Staphylococcus aureus

Nutrition, 1993 Nov-Dec, 9(6), 524 - 7
Nucleoside-nucleotide mixture and its components and response to methicillin-resistant Staphylococcus aureus infection in mice; Yamamoto S et al.; The effects of a nucleoside-nucleotide mixture and its individual components on response to methicillin-resistant Staphylococcus aureus (MRSA) strain 8985N were studied in mice . BALB/c mice were fed a nucleic-acid-free 20% casein diet and intraperitoneally administered a nucleoside-nucleotide mixture, its individual components (inosine, GMP2Na, uridine, thymidine, cytidine), or saline for 30 days . On the 10th day of this treatment, the mice were inoculated intravenously with the viable MRSA organisms . By the 20th day after inoculation, mice in the saline group showed 33% survival, whereas mice in the nucleoside-nucleotide mixture group showed 75% survival . The survival rates in the inosine (62%), GMP2Na (57%), uridine (54%), cytidine (50%), and thymidine (46%) groups were not significantly different . The survival rates of the individual-component groups tended to be higher than that of the saline group, but this was not statistically different . Furthermore, there was a greater reduction in viable organism recovery in the spleen and kidney of the surviving mice in the component groups than in the saline group . However, the survival rates in the individual-component groups did not exceed that of the nucleoside-nucleotide mixture group . This study suggests that intraperitoneal administration of a nucleoside-nucleotide mixture appears to be important in producing a high survival rate after challenge with MRSA . The effect cannot be achieved with the specific components of the mixture administered individually.

Rev Inst Med Trop Sao Paulo, 1993 Nov-Dec, 35(6), 551 - 5
{Staphylococcal coagglutination reaction in the identification of mycoplasma}; Timenetsky J et al.; Staphylococcal Coagglutination was used as method for a rapid identification of mycoplasmas that could be performed by non specialized laboratories . Suspensions of Staphylococcus aureus (Cowan I) sensitized with rabbit antibodies against NCTC mycoplasma strains have identified these microorganisms and the strains isolated from humans, cell cultures rats and mice in concentrated suspensions from cultures of 4.0 ml . Fourty eight strains of M.pulmonis, 6 of M . arthritidis, 8 of M.arginini, 3 of M.orale, 15 of A.laidlawii, 8 of M.hominis and 3 of M.pneumoniae were identified by staphylococcal coagglutination and confirmed by Growth Inhibition Test . Optimal parameters of coagglutination were established and the stability of the conjugates were preserved for 90 days when added with acetyl cysteine . The reaction was visualized without optical resources . The sera were previously absorbed with heterologous NCTC strains and with the pellet of the sterile broth.

J Hosp Infect, 1993 Nov, 25(3), 207 - 10
Staphylococcal pneumonia in ventilated patients: a twelve-month review of cases in an intensive care unit; Inglis TJ et al.; We reviewed staphylococcal lower respiratory tract infections in our intensive care unit over a 12-month period . Staphylococcus aureus was isolated from tracheal aspirates more commonly in patients with intracranial trauma (P < 0.001), between one and six days (mean = 3) after admission to the intensive care unit . Bacteriophage typing of all S . aureus lower respiratory tract isolates from the 17 patients with head injury did not provide evidence for a common external source of infection or patient-to-patient transmission.

Immunopharmacology, 1993 Nov-Dec, 26(3), 197 - 202
Cladribine (2-chloro-deoxyadenosine, CDA): an inhibitor of human B and T cell activation in vitro; Gorski A et al.; We have previously shown that the novel immunosuppressive agent cladribine (CDA) inhibits human T and B cell lymphoproliferative responses and immunoglobulin synthesis in vitro, yet appears to be particularly efficacious as an inhibitor of B cell responses . We now report the effects of CDA on the human mixed lymphocyte reaction and on expression of T and B cell activation markers . CDA produced a significant inhibition of lymphocyte proliferation in human mixed lymphocyte reactions at a concentration of 10 nM . At concentrations of 10-100 nM the drug inhibited phytohaemagglutinin-induced expression of CD25 and HLA-D (by approximately 50%), but not phorbol myristate acetate-induced expression of CD69 on purified human T cells . At a concentration of 10 nM CDA totally abolished Staphylococcus aureus Cowan-induced expression of CD25 on purified B cells . These findings confirm that CDA is a potent immunosuppressive agent with some selectivity towards B cells . The drug may have potentially wide applications in clinical immunosuppression.

Antimicrob Agents Chemother, 1993 Nov, 37(11), 2278 - 84
Sequential acquisition of norfloxacin and ofloxacin resistance by methicillin-resistant and -susceptible Staphylococcus aureus; Hori S et al.; The acquisition of ofloxacin resistance by a susceptible clinical Staphylococcus aureus strain was found to be achieved in two sequential steps: the first step was accompanied by 4-fold increases in the ofloxacin MIC and 8- to 16-fold increases in the norfloxacin MIC . The second step was accompanied by further increases in both the ofloxacin and the norfloxacin MICs . A mutation of the gyrA gene resulting in an amino acid substitution was found in the second-step but not in the first-step resistant subclone . On the other hand, there was no difference in the accumulation of norfloxacin in the parent strain and the resistant subclones of each step . The rates of mutation to resistance in the steps were (1.58 to 6.81) x 10(-9) and (0.71 to 2.59) x 10(-9), respectively, and did not depend on whether the parent strain was resistant to methicillin . Some implications of these observations for clinical as well as mechanistic aspects of the prevalence of methicillin- and ofloxacin-resistant S . aureus are discussed.

Biosci Biotechnol Biochem, 1993 Nov, 57(11), 1854 - 61
The complete amino acid sequence of chitinase-c from the seeds of rye (Secale cereal); Yamagami T et al.; The complete amino acid sequence of rye seed chitinase-c (RSC-c) has been analyzed . This was done by first sequencing the tryptic peptides from RCm-RSC-c and then connecting them by analyzing the peptides produced by digestions with lysylendopeptidase and Staphylococcus aureus V8 protease of RCm-RSC-c, and by chymotryptic digestion and formic acid cleavage of S . aureus V8 protease peptides . RSC-c consists of 243 amino acid residues and has a molecular mass of 26,093, and has 92% sequence homology with barley seed basic chitinase which lacks a Cys-rich domain . Cys204 is free and six cysteine residues are linked by disulfide bonds between Cys23 and Cys85, Cys97 and Cys105, and Cys223 and Cys236.

Proc Natl Acad Sci U S A, 1993 Nov 1, 90(21), 9935 - 8
Lipopolysaccharide-binding protein as a major plasma protein responsible for endotoxemic shock; Gallay P et al.; Because lipopolysaccharide (LPS)-binding protein (LBP) sensitizes monocytes to LPS in vitro, it has been suggested that LBP initiates host defenses against Gram-negative bacteria . The role of LBP in vivo, and particularly in endotoxemic shock, is unknown, however . Therefore an IgG against murine LBP was prepared . It was found to neutralize binding of LPS and subsequent activation of murine macrophages in vitro . This anti-LBP protected mice against the lethal effect of LPS when given at the same time as LPS challenge, but it failed to protect mice when delayed 15 min after LPS challenge . The same preparation was also effective after challenge with lipid A but not after challenge with Staphylococcus aureus enterotoxin . The protection was correlated with a strong decrease of circulating tumor necrosis factor . These data demonstrate that in vivo LBP is a major mediator of the lethal effects of endotoxemia.

J Immunol, 1993 Nov 1, 151(9), 4982 - 8
P-selectin blockade does not impair leukocyte host defense against bacterial peritonitis and soft tissue infection in rabbits; Sharar SR et al.; Adhesion molecules are responsible for PMN-endothelial cell interactions involved in both PMN-mediated endothelial injury (e.g., after ischemia-reperfusion injury) and PMN-mediated host defense against bacterial infection . Inhibition of PMN-endothelial adherence with CD18 and P-selectin mAb has been shown to ameliorate the tissue injury resulting from ischemia and reperfusion under a variety of experimental conditions . However, interference with PMN function may result in an increased risk of bacterial infection . Previous investigations suggest that CD18 blockade can lead to increased infectious risk . Little is known of the infectious risks associated with selectin blockade . We report the effects of P-selectin blockade (using mAb PB1.3) on bacteria-induced PMN emigration into the peritoneum and subcutaneous (s.c.) tissue in rabbits . Leukocyte and PMN emigration into the peritoneum 4 h after inoculation with 10 ml of 10(9) CFU/ml Escherichia coli was significant in saline-treated animals, and not different in animals pretreated with mAb PB1.3 . Similarly, the incidence and severity of abscess formation 7 days after s.c . inoculation with Staphylococcus aureus (10(7), 10(8), or 10(9) CFU) was not increased in rabbits pretreated with mAb PB1.3 compared to saline . PMN emigration to the s.c . S . aureus was also similar in both saline and mAb PB1.3-treated animals, as determined by light microscopy . We conclude that P-selectin blockade with mAb PB1.3: 1) does not interfere with acute, E . coli-induced PMN emigration into the peritoneum, 2) does not increase the incidence or severity of S . aureus abscess formation in s.c . tissue, and 3) interferes less with PMN antibacterial host defense mechanisms than inhibition of CD18-mediated PMN adherence.

Biochemistry, 1993 Oct 26, 32(42), 11428 - 35
Identification and biochemical characterization of the ligand binding domain of the collagen adhesin from Staphylococcus aureus; Patti JM et al.; We have recently shown that the expression of a collagen adhesin is both necessary and sufficient to mediate the attachment of Staphylococcus aureus to cartilage, a complex collagen-containing substrate {Switalski, L . M., Patti, J . M., Butcher, W., Gristina, A . G., Speziale, P., & Hook, M . (1993) Mol . Microbiol . 7, 99-107} . We now report on the localization of the ligand binding site within the 135-kDa S . aureus collagen adhesin . Using deletion mutagenesis in combination with Western ligand blot and direct binding assays, the collagen binding domain (CBD) was localized to a 168 amino acid long segment {CBD(151-318)} within the N-terminal portion of the adhesin . Using biospecific interaction analysis, pepsin-digested bovine type II collagen was found to contain eight binding sites for CBD(151-318); two binding sites were of "high" affinity (Kd = 3 microM) and six sites were of low affinity (Kd = 30 microM) . Short truncations in the terminal flanking regions of CBD(151-318) resulted in two CBDs (180-318 and 151-297) that lacked collagen binding activity . Analysis by circular dichroism of the recombinant CBDs in the far UV revealed similar secondary structures, predominantly beta-sheet, whereas the near-UV spectra indicated dramatic changes in the degree of intermolecular packing (tertiary structure) . The deduced amino acid sequence of the ligand binding domain of the collagen adhesin is presented.

Biochim Biophys Acta, 1993 Oct 20, 1182(3), 275 - 82
Pore formation by a two-component leukocidin from Staphylococcus aureus within the membrane of human polymorphonuclear leukocytes; Finck-Barbancon V et al.; The effects of the Staphylococcus aureus leukocidin (PVL), a two-component non-hemolytic toxin, were investigated on the membrane permeability of human polymorphonuclear leukocytes (PMNs) . In the absence of extracellular Ca2+, the fluorescence of ethidium bromide added to the extracellular medium increased after PVL application in a concentration-dependent manner and no variations in the free intracellular {Ca2+} of Fura2-loaded PMNs were detected . In the presence of extracellular Ca2+, the fluorescence of ethidium was not modified but the free intracellular {Ca2+} of PMNs increased after application of PVL in a concentration-dependent manner . The time lag observed before an increase in the ethidium fluorescence was longer than the time lag observed before a Fura2 fluorescence increase . Simultaneous recordings of the two probes fluorescence variations have shown the protective effect of Ca2+ and Zn2+ and the closing of the pore by 50 mM Ca2+ or 2 mM Zn2+ . Moreover, the effect of Ca2+ could be reversed by the addition of EGTA . In the presence of 1 mM extracellular Ca2+ or 0.8 mM extracellular Zn2+, the pore induced by PVL had an ionic size allowing Ca2+, Mn2+, Zn2+ and Mg2+ fluxes . The addition of antibodies against either component of PVL inhibits the permeabilization provoked by the toxin even after it was initiated . It is concluded that leukocidin from S . aureus is a pore-forming toxin which, under physiological conditions ({Ca2+} = 1 to 1.5 mM), provokes the formation of an ion-sized pore inducing an increase in the free intracellular Ca2+ which may activate PMN functions.

Biochem J, 1993 Oct 15, 295 ( Pt 2), 437 - 45
Biochemical characterization of hamster oviductin as a sulphated zona pellucida-binding glycoprotein; Malette B et al.; Oviductins are a family of glycoproteins, synthesized and released by oviductal secretory cells, which bind to the zona pellucida of the oocyte after ovulation . Hamster oviductin migrates as diffuse species of 160-350 kDa during SDS/PAGE under reducing as well as non-reducing conditions . In this report, we describe the one-step purification of hamster oviductin using either immuno- or lectin-affinity chromatography . Probing with specific lectins showed that the glycoprotein contains terminal alpha-D-GalNAc, and either terminal alpha-D-NeuAc or non-terminal beta-D-(GlcNAc)2 residues, but fails to react with concanavalin A and Ulex Europeus A-1 lectins which are specific for branched alpha-D-mannose and alpha-L-fucose moieties respectively . Intraovarian oocytes do not contain this glycoprotein and we demonstrate here that the immunoaffinity-purified oviductin readily binds to their zonae pellucidae in vitro, thus mimicking the in vivo phenomenon . Two major immunologically related forms of hamster oviductin (named alpha and beta) were characterized using one- and two-dimensional gel electrophoresis . The alpha-form (160-210 kDa) has an acidic pI of 3.5-4.5 and the beta-form (approx . 210-350 kDa) is localized at the cathodic site in the isoelectric focusing dimension; in between these two major forms lies a smear of minor-charge isomers . Peptide mapping of both major forms with papain and Staphylococcus aureus V8 protease yielded fragments of identical size . Moreover, the two forms share the same N-terminal sequence which display no significant homology with other reported proteins . Treatment with trifluoromethanesulphonic acid showed that a protein with the size and pI of the alpha-form can be generated from the beta-form . Both the alpha- and beta-forms are sulphated on O-linked oligosaccharide side chains but are not phosphorylated . Collectively, these results suggest that the hamster oviductin polymorphism observed in two-dimensional PAGE is a consequence of different glycosylation patterns and not the polypeptide chain itself . Hamster oviductin is mostly O-glycosylated and contains a few N-linked oligosaccharide side chains (approx . 10 kDa) . We propose that hamster oviductin is a mucin-type glycoprotein which might act as a protective secretion influencing the first steps of the reproductive process necessary for the normal triggering of fertilization and early embryonic development.

Biochem Biophys Res Commun, 1993 Oct 15, 196(1), 473 - 9
Purification and characterization of a catalytically active human liver UDP-glucuronosyltransferase expressed as a fusion protein in E . coli; Pillot T et al.; The purification and the characterization of functional human liver UDP-glucuronosyltransferase 2B4 produced as a Staphylococcus aureus protein A fusion protein in E . coli are described . The purified fusion protein was able to catalyze the glucuronidation of hyodeoxycholic acid, the major substrate described for this isoform to date . The effects of the amount and the nature of the phospholipids upon reconstitution into phospholipid micelles were investigated . Apparent determined Km values for hyodeoxycholic acid and UDP-glucuronic acid were 0.55 and 0.43 mM, respectively . Moreover, photoaffinity labelling of the fusion protein with a photoactivatable analog of UDP-glucuronic acid strongly suggested that this recombinant protein exhibited similar binding properties as the microsomal protein, which emphasizes its use for further structural analyses.

Nucleic Acids Res, 1993 Oct 11, 21(20), 4830 - 5
The mouse antiphosphotyrosine immunoreactive kinase, TIK, is indistinguishable from the double-stranded RNA-dependent, interferon-induced protein kinase, PKR; Baier LJ et al.; The mouse TIK protein, a serine/threonine kinase, was originally isolated from a murine pre-B cell expression library by its ability to bind anti-phosphotyrosine antibodies (Icely et al., J . Biol . Chem . 266, 16073-16077, 1991) . The 67 kDa protein was found to have an associated autophosphorylation activity when incubated with ATP . Our results show that TIK is actually the mouse interferon-induced, dsRNA-dependent protein kinase, PKR . We demonstrate that the TIK message is interferon-inducible in mouse L-cells and in vitro transcription and translation of the TIK cDNA produces a protein that is capable of binding double-stranded RNA . The in vitro synthesized TIK protein migrated as a 65 kDa protein on SDS-PAGE when incubated with ATP, but migrated as a 60 kDa protein when incubated with an inhibitor of PKR, 2-aminopurine . We further show that proteolytic digestion of TIK with Staphylococcus aureus V8 protease results in a cleavage pattern identical to that obtained by V8 digestion of authentic PKR . Antiserum to TIK specifically recognized PKR . Cloned TIK had inhibitory activity for replication of EMCV but not VSV . From these observations we conclude that TIK kinase is the mouse interferon-induced, double-stranded RNA-dependent kinase, PKR.

Med Clin (Barc), 1993 Oct 2, 101(10), 379 - 82
{Mitral endocarditis caused by Staphylococcus aureus resistant to methicillin, aminoglucosides and rifampicin: description of 2 cases with fatal course}; Serrano R et al.; Two patients with infectious endocarditis (IE) by Staphylococcus aureus resistant to methicillin, aminoglucosides and rifampicin (SARMAR) acquired in hospital during the course of an epidemic outbreak of this microorganism in the Hospital Clinic i Provincial of Barcelona . Both patients had undergone surgery of the lower limbs . The entrance of the microorganism was the infection of the surgical wound, with bacteriemia, followed by mitral IE after a short time interval (20 days) . Despite adequate treatment with vancomycin both patients died . The culture of mitral vegetation was positive for SARMAR in one . Analysis of the chromosomic DNA of all the isolations from the patients was identical and coincided with that of the SARMAR strains isolated in the epidemic outbreak of the hospital . The current situation of IE by SARMAR is reviewed and the therapeutic implications commented upon suggesting that treatment of this entity should simultaneously include the administration of vancomycin and phosphomycin or cotrimoxazole, with surgery being considered if infection persists.

J Med Microbiol, 1993 Oct, 39(4), 305 - 9
Lectin typing of methicillin-resistant Staphylococcus aureus from Singapore, England and Wales, and Denmark; Jarlov JO et al.; Methicillin-resistant Staphylococcus aureus (MRSA) isolates from a possible outbreak in Singapore (84) were examined together with all MRSA isolated in Denmark in 1986-1990 (58) and 14 distinct epidemic and 10 distinct single hospital strains from England and Wales . All 84 Singapore isolates were phage typed routinely and 52 isolates were further analysed together with the Danish isolates with an additional set of experimental phages and by lectin typing . The British strains, previously phage typed in the same way, were lectin typed . The following lectins were used: wheat-term agglutinin, soy-bean agglutinin, tomato lectin and Concanavalin-A . Routine phage typing of the Danish isolates showed that 41 isolates belonged to 19 different types; 17 isolates were non-typable (NT) . Addition of experimental phage typing and lectin typing enhanced discrimination to 47 types . The 24 British strains could be divided into eight {corrected} "lectin types" . Sixty-one of the isolates from Singapore were non-typable by phage typing; the remaining 23 strains belonged to five types . Further examination of 52 isolates with the experimental set of phages and by lectin typing gave 14 closely related types; 48% of these isolates belonged to only two types.

Infect Immun, 1993 Oct, 61(10), 4254 - 62
Characterization of novel type C staphylococcal enterotoxins: biological and evolutionary implications; Marr JC et al.; The type C staphylococcal enterotoxins (SEC) are a group of highly conserved proteins with significant immunological cross-reactivity . Although three antigenically distinct SEC subtypes (SEC1, SEC2, and SEC3) have been reported in the literature, we observed that the isoelectric points of SEC from several Staphylococcus aureus isolates are different from those of any of these three subtypes . This observation led us to propose that additional SEC molecular variants exist . For assessment of this possibility, the sec genes from representative human, animal, and food isolates were cloned and sequenced . The toxins encoded by the 18 isolates used in this study included five unique SEC proteins in addition to SEC1, SEC2, and SEC3 . Six of the SEC proteins (including SEC1, SEC2, and SEC3) were produced by human and food isolates . Analysis of seven bovine and ovine isolates showed that isolates from each animal species produced a unique host-specific SEC . All of the SEC caused lymphocyte proliferation, although some of the toxins differed in their ability to stimulate cells from several animal species . An explanation for these results, which is supported by our phenotypic analysis of Sec+ staphylococcal isolates, is that toxin heterogeneity is due to selection for modified SEC sequences that facilitate the survival of S . aureus isolates in their respective hosts.

Exp Hematol, 1993 Oct, 21(11), 1467 - 72
The effects of treatment with PIXY321 (GM-CSF/IL-3 fusion protein) on human polymorphonuclear leukocyte function; Buescher ES et al.; During a phase I trial of the genetically engineered hematopoietic growth factor PIXY321 (granulocyte-macrophage colony-stimulating factor/interleukin-3 {IL-3} fusion protein), we examined the effects of PIXY321 treatment on human polymorphonuclear leukocyte (PMN) locomotive, respiratory burst, and phagocytic responses . PIXY321 treatment was associated with transient suppression of both unstimulated locomotion and chemotaxis responses to multiple stimuli, as well as significant transient enhancement of formyl peptide-stimulated H2O2 production . No effects on opsonic phagocytosis of Staphylococcus aureus were observed . In vitro exposure of control PMN to PIXY321 resulted in suppression of unstimulated locomotion/chemotaxis and enhancement of formyl peptide-stimulated H2O2 production but had no effects on phagocytosis . When patient cells were exposed in vitro to PIXY321 during treatment, suppression of chemotaxis and enhancement of H2O2 production were observed before PIXY321 treatment, but these effects diminished during treatment . The in vivo and in vitro exposure effects of PIXY321 treatment on PMN function are similar to those of the parent molecule, granulocyte-macrophage colony-stimulating factor (GM-CSF).

Obstet Gynecol, 1993 Oct, 82(4 Pt 2 Suppl), 660 - 2
Toxic shock syndrome associated with vulvar necrotizing fasciitis; Farley DE et al.; BACKGROUND: Fifty percent of toxic shock syndrome is associated with nonmenstrual etiologies such as postoperative wound infection . CASE: A 44-year-old woman developed necrotizing vulvar fasciitis that was successfully treated with surgical debridement and broad-spectrum antibiotics . However, after improving for 3 days postoperatively, she developed fever, a generalized maculopapular rash, and renal and liver abnormalities . As her condition worsened, she developed hypotension and respiratory distress . After 5 days in the intensive care unit, she gradually improved . Her wound culture from admission grew multiple organisms, including Staphylococcus aureus that produced toxic shock syndrome toxin-1 . CONCLUSION: Toxic shock may occur in varied gynecologic settings, including pelvic and perineal infection . Successful management requires a prompt and aggressive response to multi-organ system failure.

J Infect Dis, 1993 Oct, 168(4), 961 - 8
Exposure to ethanol up-regulates the expression of Mycobacterium avium complex proteins associated with bacterial virulence; Bermudez LE et al.; Mycobacterium avium complex (MAC) organisms are the most common bacterial cause of disseminated infection in patients with AIDS . MAC, facultative intracellular bacteria, invade and multiply within macrophages . Treatment of MAC-infected macrophages with ethanol (10-100 micrograms/dL) is associated with increased intracellular multiplication of MAC . To investigate whether this enhanced growth is due to a stress-related response induced by nonlethal concentrations of ethanol, strain 101 (serovar 1) was exposed to ethanol, and the regulation of the expression of proteins was examined . Exposure of MAC to ethanol (range, 10-100 micrograms/dL) was associated with up-regulation of the expression of a number of bacterial proteins, some of which (65 and 33 kDa) interfered with macrophage functions, such as production of superoxide anion and killing of Staphylococcus aureus . Thus, exposure of MAC to small concentrations of ethanol may induce a stress-related response with consequent increase in the synthesis of proteins possibly associated with its ability to survive within macrophages.

J Infect Dis, 1993 Oct, 168(4), 893 - 6
The effect of zinc on microbial growth and bacterial killing by cefazolin in a Staphylococcus aureus abscess milieu; Bamberger DM et al.; Microbial growth and antimicrobial bacterial killing are both diminished in abscesses . It was postulated that zinc depletion in abscesses, perhaps secondary to a neutrophil protein resembling calprotectin, may be partly responsible for these effects . In a rabbit tissue-cage abscess model, pooled abscess supernatant concentration of zinc was < 1.53 microM . The addition of 41.7 microM zinc had no effect on Staphylococcus aureus growth or the bacterial killing effect of cefazolin in serum . In abscess fluid supernatants, bacterial growth without antibiotic and bacterial killing by cefazolin were both enhanced by the addition of zinc . Fractionation of the abscess fluid with ultrafiltration membranes showed that these effects could be reproduced with the fraction between 30 and 50 kDa . These findings suggest that a protein in abscess fluid supernatants that resembles the neutrophil protein calprotectin may, through its zinc binding effects, inhibit microbial growth within an abscess but also inhibit the activity of bactericidal antibiotics.

J Infect Dis, 1993 Oct, 168(4), 1030 - 3
Passive local immunotherapy of experimental staphylococcal pneumonia with human intravenous immunoglobulin; Ramisse F et al.; Staphylococcus aureus remains a life-threatening agent of nosocomial pneumonia in immunocompromised patients . The increasing incidence of strains exhibiting wide-spectrum resistance to antibiotics, such as methicillin-resistant S . aureus (MRSA), requires new therapeutic strategies . There is renewed interest in passive immunization with human plasma-derived immunoglobulins (IVIG) as antiinfective agents . The efficacy of IVIG was tested in an experimental model of staphylococcal pneumonia, using both an MRSA clinical isolate and reference strain Cowan III, in mice immunosuppressed with cyclophosphamide . Efficient antistaphylococcal activities were obtained with IVIG administered intravenously or intranasally . IVIG saturated with protein A or its F(ab')2 fragments were as efficient as intact IVIG, suggesting that protection did not require opsonization through IgG Fc-phagocyte Fc gamma-receptor interactions . Thus, topical administration of IVIG may replace a local antibody response to S . aureus in an immunocompromised host and may be useful in prophylaxis and treatment of nosocomial S . aureus pneumonia.

J Immunol, 1993 Oct 1, 151(7), 3478 - 88
Regulation of C gamma subclass germ-line transcripts in human peripheral blood B cells; Kitani A et al.; In the present study we investigated the early steps of human IgG subclass differentiation by defining the conditions necessary for IgG subclass-specific production of germ-line transcripts in human peripheral blood B cells . Constant region of gamma-globulin (C gamma) subclass germ-line transcripts were measured using newly developed reverse transcription and polymerase chain reaction (RT-PCR) assays that were shown to be C gamma subclass-specific germ-line transcripts by size of the amplification products obtained before and after digestion with appropriate endonucleases (NarI and NcoI) . In initial studies we found that C gamma 1 and C gamma 2 germ-line transcripts were constitutively expressed in total peripheral blood B cells, but not in high density sIgM+(sIgG-) B cells prepared with Percoll density gradients and magnetic beads separation techniques; the latter cells were therefore used throughout this study . Induction of germ-line transcripts (germ-line C gamma 1 transcript) was noted in stimulated B cells (SAC plus IL-2) at 6 h; thus, the appearance of germ-line transcripts could not be attributed to preferential growth of B cells expressing germ-line transcripts . In subsequent studies we found that induction of germ-line transcripts for the various IgG subclasses fell into two patterns . Induction of C gamma 3 and C gamma 1 germ-line transcripts, transcripts of genes in the first human duplication unit, generally required a proliferative stimulus (Staphylococcus aureus Cowan I, SAC) and was brought about by SAC plus IL-4 (C gamma 3 germ-line transcripts) and SAC alone or SAC plus IL-2 (C gamma 1 germ-line transcripts); in contrast, induction of C gamma 2 and C gamma 4 germ-line transcripts, transcripts of genes in the second duplication unit, was accomplished with cytokines alone: IFN-gamma (C gamma 2 germ-line transcripts) and IL-4 (C gamma 4 germ-line transcripts), and was not augmented by addition of a proliferative stimulus . Finally, we found that IFN-gamma inhibited IL-4-induced C gamma 3 and C gamma 4 germ-line transcripts (with or without SAC) . These findings establish that the various human IgG subclasses manifest distinct requirements for the regulation of early steps in isotype differentiation . In addition, they suggest that human C gamma genes exhibit patterns of regulation related to their respective duplication units.

Ann Intern Med, 1993 Oct 1, 119(7 Pt 1), 560 - 7
Prosthetic valve endocarditis resulting from nosocomial bacteremia . A prospective, multicenter study; Fang G et al.; OBJECTIVE: To determine the incidence of endocarditis in bacteremic patients with prosthetic heart valves and the risk factors for and the effect of duration of antibiotic therapy on development of endocarditis in such patients . DESIGN: Multicenter, prospective observational study . SETTING: Six university teaching hospitals with high-volume cardiothoracic surgery . PARTICIPANTS: One hundred seventy-one consecutive patients with prosthetic heart valves who developed bacteremia during hospitalization . MEASUREMENTS AND MAIN RESULTS: Patients were evaluated when they were identified as having bacteremia and 1, 2, 6, and 12 months after its occurrence . Of 171 patients, 74 (43%) developed endocarditis: Fifty-six (33%) had prosthetic valve endocarditis at the time bacteremia was discovered ("endocarditis at outset"), whereas 18 (11%) developed endocarditis a mean of 45 days after bacteremia was discovered ("new endocarditis") . Mitral valve location and staphylococcal bacteremia (Staphylococcus aureus or S . epidermidis) were significantly associated with the development of "new" endocarditis . All 18 cases of new endocarditis were nosocomial, and in 6 of these cases (33%) bacteremia was acquired via intravascular devices . Twenty-one patients without evidence of endocarditis at the time of bacteremia received short-term antibiotic therapy (< 14 days); 1 patient (5%) developed endocarditis . Eleven of 70 patients (16%) who received long-term antibiotic therapy (> 14 days) developed endocarditis (P > 0.2) . CONCLUSIONS: Bacteremic patients with prosthetic heart valves were at notable risk for developing endocarditis, even when they received antibiotic therapy before endocarditis developed and regardless of the duration of such therapy . Intravascular devices were a common portal of entry.

Ostomy Wound Manage, 1993 Oct, 39(8), 26 - 7, 30, 32
Wound cultures: what, when and how; Burdette-Taylor S et al.; Collecting wound cultures is a very controversial issue at this time when cost containment is at the forefront of healthcare providers' minds . It is also controversial in this time of Methicillin Resistant Staphylococcus-aureus (MRSA) becoming more common and very difficult to manage in acute and long term care facilities . While the basics of culturing may have not changed, the decision to culture or not, and knowing what, when and how to culture, are of vital importance in the treatment and quality of care for the patient, staff and others . The purpose of this article is to present the implications for culturing a wound and the proper procedure for collecting the specimen and planting the organism . In this discussion of wound culturing, the authors will provide guidelines to accurately interpret the results to accommodate proper treatment in a cost-effective manner.

Mech Ageing Dev, 1993 Oct 1, 71(1-2), 31 - 46
Age-related alterations in the activation and expression of phosphotyrosine kinases and protein kinase C (PKC) among human B cells; Whisler RL et al.; Age-related changes in the functional properties of human B cells have been reported by several groups, but little is known about the early biochemical events and signaling pathways that might be altered during aging . The present investigation examined whether differences in the activation of protein tyrosine kinases (PTK) and in the expression of protein kinase C (PKC) enzymatic activity could be identified in B cells from 16 elderly subjects (mean 77 years) compared to B cells from 15 young subjects (mean 33 years) . B cells from young subjects stimulated with the surface immunoglobulin (sIg) crosslinkers anti-IgM or Staphylococcus aureus Cowan I (SAC) demonstrated rapid increases in PTK mediated de novo tyrosine phosphorylation of endogenous proteins . In comparison, stimulated B cells from elderly subjects were reduced 22-46% in tyrosine phosphorylations . Quantitation of the enzymatic levels and activation/translocation of PKC activity among resting and sIg stimulated B cells showed that B cells from approximately 50% of elderly subjects had significant reductions compared to B cells from young subjects . Further analyses of the expression of PTK and PKC enzymatic activity by stimulated B cells from elderly subjects demonstrated that aging was associated with greater heterogeneity in PKC expression and that defects in PKC enzymatic activity could coexist with relatively normal PTK activity . Thus, these data suggest that aging can alter the expression of PTK/PKC enzymatic activity in human B cells and that these age-related alterations might perturb the balance between PKC-dependent and -independent signaling pathways.

Eur J Clin Microbiol Infect Dis, 1993 Oct, 12(10), 769 - 72
Non-tropical pyomyositis in adults: report of four cases and literature review; Skoutelis A et al.; Four cases of non-tropical pyomyositis in adults are presented and 72 cases reported in the literature are reviewed . The diagnosis is often overlooked or delayed because most physicians are not familiar with the entity . Local signs of inflammation fever, leukocytosis and an elevated erythrocyte sedimentation rate are common features . Staphylococcus aureus is the most common pathogen and the thigh muscles are the most common site involved . Computerized tomography is used to establish the diagnosis and surgical incision and drainage in combination with antibiotic therapy is successful in the majority of the cases.

Clin Investig, 1993 Oct, 71(10), 780 - 6
Iatrogenic epidural spinal abscess; Bollensen E et al.; We present four cases of iatrogenic epidural spinal abscess directly caused by externally introduced catheters or probes . In two patients the infection spread per continuum, in the other two patients due to haematogenous dissemination . Clinical presentation in each case included generalized malaise with fever, signs of meningeal inflammation and focal neurological signs at the spinal level . The diagnosis was made on the basis of inflammatory changes in the cerebral spinal fluid and localization of the abscess by means of computer and magnetic resonance tomography . A broad-spectrum antibiotic regimen included a penicillinase-resistant preparation because of the frequent involvement of Staphylococcus aureus . It is our experience that a good outcome is dependent on early and specific treatment.

Comp Immunol Microbiol Infect Dis, 1993 Oct, 16(4), 323 - 30
Antibody dependent haemolysin, complement and opsonin in sera of a major carp, Cirrhina mrigala and catfish, Clarias batrachus and Heteropneustes fossilis; Saha K et al.; The present communication is a continuation of our earlier study on the natural serum haemagglutinin/lectins of Cirrhina mrigala, Clarias batrachus and Heteropneustes fossilis . Sera of Cirrhina mrigala, belonging to the major carp family, could not only agglutinate heterologous rabbit erythrocytes, but also lyse them spontaneously . This lysis of rabbit RBC by Cirrhina mrigala sera was calcium ion dependent and heat sensitive, indicating thereby that the haemolysis was mediated by the fish serum complement system via the classical pathway . Quantification of CH50 and APCH50 levels in the sera of Clarias batrachus and Heteropneustes fossilis as well as in the sera of amphibia, aves and mammals showed that lower vertebrates predominantly possessed an alternative pathway of the complement system, while on the other hand, in the higher vertebrates the major pathway of complement activation was classical . Furthermore sera of Clarias batrachus and Heteropneustes fossilis had opsonins, which could stimulate heterologous rat peritoneal macrophages to engulf Staphylococcus aureus with the production of superoxide anion . From this study we concluded that fishes have been armed with various powerful natural humoral defense systems for their protection against environmental pathogens.

Comp Immunol Microbiol Infect Dis, 1993 Oct, 16(4), 317 - 21
Studies on some biochemical characteristics of Staphylococcus aureus of buffalo mammary origin; Varshney JP et al.; A total of 49 isolates of Staphylococcus aureus of buffalo mammary origin were studied for biochemical characteristics . Coagulase production, clumping factor, haemolytic activity, pigment production and fermentation of maltose and mannitol were employed to differentiate S . aureus from S . hyicus and S . intermedius . Out of 49 isolates, 97.95, 93.87, 93.87, 89.79, 95.91, 100.0, 95.91, 59.18, 100.0, 100.0, 100.0, 89.79, 91.83 and 100.0% isolates were positive for coagulase production, protein-A production, haemolysin production, thermostable nuclease production, deoxyribonuclease production, tellurite reduction, nitrate reduction, lipase production, phosphatase production, mannitol fermentation, glucose fermentation, M.R . test, V.P . test and pigment production respectively . The only isolate from which coagulase production could not be detected, however, showed haemolytic activity, protein-A productivity, pigmentation and mannitol fermentation . One of the protein-A negative isolate was coagulase positive and showed mannitol fermentation, pigmentation and haemolytic activity . The study revealed that the biochemical characteristics of S . aureus of buffalo mammary origin did not differ from those of cattle origin . Coagulase, haemolysin, thermostable nuclease, deoxyribonuclease, phosphatase, lipase, tellurite and nitrate reduction closely related with protein-A . The presence of protein-A seems to be as reliable an indicator for S . aureus of buffalo origin as is coagulase production.

