) strains needing extra tests; 5.6% (7/124) strains were not identified and 4.8% (6/124) were incorrectly identified . ATB 32 A is an interesting way of identifying quite a difficult bacterial group.

Pharmacotherapy, 1991, 11(2 ( Pt 2)), 80S - 83S
The effect of timentin in the treatment of female pelvic soft tissue infections; Faro S; Ticarcillin plus clavulanic acid (Timentin) has a broad-spectrum activity that includes gram-positive aerobes, and facultative and obligate anaerobes . Numerous studies have demonstrated that single agents, including this combination, are as efficacious as clindamycin plus an aminoglycoside in treating gynecologic soft tissue infections . Its spectrum of activity, together with its potential for treating Chlamydia trachomatis, makes it suitable for the treatment of pelvic inflammatory disease.

Pharmacotherapy, 1991, 11(2 ( Pt 2)), 72S - 79S
Antimicrobial therapy of anaerobic infections, 1991; Sanders CV et al.; Most anaerobic infections are polymicrobial and must be treated with agents active against a variety of both aerobic and anaerobic bacteria . Antimicrobial therapy is used both to contain infections and to treat those that have not been contained (bacteremia) . Bacterial resistance, especially to penicillins and tetracyclines, but also to newer agents of other classes, continues to increase and often requires treatment with more than one drug . Combination therapy is also frequently necessary in serious infections, and is indicated for empiric management before receiving results of in vitro microbiology laboratory tests . However, recent results suggest that monotherapy for anaerobic infections may dominate in the future, although combination therapy has been the mainstay of antimicrobial therapy . Selection of an agent must take into account the site of infection and thus the bacteria most likely to be found . It should be kept in mind that in vitro susceptibility is not the only determinant of antimicrobial effectiveness . The pharmacology of the drug--absorption, distribution, concentration in body fluids and tissues, and metabolism--also plays an important role . Finally, the nature and severity of the underlying illness, the toxicity of the agent, and costs must be considered.

Jpn J Surg, 1991 Jan, 21(1), 1 - 7
A bacteriological study of perforated duodenal ulcers; Shinagawa N et al.; Peritoneal fluid sampling and bacteriological examination were performed in 63 patients with perforated duodenal ulcers, and the results compared with those in 175 patients with other perforations . Bacterial culture was positive in 100 per cent of the patients whose perforations occurred in the colon, whereas it was positive in only 44.4 per cent of those with duodenal perforations, being negative in many cases when the interval from perforation to surgery was short . A mixed contamination with both aerobes and anaerobes was usually found in the cases of lower digestive tract perforation, and the isolates from duodenal perforations were uniquely aerobes in most cases . It is suggested that bacteria play a minor role in the pathogenesis of early stage duodenal perforation, which supports the technique of primary closure without indwelling drainage tubes during early stage operations following sufficient peritoneal lavage . Moreover, if the stomach is empty at the time of perforation and the peritonitis is localized, even conservative therapy seems possible, provided it is begun shortly after the perforation.

Acta Otolaryngol, 1991, 111(1), 135 - 43
Chronic maxillary sinusitis . Energy metabolism in sinus mucosa and secretion; Stierna P et al.; The energy metabolism in maxillary sinus mucosa and secretion from 41 patients with, in most cases, recurrent or chronic sinusitis was studied and compared with that in mucosal samples from patients with no previous history of sinus abnormality or infection . In freeze-dried samples, glucose and lactate were measured by enzymatic assays and adenine nucleotides by HPLC . In chronic sinusitis the lactate concentration in the mucosa was increased, probably as a result of increased glycolysis or of impaired diffusion within the mucosa . The lactate concentrations in purulent and non-purulent secretions were 16.3 and 1.1 mmol x kg-1 w.w., respectively . The higher concentration in the purulent secretion was due mainly to leucocyte metabolism . The adenine nucleotide contents in the mucosa were similar in all groups studied . Anaerobic bacteria were isolated only in secretions with a high lactate concentration.

Hosp Pract (Off Ed), 1991, 26 Suppl 4, 11 - 7; discussion 48
Use of third-generation cephalosporins . Anaerobes; Nichols RL et al.; The third-generation cephalosporins have an increased spectrum of activity against gram-negative bacteria, moderate activity against anaerobic bacteria, and reduced anti-gram-positive activity as compared with earlier cephalosporins . This spectrum allows the drugs to be considered as monotherapy for the treatment of mixed aerobic-anaerobic infections and as prophylaxis in patients in whom such mixed flora are expected . In vitro testing of anaerobes with the third-generation cephalosporins shows susceptibility to be method dependent, with regional differences also observed . The microtube broth dilution method shows the best relationship to in vivo results . Moreover, the apparent in vitro susceptibility or resistance does not always correlate with clinical efficacy . Clinical studies indicate that the expanded-spectrum third-generation cephalosporins may be used in place of combination therapy in patients with polymicrobial infection or as prophylaxis when mixed microflora are expected.

