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 detect