APMIS, 1993 Oct, 101(10), 753 - 61
Comparative study of the cellular fatty acids of methicillin-resistant and -susceptible Staphylococcus aureus; Asai S et al.; The cellular fatty acid compositions of 26 strains of methicillin-resistant Staphylococcus aureus (MRSA) and 17 strains of methicillin-susceptible S . aureus (MSSA) were analyzed by gas-liquid chromatography . The fatty acid compositions of the two groups were very similar with 16 identified components . The major fatty acids were Ci14 = 0, Ci15 = 0, C18 = 0 and C20 = 0 . Among these fatty acids, the percentage of the Ci15 = 0 fatty acid component of MRSA strains (11.4 +/- 3.9%) was statistically higher than that of MSSA strains (6.2 +/- 2.4%) (p < 0.001) . On the other hand, the percentage of the C20 = 0 fatty acid components of MRSA strains (20.2 +/- 8.8%) was statistically lower than that of MSSA strains (30.7 +/- 10.4%) (p < 0.001) . The production of beta-lactamase and beta-hemolysin in both groups' strain was also unrelated to the relative amounts of the fatty acid components . These results indicated a statistical tendency for the percentage fatty acid compositions of the MRSA strains to be quantitatively different from those of the MSSA for both the Ci15 = 0 and C20 = 0 fatty acid components . Analysis of the fatty acid compositions may have an application in the differentiation of MRSA and MSSA strains.

Int J Immunopharmacol, 1993 Oct, 15(7), 829 - 32
IL-4 receptor expression by SAC-activated B-lymphocytes: its role in B-cell proliferation and the effect of cyclosporine (CsA), prednisolone and verapamil; Degiannis D et al.; Expression of the IL-4 receptor was studied in a highly purified population of human B-lymphocytes stimulated by Staphylococcus aureus, cowan I (SAC) . Flow cytometric analysis showed that incubation with SAC in the absence of detectable levels of IL-2, IL-4 and IL-6 resulted in a striking increase in cellular binding of IL-4 . The SAC-stimulated B-cells responded to exogenous IL-4 by DNA synthesis . This response was unaffected by CsA or prednisolone, but was inhibited by the Ca2+ channel blocker verapamil.

Arch Dis Child, 1993 Oct, 69(4), 443 - 5
Resolution of hepatic abscess after interferon gamma in chronic granulomatous disease; Hague RA et al.; Recombinant interferon gamma has been used prophylactically in children with chronic granulomatous disease, but its role in the treatment of acute infective episodes has not been defined . A 3 year old boy presented with multiple candidal liver abscesses and was given intravenous antifungal treatment and he showed initial improvement . After six weeks his erythrocyte sedimentation rate and C reactive protein remained raised, and a computed tomogram showed a single abscess in the left lobe of the liver from which pus was drained and Staphylococcus aureus isolated . During the next eight months the abscess persisted despite appropriate intravenous antibiotics and percutaneous drainage . Subphrenic extension precluded definitive surgery . Nine months after initial presentation recombinant interferon gamma 0.05 mg/m2 intravenously was commenced three times a week . Complete resolution occurred within two months . It is concluded that interferon gamma is useful in treating infective episodes, and further study of the use of prophylactic antimicrobial treatment and intermittent interferon gamma during acute episodes is now required.

Clin Ter, 1993 Oct, 143(4), 279 - 90
Sepsis-bacteraemia and other infections due to non-opportunistic bacterial pathogens in a consecutive series of 788 patients hospitalized for HIV infection; Manfredi R et al.; A retrospective study was carried out to evaluate the incidence, etiology and role of non-opportunistic bacterial infections in a series of 788 consecutive HIV-infected patients hospitalized during the last 7 years; 71.9% of patients were i.v . drug addicts, 15.6% homo-bisexual men, 7.4% heterosexuals, 2.7% haemophiliacs and 2.4% children with vertically-acquired infection . According to the CDC classification of HIV infection, 71 patients were classified as CDC I-II, 148 as CDC III, and 569 (72.2%) as CDC IV . Diagnosis of bacterial infection was based on signs and symptoms, in association with the isolation of microorganisms consistent with the clinical picture . Two hundred and nineteen patients out of 788 (27.8%) (4 in CDC group I-II, 34 in CDC III and 181 in CDC IV), presented one or more episodes of non-opportunistic bacterial infection . The morbidity of these infections showed a significant correlation with the progression of HIV disease (CDC III vs . CDC I-II {p < 0.003} and CDC IV vs . CDC III {p < 0.05}), but no significant relation was found with age, sex or type of risk for HIV infection . The most frequent clinical picture was sepsis/bacteraemia (33.3%), followed by respiratory tract (23.8%), and genitourinary tract (20.8%) infections . A total of 399 bacterial pathogens were isolated in 303 different episodes of infection: 211 (52.9%) were gram-positive and 188 gram-negative, with Staphylococcus aureus (69 isolations), Staphylococcus epidermidis (50), and Pseudomonas spp . (48) as the major pathogens . Sepsis/bacteraemia was the most frequent clinical picture associated with growth of gram-positive pathogens, while detection of gram-negative bacteria appeared more significantly related with genitourinary or respiratory tract localizations . Bacterial infections in hospitalized HIV-infected patients, even though rarely life-threatening, need particular attention because of the high incidence and recurrence rate, the wide aetiological and clinical spectrum, the frequent microbial associations and the strict relationship with the progression of HIV disease.

Rev Clin Esp, 1993 Oct, 193(5), 235 - 8
{Pyogenic sacroiliitis . Presentation of 10 cases}; Gutierrez Macias A et al.; We report the clinical, radiological and microbiological features of ten patients diagnosed of pyogenic sacroiliitis in an Internal Medicine Department during a 13 years period . Clinical signs and radiological or scintigraphical findings were present in every case . Staphylococcus aureus was isolated in blood cultures in eight cases . We remark mean age (26.2 years), male predominance and the high prevalence of intravenous drug abuse as the main epidemiological data in our patients . Onset was acute in 60% of the cases, and subacute in the others . Erythrocyte sedimentation rate and a high white blood cell count were uniformly elevated among laboratory tests . Initial roentgenograms were normal in 60% . Bone scans were the most sensitive diagnostic aid . All the patients were treated with intravenous cloxacilin between two and eight weeks; aminoglycosides were added in four patients . We have observed two cases of psoas abscesses that required surgical drainage.

Kansenshogaku Zasshi, 1993 Oct, 67(10), 987 - 91
Nasal carriers of Staphylococcus aureus among healthy individuals; Tanaka Y et al.; Staphylococcus aureus and Staphylococcus spp . were isolated from healthy students and their drug resistance was investigated . S . aureus was isolated from 17 of 70 persons (24.3%) . Fourteen strains of 22 isolates of S . aureus were ampicillin-resistant . Two strains each were cefmetazole-resistant and gentamicin-resistant . None of the strains was found to be methicillin-resistant . Compared with the strains isolated from the hospital ward environment, S . aureus in healthy individuals was relatively sensitive to antibiotics.

Kansenshogaku Zasshi, 1993 Oct, 67(10), 1005 - 10
{Methicillin resistance, production of toxic shock syndrome toxin-1 and types of enterotoxin, protease and coagulase at vaginal isolates of Staphylococcus aureus}; Arai K et al.; The vaginal colonization with Staphylococcus aureus, including strains that have methicillin resistance and production of toxic shock syndrome toxin-1 (TSST-1), enterotoxins and protease was studied in 308 women at the time of delivery . Thirty-six of these women were colonized with S . aureus in the vagina . All of the isolates were methicillin sensitive S . aureus (MSSA), except one women who had both methicillin resistant S . aureus (MRSA) and MSSA . The strains, included MRSA, did not elaborate the TSST-1 and produced protease . The distribution of protease pattern (types) observed by MSSA strains on standard methods caseinate agar plates was type A, 1 strain; type B, 15 strains; type C, 6 strains; type D, 14 strains . Sixteen of the 36 strains produced non of the enterotoxins and 20 strains produced enterotoxins and the type distribution was enterotoxin type A, 6 strains; type B, 10 strains; type C, 1 strain; A and B, 1 strain; A, B and C, 2 strains . These results provide the possibility of pathogenic S . aureus colonized in vagina transmit to neonates at the time of delivery.

Int J Food Microbiol, 1993 Oct, 20(1), 45 - 8
Growth of Staphylococcus aureus in pasta in relation to its water activity; Valik L et al.; Water activity (aw) of pasta decreased linearly with time during drying . A strain of Staphylococcus aureus isolated from commercial pasta began multiplying immediately after inoculation but decreased in number when aw was reduced to below 0.93 . Another strain of S . aureus appeared to multiply until the aw was below 0.86 . The results are discussed in relation to practices for pasta production.

Appl Environ Microbiol, 1993 Oct, 59(10), 3327 - 33
Rapid, automated separation of specific bacteria from lake water and sewage by flow cytometry and cell sorting; Porter J et al.; The use of fluorescence-activated flow cytometric cell sorting to obtain highly enriched populations of viable target bacteria was investigated . Preliminary studies employed mixtures of Staphylococcus aureus and Escherichia coli . Cells of S . aureus, when mixed in different proportions with E . coli, could be selectively recovered at a purity in excess of 90% . This was possible even when S . aureus composed only approximately 0.4% of the total cells . Cell sorting was also tested for the ability to recover E . coli from natural lake water populations and sewage . The environmental samples were challenged with fluorescently labelled antibodies specific for E . coli prior to cell sorting . Final sample purities of greater than 70% were routinely achieved, as determined by CFU . Populations of E . coli released into environmental samples were recovered at greater than 90% purity . The use of flow cytometry and cell sorting to detect and recover viable target bacteria present at levels of less than 1% within an indigenous microflora was also demonstrated.

Int J Oral Maxillofac Surg, 1993 Oct, 22(5), 292 - 7
Septic arthritis of the temporomandibular joint: review of the literature and report of two cases in children; Leighty SM et al.; Septic arthritis of the temporomandibular joint (TMJ) has a high morbidity, is infrequently reported, and has been described almost exclusively in adults . We present two cases of septic arthritis of the TMJ that occurred in children after minor blunt trauma . Literature related to septic arthritis of the TMJ was reviewed, and a composite list of cases was constructed . The most common causes were various infections of the head and neck, rheumatic joint disease, and iatrogenesis . Pathogens may gain access to the TMJ by several routes . Patients typically present with an acute, tender, monarticular arthritis with associated swelling and erythema . Malaise, nausea, and vomiting may also be present . Traumatic effusions, fractures, and neoplasms may present in a similar fashion, and mimic TMJ septic arthritis . Staphylococcus aureus is the most commonly reported pathogen and often causes permanent joint damage . Aspiration and analysis of joint fluid, as well as blood chemistry, imaging studies, and clinical impression, may assist in the diagnosis . Timely diagnosis and treatment are essential for a successful outcome; therapy should include antimicrobial agents, adequate drainage, and resting of the joint . Complications include spread of infection, postinfectious bony changes, and fibrous (or bony) ankylosis of the temporomandibular joint.

Cytometry, 1993 Oct, 14(7), 811 - 8
Rapid flow cytometric antibiotic susceptibility assay for Staphylococcus aureus; Ordonez JV et al.; Conventional techniques for antibiotic susceptibility testing usually require 24 h or more to produce accurate results . This long waiting period to demonstrate antibiotic action is necessary because such tests rely on growth (or the lack of it), when the microorganisms are incubated in the presence of the antibiotic . In an effort to improve antibiotic susceptibility testing, we developed a flow cytometric technique for Staphylococcus aureus in which antibiotic action is determined by monitoring drug-induced membrane potential changes, using the potential-sensitive dye 3,3'-dipentyloxacarbocyanine iodide . Three ATCC reference strains of S . aureus and 13 unknown strains of the same microorganism were tested for susceptibility to penicillin G and oxacillin . Our results indicate that susceptibility of S . aureus to these antibiotics can be measured reliably at 90 min after addition of the antibiotic, and the results are comparable to those obtained with conventional susceptibility tests.

Circ Shock, 1993 Oct, 41(2), 88 - 102
Retrospective study comparing the pathophysiology of antibiotic-treated and untreated Escherichia coli- and Staphylococcus aureus-infused baboons; He S et al.; Escherichia coli and Staphylococcus aureus are the most common pathogens encountered in septic shock . This is a descriptive study in which the pathophysiologic response to infusions of LD100 concentrations of E . coli and S . aureus are staged and compared . Equivalent concentrations of both organisms were infused over a 2 hr period into antibiotic-treated and untreated animals with the following results: 1) The apparent clearance of E . coli was less than that of S . aureus over the 2-hr infusion period, but far greater during the next 8 hr in both antibiotic-treated and untreated animals . Thus the clearance of E . coli fits a one-compartment (intravascular), and that of S . aureus fits a two-compartment (intra- and extravascular) model . 2) The intensity of the cardiovascular, temperature, and metabolic response to E . coli was greater, whereas that of the disseminated intravascular coagulant (DIC) response to S . aureus was greater . We conclude, therefore, that the response to E . coli consists of four stages with no invasion and colonization of tissues, whereas the response to S . aureus consists of two stages with invasion and colonization of tissues.

Allergy, 1993 Oct, 48(7), 504 - 10
Effects of interleukin-4 and interferon-gamma on the secretion of IgG4 from human peripheral blood mononuclear cells; Sutherland M et al.; Whereas IgE antibodies are linked with allergy, IgG4 antibodies may reflect the state of immunity and protection against a particular antigen . It has been shown that interleukin (IL)-4 is required for induction of IgE synthesis . In order to elucidate the role of IL-4 in the production of IgG4 and to compare IgG4 and IgE regulatory processes, we quantified these immunoglobulin isotypes after in vitro culture of peripheral blood mononuclear cells (PBMC) in the presence of IL-4 . The production of IgG4 was increased by IL-4 under the same conditions which are optimal for IgE production but not among PBMC from all donors, depending on the magnitude of spontaneous IgG4 secretion: IL-4 was effective only when the spontaneous secretion of IgG4 was < 7% of the total IgG secretion; it had no effect when spontaneous IgG4 production was > 7% of total IgG . The IL-4-induced IgE response was consistently obtained when IgG4 was < 7% of total IgG but was markedly diminished or absent when IgG4 was > 7% of total IgG . If Staphylococcus aureus strain Cowan 1 (SAC) was present during the 48-h preincubation step, spontaneous IgG4 production was increased, but the stimulatory effect of this mitogen on immunoglobulin production, including IgG4, was markedly blocked by the addition of IL-4 . In contrast, IL-4-induced IgE synthesis was strongly blocked by the presence of SAC . Finally, secretion of IgG4 (spontaneous and IL-4-induced) was suppressed among cells from most donors by interferon-gamma (IFN-gamma).(ABSTRACT TRUNCATED AT 250 WORDS)

Am J Physiol, 1993 Oct, 265(4 Pt 1), C927 - 33
Metabolism of a long-chain diacylglycerol by permeabilized A10 smooth muscle cells; Chuang M et al.; The regulatory effects of diacylglycerol (DAG) second messengers will be terminated by metabolism . A long-chain DAG, 1-palmitoyl-2-{1-14C}oleoyl-sn-glycerol (2-{14C}POG), was metabolized by cultured A10 smooth muscle cells after permeabilization by preincubation with 340 U/ml alpha-toxin from Staphylococcus aureus . In contrast to results with the cell-permeable DAG analogue, dioctanoyl-glycerol ({3H}diC8), no appreciable 2-{14C}POG degradation could be detected in control A10 cells not treated with alpha-toxin . With permeabilized A10 cells, 2-{14C}POG was mainly converted into lipolytic products of a lipase pathway, monoacylglycerol (MG) and fatty acid (FA); very little radioactivity was incorporated into triacylglycerol (TG) or phospholipid (PL) via reactions catalyzed by either DAG acyltransferase, cholinephosphotransferase, or DAG kinase . Similar results were obtained in experiments with 1-stearoyl-2-{1-14C}arachidonoyl-sn-glycerol . The conversion of 2-{14C}POG into PL and TG was not enhanced by the addition of 1 mM ATP-MgCl2, 1 mM CDP-choline, or 1 mM oleoyl-CoA to the alpha-toxin-treated A10 cells . The formation of FA and MG by permeabilized A10 cells was inhibited by DAG lipase inhibitors, U-57,908 (50 microM) and tetrahydrolipstatin (1-25 nM) . The predominant contribution of the lipase pathway to the metabolism of a long-chain DAG, 2-{14C}POG, by alpha-toxin-treated A10 cells is similar to results for the degradation of {3H}diC8 by intact A10 cells.

Mol Gen Genet, 1993 Oct, 241(1-2), 185 - 92
Characterization of the Staphylococcus aureus chromosomal gene pcrA, identified by mutations affecting plasmid pT181 replication; Iordanescu S; The Staphylococcus aureus chromosomal gene pcrA, identified by mutations, such as pcrA3, that affect plasmid pT181 replication, has been cloned and sequenced . The pcrA gene encodes a protein with significant similarity (40% identity) to two Escherichia coli helicases: the helicase II encoded by the uvrD gene and the Rep helicase . The pcrA3 mutation was found to be a C to T transition leading to a threonine to isoleucine substitution at amino acid residue 61 of the protein . The pcrA gene seems to belong to an operon containing at least one other gene, tentatively named pcrB, upstream from pcrA . The PcrA protein was shown to be essential for cell viability and overproduction has deleterious effects on the host and plasmid replication.

Kyobu Geka, 1993 Oct, 46(11), 956 - 9
{Successful treatment by using a pedicled omental flap for sternal osteomyelitis and mediastinal infection caused by MRSA}; Morimoto T et al.; A 56-year-old male case, who was complicated with sternal osteomyelitis and mediastinitis after aortic valve replacement, was reported . Its infection was caused by MRSA (methicillin resistant Staphylococcus aureus) . He was treated with sterilization of wound using povidone iodine, Minomycin solution and its injection for 10 days . And thereafter we decided to apply the plastic surgical technique to this case . After debridement of the infected granulation and sternum thoroughly, a pedicled omental flap was transposed successfully.

Infect Control Hosp Epidemiol, 1993 Oct, 14(10), 576 - 8
Infection with methicillin-resistant Staphylococcus aureus among hospital employees; Muder RR et al.; OBJECTIVE: To describe the spectrum of clinical infection caused by methicillin-resistant Staphylococcus aureus (MRSA) in healthcare workers . DESIGN: Case series . SETTING: Two Veterans Affairs hospitals in which methicillin-resistant S aureus (MRSA) is endemic . PATIENTS: Five employees presenting to employee health or infectious disease clinic . RESULTS: All employees had had direct exposure to patients colonized with MRSA . Employee infections included cellulitis, impetigo, folliculitis, paronychia, and conjunctivitis . MRSA was isolated from all clinically infected sites and from the anterior nares of two employees . Three employees received a variety of ineffective oral antimicrobials before MRSA was recognized as the causative agent . All infections responded to appropriate therapy . CONCLUSIONS: Employees of hospitals with endemic MRSA may acquire MRSA infection . Presentation in our employees was that of relatively uncomplicated soft tissue infection, but several employees received inappropriate therapy before bacteriologic diagnosis . We recommend that culture and susceptibility testing be obtained prior to institution of therapy when hospital employees present with soft tissue infection.

J Dairy Sci, 1993 Oct, 76(10), 2913 - 24
Histologic response of the heifer mammary gland to intramammary infusion of interleukin-2 or interferon-gamma; Quiroga GH et al.; The histologic and cytologic responses of heifer mammary glands infected with Staphylococcus aureus were studied after infusion of interleukin-2 or interferon-gamma . Two groups of 4 heifers each, which were infected experimentally with S . aureus in all 4 mammary quarters, were infused in diagonal quarters with 7.5 x 10(5) units of interleukin-2 or 10(5) units of interferon-gamma; remaining quarters received PBS . Heifers in both trials were slaughtered 14 d after cytokine infusion, and mammary tissues were collected for histological examination . Uninfected quarters from 2 additional heifers were left untreated to compare infected with uninfected tissues for both trials . Morphologic evaluation and leukocyte infiltration scores were performed on tissue sections stained with hematoxylin and eosin, and plasma cells were quantified on sections stained with immunoperoxidase . Infected quarters had lower percentages of alveolar epithelial and luminal areas and higher percentages of stromal area than did uninfected quarters in the interleukin-2 trial, but no differences were observed between infected quarters that had been treated with PBS or interleukin-2 . Likewise, interferon-gamma treatment had no effect on mammary parenchymal components in the infected quarters . Interleukin-2 treatment significantly elevated leukocytosis into the mammary gland parenchyma compared with infected quarters treated with PBS and uninfected quarters . Among the leukocyte types evaluated, eosinophilic infiltration was elevated in interleukin-2 quarters over that of PBS controls . In both trials, concentrations of plasma cells bearing Ig were elevated in infected versus uninfected quarters . Plasma cell concentrations also were higher in cytokine than PBS controls, especially in interleukin-2 quarters . Results suggested that neither cytokine influenced the histology of infected mammary tissues, but both interleukin-2 and interferon-gamma increased, although insignificantly, the prevalence of all isotypes of plasma cells bearing Ig, suggesting enhancement of the local immune response to IMI.

J Clin Periodontol, 1993 Oct, 20(9), 662 - 7
Late onset Papillon-Lefèvre syndrome? A chromosomic, neutrophil function and microbiological study; Bullon P et al.; We had the opportunity to study a family with one of the most destructive forms of periodontal disease known, the Papillon-Lefevre syndrome . The parents had no consanguinity and were not affected, and were therefore to be considered carriers of the disease . 2 sisters, the eldest and youngest, showed periodontal breakdown and hyperkeratotic skin lesions, but their deciduous dentition was not affected . 2 brothers had skin lesions only and another brother and sister were healthy . Furthermore, 2 babies died at birth one after a 9-month pregnancy and the other after a 6-month pregnancy, and the mother also suffered 3 miscarriages . For 4 years, we studied the family: in the case of both sisters, mechanical periodontal treatment and antibiotics were unable to control the disease . In the chromosomic study of the 2 sisters affected, the GTG banding technique found no trace of anomalies in the cells analyzed, whose chromosomic formation was 46,XX . Before treatment, the chemotaxis of the PMN, the phagocytosis of opsonized Staphylococcus aureus, and production of superoxide radicals by PMN was significantly impaired in both sisters . Despite scaling and root planing, the periodontal lesions still progressed, but the PMN functions evaluated were now normal in both sisters . An orally asymptomatic but dermatologically affected brother showed no significant defect in the phagocytic activity and the production of superoxide radicals.

Int J Biochem, 1993 Oct, 25(10), 1399 - 406
Collapse of K+ and ionic balance during photodynamic inactivation of leukemic cells, erythrocytes and Staphylococcus aureus; Malik Z et al.; 1 . The immediate and fast ionic fluxes in Friend erythroleukemic cells (FELC), erythrocytes and Staphylococcus aureus during short intervals of porphyrin mediated photosensitization were determined uniquely by X-ray microanalysis (XRMA) combined with electron microscopy . 2 . Photodynamic inactivation of FELC was mediated by either endogenous protoporphyrin induced by 5-amino levulinic acid (5-ALA), or Photofrin-II . We describe the predominant phenomena of > 85% K-loss within 2-10 min of photoactivation . However the accompanied Na inflow and the collapse of the cellular balance of elemental-composition were inconsistent and acted as a function of cell damage . 3 . Erythrocytes treated with hematoporphyrin (HP) lost most of their intracellular K yet instantly gained Na . Nevertheless the K/Na molar ratio of the control erythrocytes was nearly 12/1 while after photosensitization and K loss it changed to 1/1 . 4 . The S . aureus bacteria photosensitized with HP showed entire K-loss as well as marked Na efflux which increased with irradiation time; this was accompanied by the decline of other cell elements . 5 . The prevailing K loss in FELC, erythrocytes and bacteria during the first minutes of photosensitization is deduced to be an immediate primary consequence of the photodynamic effect, while other ionic changes are joined in order with the development of cellular damage.

Anesth Analg, 1993 Oct, 77(4), 766 - 8
Growth of Staphylococcus aureus in four intravenous anesthetics; Sosis MB et al.; Patient infections related to the use of propofol have been reported . To investigate the growth of Staphylococcus aureus in propofol, thiopental, methohexital, etomidate, and 0.9% saline containing no bacteriostatic drug, these preparations were inoculated and samples were plated onto blood agar at 0, 3, 6, 21, 24, and 27 h . The number of colony-forming units (CFU) on the plates was then determined after 24 h of incubation . Samples from the inoculated etomidate solution showed zero CFU at 3 h and thereafter, whereas 21 h were required by the methohexital and thiopental solutions to reduce the number of CFU to zero . For normal saline, no significant change in CFU was seen before the first 6 h, then the number of CFU gradually declined, although some S . aureus CFU were still present at 27 h . Inoculation of the propofol emulsion resulted in a substantial growth of S . aureus between 6 and 21 h after inoculation . We conclude that, of the preparations tested, only propofol was an excellent medium for the rapid growth of S . aureus . Meticulous sterile technique, therefore, is advised when handling it.

South Med J, 1993 Oct, 86(10), 1175 - 8
Staphylococcus aureus meningitis associated with pyogenic infection of the sacroiliac joint; Cieslak TJ et al.; Although we have reported the first case of Staphylococcus aureus meningitis due to pyogenic arthritis of the sacroiliac joint, this finding is actually not surprising, given the strong association between this form of meningitis and underlying bone, joint, and soft tissue infections . The physician faced with a case of meningitis due to S aureus in a patient without a history of trauma or neurosurgical manipulation must do a prompt and thorough search for underlying infectious conditions . In the case of sacroiliitis in particular, a high index of suspicion needs to be maintained, given the difficulties and delays in diagnosis associated with this infection . Radionuclide scanning with 99mTc or 67Ga is usually helpful in the early confirmation of this condition, the presence of which may be suspected on the basis of thorough physical examination.

Singapore Med J, 1993 Oct, 34(5), 435 - 7
Nasal septal abscess--retrospective analysis of 14 cases from University Hospital, Kuala Lumpur; Jalaludin MA; Fourteen patients who presented to the University Hospital of Kuala Lumpur between June 1981 and June 1991 were reviewed retrospectively . Nasal septal abscesses are uncommon and therefore there are limited reports in the medical literature . Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection . Two out of the fourteen patients developed saddle nose deformity and septal perforation because of delay in treatment, the cases were misdiagnosed by non-otolaryngologist as turbinates swelling . The leading cause of nasal septal abscess was non-surgical trauma which accounted for about 85.7% . The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus.

Zentralbl Veterinarmed B, 1993 Oct, 40(8), 559 - 68
Effect of partially purified Staphylococcus aureus beta-haemolysin on the mammary gland of the mouse; Calvinho LF et al.; Partially purified Staphylococcus aureus Beta-haemolysin and a S . aureus strain (FGH28), isolated from a clinical case of bovine mastitis, known to produce in vitro Beta-, but neither Alpha- nor Delta-haemolysins were each injected separately into the mammary gland of mice . Relative purity and in vitro biological activities of this preparation were assessed . The effects of both the partially purified preparation and the S . aureus strain injected were assessed in terms of mortality, clinical appearance, macroscopic and microscopic changes, recovery of organisms from the inoculated glands and biological activity in supernatants from ground mammary glands . When injected alone, partially purified Beta-Haemolysin was not found to be an important virulence factor, being a diffuse infiltration of neutrophils into the alveoli the pathological effect observed following its inoculation . Vascular lesions were observed, in the most severe cases, following injection of S . aureus FGH28.

J Chemother, 1993 Oct, 5(5), 289 - 92
Macrolides induced suppression of virulence factors produced by Staphylococcus aureus; Moneib NA et al.; The effect of sub-MICs of azithromycin, clarithromycin and roxithromycin, as compared to erythromycin, on the production of coagulase, beta-hemolysin, lecithinase and deoxyribonuclease by Staphylococcus aureus was studied . All new macrolides completely inhibited coagulase and beta-hemolysin production and partially inhibited lecithinase and deoxyribonuclease . Such inhibition is not related either to growth inhibition or to inhibition of enzyme activity . Erythromycin, on the other hand, had no effect on coagulase or beta-hemolysin production but slightly suppressed the production of lecithinase and deoxyribonuclease . This inhibitory effect might have clinical significance if it was found to occur in vivo.

Mol Microbiol, 1993 Oct, 10(1), 7 - 12
Human Menkes X-chromosome disease and the staphylococcal cadmium-resistance ATPase: a remarkable similarity in protein sequences; Silver S et al.; A search with the proposed amino acid translation product from the new 'candidate gene' for human Menkes disease against protein sequence libraries showed a remarkable similarity to that for the cadmium efflux ATPase from Staphylococcus aureus resistance plasmids . The Menkes sequence appears closer to the CadA Cd2+ sequence than to P-type ATPases from animal sources . Menkes syndrome is an X-chromosome invariably fatal disease that results from aberrant copper metabolism . The gene that is defective in Menkes patients, i.e . the Menkes candidate gene, encodes a P-type ATPase, whose properties satisfactorily explain the phenotype of the disease . P-type ATPases are all cation pumps, either for uptake (e.g . the bacterial Kdp K+ ATPase), for efflux (e.g . the muscle sarcoplasmic reticulum Ca2+ ATPase), or for cation exchange (e.g . the animal cell Na+/K+ ATPase) . These enzymes have a conserved aspartate residue that is transiently phosphorylated from ATP during the transport cycle, hence the name 'P-type' ATPase . The Menkes sequence shares with the staphylococcal CadA ATPase those regions common to all P-type ATPases and also an N-terminal dithiol region that was proposed to be a 'metal-binding motif' . There are one or two copies of this motif in the available CadA sequences and six copies in the Menkes sequence.

J Hosp Infect, 1993 Oct, 25(2), 97 - 108
Genetic analysis of community isolates of methicillin-resistant Staphylococcus aureus in Western Australia; Udo EE et al.; Methicillin-resistant Staphylococcus aureus (MRSA) obtained from patients who had not been hospitalized outside Western Australia (WA) were studied for antimicrobial resistance and plasmid content and by pulsed-field gel electrophoresis . They were found to be of several types, none of which appeared to be related to MRSA which have been previously studied . It appears that new MRSA strains have emerged in communities in the far north of WA and are being isolated at an increasing frequency in Perth hospitals 2000 km south.

J Hosp Infect, 1993 Oct, 25(2), 91 - 6
Nosocomial spread of Staphylococcus aureus showing intermediate resistance to methicillin; Richards J et al.; A nosocomial outbreak of infection and colonization involving six patients and caused by a strain of Staphylococcus aureus showing intermediate resistance to methicillin (MIC = 4-8 mg l-1) is described . The outbreak was associated with skin-carriage of the epidemic strain by a nurse suffering from severe eczema . The reduced susceptibility of the outbreak strain to methicillin was associated with beta-lactamase production . Elimination or inhibition of beta-lactamase activity produced a two-fold decrease in methicillin MIC . There was no evidence for the presence of either penicillin-binding protein 2a or the corresponding mec gene, which mediate resistance in fully methicillin-resistant strains.

Transplantation, 1993 Oct, 56(4), 985 - 90
Responsiveness of preactivated B cells to IL-2 and IL-6 . Effect of cyclosporine and rapamycin; Hornung N et al.; In order to determine which drug may be more effective in clinical abnormalities associated with polyclonal B lymphocyte activation, we compared the in vitro effects of CsA and rapamycin on proliferation or differentiation of preactivated B cells . For that purpose, highly purified B lymphocytes were preactivated in the presence of formalinized Staphylococcus aureus bacteria and then recultured in the presence or in the absence of either rIL-2, rIL-6, or combination or rIL-2 and rIL-6 . After 48 hr in culture, S . aureus bacteria upregulated significantly the binding of phycoerythrin-conjugated IL-2 and IL-6, respectively, by purified B lymphocytes, indicating generation and/or upregulation of receptors for these cytokines . Such preactivated B lymphocytes proliferated in response to optimal concentrations of rIL-2, whereas the addition of rIL-6 to preactivated cells was always accompanied by a decrease of the proliferation rate . CsA upregulated cell proliferation when it was added in the second culture period in the presence or in the absence of rIL-6, whereas rapamycin had no effect in these cases . A combination of rIL-2 plus rIL-6 upregulated significantly the proliferative responses of preactivated B cells . In such cultures both CsA and rapamycin had an inhibitory effect on the proliferative responses . IgM production was unaffected by the addition of rIL-6 to cultures of preactivated B cells, whereas addition of rIL-2 and of the IL-2/IL-6 combination enhanced considerably IgM production . Irrespective of cytokines added, CsA upregulated the production of IgM . In contrast, rapamycin inhibited IgM production in all cases . Our results indicate that, in this experimental system, rapamycin is an effective immunosuppressive agent and its use, at least in vitro, is not accompanied by an upregulation of either the proliferation or differentiation of B lymphocytes.

J Clin Invest, 1993 Oct, 92(4), 2053 - 9
Lipopolysaccharide (LPS) recognition in macrophages . Participation of LPS-binding protein and CD14 in LPS-induced adaptation in rabbit peritoneal exudate macrophages; Mathison J et al.; Exposure of rabbit peritoneal exudate macrophages (PEM) or whole blood to picomolar concentrations of LPS induces adaptation or hyporesponsiveness to LPS . Because of the importance of plasma LPS-binding protein (LBP) and the macrophage cell membrane protein CD14 in recognition of LPS, we examined the effect of LBP on LPS-induced adaptation in PEM . PEM exposed to LPS in the presence of LBP for 8 h were markedly less responsive to subsequent stimulation by LPS than monocytes/macrophages (M phi) adapted in the absence of LBP . LPS-induced expression of TNF was sharply reduced in LBP-LPS-adapted PEM, but in contrast these cells remained fully responsive to Staphylococcus aureus peptidoglycan . We considered that specific hyporesponsiveness in LPS-adapted M phi or in blood monocytes could be due to decreased expression of CD14 or diminished binding of LBP-LPS complexes to CD14 . However, flow cytometry analysis revealed only minimal reduction of CD14 expression or CD14-dependent binding of a fluorescent LPS derivative when normo- and hyporesponsive cells were compared . These results show that complexes of LPS and LBP are more effective than LPS alone in inducing adaptation to LPS, and LPS-induced hyporesponsiveness probably results from changes in cellular elements distinct from CD14 that are involved in either LPS recognition or LPS-specific signal transduction.

EMBO J, 1993 Oct, 12(10), 3967 - 75
Synthesis of staphylococcal virulence factors is controlled by a regulatory RNA molecule; Novick RP et al.; The production of most toxins and other exoproteins in Staphylococcus aureus is controlled globally by a complex polycistronic regulatory locus, agr . Secretory proteins are up-regulated by agr whereas surface proteins are down-regulated . agr contains two divergent promoters, one of which directs the synthesis of a 514 nucleotide (nt) transcript, RNAIII . In this report, we show that the cloned RNAIII determinant restores both positive and negative regulatory functions of agr to an agr-null strain and that the RNA itself, rather than any protein, is the effector molecule . RNAIII acts primarily on the initiation of transcription and, secondarily in some cases, at the level of translation . In these cases, translation and transcription are regulated independently . RNAIII probably regulates translation directly by interacting with target gene transcripts and transcription indirectly by means of intermediary protein factors.

Biochemistry, 1993 Sep 28, 32(38), 9936 - 43
Resolving the two monolayers of a lipid bilayer in giant unilamellar vesicles using deuterium nuclear magnetic resonance; Marassi FM et al.; Giant unilamellar vesicles (GUVs) composed of mixtures of POPC (1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine) plus DMPG (1,2-dimyristoyl-sn-glycero-3-phosphoglycerol) and/or CHOL (cholesterol) were prepared using detergent dialysis . Vesicles containing at least 30 mol % CHOL had diameters exceeding 450 nm . POPC in such GUVs, deuterium-labeled at either the choline alpha or beta segments, yielded deuterium (2H) and phosphorus (31P) nuclear magnetic resonance (NMR) Pake pattern line shapes, quadrupole splittings and chemical shift anisotropies identical to those obtained with multilamellar vesicles (MLVs) of identical composition . Exposing exclusively the vesicle exterior to either calcium or perchlorate ions, both of which are known to influence lipid head-group conformation through surface charge effects, caused the appearance of two overlapping 2H Pake patterns of equal intensity . The quadrupole splitting of one component remained unchanged while that of the second component was altered in the manner expected for choline alpha or beta deuterons in the presence of a cationic (calcium) or anionic (perchlorate) surface charge . Freeze-thawing the GUVs to equilibrate the exterior and interior vesicular contents eliminated the initially unchanged spectral component . It was likewise possible to resolve two quadrupole splittings when Staphylococcus aureus delta-toxin, a surface-active peptide known to influence lipid head-group orientational ordering, was added to the exterior vesicular solution only . This indicates that delta-toxin upon binding remains confined to one monolayer of the lipid bilayer and does not traverse the membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

J Biol Chem, 1993 Sep 25, 268(27), 20668 - 75
Development of an artificial antibody system with multiple valency using an Fv fragment fused to a fragment of protein A; Ito W et al.; In antigen-antibody interactions, the high avidity of antibodies for their specific antigens can be achieved both by exploiting the high affinity of each binding site and by multivalence of antibodies . In this study, we developed artificial antibodies with multiple valency . The Fv fragments of an antibody fused with one and with two domains of the Fc-binding protein A from Staphylococcus aureus (designated Fv-P and Fv-PP, respectively) were expressed in secreted forms in Escherichia coli . Their physical characteristics were examined . The Fv portions of Fv-P and Fv-PP had virtually the same affinity for the antigen as that of the original Fv molecules, and each protein A-derived domain could be bound to IgG . When Fv-P was mixed with IgG, the complex formed was composed of two Fv-P molecules and one IgG molecule . In the case of Fv-PP, a complex composed of three Fv-PP molecules and two IgG molecules was preferentially formed . Analysis of surface plasmon resonance in a BIAcore system indicated multivalency of these complexes for antigens . There was 3.5-fold decrease in the dissociation constant of the complex between Fv-PP and the antigen upon the addition of IgG . The use of these complexes as reagents in enzyme-linked immunosorbent assay and Western blotting gave much stronger signals than Fv, Fv-P, and Fv-PP alone.