Int Endod J, 1991 Jan, 24(1), 1 - 7
Effects of extensive apical reaming and calcium hydroxide dressing on bacterial infection during treatment of apical periodontitis: a pilot study; Orstavik D et al.; An apical dentine sampling technique was applied in order to monitor the bacteriology of the pulp canal and radicular dentine before and during treatment of teeth with chronic apical periodontitis . Twenty-three teeth with a radiographic diagnosis of apical periodontitis were studied . They were subjected to a standardized two-appointment treatment regimen of extensive apical reaming in the absence of antimicrobial agents and 1-week dressing with calcium hydroxide . Bacteriological samples were taken from the root canal at the start, and apical dentine samples at the end, of each sitting . Provision was made to allow growth of anaerobic bacteria . All root canals but one showed growth at the start of treatment . Dentine samples were positive in 14 of the 23 teeth at the end of the first appointment . Eight of the 23 canals had detectable growth from the canal at the start of the second appointment, but in sufficient numbers for quantification in only one root canal . The subsequent dentine samples were otherwise negative at the second appointment . There was a tendency for teeth causing symptoms to harbour more bacteria than symptomless teeth.

Can J Vet Res, 1991 Jan, 55(1), 50 - 5
Use of a protected catheter brush for culture of the lower respiratory tract in horses with small airway disease; Grandguillot L et al.; A protected catheter brush introduced by fiberoptic bronchoscopy was used to sample the tracheai and bronchial mucosa in 28 horses with small airway disease . Tracheal and bronchial brushings were examined for the presence of fungi, aerobic and anaerobic bacteria, and a cytoiogical evaluation was also done on fluid collected by the bronchoalveolar lavage (BAL) technique . Microorganisms (bacteria and fungi) were isolated more often in tracheal brushings (53.6%) than in bronchial brushings (10.7%) . Anaerobic bacteria were not isolated . Results of this study indicate that fiberoptic bronchoscopy using a protected catheter brush is an easy and practical technique to obtain minimally contaminated samples for isolation of microorganisms from the lower respiratory tract of horses . However, no association was observed between isolation of high numbers of microorganisms from the bronchi and severity of small airway disease.

Klin Khir, 1991, (4), 21 - 3
{Ultrastructural changes in neutrophils and anaerobic microorganisms during their interactions in experimental acute intestinal obstruction}; Medvetskii EB et al.; The authors established that 12 h after development of acute obstructive ileus in inactive neutrophil granulocytes (NG), the anaerobic microorganisms were intact, or at the process of division; in the active NG, they were destroyed, or when forming "halo", might preserve and migrate in the matrix of NG . In interaction of NG with microorganisms, the numerous oval and roundish bacterial bodies with a diameter of 0.2-0.5 micron capable to penetrate into the non-phagocytic cells are formed . A function of the formations revealed is not studied.

Obstet Gynecol, 1991 Jan, 77(1), 134 - 8
False-positive cultures of the cul-de-sac associated with culdocentesis in patients undergoing elective laparoscopy; Soper DE et al.; We studied 21 women undergoing elective laparoscopy to determine whether positive bacterial cultures obtained by culdocentesis were contaminants from the vaginal mucosa . Cultures for aerobic and anaerobic microorganisms were prepared from swabs of the posterior vaginal fornix, laparoscopic cul-de-sac aspirates, culdocentesis aspirates, and repeat laparoscopic aspirates of the cul-de-sac . Cultures were positive from the vaginal fornix in all cases . All cultures from the cul-de-sac before culdocentesis were negative . Five of seven cultures (71.4%) from culdocentesis specimens and seven of nine cultures (77.8%) from repeat laparoscopic cul-de-sac aspirates were positive in women without povidone-iodine vaginal preparation . Five of 12 cultures (41.7%) from culdocentesis specimens and three of 12 cultures (25%) from repeat laparoscopic cul-de-sac aspirates were positive in the women with vaginal preparation . Both aerobic and anaerobic bacteria were recovered . We conclude that false-positive culdocentesis cultures occur and that bacterial contamination of the cul-de-sac following culdocentesis may lead to false-positive cultures of specimens obtained during subsequent laparoscopy.

Scand J Gastroenterol Suppl, 1991, 188, 1 - 7
Intrinsic factor secretion and cobalamin absorption . Physiology and pathophysiology in the gastrointestinal tract; Festen HP; Intrinsic factor is produced by the gastric parietal cell . Its secretion is stimulated via all pathways known to stimulate gastric acid secretion: histamine, gastrin, and acetylcholine . There is, however, a different mode of secretion for both substances: atropine, vagotomy, and H2 receptor antagonists inhibit both intrinsic factor and acid secretion, but secretin and the hydrogen-potassium ATPase antagonist omeprazole have no effect on intrinsic factor while substantially reducing acid secretion . Cobalamin in food is bound to animal protein . Cobalamin deficiency due to inadequate dietary intake is rarely seen in extreme vegetarians (vegans) . In the stomach cobalamin is liberated from its protein binding by peptic digestion and bound to R-proteins . Hypochlorhydria or achlorhydria, whether medically induced or not, may impair cobalamin uptake . The cobalamin-R-protein complex is split by pancreatic enzymes in the duodenum, where cobalamin is bound to intrinsic factor . Pancreatic insufficiency may lead to cobalamin deficiency . Lack of intrinsic factor is the commonest cause of cobalamin deficiency; very rarely, aberrant forms of intrinsic factor are produced, but the clinical syndrome is similar . Gram-negative anaerobe bacteria bind the cobalamin-intrinsic factor complex, and bacterial overgrowth of the small intestine diminishes cobalamin resorption . Parasitic infections with fish tape-worm and Giardia lamblia are also associated with cobalamin malabsorption . The cobalamin-intrinsic factor complex binds to the ileal receptors in the terminal ileum . Cobalamin absorption may be impaired after resection or by diseases affecting more than 50 cm of the terminal ileum, such as Crohn's disease, coeliac disease, tuberculosis, lymphoma or radiation . There is clearly a wide diversity in the aetiology of cobalamin deficiency, which requires a versatile diagnostic approach.