J Immunol, 1993 Sep 15, 151(6), 3180 - 6
In vivo tumor immunotherapy by a bacterial superantigen; Ochi A et al.; We have investigated the in vivo efficacy of Staphylococcus aureus enterotoxin B (SEB) coupled to tumor-specific anti-idiotypic antibody in redirecting T cell effector activity to the growth inhibition of B lymphoma 38C13 . Incubation of 38C13 lymphoma cells with syngeneic C3H/He splenic cells and SEB-anti-Id conjugate was associated with between 80 and 100% growth inhibition of the tumor cells . V beta 8+ T cells were integral for the SEB-anti-Id-induced tumor cell growth inhibition . Administration of SEB-anti-Id i.v . to mice previously inoculated with 38C13 lymphoma cells led to greater than 40% survival at 100 days compared to a mean survival of 21 days in control animals . When we compared this reagent with other targeting constructs--the anti-CD3-anti-Id and anti-TCR V beta 8-anti-Id--these more or less effectively prevented tumor growth . However, anti-CD3-anti-Id impaired almost the entire T cell response, whereas the effects of SEB-anti-Id or anti-V beta 8-anti-Id had effects limited to V beta 8+ T cells . Previous studies showed that in vivo administration of SEB caused a small change in V beta 8+ T cell numbers in contrast to anti-V beta 8 antibody, which depleted the entire population . These results together suggest that SEB-anti-tumor antibody conjugates represent a potentially powerful approach for better tumor immunotherapy.

JAMA, 1993 Sep 15, 270(11), 1329 - 33
Recurrent epidemics caused by a single strain of erythromycin-resistant Staphylococcus aureus . The importance of molecular epidemiology; Back NA et al.; OBJECTIVE--To compare the accuracy of clinical epidemiologic findings with results of molecular epidemiologic analysis in identifying the source of recurrent epidemics of erythromycin-resistant Staphylococcus aureus (ERSA) infections in a well-baby nursery . DESIGN--Epidemic investigations with retrospective and prospective microbiological surveillance . Staphylococcus aureus isolates were evaluated by plasmid analysis and genotyping . SETTING--A well-baby nursery in a 700-bed university teaching hospital with approximately 250 deliveries per month . PATIENTS--Newborn infants who developed ERSA infections during 1990 and 1991 . INTERVENTION--Traditional infection control measures, including cohorting of infected infants and hand washing, were implemented . Personnel were cultured for nasal carriage of S aureus during both epidemics . Employees carrying ERSA were removed from the nursery and treated with mupirocin . RESULTS--In the first epidemic, 15 infants were infected with ERSA . A nursing assistant who cared for most of the infants was found to be a carrier of ERSA . She was removed from the nursery and the epidemic resolved . Fifteen months after the first epidemic ended, an epidemic that involved 11 infants began . The attending physician had a facial furuncle and was found to be a carrier of ERSA . The physician was treated and the epidemic resolved . Plasmid and genotyping showed the ERSA organisms from both epidemics were the same . The employee implicated in the first epidemic did not have the epidemic strain, but the physician who attended during both epidemics did . CONCLUSIONS--Traditional epidemic investigations may lead to false conclusions that can only be recognized with molecular epidemiologic techniques . For these techniques to be useful in the control of outbreaks, plasmid analysis and/or genotyping must be readily available.

JAMA, 1993 Sep 15, 270(11), 1323 - 8
Value of molecular epidemiologic analysis in a nosocomial methicillin-resistant Staphylococcus aureus outbreak; Fang FC et al.; OBJECTIVE--To evaluate two molecular epidemiologic methods used in the analysis of a nosocomial methicillin-resistant Staphylococcus aureus (MRSA) outbreak . DESIGN--Restriction endonuclease analysis of plasmid DNA (REAP) was used in the analysis of 45 MRSA isolates . After termination of the outbreak, isolates were retrospectively analyzed in a blind fashion using the newly described technique of arbitrarily primed polymerase chain reaction (AP-PCR) . Molecular analyses were compared with epidemiologic and antimicrobial susceptibility data . SETTING--Tertiary care university hospital . SUBJECTS--Twenty-eight patients and 12 employees infected or colonized with MRSA during a 6-week period . RESULTS--A clonal relationship demonstrated among isolates from burn unit patients and staff was clearly distinguishable from MRSA isolates arising from other hospital wards . The combination of REAP and AP-PCR provided complementary information in several instances . Aggressive measures to isolate infected patients and eradicate colonization from patients and staff terminated the outbreak . CONCLUSIONS--Although traditional epidemiologic methods retain their central role in modern hospital infection control, molecular epidemiologic analysis can significantly enhance the ability of infection control officers to analyze and terminate hospital epidemics . The combination of AP-PCR and REAP may prove to be a particularly informative means of tracking the nosocomial spread of microbial strains and their mobile genetic elements.

J Chromatogr, 1993 Sep 10, 647(1), 3 - 12
Peptide mapping of recombinant human interferon-gamma by reversed-phase liquid chromatography with on-line identification by thermospray mass spectrometry and UV absorption spectrometry; Legrand R et al.; The detection and identification of minor peaks in a complex peptide map of recombinant human interferon-gamma was realized by on-line analysis of the eluted peptides using thermospray mass spectrometry and UV absorbance spectrometry . By this procedure the time-consuming process of collection, purification and chemical sequence analysis is avoided . Owing to the formation of multiple charged ions, the domain of the covered masses is extended . Fragmentation of the peptides in the thermospray source was observed resulting from, amongst others, cleavage by acid hydrolysis of peptide bonds involving an aspartic acid . This was of great use for the identification of peptides in a digest of recombinant human interferon-gamma by Staphylococcus aureus strain V8 endoprotease.

J Mol Biol, 1993 Sep 5, 233(1), 170 - 2
Crystallization and preliminary X-ray analysis of a microbial superantigen staphylococcal enterotoxin C2; Passalacqua EF et al.; High yields of staphylococcal enterotoxin C2, from Staphylococcus aureus, have been purified using dye ligand chromatography . Crystals suitable for X-ray diffraction work were obtained by vapour diffusion using ammonium sulphate and polyethylene glycol as precipitants . They belong to the tetragonal space group P4(1)22 with unit cell dimensions a = b = 43.2 A and c = 290.9 A with one molecule per asymmetric unit . The crystals diffract to at least 2.8 A resolution and are suitable for three-dimensional X-ray structural analysis.

Pediatr Infect Dis J, 1993 Sep, 12(9), 743 - 7
Role of anaerobic bacteria in liver abscesses in children; Brook I et al.; Aspirates from pyogenic liver abscesses obtained from 14 children were cultured for aerobic and anaerobic bacteria . Of 29 organisms that were recovered, 17 were anaerobic and 12 were aerobic or facultative . The predominant organisms were Peptostreptococcus spp . (5 isolates) . Bacteroides fragilis group (4), Fusobacterium spp . (3) and Staphylococcus aureus (4) . Aerobic or facultative bacteria only were recovered in five cases, anaerobic bacteria only in four and mixed aerobic and anaerobic bacteria in five . Anaerobic bacteria were recovered in liver abscesses that were associated with other infection in which these organisms were predominant (i.e . abdominal infection, abscesses) . This study highlights the potential importance of anaerobic bacteria in pyogenic liver abscess.

J Am Dent Assoc, 1993 Sep, 124(9), 76 - 84
Enhancing infection control for elderly and medically compromised patients; Shuman SK et al.; Some patients may be at risk for complications from relatively common infectious diseases . Influenza, tuberculosis and methicillin-resistant Staphylococcus aureus infection can lead to illness and even death in elderly, medically compromised and institutionalized individuals . Dental personnel caring for these individuals should adopt preventive strategies that are simple and inexpensive in addition to standard infection control guidelines.

J Clin Microbiol, 1993 Sep, 31(9), 2281 - 5
Phenotypical and genotypical characterization of epidemic clumping factor-negative, oxacillin-resistant Staphylococcus aureus; Schwarzkopf A et al.; A total of 50 oxacillin-resistant Staphylococcus aureus (ORSA) strains that were clumping factor negative (CFN) and protein A negative by latex agglutination were collected from patients in six different hospitals at different locations in Germany during 1991 and 1992 . Antibiograms, bacteriophage typing, and plasmid analysis were performed . The antibiograms showed that, besides oxacillin, all CFN ORSA strains were resistant to gentamicin, clindamycin, erythromycin, ciprofloxacin, and fosfomycin . All these isolates were nontypeable with an international set of phages, and an additional experimental phage set indicated that the strains were phage type 16, 192 . Moreover, all isolates possessed a single plasmid of 30 kb, and restriction analysis of those plasmids revealed identical patterns . For genotyping, these 50 isolates were also analyzed by pulsed-field gel electrophoresis (PFGE) and polymerase chain reaction (PCR) of the coagulase and protein A genes and then by restriction enzyme digestion and analysis of restriction fragment length polymorphisms (RFLPs) . With 49 strains, electrophoresis of SmaI-digested chromosomal DNA revealed identical PFGE patterns regarding the number and size of the DNA fragments, which could be differentiated from those of clumping factor-positive ORSA strains . Typing for the coagulase gene by PCR revealed PCR products of identical sizes . The AluI restriction digestion patterns of the PCR products were identical . PCR with primers derived from the region of that part of the protein A gene that encodes the immunoglobulin G-binding domains showed a PCR product that was about 170 bp smaller than that of the protein A gene from strains that were positive in the protein A latex agglutination test . Since it is precisely this size that is required in order to encode one immunoglobulin G-binding region, we assume that this is not present in the CFN ORSA strains . The phenotypical and genotypical features identify these very unusual CFN ORSA stains as being of clonal origin.

FEMS Microbiol Lett, 1993 Sep 1, 112(2), 173 - 7
The antibacterial activity of haemin compared with cobalt, zinc and magnesium protoporphyrin and its effect on potassium loss and ultrastructure of Staphylococcus aureus; Ladan H et al.; The unique antibacterial properties of Fe-protoporphyrin (haemin) on Staphylococcus aureus, compared to Co-protoporphyrin (Co-PP), Mg-protoporphyrin (Mg-PP) and Zn-protoporphyrin (Zn-PP) are described . Only haemin (20 microM) exhibits a strong light-independent antibacterial effect on S . aureus; the other metalloporphyrins, Co-PP, Mg-PP or Zn-PP, have no antibacterial effect in the dark . Only light photosensitization of Mg-PP-treated cells resulted in the inhibition of the bacterial growth, while Co-PP or Zn-PP were photodynamically inactive . A notable effect of haemin on inactivation of S . aureus was the induction of immediate ion fluxes as determined by X-ray microanalysis (XRMA) of fast-frozen cells . A marked efflux of K (96%) and Cl (94%) was expressed immediately as determined by X-ray microanalysis of S . aureus cells treated with haemin for 5 min . Only 48% loss of Na was detected in the cells under these treatment conditions, while P content was increased by 150% . Electron microscopy analysis revealed the appearance of a mesosome-like structure connected to the new septa, filamentous chromosome and arrays of aggregated ribosomes in the cytoplasm . We propose that haemin has multiple cellular targets for its oxidative effect in S . aureus.

No Shinkei Geka, 1993 Sep, 21(9), 805 - 8
{Stellate ganglion blocks as the suspected route of infection in a case of cervical epidural abscess}; Makiuchi T et al.; Spinal epidural abscess is a comparatively rare disease . Its prognosis reportedly depends on degree and duration of the neurological symptoms before the treatment . Thus, the importance of early diagnosis and prompt surgical treatment has been emphasized repeatedly . In the case reported here stellate ganglion blocks were considered to be involved in the etiology of a cervical epidural abscess . <Case> The 47-year old woman complained of tinnitus and vertigo and repeatedly underwent stellate ganglion blocks over a period of 10 months . In August, 1991, the patient complained of back pain and developed fever . A few days later she noticed motor weakness and sensory disturbances in the legs . Ten days after the onset of these neurological symptoms she complained of rapidly progressive tetraplegia and was referred to this hospital for admission . On admission, she was fully conscious but febrile . Neurologically, she presented tetraplegia, hypesthesia below level of C7 and slight cervical rigidity . Bladder and bowel dysfunction were also observed . MRI examination showed an epidural mass behind vertebral bodies C6-7 compressing the spinal cord . Antibiotic therapy was initiated immediately and emergency surgical decompression was performed through an anterior approach . Intraoperative findings showed a discitis and yellowish liquid pus in the epidural space . Culture of the pus revealed staphylococcus aureus . In this case repeated stellate ganglion blocks before onset of the symptoms were the suspected route of infection . Postoperative MR images confirmed satisfactory decompression of the spinal cord and motor power was gradually recovered after surgery . Approximately 4 months after surgery she could walk independently . Cervical epidural abscess has been rarely reported as a complication of stellate ganglion block.(ABSTRACT TRUNCATED AT 250 WORDS)

J Vasc Surg, 1993 Sep, 18(3), 477 - 84; discussion 485
Direct replacement of mycotic thoracoabdominal aneurysms; Hollier LH et al.; Direct graft replacement with local debridement and prolonged administration of antibiotics was used in the treatment of six patients with mycotic thoracoabdominal aneurysms . The only early death occurred in a patient with systemic sepsis related to Staphylococcus aureus mycotic suprarenal aneurysm . Long-term survival of the remaining patients has been excellent: two patients died of unrelated causes at 5 and 6 years, respectively; one patient remains alive with known persistent infection at 5 years; and the remaining patients are alive with no evidence of infection at 1 1/2 and 10 years, respectively . Percutaneous aspiration of infected perigraft fluid with local instillation of antibiotics along with administration of intravenous antibiotics may provide palliation in selected patients with recurrent infections . In view of the magnitude of the problems associated with recurrent infection, life-time administration of antibiotics is recommended after in situ graft replacement of mycotic thoracoabdominal aneurysms.

Eur J Immunol, 1993 Sep, 23(9), 2372 - 4
Linomide, a novel immunomodulator that prevents death in four models of septic shock; Gonzalo JA et al.; Intravenous injections of 50 micrograms Staphylococcus aureus enterotoxin B (SEB) or bacterial lipopolysaccharide (LPS) are lethal, provided that mice are simultaneously sensitized with either N-galactosamine (GalN) or the anti-glucocorticoid RU-38486 . Similar to the synthetic glucocorticoid (GC) receptor agonist dexamethasone, pharmacological doses of the immunomodulator linomide (quinoline-3-carboxamide) prevent death in all four models of lethal septic shock (LPS + GalN, LPS + RU-38486, SEB + GalN, and SEB + RU-38486) and inhibit the secretion of tumor necrosis factor, one of the major intermediate effector molecules of SEB and LPS toxicity . In this system, cyclosporine A (CsA), although effective in suppressing SEB toxicity, fails to counteract the lethal effect of LPS . This observation, together with the fact that linomide acts in the presence of excess amounts of GC receptor antagonist, indicates that linomide functions in a different way to that of known immunosuppressive agents like CsA and GC.

Nurs Clin North Am, 1993 Sep, 28(3), 625 - 37
Methicillin-resistant Staphylococcus aureus . Past, present, and future; Morita MM; The MRSA control program at UCDMC is one of many approaches used in hospitals today . With this less restrictive program, we have been able to maintain control of MRSA for approximately 5 years . By establishing a threshold for investigation at four new nosocomial cases per month, the ICD has been able to maintain a manageable endemic level of MRSA . Figure 2 shows the downward trend of new cases of MRSA per fiscal year . During 1991, however, we experienced clustering of cases in two areas of the hospital along with a major outbreak in our burn unit . This is reflected in the significant rise in the number of new cases for that year . Even with these outbreaks, however, we have been able to re-establish control . Figure 3 represents the number of new MRSA cases per month during fiscal year 1991 . After the peak in April, we have again seen a downward trend, with an average of four new cases per month during the first quarter of fiscal year 1992 . The success of this program is attributed to the cooperation and excellent communication among the hospital departments who are active participants in this control program . It is also owing to the establishment of a very active antibiotic control program that discourages inappropriate use of antimicrobial agents . This team effort is critical to the success of any infection control program . Infection control protocols are constantly changing, even if they are directed toward the same pathogen . Hospital epidemiology provides us with a very systematic approach to controlling the spread of disease . During the process, however, we are constantly collecting new information about the pathogen, allowing us to re-evaluate and, we hope, improve our approach to control . This is one reason for the numerous approaches to control found in the vast array of MRSA literature . MRSA continues to be a challenge of the 1990s . It appears to be an increasing problem in US hospitals, regardless of hospital size . Although its elusive behavior evades the most comprehensive and carefully planned control programs of even the most skilled hospital epidemiologists, hospitals continue to struggle for control of this organism . The alternative to control is probable resistance to vancomycin, which would have devastating public health consequences, particularly as alternative antibiotic therapy is not yet available.

Infect Immun, 1993 Sep, 61(9), 3879 - 85
The accessory gene regulator (agr) controls Staphylococcus aureus virulence in a murine arthritis model; Abdelnour A et al.; We have studied the role of the accessory gene regulator (agr) of Staphylococcus aureus as a virulence determinant in the pathogenesis of septic arthritis . At least 15 genes coding for potential virulence factors in Staphylococcus aureus are regulated by a putative multicomponent signal transduction system encoded by the agr/hld locus . agr and hld mutants show a decreased synthesis of extracellular toxins and enzymes, such as alpha-, beta-, and delta-hemolysin, leucocidin, lipase, hyaluronate lyase, and proteases, and at the same time an increased synthesis of coagulase and protein A as compared with the wild-type counterpart . We have used a recently described murine model of S . aureus-induced arthritis to study the virulence of S . aureus 8325-4 and two agr/hld mutants derived from it . Sixty percent of the mice injected with the wild-type strain developed arthritis, whereas agrA and hld mutants displayed joint involvement in only 10 and 30%, respectively . In addition, 40% of the mice inoculated with the wild-type strain displayed an erosive arthropathy; such changes were not detectable at all in mice inoculated with the agrA mutant . Serum levels of interleukin-6, a potent B-cell differentiation factor, were significantly higher (P < 0.001) in the mice inoculated with the wild-type strain than in those inoculated with the agrA mutant counterpart . Overall, our results suggest that the agr system of S . aureus is an important virulence determinant in the induction and progression of septic arthritis in mice.

J Pediatr, 1993 Sep, 123(3), 422 - 4
Microbiology of kerions; Honig PJ et al.; Qualitative and semiquantitative bacterial culture specimens were obtained from 44 patients with kerions . Staphylococcus aureus was isolated from the scalp surface overlying the kerion in 29% of patients and from the pus within the kerion in 48% of patients . Gram-negative bacteria were found in the same locations in 11.3% and 18% of patients, respectively . The data indicate that bacteria are frequently cultured from kerions.

Eur J Epidemiol, 1993 Sep, 9(5), 559 - 62
Antibiotic susceptibility and phage typing of methicillin-resistant Staphylococcus aureus clinical isolates from blood cultures of 692 patients in 15 Israeli hospitals; Samra Z et al.; Six hundred ninety-two clinical isolates of Staphylococcus aureus were collected from blood cultures of 692 patients in 15 Israeli hospitals over a two year period . Antibiotic sensitivity was tested by the standard disk diffusion technique . Of these isolates, 41.6% were methicillin-resistant (MRSA) . All 288 MRSA isolates were sensitive to vancomycin and pristinomycin; 98.6% were sensitive to fucidine; 97.9% to imipenem; 79% to rifampicin; 63.6% to amikacin; 54.5% to augmentin; 36.4% to clindamycin; 12.6% to ciprofloxacin; 11.9% to cotrimoxazole and ofloxacin; 10.5% to gentamicin; 9.8% to erythromycin; and 8.4% to norfloxacin . Phage typing was determined by using the international set of phages . All the isolates that were sensitive to Group I phages, and 91.8% of those sensitive to Group II phages, were sensitive to methicillin . Of the isolates that were sensitive to Group III phages, 79.2% were methicillin-resistant and 72.4% of the latter were sensitive to phages 75/85 . Of the isolates that were sensitive to Group III and miscellaneous phages, 50.7% were methicillin-resistant and 71% of the latter were sensitive to phages 75/85 as well.

Microb Pathog, 1993 Sep, 15(3), 227 - 36
Immunization with fibronectin binding protein from Staphylococcus aureus protects against experimental endocarditis in rats; Schennings T et al.; Rats were immunized with a fusion protein (gal-FnBP) encompassing beta-galactosidase and the domains of fibronectin binding protein from Staphylococcus aureus responsible for binding to fibronectin . Antibodies against gal-FnBP were shown to block the binding of S . aureus to immobilized fibronectin in vitro . Endocarditis in immunized and non-immunized control rats was induced by catheterization via the right carotid artery, resulting in damaged aortic heart valves which became covered by fibrinogen and fibronectin . The catheterized rats were then infected intravenously with 1 x 10(5) cells of S . aureus . The number of bacteria associated with aortic valves was determined 1 1/2 days after the challenge infection and a significant difference in bacterial numbers between immunized and non-immunized groups was then observed (p < 0.05).

J Antimicrob Chemother, 1993 Sep, 32(3), 453 - 8
Efficacy of cefoperazone in combination with sulbactam in experimental Staphylococcus aureus endocarditis in rabbits; Chambers HF et al.; The activity of cefoperazone with and without sulbactam was studied in vitro and in vivo against strains of methicillin-resistant and methicillin-susceptible Staphylococcus aureus . Cefoperazone with or without sulbactam was inactive in vitro against the methicillin-resistant strain and was bound by penicillin-binding protein 2a with an IC50 of 190 mg/L (the concentration that reduced radio-labelling with 3H-penicillin by 50%) . Cefoperazone was hydrolysed by beta-lactamase in vitro but sulbactam improved cefoperazone activity in a rabbit model of aortic valve endocarditis caused by a beta-lactamase producing methicillin-susceptible strain.

J Antimicrob Chemother, 1993 Sep, 32(3), 431 - 44
Behaviour of beta-lactamase-positive and -negative Staphylococcus aureus isolates in susceptibility tests with piperacillin/tazobactam and other beta-lactam/beta-lactamase inhibitor combinations; Bonfiglio G et al.; beta-Lactamase production protects Staphylococcus aureus against piperacillin and amoxycillin . Tazobactam and clavulanate inhibit the enzyme, but beta-lactamase producers remained substantially less susceptible than non-producers to piperacillin/tazobactam and co-amoxiclav in disc tests . These observations reflected the fact the inhibition zones for beta-lactamase non-producers expanded with time, as bacterial growth was killed by the diffusing antibiotic, whereas those for enzyme producers maintained a constant diameter after they first became discernible, indicating equilibrium between diffusion and destruction of the antibiotic . The antibiotic destruction required for this equilibrium depended on biomass formation, which was apparent from the luxuriant growth on beta-lactamase-producers around the inhibition zone edges, and on beta-lactamase induction, which was demonstrable when S . aureus cultures were exposed to discs containing tazobactam alone . beta-Lactamase-related effects on the activity of inhibitor combinations were apparent also in MIC tests, but only when these were performed with large inocula . Thus, the MICs of piperacillin or amoxycillin with tazobactam or clavulanate were only two- to four-fold higher for beta-lactamase producers than non-producers at low inocula (10(4) cfu), but this differential increased to 6- to 16-fold at high inocula (10(6) cfu) . Inoculum effects were greater for tazobactam combinations than for clavulanate combinations, irrespective of the partner penicillin . These beta-lactamase-related inhibition zone differentials and inoculum effects for the inhibitor combinations resemble previous observations for first-generation cephalosporins, notably cephazolin and cephaloridine . Their significance for the latter compounds has occasioned long debate.

J Antimicrob Chemother, 1993 Sep, 32(3), 401 - 11
Antimicrobial susceptibility testing of enterococci: results of a survey conducted by the United Kingdom National External Quality Assessment Scheme for Microbiology; Snell JJ et al.; Six strains of enterococci were distributed to participants in the United Kingdom National External Quality Assessment Scheme for Microbiology with a request that they be tested for susceptibility to ampicillin/penicillin and vancomycin and for high-level resistance to gentamicin . More than 98% of laboratories correctly reported the resistant strains as resistant to penicillin and ampicillin . However, there was a poorer correlation for the susceptible strains, with only 1-6% and 69-83% of laboratories reporting the strains as susceptible to penicillin and ampicillin respectively . Those laboratories which used 5-25 micrograms ampicillin discs or breakpoint methods reported proportionally more results correctly for the susceptible strains than those using 2 micrograms discs . Participants using Escherichia coli or an enterococcus as a control and those not using a control at all were more likely to report ampicillin-susceptible strains correctly than those using Staphylococcus aureus NCTC 6571 (Oxford strain) . For vancomycin-susceptible and high-level vancomycin-resistant strains, 93-96% and 96-99% of reports respectively were correct . For the low-level vancomycin-resistant strains, only 50-54% of reports were correct . Participants using a 5 micrograms vancomycin disc reported proportionally more of the low-level resistant strains correctly than those using 10, 20, 25, 30 or 100 micrograms discs . Participants not using controls were proportionally more likely to report the low-level resistant strains as susceptible than those using an enterococcus or S . aureus NCTC 6571 as a control . For the high-level gentamicin-resistant (HLGR) strains, 96-98% of reports were correct . Depending on the strain, between 12% and 41% of participants also reported high-level resistance for the strains which were not HLGR . Those using low-content discs (< or = 30 micrograms) and breakpoint or MIC methods were more likely to report strains which were not HLGR as HLGR than those using high-content discs . Those using an enterococcus as a control were less likely to report strains which were not HLGR as HLGR than those using either S . aureus NCTC 6571 or E . coli as a control and those not using a control.

Clin Rheumatol, 1993 Sep, 12(3), 422 - 5
Isolated sternoclavicular joint arthritis in heroin addicts and/or HIV positive patients: three cases; Covelli M et al.; The authors describe three patients in whom septic arthritis of the sternoclavicular joint (SCJ) occurred, drug addiction and human immunodeficiency virus (HIV) infection representing the predisposing conditions . Infectious arthritis is well known in intravenous drug users, but it is rare in HIV positive patients, who are prone to bacterial infections from usual or unusual microorganisms . In one case, staphylococcus aureus methicillin sensitive was responsible for septic arthritis . In another case, SCJ infection was associated with pneumonitis.

Nihon Kyobu Shikkan Gakkai Zasshi, 1993 Sep, 31(9), 1140 - 5
{Adult respiratory distress syndrome due to sepsis caused by Staphylococcus aureus: a case report}; Nagaoka H et al.; A 59-year-old man, under treatment for osteoarthritis of the right hip joint, was admitted to the Department of Orthopedic Surgery of Health Insurance Nankai Hospital with complaints of high fever and severe right hip joint pain . Since he developed shock, he was transferred to the Department of Internal Medicine . The laboratory data showed marked increase of acute phase reactants, and Staphylococcus aureus was cultured from the abscess in the right hip joint . The chest X-ray film the next day showed diffuse pulmonary edema of both lungs . The diagnosis of adult respiratory distress syndrome (ARDS) due to sepsis caused by S . aureus was made . Septic ARDS due to S . aureus is rare . The patient was cured by mechanical ventilation and administration of antibiotics, methyl-prednisolone and Urinastatin, along with drainage of the abscess in the right hip joint.

Rinsho Byori, 1993 Sep, 41(9), 1037 - 42
{A simple and rapid method capable of detecting methicillin-resistant Staphylococcus aureus (MRSA) by single culture on an agar plate}; Yoshida S et al.; A novel simple agar plate capable of detecting methicillin-resistant Staphylococcus aureus (MRSA) by single culture was developed . The agar plate included 1) mannitol and a pH indicator, and 4-methylumbelliferyl phosphoric acid, both for identification of Staphylococcus aureus by its ability to digest mannitol and produce phosphatase; detection of the former by change in color of pH indicator and the latter by fluorescence of 4-methylumbelliferone, 2) oxacillin at a minimum concentration just to eliminate methicillin-sensitive Staphylococcus aureus (MSSA), and 3) phenylethyl alcohol to inhibit growth of most gram negative rods . The method was simple, sensitive, time-saving, and quite effective in the identification of MRSA directly from clinical specimens . Neither false positive nor false negative results were observed by the present method.

Jpn J Antibiot, 1993 Sep, 46(9), 794 - 800
{Antimicrobial activities of arbekacin against methicillin-resistant Staphylococcus aureus isolated from patients of a pediatrics ward}; Deguchi K et al.; Aiming at measuring the antimicrobial activities of arbekacin (ABK) against the strains of methicillin-resistant Staphylococcus aureus (MRSA), isolated from pediatrics patients in 1992, the minimum inhibitory concentration (MIC) of 8 antibiotics including ABK was determined and the coagulase types of those strains were also examined . The obtained results are summarized as follows . 1 . Among coagulase types of a total of 78 strains, Type II, Type IV and Type VII were 84.6%, 12.8% and 2.6%, respectively . No clear difference in coagulase types were observed among their origins of isolation . 2 . MIC90 of ABK against 42 strains isolated from the air passage of suspected pneumoniae patients and 36 strains isolated from the blood of suspected septicemia patients were 1.56 micrograms/ml and 3.13 micrograms/ml, respectively, and MIC90 of ABK against the 78 strains was 1.56 micrograms/ml, which was equal to that of vancomycin (VCM) . 3 . Most of these strains exhibited resistance against multiple antibiotic agents including cefmetazole (CMZ), imipenem (IPM), fosfomycin (FOM) and minocycline . Strains isolated from the blood were mostly resistant to multiple agents, and most of them were especially highly resistant to CMZ and IPM . ABK, however, showed potent antimicrobial activities even to those strains . These results were similar to the results obtained several years ago . 4 . Considering the fact that ABK demonstrates not only potent antimicrobial activities against MRSAs isolated from the pediatric patients, but also shows remarkable clinical effects with concomitant use with beta-lactams or FOM, the prospect of ABK use in MRSA infectious diseases of children is excellent.

Hiroshima J Med Sci, 1993 Sep, 42(3), 101 - 7
Susceptibility of methicillin-resistant Staphylococcus aureus clinical isolates to various antimicrobial agents . III . Novel, inducible resistance to macrolide-lincosamide-streptogramin B (MLS) antibiotics; Inouye Y et al.; Resistance patterns against 25 antimicrobial agents consisting of beta-lactams, aminoglycosides, tetracyclines, fluoroquinolones, macrolides and etc . were examined for 69 strains of methicillin-resistant Staphylococcus aureus (MRSA) isolated at Hiroshima University Hospital from July 1991 to April 1992 . Regarding overall resistance (the percentage of highly and moderately resistant strains), the following antimicrobial agents were no more effective chemotherapeutics for MRSA infections (%resistance): methicillin (100), flomoxef (100), kanamycin (100), tobramycin (100), amikacin (100), isepamicin (100), gentamicin (78), dibekacin (100), ofloxacin (99), levofloxacin (99), temafloxacin (99), erythromycin (100), clarithromycin (100), tetracycline (93), minocycline (93) and fosfomycin (100) . Further spread of arbekacin-resistant strain, which was isolated in April 1991, into a clinical environment could not be recognized during the period covered in the present study . All the MRSA strains were resistant either constitutively (26 strains) or inducibly (43 strains) to macrolide-lincosamide-streptogramin B (MLS) antibiotics . When expression is constitutive, the strains are resistant to all MLS antibiotics . In contrast, 16-membered macrolide (i.e., jasamycin), lincomycin and mikamycin B escape resistance in the strains with a typical inducible resistance overcome in the presence of 14-membered macrolides by a translational attenuation mechanism . Three of 4 beta-lactamase-positive strains, however, can not be classified in these two resistance groups, being exclusively resistant to mikamycin B . The strains grown in the presence of any inducing MLS antibiotic became susceptible to mikamycin B even in the inducer-free culture.

Conn Med, 1993 Sep, 57(9), 611 - 7
Guidelines for management of patients with methicillin-resistant Staphylococcus aureus in acute care hospitals and long-term care facilities . The MRSA Interagency Advisory Committee in conjunction with the Connecticut Department of Public Health and Addiction Services, July 1993; Survey of clinical isolates of Staphylococcus aureus for borderline susceptibility to antistaphylococcal penicillins; Institute of Microbiology, University of Ancona Medical School, ItalyOn the basis of the MICs of methicillin and oxacillin, 975 clinical isolates of Staphylococcus aureus were categorized as having resistance, borderline susceptibility or full susceptibility to penicillinase-resistant penicillins (PRPs) . The borderline phenotype accounted for 122 isolates (12.5%), whereas 562 isolates were fully susceptible and 290 resistant; one remaining isolate had resistance to methicillin and borderline susceptibility to oxacillin . Reductions in the MICs of methicillin and oxacillin in the presence of sulbactam were greater in strains with borderline PRP susceptibility than in fully susceptible or resistant isolates . Over 99% of fully PRP-susceptible strains, 93% with borderline susceptibility and 71% of resistant strains were susceptible to ampicillin/sulbactam . The production of beta-lactamase, assayed in all strains using nitrocefin as substrate, could be detected without prior induction in 729 strains and after induction only in another 156 strains . With only two exceptions, the beta-lactamase negative strains were part of the fully PRP-susceptible group of organisms (88 of 562 isolates) . Among the borderline isolates, strong beta-lactamase reactions were encountered with particular frequency, but not in all strains and not exclusively in borderline strains . Although associated with the majority of borderline strains, beta-lactamase hyperproduction thus did not appear to be an essential feature of the borderline phenotype . The results obtained may have implications for laboratory and clinical medicine, also in the light of recent findings suggesting that other mechanisms besides beta-lactamase hyperproduction may account for borderline susceptibility to PRPs.

Antimicrob Agents Chemother, 1993 Sep, 37(9), 2003 - 6
Detection and characterization of mupirocin resistance in Staphylococcus aureus; Janssen DA et al.; Fourteen mupirocin-resistant Staphylococcus aureus strains were isolated over 18 months; 12 exhibited low-level resistance, while two showed high-level resistance . Highly mupirocin-resistant strains contained a large plasmid which transferred mupirocin resistance to other S . aureus strains and to Staphylococcus epidermidis . This plasmid and pAM899-1, a self-transferable gentamicin resistance plasmid, have molecular and biologic similarities.

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 1993 Sep-Oct, 34(5), 385 - 9
Neonatal Staphylococcus aureus pancarditis: report of one case; Chen CH et al.; Due to poor feeding, decreased activity and severe abdominal distension, a 20-day old female infant was admitted to our hospital . The patient was diagnosed as having necrotizing enterocolitis and received a multiple segmental resection . During the hospitalization, recurrent sepsis and candidiasis occurred . On the 56th day of admission, tachycardia, thrombocytopenia and cardiomegaly were noted . Sudden onset of cardiac arrest occurred and a post-mortem examination revealed staphylococcal pancarditis . Pancarditis is a rare and fatal disease in newborns . When a patient with a catheter insertion shows unknown cause of thrombocytopenia and acute onset of cardiomegaly, an echocardiogram is highly suggested . Early diagnosis and proper parenteral antibiotics may be life-saving.

Thorax, 1993 Sep, 48(9), 925 - 7
Empyema thoracis: a problem with late referral?
Cham CW, Haq SM, Rahamim J.
BACKGROUND--Patients are often referred to thoracic units for management of empyema after the acute phase has been treated with antibiotics but without adequate drainage . This study evaluates the effects of delay in surgical treatment of empyema thoracis on morbidity and mortality . METHODS--Thirty nine consecutive patients were studied from January 1991 to June 1992 . Two groups (group 1, 16 patients; group 2, 23 patients) were compared depending on the time spent under the care of other specialists before referral to the thoracic unit (group 1, seven days or less; group 2, eight days or more) . The reasons for delay in referral were analysed . RESULTS--Four patients were treated conservatively with chest drainage alone (all in group 1) . Thirty five patients required rib resection and drainage of their empyema (group 1, 12 patients; group 2, 23 patients) . Nineteen (all in group 2) of the 35 patients who had rib resections went on to have decortication . The commonest cause of empyema was post-pneumonic (37 out of 39 patients) . Staphylococcus aureus was the commonest organism isolated . Misdiagnosis (five patients), inappropriate antibiotics (six patients), and inappropriate placement of chest drainage tubes (three patients) all contributed to persistence and eventual progression of empyema . The overall mortality was 10% and mortality increased with age . The median stay in hospital was 9.5 days (range 7-12 days, n = 4) for patients treated with closed tube drainage only; 18 days (range 10-33 days, n = 16) for patients who had undergone rib resections and open drainage; and 28 days (range 22-49 days, n = 19) for patients who underwent decortication . The likelihood of having a staged procedure (antibiotics, closed tube drainage, open drainage with rib resection, and finally decortication) increased when closed tube drainage was persevered with for more than seven days . The total hospital stay was positively related with the time before referral for surgical treatment . Anaemia, low albumin concentrations, and worsening liver function were found in group 2 compared with group 1 . CONCLUSIONS--Early adequate operative drainage in patients with empyema results in low morbidity, shorter stays in hospital, and good long term outcome . These patients should be treated aggressively and early referral for definitive surgical management is recommended.

Plasmid, 1993 Sep, 30(2), 170 - 5
Transformation of Mycoplasma pneumoniae with Tn4001 by electroporation; Hedreyda CT et al.; Mycoplasma pneumoniae was transformed with the Staphylococcus aureus transposon Tn4001 by electroporation . A transformation frequency of 10(-3) to 10(-5)/colony-forming unit was observed using 30.0 microgram plasmid DNA and 10(7)-10(8) M . pneumoniae colony-forming units . DNA hybridization analyses using standard and pulsed field agarose gel electrophoresis confirmed chromosomal insertion of the transposon, apparently by a transpositional mechanism into random sites . These studies demonstrate the functionality of Tn4001 in M . pneumoniae and suggest its potential as a genetic tool in this mycoplasma.

Plasmid, 1993 Sep, 30(2), 163 - 6
The tet(K) gene of plasmid pT181 of Staphylococcus aureus encodes an efflux protein that contains 14 transmembrane helices; Guay GG et al.; The corrected DNA sequence of the tet(K) structural gene, encoding the tetracycline efflux protein from Staphylococcus aureus, is reported . The Tet(K) protein is homologous to related tetracycline efflux proteins throughout the protein, including at the C-terminal end . Hydropathy plotting now clearly indicates that the Tet(K) protein contains 14 transmembrane alpha-helices.

Nippon Ronen Igakkai Zasshi, 1993 Sep, 30(9), 795 - 801
{Effect of gentian violet on the elimination of methicillin-resistant Staphylococcus aureus (MRSA) existing in the decubitus region}; Saji M et al.; Methicillin-resistant Staphylococcus aureus (MRSA) is frequently isolated from skin lesions, such as in the decubitus region . There is a possibility that MRSA through these lesions can spread widely in a hospital . However, local treatment with most antibiotics and antiseptics (povidone-iodine) is not effective to eradicate MRSA from the infected decubitus . We have recently demonstrated that gentian violet (Gv) possessed a bactericidal effect against MRSA isolated from clinical specimens in vitro . This examination evaluated whether or not a topical ointment containing 0.1% Gv is effective to eradicate MRSA which existed in decubitus regions . Decubitus (14 clinical cases, ages 59-87 years) infected with MRSA were treated with 0.1% Gv-ointment once or twice daily after bathing in 0.1% Gv aqueous solution . Although all patients were treated with povidone-iodine and 9 out of 14 patients were given either local or systemic administration of antibiotics, those treatments were not effective to eradicate MRSA from decubituses . However, MRSA was not detectable in all cases within 34 days (average: 10.8 days +/- 2.7) after treatment with 0.1% Gv-ointment . The eradication of MRSA from decubitus areas tended to be delayed, depending upon the size and depth of decubituses (Grade III and IV) and complications such as diabetes mellitus . Skin irritability was not observed in any patients . These results suggest that 0.1% Gv-ointment is a useful material for the treatment of the MRSA-local wound infection . Treatment with Gv-ointment to MRSA-infected decubitus may exhibit a protective effect with regard to infection with MRSA in hospital.

Masui, 1993 Sep, 42(9), 1359 - 62
{Rupture of asymptomatic mycotic aneurysm after valve replacement in infective endocarditis}; Kanaya N et al.; Mycotic cerebral aneurysms (MCA) are one of the most serious complications of infective endocarditis . The rupture of MCA in patients under anticoagulant therapy following valve replacement carries high mortality . We encountered this serious complication in a patient who had no neurologic symptoms . A 12-year-old girl was scheduled for mitral valve replacement (MVR) 5 weeks after antibiotic therapy for infective endocarditis caused by Staphylococcus aureus . Before the surgery, she did not have any neurologic symptoms or abnormal findings in CT scanning examination . The surgery to remove her mitral valve with bacterial vegetations and replace it with an artificial valve proceeded smoothly and she appeared to begin an uneventful postoperative recovery . However, she suddenly began to complain of severe headache and became unconscious on the fifth days after MVR . A CT scan showed cerebral herniation due to a major subdural hematoma . A ruptured MCA was detected in the orbito-frontal artery and clipped in an emergency operation . She was transferred to the intensive care unit and given continuous infusion of barbiturate to prevent increase of her intracranial pressure . CT scanning and arteriography 10 days after the MCA clipping, revealed a new subdural hematoma and MCA just proximal to the previous clip . It is important to bear in mind that patients with infective endocarditis can have mycotic cerebral aneurysms without any clinical neurologic symptoms.

J Okla State Med Assoc, 1993 Sep, 86(9), 437 - 40
Methicillin-resistant Staphylococcus aureus: long-term routes of acquisition in hospital patients; Flournoy DJ et al.; Five hundred fifty three patients and two personnel (1986-1991) were categorized according to acquisition route of methicillin-resistant Staphylococcus aureus (MRSA) and initial culture date . Of the 555, there were 218 with nosocomial infections, 100 with nosocomial colonizations, 92 with community-acquired infections, and 145 with community-acquired colonizations . Nosocomial infections occurred significantly more often than nosocomial colonizations, community-acquired infections, or colonizations (p < 0.001) . Results of this study show that over a long period, our patients acquired MRSA by different routes, none of which were related to seasons of the year . Although seasonal outbreaks of epidemic MRSA are important, an awareness of the occurrence of endemic MRSA is also important because it serves as a reminder that MRSA reservoirs are continuously present in some institutions.

J Neurol Sci, 1993 Sep, 118(2), 188 - 93
Blood-brain barrier permeability and the brain extracellular space in acute cerebral inflammation; Lo WD et al.; The diffusion properties of the brain cortical extracellular space have never been examined in models of inflammation, even though inflammation can cause increased blood-brain barrier permeability . Uptake of intravascular 125I-labelled albumin and the diffusion of the tetramethylammonium ion within the brain extracellular space was measured in an experimental brain abscess to determine the effect of acute inflammation upon blood-brain barrier permeability and diffusion properties of the cortical extracellular space . The blood-brain transfer constant for albumin was increased in the abscess region, indicating that an increase in blood-brain barrier permeability occurred in animals inoculated with a weakly pathogenic strain of Staphylococcus aureus . The volume fraction of the extracellular space, as measured by the diffusion of tetramethylammonium ion, ranged from 0.19 to 0.23 in bacteria inoculated subjects and from 0.21 to 0.22 in controls . The tortuosity of the extracellular space ranged from 1.40 to 1.42 in bacteria inoculated subjects and was 1.39 in controls . These results showed that the volume fraction and tortuosity of the cortical extracellular space were not affected by inflammation even though vascular permeability was increased . This result was supported by the finding that brain water content, measured in the same animals, was increased to a non-significant extent in the bacteria inoculated subjects . These findings lead to the conclusion that acute inflammation induced by a weak pathogen can cause increased blood-brain barrier permeability without a significant change in the diffusion properties of the brain cortical space.

Fukuoka Igaku Zasshi, 1993 Sep, 84(9), 402 - 10
Serum inhibition of antibiotic-dependent L-form growth in Staphylococcus aureus: likely involvement of serum high-density lipoprotein; Ikeda M; The L-form growth of Staphylococcus aureus induced by ampicillin or fosfomycin was found to be severely depressed by horse or bovine serum included in the culture medium . Fractionation of horse serum revealed that the inhibitory activity was copurified with high-density lipoprotein through floating ultracentrifugation, gel filtration, and isoelectric focusing . It was also shown that the inhibition was reversible: ampicillin-induced L-form cells lost their ability to form L-form colonies when mixed with the lipoprotein fraction or serum before plating, but the colony-forming ability was restored to the original level by treatment of the mixture with a protease, while simple dilution was ineffective . A mechanism for the growth inhibition remains to be clarified.

Clin Infect Dis, 1993 Sep, 17(3), 496 - 504
Spread of methicillin-resistant Staphylococcus aureus in a hospital after exposure to a health care worker with chronic sinusitis; Boyce JM et al.; A dramatic increase in the incidence of methicillin-resistant Staphylococcus aureus at a teaching hospital was documented to be due to three factors: a hospital-wide outbreak of 32 cases caused by an epidemic strain, an increase in the number of nosocomial cases caused by several other strains, and an increase in the number of patients admitted carrying strains acquired at other institutions . Case patients with the epidemic strain were significantly more likely than control patients to have had previous exposure to a respiratory therapist (P = .005) who had chronic sinusitis due to the epidemic strain . The plasmid DNA of isolates from the implicated respiratory therapist and affected patients yielded the same patterns on restriction endonuclease digestion . Implementation of general control measures and eradication of the respiratory therapist's sinusitis and nasal carriage terminated the epidemic . Establishing the importance of the infected health care worker by epidemiological methods led to control of the outbreak without the institution of wide-scale culture of specimens from personnel and the environment or other expensive and labor-intensive measures.

Clin Infect Dis, 1993 Sep, 17(3), 466 - 74
Elimination of Staphylococcus aureus nasal carriage in health care workers: analysis of six clinical trials with calcium mupirocin ointment . The Mupirocin Collaborative Study Group; Doebbeling BN et al.; Six double-blind, independently randomized studies evaluated the efficacy and safety of calcium mupirocin ointment in eliminating nasal carriage of Staphylococcus aureus among health care workers . Healthy volunteers with stable nasal carriage of S . aureus (n = 339) received either calcium mupirocin ointment (n = 170) or an identical placebo ointment (n = 169) intranasally for 5 days . Nasal carriage was eliminated 48-96 hours after completion of treatment in 130 (91%) of 143 evaluable volunteers receiving mupirocin but in only 8 (6%) of 142 evaluable volunteers receiving placebo . The 85% crude difference represents a 90% pooled (adjusted) estimate of the risk difference (95% confidence interval, 0.86-0.95) and a risk ratio of 16 (P < .0001) . This effect of treatment with mupirocin was observed consistently (risk ratio, 8-32) in all six centers . In addition, 96 of the 130 mupirocin-treated volunteers and 1 of the 8 placebo-treated volunteers who were culture-negative at the end of therapy remained free of S . aureus 4 weeks after treatment . Adverse events in each treatment arm were mild and equally frequent . These data, consistent across six institutions, demonstrate that calcium mupirocin ointment administered intranasally for 5 days is safe and effective in eliminating stable nasal carriage of S . aureus.

Indian J Pediatr, 1993 Sep-Oct, 60(5), 669 - 73
Pyogenic meningitis in Ahmedabad; Panjarathinam R et al.; One hundred and thirty five cerebrospinal fluid (CSF) samples from children clinically diagnosed Pyogenic meningitis (in and around Ahmedabad) were subjected to physical, bacteriological, cytological and biochemical examinations . It was found that all CSF specimens were turbid, the culture positivity varied form 12.12 to 56% . The highest percentage was found in children of less than one year of age . The average percentage of culture positivity was 28.68% . The result of gram stain was more than that of cultural examination . Gram stain of CSF was specific, accurate and highly valuable in the diagnosis of pyogenic meningitis . Among gram positive organisms isolated, Staphylococcus aureus was highest (8.8%) followed by Diplococcus pneumoniae (3.7%), but Klebsiella was predominant (6.6%) among gram negative bacilli . Staph . aureus was 100% sensitive to erythromycin, gentamycin, kanamycin and ampicillin . The results of cytological and biochemical tests correlated (67.1%) . There was increase in polymorphs and protein, sugar levels decreased.

Chin Med Sci J, 1993 Sep, 8(3), 157 - 61
Plasmid analysis and phage typing in the study of staphylococcal colonization and disease in newborn infants; Wu S et al.; Plasmid analysis, bacteriophage typing and antibiograms were used to detect the source and rate of Staphylococcus aureus colonization and disease in newborn infants in a nursery . Staphylococcal colonization on the nasal mucosa and umbilicus of 140 neonates took place within 12 hours after birth . The colonization rates reached 100% from the fourth day onward and fell to 66.7%, 25.5% and 17.5% by the age of 1 month, 6 months and 1 year, respectively . The incidence of nursery-acquired infection caused by S . aureus was at least 16.4% . All infections were confined to the skin or mucosa and were not serious . It is believed that the S . aureus which colonized and infected the newborn infants mainly originated from the nares and the hands of nurses, because only S . aureus strains from nurses and infected infants had the same phage patterns (52/52A/47/53/75/77/81) and carried 2 plasmids of the same size (1.4 and 1.7 Md), whereas S . aureus isolated from other sources did not have the same phage patterns or plasmid profiles . In view of the results of this study, it is considered that the importance of careful washing of the hands of personnel before and after handling infants should be emphasized.

Arch Biochem Biophys, 1993 Sep, 305(2), 298 - 306
Isolation of a membrane-associated cathepsin D-like enzyme from the model antigen presenting cell, A20, and its ability to generate antigenic fragments from a protein antigen in a cell-free system; Williams KP et al.; The biochemical mechanisms and enzymes involved in the processing of protein antigens for presentation by major histocompatibility complex class II molecules are poorly understood . This work describes the purification of a cathepsin D-like enzyme isolated from the murine B lymphoma cell line A20, a model antigen presenting cell . Two forms of cathepsin D-like enzyme were detected . One is soluble and located in the lysosome-enriched subcellular fraction . The other is membrane-associated and located in the endosome-enriched fraction . The membrane-associated form was purified to apparent homogeneity by affinity chromatography on pepstatin A-Sepharose . Its apparent molecular weight is 48,000, and its pH optimum is pH 4.0 . Endosomal cathepsins are known to be involved in antigen processing in vivo, and the purified membrane-associated cathepsin D-like enzyme from A20 cells was used to study antigen processing in vitro . The enzyme cleaved a model protein antigen, Staphylococcus aureus nuclease (Nase) and thereby generated antigenic fragments recognized by a Nase-specific T cell hybridoma . Such studies have allowed us to begin to understand the role of protease specificity and T cell determinant selection.

J Exp Med, 1993 Sep 1, 178(3), 1041 - 8
Interleukin 10 (IL-10) inhibits human lymphocyte interferon gamma-production by suppressing natural killer cell stimulatory factor/IL-12 synthesis in accessory cells; D'Andrea A et al.; Natural killer cell stimulatory factor or interleukin 12 (NKSF/IL-12) is a heterodimeric cytokine produced by monocytes/macrophages, B cells, and possibly other accessory cell types primarily in response to bacteria or bacterial products . NKSF/IL-12 mediates pleiomorphic biological activity on T and NK cells and, alone or in synergy with other inducers, is a powerful stimulator of interferon gamma (IFN-gamma) production . IL-10 is a potent inhibitor of monocyte-macrophage activation, that inhibits production of tumor necrosis factor alpha (TNF-alpha), IL-1 and also IFN-gamma from lymphocytes acting at the level of accessory cells . Because TNF-alpha and IL-1 are not efficient inducers of IFN-gamma, the mechanism by which IL-10 inhibits IFN-gamma production is not clear . In this paper, we show that IL-10 is a potent inhibitor of NKSF/IL-12 production from human peripheral blood mononuclear cells activated with Staphylococcus aureus or lipopolysaccharide (LPS) . Both the production of the free NKSF/IL-12 p40 chain and the biologically active p70 heterodimer are blocked by IL-10 . NKSF/IL-12 p40 chain mRNA accumulation is strongly induced by S . aureus or LPS and downregulated by IL-10, whereas the p35 mRNA is constitutively expressed and only minimally regulated by S . aureus, LPS, or IL-10 . Although IL-10 is able to block the production of NKSF/IL-12, a powerful inducer of IFN-gamma both in vitro and in vivo, the mechanism of inhibition of IFN-gamma by IL-10 cannot be explained only on the basis of inhibition of NKSF/IL-12 because IL-10 can partially inhibit IFN-gamma production induced by NKSF/IL-12, and also, the IFN-gamma production in response to various stimuli in the presence of neutralizing antibodies to NKSF/IL-12 . Our findings that antibodies against NKSF/IL-12, TNF-alpha, or IL-1 beta can significantly inhibit IFN-gamma production in response to various stimuli and that NKSF/IL-12 and IL-1 beta can overcome the IL-10-mediated inhibition of IFN-gamma, suggest that IL-10 inhibition of IFN-gamma production is primarily due to its blocking production from accessory cells of the IFN-gamma-inducer NKSF/IL-12, as well as the costimulating molecule IL-1 beta.

J Hosp Infect, 1993 Sep, 25(1), 45 - 52
Characterization of a strain of methicillin-resistant Staphylococcus aureus (EMRSA-15) by conventional and molecular methods; Richardson JF et al.; A strain of methicillin-resistant Staphylococcus aureus (MRSA), EMRSA-15, was isolated in both the Midlands and south-east of England . This strain could be distinguished from another, very similar strain, found in the north of England, by both conventional and molecular typing . Conventional typing allowed distinction between the Midlands and southern variants of EMRSA-15, while molecular typing (pulse-field gel electrophoresis) allowed recognition of local variants in the south . In this investigation conventional and molecular typing methods were complementary.

J Biotechnol, 1993 Sep, 30(3), 367 - 78
Expression, in Escherichia coli, of a soluble human tumor necrosis factor receptor; Saccardo MB et al.; We have expressed in Escherichia coli a soluble, truncated form of the human 55 kDa Tumor Necrosis Factor (TNF) receptor . For this purpose a plasmid was constructed which contains the extracellular domain of the 55 kDa TNF receptor fused to the coding sequence of the IgG binding domains of protein A from Staphylococcus aureus . The fusion product (TNFR-PA) obtained in E . coli is a soluble protein which bound human TNF alpha (huTNF alpha) with high affinity . In ligand-blotting experiments huTNF alpha bound to a single 52 kDa protein, a molecular mass corresponding to that expected for the monomeric fusion product . In gel filtration experiments binding activity was recovered from fractions that eluted at a volume corresponding to 140-150 kDa . TNFR-PA neutralized huTNF alpha in an in vitro cytotoxicity assay.

Eur J Haematol, 1993 Sep, 51(3), 144 - 51
G-CSF enhances the immunoglobulin generation rather than the proliferation of human B lymphocytes; Morikawa K et al.; The effect of granulocyte-colony stimulating factor (G-CSF) on human B-cell function was studied in in vitro cultures . G-CSF alone had no effect on the proliferative response of resting B cells, but it slightly enhanced the proliferative response of these cells in the presence of polyclonal B-cell mitogen, Staphylococcus aureus Cowan strain I (SAC) at concentrations of 0.2 to 25 micrograms/ml (1.5-fold increase in the DNA synthesis) . In contrast, immunoglobulin (Ig) secretion of activated B cells was increased approximately three-fold to four-fold by adding G-CSF to the cultures . The neutralization of G-CSF bioactivity with anti-G-CSF antibody abrogated this effect . Though cytoplasmic Ig-positive cells or plasma cell marker-positive cells did not change, the expression of IgM mRNA in antibody-producing B cells increased in the presence of G-CSF in the cultures . Interestingly, human B lymphocytes are shown to express the binding to biotin-conjugated G-CSF preparation, but not to biotin-conjugated GM-CSF preparation when examined by flow cytometry . These data suggest that G-CSF may influence B-cell function in special circumstances.

J Clin Invest, 1993 Sep, 92(3), 1374 - 80
Presence of IgE antibodies to staphylococcal exotoxins on the skin of patients with atopic dermatitis . Evidence for a new group of allergens; Leung DY et al.; In the current study, we investigated whether Staphylococcus aureus grown from affected skin of atopic dermatitis (AD) patients secreted identifiable toxins that could act as allergens to induce IgE-mediated basophil histamine release . The secreted toxins of S . aureus grown from AD patients were identified by ELISA using antibodies specific for staphylococcal enterotoxin (SE) exfoliative toxin (ET), or toxic shock syndrome toxin (TSST-1) . S . aureus isolates from 24 of 42 AD patients secreted identifiable toxins with SEA, SEB, and TSST accounting for 92% of the isolates . 32 of 56 AD sera (57%) tested contained significant levels of IgE primarily to SEA, SEB, and/or TSST . In contrast, although SEA, SEB, or TSST secreting S . aureus could be recovered from the skin of psoriasis patients, their sera did not contain IgE antitoxins . Freshly isolated basophils from 10 AD patients released 5-59% of total histamine in response to SEA, SEB, or TSST-1 but only with toxins to which patients had specific IgE . Basophils from eight other AD patients and six normal controls who had no IgE antitoxin failed to demonstrate toxin-induced basophil histamine release . Stripped basophils sensitized with three AD sera containing IgE to toxin released 15-41% of total basophil histamine only when exposed to the relevant toxin, but not to other toxins . Sensitization of basophils with AD sera lacking IgE antitoxin did not result in release of histamine to any of the toxins tested . These data indicate that a subset of patients with AD mount an IgE response to SEs that can be grown from their skin . These toxins may exacerbate AD by activating mast cells, basophils, and/or other Fc epsilon-receptor bearing cells armed with the relevant IgE antitoxin.

J Rheumatol, 1993 Sep, 20(9), 1478 - 84
In vitro IgM rheumatoid factor production by peripheral blood mononuclear cells from patients with seronegative rheumatoid arthritis; Nonaka S et al.; OBJECTIVE . We investigated whether mononuclear cells (MNC) from patients with seronegative rheumatoid arthritis (SNRA) are able to produce rheumatoid factor (RF) in response to lectin stimulation, Staphylococcus aureus Cowan I (SAC) or pokeweed mitogen (PWM), and also we investigated the role of CD5+ B cells in the pathogenesis of in vitro IgM RF production . METHODS . IgM RF production was measured by enzyme linked immunosorbent assay and CD5+ B cells by flow cytometry . Also, the effects of monocyte depletion and the inhibition of prostaglandin (PG) were compared in SNRA, seropositive RA (SPRA) and healthy controls . RESULTS . Peripheral blood MNC of patients with SNRA were able to produce the same amount of IgM RF as patients with SPRA following stimulation and SAC . CD5+ B cells also increased in patients with SNRA as well as patients with SPRA compared to healthy controls . However, a definite contribution of the CD5+ B cells to SAC-induced IgM RF production could not be demonstrated . The role of macrophage and PG on in vitro IgM RF synthesis were insignificant . CONCLUSION . MNC of patients with SNRA were able to produce IgM and IgG RF in response to SAC stimulation as well as that of the healthy controls . However, we could not find a significant role of CD5+ B cells and monocytes on in vitro IgM RF synthesis by MNC of patients with SNRA.

J Chromatogr, 1993 Aug 27, 646(1), 207 - 12
Human pepsin 3b peptide map sequence analysis, genotype and hydrophobic nature; Jones AT et al.; Peptides from a Staphylococcus aureus (V8) proteinase digest of human pepsin 3b have been identified by amino acid sequence analysis . Only 137 out of 326 expected residues were detected from the C and N terminal regions of the molecule . Comparison with amino acid sequences derived from nucleotide analysis of three different pepsinogen A genes, identified 2 out of 4 possible substitutions . The presence of valine at position 30 and leucine at 291 indicates that the major pepsin component of gastric juice, pepsin 3b, corresponds to pepsinogen genotype PGA-3 . Reversed-phase chromatography of native human pepsin 3b on C4 (300 A), C18 (300 A) or polymer (1000 A) columns was optimal on the C4 column and gradient elution with 2-propanol rather than acetonitrile . Denaturation of the protein in guanidinium hydrochloride, urea or high pH resulted in irreversible column retention . The marked hydrophobicity of denatured pepsin 3b may thus explain why the central segment of the protein was not revealed by peptide map analysis.

FEBS Lett, 1993 Aug 23, 329(1-2), 219 - 22
The C-terminal region of the S component of staphylococcal leukocidin is essential for the biological activity of the toxin; Nariya H et al.; The Staphylococcal toxin leukocidin consists of two protein components, F and S . From a culture medium of Staphylococcus aureus RIMD 310925, we isolated a truncated form of S (LS2), of which the C-terminal 17-residue segment is missing . Unlike intact S, LS2, showed neither leukocytolytic activity in the presence of F nor affinity for monosialoganglioside GM1 (GM1) . When excited at 280 nm, both S and LS2 exhibited intrinsic tryptophan fluorescence with an emission maximum at 318 nm . Upon binding to GM1, the emission maximum of S underwent a blue shift to 310 nm, whereas no change in fluorescence took place on mixing GM1 with LS2 . We conclude that the C-terminal region of S is essential for its biological activity as well as for its binding to GM1 and that this binding is accompanied by a conformational change of the S protein.

Arch Intern Med, 1993 Aug 23, 153(16), 1902 - 8
Staphylococcus aureus meningitis . A review of 104 nationwide, consecutive cases; Jensen AG et al.; METHODS: Based on a nationwide registration, the clinical and bacteriologic data from 61 postoperative and 43 hematogenous cases of Staphylococcus aureus meningitis in Denmark from 1986 through 1989 were reviewed . RESULTS: Postoperative meningitis was a foreign body infection in 89% of the cases and had a lower mortality (18% {11/61}) compared with hematogenous meningitis (56% {24/43}) . Hematogenous S aureus meningitis seems to be part of an overwhelming, disseminated infection as indicated by the following: 81% of the patients had bacteremia, 21% had endocarditis, and 12% had osteomyelitis . Most patients were older, often with underlying diseases, community-acquired infections, and a clinical picture of severe meningitis . The major findings were mental status changes and a high rate (34%) of focal neurological changes . The initial leukocyte count in the cerebrospinal fluid sample was low, and the bacteria were seen in Gram's stain smears in 40% of cases only . The prognosis was related to the age of the patients and the initial antibiotic treatment . Patients treated with penicillinase-stable penicillins in combination with fusidic acid may have a better prognosis . Three (12%) of 25 surviving patients had severe sequelae . CONCLUSIONS: Hematogenous S aureus meningitis is a severe disease with a high mortality related to age, presence of shock, and infection with strains of phage type 95.

FEBS Lett, 1993 Aug 16, 328(3), 285 - 90
Determination of the disulphide bridge arrangement of bovine histidine-rich glycoprotein; Sorensen CB et al.; Histidine-rich glycoprotein (HRG) was purified from bovine plasma and the disulphide bridge arrangement established . Disulphide-bridged peptides were obtained from peptic and tryptic degradation of native bovine HRG . Twelve half-cystine residues were found in bovine HRG (compared to sixteen cysteines in human HRG), all involved in the formation of six disulphide bridges connecting Cys-1 to Cys-12, Cys-2 to Cys-3, Cys-4 to Cys-5, Cys-6 to Cys-11, Cys-7 to Cys-8, and Cys-9 to Cys-10 . Additional sequence analysis of 14C-carboxymethylated chymotryptic and Staphylococcus aureus V8 protease generated peptides and CNBr-fragments of bovine HRG yielded a partial amino acid sequence of bovine HRG constituting 78% of the sequence when compared to the human cDNA sequence.

FEMS Microbiol Lett, 1993 Aug 15, 112(1), 87 - 91
Construction and overexpression in Escherichia coli of genetically engineered derivatives of penicillin-binding protein 2' of Staphylococcus epidermidis; Westendorp MO et al.; Removal of the putative amino-terminal membrane spanning region of penicillin-binding protein 2' (PBP-2') of Staphylococcus epidermidis WT55 was carried out by truncating the amino terminus-coding end of the mecA gene . PCR and site directed mutagenesis were used to introduce unique restriction sites at position 68 (HindIII) and at position 80 (NcoI) of the mecA gene, respectively . The coupling of the shortened coding regions to the trc promoter and gene fusion to the lacZ gene, aimed to facilitate subsequent protein purifications, resulted in strong expression in the cytoplasm of Escherichia coli and partial sequestration into insoluble protein granules . The truncated PBP-2' retained its penicillin-binding ability and also bound the monoclonal antibody directed against PBP-2' of Staphylococcus aureus.

Ann Intern Med, 1993 Aug 15, 119(4), 304 - 11
Short-course therapy of catheter-related Staphylococcus aureus bacteremia: a meta-analysis; Jernigan JA et al.; OBJECTIVE: To determine, through structured methodologic review of published articles, the effectiveness of short-course (< or = 2 weeks) antibiotic therapy for catheter-related Staphylococcus aureus bacteremia . DATA SOURCES: English-language publications on catheter-related S . aureus bacteremia identified using MEDLINE (1966 to the present) and bibliographic review of relevant articles and textbooks . STUDY SELECTION: Any study reporting outcome data for patients with catheter-related S . aureus bacteremia who were treated with short-course therapy . DATA EXTRACTION: Epidemiologic criteria were applied to assess the quality of protection provided by each study against four important types of biases . In addition, the statistical precision of each study was assessed . DATA SYNTHESIS: Eleven studies were identified . Reported late complication rates varied from 0% to 29%; the pooled estimate of the late complication rate was 6.1% (95% Cl, 2.0% to 10.2%) . Ten of the 11 studies were uncontrolled . Only three provided adequate protection against treatment allocation bias . None of the studies adequately defined the illness under study, and only four provided adequate follow-up . The relapse rates in all 11 studies had low statistical precision . The complication and mortality rates for catheter-related S . aureus bacteremia when published data were pooled, regardless of duration of therapy, were 24% and 15%, respectively . CONCLUSIONS: The available data regarding the safety of short-course therapy for catheter-related S . aureus bacteremia are potentially flawed by both bias and statistical imprecision . The optimal duration of treatment remains unknown . Short-course therapy should be viewed with caution in treating this serious infection until randomized trials determine the comparative rates of late complication.

J Biol Chem, 1993 Aug 15, 268(23), 16987 - 92
cDNA cloning and gene expression analysis of the microbial proteinase inhibitor of tobacco; Heitz T et al.; Tobacco mosaic virus-infected tobacco (Nicotiana tabacum var . Samsun NN) leaves produce a serine proteinase inhibitor that has evolved a specificity for microbial proteinases . We have isolated two closely related cDNAs that were shown to encode two active inhibitors . Southern analysis of genomic DNA, comparison of deduced amino acid sequences, and characterization of the two separated proteins suggest that the two genes of tobacco are homologous originating from each parent . Amino acid sequences deduced from the cDNAs exhibit a glutamic residue at the P1 position of the active site, known to determine the specificity of this type of inhibitors . Nevertheless, the V8 proteinase from Staphylococcus aureus, an enzyme that cleaves polypeptides after glutamic acid residues, was found to be unaffected by the tobacco inhibitor . We demonstrate strong accumulation of the two mRNAs and proteins during the hypersensitive reaction of tobacco to tobacco mosaic virus . Messengers and products of the two genes are present in a 3:2 ratio, in infected leaves as well as in upper uninfected leaves, the induction being markedly lower at distance from the infection site . The transcripts were also found in sepals and petals of healthy plants, indicating that these genes are also developmentally regulated . Unlike the tomato and potato I inhibitors, the tobacco inhibitor was only weakly induced by wounding, but was expressed upon salicylic acid or ethephon treatment, as many pathogenesis-related proteins.

J Immunol, 1993 Aug 15, 151(4), 1852 - 8
Immunodominance: a single amino acid substitution within an antigenic site alters intramolecular selection of T cell determinants; Liu Z et al.; The mechanism of immunodominance was studied by mutating a single amino acid residue within an immunodominant determinant of Staphylococcus aureus nuclease (Nase) . Residues 81 to 100, which can be further reduced to 86 to 100, were determined to be the immunodominant determinant of Nase in H-2k mice . By introducing selected single amino acid substitutions into the peptide encompassing residues 86 to 100 (p86-100), residue 90 was shown to be one of the critical amino acids for T cell recognition, inasmuch as most of the T cells recognizing p86-100 do not respond to a p86-100 analog with a substitution of leucine for alanine at the residue 90 . A mutant of Nase with a replacement of alanine by leucine at residue 90 (A90L) was constructed, and for A90L region 112 to 130, which is a subdominant determinant in Nase, becomes immunodominant . Although unable to respond to Nase, T cells primed in vivo with the peptides covering various cryptic determinants proliferate when challenged with A90L in vitro . Our results suggest that at the protein level there is competition among potential T cell determinants of protein Ag for binding to MHC molecules, and that this competition plays a role in determining which determinant may become immunodominant.

Biochemistry, 1993 Aug 10, 32(31), 7839 - 45
An improved strategy for determining resonance assignments for isotopically enriched proteins and its application to an engineered domain of staphylococcal protein A; Lyons BA et al.; Sequence-specific resonance assignments provide the basis for interpreting multidimensional NMR spectra and for determining 3D structures of proteins from these data . We have developed an improved strategy for determining these sequence-specific NMR assignments in small proteins and applied this method in determining proton and nitrogen resonance assignments for an 8.2-kDa engineered domain (the Z-domain) of the cell wall protein A of Staphylococcus aureus . First, HCCNH-TOCSY {Lyons, B . A . & Montelione, G.T . (1993) J . Magn . Reson . 101B, 206} data were used together with 2D 2QF-COSY, TOCSY, and 15N-HSQC data to identify amino acid spin systems . Most asparagine and glutamine spin systems were also identified uniquely from these triple-resonance data . Next, complementary HCC(CO)-NH-TOCSY {Montelione, G . T., et al . (1992) J . Am . Chem . Soc . 114, 10975} data were used to identify sequential connections from the aliphatic H alpha, H beta, H gamma, H delta, and H epsilon resonances of residue i to the amide and nitrogen resonances of residue i + 1 . By combined analysis of HCCNH-TOCSY and HCC(CO)NH-TOCSY spectra we have determined most of the proton and nitrogen resonance assignments for the Z-domain . This represents the first example of the use of this triple-resonance technique to determine extensive resonance assignments in a small protein.

J Biol Chem, 1993 Aug 5, 268(22), 16437 - 42
Photoaffinity labeling of human placental NAD(+)-linked 15-hydroxyprostaglandin dehydrogenase with {alpha-32P}2N3NAD+ . Identification of a peptide in the adenine ring binding domain; Chavan AJ et al.; Oxidation of many prostaglandins at C-15 results in the formation of 15-keto metabolites, which have reduced biological activity . This reaction is catalyzed by NAD(+)-dependent 15-hydroxyprostaglandin dehydrogenase . Using the photoaffinity analog of NAD+, {alpha-32P}nicotinamide-2-azidoadenine dinucleotide, we have identified a peptide in the adenine ring binding domain of the NAD+ binding site of 15-hydroxyprostaglandin dehydrogenase . The specificity of photolabeling was demonstrated by saturation and protection experiments . Saturation of photolabeling was observed at approximately 45-50 microM with an apparent Kd of 8-10 microM . Approximately 90% of photolabeling could be protected by 200 microM NAD+ when the protein was photolyzed in the presence of 10 microM probe . The photolabeled protein was digested with Staphylococcus aureus V8 or chymotrypsin, and the photolabeled peptides were purified by either boronate affinity chromatography or Fe+3 chelate chromatography followed by reverse phase HPLC . The photolabeled peptide region was identified to be Val32-Glu40.

Biochim Biophys Acta, 1993 Aug 4, 1182(1), 94 - 100
Effects of monoclonal antibodies on alpha-staphylotoxin action against erythrocytes and model phospholipid membranes; Krasilnikov OV et al.; It was found that one of twenty tested monoclonal antibodies (MABs) existed which drastically enhanced ability of Staphylococcus aureus alpha-toxin (ST) to both lysis of human erythrocytes and increase of planar phospholipid bilayer conductance more than 10 and 1,000 times respectively . Other 19 MABs possessed only neutralized effect . The activation could only be observed if the activating MAB (AMAB) interacted with ST in solution but not in membrane . The one molecule of AMAB was able to activate approximately 2-4 molecules of ST . It was assumed that this activation was a result of the AMAB-induced transition of ST from a hydrophilic to an amphiphilic form . The activation could not be observed when the activity of AMAB/ST mixtures was tested on highly sensitive rabbit erythrocytes . All the tested MABs (including AMAB) were able to inhibit the ST-induced lysis of rabbit erythrocytes . The activating effects of AMAB on ST action in BLM and in human erythrocytes as well as their inhibiting influence on the ability of toxin to cause a lysis of rabbit erythrocytes indicate the presence of an ST-specific receptor on the membrane of rabbit erythrocytes.

J Gen Microbiol, 1993 Aug, 139 ( Pt 8), 1907 - 13
Cell wall assembly in Staphylococcus aureus: proposed absence of secondary crosslinking reactions; Gally D et al.; The distribution of muropeptides formed by muramidase digestion of peptidoglycan from Staphylococcus aureus H was determined by gel-filtration HPLC . The observed crosslinking pattern supports the conclusion that incorporation of peptidoglycan in S . aureus proceeds by a similar mechanism to that proposed earlier for Bacillus megaterium . In this mechanism single glycan-peptide strands are incorporated into the sacculus by crosslinking reactions that take place only between the monomer muropeptide units of the incoming glycopeptide and muropeptides present in the innermost region of wall at the wall-membrane interface: such crosslinking reactions take place only during incorporation and no other crosslinking reactions occur . This assembly process has now been termed restricted monomer addition . The present analysis shows that the distribution of muropeptides in S . aureus peptidoglycan is in excellent agreement with that predicted by this mechanism . We propose that cell wall assembly in S . aureus proceeds via restricted monomer addition without any requirement for the secondary crosslinking reactions that have been suggested to occur in this organism . The high degree of crosslinking in S . aureus, 80% in this study, may result mainly from the freedom for crosslinking provided by the pentaglycine bridge peptide.