Klin Khir, 1991, (9), 5 - 8
{Specifics of surgical approach in purulent cholangitis}; Shor-Chudnovskii ME et al.; When analysing the results of examination of 773 patients with obstructive jaundice (OJ) of benign genesis, purulent cholangitis (PC) was revealed in 323 . In PC diagnosis, the ultrasound study is a valuable adjunctive method . In presence of the clinical signs of PC in patients and absence of the effect from conservative therapy, and as well in preservation of the high indices of bilirubinemia, the early operative treatment performed, as a rule, no later than 48 h after hospitalization is indicated . PC in patients with OJ is most frequently caused by choledocholithiasis . The causative agents of PC are represented by aerobic and anaerobic microorganisms, requiring the use of broad spectrum antibiotics before the operation and 6-12 h after it . Adequate restoration of bile passage and pathogenetically substantiated local influencing upon the inflammatory process in the bile ducts are tasks of operative intervention . Direct administration into the bile ducts of antibiotics and antiinflammatory preparations, in particular of quercitrol, via the external drain of the common bile duct is expedient.

Lab Delo, 1991, (12), 51 - 4
{Characteristics of the anaerobic bacterial spectrum in children with periodontitis}; Ivashkevich LG et al.; Analysis of the bacterial spectrum of 25 children with periodontitis has revealed that obligate anaerobes make up 65% of the bacteria . In 96% of cases anaerobic microorganisms are isolated in associations . Bacterial associations are analyzed.

Lab Delo, 1991, (7), 69 - 71
{A standard tampon for quantitative studies of mixed anaerobic-aerobic microflora}; Ushakov RV et al.; A tampon made of the new spongy polyvinyl-formal AQUIPOR 3500/40 is suggested for quantitative studies of mixed anaerobic-aerobic microflora . Comparison of the adsorption characteristics, the preservation of the tested pathologic material during the collection and transportation of the material, and the potential antibacterial characteristics of the suggested tampon and the traditional cotton wool tampons has shown the advantages of the new tampon, that permits standardization of the investigation by the quantitative bacteriologic method and preserves both aerobic and anaerobic microorganisms viable . This tampon may be used in studies of purulent wound and periodontal pocket microflora.

Lab Delo, 1991, (11), 65 - 7
{A micromethod of determining the sensitivity of anaerobic bacteria to antibacterial preparations}; Ushakov RV et al.; An economic rapid 'cassette' micromethod for estimating the sensitivity of obligate anaerobes to antibiotics has been developed, applicable at clinical laboratories . The method permits simultaneous testing of a microorganism with a wide range of antibiotics and assessment of the minimal inhibiting concentration of the agent, making use of the minimized volume of the inoculum . The technique has been tried with 176 anaerobe strains isolated from maxillofacial purulent foci from 76 patients; sensitivities to 42 antibiotics and antiseptics have been tested . Parallel inoculations were carried out, as was a comparative study with the traditional serial dilutions in solid nutrient medium . The suggested method is available and rapid; the results are ready within 1-3 days.

Lab Delo, 1991, (1), 53 - 6
{Non-sporogenous anaerobes in the microflora of carious teeth}; Ivashkevich LG et al.; Microflora of carious cavities was examined in 38 children . The authors describe the methods for anaerobic microflora isolation and microflora composition . Obligate anaerobes make up 70 percent of the total number of microorganisms . Anaerobic microorganisms are isolated in associations in 84 percent of cases . Bacterial associations are analyzed in detail, and the ratio of obligate to facultative anaerobes is presented, which depends on the activity of the carious process.

Drugs, 1991 Jan, 41(1), 19 - 37
Antibiotic prophylaxis in hysterectomy and induced abortion . A review of the evidence; Houang ET; By the early 1980s, perioperative prophylaxis in vaginal hysterectomy had been shown consistently to be of such value in reducing postoperative infection that some authors maintained that further placebo-controlled studies were no longer ethical . The benefit of prophylaxis in abdominal hysterectomy was less uniformly demonstrated, in studies which were prospective, placebo-controlled, double-blind and randomised . Prophylaxis may significantly reduce the incidence of febrile morbidity and/or wound/pelvic infection, the duration of hospital stay, or the total usage of antibiotics . It is therefore generally agreed that each centre should itself scientifically evaluate the efficacy of prophylaxis before a decision on its routine use in abdominal hysterectomy is made . In comparative studies, agents which were active against both anaerobic and aerobic organisms were more efficacious than those active against anaerobes only . Antibiotics with similar spectra of activity showed similar efficacy in both types of hysterectomy . Multiple- and single-dose regimens of the same antibiotics also showed equal efficacy . The new cephalosporins with a longer half-life were attractive theoretically as agents in single-dose regimens; ceftriaxone, however, has been shown to have an adverse effect on the normal gut flora . With the increased numbers of induced abortions carried out in the UK and other parts of the world in recent years, the need to reduce postabortal infection is generally appreciated . The results of early studies using tetracyclines as the prophylactic agents were difficult to evaluate because of the incomplete follow-up and different definitions of pelvic infections . No benefit was demonstrated in 2 studies using a single preoperative dose of tinidazole, whereas oral metronidazole in 3 doses and penicillin/pivampicillin for 4 days were shown to be efficacious in reducing postabortal infection . In a recent study with doxycycline, significant benefit was shown in patients with negative preoperative screening for gonococcal and chlamydial infection . These genital infections, together with a history of previous pelvic inflammatory disease (PID)/gonorrhoea, nulliparity with multiple partners, young age of the patient and gestational age have been described as significant risk factors . Some researchers hold the view that selective prophylaxis based on these risk factors should be practised instead of mass prophylaxis . All agree that an antibiotic regimen that is both efficacious and well tolerated has yet to be found.

Zhonghua Kou Qiang Yi Xue Za Zhi, 1991 Jan, 26(1), 28 - 30, 62-3
{Anaerobes in infected canals: a preliminary study}; Liang JP; Anaerobes of 17 infected canals with periapical periodontitis were studied . Most of root flora were not only anaerobes but also aerobes . Anaerobes were predominant in chronic periapical periodontitis . Major anaerobes isolated from canals were peptostreptococcus, B . melaninogenicus and B . oralis . The chi-square results indicated that the peptostreptococcus were significantly related to apical radiolucency and B . melaninogenicus were significantly related to percussion or foul smell . Animal experiment results showed that rats inoculated with mixed flora developed many abscesses . But the monoinfected rats had infiltration of PMNs, dilation and hypermia of vessels . B . melaninogenicus, B . oralis and mixed flora had liquefied gelatin and indicated these bacteria had collagenase which could dissolve collagen fibers and significantly related to destroy of collagen fibers and bone in periapical tissues.

Ann Otol Rhinol Laryngol, 1990 Dec, 99(12), 980 - 3
Microbiology of "normal" tonsils; Brook I et al.; Core tonsillar cultures for aerobic and anaerobic bacteria were performed on four normal tonsils removed from four children because of velopharyngeal insufficiency and on four tonsils removed from four children because of recurrent tonsillitis . The data illustrate the presence of polymicrobial flora in the cores of normal noninflamed tonsils and the increase in their number and encapsulation during the inflammatory process.

J Chemother, 1990 Dec, 2(6), 362 - 7
Antimicrobial activity of artemisinin and its derivatives against anaerobic bacteria; Shoeb HA et al.; Artemisinin and nine of its semisynthetic derivatives were tested for antibacterial activity against anaerobic, facultative anaerobic, microaerophilic and aerobic bacteria . Only anaerobic bacteria and gonococci showed sensitivity to artemisinin derivatives . Artemisinin and its deoxy derivatives had no activity at 100 micrograms/ml concentration . The newly synthesized methyl diperoxy derivative had the highest activity against all tested anaerobes with a MIC of 9.4 micrograms/ml.

Fed Oper Dent, 1990 Dec, 1(2), 30 - 6
The effect of metronidazole on the anaerobic microorganisms of the root canal--a clinical study; Sanjiwan R et al.; The antibacterial effect of 0.25% metronidazole solution as root canal irrigant on anaerobic bacteria was studied in ten central incisors . Each tooth was treated at four appointments, and the presence of anaerobes in the root canal was studied on each occasion . No antibacterial intracanal dressings were used between the appointments . No anaerobes could be recovered from any tooth on the fifth appointment . In the control group, where normal saline was used as an irrigant, anaerobes could be recovered in four of the ten canals . These results suggest that 0.25% metronidazole solution is more effective than saline solution as a root canal irrigant.

Kansenshogaku Zasshi, 1990 Dec, 64(12), 1493 - 8
{Clinical studies on hospital acquired pneumonia in the elderly}; Yamamoto K et al.; We compared hospital acquired pneumonia (HAP) with nursing home acquired pneumonia in the elderly . There were no differences in the underlying diseases, clinical signs and symptoms between HAP and nursing home acquired pneumonia, but activities of daily living were poor in HAP than nursing home acquired pneumonia . By the bacterial studies from Transtracheal aspiration (TTA), S . aureus, K . pneumoniae, P . aeruginosa and anaerobes were more isolated in HAP . On the other hand, S . pneumoniae and H . influenzae were isolated more in the nursing home acquired pneumonia . In the laboratory data, no difference was detected in inflammatory reaction between both groups, but in immunological data, especially complement C3 and tuberculin skin test were markedly reduced in HAP . The prognosis were significantly poor in HAP because the fatal rate was higher in HAP than nursing home acquired pneumonia . With regard to HAP in the elderly, severe underlying disease, poor whole body state, aspiration, bacterial resistance to drugs, superinfection and polymicrobial infection were the factors predisposing difficulty in treatment of pneumonia in the elderly . From the above results, prevention is the most necessary in HAP.