Kansenshogaku Zasshi, 1993 Aug, 67(8), 747 - 52
{An infection model which was induced in a carboxymethyl cellulose (CMC) pouch on the back of the rat}; Kawashima T et al.; The air-pouch model of inflammation in rats is excellent in that it allows quantitative evaluation of inflammation, and it is used for analysis of inflammatory mediators and as an evaluation system for anti-inflammatory drugs . We investigated the possibility of using this system as an experimental infection system . As a result, inflammation was found to be caused by injection of a constant amount of Staphylococcus aureus solution (10(4)-10(8)) . The amount of infiltration and the number of infiltrating cells varied with quantity of bacteria . The infiltrating cells consisted mainly of neutrophils . In this experimental model of infectious disease, the severity of inflammation could be quantitatively evaluated as a function of time in terms of bacterial proliferation and the body's response to bacterial proliferation based on the amount of fluid in the air pouch and the number of infiltrating cells, suggesting that the model is useful . In this experimental system, there were no differences between the number of live bacteria, the number of infiltrating cells or the amount of infiltration when S . aureus Smith strain and clinically-isolated methicillin-resistant S . aureus (MRSA) were used, suggesting that there is no difference between the inflammation-induced activity of MRSA and MSSA.

J Appl Bacteriol, 1993 Aug, 75(2), 123 - 8
Effect of sub-inhibitory concentrations of antibiotics on the virulence of Staphylococcus aureus; Doss SA et al.; The production of virulence factors by various bacteria can be influenced by sub-inhibitory concentrations of antibiotics . The effect of six antibiotics on the production of representative extracellular enzymes and toxins produced by Staphylococcus aureus was investigated . The production of the virulence determinants coagulase, protein A, alpha and delta haemolysin was monitored in the presence of ciprofloxacin, enoxacin, chloramphenicol, gentamicin, tetracycline and methicillin . The protein synthesis inhibitors reduced the production of coagulase and protein A, and almost completely inhibited the production of the haemolysins . Haemolysin production was also reduced by ciprofloxacin and enoxacin, but these antibiotics had little effect on the production of coagulase and protein A . Methicillin stimulated the production of alpha and delta haemolysins but had no effect on the production of coagulase and protein A.

FEMS Immunol Med Microbiol, 1993 Aug, 7(2), 145 - 52
Interferon-gamma, interleukin-1 and tumour necrosis factor-alpha synthesis during experimental murine staphylococcal infection; Rozalska B et al.; Several exotoxins of Staphylococcus aureus were shown to modulate the host immune system by stimulation of monokine release . BALB/c mice infected intravenously (i.v.) with live cells if S . aureus, strain Cowan 1, had a detectable serum level of TNF-alpha at 3, 4 and 5 h after injection . When S . epidermidis (strain E3380, clinical isolate) was used to infect mice, the level of TNF-alpha was lower (the detection limit of the cytotoxicity assay with WEHI cells was 40 pg ml-1) . Kinetics of TNF synthesis was different from that observed in experimental infections caused by Gram-negative bacteria . Similarly to TNF-alpha, IL-1 alpha appears in a measurable level at 3 h after i.v . injection of bacteria . The highest serum level of IFN-gamma was observed 12 h after infection with both S . aureus and S . epidermidis . A quantity ten times more of S . epidermidis than of S . aureus cells was required to induce similar levels of TNF-alpha and IFN-gamma . Recombinant IFN-gamma administered in vivo in four daily doses followed by infection of S . aureus resulted in increased elimination of bacteria from the spleen, liver and peritoneal cavity of mice.

Bone Marrow Transplant, 1993 Aug, 12(2), 167 - 8
HIV infection after autologous bone marrow transplantation despite HIV-antibody and HIV-antigen screening; Jootar S et al.; We report a 41-year-old woman who underwent ABMT for non-Hodgkin's lymphoma during her third CR . Her post-transplant course was complicated by interstitial pneumonitis, hemorrhagic cystitis, cytopenia and episodes of infection from herpes zoster virus and Staphylococcus aureus . She required prolonged blood product support and was later found to be seropositive for anti-HIV on day +191 despite HIV-antibody and HIV-antigen screening of blood donors.

J Am Soc Nephrol, 1993 Aug, 4(2), 178 - 86
Intradialytic granulocyte reactive oxygen species production: a prospective, crossover trial; Himmelfarb J et al.; By the use of flow cytometric techniques, this prospective, randomized crossover study was designed to analyze intradialytic granulocyte reactive oxygen species (ROS) formation in whole blood with complement-activating and noncomplement-activating hollow fiber membranes . Dialysis with a complement-activating membrane resulted in a 6.5-fold increase in granulocyte hydrogen peroxide production 15 min after dialysis initiation and remained significantly elevated (P < 0.01) through the first 30 min with this membrane in comparison to both predialysis values and simultaneous values with a noncomplement-activating membrane . Further studies demonstrated that blood obtained at 15 min with a complement-activating membrane generated significantly less granulocyte ROS production in response to Staphylococcus aureus incubation than blood obtained either predialysis or at the same time in dialysis with a noncomplement-activating membrane . Both complement-activating and noncomplement-activating dialysis membranes caused slightly decreased granulocyte responsiveness to phorbol myristate acetate . It was concluded that hemodialysis with complement-activating membranes results in increased granulocyte ROS production and decreased responsiveness to S . aureus challenge during the dialysis procedure . These results document the potential role of ROS in hemodialysis-associated pathology and susceptibility to infection.

J Am Acad Dermatol, 1993 Aug, 29(2 Pt 2), 318 - 21
Malignant fibrous histiocytoma resembling mycetoma; Soohoo L et al.; A case of malignant fibrous histiocytoma resembling mycetoma is reported . We describe a patient with a draining purulent mass and localized swelling of the left ankle . The lesion's ulcerated surface produced purulent material that contained black "granules" resembling those seen in mycetoma . Cultures revealed a heavy growth of Staphylococcus aureus and no growth of fungi . Treatment with oral antibiotics resulted in resolution of the infection with persistence of the mass . Histopathologic examination of the mass was consistent with malignant fibrous histiocytoma . This case represents an example of a malignant lesion whose initial presentation was complicated by a bacterial infection resembling a mycetoma.

J Clin Microbiol, 1993 Aug, 31(8), 2105 - 9
Twelve aberrant strains of Staphylococcus aureus subsp . aureus from clinical specimens; Fontana C et al.; A new biovar of Staphylococcus aureus subsp . aureus was isolated from human clinical specimens and described on the basis of studies of 12 isolates that were compared with 11 standard reference strains . Both DNA hybridization experiments and numerical taxonomy analysis demonstrated that these strains were strictly related to S . aureus subsp . aureus; however, they were significantly different from the latter . The atypical strains belonging to the new biovar can be distinguished from typical S . aureus subsp . aureus strains by their alpha-chymotrypsin, alpha-glucosidase, beta-N-acetylglucosaminidase, lipase (C-14), and leucine arylamidase enzymatic activities and novobiocin resistance . Thus, the combination of alpha-glucosidase and beta-N-acetyl-glucosaminidase is more useful for distinguishing these S . aureus strains from the other, typical ones.

Appl Environ Microbiol, 1993 Aug, 59(8), 2734 - 6
Identification of a high-affinity glycine betaine transport system in Staphylococcus aureus; Bae JH et al.; Staphylococcus aureus accumulates proline and glycine betaine when cells are grown at low water activity . In the present study, we have identified a high-affinity glycine betaine transport system in this bacterium . Optimal activity for this transport system was measured in the presence of high NaCl concentrations, but transport activity was not stimulated by high concentrations of other solutes.

Proteins, 1993 Aug, 16(4), 364 - 83
Crystal structure of Escherichia coli TEM1 beta-lactamase at 1.8 A resolution; Jelsch C et al.; The X-ray structure of Escherichia coli TEM1 beta-lactamase has been refined to a crystallographic R-factor of 16.4% for 22,510 reflections between 5.0 and 1.8 A resolution; 199 water molecules and 1 sulphate ion were included in refinement . Except for the tips of a few solvent-exposed side chains, all protein atoms have clear electron density and refined to an average atomic temperature factor of 11 A2 . The estimated coordinates error is 0.17 A . The substrate binding site is located at the interface of the two domains of the protein and contains 4 water molecules and the sulphate anion . One of these solvent molecules is found at hydrogen bond distance from S70 and E166 . S70 and S130 are hydrogen bonded to K73 and K234, respectively . It was found that the E . coli TEM1 and Staphylococcus aureus PC1 beta-lactamases crystal structures differ in the relative orientations of the two domains composing the enzymes, which result in a narrowed substrate binding cavity in the TEM1 enzyme . Local but significant differences in the vicinity of this site may explain the occurrence of TEM1 natural mutants with extended substrate specificities.

J Trauma, 1993 Aug, 35(2), 303 - 9; discussion 309-11
Empiric monotherapy versus combination therapy of nosocomial pneumonia in trauma patients; Croce MA et al.; Combination therapy for nosocomial pneumonia with a beta-lactam and aminoglycoside is widely accepted because of synergy and reduction of resistant bacteria . This prospective study of 109 trauma patients (94 blunt, 15 penetrating) with nosocomial pneumonia was performed in consecutive phases . In phase 1, patients were randomized to an anti-pseudomonal third-generation cephalosporin--cefoperazone or ceftazidime . Gentamicin was added to each regimen in phase 2 . The mean age of the patients was 37 years, the mean ISS was 31, and there were no differences among the four treatment groups relative to associated injuries . Patients receiving monotherapy had a 56% cure rate compared with 31% for combination therapy (p < 0.04) . Persistence rates were similar in these two groups (15% and 20%), but superinfection was significantly higher in the combination group (49% vs . 28%; p < 0.04) . The predominant superinfecting organism was methicillin-resistant Staphylococcus aureus (MRSA) . Nine patients died (5% monotherapy, 10% combination), and eight had a superinfection . We conclude that monotherapy had a higher cure rate than combination therapy for empiric therapy of pneumonia in our trauma patients . Combination therapy failed because of superinfection (primarily MRSA) . Emergence of MRSA may be from host overgrowth or plasmid-mediated induction of resistance, possibly caused by gentamicin.

Epidemiol Infect, 1993 Aug, 111(1), 55 - 61
Outbreak of nosocomial infections with two different MRSA-strains involved: significance of genomic DNA fragment patterns in strains otherwise difficult to type; Cuny C et al.; Methicillin-resistant Staphylococcus aureus isolates from an outbreak of 17 cases of wound infection in a municipal hospital were typed by conventional methods, phage typing by three sets of phages, reverse phage typing and plasmid profiles, as well as by genomic DNA fragment patterns obtained after Sma-I digestion and pulsed-field electrophoresis . These isolates were non-typable by phages, only some were typable by reverse phage typing and were not uniform in plasmid profile . Only the genomic DNA fragment patterns resulted in a clear discrimination of 2 strains (12 isolates for the first and 7 isolates for the second) . Both strains were disseminated in different wards of the same hospital and one strain had obviously spread to another clinic in the same city.

Clin Exp Immunol, 1993 Aug, 93(2), 212 - 7
IL-2 enhances polyclonal IgM but not IgM-rheumatoid factor synthesis by activated human peripheral blood B cells; Callaghan M et al.; IgM-rheumatoid factor (RF) is thought to be involved in the pathogenesis of rheumatoid arthritis (RA) . Several cytokines are known to regulate immunoglobulin synthesis . In this study the effects of IL-2 on polyclonal IgM and IgM RF synthesis were compared . Cytokines were added to peripheral blood B cells from normal subjects and patients with RA after activation by Staphylococcus aureus Cowan 1 (SAC) . The addition of IL-2, but not IL-4 or IL-6, resulted in significant enhancement of IgM synthesis in cultures from both healthy subjects and patients with RA . Similar degrees of enhancement were seen in both peripheral blood mononuclear cell and highly purified B cell cultures . IgM-RF was synthesized after activation in cultures from healthy subjects and spontaneously in cultures from RA patients . In contrast to polyclonal IgM synthesis, IL-2 failed to augment IgM-RF synthesis in cell cultures from either healthy subjects or RA patients . This study demonstrates different effects of IL-2 on IgM and IgM-RF synthesis.

Br J Rheumatol, 1993 Aug, 32(8), 699 - 701
Pyogenic sacroiliitis in Qatar; Siam AR et al.; We describe our experience in handling six cases of pyogenic sacroiliitis . Two were males and four were females with a mean age of 24.9 years . None had a history of i.v . drug abuse . Blood cultures were positive in half of the patients . The sacroiliac joint aspirate was positive in one additional patient . Staphylococcus aureus was recovered from three of four culture positive cases . Bone and CT scans revealed abnormalities in all patients . Response to antibiotic therapy was satisfactory in all except one patient who had an early relapse . Early diagnoses and proper treatment would result in improved outcomes.

J Med Microbiol, 1993 Aug, 39(2), 128 - 34
Detection of Staphylococcus aureus with biotinylated monoclonal antibodies directed against staphylococcal TNase complexed to avidin-peroxidase in a rapid sandwich enzyme-linked immunofiltration assay (sELIFA); Brakstad OG et al.; For rapid identification of Staphylococcus aureus, a monoclonal antibody (MAb)-biotin-avidin-peroxidase complex, directed against the S . aureus thermostable nuclease (TNase), was formed and used in a rapid three-step sandwich enzyme-linked immunofiltration assay (sELIFA) and a three-step sandwich enzyme-linked immunosorbent assay (sELISA) . The MAb-peroxidase complex was formed by incubating the biotinylated MAbs with a streptavidin-peroxidase conjugate and the complex was purified by gel permeation chromatography . When compared with a four-step MAb-based sELISA described previously, this complex permitted one reagent step to be omitted in a three-step sELISA, and the test time was significantly reduced . The test sensitivity was slightly reduced in the three-step ELISA (detection limit 1.0-2.0 ng of TNase/ml) when compared to the four-step sELISA (detection limit 0.5-1.0 ng of TNase/ml) . The sELIFA method was based on the filtration of bacterial culture supernates through nitrocellulose membrane disks pre-spotted with a MAb directed against the S . aureus TNase, followed by detection with the MAb-peroxidase complex (three-step sELIFA) . A detection limit of 0.5-2.0 ng of TNase/ml was achieved with the three-step sELIFA, depending on the filtrate volume of culture supernates . The total test time was 10-15 min when pre-spotted and blocked membranes were used . A total of 85 bacterial strains was tested in the sELIFA . All the 28 S . aureus strains showed positive results, but none of the 57 non-S . aureus strains did so, although some of these produced thermostable nuclease activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Am Rev Respir Dis, 1993 Aug, 148(2), 365 - 9
Increased adherence of Staphylococcus aureus from cystic fibrosis lungs to airway epithelial cells; Schwab UE et al.; Airway colonization by Staphylococcus aureus is a frequent feature of cystic fibrosis (CF) . To assess the pathogenesis of selective colonization with this organism, we compared the capacity of S . aureus isolated from the respiratory tract of CF and non-CF patients to adhere to epithelial cells from the upper and lower airways of CF and control subjects . Bacterial adherence to bronchial epithelial cell lines was significantly greater for CF than for non-CF isolates (p < 0.001) . Of 17 CF S . aureus isolates 12 adhered at a level > 1 bacterium per cell; this was true for only 1 of 14 non-CF isolates . CF S . aureus isolates also bound more avidly than non-CF isolates to ciliated (p < 0.05) and squamous nasal cells (p < 0.02) and buccal epithelial cells (p < 0.005) freshly harvested by scraping . Each S . aureus isolate bound with equal avidity to epithelial cells from CF patients and healthy individuals . Adherence was not related to sex, age, severity of pulmonary disease, presence of other microorganisms in the airways, or genotype of the CF hosts . Binding of S . aureus was blocked by proteinase treatment of organisms, suggesting that adherence is mediated by one or more peptide adhesins . We propose that the high prevalence of adherent S . aureus is due either to selection of adherent strains by CF airways or to induction of an adherent phenotype by factors residing at the CF airways surface.

Orv Hetil, 1993 Aug 1, 134(31), 1689 - 93
{The role of two-dimensional echocardiography in the detection of pacemaker-induced endocarditis}; Bohm A et al.; The authors analysed the data of eight patients who had to undergo open heart surgery because of pacemaker endocarditis in the last four years . Repeated surgical interventions on the pacemaker system was the most predisposing factor . The most common causative organisms were Staphylococcus aureus and Staphylococcus epidermidis . Two-dimensional echocardiography (2DE) had a decision making role in the diagnosis beside the clinical picture and blood culture . Conclusions: 1 . Each pacemaker patient with fever must be considered to have a pacemaker endocarditis; 2 . All these patients must be examined by two-dimensional echocardiography.

Am J Respir Cell Mol Biol, 1993 Aug, 9(2), 141 - 7
Human alveolar macrophages inhibit immunoglobulin production in response to direct B cell mitogen; Wilkes DS et al.; B lymphocytes are crucial participants in pulmonary immune defense . However, excess local antibody production is associated with accelerated lung destruction in several types of lung disease . The purpose of the current study was to study the potential role of alveolar macrophages (AM) in the local regulation of immunoglobulin (Ig) production in the lung in response to a direct B cell mitogen, Staphylococcus aureus Cowan strain (SAC) . AM, when added to peripheral blood mononuclear cells, caused a dose-dependent inhibition of IgG and IgM, while not affecting IgA production in response to SAC . The mechanism of the AM-induced inhibition included both membrane-bound and soluble signals . The inhibition was not abrogated by indocin and catalase, or reversed by blocking antibodies to transforming growth factor-beta or interferon-gamma . Mononuclear cells isolated from human lung parenchyma displayed a reduced response to SAC compared with blood cells . However, depletion of macrophages from the parenchymal cells was associated with a restoration of IgG production in response to SAC . The results demonstrate that AM inhibit B cell responses to direct B cell mitogen and suggest that the effect of AM is selective for IgM and IgG.

J Bacteriol, 1993 Aug, 175(15), 4927 - 9
The tet(K) gene from Staphylococcus aureus mediates the transport of potassium in Escherichia coli; Guay GG et al.; The tet(K) gene, encoding the tetracycline efflux protein from Staphylococcus aureus, mediates the transport of potassium in an Escherichia coli mutant defective in potassium uptake . Deletion mapping indicates that the first third of the tet(K) gene is sufficient to mediate potassium transport.

Infect Immun, 1993 Aug, 61(8), 3175 - 83
Lack of complete correlation between emetic and T-cell-stimulatory activities of staphylococcal enterotoxins; Harris TO et al.; This study examined the emetic activity of several staphylococcal enterotoxin type A and B (SEA and SEB, respectively) mutants that had either one or two amino acid residue substitutions . New sea gene mutations were constructed by site-directed mutagenesis; gene products were obtained with glycine residues at position 25, 47, 48, 81, 85, or 86 of mature SEA . Culture supernatants from Staphylococcus aureus RN4220, or derivatives containing either sea or a sea mutation, were analyzed for the ability to stimulate proliferation of murine splenocytes, as determined by incorporation of {3H}thymidine . Culture supernatants containing SEA-N25G (a SEA mutant with a substitution of glycine for the asparagine residue at position 25), SEA-F47G, or SEA-L48G did not stimulate T-cell proliferation, unlike supernatants containing the other substitution mutants . Purified preparations of SEA-N25G had weak activity and those of SEA-F47G and SEA-L48G had essentially no activity in the T-cell proliferation assay . All mutants except SEA-V85G, which was degraded by monkey stomach lavage fluid in vitro, were tested for emetic activity . SEA-C106A and two SEB mutants, SEB-D9N/N23D and SEB-F44S (previously referred to as BR-257 and BR-358, respectively), whose construction and altered immunological properties have been reported previously, were also tested in the emetic assay . Each mutant was initially administered intragastrically at doses of 75 to 100 micrograms per animal; if none of the animals responded, the dose was increased four-to fivefold . SEA-F47G, SEA-C106A, and SEB-D9N/N23D were the only mutants that did not induce vomiting at either dose tested; these three mutants had reduced immunological activity . However, there was not a perfect correlation between immunological and emetic activities; SEA-L48G and SEB-F44S retained emetic activity, although they had essentially no T-cell-stimulatory activity . These studies suggest that these two activities can be dissociated.

Infect Immun, 1993 Aug, 61(8), 3117 - 22
Gamma interferon is produced by human natural killer cells but not T cells during Staphylococcus aureus stimulation; Yoshihara R et al.; Gamma interferon (IFN-gamma) production from cultured human peripheral blood mononuclear cells was studied during stimulation with Staphylococcus aureus Cowan I or S . aureus Wood . IFN-gamma was specifically produced from CD16+ natural killer (NK) cells under stimulation by S . aureus Cowan I or Wood because these strains (i) induced IFN-gamma production exclusively from CD3-, CD4- CD8-, and CD16+ cells and (ii) induced CD69 and interleukin 2 (IL-2) receptor alpha expression on CD16+ cells without simultaneously augmenting CD71 or IL-2 receptor alpha on T cells . The effects of biological agents on the induction of S . aureus-induced IFN-gamma production paralleled those of S . aureus-induced CD69 expression on CD16+ cells: IL-2, IFN-alpha, and indomethacin augmented the S . aureus-induced IFN-gamma production, whereas IL-4, transforming growth factor beta 1, prostaglandin E2, and dexamethasone inhibited it . However, IFN-alpha was unique in that it did not induce IFN-gamma production from NK cells while it simultaneously augmented CD69 expression on NK cells, suggesting a unique pathway in the activation of NK cells . Thus, we may conclude that S . aureus-induced IFN-gamma production appears to faithfully represent NK cell function within peripheral blood mononuclear cells.

J Nutr Sci Vitaminol (Tokyo), 1993 Aug, 39(4), 405 - 10
Effect of a glutamine-supplemented diet on response to methicillin-resistant Staphylococcus aureus infection in mice; Suzuki I et al.; The following study was undertaken to determine whether dietary supplementation with glutamine can be used to modulate the immune response following challenge with methicillin-resistant Staphylococcus aureus (MRSA) organisms in mice . Thirty BALB/c female mice were randomized into 3 groups: group A (n = 10) were fed 20% casein diet (control), whereas the mice in Groups B (n = 10) and C (n = 10) were given 20% casein diet supplemented with 2 and 4% glutamine, respectively . The diets were made isonitrogenous by glycine and alanine supplementation . On the 10th day on these treatments, each mouse was challenged intravenously with 2 x 10(8) colony-forming units (CFU)/ml of MRSA organisms and mortality was noted for 20 days . The survival rate in Group A (20%) tended to be lower than the rates in Group B (40%), and Group C (70%) . CFU values of spleen and kidney of the surviving mice 20 days post challenge were not different among the three groups (p < 0.05) . The present results suggest that dietary glutamine supplementation may be effective as a nutritional immunomodulator for the recovery from MRSA infection.

Postgrad Med J, 1993 Aug, 69(814), 615 - 20
Right-sided endocarditis in the non-drug addict; Naidoo DP; Fifteen patients with right-sided infective endocarditis during a 5 year period (1985-1990) were retrospectively reviewed . Isolated tricuspid valve involvement occurred in nine patients . Staphylococcus aureus was the causative organism in seven cases; four were culture negative . The diagnosis was established by two-dimensional echocardiography in 11 patients and at postmortem in the remaining four patients who succumbed shortly after admission . Fever, tachypnoea and pneumonia were universal features . A successful outcome ensued in eight patients with medical therapy alone and in two patients who were submitted to valve replacement . Five patients died, two from uncontrolled infection with repeated pulmonary emboli . Right-sided infective endocarditis should be suspected in any pneumonic illness that complicates post-abortal infection or other inadequately treated sepsis . Two-dimensional echocardiography is important in diagnosis since cardiac signs are minimal at presentation.

J Rheumatol, 1993 Aug, 20(8), 1411 - 3
Pyomyositis: cervical localization; Flory P et al.; We describe an uncommon case of cervical pyomyositis in a 60-year-old woman without predisposing factors, admitted for cervicobrachial neuralgia with fever and paravertebral contracture . Ultrasonography and computed tomography (CT) showed a collection in the left longissimus capitis . Ultrasonography guided needle aspiration yielded thick pus, which cultured Staphylococcus aureus . Our patient completely recovered after antibiotherapy . Pyomyositis is rare and most commonly affects rhizomelic muscles (cervical localization is extremely rare) and occurs in patients with predisposing factors . Staphylococcus aureus is responsible for over 85% of cases; ultrasonography and CT scan are useful for abscess localization and aspiration.

J Reprod Immunol, 1993 Aug, 24(3), 223 - 33
Determination of immunoglobulin classes and subclasses of sperm immobilizing antibodies in infertile women and the inhibitory effect of IgG4 subclass on the sperm immobilizing antibody activity; Tsuji Y et al.; Immunoglobulin classes and subclasses of sperm immobilizing antibodies (SI-Abs) in the sera of sterile women were determined by the absorption of patients' sera with Staphylococcus aureus and immunoadsorbents bound with class or subclass-specific anti-human immunoglobulin antibodies . Among 18 patients' sera tested, 16 had the IgG-dominant SI-Abs and the remaining 2 sera contained IgM-dominant SI-Abs . From the former patients' sera, 9 were further studied to determine the IgG subclasses; 6 of them had IgG1-dominant SI-Abs, one IgG2-dominant, and in the other two IgG1 and IgG2 were equally dominant . Interestingly, SI-Ab activities in 6 of the 9 patients' sera increased after absorption of IgG4 subclass and the addition of IgG4 purified from an SI-positive patient to the same patient's serum diminished the SI-Ab activities.

J Chemother, 1993 Aug, 5(4), 215 - 22
Different kinetic of enzymatic inactivation of lincomycin and clindamycin in Staphylococcus aureus; Barcs I; Lincosamide inactivation nucleotidylation (Lin) enzyme determined by the pBI109PGL plasmid of Staphylococcus epidermidis exhibits high level resistance to lincomycin but sensitivity to clindamycin by standard susceptibility methods . Substrate profile determination showed clindamycin to be a better substrate for the enzyme than lincomycin . In cultures of the plasmid-harboring strain, the level of clindamycin decreased below the inhibitory concentration in the first 4 hours of incubation but the level of lincomycin persisted longer . The initial extended inhibitory effect of clindamycin is due to better membrane penetrating ability, resulting in a higher intracellular concentration than that of lincomycin . Moreover, energy-dependent reduction in clindamycin uptake, probably due to active efflux of clindamycin but not of lincomycin, was observed . A therapeutic effect of clindamycin is not expected in infections caused by Lin-producer strains because the bacteriostatic effect of the drug is rapidly eliminated after administration.

Zentralbl Bakteriol, 1993 Aug, 279(3), 426 - 33
Efficacy of a central venous catheter (Hydrocath) loaded with teicoplanin in preventing subcutaneous staphylococcal infection in the mouse; Romano G et al.; Segments (1 cm in length) of a central venous catheter (Hydrocath) coated with teicoplanin, or uncoated, were inserted subcutaneously into mice and Staphylococcus aureus or Staphylococcus epidermidis were inoculated nearby . At 24 and 48 h after infection, the mean titre of adherent bacteria (recovered by sonication) for the teicoplanin-coated catheters was less than 10 CFU as compared to more than 10(4) CFU (S . aureus) and 10(3) CFU (S . epidermidis) from the uncoated catheters . In the S . aureus infection, teicoplanin coating also prevented the formation of abscesses which were observed around uncoated catheters.

APMIS, 1993 Aug, 101(8), 595 - 601
Theoretical aspects of detection of bacteraemia as a function of the volume of blood cultured; Jonsson B et al.; Clinically significant bacteraemia in adults is characterized by low numbers of circulating bacteria . Assuming a Poisson or a binomial distribution we have calculated the probability of detecting bacteria as a function of the concentration in blood, estimated the concentration of bacteria in blood from a given test result, and calculated the blood volume required to detect bacterial growth with a probability of 95% at a given mean number of colony-forming units (cfu) per sample unit . These theoretical assumptions have been used on an empirical population of patients with proven bacteraemia . Results: 18% of Staphylococcus aureus bacteraemias and 29% of Escherichia coli bacteraemias have circulating bacteria with an estimated spread of less than 0.04 cfu/ml . With a 95% probability of detection of a bacteraemia, a concentration in blood corresponding to 3 cfu/sampling unit is necessary . In our empirical material, where 30 ml was cultured, the probability of detection of E . coli bacteraemias would have decreased by 11% if 20 ml had been cultured, and 27% if only 10 ml had been cultured . The corresponding figures for S . aureus were 6% and 15%, respectively . For low grade E . coli bacteraemias (< 0.04 cfu/ml) the decrease would have been 33% and 67%, respectively.

Antimicrob Agents Chemother, 1993 Aug, 37(8), 1624 - 9
Detection of tetracyclines and efflux pump inhibitors; Rothstein DM et al.; Screening assays for the detection of tetracyclines and inhibitors of tetracycline efflux pumps are described . The tetracycline assay is based on the observation that the tetA(B) gene encoding the efflux pump of transposon Tn10 is induced by tetracycline . The Escherichia coli strain designed to detect tetracyclines contains a single copy of a tetA(B)-lacZ transcriptional fusion integrated into the chromosome and the tetR gene encoding the tetracycline repressor on a plasmid . The assay specifically detects tetracyclines of distinct structures, but not other classes of drugs . A strain capable of detecting inhibitors of the TetA(B) efflux pump contained the tetA(B)-lacZ fusion and, in addition, a tetA(B) structural gene lacking its transcriptional regulatory signals which mediated resistance to only 5 micrograms of tetracycline per ml . This strain was more refractory to induction by tetracycline because of the action of the pump . Inhibitors were detected in two ways: (i) beta-galactosidase induction in the presence of 5 ng of tetracycline per ml, a subinducing concentration, and (ii) growth inhibition in the presence of 5 micrograms of tetracycline per ml . A strain designed to detect inhibitors of the Tet(K) efflux pump from Staphylococcus aureus was constructed by substituting the tet(K) structural gene for the tetA(B) gene . Nocardamine and other siderophores were found to interfere with the action of tetracycline efflux pumps.

Vnitr Lek, 1993 Aug, 39(8), 784 - 7
{An unusual cause of recurrent septic states}; Sochman J et al.; The authors describe the septic sequelae of an unobserved embolization of a central venous catheter into right-sided cardiac compartments . The finding of an embolized fragment of a catheter which was in the patient's circulation for 89 days was quite incidental . The previous period was associated with diagnostic doubts in various departments . The most frequent diagnosis of repeated septicaemia was bacterial endocarditis, although repeated echocardiographic examinations did not confirm it . Similarly, repeated X-rays did not contribute to the diagnosis--this can be explained by dilatation of the heart of the patient . Extraction of the embolized fragment by means of a catheter resolved the problem . The fragment was colonized by the causal agent of the febrile conditions--Staphylococcus aureus.

J Hosp Infect, 1993 Aug, 24(4), 313 - 25
Methicillin resistant Staphylococcus aureus in three adjacent health districts of south-east England 1986-91; Barrett SP et al.; The experiences with methicillin-resistant Staphylococcus aureus (MRSA) of two contiguous Health Districts during 1986-91 and of a third mutually adjacent District in south-east England during 1989-91 were compared . Although the three Districts were in many ways similar, the nature of the problems posed by MRSA differed . The Districts had dealt with MRSA independently but had evolved similar strategies for coping with the organism . In two Districts a gradual relaxation of case-finding and of infection control precautions applied to individual patients and outbreaks, was followed by a reduction in the number of new patient-isolates identified from routine bacteriology specimens . Standardization of MRSA isolation rates for patient throughput and for length of hospital stay showed the examination of crude total isolates to provide misleading comparisons of relative risks of acquiring MRSA in different specialties . It was also found that patients discharged from specialties with short inpatient stays were more likely to have MRSA detected after discharge by their physicians working in the local community served by the hospitals but there was no evidence of spread outside hospital . It is suggested that good all-round standards of infection control practice are more important than specific radical policies in dealing with endemic MRSA.

Bratisl Lek Listy, 1993 Aug, 94(8), 444 - 8
{The effect of Staphylococcus aureus vaccine on professional phagocytes in vitro and in vivo}; Takacova J et al.; Effect of Staphylococcus aureus vaccine on metabolic and functional activities of polymorphonuclear leucocytes and guinea pig macrophages was observed . The tested vaccine following a short contact with human polymorphonuclear leucocytes isolated from peripheral blood inhibited candidacidal and phagocytic activities, whereas the phagocytic index stayed unchanged . The tested vaccine stimulated the INT-reductase activity and superoxide production, as well as extracellular liberation of lysosome enzymes from polymorphonuclear leucocytes . Application of the Staphylococcus aureus vaccine to guinea pigs 35, 30, 28, and 23 days prior to the acquirement of peritoneal macrophages, augmented, as compared to the control group, the amount of peritoneal macrophages and their phagocytic activity . Candidacidal and metabolic activities stayed unchanged . The results imply that the contact of phagocytic cells with the antigen, affects their biochemical and functional activities . Activities are dependent of the length of the period during which the antigen stimulation takes place, and of its quantity . Examination of phagocytes can be recommended for adjustment of both, vaccine doses and intervals between their individual applications . (Tab . 5, Ref . 19.).

Exp Dermatol, 1993 Aug, 2(4), 171 - 4
Influence of staphylococcal lipoteichoic acid on the frustrated phagocytosis of neutrophils against opsonized corneocytes; Kato T et al.; Stratum corneum (SC) exerts a proinflammatory effect in the presence of complement . When Staphylococcus aureus (S . aureus) invades the skin through damaged SC, neutrophils accumulate at the subcorneal portion of epidermis to phagocytize the S . aureus as noted in impetigo . Besides the phagocytosis of bacteria, neutrophils interact with opsonized SC in a form of frustrated phagocytosis, increasing a damage of the surrounding tissues . Based on our previous finding that staphylococcal protein A promotes the interaction between SC and neutrophils, we investigated whether lipoteichoic acid (LTA), another cell wall component of S . aureus, also shows similar properties . We found that LTA significantly promoted the binding of neutrophils to opsonized SC, resulting in an increase in SC-induced respiratory burst of neutrophils assessed by chemiluminescence (CL) . The binding of neutrophils to the SC was almost completely inhibited by the blocking of CR3 with anti-CD11b antibody, suggesting that the binding between SC and neutrophils is mediated by interaction between C3bi and CR3 (Mac-1) . Such enhanced interaction seems to function in the primary host defence mechanism against the invading S . aureus through the skin such as in impetigo.

Acta Derm Venereol, 1993 Aug, 73(4), 276 - 9
Scintigraphic diagnosis of syphilitic lesions in rabbits by radiolabelled monoclonal antibodies specific for Treponema pallidum; Lee MG et al.; Immunoscintigraphy with radiolabelled monoclonal antibodies has been widely used to detect solid tumours . The purpose of this study was to investigate its potential for the specific localization of syphilitic lesions . F(ab')2 fragments were prepared from murine monoclonal antibodies against Treponema pallidum produced in our laboratory and labelled with 131I . Bilateral testicular infections were created in rabbits by inoculation with T . pallidum or Staphylococcus aureus . Seven to 10 days after inoculation, radiolabelled antibodies were injected intravenously . Serial gamma images were then taken 2 h after the injection and at 24 h intervals thereafter . Beginning as early as 2 h post-injection, the testicles could be visualized with either specific or non-specific antibodies . Gamma images in the monoclonal antibody-treated, T . pallidum-infected group persisted up to 48 h post-injection . Lesions were not discernible from background in the S . aureus-infected group injected with the monoclonal antibody and the S . aureus-infected and T . pallidum-infected groups injected with the polyclonal antibody at 24 h post-injection or later . Therefore, due to its ability to differentiate between specific and non-specific antibody-generated images from 24 h post-injection, immunoscintigraphy using monoclonal antibodies specific for T . pallidum may be employed as one of the methods to diagnose difficult cases of syphilitic internal organ involvement as well as syphilis infection in seronegative HIV-infected patients.

Diagn Microbiol Infect Dis, 1993 Aug-Sep, 17(2), 97 - 101
GyrA sequence analysis of Staphylococcus aureus and methicillin-resistant S . aureus strains selected, in vitro, for high-level ciprofloxacin resistance; Peterson LR et al.; Four methicillin-susceptible Staphylococcus aureus and eight methicillin-resistant S . aureus (MRSA) isolates, all of which were ciprofloxacin susceptible (MIC < 2.0 micrograms/ml) were manipulated, in vitro, to achieve high-level ciprofloxacin resistance by means of up to 14 passages onto media containing increasing concentrations of ciprofloxacin . Resistance to ciprofloxacin at a concentration of at least 512 micrograms/ml was achieved in all 12 isolates tested . This resistance was continually detected during weekly passage on antibiotic-free media for 12 weeks . The parent and daughter cells from four strains had their gyrA sequenced from amino acid (aa) codons 70-100, the region of previous mutations in high level quinolone-resistant S . aureus . Mutations at aa codon 84 were seen in three of four strains, but appeared at varying levels of ciprofloxacin resistance . High-level resistance of S . aureus and MRSA to ciprofloxacin can be developed in vitro using multiple exposures to incremental concentrations of the drug . It is apparently due to multiple mechanisms and, once established, remains stable over time.

Mil Med, 1993 Aug, 158(8), 571 - 2
Differential diagnosis of Staphylococcus aureus from Staphylococcus epidermidis and Staphylococcus saprophyticus by alphazurine A dye; Ayres WW et al.; Staphylococcal bacterial suspensions were streaked on Trypticase soy agar with 5% sheep blood culture plates . Paper discs containing alphazurine A, a triphenylmethane dye, were placed on the inoculated plates which were incubated at 37 degrees C for 24 hours . A wide zone of inhibition of growth of Staphylococcus aureus was present around the paper discs . Growth of Staphylococcus epidermidis and Staphylococcus saprophyticus was not inhibited.