Arch Biochem Biophys, 1990 Nov 15, 283(1), 210 - 6
Characterization of a superoxide dismutase gene from the archaebacterium Methanobacterium thermoautotrophicum; Takao M et al.; A gene encoding superoxide dismutase (SOD) was cloned from the archaebacterium Methanobacterium thermoautotrophicum, the first example from an anaerobic bacterium . The deduced amino acid sequence showed overall similarity to sequences of known Mn- and Fe-SODs from aerobic organisms . Judging from a detailed sequence comparison, the cloned SOD gene is classified as Mn-SOD . By comparison of Mn-SOD sequences among various species it was suggested that archaebacterial superoxide dismutase is a direct descendant of a primordial enzyme . Between a putative promoter and the start codon there is an inverted repeat sequence which is also found in the counterpart of Halobacterium halobium.

Nippon Sanka Fujinka Gakkai Zasshi, 1990 Nov, 42(11), 1551 - 5
{Intravaginal bacterial flora in patients with uterine cervical cancer, with special reference to Gardnerella vaginalis}; Ito K et al.; In a total of 18 subjects, comprising 16 cases of uterine cervical cancer (4 cases, stage Ib; 1 case, stage IIa; 11 cases, stage IIb) and 2 cases of cervical dysplasia, the intravaginal bacterial floras, including Gardnerella vaginalis (G . vaginalis) and Mobiluncus spp., were investigated . In uterine cervical cancer, there were mixed bacterial flora of aerobes and anaerobes but what is of note is that G . vaginalis was detected in 7 out of 16 cases of uterine cervical cancer and in 1 out of 2 cases of dysplasia . The number of G . vaginalis present was far greater than that of the other coexisting species . In contrast, none of the Mobiluncus spp . was detected . Since G . vaginalis was detected at a high incidence in uterine cervical cancer and dysplasia, the possibility of a relationship between G . vaginalis and uterine cervical cancer was suggested.

J Clin Pathol, 1990 Nov, 43(11), 947 - 9
Comparison of three-compartment Petri dishes and individual plates for routine culture of vaginal swabs; Reeder JC et al.; Recovery of aerobes and facultative anaerobes from 200 consecutive randomly selected high vaginal swabs was evaluated using three-compartment Petri dishes containing Sabouraud, dextrose agar, GC selective agar, and chocolate agar . The method was compared with the traditional method using individual Petri dishes . The two methods produced comparable results both in terms and quantities of organisms recovered from the specimens . As three-compartment Petri dishes use less agar, save time in culturing specimens, yet still maintain the same standard of culture, they provide a more economical alternative to the traditional method for routine culture of vaginal swabs.

Am Surg, 1990 Nov, 56(11), 655 - 8
Human intestinal tissue antibiotic concentrations . Clindamycin, gentamicin, and mezlocillin; Thadepalli H et al.; An antibiotic, to be effective for prophylaxis in abdominal trauma, should quickly achieve high concentrations in the intestinal wall and at enough inhibitory levels to kill most aerobic and anaerobic bacteria that are potential contaminants at the site of surgical incision . Therefore, we studied the intestinal tissue levels of clindamycin, gentamicin, and mezlocillin to see whether the tissue levels achieved by these antibiotics in the intestinal tissue were adequate . A single dose of mezlocillin, 4 grams; clindamycin, 600 mg and gentamicin, 80 mg; quickly reached the desired concentrations, i.e., 52.3, 9.69 and 6.1 micrograms/gram of intestinal tissue respectively . These levels were high enough to inhibit the growth of most isolates of E . coli and B . fragilis, common pathogens involved in intra-abdominal abscess.

Antimicrob Agents Chemother, 1990 Nov, 34(11), 2086 - 92
Effects of trospectomycin on serum sensitivity of Escherichia coli UC 9451; Cialdella JI et al.; Trospectomycin sulfate, a chemically synthesized analog of spectinomycin, exhibits a broad range of activity against both aerobes and anaerobes, including the etiological agents of sexually transmitted diseases . Its activity in vitro against Escherichia coli is considered only moderate . At subinhibitory levels, however, trospectomycin induced changes in a pathogenic strain of E . coli, UC 9451, which significantly increased its sensitivity to serum lysis . This strain of E . coli shows high-level resistance to serum in vitro, typically growing twofold within a 45-min incubation period . Following exposure to one-fifth the MIC of trospectomycin, greater than 99% of the bacteria were killed in 25% serum within 15 min . Surviving bacteria were static in this level of serum for over 3 h . Killing was due to lysis mediated by both the classical and alternative complement pathways . The bacteria exposed to trospectomycin were enlarged in both diameter and length, but they still grew at rates comparable to those of untreated bacteria . No other visible morphological changes could be directly related to the increase in serum sensitivity . The profile of outer membrane proteins obtained by sodium dodecyl sulfate-polyacrylamide gel electrophoresis was identical for trospectomycin-treated or untreated bacteria . However, the relative proportion of four major outer membrane proteins varied considerably.

Dtsch Z Mund Kiefer Gesichtschir, 1990 Nov-Dec, 14(6), 418 - 23
{Perioperative antimicrobial prophylaxis in Obwegeser-Dal Pont surgery for prognathism}; Liebermann B et al.; The value of ultra short antimicrobial prophylaxis using azlocillin in preventing postoperative wound infections was studied in a prospective clinical/bacteriological study in 41 orthognathic operations . Preoperatively the oral mucosa and pharyngeal flora of each patient was subjected to bacteriological identification with particular emphasis on anaerobes and sensitivity tests for organisms with established pathogenic potential . The results of a bacteriological examination of the redon drains on day 1 postoperatively indicated a contamination of the surgical wound . Clinically 31 patients showed moderate postoperative edema of the buccal soft tissues and 10 patients had hematomas or hemorrhages . In all patients the operation was followed by primary intraoral wound healing without any signs of an early infection.

J Am Soc Nephrol, 1990 Nov, 1(5), 837 - 40
A novel method of inducing and assuring total anoxia during in vitro studies of O2 deprivation injury; Joseph JK et al.; Oxyrase is an enzyme mixture coveted by microbiologists for its unique ability to remove O2 from media in which anaerobic bacteria are grown . The study reported here examined the potential usefulness of Oxyrase as an adjunct to gassing freshly isolated rat proximal tubules (RPT) with 95% N2-5% CO2 in an attempt to achieve totally O2-free conditions (anoxia) before initiating studies on the mechanism of O2 deprivation injury in vitro . RPT, in 6 ml of Krebs-Henseleit buffer (KHB), were initially gassed with 95% N2-5% CO2 at 1.5 liters/min for 5 min and incubated for 15 to 30 min at 37 degrees C in a shaking water bath, pO2 decreased from approximately 400 to 80 mm Hg . If RPT were present in the KHB, pO2 was even lower, i.e., approximately 50 mm Hg . Addition of increasing concentrations of Oxyrase (300 to 1,500 mU) to KHB alone, that is, without RPT, reduced pO2 from 80 mm Hg to less than 5 mm Hg; increasing the gas rate from 1.5 to 3.0 liter/min of 95% N2-5% CO2, the concentration of Oxyrase to 1,800 mU, and adding RPT reduced pO2 to zero . In this latter condition, pO2 remained unmeasurable during the 20 min of study and neither pH nor pCO2 changed compared with control values . Oxyrase (1,800 mU) had no effect on lactate dehydrogenase release, a sign of membrane injury, in normoxic RPT in KHB . We conclude that anoxia can easily be achieved by the addition of Oxyrase to KHB in which RPT are suspended, if the appropriate concentration of Oxyrase is added and if the RPT are gassed with 95% N2-5% CO2 . This concentration of Oxyrase exerts no detrimental effects on RPT gassed with 95% O2-5% CO2.

Antibiot Khimioter, 1990 Nov, 35(11), 47 - 51
{Efficacy of a combination of dioxidine with beta-lactam antibiotics in the prevention and treatment of purulent-inflammatory complications}; Bogomolova NS et al.; Schemes for prevention and treatment of purulent inflammatory complications were developed on the basis of in vitro studies on antimicrobial activity of dioxidine and 7 beta-lactam antibiotics such as mezlocillin, carbenicillin, ampicillin, cefotaxime, cefoxitin, cefuroxime and cephalothin under conditions of aero- and anaerobiosis with an account of the isolated microflora, its sensitivity to antibacterial agents and conditions required for vital activity of obligate anaerobes in humans, i.e . decreased partial oxygen pressure, low oxidation-reduction potentials and high tissue concentrations of carbon dioxide . The use of dioxidine in combination with the antimicrobial drugs enabled one to decrease the number of cases with purulent inflammatory complications after large intestine esophagoplasty to 30.4 per cent against 67.5 per cent in the control group of the patients untreated preventively with the antibacterial drugs . The number of cases with similar complications after gastrectomy amounted to 16.1 per cent against 62 per cent in the control . The use of dioxidine+ in combination with ampicillin and cefotaxime in treatment of purulent necrotic affections of the foot in patients with diabetes mellitus enabled one to increase the number of satisfactory outcomes by 32 per cent, to decrease the number of high amputations by 21.9 per cent and to lower the number of deaths more than 2-fold as compared to the results in the control group of the patients subjected to chemotherapy based on sensitivity of the aerobic microflora alone.

Kansenshogaku Zasshi, 1990 Nov, 64(11), 1433 - 8
{Studies of polymicrobial infection on pneumonia by transtracheal aspiration in the elderly}; Yamamoto K et al.; We studied the polymicrobial infection by transtracheal aspiration (TTA) on pneumonia in the elderly . Incidence of mixed isolation of organisms from TTA was 35% or 39 out of 111 episodes . The principal organisms in polymicrobial infection detected from TTA were S . aureus (N.23), P . aeruginosa (N . 15), K . pneumoniae (N . 12) and S . pneumoniae (N . 11) . The principal combination of mixed infection were S . aureus + P . aeruginosa (N.7), S . aureus + K . pneumoniae (N.5), S . aureus + S . marcescens (N.5), S . aureus + S . pneumoniae (N.5), S . aureus + Anaerobes (N.4) and K . pneumoniae + P . aeruginosa (N.4) . Hospital acquired pneumonia was of a higher rate of mixed infection than the nursing home acquired pneumonia . In the mixed infection on pneumonia in the elderly, normal upper airway flora was highly detected with pathogens from transtracheal aspirates . From these results, we realize that aspiration and superinfection were important factors in mixed infection in the elderly.