Kansenshogaku Zasshi, 1993 Aug, 67(8), 767 - 71
{Treatment of severe pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA) and Candida krusei with granulocyte colony-stimulating factor (G-CSF): a case report}; Yoshida M et al.; A 24-year-old male with chronic renal failure on Continuous Ambulatory Peritoneal Dialysis (CAPD) complained of cough and dyspnea . Chest X-ray film showed a pneumonia shadow and MRSA and Candida krusei were detected in the sputum . Pneumonia improved with vancomycin and fluconazole . Treatment with methylprednisolone was needed for retinodialysis . After this treatment, pneumonia deteriorated . Pneumonia did not improve with vancomycin and anti-fungal agents . This severe pneumonia was improved with a combination therapy of vancomycin, miconazole and G-CSF . A combination therapy of antibiotics and G-CSF is considered to be effective for severe pneumonia.

Inflammation, 1993 Aug, 17(4), 465 - 79
Abnormal glycosylation of alpha 2-macroglobulin, a non-acute-phase protein in patients with autoimmune diseases; Saso L et al.; Previous studies from this and other laboratories have shown that abnormal glycosylation of several acute-phase proteins can be detected in various pathological conditions including autoimmune diseases . In the present study, we have investigated if abnormal glycosylation is limited to acute-phase proteins . We used the concanavalin A (Con A) blots in conjunction with the peptide mapping techniques to analyze serum samples and cerebrospinal fluids (CSF) obtained from patients with autoimmune diseases: systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), mixed connective tissue disease (MCTD), scleroderma (SCL), Sjogren's syndrome (SS), and polymyositis (PM); diseases of probable autoimmune origin: hepatopathies (HP); diseases of suspected autoimmune origin: schizophrenia and Alzheimer's disease (AZ); and conditions not related to autoimmunity: pregnancy (PG) and elevation of the carcinoembryonic antigen (CEA), in comparison to normal donors (NHS) . We have micropurified two human proteins; alpha 2-macroglobulin, a non-acute-phase protein and beta-chain of haptoglobin, a known acute-phase protein, from serum samples of individual patients with SLE, RA, MCTD, SCL and SS, and from PG and NHS for analysis . The identity of the purified proteins was confirmed by immunoblots using either monospecific polyclonal or monoclonal antibodies, and by direct N-terminal amino acid sequencing . Peptide maps for each of these proteins were generated using Staphylococcus aureus protease V8, a Glu-C endopeptidase . When the peptide fragments of alpha 2-macroglobulin were resolved by SDS-PAGE and visualized using silver staining, no differences were noted between patient samples and controls . However, when they were examined by lectin blots using Con A, the Con A-reactive fragments increased specifically and significantly in samples derived from patients of SLE, SCL, MCTD, and RA . Similarly when the peptide fragments of the beta-chain of haptoglobin were visualized by silver staining, no differences were noted; however, the Con A reactivity of specific fragments increased in SLE, RA, SCL, and SS patients . Analysis of these results indicated that there has been a selective increase in Con A-reactive fragments in both acute-phase and non-acute-phase proteins in autoimmune conditions . Thus, the study of changes in glycosylation patterns in selected serum proteins may be a valuable diagnostic approach to define the pathophysiology of inflammatory and autoimmune disorders.

Int Immunol, 1993 Aug, 5(8), 809 - 16
Induction of CD5 antigen on human CD5- B cells by stimulation with Staphylococcus aureus Cowan strain I; Morikawa K et al.; We have examined whether the CD5 phenotype could be induced on human B cell surfaces by the polyclonal B cell stimulator, Staphylococcus aureus Cowan strain I (SAC) . Fresh tonsillar B cells were prepared by Percoll density gradient from E- cells . The proportion of CD5+ B cells in the 50/60% and 60/70% interface high-density fractions varied between 1.2 and 10.2% depending on the tonsil preparations when they were placed on the in vitro culture 12-60 h prior to flow cytometric analysis . The expression of CD5 antigen obviously increased in the presence of SAC (1:10(5) v/v) . The percentage of CD5+ B cells varied from tonsil to tonsil, from 25.1 to 65.9% in a series of experiments . The CD5+ B cells were found both among CD23+CD25+CD71+ and CD23-CD25-CD71- B cells . The level of CD5 expression was related to the cell size enlargement . The addition of anti-CD5 antibody in the culture blocked the CD5 induction by SAC without interfering with the expression of other activation markers . A time-course study showed that CD5 antigen appeared to be induced on the cell surface during the G0 to G1 phase transition in the cell cycle . When CD5+ and CD5- B cells were separated by magnetic isolation, the CD5- B cells showed DNA synthesis to the stimulation by SAC and expressed CD5 antigen on their cell surface . These results suggest that human CD5- B cells can express the CD5 phenotype by stimulation with the polyclonal B cell stimulator, SAC.

J Immunol, 1993 Aug 1, 151(3), 1448 - 55
Orthovanadate induces translocation of phospholipase C-gamma 1 and -gamma 2 in permeabilized mast cells; Atkinson TP et al.; Rapid activation of phospholipase C (PLC) with a resultant increase in phosphatidylinositol hydrolysis occurs after aggregation of the high affinity receptor for IgE (Fc epsilon RI) on the surface of mast cells . We previously described an increase in PLC activity associated with the particulate fraction of rat basophilic leukemia (RBL) cells after Fc epsilon RI aggregation, and this redistribution of enzyme activity correlated with an increase in immunoreactivity of the gamma 1 isozyme of PLC in the particulate fraction by Western blot analysis (J . Immunol . 148:2194-2200, 1992) . We now report that the tyrosine phosphatase inhibitor orthovanadate mimics Fc epsilon RI-mediated activation of PLC-gamma 1 in RBL cells after permeabilization with Staphylococcus aureus alpha-toxin . Orthovanadate treatment of permeabilized cells induced: 1) a large increase in phosphoinositide hydrolysis in endogenously labeled cells; 2) an increase in PLC activity associated with the particulate fraction; and 3) an increase in immunoreactivity of PLC-gamma 1 in Western blots of the particulate fraction . In addition, incubation of RBL cells with either oligomeric IgE or orthovanadate results in the translocation of PLC-gamma 2 from the cytosol to the particulate fraction . All of the above effects were qualitatively similar to those seen after Fc epsilon RI aggregation . These data suggest that translocation and activation of PLC in mast cells are controlled by tyrosine phosphorylation of either the enzyme itself or some regulatory component . The equilibrium can be shifted to the phosphorylated state during either receptor-mediated activation of a tyrosine kinase or by blockade of dephosphorylation.

Antibiot Khimioter, 1993 Aug-Sep, 38(8-9), 22 - 5
{Isolation and investigation of Staphylococcus aureus strains resistant to the membrane active antibiotic, gramicidin S}; Bulgakova VG et al.; Strains of Staphylococcus aureus 209P growing in the presence of 20 micrograms/ml of gramicidin S were isolated after the successive subculture on a liquid medium with increasing concentrations of the antibiotic . The resistance was stable and preserved after the subculture on media not containing the antibiotic . The development of the resistance to gramicidin S did not lower the cell sensitivity to a large number of antibiotics known as inhibitors of the cell wall synthesis, protein synthesis and RNA-polymerase reaction . There was observed the development of moderate resistance to actinomycin D but not to other antibiotics interacting with DNA . The gramicidin resistant strains were also resistant to tyrocidine, a membrane active polypeptide . By the amount of the bound gramicidin S the cells of the sensitive and resistant strains did not practically differ.

FEMS Microbiol Lett, 1993 Jul 15, 111(1), 115 - 22
Agr-related sequences in Staphylococcus lugdunensis; Vandenesch F et al.; Sequences related to the Staphylococcus aureus accessory gene regulator (agr) were demonstrated in S . lugdunensis by Southern blot analysis of 13 strains and sequencing of the S . lugdunensis agr-like locus (agr-sl) . Northern blot analysis of cellular RNA revealed the presence of a transcript having homology with the agr-P3 transcript (RNAIII) for three of the six strains tested . The three strains containing this transcript produce a hemolysin with phenotypic properties similar to that of S . aureus delta-hemolysin . Nevertheless, unlike agr-P3 from S . aureus, agr-sl does not encode any potential peptide homologous to S . aureus delta-hemolysin, suggesting that the hemolytic activity detected in S . lugdunensis is encoded elsewhere and may be controlled by agr-sl.

J Med Chem, 1993 Jul 9, 36(14), 1971 - 6
Discovery and structure-activity relationship of a series of 1-carba-1-dethiacephems exhibiting activity against methicillin-resistant Staphylococcus aureus; Ternansky RJ et al.; The synthesis and antimicrobial activity of several new 1-carba-1-dethiacephalosporins is described . The discovery of unique activity of some of the analogues against methicillin-resistant Staphylococcus aureus led to the development of a structure-activity relationship designed to optimize this activity . The results of this investigation along with the pharmacokinetic characteristics of select compounds are described.

J Infect Dis, 1993 Jul, 168(1), 75 - 83
Increased phagocytosis and generation of reactive oxygen products by neutrophils and monocytes of men with stage 1 human immunodeficiency virus infection; Bandres JC et al.; Flow cytometry was used to study phagocytic function and release of reactive oxygen products following phagocytosis by neutrophils (PMNL) and monocytes of heparinized whole blood from stage 1 human immunodeficiency virus type 1 (HIV-1)-infected men . Phagocytic capacity was assessed by measuring uptake of Texas red-labeled bacteria . Reactive oxygen generation after phagocytosis was estimated by the quantity of dichlorofluorescein diacetate converted to dichlorofluorescein intracellularly . Compared with results in samples from age- and sex-matched controls, PMNL and monocytes from HIV-1-infected patients exhibited a significantly increased capacity to phagocytose Staphylococcus aureus and Escherichia coli and generate reactive oxygen products . These results are consistent with the hypothesis that stimuli associated with early HIV-1 infection enhance the nonspecific response of phagocytic cells to potential bacterial pathogens.

J Infect Dis, 1993 Jul, 168(1), 152 - 7
Comparative prophylactic efficacy of cefazolin and vancomycin in a guinea pig model of Staphylococcus aureus wound infection; Kernodle DS et al.; The increasing prevalence of methicillin-resistant Staphylococcus aureus as a wound pathogen in some institutions has prompted the use of vancomycin for surgical prophylaxis, although clinical data comparing vancomycin and cephalosporins are not available . A guinea pig model was used to compare the efficacy of vancomycin and cefazolin in preventing intermuscular abscess formation by 7 S . aureus strains . Both antibiotics were administered to achieve peak serum levels at the time of bacterial inoculation, and each remained > 1 micrograms/mL for a comparable duration . Vancomycin provided equivalent protection from infection by 1 methicillin-susceptible strain and significantly better protection against 4 methicillin-susceptible and both methicillin-resistant S . aureus strains . For most strains, the bacterial inoculum with a 50% probability of causing an abscess was 2 to 4 log10-fold higher with vancomycin than cefazolin prophylaxis . Prophylaxis with vancomycin is superior to cefazolin in preventing intermuscular infection by methicillin-susceptible and -resistant S . aureus.

J Infect Dis, 1993 Jul, 168(1), 128 - 34
Recombinant interferon-gamma preserves human granulocyte bactericidal and chemoluminescence activities; Brar DW et al.; The effects of recombinant human interferon (IFN)-gamma on functions of human granulocytes (PMNL) were investigated . Incubation with IFN-gamma for up to 24 h enhanced the chemoluminescent (CL) response of polymorphonuclear leukocytes (PMNL) to Staphylococcus aureus, FMLP, opsonized zymosan, and PMA in a dose-dependent fashion for concentrations of 1-1000 units/mL . Short exposures to tumor necrosis factor (TNF)-alpha also enhanced the CL responses of PMNL, but the effects IFN-gamma and TNF alpha together, at the concentrations used, were less than additive . Incubation of PMNL for 8 h with IFN-gamma preserved their bactericidal capabilities relative to control PMNL incubated for the same length of time without IFN-gamma . Preservation of neutrophil function may be a subtle but important role for IFN-gamma.

Infect Immun, 1993 Jul, 61(7), 2973 - 7
Purification of exfoliative toxin produced by Staphylococcus hyicus and its antigenicity; Tanabe T et al.; We previously reported the isolation of an exfoliative toxin from culture filtrates of Staphylococcus hyicus (shET) and reproduction of exfoliation in piglets injected with partially purified shET . In this study, we purified shET and compared the biological and physicochemical properties of shET and Staphylococcus aureus exfoliative toxin (sETA and sETB) . shET was purified by ammonium sulfate precipitation, DEAE-cellulofine A-500 column chromatography, Sephadex G-75 gel filtration, and polyacrylamide gel electrophoresis (7.5% polyacrylamide) . Purified shET (p-shET) did not cause exfoliation of the epidermis in suckling mice but did cause exfoliation in 1-day-old chickens, whereas sETA and sETB produced by S . aureus caused exfoliation in suckling mice but not in 1-day-old chickens . The molecular mass of p-shET was determined as 27 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis . p-shET did not show any cross-reactivity with sETA and sETB in Western immunoblotting analysis or the immunodiffusion test.

J Reprod Med, 1993 Jul, 38(7), 531 - 3
Microbiologic effects of atmospheric conditions used in operative laparoscopy; Miner DW et al.; We tested whether the atmospheric conditions used in operative laparoscopy were responsible for its low infection rate . A plexiglass chamber was used to recreate the atmospheric conditions in an operative laparoscopic procedure with CO2 pneumoperitoneum, including a CO2 atmosphere, gas flow and temperature control . Staphylococcus aureus and Escherichia coli were exposed to this atmosphere and their growth compared to that on control plates exposed to standard culture conditions . The ratio of colony growth on experimental versus control plates was 1.08 +/- 0.19 SD for Staphylococcus and 1.13 +/- 0.66 SD for E coli . We noted no direct inhibitory effect of the pelviscopic atmosphere upon microbiologic growth . The factors responsible for pelviscopy's low infection rate remain obscure.

J Perinatol, 1993 Jul-Aug, 13(4), 285 - 7
Sudden death in neonate with staphylococcal endocarditis; Perez-Benavides F et al.; A 27-week-old girl, 936 gm, with initial diagnosis of birth asphyxia resulting from prolapse of the umbilical cord, respiratory distress syndrome, and suspected neonatal sepsis received antibiotics for the first 7 days of life . On day 24, evidence developed of acute Staphylococcus aureus endocarditis of the anterior leaflet of the mitral valve, and she died 4 days later . We believe that a rapid enlargement of the endocardial vegetation caused acute occlusion of the small mitral valve and was the cause of sudden death in this infant.

Nippon Seikeigeka Gakkai Zasshi, 1993 Jul, 67(7), 572 - 82
{One stage operation for dead space of pyogenic and tuberculous osteomyelitis}; Shinjo K et al.; Pyogenic and tuberculous osteomyelitis is known to have difficult surgical problems . Complete surgical excision of dead and grossly infected soft tissues and osseous structures frequently results in large defects . Hydroxyapatite filler has been used to pack osteomyelitic defects . Between 1984 and 1991 we have treated 6 foci in 6 patients: 4 males aged 61, 54, 47 and 26 and; 2 females aged 59 and 36 years . There were 3 cases of chronic osteomyelitis, and one each of acute osteomyelitis, tuberculous osteomyelitis, and Brodie's abscess . All were reviewed within a period of between 21 to 94 months postoperatively . The pathogens cultivated were Mycobacterium tuberculosis in case 2 and Staphylococcus aureus in case 3 and case 6 . In other cases, cultures revealed no pathogens . The hydroxyapatite fillers were mixed with an antibiotic . In addition, in the last four cases the fibrin sealant and CaCl2-thrombin solution were mixed . The excavated bone defect was packed with this composite biomaterial . Neither closed irrigation/suction using antibiotic solution nor a cast was used . Antimicrobial therapy directed specifically to the deep tissue specimens, was administered to all patients . On examination, all of the foci had completely healed by the end of the follow-up period . The cure of pyogenic and tuberculous osteomyelitis is obtained from obliterating dead spaces, which prevent the survival of organisms . Hydroxyapatite is the biomaterial most compatible with human bone and is also suitable for obliterating dead space . The advantages of the fibrin sealant system are that defects can be packed without gaps . Thus, postoperative hematomas can be avoided . In addition, the antibiotic incorporated into the fibrin sealant is released more slowly from the concentrated fibrin than from hematomas . As a result, pathogens multiply more slowly in fibrin . From these findings, we believe that this new method is simple, can be performed safely in one stage, and offers satisfactory results.

J Antimicrob Chemother, 1993 Jul, 32 Suppl A, 77 - 89
Diagnosis and management of the diabetic foot ulcer; Gentry LO; Infected leg ulcers in patients with diabetes mellitus are a common and potentially serious problem . Neuropathy and vascular disease associated with diabetes mellitus allow the possibility of significant microbial invasion . Infections in diabetic patients are usually polymicrobial reflecting the normal flora of the foot skin . Curettage of the base of foot ulcers and deep tissue cultures are the most reliable methods for identifying the true pathogens, which are aerobic Gram-negative bacilli, anaerobes, and Staphylococcus aureus . Empirical antibiotic therapy should be directed against these pathogens . Once culture and sensitivity results are available, therapy should be targeted specifically for the pathogens present to prevent long-term use of broad-spectrum antibiotics . Preventive care of the foot in patients with diabetes mellitus is extremely important and may reduce complications associated with infections of the foot.

Immunopharmacology, 1993 Jul-Aug, 26(1), 11 - 20
Effect of mycophenolate mofetil (RS-61443) on cytokine production: inhibition of superantigen-induced cytokines; Nagy SE et al.; The effects of the immunosuppressant mycophenolate mofetil (MPAM, RS-61443) on cytokine production at the single cell level were assessed using in vitro activated human mononuclear cells . Cytokine production was studied with UV microscopy of fixed and permeabilized cells stained with cytokine specific monoclonal antibodies (mAbs) . The cytokines evaluated included interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-2, IL-3, IL-4, IL-5, IL-6, IL-10 interferon gamma (IFN-gamma), tumor necrosis factor alpha (TNF-alpha), TNF-beta, and granulocyte macrophage-colony stimulating factor (GM-CSF) . MPAM exhibited a marked antiproliferative effect without cytotoxicity in all mononuclear cell cultures . Six to 24 hours after stimulation with the superantigen Staphylococcus aureus enterotoxin A (SEA), most cytokine production was unaffected by MPAM at therapeutic concentrations (10(-6) M), with the exception of GM-CSF . In contrast, by 48 h after antigen activation, MPAM significantly inhibited all studied cytokine production (p < 0.05) . Cyclosporin A (CsA), used as a control at a concentration of 100 ng/ml, inhibited production of all studied cytokines, at all time points . Monokine production after lipopolysaccharide (LPS) stimulation was unaffected by MPAM . Similarly, the production of most of the cytokines studied after mitogen stimulation with phorbol ester (PMA) plus calcium ionophore (ionomycin) was not affected by MPAM, in comparison to CsA which demonstrated significant inhibition of all cytokines tested under these conditions . However, a late inhibitory effect on IL-3 production was seen by MPAM at 48 h after mitogenic stimulation . Further observations are required to explain the divergent results on cytokine production by MPAM in superantigen-activated and mitogen-activated human mononuclear cells.

Eur J Clin Microbiol Infect Dis, 1993 Jul, 12(7), 545 - 8
In vitro activity of vancomycin and teicoplanin against Staphylococcus aureus and Staphylococcus epidermidis colonizing catheters; Kropec A et al.; In a quantitative in vitro model the activity of vancomycin and teicoplanin in two concentrations (4 x MBC and 1 mg/l) against Staphylococcus aureus and a slime-producing Staphylococcus epidermidis strain colonizing the internal surface of polyurethane and silicone catheters was studied . In comparison with vancomycin, teicoplanin achieved a significantly greater reduction (p < 0.05) in the counts of Staphylococcus aureus and Staphylococcus epidermidis adhering to both polyurethane and silicone catheters.

Clin Exp Dermatol, 1993 Jul, 18(4), 300 - 4
Skin microflora of atopic eczema in first time hospital attenders; Goodyear HM et al.; The bacterial flora of the skin was assessed quantitatively in 50 children with eczema, aged 6 months to 14 years, referred to the hospital for the first time . Twenty nonatopic controls with an unrelated non-infective disorder were also studied . Cotton-tipped swabs and contact agar discs were taken from the worst affected area of eczema and from an uninvolved site in patients and from the forearm in controls . Swabs were also taken from the nose, axilla and groin in all children . Bacterial colonization of the skin was consistently more common and greater in amount from patients compared with controls . Staphylococcus aureus was the most common pathogen isolated from patients only; from the worst affected area of eczema in 74% of patients and from an uninvolved skin site in 30% of patients . Quantitative assessment showed that the density of colonization was proportional to the severity of eczema . The most common S . aureus phage group was group II accounting for 32% of strains . Resistance to penicillin was present in 88% of strains and to two or more antibiotics in 38% of strains . No relationship was noted between the pattern of resistance and phage group.

Biol Pharm Bull, 1993 Jul, 16(7), 711 - 3
Characteristics and localization of a determinant conferring partial macrolide resistance in Staphylococcus aureus carrying plasmid; Matsuoka M et al.; Staphylococcus aureus TPR-27, a clinically isolated strain, showed constitutive resistance to some macrolide antibiotics (erythromycin, oleandomycin, spiramycin, and josamycin), but susceptibility to the other macrolide (tylosin, rokitamycin, and mycinamicin), lincosamide, and streptogramin type B antibiotics (PM-resistance) . The PM-resistant strain TPR-27 has carried for visible plasmids . Attempts to eliminate the resistant determinant in terms of ethidium bromide (about 3 micrograms/ml) did not succeed, and every trial to transduce the PM-resistant determinant into rec- mutant ISP105 using phage 80L2 propagated on strain TPR-27 also failed at the frequency of less than 1.1 x 10(-10) transductants per plaque-forming unit . These results suggest that the PM-resistance determinant is localized in chromosomal DNA.

J Pediatr Orthop, 1993 Jul-Aug, 13(4), 452 - 5
Three cases of staphylococcal pyomyositis in adolescence, including one patient with neurologic compromise; Armstrong DG et al.; Pyomyositis is rarely reported in the United States and is not easily recognized . In a 4-year period, we treated three adolescents from our vicinity with muscle infection resulting from Staphylococcus aureus . One was an insulin-dependent diabetic patient . Two patients had deep infections about their pelvis, one of which resulted in acute loss of bowel and bladder function . In all three cases, the patient did not recover until the abscess was operatively drained . Diagnosis was delayed because of lack of awareness of the condition, the deep muscles involved, and clinical presentation before formation of a localized abscess . Indium scan may be a very useful initial diagnostic test.

J Exp Med, 1993 Jul 1, 178(1), 337 - 41
Pore-forming bacterial toxins potently induce release of nitric oxide in porcine endothelial cells; Suttorp N et al.; Nitric oxide (NO) is believed to play an important role in sepsis-related hypotension . We examined the effects of two pore-forming bacterial exotoxins, Escherichia coli hemolysin and Staphylococcus aureus alpha-toxin, on NO formation in cultured porcine pulmonary artery endothelial cells . NO was quantified using a difference-spectrophotometric method based on the rapid and stoichiometric reaction of NO with oxyhemoglobin . Endothelial cyclic guanosine monophosphate levels were also monitored . Both exotoxins increased NO synthesis in endothelial cells in a time- and dose-dependent manner to an extent exceeding that observed with the ionophore A23187 or thrombin . The capacity of exotoxins to induce NO formation may be relevant in patients with severe local or systemic bacterial infections.

J Gen Microbiol, 1993 Jul, 139 ( Pt 7), 1449 - 60
Sequence and mapping of the aroA gene of Staphylococcus aureus 8325-4; O'Connell C et al.; The aroA gene of Staphylococcus aureus 8325-4 was cloned . Sequence analysis and the phenotype of directed plasmid insertions 5' to aroA suggest that aroA is located in an operon and that it maps 3' to the aroC and aroB genes . A revised consensus sequence for the aroA gene product EPSP synthase binding site for its substrate (phosphoenolpyruvate) and an inhibitor (glyphosate) is proposed . An aroA insertion mutant isolated by allelic replacement was employed in genetic mapping experiments which demonstrated the gene order thy aroA tyrB in SmaI fragment A of the S . aureus 8325-4 chromosome . The aroA::Tcr mutant required aromatic amino acids but remained independent of p-aminobenzoic acid (PAB) . This could be due to the insertion being located close to the 5' end of the gene, allowing expression of a truncated protein . The PAB independence may explain the finding that the mutant was not attenuated in mouse infection experiments . It was not possible to isolate a null mutant in aroA.

Am J Vet Res, 1993 Jul, 54(7), 1145 - 53
Functional variation in endogenous and exogenous immunoglobulin binding to bovine neutrophils relative to parturition; Berning LM et al.; Ten healthy first- and second-lactation Holstein cows were observed from 1 week before to 1 week after calving and at postpartum day 30 to determine polymorphonuclear neutrophil (PMN) functional variation and immunoglobulin binding profiles . Blood and mammary PMN were obtained 3 times weekly and within 24 hours of calving . Functional traits measured included phagocytosis of Staphylococcus aureus and in vitro chemotaxis through micropore filters in a Boyden chamber . Additionally, PMN were evaluated for endogenous binding of IgG1, IgG2, IgA, and IgM before and after in vitro chemotaxis . Exogenous binding of the same isotypes was determined after incubation in pooled colostrum, purified immunoglobulin, and pooled sera . Phagocytosis results indicated a significant and transient increase in percentage of milk PMN with associated, rather than phagocytosed, bacteria for 1 week after calving . Blood PMN phagocytosis was not significantly different during this period . Though total chemotaxis was essentially unchanged, the percentage of PMN that were unable to complete migration increased substantially on the day of calving, an effect that disappeared by postpartum day 4 . A significant (P < 0.01) positive correlation (r = 0.29) between percentage of PMN migrating completely through the micropore filter and percentage of blood PMN with associated bacteria was observed . Changes were not observed in endogenous immunoglobulin binding, with the exception of a peak in relative fluorescence intensity for IgG1 on the day of calving; this disappeared within 2 days after calving . Correlations between relative intensities of IgG2 and IgM, and percentage of mammary neutrophils phagocytosing were 0.37 and 0.70.(ABSTRACT TRUNCATED AT 250 WORDS)

Nihon Kyobu Shikkan Gakkai Zasshi, 1993 Jul, 31(7), 809 - 15
{A clinical study of respiratory infection with methicillin-resistant Staphylococcus aureus (MRSA)}; Niimi T et al.; We investigated patients with positive sputum for MRSA at Daido Hospital . The study was conducted from 1990 to 1991 . The number of cases with positive sputum for MRSA is moderately increased . We classified 116 MRSA isolated cases into three groups, 67 cases of colonization with MRSA, 26 cases of suspected bronchopulmonary infection, and 23 cases of bronchopulmonary infection with MRSA . The coagulase types of MRSA were type II or type II + III . Examination of the susceptibility to antibiotics of MRSA showed that all MRSA strains were susceptible to sulfamethoxazole trimethoprim, arbekacin, and vancomycin . A few strains were resistant to rifampicin . There were no differences in coagulase types and susceptibility to antibiotics between the three groups . Bronchopulmonary infection with MRSA was frequently associated with underlying bronchopulmonary disease, whether malignant or not . Risk factors for MRSA bronchopulmonary infection could not be identified, but the prognosis of MRSA bronchopulmonary infection was poor in cases with higher grade of performance status . MRSA eradication rate in sputum after therapy was low, and was not improved by adding inhalation of antibiotics including vancomycin to systemic chemotherapy . This investigation demonstrates the importance of environmental prevention of MRSA infection in hospitals.

Antimicrob Agents Chemother, 1993 Jul, 37(7), 1531 - 5
Use of cephalosporins for prophylaxis and therapy of polymicrobial infection in mice; Brook I; Cefoxitin, cefotetan, and cefmetazole were compared in 10-day therapy of intra-abdominal and subcutaneous infections caused by three organisms: Bacteroides fragilis and Bacteroides thetaiotaomicron combined with either Escherichia coli or Staphylococcus aureus . Intra-abdominal infection was caused by B . fragilis plus B . thetaiotaomicron plus E . coli . Therapy was initiated immediately before inoculation or was delayed for 8 h . Mortality was 14 of 30 (47%) for saline-treated mice, and all survivors developed abscesses . Immediate therapy reduced mortality and the percentage of mice with abscesses (in survivors), respectively, to 17 and 20% with cefoxitin, 0 and 13% with cefotetan, and 0 and 17% with cefmetazole, and the numbers of all bacteria were reduced by all the cephalosporins . Delayed therapy reduced mortality and abscess formation, respectively, to 20 and 8% of mice with cefoxitin, 10 and 93% with cefotetan, and 7 and 96% with cefmetazole . B . thetaiotaomicron survived in all abscesses treated with cefotetan and cefmetazole . Subcutaneous abscesses were caused by each organism alone or in combinations of one aerobe (S . aureus or E . coli) and one or two Bacteroides species . Early therapy reduced the numbers of all bacteria independent of their in vitro susceptibility . All agents reduced the number of each Bacteroides species with either E . coli or S . aureus . However, when therapy was delayed, cefotetan and cefmetazole were less effective than cefoxitin against B . thetaiotaomicron . Cefotetan was the most active agent against E . coli, and cefmetazole was the most effective against S . aureus . These data illustrate the efficacy of all tested cephalosporins in the prophylaxis of polymicrobial infections.

Antimicrob Agents Chemother, 1993 Jul, 37(7), 1400 - 5
Characterization of the gene for chromosomal trimethoprim-sensitive dihydrofolate reductase of Staphylococcus aureus ATCC 25923; Dale GE et al.; The gene for the trimethoprim-sensitive (Tmps) chromosomal dihydrofolate reductase (DHFR) of Staphylococcus aureus ATCC 25923 was cloned and characterized . The structural gene encodes a polypeptide of 159 amino acid residues and has a calculated molecular weight of 18,251 . The amino acid sequences of this Tmps DHFR and those of the trimethoprim-resistant type S1 DHFR encoded by transposon Tn4003 are 80% identical . In contrast to the trimethoprim-resistant enzyme, the Tmps DHFR can be highly overexpressed in Escherichia coli, with most of the recombinant protein occurring in a soluble and an active form.

Rinsho Byori, 1993 Jul, 41(7), 773 - 8
{Detection of methicillin-resistant Staphylococcus aureus by in vitro enzymatic amplification of mecA and femA genes}; Oshima T et al.; In the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection, rapid detection of MRSA is extremely important . The mecA gene codes the new drug resistant polypeptides called penicillin-binding protein 2a (PBP2a) or 2'(PBP2'), which mediates the clinically relevant resistance to all beta-lactam antibiotics . This gene could be beneficial in the detection of MRSA using the polymerase chain reaction (PCR) . However, the identical mecA gene has been found in both coagulase-positive and coagulase-negative Staphylococcus with the appropriate methicillin-resistant phenotype . The second gene related to the expression of methicillin-resistance has been called femA . In this study, we amplified both mecA and femA genes by PCR in 97 strains and 32 clinical specimens . The mecA gene was positive in all 63(100%) MRSA strains and 2(6%) of the 34 methicillin-sensitive Staphylococcus aureus (MSSA) strains . Two strains with the methicillin-sensitive phenotype and the mecA gene resulted in methicillin-resistance when cultured on an agar plate containing 4.5% NaCl . The mecA gene was also present in all 10(100%) coagulase-negative Staphylococcus strains with the methicillin-resistant phenotype . The femA gene was positive in all 97(100%) MRSA and MSSA strains . On the other hand, the femA gene was absent from coagulase -negative Staphylococcus strains with the methicillin-resistant phenotype . Although the mechanism by which the product of femA gene influences the expression of methicillin-resistance is unknown, the gene appears to be restricted only in coagulase-positive Staphylococcus, regardless of methicillin-resistance . In conclusion, in vitro enzymatic amplification of both mecA and femA genes would lead to rapid and definite diagnosis of the MRSA infection.

J Pharm Sci, 1993 Jul, 82(7), 755 - 7
Antibacterial organophosphorus compounds: phosphoranilidohydrazones of 5-nitro-2-furaldehyde; Jones GS Jr et al.; A series of phosphoranilidohydrazones of 5-nitro-2-furaldehyde was synthesized and evaluated for antibacterial activity . The series was prepared to examine the applicability of phosphoramidic hydrazones as carriers for the antibacterial nitrofuran moiety . Designed as analogues of nitrofurantoin, members of the series were chosen according to the Topliss approach to analogue design . The title compounds were devoid of gram-negative activity but possessed moderate antistaphylococcal activity . The most potent members of the series were equipotent with nitrofurantoin against Staphylococcus aureus . The relationship between structure and antistaphylococcal activity is discussed.

Kansenshogaku Zasshi, 1993 Jul, 67(7), 629 - 34
{Effect of the passage and storage of strains, and inoculum size on the change of zone pattern types and sizes produced by protease of methicillin resistant Staphylococcus aureus}; Arai K et al.; Protease produced by Staphylococcus aureus precipitates digests of casein in standard methods caseinate agar (SMCA) plate, and the various sizes of A to E precipitation types were produced depending on strains of inoculated Staphylococcus aureus, as previously reported . To evaluate these phenomena for epidemiological use, we investigated the effects of bacterial passage, storage and dosage on zonal pattern and the size of precipitation rings . Methicillin resistant Staphylococcus aureus (MRSA) was found to produce variable types and sizes of precipitation rings depending upon the inoculated strains . After 5, 30 and 50 passages in heart infusion broth (HIB), each of the strains randomly selected from MRSA strains showed that the precipitation pattern of A to E produced the same types and sizes of precipitation rings . The storage effects were assessed by comparing those strains in different storage time . The strain stored for 1 and 3 years at room temperature in HIB contained 0.8% agar produced the same pattern of precipitation rings at that of the freshly isolated one . Finally, the dosage of inoculated bacteria was examined . Overnight broth (HIB) cultures of MRSA were directly inoculated in SMCA plates, and were found to produce almost the same size of precipitation rings (reproducible within 3 mm) . These findings indicated that protease digestion on SMCA plate provides a rapid, sensitive, and specific assay that can supplement the currently available modalities for typing of MRSA strains.

Kansenshogaku Zasshi, 1993 Jul, 67(7), 615 - 21
{In vitro and clinical studies of MRSA infections in compromised hosts}; Kawayama T et al.; From January to December 1991, 47 clinical cases in when methicillin-resistant Staphylococcus aureus (MRSA) strains were isolate were investigated at our internal medicine ward . The MRSA infection rate was 57.4% (27/47) . The mortality due to MRSA bacteremia was 75.0% (9/12) and that due to MRSA pneumonia was 57.1% (4/7) . We think that MRSA infections must be treated by multiple antibiotics . At out institution, most of the patients were given a combination therapy of imipenem + fosfomycin or imipenemt + mynocycline . Although in vitro the MICs of imipenem did not show excellent activity against MRSA strains, in vivo these combination therapy including imipenem showed excellent activity against MRSA infections . We think that this result was due to the additive effect of the two drug combination . We determined the MICs of single antibiotics against MRSA strains . Most of the MRSA strains were sensitive to minocycline and arbekacin . All MRSA strains were sensitive to vancomycin we think that vancomycin is a highly useful drug to combat MRSA infection.

Diagn Microbiol Infect Dis, 1993 Jul, 17(1), 53 - 6
Sensitivity of surveillance cultures for the detection of methicillin-resistant Staphylococcus aureus in a nursing-home-care unit; Sewell DL et al.; This study compared the sensitivity of nasal culture alone versus multiple-site cultures and single versus duplicate sampling for the detection of methicillin-resistant Staphylococcus aureus (MRSA)-colonized individuals in a nursing-home population . Repeat culture of 68 specimens collected from 35 colonized subjects yielded identical results for 57 specimens, (84%), and 89% of the colonized residents (31 of 35) were identified by the first culture of multiple sites . A single nares culture detected 27 (77%) of 35 (first screen) and 29 (83%) of 35 (second screen) residents colonized with MRSA at any site . The most cost-effective screening would consist of a nasal culture only or combined with a gastrostomy tube site, if applicable . To identify all colonized individuals, however, it would be necessary to culture more than one specimen from multiple sites on each resident.

Diagn Microbiol Infect Dis, 1993 Jul, 17(1), 41 - 4
Posthysterectomy wound infection . A review; Miranda C et al.; We reviewed the microorganisms isolated from gynecologic surgery wounds showing signs of infection, from January to December 1990 . A total of 88 samples of abdominal wall exudates from as many patients who had undergone abdominal hysterectomy were studied . In 54 women (61.3%), cultures were positive and, in 26 specimens (48.1%), mixed aerobic-anaerobic flora were isolated . In 28 cases (51.9%), a single microorganism was isolated, the most frequent being Staphylococcus aureus, followed by Mycoplasma hominis and Escherichia coli . Mycoplasma hominis was unexpectedly frequent, appearing in five women with wall abscess and fever.

Can J Vet Res, 1993 Jul, 57(3), 212 - 4
Response of heifer mammary gland macrophages and neutrophils to interferon-gamma stimulation in vitro; Quiroga GH et al.; The phagocytic and killing abilities of heifer mammary gland macrophages (M phi) and neutrophils were evaluated after exposure to recombinant bovine interferon-gamma (rBoIFN-gamma) stimulation in vitro . Macrophages or neutrophils were cultured for 2 h with 0, 10(2), 10(4) and 10(5) units rBoIFN-gamma/mL . Phagocytosis assays were performed by incubation with Staphylococcus aureus at a leukocyte:bacteria ratio of 1:10 . After 45 min, cells were stained with acridine-orange and phagocytic and killing abilities were determined . Although rBoIFN-gamma had no effect on M phi phagocytic activity, neutrophil phagocytic activity after incubation in 10(4) units rBoIFN-gamma (41.62%) was significantly higher than 0 (25.24%) or 10(2) units rBoIFN-gamma (24.73%) . Neutrophil and M Phi killing abilities were not affected by any dose of rBoIFN-gamma . Results suggested that rBoIFN-gamma promoted neutrophil phagocytic activity, but did not affect neutrophil killing or overall M phi function in vitro.

Rev Esp Enferm Dig, 1993 Jul, 84(1), 22 - 5
{Effect of antibiotic prophylaxis with vancomycin on methicillin-resistant Staphylococcus aureus infection following liver transplantation}; Calleja Kempin JI et al.; An epidemic outbreak of Methicillin-resistant Staphylococcus Aureus (MRSA) infections affecting liver transplantation patients was detected in our hospital . In this study we describe the special characteristics of the infections and the results of prophylactic treatment with Vancomycin . Between april 1990 and december 1991, 47 patients with mean age of 54.4 +/- 10 years underwent liver transplantation . The patients were included in two chronological groups: 1) Group I: 20 patients not treated prophylactically with Vancomycin; 2) Group II: 27 consecutive patients treated with Vancomycin . Systematical cultures of body fluids for bacteria and fungi were done in every patient, and were repeated after 24 hours . The cultures were repeated again in case of sepsis . Group I patients had a significantly higher frequency of MRSA infections than group II patients . Furthermore, in patients with MRSA infection, independently of the group, duration of transplantation (p < 0.01), reoperations (p < 0.001) and prophylactic treatment with Vancomycin (p < 0.001) were significative factors . In conclusion, Vancomycin appears to be an elective prophylactic antibiotic in case of high risk of MRSA sepsis after liver transplantation.

Infect Control Hosp Epidemiol, 1993 Jul, 14(7), 369 - 75
An outbreak of mupirocin-resistant Staphylococcus aureus on a dermatology ward associated with an environmental reservoir; Layton MC et al.; OBJECTIVE: To investigate a cluster of mupirocin-resistant Staphylococcus aureus on a dermatology ward . DESIGN: An outbreak of mupirocin-resistant S aureus was noted on the dermatology ward during a prospective epidemiologic study of methicillin-resistant S aureus (MRSA) and borderline methicillin-susceptible S aureus (BMSSA) . Pulsed-field gel electrophoresis (PFGE) of whole-cell DNA digested with Sma I was used as a marker of strain identity . SETTING AND PATIENTS: An 850-bed university hospital with a 12-bed inpatient dermatology ward . Most patients have severe, exfoliating dermatologic disorders . RESULTS: MRSA or BMSSA were isolated from 13 patients on the dermatology ward over a 14-month period . Eleven of these isolates (84.6%) were mupirocin-resistant . Nine isolates were present on admission (81.8%); 8 of these patients had been hospitalized on the same ward within the last two months . Nasal and hand cultures from 36 personnel were negative for mupirocin-resistant MRSA or BMSSA . Extensive environmental culturing revealed that a blood pressure cuff and the patients' communal shower were positive for mupirocin-resistant BMSSA . PFGE of all mupirocin-resistant isolates demonstrated that the nine patients and both environmental sources had identical DNA typing patterns . INTERVENTIONS: Changing of blood pressure cuffs between patients and more stringent cleaning of communal areas was initiated . Repeat environmental cultures were negative . CONCLUSIONS: S aureus is not usually associated with an environmental reservoir; however, these patients all had severe desquamation, which may have prolonged environmental contamination.

Rev Esp Cardiol, 1993 Jul, 46(7), 458 - 60
{Cerebral embolism as the first manifestation of Staphylococcus aureus endocarditis: the role of transesophageal echocardiography in the therapeutic decision}; Garcia Pascual J et al.; In patients with endocarditis due to Staphylococcus aureus, the issue of medical or surgical treatment still remains controversial . Likewise, there is no agreement in the management of those patients who have suffered cerebral embolism and show large vegetations in echocardiography . Moreover, transthoracic echocardiography not always disclose endocarditis vegetations as accurately as transesophageal echocardiography . We describe a patient with cerebral embolism due to Staphylococcus aureus endocarditis in which adequate medical diagnosis and management was achieved by means of transesophageal echocardiography.

Br J Rheumatol, 1993 Jul, 32(7), 550 - 5
Association of in vitro immune functions with the severity of the disease in rheumatoid arthritis; Jokinen EI et al.; The production of immunoglobulins in vitro by lymphocytes from rheumatoid patients has been earlier shown to be defective . This report describes a 2-year follow up study which shows that this defect is associated with the severity of RA . Pokeweed mitogen and Staphylococcus aureus Cowan I were used to stimulate in vitro immunoglobulin production by lymphocytes from patients with recent onset RA, and the relationship of responses to clinical characteristics were studied . Impaired polyclonal IgM synthesis, already detectable at the onset of disease, associated with joint destructions observed after a 2-year follow up period . Further, phytohaemagglutinin-induced interleukin-2 (IL-2) release by the cells of patients with erosive disease was found to be reduced compared to cells from patients without eroded joints . The results indicate that altered immune functions--manifested as decreased production of IgM and IL-2--in RA are involved in the progression of the disease and affect the outcome of patients and, thus, represent an unfavourable prognostic feature.

Cell Immunol, 1993 Jul, 149(2), 390 - 401
Recombinant human IL-5 augments immunoglobulin generation by human B lymphocytes in the presence of IL-2; Morikawa K et al.; The biological activity of interleukin-5 (IL-5) on human B lymphocytes was examined by using a newly purified recombinant human IL-5 preparation . Different densities of B cells from human tonsil samples were isolated by Percoll density gradient from nonrosetted cells . The IL-5 preparation did not act as a B cell growth factor on the large (in vivo-activated) or small (resting) B cells after activation with polyclonal B cell activators . The IL-5 augmented the immunoglobulin (Ig) generation of Staphylococcus aureus Cowan strain I (SAC)-activated B blasts in the presence of interleukin-2 (IL-2) . The effect of IL-5 on Ig generation was greater in pokeweed mitogen (PWM)-driven B blasts than that in SAC-induced B blasts when assessed by enzyme-linked immunosorbent assay . The amounts of mu RNA isolated from IL-5/PWM-treated cells were also larger than those from IL-5/IL-2-treated B blasts . These results suggest that the human IL-5 can increase Ig generation of B cells in the presence of IL-2 by working at the level of mRNA coding for Ig.

J Med Microbiol, 1993 Jul, 39(1), 58 - 63
Growth cycle-induced changes in sensitivity of Staphylococcus aureus to bactericidal lipids from abscesses; Xiong Z et al.; Three Staphylococcus aureus strains (303, 18Z and TG), exhibiting various patterns of survival within abscesses, were significantly more sensitive to the bactericidal activity of oleic acid during the log phase of growth than at other stages of the growth cycle . Cells entering the stationary phase showed diminished sensitivity to the fatty acid . These changes were reflected by changes in the LD50 and also by differences in the rate of killing by oleic acid . Additional changes were noted: the rate of killing by oleic acid declined over a 4-day period; a progressively greater proportion of the staphylococcal population became resistant to even high concentrations of oleic acid; from the fourth day onwards c . 50-55% of the cocci were totally resistant to the fatty acid . Strains 303 and 18Z became more sensitive to mono-olein during the log phase of growth, but strain TG was very resistant to mono-olein throughout the growth cycle . Growth in the presence of glycine 6% to reduce cross-links in the peptidoglycan did not alter bacterial sensitivity to oleic acid . However, all three S . aureus strains exhibited significant increases in membrane fluidity during the log phase of growth, but upon entering the stationary phase membrane fluidity again decreased . Concomitant changes in carotenoid content occurred during the growth cycle, but these changes did not appear to be solely responsible for the changes in sensitivity to the lipids.

J Immunol, 1993 Jul 1, 151(1), 330 - 8
Signaling properties of CR3 (CD11b/CD18) and CR1 (CD35) in relation to phagocytosis of complement-opsonized particles; Fallman M et al.; Human neutrophils preincubated with antibodies against complement receptor type 1 (CR1) (anti-CD35) and/or complement receptor type 3 (CR3) (anti-CD11b or anti-CD18) exhibited a reduced ability to engulf complement-opsonized yeast particles, whereas cellular adhesion of these particles was reduced only in the presence of anti-CD35 antibodies . These data support the idea that CR1 primarily promotes the adhesion of particles and CR3 mediates the subsequent engulfment . However, the effects of anti-CR1 and anti-CR3 antibodies on particle-induced diglyceride production correlate with the effects of these antibodies on the cellular uptake of the particles . Hence, it seems reasonable to suggest that CR1 also participates in mediating the signal(s) that induce particle uptake . This idea is further supported by the findings that cross-linking surface-bound anti-CD11b, anti-CD18 as well as anti-CD35 antibodies results in activation of phospholipase D (PLD), a signal closely associated with phagocytosis of complement-opsonized yeast particles in human neutrophils . The signaling property of CR1 was further revealed by the observation that cross-linking of surface-bound anti-CD35 triggered a rapid and transient mobilization of intracellular Ca2+, a signal most likely involved in the phagosome-lysosome fusion that occurs after the uptake of a particle . Pretreatment with PMA, which positively modulates CR-mediated engulfment of particles, was found to potentiate the CR3- and CR1-induced activation of PLD but impair the activation of phospholipase C, giving added support to the idea that PLD activation is the principal signal for the engulfment process . The activation of PLD was also increased by stimulating the cells with anti-CD18 or anti-CD35 antibodies prefixed on Staphylococcus aureus particles, instead of cross-linking cellular-bound antibodies, suggesting that the form of ligand presentation is a critical parameter of phagocytic signaling . Taken together, the present results demonstrate that both CR1 and CR3 can initiate transmembrane signaling in human neutrophils and, in particular, activation of PLD . This activation was also further recognized as an important signal regulating the engulfment of complement-opsonized particles.

J Gerontol Nurs, 1993 Jul, 19(7), 22 - 8
A nursing challenge: methicillin-resistant Staphylococcus aureus in long-term care; Williams CO et al.; 1 . Methicillin-resistant Staphylococcus aureus (MRSA) are gram-positive cocci, differing from methicillin-resistant species of S epidermidis because they produce coagulase . MRSA is distinguished from methicillin-sensitive S aureus by its resistance to methicillin and other antibiotics . MRSA has not been found to be an organism of greater virulence than methicillin-sensitive strains of S aureus, but infections caused by MRSA are sometimes of greater concern because of the limited antibiotic treatment options . 2 . In the past 25 years there has been an increase in the number of reported infections in patients caused by MRSA . As infections with MRSA have become more prevalent in community hospitals throughout the country, the difficulty in controlling the spread within the community hospitals has mirrored the experiences of the tertiary care centers . 3 . Education regarding the transmission of microorganisms and the caregiver's role in prevention is essential for every nursing facility . Interfacility communication is essential for hospital and nursing home staff to plan and manage the care of infected or colonized residents . 4 . A facility-specific MRSA policy should optimize the opportunity for infected persons to receive nursing home care--without jeopardizing other residents.

Eur J Immunol, 1993 Jul, 23(7), 1494 - 500
Pathogenesis of the toxic shock syndrome: T cell mediated lethal shock caused by the superantigen TSST-1; Miethke T et al.; The pathogenesis of the toxic shock syndrome (TSS) is only incompletely understood . We now present evidence that TSS toxin-1 (TSST-1), one of the superantigens produced by Staphylococcus aureus, induces lethal shock in D-galactosamine sensitized mice . In this model TSS is dependent on T cells, since cyclosporin A (CsA) completely blocked development of shock, and since T cell-deficient SCID mice did not show signs of disease upon injection with TSST-1 . However, SCID mice repopulated with T cells succumbed to lethal shock . The disease is characterized by a burst of lymphokines like interleukin-2 (IL-2) and tumor necrosis factor (TNF) released into the sera of TSST-1-treated animals . Already 1-2 h after TSST-1 application TNF serum levels peaked and IL-2 levels peaked around 4 h after treatment . TNF appears as key mediator of TSS, because anti-TNF monoclonal antibodies protected TSST-1-challenged mice . Interestingly, the burst of TNF in serum was noted well in advance of detectable markers of T cell activation . Thus, about 5% of all peripheral T cells started to express the IL-2 receptors as late as 4 h after treatment . Comparing TSST-1- and endotoxin-induced shock we conclude that TNF effects shock in both diseases . However, the type of cells involved appears distinct in that T cells cause TSS triggered by the exotosin TSST-1 while macrophages mediate the shock induced by endotoxins.

Am Surg, 1993 Jul, 59(7), 448 - 50
Peritonitis associated with continuous ambulatory peritoneal dialysis: the pseudo-surgical abdomen; Apostolidis NS et al.; In this work, 12 patients undergoing continuous ambulatory peritoneal dialysis with peritonitis showing clinical symptomatology of "acute surgical abdomen" were studied . The infective cause of peritonitis was Staphylococcus epidermidis (eight cases) and Staphylococcus aureus (four cases) . All patients, under strict and continuous observation, were managed with conventional chemotherapy and showed improvement within 6 to 24 hours . The need of prompt recognition and correct evaluation of this condition by surgeons familiar with it is emphasized in order to avoid an unnecessary surgical procedure.

South Med J, 1993 Jul, 86(7), 836 - 8
Acute epiglottitis during pregnancy; Glock JL et al.; A 26-year-old woman in her third trimester of pregnancy had stridor . Epiglottitis was diagnosed by fiberoptic laryngoscopy . Staphylococcus aureus was the predominant organism isolated from the laryngeal aspirate . Early intubation proved effective in managing this potentially life-threatening disease . Although pharyngitis is the most common cause of sore throat in the adult, acute epiglottitis must be considered in the differential diagnosis when there is unrelenting throat pain and minimal objective signs of pharyngitis . An early diagnosis with aggressive airway management can be life saving to both mother and fetus.

J Investig Allergol Clin Immunol, 1993 Jul-Aug, 3(4), 217 - 20
Perforation of the nasal wall and hyper-IgE syndrome; Fernandez M et al.; Hyper-IgE syndrome is basically characterized by recurrent infections, chronic eczematous lesions, specific IgE antibodies against Staphylococcus aureus and markedly high serum IgE values . We present the case of an 11-year-boy with no relevant personal or family history, who came to our Department with highly pruriginous papulovesicular skin lesions of 3 years' duration . He presented marked obesity (+4 SD) and micropapulovesicular lesions in the trunk and extension areas of the limbs . The rest of the physical exploration was normal . Complementary studies revealed peripheral eosinophilia, increase in globular sedimentation rate and IgE values of 20,000 IU/ml, a nonspecific reaction to skin tests, and a skin biopsy compatible with atopic dermatitis . Three months later, he presented eczematous lesions in the trunk and limbs, perforation of the nasal wall due to staphylococcal abscess (diagnosed by biopsy), bilateral maxillary sinusitis and IgE values of 59,238 IU/ml . The differential diagnoses are discussed, as well as new diagnostic-therapeutic possibilities.

Braz J Med Biol Res, 1993 Jul, 26(7), 689 - 97
Participation of glycosylation sites in the binding of Staphylococcus aureus to laminin; Carneiro CR et al.; 1 . Microbial pathogenicity is in many instances associated with the ability to adhere to host surfaces or to extracellular matrix components . 2 . Laminin is a major glycoprotein of basement membranes which can promote specific bacterial adhesion . Staphylococcus aureus is a pathogenic bacterium which presents a laminin receptor of about 50-kDa molecular mass (Lopes JD, Reis M & Brentani RR (1985) . Science, 229: 275-277) . 3 . Adhesion inhibition assays of {125iodine}-labeled bacteria to laminin demonstrate that the receptor binding site is contained in the pepsin-derived (P1) laminin fragment . 4 . Cell adhesion to laminin is unaffected by periodate oxidation of sugars on the surface of bacteria or by removal of divalent cations by ethylenediaminetetraacetic acid (EDTA) . In contrast, bacterial adhesion is reduced when laminin is deglycosylated with N-glycosidase F or when bacteria are submitted to controlled trypsin digestion . 5 . Laminin binding to the S . aureus 50-kDa band in immunoblotting assays has confirmed all of these results obtained in cell adhesion experiments.

Br J Clin Pract, 1993 Jul-Aug, 47(4), 217 - 8
Surgical presentation of toxic shock syndrome; Goh DW et al.; Three infants with clinical features of sepsis, hypovolaemia and an acute abdomen were referred to a paediatric surgical unit . Subsequent clinical signs of diffuse macular erythema followed by desquamation and isolation of Staphylococcus aureus from nasal or umbilical swabs led to a diagnosis of staphylococcal toxic shock syndrome . Surgical intervention was not indicated.

Avian Dis, 1993 Jul-Sep, 37(3), 835 - 8
Chicken heterophil chemotaxis using Staphylococcus-generated chemoattractants; Andreasen JR Jr et al.; Heterophil chemotaxis, in response to chemotactic factors generated by three different strains of staphylococcal bacteria, was measured using the modified Boyden-chamber technique . Heterophils were obtained from healthy 6-to-8-week-old broiler chickens . Each bacterial strain generated factors that were chemotactic for chicken heterophils . Factors generated by two pathogenic isolates of Staphylococcus aureus, however, induced significantly greater chemotaxis in chicken heterophils than those generated by a nonpathogenic Staphylococcus isolate.

Pharmacol Res, 1993 Jul-Aug, 28(1), 11 - 9
Favourable effects of sub-MIC rufloxacin concentrations in decreasing the pathogen-host cell adhesion; Braga PC et al.; The in vitro effects of sub-inhibitory concentrations of rufloxacin on Escherichia coli and Staphylococcus aureus adherence to human buccal epithelial cells were investigated . Epithelial cells were incubated with bacteria, grown in presence of serial dilutions of rufloxacin, from 1/2 MIC (Minimum Inhibitory Concentration) to 1/128 MIC . The mean number of bacteria adhering to cells and the percentage of cells bearing > or = 50 bacteria on their surface were counted and compared with those of controls (cells incubated with bacteria without rufloxacin) . For both the bacterial strains tested, the maximal inhibition of bacterial adhesion occurred at 1/2 MIC concentrations . A lower, but statistically significant, inhibition was also observed with other sub-MIC concentrations up to 1/32 for both S . aureus and E . coli adhesion . These findings indicate that sub-inhibitory concentrations of rufloxacin, which may be present in vivo in the mucosae in the troughs of the dosage cycle, significantly inhibit the adhesive properties of bacteria involved in mucosal colonization.

Infection, 1993 Jul-Aug, 21(4), 248 - 50
Postoperative cauda syndrome caused by Staphylococcus aureus; Arend SM et al.; Toxic shock syndrome (TSS) is a well-defined clinical syndrome attributed to certain exotoxins produced by Staphylococcus aureus . The acute episode is often characterized by a toxic encephalopathy, possibly caused by direct neurotoxicity of these exotoxins, although this mechanism has never been proven . We describe a patient who developed TSS, meningitis and cauda equina syndrome simultaneously several days after lumbar laminectomy . A space-occupying lesion was excluded . Enterotoxin C-producing S . aureus was cultured from the surgical wound and the cerebrospinal fluid (CSF) . The patient recovered from TSS but remained partially paralyzed . Presumably the cauda equina syndrome was caused by neurotoxic effects of the intrathecally produced S . aureus exotoxins . This case provides evidence for the neurotoxic effects of TSS-associated S . aureus exotoxins.

Immunol Lett, 1993 Jul, 37(1), 7 - 12
Membrane expression of IL-1 alpha in chronic B lymphocytic leukemia; Aguilar-Santelises M et al.; Patients with B chronic lymphocytic leukemia (B-CLL) demonstrate a high variability in disease activity, from a benign monoclonal lymphocytosis to a rapidly fatal condition . Progressive B-CLL is related to a high expression of different growth factor receptors on the leukemic cells and to a high proliferative in vitro response to Staphylococcus aureus strain Cowan 1 (SAC) . As the expression of membrane IL-1 alpha (mIL-1 alpha) indicates B lymphocyte activation, we have investigated mIL-1 alpha on cells from patients at different stages of the disease . Total cellular levels of IL-1 alpha were measured by flow cytometry of permeabilized cells and compared with CD5, CD19, CD25 and IgM expression on the cell surface . mIL-1 alpha is upregulated, both in leukemic and normal lymphocytes, in response to sIgM cross-linking with SAC or phorbol ester activation . A significantly higher expression of mIL-1 alpha was found in cells from patients with a clinically benign form of the disease.

Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 1993 Jul-Aug, 34(4), 285 - 93
Investigation and elimination of epidemic methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit; Liu CC et al.; A recent outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infection in neonatal intensive care unit (NICU) in a teaching hospital was investigated . A total of 25 MRSA isolates, 16 from the patients and nine from the staffs (carriers), was collected for the study . The possible relationship among the isolates was investigated by using antibiograms and restriction enzyme analysis of plasmid DNA . Control strategy of the MRSA nosocomial infection was proposed after the study of antibiograms and plasmid profile . There were four plasmid patterns (I-IV), each containing 7, 8, 2, and 8 isolates . Six of the 16 isolates from the patients had identical plasmid patterns as the carriers (I and II) . Person to person transfer via hand contact by medical personnel was found to be the most frequent mode of transmission identified in the outbreak of MRSA nosocomial infection in the NICU . Our strategy for control of the outbreak and elimination of the MRSA from all patients and carriers was successful after intensive surveillance and control measures . These included (a) strict isolation and cohorting; (b) hand washing between patient contacts to prevent transmission; (c) treatment of the carrier state in health care workers and patients with safe and effective topical agents such as mupirocin.

Z Orthop Ihre Grenzgeb, 1993 Jul-Aug, 131(4), 370 - 6
{Standardized infection model for the study of bony ingrowth dynamics of hydroxyapatite-coated and uncoated pure titanium mesh in swine femur}; Wilke A et al.; The authors studied the ingrowth dynamics of bone tissue into the pores of Hydroxyapatite-coated (plasma-spraying technique) and uncoated wiremeshs of pure titanium in an infected implantation site . Samples of the tested materials were implanted into the femora of 15 adult Gottingen minipigs . Just before implantation they were contaminated with Staphylococcus aureus . The animals were sacrificed after 4, 8, 12 and 24 weeks . Undecalcified ground-sections of bone tissue were prepared (app . 100 microns) and stained with toluidine blue for comparative histological evaluation . The HA-coated implants demonstrated advanced new bone formation already after 4 weeks and nearly complete osseointegration after 12 weeks although all samples showed gross and histological signs of persisting infection . Comparable reactions of the uncoated implants could only be observed after 24 weeks . Signs of degradation of the Hydroxyapatite-coating could be seen in contact to soft tissue and were more extensive compared to the behaviour in an uninfected site . The results and possible clinical consequences are discussed.

Lik Sprava, 1993 Jul, (7), 97 - 100
{The Staphylococcus aureus carrier state among the workers of a machine-building plant}; Malanchyn IM et al.; 120 workers of beet-harvesting combines plant and 120 students and teachers (control group) were examined for S . aureus carrying . In workers level of carrying on nasal and pharyngeal mucosa as well as on the skin of hands was 3-7 times as high as in members of control group . Number of carriers and quantity of microbial population on the skin of hands depended on the use of oils and emulsion in production process . Contact with oils favoured skin contamination while emulsions reduced bacterial colony . 36% of mechano-assembly shop workers and 10-12% of those employed at mechano-processing constitute the risk group which is likely to develop purulent skin diseases in microtraumas of hand and fingers.

Blood, 1993 Jul 1, 82(1), 192 - 201
Functional abnormalities of CD8+ T cells define a unique subset of patients with common variable immunodeficiency; Jaffe JS et al.; A substantial subgroup of patients with common variable immunodeficiency (CVI) exhibit an abnormal T-cell phenotype characterized by a low CD4/CD8 ratio associated with a significant increase in the absolute number of CD8+ T cells (CVI4/8low patients) . In the present study, we examined the phenotypic and functional properties of purified T-cell subsets in this group of CVI patients . CD8+ T cells from CVI4/8low patients manifested increased expression of HLA-DR and CD57 and decreased expression of CD45RA as compared with CD8+ T cells from normal controls . When stimulated with anti-CD3 and phorbol 12-myristate 13-acetate, purified patient CD8+ T cells exhibited significantly decreased proliferation, c-myc expression, and interleukin-2 (IL-2) production compared with that of normal CD8+ T cells . Nevertheless, mitogen-activated patient CD8+ T cells secreted elevated amounts of gamma-interferon and IL-5 and normal amounts of IL-4 . This abnormal pattern of proliferation and cytokine production was limited to the CD8+ T-cell subset as CD4+ T cells from these patients exhibited normal proliferation and cytokine production . In further functional studies, purified CD8+ T cells from CVI4/8low patients manifested increased cytotoxic T-lymphocyte activity and suppressor activity, as compared with normal CD8+ T cells, when they were tested in (1) an anti-CD3 "redirected" cytotoxicity assay and (2) a suppressor assay consisting of CD8+ T cells and Staphylococcus aureus Cowan I (SAC) plus IL-2-stimulated normal (allogeneic) B cells . In the latter case, patient CD8+ T cells suppressed IgG production, but not IgM production . Finally, in studies to evaluate the role of patient CD8+ T cells in the pathogenesis of hypogammaglobulinemia, we determined the capacity of SAC and IL-2 to induce Ig production in highly purified patient B cells, ie, in the absence of patient CD8+ T cells . We found that, whereas B cells from one patient produced normal amounts of IgG, B cells from three patients were unable to produce normal amounts of IgG under these conditions . These data establish the phenotypic and functional characteristics of CD8+ T cells in CVI4/8low and clearly distinguish CVI4/8low patients from other patients with this syndrome . The data do not support the contention that hypogammaglobulinemia in CVI4/8low patients is due to a direct effect of CD8+ T cells on terminal B-cell differentiation, except in the occasional patient . The abnormal CD8+ T cells may, nevertheless, have more subtle effects of lymphoid function that play a role in disease pathogenesis.

Rehabil Nurs, 1993 Jul-Aug, 18(4), 240 - 3, 252
Managing an outbreak of Staphylococcus aureus in a rehabilitation center; Curry K et al.; Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen . This article describes the management of an out-break of MRSA in a comprehensive rehabilitation center affiliated with a major referral hospital in the Southeast . Collective efforts involving quality assurance measures, restricted admissions, staff education, and infection control surveillance were employed in managing this outbreak . An effective management program that included standardized isolation precautions was developed and implemented . An algorithm for managing infected or colonized patients is featured.

Biosci Biotechnol Biochem, 1993 Jul, 57(7), 1234 - 6
Gamma-hemolysin genes in the same family with lukF and lukS genes in methicillin resistant Staphylococcus aureus; Rahman A et al.; Cloning and DNA sequencing of gamma-hemolysin genes from two strains of Staphylococcus aureus showed three open reading frames, transcribed serially within the sequenced 4353 nucleotide bases . In this report, from the nucleotide sequence, we demonstrate that leukocidin and gamma-hemolysin share the F or H gamma I component and the specificity of both toxins depends on this component.

Immunology, 1993 Jul, 79(3), 408 - 11
Phagocytosis and induction of nitric oxide synthase in murine macrophages; Cunha FQ et al.; The murine macrophage cell line, J774, produced little or no detectable levels of nitric oxide (NO) when stimulated with interferon-gamma (IFN-gamma) alone in vitro . However, they expressed high levels of NO synthase and produced large amounts of NO when cultured with IFN-gamma in the presence of lipopolysaccharide (LPS) . The synergistic action of LPS can be replaced by ingestion by the macrophages of zymosan, Staphylococcus aureus or Leishmania major in a dose-dependent manner . In contrast, the ingestion of particles such as latex beads or silica in the presence of IFN-gamma did not lead to the induction of NO synthase activity . Furthermore, ingestion of ink particles significantly reduced the ability of the macrophages to express NO synthase in response to the optimal stimulation of IFN-gamma and LPS . These results therefore demonstrate that phagocytosis per se is not sufficient to provide the additional signal for the induction of NO synthase activity in macrophages by IFN-gamma, and that the ingestion of certain particles can lead to the paralysis of the expression of this enzyme.

Stem Cells, 1993 Jul, 11 Suppl 2, 150 - 5
Production of hematopoietic growth factors by human B lymphocytes: mechanisms and possible implications; Pistoia V et al.; In this study we have investigated the ability of human B lymphocytes to produce granulocyte-macrophage colony stimulating factor (GM-CSF) and, in preliminary experiments, granulocyte CSF (G-CSF) . The sources of human B cells were surgically removed tonsils from normal individuals and peripheral blood from patients with B cell chronic lymphocytic leukemia (B-CLL) . Tonsil B lymphocytes were purified by E rosetting and complement-mediated cytotoxicity with selected monoclonal antibodies and subsequently fractionated by a Percoll density gradient into in vivo activated and resting cells . The latter cell fractions were subsequently cultured with or without stimuli . GM-CSF was detected by a bioassay, G-CSF by an enzyme-linked immunoassay . In vivo and in vitro activated B cells produced GM-CSF, whereas in vivo activated, but not in vitro activated, B lymphocytes produced G-CSF . These results were confirmed by Northern blot experiments with cDNA probes specific for GM-CSF and G-CSF genes . Many B cell suspensions from B-CLL patients produced GM-CSF or G-CSF only following Staphylococcus Aureus Cowan I (SAC) stimulation; in some cases, a spontaneous production or no production at all of the two cytokines was detected . The possible implications of these results for B cell physiology and for the pathogenesis of immunologically mediated diseases will be discussed.

Eur J Immunol, 1993 Jul, 23(7), 1687 - 92
Interleukin-9 potentiates the interleukin-4-induced immunoglobulin (IgG, IgM and IgE) production by normal human B lymphocytes; Dugas B et al.; IgE production by normal peripheral blood lymphocytes (PBL) is known to be triggered upon stimulation by interleukin (IL)-4 . In the present study we showed that IL-9, another T cell-derived cytokine, markedly potentiated IgE production induced by suboptimal doses of IL-4, whereas no effect of IL-9 was observed in the absence of IL-4 . The potentiating effect of IL-9 appeared to be associated with the increased frequency of IgE-producing cells, as revealed by a specific ELISA-spot assay . Under the same experimental conditions, IL-9 also enhanced the IL-4-induced IgG production but did not elicit IgM production . However, IL-9 did not amplify the IL-4-dependent expression of membrane-bound and soluble low affinity receptor for IgE (CD23) . IL-4-induced IgE production was also potentiated by IL-6 but not by tumor necrosis factor-alpha and IL-1 beta . The possibility that the activity of IL-9 was mediated by IL-6 released from accessory cells was excluded by the observations that monocyte depletion did not abolish the effect of IL-9 and that IL-9 was still active on fluorescence-assisted cell sorted CD20+ B lymphocytes co-cultured with irradiated murine EL4 cells . In addition, IL-9 was shown to potentiate the IL-4-induced IgG and IgM production by normal human B lymphocytes preactivated with Staphylococcus aureus Cowan strain . Taken together, these data suggest that IL-9 plays a regulatory role in the IL-4-dependent immunoglobulin production.

Antibiot Khimioter, 1993 Jul, 38(7), 1 - 4
{Comparative study on the activity of some enzyme systems in cells of gramicidin S sensitive and resistant strains of Staphylococcus aureus}; Bulgakova VG et al.; Polarographic determination of the rate of endogenic respiration of the cells of Staphylococcus aureus 209P showed that the respiration activity of the cells of the strain resistant to 20 micrograms/ml of gramicidin S was 20 to 30 per cent lower than that of the sensitive strain . The rate of oxygen consumption in oxidation of NADH by the membrane preparations of the resistant cells was also 25 to 30 per cent lower . By comparison with the initial sensitive strain the activity of endogenic DPI-reductases of the intact cells and NADH-dehydrogenases of the membranes of the resistant strain was also lower . The velocity of the valine transport to the resistant cells was much lower than that of the amino acid transport to the cells of the sensitive strain . Development of gramicidin S resistance in the staphylococcal strain was likely accompanied by a decrease in the activity of the energy metabolism in the membranes.

Proc Natl Acad Sci U S A, 1993 Jun 15, 90(12), 5529 - 33
Genetic evidence for replication enhancement from a distance; Gennaro ML; Rolling circle replication of the Staphylococcus aureus plasmid pT181 requires interaction of the RepC initiator protein with the origin of replication (the ori site) . A second site named cmp, which is distant from ori, is thought to stimulate replication, since a mutant pT181 plasmid lacking cmp cannot coexist with a cmp+ wild-type plasmid . Second-site mutations compensating for the loss of cmp were shown to map in repC . The compensatory mutations produced RepC proteins that, unlike the wild-type, either failed to discriminate between cmp+ and cmp- plasmids or preferred cmp- to cmp+ plasmids . These studies demonstrate that cmp stimulates the interaction of the replication initiator protein with the origin and therefore enhances DNA replication from a distance.

Proc Natl Acad Sci U S A, 1993 Jun 15, 90(12), 5423 - 7
Expression of functional trk protooncogene in human monocytes; Ehrhard PB et al.; There is increasing evidence that neurotrophins, including nerve growth factor (NGF), exert specific effects on cells of the immune system in addition to their neurotrophic actions . This report shows that human monocytes express the trk protooncogene, encoding the signal-transducing receptor unit for NGF . This receptor is functional, since interaction of NGF with monocytes triggered a respiratory burst, the major component of monocyte cytotoxic activity . During in vitro differentiation of human blood monocytes to macrophages trk expression decreased, suggesting a maturation-dependent trk expression decreased, suggesting a maturation-dependent trk regulation . Treatment of monocytes with Staphylococcus aureus Cowan I, a potent activator of monocytes, stimulated trk mRNA synthesis in a time-dependent way, implying a modulatory role for NGF in immune functions . The finding that dibutyryl cAMP elicited a time-dependent trk induction in monocytes as well as in phorbol ester-differentiated promonocytic U937 cells indicates that adenylate cyclase is involved in monocytic trk regulation . These results suggest that NGF, in addition to its neurotrophic function, is an immunoregulatory cytokine acting on monocytes.

Biochem Biophys Res Commun, 1993 Jun 15, 193(2), 730 - 7
Molecular characterization of the gene operon of heat shock proteins HSP60 and HSP10 in methicillin-resistant Staphylococcus aureus; Ohta T et al.; Methicillin-resistance of S.aureus (MRSA) was diminished or depressed at 44 degrees C . In order to investigate whether bacterial heat shock response is correlated with methicillin resistance, we examined the inducibility of the heat shock proteins (HSPs) in MRSA, and cloned and sequenced of their genes . A temperature shift from 37 degrees C to 46 degrees C enhanced the production of at least 8 kinds of cytoplasmic proteins as measured with two-dimensional PAGE . The induced protein profile was almost the same as methicillin sensitive S.aureus, and stress conditions due to ethanol, cadmium or low pH . Two of these proteins were HSP60 and HSP10 . Their N-terminal amino acid sequences were 79%, and 83%, homologous with thermobacterium PS3, respectively . A positively hybridized 4.2 kbp DNA fragment encoding both proteins was isolated from the chromosomal DNA of MRSA . The resulting sequence revealed two reading frames and showed high homology to those of hsp60 (groEL) and hsp10 (groES) of bacteria (E.coli) and several other species . The genes of HSP60 and HSP10 in S.aureus comprised an operon as in E.coli . The relationship between those HSPs and PBP2' is currently under investigation.

J Biol Chem, 1993 Jun 15, 268(17), 12977 - 82
Location of the dicyclohexylcarbodiimide-reactive glutamate residue in the bovine heart mitochondrial porin; De Pinto V et al.; The mitochondrial porin or VDAC (Voltage-Dependent Anion Channel), the pore-forming structure responsible for the high permeability of the outer mitochondrial membrane, was found to be one of only three mitochondrial proteins bound by {14C}dicyclohexylcarbodiimide (DCCD) at low dosages (1.5 nmol/mg of mitochondrial porin) (De Pinto, V., Tommasino, M., Benz, R., and Palmieri, F . (1985) Biochim . Biophys . Acta 813, 230-242) . Treatment of intact mitochondria with DCCD results in the inhibition of their ability to binding hexokinase (Nakashima, R . A., Mangan, P . S., Colombini, M., and Pedersen, P . L . (1986) Biochemistry 25, 1015-1021) . In the present study, mitochondrial porin was purified from {14C}DCCD-labeled mitochondria . The purified labeled porin was treated with the cleavage reagent CNBr and with the endoproteases trypsin and V8 from Staphylococcus aureus and blotted to polyvinylidene difluoride membrane . The transferred peptides were detected with Coomassie Blue dye, excised, and sequenced . The sequences of several labeled and unlabeled peptides were obtained and then overlapped . The region containing the {14C}DCCD radioactivity was limited to 50 amino acid residues and completely sequenced . Covalently incorporated {14C}DCCD was exclusively released at the position corresponding to glutamate 72 . The DCCD-reactive residue is located in the 4th of 16 predicted transmembrane amphipathic beta-strands . When the sequence surrounding the DCCD site was compared to those surrounding the DCCD-reactive residue of other membrane proteins, no homology was apparent.