Antimicrob Agents Chemother, 1990 Nov, 34(11), 2280 - 2
Fastidious anaerobe agar compared with Wilkins-Chalgren agar, brain heart infusion agar, and brucella agar for susceptibility testing of Fusobacterium species; Brazier JS et al.; Fastidious anaerobe agar supported the growth of 82 strains of fusobacteria better than brain heart infusion agar, brucella agar, and Wilkins-Chalgren agar . Fastidious anaerobe agar showed less hazing and fewer tailing endpoints with beta-lactam antibiotics . Whole-blood supplementation improved the performance of all media . Wilkins-Chalgren agar without blood failed to support the growth of 17% of the strains . All Fusobacterium ulcerans strains were resistant to clindamycin.

Med Lab Sci, 1990 Oct, 47(4), 337 - 46
Experiences with anaerobes; Allen MA et al.; Anaerobiology has long been an underdeveloped entity in the routine clinical microbiology laboratory . The difficulties and successes in setting up this specialist department in such a laboratory are outlined . It is concluded that specimen quality, technical expertise, taxonomy and identification remain the areas which need most attention.

Ann Pediatr (Paris), 1990 Oct, 37(8), 507 - 9
{An unusual germ causing a limp: Eikenella corrodens}; Ugazzi M et al.; A case of retroperitoneal appendicular abscess due to Eikenella corrodens is reported . This facultative anaerobe is normally found on the respiratory and intestinal mucosa and may be responsible for opportunistic infections . Culture is difficult and growth is slow . There have been few previous reports of the localization reported herein . A limp was the first manifestation of the infection . The differential diagnosis and pathophysiology of this symptom are discussed.

Acta Chir Scand, 1990 Oct, 156(10), 695 - 9
Primary closure or secondary granulation after excision of pilonidal sinus?
al-Hassan HK, Francis IM, Neglen P.
Two methods for treatment of chronic pilonidal disease were compared in a randomised trial of 100 patients with a mean follow-up of 29 months . Four patients were excluded from the excision and closure group, leaving 96 patients for analysis . Initial primary healing was significantly more frequent after excision and primary closure (45/46; 98%) compared with excision and healing by secondary granulation (36/50; 72%) . The mean healing time was significantly shorter in the excision and closure group (10.3 days) compared to the excision and granulation group (13 weeks) . There was, however, no significant difference between the two groups in cure rate after the first operation . The recurrence rate in the excision and granulation group was 12% and after primary closure 20% . The presence of stiff hair and anaerobic bacteria were related to the failure of primary healing, but not associated with recurrence . Although the cure rate was the same regardless which operation was done, the primary healing was quicker and the healing time and duration of sick-leave were shorter after primary closure . Excision with primary closure therefore seems to be the preferable method.

J Antibiot (Tokyo), 1990 Oct, 43(10), 1245 - 53
Structures of agglomerins; Terui Y et al.; Structures of a series of new antibiotics, agglomerins A, B, C and D, which are active against a variety of anaerobic bacteria, were determined to be 1-acyl-2,3-dihydroxy-1,3-butadiene-1-carboxylic acid, (1----3)-gamma-lactones, i.e., 2-acyl-4-ylidenetetronic acids with different hydrocarbon chains in the acyl group . Their common chromophore exhibited tautomerism in solution . The relationship of their structure to the activity against anaerobes is discussed.

J Parasitol, 1990 Oct, 76(5), 717 - 24
Axenic culture and characterization of Giardia ardeae from the great blue heron (Ardea herodias); Erlandsen SL et al.; Trophozoites of Giardia ardeae were obtained from the great blue heron (Ardea herodias) and established in axenic culture using the TYI-S-33 medium . The generation time in culture for G . ardeae was 22-25 hr, which was 3-fold longer than for Giardia duodenalis (WB strain) . A morphological comparison of trophozoites in the original intestinal isolate to those grown in culture revealed that they were identical for the following characteristics: a pyriform-shaped body, a ventral adhesive disc with a deep notch in the posterior border, teardrop-shaped nuclei, pleomorphism in median body structure ranging from a round-oval appearance (Giardia muris type) to that of a clawhammer (G . duodenalis type), and a single caudal flagellum on the right side (as viewed dorsally) with the left one being rudimentary . Analysis of the chromosomal migration patterns was performed by orthogonal-field-alternation gel electrophoresis and demonstrated that the pattern for G . ardeae was distinctly different from that for G . duodenalis (Portland 1-CCW strain) . Bacterial symbionts were seen attached to trophozoites in the original isolate but could not be detected in cultured trophozoites using scanning electron microscopy, fluorescence light microscopy using the Hoechst 33258 dye for DNA localization, or by standard microbiological techniques using nonselective media for growing aerobic or anaerobic bacteria . This study demonstrated that avian-derived Giardia could be grown in axenic culture; based on morphological criteria and chromosomal migration patterns, that G . ardeae should be considered a distinct species; and that rationale for determining Giardia spp., based on median body structure alone, should no longer be considered adequate for classification at the species level.