FEBS Lett, 1993 Jun 14, 324(2), 159 - 61
Novel antimicrobial peptides from skin secretion of the European frog Rana esculenta; Simmaco M et al.; Three antimicrobial peptides were isolated from skin secretion of the European frog, Rana esculenta . Two of them show similarity to brevinin-1 and brevinin-2, respectively, two antimicrobial peptides recently isolated from a Japanese frog {Morikawa, N., Hagiwara, K . and Nakajima, T . (1992) Biochem . Biophys . Res . Commun . 189, 184-190} . The third one, named esculentin, is 46 residues long and represents a different type of peptide . All these peptides have as a common motif an intramolecular disulfide bridge located at the COOH-terminal end . The peptides from R . esculenta show distinctive antibacterial activity against representative Gram-negative and Gram-positive bacterial species . In particular, esculentin is the most active against Staphylococcus aureus, and has a much lower hemolytic activity.

J Biol Chem, 1993 Jun 5, 268(16), 11959 - 62
Staphylococcus aureus alpha-toxin . Production of functionally intact, site-specifically modifiable protein by introduction of cysteine at positions 69, 130, and 186; Palmer M et al.; Staphylococcal alpha-toxin, the prototype of an oligomerizing, pore-forming cytotoxin, is sensitive to biochemical modifications and cannot be labeled with biotin or fluorescein under preservation of its biological activity . In this study, we have used site-directed mutagenesis to introduce cysteine residues at positions 69, 130, and 186 . Each mutant was fully and rapidly reactive with several sulfhydryl-specific reagents, indicating superficial location . Coupling of SH-groups with fluorescein-maleimide or biotin-maleimide was tolerated without loss of hemolytic activity at position 130, and the formed hexamers were visible on target cells by fluorescence microscopy and could be detected on electroblots by reaction with streptavidin-peroxidase . At the two other positions, modification caused significant loss of activity . However, the labeled proteins still bound to red cells, as shown by fluorescence microscopy and electroblotting . Intrinsically labeled alpha-toxin represents a novel tool to study the interaction of this pore-former with target membranes.

Epidemiol Infect, 1993 Jun, 110(3), 533 - 41
Hospital infections in Spain . I . Staphylococcus aureus (1978-91); Vindel A et al.; This study was undertaken to determine the distribution of phage types of Staphylococcus aureus isolates from hospital outbreaks or sporadic cases received in our laboratory during the past 14 years . The records for 15,803 isolates from 55 Spanish hospitals have been analysed . In relation to sporadic isolates we have been able to detect the predominance of phage group I and non-typable staphylococcal strains . Since 1989, we have observed a considerable increase in hospital infection caused by methicillin-resistant S . aureus strains which we could differentiate in to two groups; one belonging to phage group III (6/47/54/75/77/84/85) and other groups of nontypable strains which could be classified as phage group I-III after heat treatment (29/77/84) and with similar patterns by reverse typing (6/47/53/54/75/83A/84/85/W57/1030/18042) . During 1990 and 1991, these strains have extended widely to at least six different autonomous regions creating an epidemic situation in Spain.

Epidemiol Infect, 1993 Jun, 110(3), 519 - 31
Staphylococcal food poisoning in the United Kingdom, 1969-90; Wieneke AA et al.; Between 1969 and 1990 strains of Staphylococcus aureus from 359 outbreaks and sporadic cases of staphylococcal food poisoning in the United Kingdom were examined in the PHLS Food Hygiene Laboratory for the production of enterotoxin . In a number of instances the incriminated foods were also examined for the presence of enterotoxin . Strains from 79% of incidents produced enterotoxin A alone or together with another enterotoxin . The level of S . aureus present in the foods ranged from no viable S . aureus detected to 1.5 x 10(10) c.f.u./g with a median of 3.0 x 10(7) c.f.u./g . Enterotoxin was detected in foods in the absence of viable S . aureus in only two outbreaks and in both cheese was the implicated food . Meat, poultry or their products were the vehicle in 75% of incidents with ham and chicken most frequently implicated . Other foods included fish and shellfish (7%) and milk and milk products (8%) . Most contamination took place in the home followed by restaurants and shops . Seventy-one percent of the incident strains were lysed by phages of group III or I/III.

Epidemiol Infect, 1993 Jun, 110(3), 499 - 506
Pathogenicity of Fusobacterium necrophorum strains from man and animals; Smith GR et al.; Necrobacillosis occurs in man and animals . The typical forms of the disease in animals are caused by Fusobacterium necrophorum biovar A; biovar B strains are much less pathogenic . In this study the pathogenicity for mice of eight human isolates of F . necrophorum was compared with that of animal biovar A and B strains . By subcutaneous inoculation seven of the human strains differed from biovar A but resembled biovar B in (1) producing, at the most, mild local lesions that rapidly healed, and (2) showing no enhancement of infectivity when suspended in sub-lethal doses of Staphylococcus aureus broth culture . The eighth human strain (A2433) resembled biovar A but differed from biovar B in (1) producing severe lesions, and (2) showing greatly enhanced infectivity in the presence of S . aureus . Nonetheless, strain A2433 differed from biovar A, both in the nature of the lesions produced and in its failure to cause severe general signs of illness and rapidly fatal infection . By intravenous inoculation one of two biovar B strains and all except one of the eight human strains produced purulent lesions, often severe, in the liver and elsewhere, but infection was not usually associated with general signs of illness . In contrast, intravenous injection of a biovar A strain gave rise to a rapidly fatal infection, with severe lesions in the liver or elsewhere . The results suggest that the term 'necrobacillosis' as used in human and veterinary medicine refers to diseases that differ in important respects.

Epidemiol Infect, 1993 Jun, 110(3), 477 - 88
Enterotoxins and toxic-shock syndrome toxin-1 in non-enteric staphylococcal disease; Marples RR et al.; Over the 7 years 1985-91, 997 strains of Staphylococcus aureus from 962 patients with diseases other than food poisoning have been tested for the production of enterotoxins and toxic shock syndrome toxin-1 (TSST-1) and phage typed . In all, 128 cases could be classified as confirmed or probable toxic shock syndrome (TSS) but a further 199 cases were classified as possible or unconfirmed TSS . In 219 cases, an alternative diagnosis could be supported and 45 cases were classified as sudden infant death syndrome . In 371 cases, insufficient information for classification was available . Strains of phage group I producing TSST-1 were associated with menstrual TSS . Many menstrual TSS cases were aged less than 20 and were using non-introducer tampons . When all strains were reviewed, strong associations were observed between TSST-1 production and phage group I strains, enterotoxin B production and group V strains, enterotoxin C and phage-type 95 strains and between enterotoxin A without TSST-1 and phage group III strains.

Arch Biochem Biophys, 1993 Jun, 303(2), 436 - 42
Isolation by a new method and sequence analysis of chromosomal HMG-17 protein from porcine thymus; Boumba VA et al.; Nonhistone chromosomal protein HMG-17 from porcine thymus has been isolated by extraction in boiling water, gel filtration and HPLC, and its complete primary structure (89 residues) has been determined . Peptides derived from enzymatic hydrolysis with trypsin, Staphylococcus aureus V-8 protease, Arg-C, and Glu-C proteinases were purified by HPLC and sequenced by the 4-(N,N-dimethylamino)azobenzene-4'-isothiocyanate/phenylisothiocyanate double coupling method . Porcine HMG-17 has a molecular mass of 9248 Da and a pI > 9.8 . No glycosylation or methylation has been detected . The primary structure of this protein is almost identical to the sequence deduced from a cDNA clone derived from a human cell line . Porcine thymus HMG-17 differs from the human protein by only a single conservative substitution at position 64 (aspartic acid instead of glutamic acid) . As in other HMG-17 proteins, the sequence is characterized by a lysine- and proline-rich central region, which has been implicated in DNA binding.

Arch Biochem Biophys, 1993 Jun, 303(2), 302 - 6
Calcyclin-binding site located on the NH2-terminal domain of rabbit CAP-50 (annexin XI): functional expression of CAP-50 in Escherichia coli; Tokumitsu H et al.; CAP-50 (annexin XI) is a member of annexin family proteins originally identified and characterized as a target protein for calcyclin (H . Tokumitsu et al . (1992) J . Biol . Chem . 267, 8919-8924) . In the present work, the calcyclin-binding site of CAP-50 was determined by proteolytic study and by using various deletion mutants expressed in Escherichia coli . The 43-kDa fragment of CAP-50 digested with Staphylococcus aureus V8 protease did not bind to calcyclin in the presence of Ca2+ . CAP-50 fusion proteins, including various NH2-terminal deletion mutants were expressed in E . coli using rabbit CAP-50 cDNA and the calcyclin-binding potential was examined using the 125I-calcyclin gel overlay method and coprecipitation with phosphatidylserine-containing vesicles in the presence of Ca2+ . All recombinant protein carried the potential for Ca(2+)-dependent phospholipid binding, due to the presence of the COOH-terminal domain (core domain) . Calcyclin-binding experiments showed that CAP-50 molecules lacking the NH2-terminal 26 residues retain binding potential for calcyclin; however, deletion of an additional 26 amino acids from the NH2 terminus abolishes specific calcyclin binding . These observations suggest that the calcyclin-binding site is located on the NH2-terminal region of CAP-50, probably adjacent to or within the region from Tyr27 to Leu52.

J Med Microbiol, 1993 Jun, 38(6), 391 - 4
Co-agglutination (Co-A) test for circulating antigen in hydatid disease; Shariff M et al.; A co-agglutination (Co-A) test with Staphylococcus aureus (Cowan's strain I) bearing protein A coated with specific hydatid antibodies, was used to demonstrate circulating hydatid antigen in serum for the diagnosis of hydatid disease . The test had a sensitivity of 95% and specificity of 89% in detecting hydatid antigen in serum . A false positive reaction was observed with 18.5% of control sera from patients with various parasitic diseases . However, these all gave negative results when tested after further dilution . The test is reliable and rapid; the result could be obtained within 30-45 min of receipt of a serum sample . Since the test is simple and the reagents are inexpensive and easily available, it can be used in less well equipped laboratories in developing countries.

J Bacteriol, 1993 Jun, 175(12), 3916 - 7
Plasmid pT181-linked suppressors of the Staphylococcus aureus pcrA3 chromosomal mutation; Iordanescu S; Plasmid pT181 replication is affected in hosts carrying the chromosomal pcrA3 mutation, resulting in significantly lower plasmid copy numbers . Mutations suppressing this effect have been isolated and characterized . The suppressor mutations were found to map in the plasmid repC gene and manifested pcrA allele specificity, suggesting the existence of a direct RepC-PcrA interaction.

Postgrad Med, 1993 Jun, 93(8), 143 - 6, 149-50
Arthropathy and HIV infection . A muddle of mimicry; Malin JK et al.; Several rheumatic diseases are associated with human immunodeficiency virus (HIV) infection . The most common are reactive and psoriatic arthritis . Classic septic arthritis caused by Staphylococcus aureus and other common organisms is very rare: Instead, infectious arthritis caused by unusual organisms is the rule . Some of the HIV-related rheumatic syndromes behave like classic rheumatic diseases, while others may actually be new forms of disease . Often, one of the rheumatic syndromes is the presenting manifestation of underlying HIV infection . HIV-infected patients and patients with rheumatic disease often have similar laboratory abnormalities . Systemic lupus erythematosus, in particular, may be mistaken for HIV infection, in part because of cross-reactivity of antibodies . However, coexistence of systemic lupus erythematosus and rheumatoid arthritis with HIV infection is a rare occurrence . Traditional therapy for rheumatic diseases may not be indicated in HIV-infected patients and in fact may even be contraindicated.

J Trop Med Hyg, 1993 Jun, 96(3), 146 - 50
Malaria with bacteraemia in acutely febrile preschool children without localizing signs: coincidence or association/complication?
Akpede GO, Sykes RM.
Data were collected on 642 preschool children who presented consecutively to casualty with fever and no localizing signs . Four hundred and forty-six (69%) had malaria parasitaemia . The proportion of children with bacteraemia was similar in those children with malaria (43/446, 9.6%) and those without malaria (24/196, 12.2%, P < 0.5) . The pathogens in both groups of children were mainly Staphylococcus aureus and coliform bacteria . Although children with malaria/bacteraemia had a significantly higher prevalence of anaemia (P = 0.001), hepatosplenomegaly (P < 0.01) and combination of hepatosplenomegaly and severe anaemia (P = 0.02), compared with children with malaria alone, there was no correlation between the severity of parasitaemia and prevalence of malaria with bacteraemia . The association of malaria with bacteraemia appears to be coincidental.

Crit Care Med, 1993 Jun, 21(6), 914 - 24
Continuous arteriovenous hemofiltration therapy for Staphylococcus aureus-induced septicemia in immature swine; Lee PA et al.; OBJECTIVES: The goals of this study were: a) to evaluate the efficacy of controlled, continuous arteriovenous hemofiltration in improving morbidity and mortality rates in an immature swine model of Staphylococcus aureus-induced septicemia; b) to determine if ultrafiltrate from septic animals contained mediators that produce pathophysiologic changes observed in untreated S . aureus septic pigs . DESIGN: Prospective, randomized, controlled study with age-matched controls . SETTING: U.S . Department of Agriculture-licensed biomedical research facility . SUBJECTS: Sixty-five weaned Poland-China swine (4 to 6 wks of age; 5 to 10 kg) . INTERVENTIONS: Part 1: Animals received a lethal dose of live S . aureus (8 x 10(9) colony-forming units/kg) over 1 hr . The three treatment groups included: hemofiltration group 1 (eight filtered, eight nonfiltered animals), plasma filtration fraction = 5.5%; hemofiltration group 2 (six filtered, six nonfiltered animals), filtration fraction = 16.6%; and hemofiltration group 3 (six filtered, six nonfiltered animals), filtration fraction = 33.4% . A control, nonseptic group of animals (n = 4) was filtered to obtain "clean" ultrafiltrate (hemofiltration group 4) . Part 2: Sterile ultrafiltrate concentrate batches obtained from each group of filtered, septic animals were concentrated and infused into healthy, nonseptic pigs (reinfusion groups 1 through 3) . MEASUREMENTS AND MAIN RESULTS: Physiologic, biochemical, and hematologic variables were measured in all animals every 1 to 3 hrs . Overall length of survival was also recorded . In hemofiltration groups 1 through 3, filtered animals survived significantly longer than matched, nonfiltered (sham-filtered) animals . Increments in survival time increased directly with filtration fraction . Ultrafiltrate concentrate from septic pigs produced death (LD41) and disease similar to those rates observed in untreated S . aureus-septic pigs . Infusion of clean ultrafiltrate concentrate produced no response . CONCLUSIONS: Continuous arteriovenous hemofiltration significantly improved survival rates in swine with S . aureus-induced sepsis . Resultant ultrafiltrate concentrate contained mediators responsible for some pathophysiologic responses observed in this animal model.

Circulation, 1993 Jun, 87(6), 1850 - 3
Coronary thrombolysis with recombinant staphylokinase in patients with evolving myocardial infarction; Collen D et al.; BACKGROUND . Staphylokinase (STA), a protein with known profibrinolytic properties, is produced by transduced Staphylococcus aureus strains . In experimental animal models, recombinant staphylokinase (STAR) is less immunogenic and more active toward platelet-rich arterial blood clots than streptokinase . METHODS AND RESULTS . In the present study, 10 mg STAR given intravenously over 30 minutes was found to induce angiographically documented coronary artery recanalization within 40 minutes in four of five patients with acute myocardial infarction . Plasma fibrinogen and alpha 2-antiplasmin levels were unaffected, and allergic reactions were not observed . Postinfusion disappearance of STAR antigen followed a biphasic mode with a t1/2 alpha of 6.3 +/- 0.6 minutes (mean +/- SD) and a t1/2 beta of 37 +/- 15 minutes, corresponding to a plasma clearance of 270 +/- 100 mL/min . Neutralizing antibodies against STAR could not be demonstrated at baseline and up to 6 days after infusion, but STAR neutralizing activity, which did not cross-react with streptokinase, was consistently demonstrable in plasma at 14-35 days . CONCLUSIONS . STAR can induce clot-selective coronary thrombolysis in patients with evolving myocardial infarction without concomitant induction of a systemic lytic state . STAR, a small protein that can be easily produced by recombinant DNA technology, may therefore offer promise for thrombolytic therapy in patients with thromboembolic disease.

J Bacteriol, 1993 Jun, 175(11), 3480 - 5
Arsenic efflux governed by the arsenic resistance determinant of Staphylococcus aureus plasmid pI258; Broer S et al.; The arsenic resistance operon of Staphylococcus aureus plasmid pI258 determined lowered net cellular uptake of 73As by an active efflux mechanism . Arsenite was exported from the cells; intracellular arsenate was first reduced to arsenite and then transported out of the cells . Resistant cells showed lower accumulation of 73As originating from both arsenate and arsenite . Active efflux from cells loaded with arsenite required the presence of the plasmid-determined arsB gene . Efflux of arsenic originating as arsenate required the presence of the arsC gene and occurred more rapidly with the addition of arsB . Inhibitor studies with S . aureus loaded with arsenite showed that arsenite efflux was energy dependent and appeared to be driven by the membrane potential . With cells loaded with 73AsO4(3-), a requirement for ATP for energy was observed, leading to the conclusion that ATP was required for arsenate reduction . When the staphylococcal arsenic resistance determinant was cloned into Escherichia coli, lowered accumulation of arsenate and arsenite and 73As efflux from cells loaded with arsenate were also found . Cloning of the E . coli plasmid R773 arsA gene (the determinant of the arsenite-dependent ATPase) in trans to the S . aureus gene arsB resulted in increased resistance to arsenite.

Infect Immun, 1993 Jun, 61(6), 2479 - 85
Identification of a Staphylococcus aureus extracellular matrix-binding protein with broad specificity; McGavin MH et al.; A staphylococal surface protein capable of binding several extracellular matrix glycoproteins was purified as a result of our attempts to identify a receptor(s) for bone sialoprotein (BSP) on Staphylococcus aureus cells . Proteins from different staphylococcal strains were solubilized in sodium lauryl sulfate, separated by polyacrylamide gel electrophoresis, blotted onto Immobilon P membranes, and probed with 125I-BSP . Several bacterial proteins bound the radiolabeled ligand, and various strains expressed different repertoirs of BSP-binding proteins . Major BSP-binding proteins with apparent M(r)s of 72,000 or 60,000 were present on most strains, and these proteins were further studied . The 72- and 60-kDa proteins were preferentially expressed when bacteria were cultured in Luria broth compared with when they were cultured on tryptic soy broth, and the abundance of the proteins could be correlated to an increased 125I-BSP binding . Both the 72-kDa and the 60-kDa proteins were solubilized by extraction of cells with 1 M LiCl and were purified by cation-exchange chromatography . Amino acid composition analysis of the purified 72-kDa protein indicated a high content of lysine (11.9%) and hydrophobic amino acids (28.0% combined) . In Western ligand blotting (immunoblotting) experiments, the 72-kDa protein bound not only BSP but also radiolabeled fibronectin, fibrinogen, vitronectin, thrombospondin, and, to some extent, collagen . Addition of the purified 60-kDa protein to S . aureus cells did not inhibit binding of the different ligands but in some cases resulted in an augmentation of the binding of 125I-ligand . Purified 60-kDa protein could hemagglutinate sheep erythrocytes at a concentration of 61 micrograms/ml . The agglutination reaction was inhibited by high concentrations of fucose, mannose, or melibiose . These data suggest that the purified proteins may serve as bacterial receptors with broad specificity for matrix glycoproteins and that the proteins may act as carbohydrate-binding proteins.

Arch Otolaryngol Head Neck Surg, 1993 Jun, 119(6), 672 - 5
Neonatal otitis media . An update; Burton DM et al.; Neonatal otitis media may be an isolated infection or part of a more complex sepsis syndrome . Because early studies suggested that the microbiologic characteristics of neonatal otitis media included a high risk of gram-negative coliforms and Staphylococcus aureus, tympanocentesis was recommended routinely . Subsequent studies have supported empiric medical therapy in selected patients, reserving tympanocentesis for patients in whom medical treatment fails . Because of these conflicting recommendations, records from 37 neonates with otitis media who underwent tympanocentesis from 1986 through 1991 were studied retrospectively . Cultures in one outpatient (11%) and four inpatients (13%) yielded Escherichia coli, all of which were sensitive to amoxicillin . No cultures of S aureus were identified . Sterile cultures and pneumococcus isolates were found most frequently . No septic or intracranial complications were noted . All patients were discharged on regimens of routine antibiotics for otitis media.

Phys Ther, 1993 Jun, 73(6), 355 - 60
Treatment of a large infected thoracic spine wound using high voltage pulsed monophasic current; Fitzgerald GK et al.; This case report describes the use of electrical stimulation with high voltage pulsed monophasic current for treatment of a large, infected wound of the thoracic spine, following a surgical debridement procedure . The patient was a 21-year-old man with spastic quadriplegic cerebral palsy who was dependent for all self-care and was severely mentally retarded . The initial wound size was as follows: length = 17 cm, top width = 7.5 cm, middle width = 5.5 cm, bottom width = 2 cm, and depth = 5 cm . The wound was infected with Staphylococcus aureus . The initial treatment consisted of 60 minutes of electrical stimulation (20 minutes of negative polarity followed by 40 minutes of positive polarity) once daily . The frequency of treatment was increased to twice daily after 2 weeks . Total treatment duration was 10 weeks . The patient received antibiotic treatment and daily nursing wound care in addition to electrical stimulation treatment . The wound was completely closed after 10 weeks of treatment . The possible role of high voltage pulsed monophasic current in accelerating the wound-healing process is discussed.

J Immunol, 1993 Jun 1, 150(11), 4958 - 65
Differential action of cycloheximide and activation stimuli on transcription of tumor necrosis factor-alpha, IL-1 beta, IL-8, and P53 genes in human monocytes; Osipovich OA et al.; In the present study we have analyzed superinduction of TNF-alpha mRNA and enhancement of TNF-alpha gene transcription by cycloheximide (Chx) in human blood monocytes isolated by continuous Percoll gradient and activated in vitro . In the same monocyte cultures, we have compared the rate of gene transcription of TNF-alpha, IL-1 beta, IL-8, and the P53-antioncogene under the influence of plastic adherence, Staphylococcus aureus Cowan 1 (SAC), and Chx added at different times of monocyte culture . It was shown that the cytokine genes have low or negligible transcriptional activity in freshly isolated monocytes, whereas P53 gene transcription was constant in freshly isolated and in vitro-stimulated cells . Transcription of the IL-1 beta and IL-8 genes was induced by adherence and was not more enhanced by SAC . Transcription of the TNF-alpha gene was not induced by adherence . Chx added at the beginning of the monocyte culture did not block TNF-alpha or IL-1 beta gene transcription . IL-8 gene transcription, however, was abrogated by Chx . Addition of SAC to monocyte culture containing Chx caused significant enhancement of TNF-alpha gene transcription . Addition of Chx after 2.5 or 4 h of SAC activation caused "superinduction" of TNF-alpha mRNA and enhancement of TNF-alpha gene transcription . The data imply that TNF-alpha gene transcription in activated human monocytes might be regulated by both positive and negative regulatory factors that differ in their stability and protein synthesis dependence . In addition, results demonstrate that TNF-alpha, IL-1 beta, IL-8, and p53 genes in human monocytes are differently regulated.

J Ethnopharmacol, 1993 Jun, 39(2), 119 - 28
Screening of plants used in Argentine folk medicine for antimicrobial activity; Anesini C et al.; Screening of 132 extracts from Argentine folk-medicinal plants for antimicrobial activity has been conducted using a penicillin G resistant strain of Staphylococcus aureus, Escherichia coli and Aspergillus niger as test microorganisms . Cephazolin, ampicillin and miconazole were used as standard antibiotics and concentration-response curves were obtained using the agar-well diffusion method . Boiling water extracts of plant materials were tested and 12 species were active against Staphylococcus aureus, whereas 10 were effective against Escherichia coli and 4 against Aspergillus niger . Tabebuia impetiginosa bark, Achyrocline sp . aerials parts, Larrea divaricata leaves, Rosa borboniana flowers, Punica granatum fruit pericarp, Psidium guineense fruit pericarp, Lithrea ternifolia leaves and Allium sativum bulbs produced some of the more active extracts.

J Antimicrob Chemother, 1993 Jun, 31 Suppl E, 5 - 16
Preferential concentration of azithromycin in an infected mouse thigh model; Retsema JA et al.; The possibility of augmentation of azithromycin delivery to infection loci was evaluated by the use of Staphylococcus aureus thigh infection models with CD-1 mice . The intramuscular infections that developed were characterized by rapid growth of bacteria and induction of a localized oedema that was assessed gravimetrically . Microscopic examination of infected thighs showed massive infiltration of polymorphonuclear leucocytes (viable and degranulated), when compared to saline-injected thighs, from 24 to > or = 72 h after infection . Azithromycin concentrations were enhanced significantly (P < or = 0.02) in infected thigh tissues compared with contralateral non-infected tissues, and correlated with oedema from 24-72 h after challenge and dosing . The azithromycin levels in infected tissue after a 5 mg/kg dose were sufficient to cause a significant reduction in the number of cfu . If azithromycin administration was delayed until inflammation was more severe, the result was an even greater preferential concentration of azithromycin into the infected thigh . Preferential concentration of azithromycin was not observed when extensive oedema was produced by injection of histamine . However, this oedema was not associated with a significant influx of polymorphonuclear leucocytes . In comparative studies, macrolide antibiotics known to be concentrated in phagocytes, such as erythromycin, roxithromycin, and clarithromycin, were not concentrated preferentially in infected tissues under the experimental conditions used; tissue levels were above or at the in-vitro MIC level for < or = 24 h . The data indicate that delivery of biologically available azithromycin to infected tissues is enhanced by cellular inflammatory processes.

J Antimicrob Chemother, 1993 Jun, 31 Suppl E, 17 - 28
Comparison of azithromycin, roxithromycin, and cephalexin penetration kinetics in early and mature abscesses; Girard D et al.; During the process of abscess formation, a myriad of changes are observed histologically that impede the penetration of antimicrobial agents into infection loci . A Staphylococcus aureus foreign body abscess, developed in rats, was employed to evaluate the penetration kinetics of azithromycin, roxithromycin and cephalexin at various stages of abscess development; the progressive patho-histological changes of abscess formation were also characterized in this model . In an early abscess (18 h post-challenge), azithromycin penetration into inflammatory fluid was enhanced (AUC of 351 vs 130 mg.h/kg) and residence prolonged relative to an inflammation control (half-life of 88 vs 27 h) . In contrast, roxithromycin and cephalexin penetration into, and residence in, inflammatory fluid were unaltered in the early abscess . However, penetration into, and egress from, a mature abscess (ten days post-challenge) were impeded for all three antimicrobials (P < or = 0.03) . The penetration kinetics of azithromycin into inflammatory fluid in an early abscess were independent of the dose regimen, but dependent on the total dose . The persistently high concentrations of azithromycin in inflammatory fluid within abscess were associated with the infiltration of phagocytic cells and encapsulation by fibrous tissue . These data are consistent with a phagocytic delivery mechanism for azithromycin, whereby the presence of high concentrations of azithromycin in inflammatory fluid are a consequence of augmented drug distribution via the release of accumulated intracellular drug from the infiltrating phagocytic cells and fibroblasts associated with abscess formation.

Vet Immunol Immunopathol, 1993 Jun, 37(1), 39 - 47
Effect of recombinant human cytokines on porcine neutrophil function; Coe NE et al.; The activity of four recombinant human cytokines on porcine neutrophils was evaluated . Porcine neutrophils were treated with varying doses of recombinant human tumour necrosis factor-alpha (rHu-TNF), interferon-gamma (rHu-IFN), interleukin-8 (rHu-lL-8), or granulocyte-macrophage colony-stimulating factor (rHu-GM-CSF) . The function of treated neutrophils was compared with that of non-treated controls in the following assays: antibody-independent neutrophil cytotoxicity (AINC), antibody-dependent cell-mediated cytotoxicity (ADCC), iodination, Staphylococcus aureus ingestion, cytochrome C reduction, random migration, and chemotaxis . Treatment with rHu-TNF produced significant (P < 0.05) depression of neutrophil random migration (2.5, 25, and 250 ng ml-1 rHu-TNF) and iodination (250 ng ml-1) and a near significant (P = 0.08) depression in ADCC (250 ng ml-1) . Treatment with 25,000 U ml-1 of rHu-IFN caused a significant increase in AINC . At lower doses of rHu-IFN, there was a trend (0.05 < P < or = 0.08) toward depression of AINC (250 U ml-1) and ADCC (25 U ml-1) and enhancement of iodination (250 U ml-1) . Treatment with 50 ng ml-1 of rHu-IL-8 caused a near significant increase (P = 0.06) in AINC . There were no significant differences noted when porcine neutrophils were treated with rHu-GM-CSF (2.5-2500 U ml-1) . No synergism was noted between rHu-TNF and rHu-IFN.

Prostaglandins, 1993 Jun, 45(6), 527 - 34
Intraperitoneal administration of leukotriene B4 (LTB4) and omega-guanidino caproic acid methane sulfonate (GCA) increased the survival of mice challenged with methicillin-resistant Staphylococcus aureus (MRSA); Yamamoto S et al.; Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) very often complicate management of immunocompromised patients . We studied the effect of leukotriene B4 (LTB4) and epsilon-guanidino caproic acid methane sulfonate (GCA), on MRSA infection . Mice fed a 20% casein diet were intraperitoneally administered LTB4, GCA, or saline (control) daily for 30 days . On the 10th day of this treatment, mice were challenged with MRSA . The survival rate in the control group (20%) was significantly lower than the rates in the GCA (60%) and LTB4 (50%) groups, respectively (p < 0.05) . There was a significant reduction of MRSA in the spleen and kidney of the survived mice in GCA group as against mice in the LTB4 and saline groups, indicating a better recovery in GCA group than the other groups . The results suggest that intraperitoneal administration of GCA and LTB4 may play a role in host defense mechanism during MRSA infections.

J Chemother, 1993 Jun, 5(3), 159 - 63
Sub-lethal concentrations of clarithromycin interfere with the expression of Staphylococcus aureus adhesiveness to human cells; Braga PC et al.; It has been known for some time that some antibiotics, generally at sub-lethal concentrations, are able to alter the morphology and the shape of bacteria . However, more subtle molecular alterations can also be present, such as disorganization of bacterial surface architecture, which leads to changes in the surface electrical charge that can influence the forces of attraction or repulsion responsible for interaction of bacterial surfaces with environmental surfaces . Bacterial adhesion to epithelial cells is a phenomenon regulated by these mechanisms . Clarithromycin, a new macrolide, at sub-inhibitory concentrations from 1/2 to 1/16 of the MIC, that is to say, from 0.12 to 0.015 microgram/ml, significantly reduces adhesion of Staphylococcus aureus to human buccal epithelial cells . Clarithromycin, as other antibiotics that interfere with the bacterial protein synthesis, should also be able to disturb the synthesis of adhesins . These are ligand molecules located on the surface of bacteria, and thus reduce the ability of bacteria to bind specifically to complementary molecules on the surfaces of epithelial cells which is necessary for host colonization.

Ann Plast Surg, 1993 Jun, 30(6), 516 - 9
Bacterial clearance capability of living skin equivalent, living dermal equivalent, saline dressing, and xenograft dressing in the rabbit; Fiala TG et al.; Two new skin substitutes, Living Skin Equivalent (LSE) and Living Dermal Equivalent (DE), have recently been developed . In this experiment, the ability of the LSE and DE preparations to function as biological dressings in an acute wound model was tested . Forty full-thickness wounds were made in New Zealand White rabbits . Each wound was inoculated with 5 x 10(5) Staphylococcus aureus organisms . Twenty-four hours later, one of the following four dressings was applied: saline gauze, porcine-derived xenograft, LSE, or DE . Daily dressing changes and wound biopsies for bacterial counts were performed . At 96 hours after inoculation, split-thickness autograft was applied to all wounds . Skin graft take was assessed 5 days later . In all treatment groups, bacterial counts decreased over time (p = 0.02) . At 72 and 96 hours after inoculation, wounds dressed with LSE or DE had significantly lower mean bacterial counts than wounds treated with xenograft dressing (p < 0.01) . No significant differences were found among the LSE-, DE-, or saline-treated groups . Skin grafts took well in LSE- and DE-treated wounds . In conclusion, the LSE and DE were more effective than xenograft in reducing bacterial wound contamination in this model, thereby demonstrating their potential application as biological dressing materials.

J Natl Med Assoc, 1993 Jun, 85(6), 441 - 4
The relationship of organism pathogenicity and route of acquisition to antimicrobial susceptibilities; Flournoy DJ et al.; Three hundred forty-eight isolates of methicillin-resistant Staphylococcus aureus were classified as representing nosocomial or community acquired infection or colonization . They were then tested against 11 antimicrobials, and the percentage of isolates that were susceptible to each antimicrobial was compared statistically among the classes . There were statistically significant (P value < 0.05, chi-square analysis) differences among isolates from several classes for chloramphenicol, imipenem, tetracycline, sulfamethoxazole-trimethoprim, ciprofloxacin, and gentamicin.

Rinsho Byori, 1993 Jun, 41(6), 655 - 60
{Magnet-supported chemiluminescent detection for amplified mecA gene of methicillin-resistant Staphylococcus aureus}; Yoshida S et al.; A method of chemiluminescent detection for mecA gene of methicillin-resistant S . aureus amplified by polymerase chain reaction, was developed . The senseprimer was biotinylated at 5'-end, and an oligonucleotide probe, complementary to the senseprimer, was labeled with acridinium ester at 5'-end . Template DNA was obtained from colonies of S . aureus cultured on blood agar . Polymerase chain reaction product was hybridized with the probe and was separated using streptavidin-coated magnetic microparticles in magnetic field . The pellet was washed by decantations, and was measured for chemiluminescence in an automatic luminescence reader . For reference, drug sensitivity and presence of mecA gene were tested by dilution method and electrophoresis of polymerase chain reaction product, respectively, for each colony studied . Results showed that methicillin-resistant S . aureus (n = 44) and methicillin-susceptible S . aureus (n = 19) can be successfully differentiated by chemiluminescence measurement . This method is specific, rapid, and suitable for handling a large number of samples.

Jpn J Antibiot, 1993 Jun, 46(6), 421 - 7
{Activities of antibiotics against methicillin-resistant Staphylococcus aureus with particular reference to synergetic effect between ticarcillin and fosfomycin on penicillinase non-producing methicillin-resistant S . aureus}; Morikawa Y et al.; We tested susceptibilities of 46 strains of clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) to arbekacin (ABK), tobramycin (TOB), ticarcillin (TIPC), clavulanic acid/ticarcillin (CVA/TIPC) and fosfomycin (FOM) . Twelve strains had penicillinase activity . Most strains were resistant to TOB, TIPC, FOM and CVA/TIPC, but ABK inhibited 80% of the 46 MRSA strains at a concentration of 1.56 microgram/ml . The combination of ABK and FOM was indifferent . Synergism was observed, however, between FOM and TIPC against 79% of penicillinase non-producing MRSA . This synergism may mean that FOM inhibits the production of penicillin-binding protein 2' in some strains of penicillinase non-producing MRSA.

What Is Bioengineering?, What Is Genome?, What Is Rhizobia?, What Is Nitrification?, What Is Anthrax?, e, Microorganism, a, Bacteria, e, Microorganisms, s, Microbes, s, Bacteriology, s, Streptococci, o, Saccharomyces yeast, o, Vibriosis, c, Eubacterium, i, Antimicrobials, c, Growth media, s, Salmonella typhimurium, e, Amikacin, o, Lactobacillus, a, P. fluorescens, e, Bacteriophages, n, Water treatment, o, Microorganisms, i, Yeasts, i, Antibiotics, n, Escherichia coli, s, Biological filters, n, Prokaryotes, a, Escherichia coli, r, Escherichia coli, a, Cryptococci

Scientific Publications - Work Done by Microbiology Reader Bioscreen C
Agricultural Microbiology Anaerobic Microbiology Antimicrobial Susceptibility Artificial Atmosphere Bioassay of Antibiotics Biofilm Microbiology Bioreactor Technology Biotechnology Cell Biology Clinical Microbiology Environmental Microbiology Experiments with Yeast	Fermentation Food Microbiology Functional Genomics Gene Technology Growth Media Development Growth Rate and Lag Time Industrial Microbiology Medical/Pharmaceutical Field Microbiological Assay Microbiological Research Microbiology of Cosmetics go to a specific theme...	Military Microbiology Molecular Microbiology Mutagenicity and Genotoxicity Oral Microbiology Patents Postantibiotic Studies Soil Microbiology Spore Microbiology Veterinary Microbiology Waste/Wastewater Treatment Water Microbiology Wine Microbiology

� 2005 Transgalactic Ltd (manufacturer of Bioscreen C software) | Privacy Statement | P.O. Box 1393, 00101 Helsinki, Finland, phone: +358 9 85172920, fax: +358 9 8749481, e-mail: microbiology@bionewsonline.com

Last modified: May 25, 2005