Panminerva Med, 1990 Oct-Dec, 32(4), 184 - 9
Treatment of pelvic inflammatory disease with combined piperacillin and minocycline therapy; Surico N et al.; Pelvic inflammatory disease (PID) has its aetiopathogenesis especially in anaerobic microorganisms and it is considered that 15% of patients with PID do not respond to initial treatment, 20% have at least one recurrence and 18% become sterile . Forty-six patients aged between 18 and 45 treated as out-patients with the association piperacillin-minocycline have been considered . These patients were monitored up to 5 weeks from the start of therapy following standard evaluation criteria and it is held that this therapy is effective and indicated as a first approach.

Am J Obstet Gynecol, 1990 Sep, 163(3), 757 - 61
Infection and labor . VI . Prevalence, microbiology, and clinical significance of intraamniotic infection in twin gestations with preterm labor; Romero R et al.; The purpose of this study was to establish the prevalence, microbiology, and outcome of microbial invasion of the amniotic cavity in twin gestation presenting with preterm labor and intact membranes . Amniocenteses were performed on both sacs of 46 women with twin gestations, preterm labor, and intact membranes . Indigo carmine was injected to ensure sampling of both amniotic sacs . Amniotic fluid was cultured for aerobic and anaerobic bacteria, Mycoplasma hominis, and Ureaplasma urealyticum . A positive amniotic fluid culture of at least one sac was noted in 10.8% (5/46) of patients admitted in preterm labor and in 11.9% (5/42) of women delivered of preterm neonates . Of the five patients with microbial invasion of the amniotic cavity, three had microorganisms isolated from both sacs . The presenting sac was involved in all cases, supporting an ascending route for microbial invasion of the amniotic cavity in twin gestation . Polymicrobial infection was found in three of the eight amniotic sacs with positive cultures . In two cases different organisms were isolated from each sac . All patients with positive amniotic fluid cultures were delivered of preterm infants within 48 hours of amniocentesis . Patients with positive amniotic fluid cultures presented with preterm labor at an earlier gestational age and with more advanced cervical dilatation than did women with negative amniotic fluid cultures . Clinical evidence of chorioamnionitis subsequently developed in two of five women with positive amniotic fluid cultures . The interval between amniocentesis and delivery was shorter in women with positive amniotic fluid cultures than in women with negative amniotic fluid cultures (median: 3.5 vs 168 hours, p less than 0.0001) . Infants born to women with microbial invasion of the amniotic cavity had a lower median birth weight and a higher incidence of respiratory distress syndrome than those born to women with negative amniotic fluid cultures (birth weight: 1085 vs 1975 gm, p = 0.024; respiratory distress syndrome: 37.5% vs 8.3%, p = 0.04).

J Infect Dis, 1990 Sep, 162(3), 695 - 9
The nonpuerperal breast infection: aerobic and anaerobic microbial recovery from acute and chronic disease; Edmiston CE Jr et al.; Sixty breast culture specimens were obtained by needle aspiration from 54 women and 2 men . A total of 221 microbial isolates were obtained from 52 culture-positive samples . Aerobes alone were recovered from 11 patients while 5 were culture-positive for anaerobes only . Thirty-six patients harbored mixed aerobic and anaerobic microbial flora, and the anaerobic gram-positive cocci were the predominant isolates recovered . The mean microbial recovery for patients with an acute abscess was 2.9 isolates, while in patients with chronic infections the mean microbial recovery was 5 . The anaerobic populations outnumbered facultative isolates by two to one, and 34% of anaerobic isolates were recovered from subculture . These findings demonstrate that, contrary to previous reports, nonpuerperal breast infections involve a mixed infection that is primarily anaerobic.

Obstet Gynecol, 1990 Sep, 76(3 Pt 1), 355 - 9
Histologic chorioamnionitis, microbial infection, and prematurity; Zlatnik FJ et al.; The purpose of this study was to relate histologic chorioamnionitis to the isolation of microorganisms from the freshly separated chorioamnion in women who had early preterm delivery (before 35 weeks' gestation) following spontaneous labor . Histologic chorioamnionitis was identified in 51 of 95 study subjects . It was more common in the second trimester (72%) than from 27-34 weeks' gestation (33%) (P less than .001) . Culture specimens were obtained for aerobic and anaerobic bacteria, yeasts, mycoplasmas, and Chlamydia . Microorganisms were recovered from 38 subjects; all culture reports were negative in 36 . A statistically significant association was demonstrated between histologic chorioamnionitis and positive culture results . If any microorganism was recovered, 68% of the subjects had histologic chorioamnionitis, versus 39% if all cultures were negative . Of cases of histologic chorioamnionitis in the third trimester, 92% were associated with positive cultures, compared with 54% in the second trimester . Our results suggest that histologic chorioamnionitis is not synonymous with infection, especially in the second trimester.

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